Report to the Operations

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• Report to the Operations
• Sub-Committee
• December 8, 2006

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Network Operations
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Web Registration

• Security Access/User ID Requests
• 2,034 User Ids generated as of 12/4/2006
• 27 Requests currently in process
• Winfax Non Web/Paper Registrations
• 104 Providers currently using paper registration

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Web Registration TotalsCompleted Web
Registrations as of 12/4/06

• Outpatient Services...21,963
• Methadone Maintenance....1,230
• Ambulatory Detoxification .77
• Family Support Team..128
• (Home Based Service)
• Psychological Testing...32

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Web Registration Continued

• 23,430 - Registrations completed as of December
  4, 2006
• Registration 21 day timely limit began November
  6, 2006
• Providers have 21 days from the initial visit to
  register CT BHP clients for Registered Services
• All fields for web registration required as of
  November 1, 2006
• Race Ethnicity (Optional)

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Provider Relations Phone Stats

• October 2006 - November 2006
• 1646 Calls
• Web Registration Inquiries General Provider
  Inquiries

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Provider Data Verification Stats Aggregate since
January 2005
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Rapid Response Team Findings

• Reviewed authorization related claims issues for
  30 providers
• Provider outreach letters sent to providers to
  offer assistance in the authorization process

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Rapid Response Team

• Provider Outreach Correspondences
• 15 PH.D. level
• 9 MD level
• 6 APRN level
• Provider Site Visits
• 1 Group Practice
• 3 Facilities

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Clinical Operations
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Average Length of Inpatient Stay not including
Riverview (not including discharge delays)
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Percent Per Facility of Discharge Delays
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Discharge Delay Reason Codes
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Inpatient Discharge Delay Status November, 2006

• 10 of children in an Inpatient setting are
  defined as Discharge Delay - represents a
  decrease from 17 last month
• 37.5 are awaiting placement in Residential
  and/or PRTF
• 9.4 are awaiting Community Services
• 12.5 are awaiting Group Home placement
• 12.5 are awaiting Placement other or
  unspecified

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ED Delayed Discharge Activity

• Started trending ED cases, source, length of
  stay, and disposition
• Despite increased numbers of members presenting
  to EDs, overall lengths of stay are trending down
  (3 outliers in November negatively impacted LOS)
  
• Members presenting to EDs are more likely to be
  DCF involved than not
• Members presenting to the ED are more likely to
  be discharged to an Inpatient level of Care than
  any other option

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ICM TRACKING REFERRAL SOURCE MONTHLY REPORT
November 2006

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Timeliness of Pre-cert and CCR Process

• Analysis of current forms/process- complete
• Re-ordering/re-working of existing forms -
  complete
• Deletion of redundant information - complete
• System was reprogrammed mid-November
• Clinician orientation and re-tooled forms on web
  site week of November 13, 2006
• Revised format implemented week of November 20,
  2006

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Residential Care TeamTransition

• IT infrastructure complete (tracking system/CANs)
• Follow up training occurring via web
• John Lyons training CSSD
• Final revisions to provider information
• Census reporting has improved to better support
  matching
• Transition occurred 12/1/06

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Customer Service/Call Center Activity
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2006 Call Volume YTD
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Calls answered in lt 30 seconds YTD
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Types of Service Connect InquiriesNovember, 2006

• 41 - Provider Referrals for Members
• 15 - Member Eligibility Verification
• 36 - Provider Related/Authorization/Enrollment/
  Billing
• 8 - General Information
  49 Member Inquiries
• No Inquiries initiated due to provider status
  change from IN to OON

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CT BHP CALL MANAGEMENTIncoming Calls Totals
November, 2006

• Total 5813

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Quality Management
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Quality Initiatives

• Adult and Child Studies underway
• Final analysis of Provider Satisfaction survey
  underway
• Member Satisfaction close to completion
• Mercer Post-Implementation evaluation scheduled
  for January 3-5, 2007
• Continues to support all departments at the CT BHP

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Total Number of Complaints Monthly 2006
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Complaints

• The complaint categories identified do not have
  enough volume to suggest a trend at this time
• All complaints will continue to be monitored
• Complaints documented at VOs Helpdesk related to
  Web Registration will be transferred to CT BHP
  data base

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Percent of Denials- Administrative and Medical
Necessity
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Appeals

• Overall appeal rate is less than 1 of
  authorizations
• A typical denial (gt90) is generated by failure
  to adhere to administrative process rather than
  Medical Necessity determination

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Grievances

• No Grievances filed in November of 2006

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Systems Management
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System Management Update

• System Managers held numerous community meetings
  to finalize assigned LADPs for submission in
  November
• The final Six LADPs were submitted and approved
  by the Departments in November

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System Management Update cond

• System Managers have established local oversight
  bodies for the implementation and monitoring of
  the LADPs
• System Managers whose plans were approved in
  October began the implementation process in
  November and have convened and facilitated
  meetings with their respective oversight bodies

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System Management Update cond

• Statewide themes and regional variations across
  all 15 plans are being compiled for future
  presentations and strategic planning purposes
• All System Managers were trained and began the
  initial phase of utilizing project management to
  monitor, track and prepare for reporting on the
  status of each plan

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System Management Update cond

• System Managers presented approved LADPs to local
  Community Collaboratives, Local Department of
  Children Area Advisory Councils and Managed
  Service System members
• System Managers continue to actively participate
  in community meetings and initiatives across the
  state
• Requests for LADPs are currently being tracked

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Community InteractionPeer/Family
Services
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Peer Support Unit

• The Peer and Family Peer Specialists worked with
  68 CT BHP members and/or families in November.
• Peer and Family Peer Specialists attended
• 9 Community Collaborative Meetings
• 16 Community Outreach Meetings
• 1 CT BHP Consumer and Family Advisory
  Sub-Committee Meeting
• 2 Home visits with members
• 1 Visit at ED with member
• 1 Child Specific Team Meeting
• 3 Treatment/Discharge Planning Meetings with
  members/families
• 17 Referrals were given to various agencies and
  organizations

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Outreach Activities for Peer Unit

• Help Me Grow Breakfast in Waterbury
• In-Service Training to the Middletown Adult
  Education Teachers
• Presentation to the Even Start Program
• Meeting with the Middlesex Coalition for Children
• Attended Provider Presentation on Respite
  Services in South Central Region
• Co-Hosted Provider Fair for School District and
  DCF Personnel with the NE Collaborative Members
• Eastern Connecticut Cooperative Workgroup Meeting
  to Plan Spring Workshops
• Attended the Families United Support Group in
  Plainville

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Examples of Referrals Given by Peer Unit

• Worked with MCO to resolve a transportation issue
  for member
• Department of Mental Health and Addiction
  Services (DMHAS)
• Connecticut Autism Spectrum Resource Center
• Access Agency
• Office of Protection and Advocacy
• DCF Ombudsman
• Childrens Law Center
• Legal Aid
• Statewide Legal Services
• North Star Support Group
• Tri-State Support Network for Families Raising
  Children with Bipolar- The Connecticut Group
• AFCAMP, Families United, PAP, NAMI-CT
• FAVOR Advocate