A Peer Recovery Program, i.e., a program that is accredited by the Council on Accreditation of Peer Recovery Support Services (CAPRSS) or is under contract with the department’s bureau of drug and alcohol services (BDAS) contracted facilitating organization All SUD / COD services are required to be in accordance with He-W 513 administrative rules: Proposed Process Milestones As part of the 2017-2018 semi-annual IDN reporting process, IDNs are required to demonstrate that organizations participating in this project (as identified in the approved IDN Project Plan) have achieved the following process milestones during, or in advance of, the timeframes noted. Jan-Jun 2017 Reporting Period Development of implementation plan, which includes: Implementation timeline Project budget Work force plan: staffing plan; recruitment and retention strategies Key organizational/ provider participants Design and development of clinical services infrastructure, includes identification or development of: Training plan Training curricula Agreements with collaborating organizations Evaluation plan, including metrics that will be used to measure program impact July-Dec 2017 Reporting Period Operationalization of program Implementation of workforce plan Deployment of training plan Implementation of any required updates to clinical protocols, or operating policies and procedures Initiation of data reporting
Follow-up After ED Visit or Hospitalization Follow-Up After Emergency Department Visit for Alcohol and Other Drug Dependence - within 30 days Proposed 2017 HEDIS measure DHHS; Claims/Encounters Annual - - P4P P4P B1,C1,C2,C3, D1, D2, D3,E3,E4,E5 Follow-up After ED Visit or Hospitalization Follow-Up After Emergency Department Visit for Mental Illness - within 30 days Proposed 2017 HEDIS measure DHHS; Claims/Encounters - - P4P P4P B1,C1,C2,C3,D2, D4,E4,E5 Follow-up ED Visit or Hospitalization Follow-up after hospitalization for Mental Illness – within 30 days HEDIS 2015 (w/Addition of IMD discharges) DHHS; Discharge Data Annual - P4P P4P P4P Follow-up ED Visit or Hospitalization Follow-up after hospitalization for Mental Illness – within 7 days HEDIS 2015 (w/Addition of IMD discharges) DHHS; Discharge Data Annual - P4P P4P P4P Integration and Core Practice Competencies Percent of patients screened for alcohol or drug abuse in the past 12 months using an age appropriate standardized alcohol and drug use screening tool AND if positive, a follow-up plan is documented on the date of the positive screen age 12+ DHHS Measure patterned off NQF #0418 IDN; IDN EHR Output Annual - P4R P4P P4P B1,C1,C2,C3, D1, D2, D3,E3,E4,E5 Integration and Core Practice Competencies Timely Electronic Transmission of Transition Record (Discharges From an Inpatient Facility in IDN (including rehab and SNF) to Home/Self Care or Any Other Site of Care) CMS Adult Core Set CTR IDN; IDN EHR Output - P4R P4P P4P All
Patient Reported Experience of Care Global Score for Mini-CAHPS Satisfaction Survey at IDN Level (including integration; access to care; baseline 2017) for kids and adults Subset of CAHPS questions DHHS; DHHS Survey Annual - P4P P4P P4P B1,D4 Physical Health/Primary Care Clinical Quality/Screening and Assessment Comprehensive and consistent use of standardized core assessment framework including screening for substance use and depression for age 12+ by IDN providers DHHS Measure IDN; IDN EHR Report X - P4R P4P P4P B1,C1,C2, D1,E3,E4,E5 Physical Health/Primary Care Clinical Quality/Screening and Assessment Global score for selected general HEDIS physical health measures, adapted for BH population HEDIS (adapted) IDN/DHHS; EHR Report Annual - P4R P4P P4P B1,C1, C2 D1, D2, D4,E1,E3,E4 BH Care Clinical Global score for selected BH-focused HEDIS measures HEDIS IDN/DHHS; EHR Report P4P P4P P4P Physical Health/Primary Care Clinical Quality/Screening and Assessment Percent of BH Population With All Recommended USPSTF A&B Services HEDIS (+) IDN; EHR Report Annual - P4P P4P P4P B1,D4 Physical Health/Primary Care Clinical Quality/Screening and Assessment Recommended Adolescent (age 12-21) Well Care visits HEDIS (adapted) DHHS; Claims/Encounters & IDN EHR Report Annual - P4P P4P P4P B1,E2, E3
Physical Health/Primary Care Clinical Quality/Screening and Assessment Smoking and tobacco cessation counseling visit for tobacco users (CPT codes NQF IDN; IDN EHR Report - P4R P4P P4P All Population Level Utilization Frequent (4+ per year) ER Visits Users for BH Population DHHS Measure DHHS; Claims/Encounters - P4P P4P P4P All Population Utilization Potentially Preventable ER Visits for BH Population and Total Population DHHS Measure DHHS; Claims/Encounters X - P4P P4P P4P All Population Level Utilization Rate per 1,000 of people without cancer receiving a daily dosage of opioids greater than 120 mg morphine equivalent dose (MED) for 90 consecutive days or longer. PQA DHHS; Claims/Encounters - P4P P4P P4P B1,C1,C2,C3, D1, D2, D3,E3,E4,E5 Workforce Capacity Engagement of Alcohol and Drug Dependence Treatment (Initiation and 2 visits within 44 days) HEDIS 2015 DHHS; Claims/Encounters Annual - - P4P P4P B1,C1,C2,C3, D1, D2, D3,E3,E4,E5 Workforce Capacity Initiation of Alcohol and Other Drug Dependence Treatment (1 visit within 14 days) HEDIS 2015 DHHS; Claims/Encounters Annual X - - P4P P4P B1,C1,C2,C3, D1, D2, D3,E3,E4,E5 Workforce Capacity Percent of new patient call or referral from other provider for CMHC intake appointment (90801 HO) within 7 calendar days DHHS Measure DHHS; Phoenix - - P4P P4P B1,C2,C3,E5
Workforce Capacity Percent of new patients where intake to first follow-up visit was within 7 days after intake DHHS Measure DHHS; Phoenix - - P4P P4P B1,C1, C2,C3,E5 Workforce Capacity Percent of new patients where intake to first psychiatrist visit was within 30 days after intake DHHS Measure DHHS; Phoenix - - P4P P4P B1,C1,C2,C3,E5