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Southeastern Center 3 Year Local Business Plan 2007-2010 Update

By Bernard Adams,2014-04-11 12:03
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Every county, through an area authority or county program, shall provide for the development, review, and approval of an LME business plan for the

Southeastern Center 3 Year Local Business Plan 2007-2010 Update

    Every county, through an area authority or county program, shall provide for the development, review, and approval of an LME business plan for the management and delivery of mental health, developmental disabilities, and substance abuse services. An LME business plan shall provide detailed information regarding how the area authority or county program will meet State standards, laws, and rules for ensuring quality mental health, developmental disabilities, and substance abuse services, including outcome measures for evaluating program effectiveness. The business plan shall be in effect for three State fiscal years.

    The current local business plan was developed to cover the three fiscal years from July 1, 2007 through June 30, 2010.

    During that period the agency has experienced a change in administrative leadership. On June 3, 2009, under the new leadership, the Management Team reviewed and revised the strategic objectives associated with this business plan. This document reflects the review process, including all deleted, revised, and new strategic objectives.

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    Southeastern Center 3 Year Local Business Plan 2007-2010 Update

    Year 1 July 1, 2007 to June 30, 2008

    OBJECTIVE TARGET DATE PERSON RESPONIBLE STATUS Ensure that the instrument for the annual performance evaluation of the Area 7/1/07 Met Area Director and

    Area Board Chair Director is in compliance with the key functional areas addressed in Communication

    Bulletin 20, Area Director Annual Evaluation Criteria.

    Support CFAC in the development of by-laws that are in compliance with Session Law 7/1/07 Met Area Director and

    Customer Services 2006-142 House bill 2077 (Part 4A 122C-170).

    Director

    Execute an agreement between CFAC and the Area Board that delineates the roles 7/1/07 Met Area Director and

    Area Board Chair and responsibilities of each in respect to the other party, channels of communication

    between them and a process for resolving disputes.

    To move to adequate space that allows improved privacy for meetings and 7/1/07 Met Directors of Customer Services, &

    Provider Services telephone conversations with consumers.

    The LME will meet Best Practice Standards for internal QI projects. 8/31/07 Met QM Director

    To move Provider Services (PS) Department to space that will ensure compliance 9/30/07 Met Director, Provider Services with HIPPA rules when discussing client specific monitoring issues and client specific

    contracts for MH/DD/SA consumers.

    Review the by-laws of the Area Board and revise as needed to comply with 12/31/07 Area Director and Not Met Communication Bulletin 60 Legislative Changes to the Structure of Area Boards. Area Board Chair This objective was extended to the 2008/2009 Fiscal Year

    Ensure that the board membership reflects equitable representation from 1/1/08 Area Director and Met Brunswick, New Hanover and Pender Counties. Area Board Chair Meet all Division Utilization Review readiness criteria. 6/30/08 Director, Care Management Met To conduct quarterly clinical case review of high-risk consumers who have used crisis 6/30/08 Service Management Director Met and inpatient services multiple times and high cost consumers (top 10% in each

    target population), to assess whether current services are assisting the consumer to

    develop symptom and crisis management, are cost effective, are not encouraging

    dependency on paid services, engage natural supports, are being delivered in 2

compliance with service definitions. Based on the clinical case review, care

    coordinators will consult with providers and participate in treatment planning

    meetings.

    To implement a system to identify and track children and adolescents placed in 6/30/08 Provider Services Director, System of Met residential treatment facilities, transferred to other facilities within the same level or Care Coordinator to other levels of care through regular contact with providers and Brunswick, Pender,

    and New Hanover DSS.

    Review the current terms of all Area Board members and make necessary 6/30/08 Area Director & Area Board Chair Met adjustments so that all terms are consistent with the legislative limits of no more

    than 2 consecutive terms of three years each. ( over the next three year cycle) -

    Deleted by Area Director because this goal is not limited to 3 years

    Review the qualifications or attributes of each board member to fill required 6/30/08 Area Director & Area Board Chair Met categories of membership to comply with the legislative mandate that not more than

    50% of the board members may be comprised of a clinical professional from one of

    the disability fields, a family member or individual from a citizen’s organization of

    one of the disability groups, and at least one openly declared consumer from one of

    the disability groups. ( and over the next three-year cycle make the adjustments

    needed) - Deleted by Area Director because this is not limited to 3 years

    Achieve Best Practice compliance with all required outcome measures and needs 6/08 QM Director (Delete) assessments.

    This objective was deleted by Management Team because it is too general and

    more specific objectives have been created

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    Southeastern Center 3 Year Local Business Plan 2007-2010 Update

    Year 2 July 1, 2008 to June 30, 2009

    OBJECTIVE TARGET DATE PERSON RESPONIBLE STATUS Continually ensure that two board members with financial expertise are appointed. 7/1/08 Area Director and Area Board Chair Met Providers are expected to use web-based connectivity to have direct access to applicable 7/1/08 Chief Fiscal Officer & IT Director Met client data, service authorization, and claims adjudication. The specific objective is to

    automate claims, billing, and payment processes through a health care services

    management system designed to integrate with a provider system.

    Improve Southeastern Center’s website to make it a better resource for communication 7/1/08 IT Director Met and education for providers and the community at large.

    Assist providers with upgrading or implementing information systems by making surplus 7/1/08 IT Director Met equipment available for their use. This will assist in the automation of claims processing.

    Automate claims, billing and payment process by replacing the current legacy CMHC 7/1/08 Chief Fiscal Officer & IT Director Met system with Netsmart Technologies, Inc. Health Services Information System (HSIS),

    Avatar Managed Services Organization (MSO) System integrated with the CareLink

    System.

    All consumers to have an accessible and meaningful crisis plan and “hot sheets” (or 7/1/08 Director, Customer Services and Care Met Advanced Directive), especially for those who have had inpatient care in the last 60 days, Management

    to ensure planned, respectful care between all levels of crisis intervention, including

    inpatient care. To be accomplished through education to providers and consumers with

    the support of CFAC and the Peer Wellness Resource Center.

    To improve the discharge planning process for those returning to the community from 7/1/08 Care Coordinator for State Facilities Met inpatient, residential and other institutional settings by the continued development of

    teleconferencing as a tool to improve this process and by increasing staffing to ensure

    integration of planning with the state facilities.

    To engage high-risk consumers in accessible, high quality care by developing a group of 7/1/08 Care Coordinator for State Facilities Met LME and Crisis Services stakeholders to identify and outreach those who have used Crisis

    and inpatient services multiple times. This includes insuring transition between levels of

    care and maintaining a caseload of those who do not have a provider as well as following

    up with providers to improve the Crisis Plans of consumers who receive emergency

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services while assigned to a clinical home provider. Recommendations for modifications

    for crisis plans are to be transmitted to providers for consumers with a clinical home.

    To provide follow-up STR for 5% of consumers referred to community (generic/faith-7/1/08 STR Manager Met based) resources or basic benefits to determine level of engagement and to follow up on 15% of consumers for whom no PCP is received in 45 days following a referral for

    enhanced services. To develop a position dedicated to the care coordination functions

    of follow-up.

    To partner with Provider Services, Quality Management, and Service Management as the 7/1/08 Director of Customer Services Met role of monitoring and provision of technical assistance is expanded. To increase staffing

    of a Client Advocate to assist in this effort.

    The Business Management and Claims Adjudication Departments are in the process of 7/1/08 Chief Fiscal Officer & IT Director Met implementing a new computer system that is designed for and encompasses all phases

    of financial management, service authorizations, and claims adjudication. This computer

    system will provide a full array of financial accountability and reporting devices.

    Human Resources intend to identify and implement strategies to recruit licensed, well-7/1/08 HR Manager Met trained and highly competent staff.

    HR will develop skill set training for staff. 7/1/08 HR & IT Director (Delete) This objective was deleted by Management Team because it is too general and more specific objectives have been created

    Establish a Utilization Review system to select and review 10% of Medicaid PCPs and 25% 7/1/08 Service Management Director Met of State Funded PCPs submitted to the LME and provide feedback and technical

    assistance to providers through the Provider Relations Division.

    To identify and track children and adolescents placed in residential treatment facilities, 7/31/08 Provider Services Director & System of Met transferred to other facilities within the same level or to other levels of care through Care Coordinator regular contact with providers and Brunswick, Pender, and New Hanover DSS. System of Care Coordinator

    Expand technical assistance activities to include 1) On-site education, problem-solving, 7/31/08 Provider Services Director Met training and coaching depending on a providers particular needs; 2) service-specific

    provider forums to address challenges for these providers, 3) topic-specific forums such

    as writing policies and procedures, quality improvement plans and activities, client

    rights, documentation, child and family teams, service authorization documentation.

    Support and strengthen our provider network by coordinating competency-based 7/08 Provider Services Director Need instruction locally in areas critical to provider operations, such as Community Support Different Delivery, effective supervision of direct care staff, person-centered and crisis planning, Goal.

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evidence based and clinical best practices, working with special populations, DSM-IV

    diagnoses, cross-disability, and other training as requested by providers.

    This objective has been revised and extended to the 2009/2010 Fiscal Year

    Continue to connect consumers, providers, and community agencies to housing by 7/31/08 Housing Specialist Met maintaining a frequently updated internet web page with housing resources for

    individuals, providing “Street Sheets”, which has a map of the community resources, and

    serve as the lead agency in the monthly Permanent Supportive Housing Coalition to link

    and track consumers connected to services and housing.

     Develop at least one home for the 18-21 year old population who are leaving 8/31/08 Quality Management & Provider Met residential or therapeutic foster care who need transition service that includes education Services Directors and employment. The home would specialize in the delivery of both evidenced-based

    supported employment and evidenced-based supported education. This will be

    accomplished by first forming a committee to bring together different departments to

    discuss the complementary service array that would meet the needs of this population

    and to meet with providers to increase their understanding of the best practices that

    could be used, provide technical assistance, training, etc.

    Develop a provider satisfaction survey to be completed once a year in 2008 and at least 12/08 QM Director Not Met annually thereafter, in order to facilitate improvement of LME procedures and processes

    and improve communication.

    This objective was extended to the 2009/2010 Fiscal Year

    Provide an authorization and review process that gives providers of service rapid and 12/31/08 Care Management Director, & IT Met efficient access to service authorization and feedback related to authorization requests Director and service planning reviews. The system used will be entirely electronic and will allow

    providers to submit plans, authorization requests, and documentation in electronic

    format and receive feedback in the timeframe mandated by the current performance

    agreement. Authorizations will be sent electronically and providers will have access to

    their authorization records in the LME system. Providers will use a web based system,

    Care Link, to submit information and have access to authorization records, status of

    authorizations, and feedback on documentation submitted. Authorization and utilization

    management of service will be done through a new system, Netsmart Avatar, to be

    operational by June 30, 2007. (15 minutes for routine requests and 30 minutes for

    complex, specialized services). This was deleted by Management Team because the

    timeline was not accurate.

    Facilitate the monthly Provider meeting to transition to a provider-managed meeting 1/31/09 Provider Services Director Met

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that providers view as meaningful and effective.

    Develop a system for promoting and supporting the use of evidenced-based service 1/31/09 QM Director Met models and best practices. Providers will accomplish this through training opportunities

    and ongoing monitoring of the use of best practices.

    Review the by-laws of the Area Board and revise as needed to comply with 6/25/09 Area Director and Area Board Chair Met Communication Bulletin 60 Legislative Changes to the Structure of Area Boards.

    Obtain accreditation in accordance with Communication Bulletin 50 and Division Director 3/20/09 QM Director Not Met Mike Moseley’s memo of November 7, 2006.

    This objective was extended to the 2009/2010 Fiscal Year

    To conduct quarterly clinical case review of high-risk consumers who have used crisis and 6/30/09 Service Management Director Met inpatient services multiple times and high cost consumers (top 10% in each target

    population), to assess whether current services are assisting the consumer to develop

    symptom and crisis management, are cost effective, are not encouraging dependency on

    paid services, engage natural supports, are being delivered in compliance with service

    definitions. Based on the clinical case review, care coordinators will consult with

    providers and participate in treatment planning meetings.

    To implement a system to identify and track children and adolescents placed in 6/30/09 Provider Services Director, System of Met residential treatment facilities, transferred to other facilities within the same level or to Care Coordinator other levels of care through regular contact with providers and Brunswick, Pender, and

    New Hanover DSS.

    Review the current terms of all Area Board members and make necessary adjustments 6/30/09 Area Director & Area Board Chair Met so that all terms are consistent with the legislative limits of no more than 2 consecutive

    terms of three years each. ( over the next three year cycle) - Deleted by Area Director

    because this goal is not limited to 3 years

    Review the qualifications or attributes of each board member to fill required categories 6/30/09 Area Director & Area Board Chair Met of membership to comply with the legislative mandate that not more than 50% of the

    board members may be comprised of a clinical professional from one of the disability

    fields, a family member or individual from a citizen’s organization of one of the disability

    groups, and at least one openly declared consumer from one of the disability groups.

    ( and over the next three-year cycle make the adjustments needed) - Deleted by Area

    Director because this is not limited to 3 years

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    Southeastern Center 3 Year Local Business Plan 2007-2010 Update

    Year 3 July 1, 2009 to June 30, 2010

    OBJECTIVE TARGET DATE PERSON RESPONIBLE STATUS To initiate and complete an annual assessment in our three counties to identify 7/1/09 Provider Services Director Met community strengths and needs with an emphasis on natural services and supports,

    and evidence-based practices.

    To enhance emergency services that include a range of options to include mobile 7/1/09 Director, Customer Services Met crisis teams and a response by law enforcement of Crisis Intervention Team (CIT)

    trained officers with the development of a Crisis Plan and its subsequent

    implementation. This includes training for Magistrates and Emergency Department

    staff to ensure the use of the least restrictive level of care.

    To develop a defined protocol for Customer Services. 7/1/09 Director, Customer Services Met To develop a fully functioning, self-governing Consumer and Family Advisory 7/1/09 Director, Customer Services Met Committee educated about clinical practice and new models of services. This includes their participation in Quality Management activities and becoming educated about aggregate data reports and Business/Strategic Planning. To enhance quality of care by assisting providers to identify three meaningful quality 7/1/09 Provider Services & QM Directors Met indicators and to offer technical assistance to set objectives, identify sources of

    information and develop mechanisms for tracking the quality indicators. These

    quality indicators could function as providers QI study.

    Increase community capacity for evidenced based and clinical best practices and 7/31/09 Provider Services Director Met specialized treatment services by encouraging providers to locate services in or very near to our catchment area. Gaps in service include Child and Adolescent Day

    Treatment in Pender and Brunswick Counties, Day Habilitation for DD population in

    two counties, sex offender specific residential treatment facilities, Level IV facilities,

    Adolescent PRTF, evidenced based practices for children and families and substance

    abuse services, residential substance abuse services for adolescents, Social Setting

    Detox, residential services for the DD population. Increase community capacity and

    therefore, consumer choice among outpatient substance abuse providers. The PS

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staff will continue to identify and encourage providers to establish evidenced based

    practices, to increase community capacity for un-served and under-served

    populations and support expansion of services into our two more rural counties.

    To assess satisfaction with housing services by completing a yearly consumer and 7/31/09 Housing Specialist Met family “Housing Questionnaire” to determine preferences with current and possible

    living situations in order to guide future development projects. Both the number of

    surveys and outcomes of surveys are measured for reliability.

    To develop and maintain a searchable database of providers of basic and enhanced 8/09 Provider Services & IT Directors services, accessible to the public on our website to allow the search by practice 8/30/09

    specialty and location. Community stakeholders have told us that this would help

    them find service providers.

    This objective was extended to a new target date.

    HR will review, develop, and revise position classification/job descriptions of the LME 7/1/09 Management Team staff to reflect changes that occur due to State requirements of LME Programs.

    This objective was extended to a new target date 9/30/09

    Develop a provider satisfaction survey to be completed once a year in 2008 and at 9/30/09 QM Director least annually thereafter, in order to facilitate improvement of LME procedures and

    processes and improve communication.

    Obtain accreditation in accordance with Communication Bulletin 50 and Division 12/31/09 QM Director Director Mike Moseley’s memo of November 7, 2006.

    Develop a competency-based instruction calendar for local instruction for provider 12/31/09 Provider Services Director operations. Identify competency needs by data trends from a competency survey

    sent to the community of providers and the provider plans of correction.

    Utilize consumer outcomes instruments for analyzing provider performance in 7/09 QM Director Not Met treatment efficacies. This will be accomplished through use of NC TOPPS reports, which are made available by the Division, and through review of provider specific NC

    TOPPS reports. Also, for services for which there is no standardized outcome

    measure, such as residential services and ADVP, we will request that providers submit

    the results of their outcome studies for evaluation.

    This objective has been revised to the following with an extended target date:

    Review and analyze NC-TOPPS data for system and provider community. Identify 12/31/09

    areas of concern and engage providers in dialogue regarding (1) noncompliance with

    data submission standards and (2) QI strategies for increasing treatment efficacy.

    The following objective was added: 12/31/09 Care Management Director

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Implement standard medical necessity and level of care protocols for authorization of

    state funded services.

    Implement a standard tool to use in review of comprehensive clinical assessments

    and person-centered plans

    The LME will provide opportunities for private providers to be aware of the uniform 12/31/09 Care Management Director Met practices, clinical protocols, and performance expectations for utilization review and

    utilizations management for state funded services. The LME will follow the same

    practices and criteria as those of the Division of Medical Assistance and Value Options

    as those practices apply to target populations and state funded services. A

    standardized monitoring tool will be developed to provide uniform review of person-

    centered plans and medical necessity criteria for service authorization.

    Engage providers in an ongoing process of Quality Improvement through their 12/31/09 QM Director Met completion of required QI projects. Utilize a supportive and educational approach to

    introduce concepts around the studies and offer technical assistance as needed.

    Emphasize the value of such a learning experience and how it relates directly to our

    mission of excellence and quality. The LME will review provider QI projects, which are

    to be submitted, and provide feedback to the provider as to the quality of its projects.

    Increase specialized and evidenced-based educational and/or vocational options 12/31/09 QM & Provider Services Directors available to CAP Waiver and IPRS geriatric DD consumers, including the medically challenged. Recruit at least one provider for Day Supports (IPRS YM580) and one provider for Adult Day Health Care. Providers will be strategically located to

    accommodate all three counties.

    The following objective was added with a new target date: 6/30/10 Care Coordinator for State Facilities To reduce risk of recidivism through participation in treatment team meetings on site

    at state facilities or via teleconferencing, by assisting the consumer to choose a

    provider prior to discharge, and though contact with the consumer and provider

    following discharge, determine if provider has engaged consumer in treatment. If

    consumer is not successfully engaged in treatment, determine what steps need to be

    taken to assist the consumer to receive and engage in treatment that will reduce

    future hospitalization.

    The following objective was added with a new target date: 6/30/10 Service Management Director To conduct quarterly clinical case review of high-risk consumers who have used crisis

    and inpatient services multiple times and high cost consumers (top 10% in each target

    population), to assess whether current services are assisting the consumer to develop

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