OMA Newsletter Outcome Measures Application Issue 15 April 2015 The DIG Recently, The Little Hoover Commission, a body charged with investigative oversight of State government, produced a report entitled Promises Still to Keep: A Decade of the Mental Health Services Act that calls for increased state oversight of the Mental Health Services Act (MHSA) and calls into question the investment and use of MHSA funds. California counties, through the County Behavioral Health Directors' Association, partnered with the newly formed Steinberg Institute to publish the first of a series of reports that demonstrates across the State, that MHSA programs are improving the lives of clients and reducing reliance on institutional care. Statewide, Full Service Partnership (FSP) programs have resulted in: Debbie Innes-Gomberg, Ph.D. District Chief, MHSA Implementation & Outcomes Division, Program Support Bureau, County of Los Angeles, Department of Mental Health 58% reduction in adults who are homeless 39% reduction in adult psychiatric hospitalizations 47% reduction in adults who are incarcerated 14% increase in adults living independently 60% decrease in out of home placement for children While the first report centered on the outcomes for FSP programs and select county Mental Health Urgent Care Center (UCC) outcomes, future reports will report more fully on outcomes for Community Services and Supports, Prevention and Early Intervention, and Innovation Plans. Continued on page 4
Kara s Corner My goal for our team is to provide excellent support to our providers for the improvement of data collection and data quality. We not only develop reports, validate data, conduct trainings, and provide end user support and technical assistance to assist in this goal, we regularly work with our Chief Information Office Bureau (CIOB) to improve the Outcome Measures Application (OMA). In 2014, we focused on upgrading PEI OMA to collect data for three additional practices our providers previously reported to the California Institute for Mental Health (CiMH). It was quite the challenge, to say the least. It took over a year to complete the complex process of integrating data that was sent to CiMH on spreadsheets with the PEI OMA, to allow providers to build on what was already reported. On February 9, 2015, we released PEI OMA version 1.5 that allowed for direct data entry for MAP, TF-CBT, and Triple P. Shortly after the release, we hosted two Informational Sessions regarding the release of version 1.5, and several PEI OMA Booster Data Entry Training sessions to demonstrate how to report data for these three practices. Our next steps are to create new reports for these practices and ensure the remaining few EBPs are incorporated into PEI OMA. We are actively working on upgrading both PEI OMA and FSP/FCCS OMA to improve data collection and the quality of data. In the near future, we will be able to enter data for Integrated Behavioral Health Information System (IBHIS) clients into both applications. In February, the Mental Health Data Alliance (MHDA), an entity contracted with the Mental Health Oversight and Accountability Commission (MHOAC) for a Full Service Partnership (FSP) Classification Project, visited Los Angeles County. They met with some of our providers, administrative staff, and consumers and their families to learn more about FSP service delivery. We emphasized the unique aspects of FSP in LA County, with increased use of outcomes to: make data-driven decisions, evaluate effectiveness, and improve programs. We try our best to help our providers utilize their outcome data to make treatment decisions and to evaluate their programs through various forums. In March, we launched the PEI General Learning Network (GLN) to reach more of our providers to help them start understanding their PEI outcome data. There is more information about the GLN on page 5. Also, in the Service Area 8 Data Workgroup, providers will begin to engage in Plan, Do, Study Act (PDSA) cycles to: identify Prevention & Early Intervention (PEI) Evidence-Based Practice (EBP) related goals/outcomes, discuss how they will measure progress, and analyze data and progress during the cycle in order to make necessary midcourse changes. I hope you will take advantage of the different workgroups and resources we have to offer! 2
Join Us! OMA USERS GROUP is for our providers. Take advantage of this opportunity to dialogue with DMH folks about OMA issues. Next meeting: Wednesday, May 27, 2014 from 2:30 4:00p.m. at 695 S. Vermont Avenue, 15 th Floor Glass Conference Room, Los Angeles, CA 90005. To participate via WebEx, email: FSPoutcomes@dmh.lacounty.gov OMA LAB is open to all OMA users who want one-on-one assistance from the data team to tackle some of your pending DCDRs or data entry issues. Offered every other Monday from 10am-Noon. Next OMA Lab is scheduled for May 4, 2015. Space is limited. Please RSVP with Miguel Juarez: mjuarez@dmh.lacounty.gov OUTCOMES TRAINING for FSP, FCCS, and PEI are available throughout the year. Check the OMA Wiki: www.dmhoma.pbworks.com for details. Contact Us FSPoutcomes@dmh.lacounty.gov FCCSoutcomes@dmh.lacounty.gov PEIoutcomes@dmh.lacounty.gov Secure Email Periodically, we receive unencrypted emails from our providers that contain client Protected Health Information (PHI). The County of Los Angeles Department of Mental Health (DMH) follows strict protocol under the Health Insurance Portability and Accountability Act (HIPAA) in the handling of client PHI because this data is highly sensitive and very personal. To ensure our compliance of HIPAA, DMH established a secure email system through Cisco to allow proper transmittal of emails containing PHI. We understand that some of our providers have their own email encryption setup; however, we ask all of our providers to use DMH s secure email system when emailing client PHI to DMH to ensure we meet DMH s interpretation of HIPAA privacy laws. If you do not have a Cisco account for transmitting secure email to DMH, you can get setup quickly by contacting us and we will initiate a secure email to you. We encourage you to read the Encrypted Email Recipient s Guide here: http://file.lacounty.gov/dmh/cms1_180460.pdf to learn more about what to do when you receive an encrypted email from DMH, and also how to reply to one. PEI Reports A PEI Outcomes Report Order Form has been developed for providers to use to request their PEI outcome data. The reports will be delivered in PDF or Excel format via email. This process offers providers an efficient way to access data to assist with monitoring and measuring their sites progress. If you are unfamiliar with the reports or evaluating data, a good starting approach is to request one report at a time until you gain an understanding of the data elements. Once you understand them, you can begin exploring other reports. If you do not know where to begin, email the PEI Outcomes Team at PEIoutcomes@dmh.lacounty.gov to ask for guidance. The form can be downloaded from the DMH OMA Wiki: http://dmhoma.pbworks.com Did you know? Recently, some PEI OMA end users have notified us that they encountered the error message below when attempting to view a treatment cycle in PEI OMA: To fix this problem try making a change to your compatitbility settings in Internet Explorer. From the menu bar in the upper right corner of Internet Explorer, select Tools, then click on Compatibility View settings. In the "Add this website:" box, type "la.ca.us" then click Add and click Close. Close your browser and relaunch Internet Explorer. Log back into PEI OMA and attempt to view the treatment cycle. You should now be able to see the client s treatment cycle information. If this does not correct the problem, please contact the Help Desk: (213) 351-1335 to report your issue. 3
Continued from page 1 MHSA programs in Los Angeles County specifically have yielded the following results for FSP: Field Capable Clinical Services (FCCS): As a result of the program, clients report increased community involvement and increased meaningful use of time. Mental Health Urgent Care Centers (UCCs): Within 30 days of a UCC visit, only 6% of clients served access services for care at an Emergency Department and only 11% are admitted to a psychiatric hospital within 30 days of a UCC visit. FSP Pilot Integration Project In June 2014, the FSP Pilot Integration Project reached the one-year mark. One of the Pilot s goals was to increase client flow through services. The chart below demonstrates that 1,716 clients were enrolled in the Pilot in Fiscal Year 2013-2014, 585 of which were disenrolled by June 30, 2014 resulting in a flow rate of 34%. A second goal of the pilot is that of 20% of clients enrolled in the Pilot will transition to a lower level of care. One way to measure this is to look at disenrollment reasons. Out of the 585 clients that disenrolled, 33% successfully met their goals. The Pilot will continue until July 2015 with a goal of articulating and applying the lessons learned in year one. 4 Total Disenrollments from July 2013 through June2014 1 (N=585) Disenrollment Reason Number Percent of of Clients Clients Client Deceased 25 4.27% Client Decided to Discontinue 107 18.29% Client Detained Serving Jail/Prison Sentence 45 7.69% Client Needs Residential/Institutional Care 38 6.50% Lost Contact 97 16.58% Moved 71 12.14% Successfully Met Goals 193 32.99% Target Pop Not Met 9 1.54% Total 585 100.00%
Group and Individual CBT for Major Depression Learning Network Since launching the Group Cognitive Behavioral Therapy (CBT) for Major Depression Learning Network in 2012, we have had the privilege of meeting and getting to know many of the providers implementing this practice countywide. We have been able to see the practice grow by participating in these learning networks and assisting providers to understand and use their outcomes data to inform clinical practice. Due to its effectiveness in treating not only depression, but anxiety and trauma related symptoms, the Department of Mental Health has rolled out several CBT trainings. With the large number of clinicians being trained in CBT, our Division, in collaboration with the Group/Individual CBT practice lead, thought it best to launch an Individual CBT Learning Network. The intent is for Group CBT to merge with the Individual CBT Learning Network. We hope that this new learning network will be as successful as its predecessor in providing support and information to those implementing the practice in Los Angeles County. For a schedule of upcoming learning networks, please visit our OMA Wiki page: www.dmhoma.pbworks.com and search for PEI Practice Learning Networks. PEI OMA General Learning Network In March 2015, we launched the PEI Outcomes General Learning Network (GLN) Module-1 for PEI providers implementing an Evidence-Based Practice (EBP) in Los Angeles County. GLN participants are provided with an overview of a countywide aggregate report, provider level data reports, and will be instructed on how to analyze their own data. The GLN target audience includes, but is not limited to, PEI providers: that do not have an active learning network unfamiliar with our reports interested in using outcome reports to make datadriven decisions Module-1 of the GLN is comprised of three sessions. The first two sessions provide an overview of a practice specific countywide aggregate report and specific provider level reports via webinar. The third session focuses on analyzing provider/ebp specific data, and is conducted in-person. We hope to conduct another GLN this summer. For more information on the GLN, please visit the OMA Wiki: www.dmhoma.pbworks.com and search for General Learning Network. A Closer Look In December 2014, our Division s PEI team released the inaugural issue of A Closer Look, a publication that dives into the world of outcome measures. A Closer Look encompasses a variety of topics related to the use and analysis of outcome measures including, but not limited to: the efficacy of Evidence-Based Practices (EBP s), outcome measure trends, clinical and administrative use of outcome measures, and showcases particular EBP s that are being provided countywide. We hope this publication will assist PEI providers and other interested parties in taking a closer look and recognizing their work in providing PEI services in Los Angeles County. For more information about A Closer Look, please visit our OMA Wiki: www.dmhoma.pbworks.com and search for PEI Publication. 5
Staff Feature: Frances Pavon-Lara What do you like to go by? Frances, Frankie, or Rebecca? She answers, All of them! It depends on who is addressing me. Her easiness about her name is revealing of her approachable nature. When you meet Frances, the name we use most often in the office, you will find that she has a knack for making you feel like a lifelong friend. You will always have her attention and she will go out of her way to help you. Frances is a member of the Prevention and Early Intervention (PEI) Outcomes Team and performs a wide range of assignments. She is the primary point of contact for the PEI Outcomes mailbox, ensuring that every incoming email that is received is routed for a response. She also conducts PEI Outcome Measures Trainings, and provides logistical support to her teammates in their trainings and to the PEI Learning Networks. Additionally, she is the project lead for the PEI Outcomes publication titled, A Closer Look. Despite the many responsibilities she has, she maintains an up-beat attitude, always volunteering to do more to help her teammates, even with her own plate full. I really enjoy working with the MHSA team. This is a very skilled and talented group that works together and plays together. There is genuine concern for one another and a big sense of team effort in this Division. Outside the office, she spends her free time with her two-year old sidekick [who is] growing up so fast. I love being so present in his life. We go to parks, museums, the aquarium, the zoo, and Disneyland! My husband and son are my heart but my parents and two brothers are the rest of my vital organs. We are all so close and need each other to function. She continues to describe her family as a charmed bunch because we live so close to each other and we see and talk to each other on a daily basis. When asked what she cannot live without, she responds, My Regular Day Off every other Friday because I get to go on adventures with my son. Occasionally, I use this day for errands or medical appointments but for the most part, my little date and I get to have fun! Though it is obvious that her family is the center of her world, she ensures she is taken care of with beauty essentials like dry shampoo, the secret to having her signature long, healthy hair. She also swears by coconut oil and uses it on everything for everything; it is a multi-purpose item she keeps stocked. She uses it for cooking and as a universal moisturizer for her face, body, hair, and nails. Above all, what she really cannot live without is laughter. I especially love making my son laugh; his laughter fills my heart with joy. It makes me happy. It probably comes natural for Frances to bring smiles to children s faces because she was once hired by a party company to play the role of Pocahontas to entertain at children s parties. A personal goal of hers is to take up photography and do maternity shoots. She has already done a couple of photo sessions that she is proud of. One of her photographs was recently featured on Amazon Mom! Congratulations on your achievements, Frances! We are fortunate to have you on our team!