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Final MDCH MHQMS 4.0 Quality Management Measures

 4.0 effective 10/01/01

Compliance Indicators | Quality Improvement Measures | Tracking Measures


  1. COMPLIANCE INDICATORS
    1. Access
      1. The percentage of persons receiving a pre-admission screening for psychiatric inpatient care for whom the disposition was completed within three hours.  Standard: 95%

      2. The percentage of persons receiving a face-to-face meeting with a professional within 14 calendar days of a non-emergency request for service (by 4 sub-populations: MI-adults, MI-children, DD-adults, DD-children).  Standard: 95%

      3. Percentage of persons starting any needed on-going service within 14 days of a non-emergent assessment with a professional (by 4 sub-populations: MI-adults, MI-children, DD-adults, DD-children).  Standard: 95% within 14 days

      4. The percentage of persons who met the OBRA Level II Assessment criteria for specialized mental health services for persons residing in nursing homes, as determined by the Department, who received CMHSP managed mental health services.  Standard: 95%

    2. Efficiency
      No compliance indicators currently required.  
    1. Outcomes
      1. Percentage of people readmitted to an inpatient psychiatric unit within 30 days (from 15 days) of discharge.  Standard: 15% or less

    1. Administrative Services
      1. Required contractual reports are submitted on the contractually-defined time frames.  Standard: 100%

      2. CMHSP maintains a 95% accuracy rate on selected data elements in demographic and service use files submitted to MDCH.

    (All MHQMS measures that have a standard applied will move to Compliance Measures with performance posted on the DCH website.)
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  1. QUALITY IMPROVEMENT MEASURES
    1. Access

      Continuity of Care

      1. The percentage of persons discharged from a psychiatric inpatient unit who were seen for follow-up care within 7 days (from 30 days).

    1. Efficiency
      Utilization of Services (data collected from Sub-Element Report))
      1. Days of psychiatric inpatient care per thousand persons with mental illness served.

      2. Percent of expenditures for persons with developmental disabilities used for 24-hour specialized residential care provided in a group home or institutional setting for which the case is paid by the CMHSP.

      3. Percent of expenditures for persons with mental illness used for psychiatric inpatient care.

    1. Outcomes
      Employment
      1. Percentage of persons with developmental disabilities receiving daytime service who are served in supported employment.

      2. Percent of persons with developmental disabilities who earned minimum wage and above.

      3. Percentage of adults (18-65 years of age) with serious mental illness who are employed and/or are in supported employment. (Information to be collected from demographic data.)

      4. Percentage of adults (18-65 years of age) with developmental disabilities who are employed and/or are in supported employment. (Information to be collected from demographic data.)

      Living Arrangement
      1. Percentage of children served living with their families1.

      2. Percentage of adults with developmental disabilities served living in their own residence2.
1"Family" means natural or adoptive relatives (parents, grandparents, siblings, etc.)
2"Own residence" means lease, rental agreement, or deed/mortgage of home, apartment, or condominium in the adult consumer's name or the name of his/her spouse, friend, guardian, relative or parent. Consumers living with (a)their parents, or (b) in a residence owned or leased by a CMHSP or provider, are not considered to be living in their "own residence."

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  1. TRACKING MEASURES
    1. Access
      Penetration Rates of Under-Served Populations
      1. Ratio of the percentage of persons under 18 in the area population receiving services to the percentage of person under 18 in the area population.

      2. Ratio of percentage of persons 65 years and older in the area population receiving services to the percentage of persons 65 years and older in the area population.

      3. Ratio of percentage of ethnic minority persons in the area population receiving services to the percentage of ethnic minority persons in the are population (by 4 sub-populations: Native American, Asian or Pacific Islander, African American, Hispanic).

      4. Ratio of percentage of persons 18 or older with serious mental illness in the area population receiving services to the percentage of persons 18 or older with serious mental illness in the area population.
        (For background information re: determining serious mental illness in the area population: Report 318 Citizens Research Council)

      5. Percentage of area Medicaid recipients having received CMHSP managed services.

      6. Percentage of total CMHSP service population, not living in a nursing home, with diagnosis of dementia.

      7. Number of children 0-3 years old, receiving home-based services, regardless of who has the open case, where the primary treatment target is the 0-3 child.

      8. Number of children under age 18 referred by courts who were assessed by CMHSP, and number who received services.

      Continuity of Care
      1. The percentage of persons who met the OBRA Level II criteria determined to need nursing home care but less than specialized mental health services, as determined by the Department, who received CMHSP managed mental health services.

      Denials/Appeals
      1. Percent of face-to-face assessments with professionals that result in denials or referrals elsewhere.

      2. Ratio of Sec.705 second opinions that result in services.

    1. Efficiency
      Cost Per Case
      1. Cost per case for adults with mental illness (18-64, 65+).

      2. Cost per case for children (under 18) with a mental illness or severe emotional disturbance.

      3. Cost per case for persons with a developmental disability (0-17, 18-84, 65+).

        Other (Data collected from consumer level demographic report)

      4. The percentage of Medicaid eligible persons who received (a) inpatient care, (b) day/night care, and (c) ambulatory services.

    1. Outcomes
      Employment
      1. Percentage of people in Supported Employment (SE) working 10+ hours per week.

      2. Percentage of adults with MI in SE earning minimum wage and above.

      3. Percentage of adults with MI and adults with DD in SE, continuously employed 6 months or longer.

      Living Arrangement
      1. Percentage of adults with MI served living in their own residence3.

      Recipient Rights (data collected semi-annually through Office of Recipient Rights Reports)
      1. Number of substantiated recipient rights complaints per 1,000 persons served, in the categories of Abuse and Neglect I and II.

      2. Total number of persons making an allegation of a rights violation per thousand persons served.

      3. Total number of substantiated allegations for all categories other than abuse and neglect per thousand persons served.

      Sentinel Events
      1. Number of sentinel events per thousand persons served (by 3 sub-populations: MI-adults, MI-children, DD).

      2. Rates of suicides per thousand persons served (by 2 sub-populations).

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