State Outcomes Measurement and Management System (SOMMS) Subcontract

September 2006

I.  SOMMS Subcontract Description

    1.  Introduction

> In July 2003, SAMHSA established a working group to review existing
> data collection programs and to establish a long-term data strategy.
> In January 2004 the group delivered a vision statement and recommended
> a data strategy for the agency.
>
> A foundation of the SAMHSA data strategy is the collection of *outcome
> measures* for all funded services. SAMHSA intends to coordinate its
> various data collection and data management programs to support the
> efficient collection of outcome measures in support of program
> performance measurement and management goals.
>
> To accomplish the collection of outcome measures from the States,
> SAMHSA has established the State Outcomes Measurement and Management
> System (SOMMS). This system will integrate and coordinate SAMHSA's
> data collection reporting requirements to comply with the Government
> Performance and Results Act (GPRA), the Office of Management and
> Budget's Program Assessment and Rating Tool (PART), and other Federal
> and agency initiatives. SAMHSA expects this effort to remedy the 2003
> PART assessment of the Number range CHAPTERSubstance Abuse Prevention
> and Treatment (SAPT) Block Grant as "ineffective."

In collaboration with the States, SAMHSA identified ten domains as its
National Outcome Measures, or NOMS. These domains embody meaningful,
real life outcomes for people who are striving to attain and sustain
recovery, build resilience, and work, learn, live, and participate fully
in their communities. See Attachment 1 for the domains and outcome
measures for mental health, substance abuse treatment, and substance
abuse prevention. Only the "substance abuse treatment" measures are
addressed in this procurement.

> Data for reporting on these measures will come primarily from the
> States. States will be supported in their efforts by SAMHSA with
> infrastructure and technical assistance through a new State Outcomes
> Measurement and Management System (SOMMS) central services contract
> and with payments to the States through the State SOMMS subcontracts
> included in this request for proposals (RFP). Through this new system
> SAMHSA in partnership with the States will:

-   Standardize operational definitions and outcome measures, link
    records to support pre- and post-service comparisons, and collect
    information to facilitate making state-wide unduplicated client
    counts;

-   Work toward the achievement of full State reporting of NOMS by the
    end of fiscal year (FY) 2007. In the interim, each year more States
    will report with standard definitions until all States are on board;

-   Produce routine management reports to direct our technical
    assistance and science-to-services program to implement
    interventions designed to result in improved outcomes; and

-   Examine benchmarking strategies to determine the feasibility of
    developing acceptable performance requirements.

> While each State is at a different stage of readiness and some of the
> measures themselves are still in development, ultimately, as agreed by
> SAMHSA and the States, by the end of FY 2007, SAMHSA will be able to
> report at the State level consistent, cross-year data allowing the
> agency to examine the impact of programs and changes over time.
>
> SAMHSA is undertaking a two-pronged approach to the implementation of
> NOMS. First, collection of the NOMS variables is being accomplished
> through recent modification of the Drug and Alcohol Services
> Information System (DASIS) support contract to facilitate State
> reporting of NOMS in conjunction with the Treatment Episode Data Set
> (TEDS). Second, SAMHSA will provide technical assistance to States not
> able to meet the NOMS requirements, through a separate SOMMS central
> services contract.

SAMHSA is phasing in this system through the end of FY 2007.

1.  Expectations

> We are requesting that States submit a proposal to participate in this
> program. States that meet the requirements for reporting NOMS
> admission and discharge records detailed in the following pages will
> receive up to \$150,000 a year.

The admissions and discharges must cover all clients eligible to be
reported to TEDS. Discharge NOMS are to be reported for all discharge
statuses. The new NOMS data elements are not required for detoxification
clients. However, states should continue to report all other admission
and discharge data elements for detoxification clients, as specified in
the TEDS State Instruction Manuals.

2.  Required Activities

> NOMS data are to be submitted monthly or quarterly, but no less
> frequently than quarterly. Data must be submitted within 60 calendar
> days from the end of the quarter (based on a calendar year) in which
> the admission or discharge took place. Also, within 60 days from the
> end of each calendar year, States will be required to certify that all
> NOMS data for the year have been submitted.
>
> Listed below are the required NOMS variables to be submitted through
> TEDS admission and discharge reporting.
>
> [TEDS Admission Minimum Data Set:]{.underline}

-   All data items

# TEDS Admission Supplemental Data Set: 

-   Living arrangements

-   Detailed not in labor force

> [New NOMS variable for Admission Data Set]{.underline}:

-   Arrests in the 30 days prior to admission

## TEDS Discharge Data Set:

-   All data items

> [New NOMS variables for Discharge Data Set]{.underline}:

-   1st, 2nd, 3rd substances of abuse at discharge

-   Frequency of use at discharge of 1st, 2nd, 3rd substances

-   Living arrangements at discharge

-   Employment status at discharge

-   Detailed not in labor force at discharge

-   Arrests in the 30 days prior to discharge

> (See Attachment 2 for a list of the specific required data elements
> (both admission and discharge items), Attachment 3 for the detailed
> TEDS admissions data dictionary, and Attachment 4 for the detailed
> TEDS discharge data dictionary.) These attachments are available for
> download on the NOMS web page at
>
> <http://wwwdasis.SAMHSA.gov/dasis2/SOMMS.htm>.
>
> The following NOMS are under development and are expected to be
> defined by SAMHSA and incorporated into the NOMS reporting when
> explicit data items have been determined and defined. (Note: It has
> not yet been determined that TEDS will be the vehicle for reporting
> any of these NOMS.)

-   Social connectedness

-   Client perception of care

-   Use of evidence-based practices

-   Cost effectiveness

> In addition, NOMS reporting will require that, by the end of FY 2007,
> the State's client identification number be unique within the State
> and be used each time the client receives substance abuse treatment
> services regardless of provider.
>
> Subcontracts will be awarded to the most competitive States
> demonstrating the greatest ability/capacity to collect and report
> NOMS.

II. Funding Information

States will be paid \$75,000 following the first 6 months of the
agreement year, based on the submission of satisfactory quarterly
admission and discharge data for the first 6 months of the year. Payment
will be made within 5 months after the end the first 6 months of each
year during which this agreement is effect. Data must meet the
assessment criteria described below. States will be paid an additional
\$75,000 following the final 6 months of the agreement year, based on
the submission of satisfactory quarterly data for the entire year, and
provided that the States certify that all of the admissions and
discharges for the year have been submitted. The additional \$75,000
payment will be made within 5 months of the end of each year, provided
that the quarterly assessment criteria described below were met
throughout the calendar year and provided that the States certify that
all of the admissions and discharges for the calendar year have been
submitted. Thus, States will receive up to \$150,000 for each year that
data reporting requirements are met.

This funding agreement will remain in place for one year with the option
to continue for one (1) one-year contingent on performance in the
previous year. Participating States are, therefore, eligible to receive
up to \$300,000, if the option year is exercised, based on successfully
meeting data quality, completeness, and timeliness reporting standards
for each of the full agreement periods

> Payments will be made by check or electronic transfer.

III. Agreement Requirements

The following represent the criteria that will be applied in assessing
the data reported under the SOMMS subcontract:

1.  At least 80% of NOMS records (both admission and discharge) must be
    provided within 60 days after the end of the quarter in which the
    event occurred, defined as date of admission for admission records
    and date of discharge for discharge records.

2.  At least 90% of provided discharge records must match with an
    admission record. States will be asked to supply an admission record
    for all unmatched discharges.

3.  All records must contain valid codes for all variables submitted.
    Files submitted that have invalid codes will be returned for
    correction and resubmission.

4.  Variables in the current TEDS dataset must have no more than 5%
    unknown or missing codes. New NOMS variables can have 20% unknown or
    missing codes in the first year of reporting only.

5.  States will be provided with a processing/error report within 10
    days of each data submission. This report will summarize the
    processing results and list specific errors detected in the data.
    States must correct the errors and resubmit the corrected data
    within 30 days of delivery to the state of the processing/error
    report.

6.  Submitted admission record volume must be within 90% of projected
    volume, based on admission volume for the previous year. States will
    be asked to document the reasons for any change in admissions volume
    of more than 10% from one year to the next.

7.  Submitted discharge record volume must be within 90% of projected
    volume, based on admission volume for the current quarter. States
    will be asked to document the reasons for any difference in
    discharge volume of more than 10% from the volume of admissions.

8.  If the monthly or quarterly submission(s) is (are) accepted and at
    least 80% of NOMS records were submitted within 60 days from the end
    of the reporting quarter, then the timeliness criteria will have
    been met. If a submission was returned to the State for corrections,
    and the re-submission was provided within 30 days, and the
    resubmission is accepted, the timeliness criteria will have been
    met.

9.  If the quarterly number of records submitted is at least 90% of
    projected volume for both admissions and discharges, based on the
    same reporting period in the previous year for admissions and based
    on admission volume for discharges, and at least 90% of the
    discharge records match with an admission record, then the
    completeness criteria will have been met. If a State cannot meet the
    minimum volume because of a change in the treatment system that is
    affecting the volume of records, they may submit an explanation for
    the reporting change and request a revised volume projection.

```{=html}
<!-- -->
```
IV. Assessment

    1.  Assessment Reports

> Assessment reports will be provided to States to assess the data
> submitted in the previous "data quarter", defined as the calendar
> quarter in which the admission or discharge occurred. The reports will
> be cumulative, however, and data from prior quarters will also be
> included in the reports, and will reflect any additions or corrections
> received through the date of the report.
>
> States will be provided with an initial assessment report within 90
> days following each calendar quarter for which data have been
> submitted under this agreement. The assessment reports, consisting of
> 5 tables, will document the completeness, quality, and timeliness of
> the NOMS data submitted. (A sample assessment report is provided as
> attachment 5).
>
> In the event of any deficiencies in the timeliness, completeness, or
> quality of NOMS data that are submitted, the State will have 30 days
> after receipt of the initial assessment report to provide either the
> completed data for the quarter or a satisfactory explanation for the
> deficiencies, without risk of forfeiting the payment for that period.
> States will be provided with a final assessment report to reflect any
> corrections made during this 30-day correction period. Copies of the
> assessment reports will also be provided to SAMHSA to support payment
> decisions (see Section II. Funding Information).

[]{.mark}

> Thus, an initial assessment report will be provided in June each year
> to the States submitting first calendar quarter data, which will cover
> the admissions and discharges that occurred in the first quarter of
> the year and that were submitted by May 31^st^ (60 days following the
> end of the first quarter). After the 30-day correction period, a final
> first quarter assessment report will be provided to the States.
>
> The second quarter initial assessment report will be provided to the
> States in September each year, to assess admissions and discharges
> that occurred in the second quarters and that were submitted by August
> 31^st^ (60 days following the end of the second quarter). After the
> 30-day correction period, a final second quarter assessment report
> will be provided to the States.
>
> In like manner, assessment reports will be provided for the third and
> subsequent quarters for the life of the subcontract.

2.  Assessment and payments

> Payments will be based on final assessment reports as follows: The
> first \$75,000 payment each year will be based on the final
> assessments of the first two quarters of the year. This will include
> all data received within 60 days after the end of each quarter, plus
> any corrections received within 30 days after the State receives the
> initial assessment report for each quarter. Under this schedule,
> payment will be made to the States in November for the first 6 months
> data.
>
> The second \$75,000 payment will be based on the final assessment of
> admissions and discharges that occurred during all 4 quarters of the
> year and were submitted up to 60 days following the end of the fourth
> quarter of the year, including any corrections submitted during the
> 30-day correction periods.
>
> The assessment report provided to the States following the first
> quarter of year two will cover:

1)  The admissions and discharges that occurred in the fourth quarter of
    year one and that were submitted up to 60 days following the end of
    the fourth quarter, and

2)  The admissions and discharges that occurred during all 4 quarters of
    year one, provided that the quarterly assessment criteria were met
    throughout the calendar year and provided that the States certify
    that all of the admissions and discharges for the calendar year have
    been submitted.

```{=html}
<!-- -->
```
V.  Example schedule of events

The following is an example of the schedule for a state that begins to
submit the NOMS with first quarter 2007 data.

+----------------------------+-----------------------------------------+
| **Task/Event**             | ### Description/dates                   |
+----------------------------+-----------------------------------------+
|                            |                                         |
+----------------------------+-----------------------------------------+
| First quarter data to be   | Admissions and discharges that occur    |
| reported                   | from January 1 through March 31, 2007.  |
+----------------------------+-----------------------------------------+
| State submission of first  | Due by May 31, 2007                     |
| quarter data to TEDS.      |                                         |
+----------------------------+-----------------------------------------+
| First quarter assessment   | Sent to States and SAMHSA by June 30,   |
| report.                    | 2007                                    |
+----------------------------+-----------------------------------------+
| Corrections to first       | State may submit corrections during the |
| quarter data               | 30 days following State receipt of the  |
|                            | first quarter assessment report.        |
+----------------------------+-----------------------------------------+
| "Final" first quarter      | Sent to States and SAMHSA by August 31, |
| assessment report.         | 2007.                                   |
+----------------------------+-----------------------------------------+
| Second quarter data to be  | Admissions and discharges that occur    |
| reported                   | from April 30 through June 30, 2007.    |
|                            | State may also submit corrections and   |
|                            | additions to previous quarters' data.   |
+----------------------------+-----------------------------------------+
| State submission of second | Due by August 31, 2007                  |
| quarter data to TEDS.      |                                         |
+----------------------------+-----------------------------------------+
| Second quarter assessment  | Sent to States and SAMHSA by September  |
| report                     | 30, 2007.                               |
+----------------------------+-----------------------------------------+
| Corrections to second      | State may submit corrections during the |
| quarter data               | 30 days following State receipt of the  |
|                            | second quarter assessment report.       |
+----------------------------+-----------------------------------------+
| "Final" second quarter     | Sent to States and SAMHSA by November   |
| assessment report.         | 30, 2007.                               |
+----------------------------+-----------------------------------------+
| State \$75K payment for    | By November 30, 2007.                   |
| successful submission of   |                                         |
| first and second quarter   |                                         |
| data.                      |                                         |
+----------------------------+-----------------------------------------+

VI. Proposal and Submission Information

    1.  Content and Form of Response

> States should provide a narrative describing the proposed approach and
> timeline for reporting each required NOM. States should present a
> credible plan for reporting all defined NOMS and a timeline for
> reporting that identifies when the State expects to begin collecting
> each NOM from providers, and when the State expects to begin
> submitting each NOM to Synectics. The plan should also include plans
> for adopting a unique statewide client identifier by the end of FY
> 2007. To summarize the NOMS reporting plans, the State proposal should
> include a chart that displays each NOMS data element with dates for
> each item indicating when providers will begin (or have begun)
> collecting the item, when the state will begin submitting the item to
> TEDS, and the range of admission and discharge dates that will be
> included in the State's first data submission under a SOMMS
> subcontract. A sample chart is provided in attachment 6 for
> illustration.

2.  Submission Date and Time

> Proposals must be received no later than December 1, 2006, including
> proposals submitted electronically.

3.  Other Submission Requirements

> Prior to any NOMS data submission, States must update their TEDS
> crosswalk to include all of the NOMS variables. An electronic
> "crosswalk worksheet" in Excel format can be downloaded from the DASIS
> web site at
> <http://wwwdasis.samhsa.gov/dasis2/crosswalk_worksheet.xls> and is
> available upon request by calling Synectics at 703-807-2331. Inclusion
> of the worksheet with the proposal, completed to the extent possible,
> is encouraged.

4.  Method for Submitting Responses

> Responses may be mailed to Synectics at the address below, or may be
> submitted electronically by email attachment to <DASIS@SMDI.com>. Mail
> responses should include 3 copies.
>
> Synectics for Management Decisions, Inc.
>
> Attn: NOMS Reporting
>
> 1901 North Moore Street, Suite 900
>
> Arlington, VA 22209

VII. Funding Administrative Information

     1.  Agreement Approval Notification

> States responding to the RFP will be ranked according to 1) their
> reported ability to report the NOMS beginning January 2007, and 2)
> their plans for reporting all currently defined NOMS by the end of FY
> 2007.

Contact Information

2.  Agreement Administrator

> Funding agreements will be administered by:
>
> Synectics for Management Decisions, Inc.
>
> Attn: NOMS Reporting
>
> 1901 North Moore Street, Suite 900
>
> Arlington, VA 22209

3.  Agency Sponsor

> Office of Applied Studies
>
> Substance Abuse and Mental Health Services Administration
>
> 1 Choke Cherry Road
>
> Rockville, MD 20857