Slide 1

Health Planning CouncilMeeting 6

Advisory CommitteeMeeting 3A- Pre-Meeting

Madeleine Biondolillo, MDDirector, Bureau of Health Care Safety and Quality

Associate CommissionerDepartment of Public Health

December 19, 2013

Slide 2

Agenda

• Goal of meeting

• First health planning analysis: Behavioral Health– Priority Area– Timeline & Deliverables

• Methodology for selecting key questions & approach for analysis– Health Resource Planning definition “refresher”– Taxonomy

Slide 3

Agenda

• Goal of meeting

• First health planning analysis: Behavioral Health– Priority Area– Timeline & Deliverables

• Methodology for selecting key questions & approach for analysis– Health Resource Planning definition “refresher”– Taxonomy

Slide 4

Goal of Meeting

• Report out from October council meeting• Discuss planned approach • Preface for next meeting (immediately following this)

Slide 5

Agenda

• Goal of meeting

• First health planning analysis: Behavioral Health– Priority Area– Timeline & Deliverables

• Methodology for selecting key questions & approach for analysis– Health Resource Planning definition “refresher”– Taxonomy

Slide 6

2013 – 2014Proposed Priority Area

Focus existing resources on a Level III analysis of a single service line:

• Allows staff to identify methodological and process challenges and correct them in future iterations

• Pursues a rigorous, comprehensive approach to one issue area, rather than a more limited analysis of many issue areas (depth rather than breadth)

• May be able to add additional service lines, time and resources permitting Behavioral Health as Year 1 focus:

• Directly relevant to all agencies represented on the council

• Significant policy interest in understanding and addressing weaknesses of the current system; active area of focus through initiatives to integrate care, address parity, improve access

• Need for immediate, purposeful study of existing resources and need

Slide 7

2013 – 2014: Timeline

Oct. 2013 Nov. 2013 Dec. 2013 Jan. 2014 Feb. 2014 Mar. 2014 Q22014

Q3 2014

Q42014

Council Meetings Strategic Plan Presented

Check point

Check point

First deliverables

reviewed

Advisory Committee Meetings Strategic Plan

PresentedCheck point

First deliverables

reviewed

Deliverable 1: Analytic Outline, Service Line Maps

Deliverable 1 Complete Deliverable

1 submitted

Deliverable 2: Key Definitions

Deliverable 2 Complete Deliverable

2 submitted

Deliverable 3: Level III Analysis

Public Hearings on Deliverable 3 Public Hearings

Deliverable 3 Complete Deliverable

3 Complete

= delayed by one month due to missing the November meeting

Slide 8

2013 – 2014 : Deliverables

Deliverable 1A: Analytic Outline• Description of proposed methodology for Level III analysis

• Terms requiring definitions

• Proposed data sources and analyses

• Geographic regions for subservices

2013 – 2014: Deliverables

Deliverable 1B: Service Maps• Maps of existing facilities/services by geographic location

• Based on current definitions, databases• Broken down by services offered, number of beds (if possible)• Subject to change based on new definitions, methodologies, etc.

• Propose to include the following services:

Slide 9

Mental Health Substance AbuseAcute Inpatient Psychiatric Units/Facilities

(child/adult/geriatric)Acute inpatient substance abuse beds

(Adult/family/youth)

Licensed Outpatient Mental Health Clinics Residential substance abuse beds(Adult/family/youth)

Diversionary Services:Partial Hospitalization Programs

Day Treatment ProgramsEmergency Service Programs

Crisis stabilization services

Methadone treatment service providers

DMH Continuing Care Units/Facilities Substance abuse day treatment

Community Support Agencies Outpatient substance abuse counseling

DMH Site Offices

2013 – 2014: Deliverables

Deliverable 2: Key Definitions• Final definitions of all terms required for Level III analysis

• Emphasis on using existing definitions as much as possible• Any new definitions developed to be vetted with expert stakeholders

Example:

Day Treatment: an outpatient service providing direct client services through group, individual, and family substance abuse counseling a minimum of 3.5 hours per day five days per week (105 CMR 164).

– How does daily minimum hour requirement affect calculations of capacity? Most people who enroll in these programs do not attend 5 days per week.

– How does single licensure category for group, individual and family substance abuse counseling affect classification within inventory?

– Are “direct client services” defined on BSAS-issued license? How variable are services?

Slide 10

2013 – 2014: Deliverables

• Deliverable 3: Level III Analysis

Slide 11

Deliverable Description Date (2014)

Identification of key questions

• Prioritize areas for further analysis• Ascertain whether there are areas where additional targeted data

collection is desirable/feasible

January

Estimation of Need • By service/provider/bed type• Including projections of future need

January – March

Definitions • Drafted and vetted with stakeholder participation• To include ideal occupancy rates and other standards

February – March *Deliverable 2

Inventory • Start with services included in Deliverable 1 Maps, with potential for additional refinement

January - May

Analysis of Capacity

• Based on accepted industry standards, where possible• Standards vetted with experts and stakeholders, if needed

April - June

Issues Brief • Identification of laws, policies, etc. known to affect system• Narrative description of expected effect

May - July

Public Hearings • Goal to hold hearings in geographic areas of state identified as being over- or under-capacity in analysis

August – October

Final Report • Completed and submitted to legislature December*Deliverable 3

Slide 12

Agenda

• Goal of meeting

• First health planning analysis: Behavioral Health– Priority Area– Timeline & Deliverables

• Methodology for selecting key questions & approach for analysis– Health Resource Planning definition “refresher”– Taxonomy

Health Resource Planning in Brief

• Key elements of health planning:

– Inventory/Supply: how many units of a service are currently operating in the Commonwealth?

– Capacity: What volume of service is each supply unit able to provide?

– Demand: How many units would have to exist to meet the needs of all residents of the Commonwealth?

– Forecasting: How is supply and/or demand expected to change in the future?

– Gap Analysis: Is current supply sufficient to meet current and future demand?

• Health Planning is not best suited to address:– Policy Questions– Payment Questions– Scope of work Questions

Slide 13

Behavioral Health

Slide 14

• Developing a taxonomy of the care system

Slide 15

Wrap-up

• Questions/discussion• Next steps