OMA Newsletter Outcome Measures Application

Helping you understand more about the importance of outcome measures.

Outcome Measures Application Issue 13 – January 2014

Step Into the New Year

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Outcome Measures Application Issue 13 – January 2014

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In order to demonstrate the impact of the Mental Health Services Act (MHSA), counties have to agree to collect outcome data for each of the five service components of the MHSA and for programs within service components of the MHSA. The impetus for this movement involves:

§ Implementing the Affordable Care Act and the inherent need to develop a data-informed approach to the delivery of integrated care and improved whole health.

§ Using the MHSA Audit findings to develop an approach for identifying outcome measures based on program goals and objectives. The findings highlighted the collection and use of clinical outcomes in Los Angeles County. As a result of these findings, the four counties that were audited have formed a workgroup.

§ Ensuring the sustainability of the MHSA by demonstrating its effectiveness at improving the lives of the clients served and reach into unserved and underserved communities to reduce disparities in care.

From a measurement perspective, a key challenge inherent in any statewide approach to evaluation is creating some level of outcome reporting uniformity across different types of programs within the Community Services and Supports Plan or Prevention and Early

Intervention, where program goals from county to county may differ. California Mental Health Directors Association (CMHDA) will act as the lead to convene counties in the development of a statewide approach to evaluating MHSA programs across the service spectrum. The first phase of this work will be to develop a report of common data elements collected by counties on the following elements:

§ Average percent of clients re-hospitalized within 30 days § Post hospitalization follow-up rates § Reduction in homelessness, psychiatric hospitalizations,

and incarcerations for adults in FSP programs § Reduction in trauma symptoms for children who

completed a course of Trauma Focused Cognitive Behavioral Therapy (TF-CBT)

§ Client Satisfaction Survey results on satisfaction with services and perceived improvement

§ Average length of time from first request for service to first clinical assessment for children and adults

The data collected will provide CMHDA with information to initiate a statewide story on the effectiveness and efficiency of county mental health services. Throughout all of this, Los Angeles County in its robust collection of outcome data, has paved the way for counties across the State to adopt similar outcomes collection systems. Our collective efforts in Los Angeles have given counties across the State the ability to initiate their own quality improvement-driven outcomes collection and reporting system.

Debbie Innes-Gomberg, Ph.D. District Chief, MHSA Implementation & Outcomes Division, Program Support Bureau, County of Los Angeles, Department of Mental Health

The DIG

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Happy New Year to our outcomes family! Much of my time has been consumed by the upcoming data transition for Prevention Early Intervention (PEI). We are working closely with the California Institute for Mental Health (CiMH) and our own Chief Information Office Bureau (CIOB) in preparation to take over the data collection for three PEI practices. By the time this newsletter goes out, providers implementing Positive Parenting Program (Triple P) and Managing and Adapting Practice (MAP) will have made their final data submissions to CiMH on Excel spreadsheets. Providers doing Trauma Focused Cognitive Behavior Therapy (TF-CBT) will make their final submission at the end of February. We are quickly making changes to the PEI Outcome Measures Application (OMA) to be able to accept direct data entry for these three practices sometime in early spring. I know this is not a small transition for providers of these PEI Child practices. We hope to provide you with as much support as possible during the transition. Hopefully when this is done all of the PEI data will be in one place and we can start to work on the next step which is creating a mechanism for providers to submit data electronically to PEI OMA to cut down on any double data entry you might be doing at your agencies in your own electronic health records.

In other news, contractors with the MHSA Oversight and Accountability Commission have released county level reports for Full Service Partnership based on the state mandated outcome data that counties submit to the state. We are in the process of reviewing all 2,400 pages of our L.A. County report and hope to have some summary information to present in our next newsletter. Based on Debbie’s message, it will be a very busy year for all of us as MHSA outcomes take center stage in an effort to justify how funds are used. So many people in Los Angeles County have benefitted from MHSA, and all of the work our providers have done in an effort to make lives better should be highlighted and celebrated. I look forward to helping programs show how effective their services are.

Kara’s Corner

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IBHIS, the Integrated Behavioral Health Information System, will be DMH’s electronic health record and claiming system. Our Pilot 1 sites went live on January 27th, and our rollout will continue through September of this year. DMH will have eight rollouts in all. Currently, in the paper world, each clinic has its own clinical record and must rely on faxes to pass clinical information to another DMH clinic that is seeing the client. IBHIS will be the single clinical record for all Directly-Operated clinics. At the touch of a button, DMH staff working with a client may access any information entered into IBHIS by another clinic. If you’re at a Contract agency, you’re probably already moving towards your own version of an Electronic Health Record (EHR) like IBHIS. Your

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system will interact with ours, but they will all be independent. Contractors will conduct IBHIS client lookups, create IBHIS episodes, update client information and submit service records directly from their own EHRs through special electronic interfaces. Once we’ve all moved on to our new EHR’s (about a year from now), the Department of Mental Health will be taking the Integrated System offline. From then on, all billing and client information will be handled through EHR’s. One thing that won’t be going away (at least not for a while) is the OMA for both FSP/FCCS and PEI. Neither one is included in the new IBHIS system, so both will continue for the forseeable future. We’ll be changing the backend of the systems to accept client ID’s and other information from the IBHIS, but for the most part they will be unchanged by the adoption of Electronic Health Records.

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As the system changes, so do the issues OMA users have with it. Last year, we introduced the OMA Troubleshooting Matrix to address some of the recurring issues our users had. It is a living document that is updated as new issues arise. Below are some of the top questions from our users and are answered in the matrix. To see the answers to these questions, click here.

1. The OMA is telling me that I can’t enter my Baseline because the client is open somewhere else. What can I do to get my assessments in?

2. I’m working on an FCCS client who has two Baselines open: mine and someone else’s. I’m stuck! (In some cases that other

provider has also CLOSED the FCCS outcomes which means you can’t do anything).

3. I am trying to enter FSP OMA’s on a client, and I’m getting an error message that reads “Partnership Error.” How do I find and fix that

error?

4. I accidentally completed a 12 or 18 or 24 (or whatever) Month assessment in FCCS when I meant to Terminate the client. How should I fix this problem?

5. I have a client I can’t enter OMA’s for because they are open under Specialized Foster Care. There’s no one I can contact who will

close that SFC program for me, so I am stuck. What do I do?

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Did you know? The majority of errors found from preliminary analysis of the CiMH data have to do with client information. Please make sure you are entering a valid Client ID and verify that the date of birth is

correct and matches what is in the IS. Also, be sure to enter all beginning of treatment information; this includes valid

therapist staff codes, DSM-IV Primary Axis I diagnosis codes, and date of first session. A much more

detailed checklist was distributed at the PEI Quarterly Providers’ Meeting and was emailed

to end users who are part of the PEI OMA. You can access it here or by clicking on

the image to the left. In the memo, you will also find PEI OMA Data Entry Tips.

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Kara Taguchi

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What is your role and what do you do in the Implementation & Outcomes Division? I am the Program Head of the Unit and I’m responsible for everything! Just kidding! I lead the MHSA Data and Outcomes team consisting of 12 team members. We are responsible for outcomes data collection for FSP, FCCS, and PEI programs. We handle the MHSA reporting to the state in the form of the annual plan and satisfying any MHSA data needs that providers or MHSA leads in LA County might have. I work closely with our Chief Information Office Bureau on developing and managing our online applications, reports, and user support.

What do you find most fulfilling about your job? The most fulfilling part of my job is that I am directly involved with the implementation of MHSA in Los Angeles County. MHSA has helped thousands of people since it passed in 2004 and I’ve been lucky enough to be a part of it since the beginning. I know the work my team does helps to demonstrate the need for the funds and highlights how many people have utilized and benefitted from the services provided through MHSA. I also love working with an amazing team of people every day.

If you could change one thing about how we collect data, what would it be? I always joke that I would put a barcode on everyone we need to collect data on and just one scan of the barcode would yield all the data anyone needs. I want the data we collect to be easy to gather, informative, and useful.

How do you spend your days away from the office? When I’m not in the office, you can find me at a baseball field or basketball court watching my son play. If I’m not there I’m likely spending my earnings at Target, hanging out with my family, or playing Bejeweled, Candy Crush, Farm Heroes, or Jewel Mania.

What are five things you can’t live without and why? 1) My family – not that my family are “things”, but I couldn’t imagine life without them. My husband,

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John, and son, Noah, are the foundation for everything I do. I also have a large extended family that definitely keeps me humble in case I try and think I’m good at something. J 2) Laughter - I never really do well with silence. I try and laugh pretty much every day. Most of the time there are amazing friends around making me laugh. 3) Food - I love many things having to do with food. Many of the best moments of my life have happened while sharing food with others. 4) Hope – it keeps you going when life happens. I’ve existed without hope before, but I definitely wasn’t “living” at the time. 5) Love – It makes life worth living.

Tell us three random facts about yourself. 1) I was on Wheel of Fortune when I was in college. I was on during the very first “Best Friends Week” with my BFF from high school. It’s not easy for short people to spin that wheel. 2) In graduate school I had a job at a golf course. I learned to drive a tractor that I would maneuver around the driving range to pick up golf balls. 3) When my mom was pregnant with me, her due date was April 12th, but I didn’t arrive until May 24th. I was born 6 weeks late with a full head of hair and long fingernails.

What is one thing you would like to accomplish in your lifetime? Process all those data change deletion request forms and learn how to swim (not necessarily in that order).

Staff Feature:

Available to OMA Users OMA Forms and Hands-On Trainings are available to all OMA users. We recommend you attend training if your last training was more than two years ago because the system is constantly changing. Visit OMA Wiki for a schedule of trainings. OMA Wiki Homepage: http://dmhoma.pbworks.com

OMA Users’ Group is for our providers. Take advantage of this opportunity to dialogue with DMH folks about OMA issues. Next

meeting: Tuesday, March 18, 2014 from 1:30 – 3:00 p.m., at 695 S. Vermont Ave, 15th Floor Glass Conference Room, L.A., 90005. To participate via

Webinar, email John Flynn: jflynn@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. Offered every other Monday from 10am–Noon. Next OMA lab: February 10, 2014. Space is limited. Please RSVP with John Flynn: jflynn@dmh.lacounty.gov

PEI Outcomes Questionnaire and Data Entry Trainings are available to all PEI providers. Training schedules are posted on the PEI OMA Wiki. Contact Us: FSPoutcomes@dmh.lacounty.gov, FCCSoutcomes@dmh.lacounty.gov, PEIoutcomes@dmh.lacounty.gov

PEI Outcome Measures Trainings Update The MHSA Implementation and Outcomes Division continues to provide PEI outcome measure trainings to PEI providers. We have recently provided training for a newly added outcome measure, the McMaster Family Assessment Device (FAD). Currently, FAD is only utilized for the PEI practice, Families OverComing Under Stress (FOCUS). Additionally, we are currently developing training for the outcome measure Devereux Early Childhood Assessment for Infants and Toddlers (DECA-I/T). The DECA-I/T will be utilized as the specific measure for Mindful Parenting Groups (MPG). Currently, outcome measure trainings are offered on the following schedule:

• ECBI/SESBI-R: every 12 weeks • OQ/YOQ/YOQ-SR: every 8 weeks

• PTSD-RI: every 8 weeks

• PHQ-9/GAD-7: every 12 weeks The following outcome measures are scheduled based on training need by request: DERS, FAD, PDS, RBPC, and TSCYC. The DECA I/T training currently being developed will also be scheduled based on training need. Please visit the PEI Outcomes website for more detail on required outcome measures and an updated listing of PEI Outcome Measures trainings and information on how to register or request future trainings.

Outcome Measures Application Issue 13 - January 2014