2019 five county community board meeting · 2019. 3. 28. · halifax agricultural center. •...

2016 Board of Directors Meeting

2019 Five

County Community

Board Meeting

January 28, 2019

FIVE COUNTY COMMUNITY BOARD AGENDA January 28, 2019 DINNER (SERVED AT 6:30 p.m.)

SPEAKER PAGE PURPOSE 1. Call to Order- Matters of the

PublicMarcelle Smith, Chair 1 Information

2. Opening Remarks Marcelle Smith, Chair 2 Information

3. Approval of October 22, 2018Meeting Minutes

Marcelle Smith, Chair 3 Action

4. Local CFAC Update Angelena Kearney-Dunlap 5 Information

5. Presentations

A. Community Relations Report

Elliot Clark 6 Information

B. Network Management Adequacy and Accessibility Analysis

Leslie Gerard 7 Information

C. Community Operations Annual Report

Elliot Clark 8 Information

D. Corporate Training & Development Annual Report

Revella Nesbit Information

6. Community Updates Marcelle Smith, Chair 10 Information

7. Closing Remarks Marcelle Smith, Chair 11 Information

Adjournment

FIVE COUNTY COMMUNITY BOARD MEMBERS

NAME PHONE EMAIL

Franklin County

Cedric K. Jones, Sr. (919) 495-1379 [email protected]

T. Allen Gardner, Jr. (919) 815-8990 [email protected]

Jacqueline Sills (919) 215-5273 [email protected]

Granville County

Halifax County Marcelle Smith, Chair

(252) 526-1861

[email protected]

Regina Schaaf-Dickens (252) 308-2994 [email protected]

Vacant

Vance County R. Dan Brummitt

(252) 432-4774

[email protected]

Danny Wright, Vice Chair (252) 432-1141 [email protected]

Vacant

Warren County

CFAC Angelena Kearney-Dunlap (252) 213-9932 [email protected]

Edgar Smoak (919) 819-0181 [email protected]

Albert H. Freeman (919) 485-9339 [email protected]

Thomas Lane (919) 906-4817 [email protected]

Bertadean Baker (252) 213-2598 [email protected]

Constance Davis (252) 213-0182 [email protected]

Arconstar Powell (252) 213-9773 [email protected]

mailto:[email protected]



FIVE COUNTY COMMUNITY BOARD AGENDA ITEM

MEETING DATE: January 28, 2019 AGENDA ITEM: 1

SUBJECT: Call to Order – Matters of the Public

BRIEF SUMMARY: Marcelle Smith, Chair, calls the meeting to order. The public may address the

Community Board.

REQUESTED ACTION: None

ATTACHMENTS: No



SUBJECT: Opening Remarks

BRIEF SUMMARY: Marcelle Smith, Chair, will provide opening remarks.

REQUESTED ACTION: Information Only

ATTACHMENTS: No



SUBJECT: Approval of the October 22, 2018 Meeting Minutes

BRIEF SUMMARY: The minutes for the October 22, 2018 Five County Community Board

meeting are attached for approval.

REQUESTED ACTION: Approve the minutes for the October 22, 2018 Five County Community

Board meeting as presented.

ATTACHMENTS: Yes

Five County Community Board

Meeting Minutes October 22, 2018

Members Present: Marcelle Smith, Chair, Dan Brummit, Constance Davis, Angelena Kearney-Dunlap, Albert Freeman, T. Allen Gardner, Cedric Jones, Thomas Lane, Arcornstar Powell, and Edgar Smoak

Members Absent: Danny Wright, Vice Chair, Bertadean Baker, Regina Dickens, and Jacqueline Sills

Staff Present: Elliot Clark, Michael Norton, and Felicia Williams

1. Call to Order

Marcelle Smith, Chair, called the meeting to order at 7:02 p.m.

Matters of the Public Any citizen may address the Community Board. No citizen addressed the Community Board.

2. Opening Remarks Opening remarks by Marcelle Smith, Chair, welcomed everyone to the meeting.

3. Approval of the July 23, 2018 Meeting Minutes The minutes from the Monday, July 23, 2018 Five County Community Board meeting were reviewed.

Dan Brummit motioned to approve the minutes as presented. Thomas Lane seconded the motion. All in favor. Motion carried.

4. Local CFAC Update Angelena Kearney-Dunlap, CFAC Representative, provided updates and pertinent information was shared with the Community Board.

5. Special Presentations A. Community Relations Report was presented by Elliot Clark.

B. Annual Fiscal Year County Dashboard Report [July-June] was reviewed by Elliot Clark.

C. Quality Assurance Annual Performance Improvement Plan was reviewed by Michael Norton.

D. Quality Management Annual Report was discussed by Michael Norton.

6. Community UpdatesMarcelle Smith, Chair, requested community updates from the Board.

Information was shared about the new hospital opening in Franklin County.

7. Closing remarksClosing remarks were provided by Marcelle Smith, Chair. The next Five County Community Boardmeeting date will be January 21, 2019.

Albert Freeman motioned to adjourn the meeting. Dan Brummit seconded the motion.

All in favor. Motion carried.

Meeting adjourned at 8:35 p.m.

Community Board Clerk Date



SUBJECT: Local CFAC Update

BRIEF SUMMARY: Angelena Kearney-Dunlap will provide the Local CFAC Update.


ATTACHMENTS: No


MEETING DATE: January 28, 2019 AGENDA ITEM: 5.A.

SUBJECT: Community Relations Report

BRIEF SUMMARY: Elliot Clark, Senior Community Executive, will present the Community

Relations Report.


ATTACHMENTS: Appendix A


MEETING DATE: January 28, 2019 AGENDA ITEM: 5.B.

SUBJECT: Network Management Adequacy and Accessibility Analysis

BRIEF SUMMARY: Leslie Gerard, Network Development and Field Director, will present the

Network Management Adequacy and Accessibility Analysis.


ATTACHMENTS: Appendix B


MEETING DATE: January 28, 2019 AGENDA ITEM: 5.C.

SUBJECT: Community Operations Annual Report

BRIEF SUMMARY: Elliot Clark, Senior Community Executive, will present the

Community Operations Annual Report.


ATTACHMENTS: Appendix C


MEETING DATE: January 28, 2019 AGENDA ITEM: 5.D.

SUBJECT: Corporate Training & Development Annual Report

BRIEF SUMMARY: Revella Nesbit, Director of Corporate Education Training, will present the

Corporate Training & Development Annual Report.


ATTACHMENTS: Appendix D



SUBJECT: Community Updates

BRIEF SUMMARY: Marcelle Smith, Chair, will request community updates from the Community

Board.


ATTACHMENTS: No



SUBJECT: Closing Remarks

BRIEF SUMMARY: Marcelle Smith, Chair, will provide closing remarks.


ATTACHMENTS: No

Appendix A: Community Relations Report NOTES

January 28, 2019

Copyright © 2016 Cardinal Innovations Healthcare. All rights reserved.

FIVE COUNTY COMMUNITY BOARD MEETINGJanuary 28, 2019

January 28, 2019


COMMUNITY RELATIONS REPORTElliot ClarkSenior Community Executive

January 28, 2019


Information provided in this presentation pertains only to the counties in the Cardinal Innovations Healthcare service area. This information is specific to the Cardinal Innovations service area and may not apply to other organizations, providers, stakeholders or individuals outside the Cardinal Innovations service area.

Presentation slides are brief, bullet-points of information and should not be used out of context.

Disclaimer

January 28, 2019


Community Partners MeetingsGeneral Update

– Common themes for FY 1819 Q2 include review of Community Reinvestment Initiatives, 211 Training, Wellness Alliance Initiatives, and TCLI Updates.

– County specific issues and community initiatives drive the content of these meetings. – The board is welcomed and encouraged to attend as schedules and interest permit.

Contact Gina Dement at [email protected] for Interest in Franklin, Granville, or Vance CP MeetingsContact Nancy Hux at [email protected] for interest in Halifax and Warren CP Meetings.

• Highlights– Franklin, Granville, and Vance

• Occurring monthly on 3rd Monday at 10am at Cardinal Innovations Office in Henderson.

• Activities around connecting training for providers and community around referrals for TCLI.

• Wellness Alliance Subcommittee work around advertising services, constructing “Walk in my Shoes” event, contributing to Public Health’s Community Health Assessment, and collaboration with Granville County Schools.

• Faith Connections Subcommittee work around connecting with local churches to offer MHFA and other trainings, and to connect congregations to services.

January 28, 2019


Community Partners Meetings (Cont.)

• Highlights– Warren

• Meeting monthly on 2nd Thursday at Warren County DSS 1pm-2:30pm.

• FY 1819 Q2 focused on promoting position of Mental HealthOfficer within the County.

– Working to ensure adequate customized training available to the officer. – Position has yet to be filled, but is being carried through 3 officers currently

on staff. Position is still posted with the county.– Shared accountability and participation through Warrenton PD and other

stakeholders.

• NC MedAssist Event OTC Medications Giveaway eventpromotion.

– Feb. 21 9am-2pm Warrenton Armory

• Active participation and feedback regarding SB 630.

January 28, 2019


Community Partners Meetings (Cont.)

– Halifax• Occurs monthly on 3rd Monday from 11:30am-1pm at the

Halifax Agricultural Center. • Engagement with Halifax Council on Aging and 211 Training• Expansion on representation from school system to include

RRGSD, Halifax County, and Weldon. Need further expansion to include KIPP and Private Sector.

• Updates on Community Reinvestment Initiative.• Expansion of Mental Health First Aid to Older Adults.

January 28, 2019


Five County Stepping Up Initiative• General Recent Updates

– Warren County Status• Contract between Cardinal Innovations, Warren County Sheriff’s Dept, and

Correctional Behavioral Health.

– Halifax County MH/SUD Court• Vision Behavioral and CCD Pilot• Clinical Staffings

– Plan for continued funding through FY 1920• MOE • Contracts• Grants to support efforts

– Expansion of MH/SUD Court efforts

January 28, 2019


Grants and Special Projects

- North Carolina Healthcare Quality Alliance- HRSA – Rural Communities Opioid Response Planning

- Joining Consortium for action planning.in Halifax County- June 2019 – May 2020 (Pending)

- Granville Vance District Health Department- Innovative Approaches: Improving Systems of Care for Children and Youth

with Special Health Care Needs- 2nd Term of Funding Secured in December 2018- Member of the Committee and Medical Home Subcommittee.

- Medical Home Projects- Interagency release for cross system communication- Medical Coverage and Resource Guide.

- Grant with NC Safer Schools through Department of Public Instruction

- Update: Working with Family Education Initiative in Granville on CIT Youth.

January 28, 2019


Grants and Special Projects (Cont.)

• Opioid and SUD County Specific Committees– Granville Opioid Advisory Committee– Warren SA Committee– SA Committee Planning Grant for Franklin County– Opioid Practice Support Project

• Committee established under grant from The Duke Endowment• Opioid Prescriptive Practice Workflow and Efficacy Models• Expansion of Medication Assisted Treatment to Rural Communities and Primary Care• Halifax and Edgecombe Counties Identified for state model pilot. • Goal: Reduce acute and chronic opioid prescribing by 30% in a 3 year period.

– Update: Expansion of MAT services project in Halifax County, with newMedicaid provider for MAT and OTP. Established Halifax Workgroup inpartnership with Area L AHEC and NCHQA

• Bridge Housing Initiative– TCLI Funded Transitional Living (RFI in process)– Available to all Cardinal Innovations Members– Locations to be determined.

July 21, 2016


Senate Bill 630

- Overview:- Legislation revising the laws pertaining to IVC in order to improve the delivery of behavioral

health services in NC. - LME/MCO community crisis services plan; commitment examiners; transporting agencies;

training; collaboration.- Every LME/MCO shall adopt a community crisis services plan in accordance with this section to

facilitate first examination in conjunction with a health screening at the same location required. - Collaboration with community stakeholders

- NC DHHS Memo- Memorandum for counties to submit Transportation Agreements by January,1 2019 around

transport of IVCs for evaluation and processing. - Limited response to request.- Cardinal outreach efforts

- Chief District Court Judges- Clerk of Superior Court- Sheriff - County Management

January 28, 2019


Senate Bill 630 (cont.)

- Activity Update- Plan for constructing community crisis plans.

- Separate Teams should coincide within the service area of local hospitals:

- 1. Franklin (Maria Parham Franklin - 2. Granville (Granville Health System) - 3. Halifax (Halifax Regional Medical Center) - 4. Vance / Warren (Maria Parham Henderson)

January 28, 2019


Facility Based Crisis Quarterly Data

• Overview:– FY 1819 Q1 Summary

• Referral Outcome Volume• Triage Outcome Data• Activity Wait Times• Readmissions• Occupancy Rates• County Specific Volume• Legal Status Outcome• Payer Source Data

January 28, 2019


Drugs Uncovered Event

Drugs Uncovered: What Parents Need to Know- Event held on January 17th

- 130 Attended including Public, School Representatives, Vance County Sheriff, 5 Providers, Families Living Violence Free, DSS, Public Health, Granville Sheriffs Dept, Henderson PD, CFAC, Halifax County Schools, and County Government.

- Follow Up event on January 30th 6-8pm at VGCC Civic Center- Open Panel Discussion with Providers, Public Health, and Cardinal Innovations

January 28, 2019


Cardinal Innovations Contacts

Connect to Services 1.800.939.5911 For 24 hour referral and crisis

Report concerns and grievances 1.888.213.9687

Comments and Requests 1.800.357.9084

Report fraud and abuse 1.844.231.0963

January 28, 2019


Discussion

• QUESTIONS??– Was this helpful?

THANK YOU FOR YOUR COMMITMENT!

January 28, 2019

APPENDIX B: Network Management Adequacy and NOT ES Accessibilty Analysis

January 16, 2019


Five County Community Board

January 29, 2019

January 16, 2019


AGENDA

January 16, 2019

• Cardinal Innovations Adequacy and AccessibilityAnalysis for FY1819

• Network Management Development Plan

• Community Operations Efforts


2018 Adequacy and Accessibility Analysis Timeline

• November, 2017: Community Operations conducted NeedsAssessment Survey

• March 6, 2018: JCB #278 notification that the due date for theAdequacy and Accessibility Analysis would be September 21,2018

• Analysis based on reporting period of July 1, 2016-June 30,2017and on contracted providers as January 1, 2018

• December 21, 2018: Received pending approval of the 2018Adequacy and Accessibility Analysis

• January 8, 2019: Final approvalJanuary 16, 2019


2018 Adequacy and Accessibility Analysis

• Assures that there is a choice of 2 providers for Medicaid and 1 for Statefunded services within the access standards- if not met at 100% there is agap

• Access standards are 30 miles/30 minutes for Urban and 45 miles/45minutes for Rural (as determined by the State per NC Office of State Budget& Management)

Urban counties- Mecklenburg, Davie, Forsyth, Stokes Rockingham, Alamance, Orange, Cabarrus, Davidson, Rowan, Union, Franklin, Person, Chatham

Rural Counties: Stanly, Caswell, Granville, Halifax, Vance, Warren

• Includes identified needs gathered via the Needs Assessment Survey

January 16, 2019

Copyright © 2017 Cardinal Innovations Healthcare. All rights reserved.January 16, 2019


2018 Adequacy and Accessibility Analysis

January 16, 2019

• Identified Gaps for Five County area:• Child and Adolescent Day Treatment (Medicaid and State)

• Day Supports (State)

• Opioid Treatment (Medicaid and State)

• Residential Level 2 other than TFC (State)

• Residential L2 TFC (State)

• Residential L4 (Medicaid and State)

• SACOT (Medicaid and Sate)

• SA Non-medical Community Residential-all counties (Medicaid)


2018 Needs Assessment

• 2,880 responses; all counties represented; all disabilities represented• Top service barriers: lack of employment, lack of reliable transportation, medical issues,

homelessness/housing issues, no insurance/cannot pay for services, lack of support fromfamily

• Top service needs: Improved provider staff competency, stability and quality of work;Improved availability of services during non-traditional hours, flexibility in scheduling,decreased wait time between appointments (particularly related to out-patient services);Increased provider choice and accessibility, especially for substance use services andmedication management; decreased perception of wait lists; Increased treatment options forchildren and youth (e.g., ages 3-6; SUD for adolescents); increased focus on person centeredthinking; Increased treatment options for dually diagnosed members (I/DD and MH);increased respite options; increased availability of non-English speaking services; increasedavailability of Innovations services; increased understanding of service continuums and howto access them

January 16, 2019


2018 Network Management Development Plan

January 16, 2019

1. Increase residential options for members with co-occurring disorders (MentalHealth/Intellectual Developmental Disabilities).

2. Increase availability of Applied Behavioral Analysis (ABA) and otherresearch-based treatment options for children with Autism Spectrum Disorder(ASD).

3. Provide training opportunities for providers to improve their ability to offertreatment for members with co-occurring disorders (MH/IDD).


2018 Network Management Development Plan Con’t.

January 16, 2019

4. Increase (b)(3) psychiatric consultation services in both the Five Countyregion and Person County.

5. Increase utilization of Cardinal Innovations In-Lieu Of ACTT-Step Downservices.

6. Align contracts and service delivery by Substance Use Disorder residentialproviders with American Society of Addiction Medicine (ASAM) Criteria.

7. Support Cardinal Innovations Psychiatric Residential Treatment Facilities(PRTF) project.


2018 Network Management Development Plan Con’t.

8. Assure follow up within seven (7) days of discharge from an acute caresetting for a minimum of 40% of MH and SUD members.

9. Monitor quality and assure capacity for services identified to supportTransitions to Community Living (TCL) members (Assertive Community Treatment Team (ACTT); Individual Placement and Support- Supported Employment (IPS-SE); Community Support Team (CST); Transition Management Services (TMS); Peer Support Services (PSS); and Individual Support Services).

10. Expand the network for Innovations Supported Living.

January 16, 2019


Community Operations

Overarching General Initiatives across Entire Footprint:• Actively engaged in community planning regarding both the

Stepping Up initiative and opioid-related initiatives across allparticipating counties in our footprint.

• Developing measureable outcomes for tracking social needs• Working with registry team to assess members waiting and

additional supports that may be available to them while waiting(community resources and Medicaid services)

• Targeting certain community members who could benefit fromCardinal education and support to better understand Cardinal’srole, limitations and operational/community efforts.

January 16, 2019


Community Operations Five County Efforts

January 16, 2019

1. Community Reinvestment: Successful program and projectimplementation that meets goals and outcomes set forth withinindividual proposals.

2. Department of Social Services (DSS) Involvement: Engage all DSSDirectors in the quarterly Joint DSS Directors Meeting.

3. Expansion of Behavioral Health clinic: Determine need, and addressthe potential for CCC presence / expanded behavioral health cliniccapacity in Granville county.

.


Community Operations Five County Efforts Con’t.

4. School System: Enhance relationships and improve access to behavioralhealth with our local school systems in Five County territory, with focuson School Board, School Health Advisory Coalitions, administration andExceptional Children / Social Worker leadership.

5. Stepping Up : Assist Five County Stepping Up Initiative to expandmembership, establish new programs, and pursue grant opportunities.

6. Halifax County: Improve current continuum of care in Halifax Countyindicative of solidifying partnership with RHG, improved feedback onservice provision through Halifax Integrated Healthcare Coalition.

January 16, 2019



7. Vance County: Participate in Community Case Management Projectin Vance County and evaluate replication in other counties.

8. Navigate through the process and submit application forHealthcare Professional Shortage Area (HPSA) designation forHalifax County.

9. Franklin County: Partner with Duke Lifepoint / Maria ParhamHospital for the successful operation of Franklin RegionalHospital.

10. Law Enforcement: Link Jail telehealth programs to bridgeprograms that promote linkage and decrease recidivism forinmates.

January 16, 2019



10. Law Enforcement: Link Jail telehealth programs to bridgeprograms that promote linkage and decrease recidivism forinmates.

11. Crisis Continuums: Assist in building of community orientedcrisis continuums as a subset of the Community Partners groups.

12. Plan and implement the County Leadership Engagement project“Walk in My Shoes” in FY 1819.

January 16, 2019

APPENDIX C: Community Operations Annual Report

NOTES

July 1, 2017 – June 30, 2018

Community Operations End of Fiscal Year Report2017 - 2018


Community Engagement

July 1, 2017 – June 30, 2018

FY 2017 – 2018: A total of 19,688 people were trained by Community Engagement employees during a total of 508 trainings.Community Engagement team members attended a total of 541 community events (excluding training) throughout all regions that we currently serve.

242 177 4 85

6512

7130

2062

3984

279 159 0 103

Northern Southern Statewide Triad

Total Community Engagement Trainings

Total Training Attendees

Total Other Events

FY 2017 ‐ 2018

128 106 63

22012059

1212

257 283 256

Northern Southern Triad

Total Community Engagement Trainings

Total Training Attendees

Total Other Events

FY 2016 ‐ 2017Total Trainings by Region



July 1, 2016 – June 30, 2017

FY 2016 – 2017: A total of 5,472 people were trained by Community Engagement employees during a total of 297 trainings.Community Engagement team members attended a total of 796 community events (excluding training) throughout all regions that we currently serve.

128

28

45

70

26

MHFA CIT QPR Cardinal Overview Other77

31

6

111

6

26

44

35

32

Cardinal Overview

CIT (Crisis Intervention Training)

Innovation Waiver Overview

MHFA (Mental Health First Aid)

Other

Psychosis Simulation

QPR (Question, Persuade, Refer)

Stigma

Trauma

FY 2016 ‐ 2017FY 2017 ‐ 2018Total Trainings by Type


Narrative outcome data is available upon request and may be accessed directly via SharePoint

A Champion Connection is a community stakeholder achievement that positively benefits or enhances services and supports to members or that contributes to various CIH business objectives.

There were a total of 72 Champion Connections during FY 2017 ‐ 2018. Please note that this data was not yet being captured in Q1.

Community Relations Champion Connections

41

8 7

3

23

2 3

13

4 5

27

7

25 4 4

22

Central Five County Mecklenburg Piedmont Triad

Q1 Q2 Q3 Q4

Cumulative

July 1, 2017 – June 30, 2018

Copyright © 2017 Cardinal Innovations Healthcare. All rights reserved.July 1, 2017 – June 30, 2018

6

11

4

23

79

2

22

9 10

4

20

Company Branding Political Gain Positive Media Exposure Strategic Alliance

Q2 Q3 Q4Company Branding: CR speaking opportunity and/or logo visibilityPolitical Gain: Interface results in positive connection or alignment with elected officialsPositive Media Exposure: CIH positively referenced in an article, news outlet or social mediaStrategic Alliance: Interface w/ key partners to promote CIH or community education

A Champion Connection is a community stakeholder achievement that positively benefits or enhances services and supports to members or that contributes to various CIH business objectives.

Community Relations Champion Connections by Impact Type


0

1

0 00

1

0 00 0

1 1

0

1

3

1

Central Northern Southern Triad

Q1 Q2 Q3 Q4

Community Relations Legislative Inquiries


Community Relations Performance Highlights

1. Participated in Community Empowerment Initiatives2. Organized Health Care Agreement consensus in Halifax Integrated Healthcare Coalition3. Assisting with procedure development focusing on treatment v. placement at YFS4. Participated in Charlotte Observer interview related to First Responder Data Collaborative focus to reduce MHSUD

crisis calls for service to 911 5. Hand delivered Narcan Kits to key stakeholders across all communities6. Coordinated Mecklenburg FQHC meetings to support integrated care partnership and development of SUD

programming7. Initiated Business Associate Agreement with Community Care Services to support transitional and coordination of

care for high risk/need individuals with SPMI and prescribed an anti‐psychotic medication8. Participated in STEP Treatment Court Leadership with county contracted providers9. Facilitated development of the FY17‐18 Crisis Continuum Work plan with new/modified goals10. Participated in co‐meetings with County Behavioral Health Division to support development of a specialized

provider network to support youth and families in custody


Member EngagementTotal Prevention Strategies Presented

July 1, 2017 – June 30, 2018

614

370

33

447 456

50

FY 2016 – 2017 = 997FY 2017 – 2018 = 1,970

183139

11

348

279

37


Training Type Total Trainings

Achieving a Better Life Experience (ABLE Act) 6

Cardinal Innovations Healthcare Overview for Members 13

Guardianship and Alternatives for Intellectual/Developmental Disabilities and Mental Health 8

Member Engagement Overview 9

Peer Support Specialist 11

Prime for Life (Now That I Am 18) 6

Upward to Financial Stability 11

Wellness Recovery Action Plan (WRAP) 75

Whole Health Action Management (WHAM) 24

Other 85

Member Engagement Total Trainings = 248


Member Engagement Medical Loss Ratio (MLR) activities and hours completed

• Any quality reporting and related documentation in non‐electronic form for wellness and health promotionactivities = 498.75 hours

• Coaching or education programs and health promotion activities designed to change member behavior andconditions (i.e., smoke or obesity) = 1,666.50 hours

• Coaching programs designed to educate individuals on clinically effective methods for dealing with specific chronicdisease or condition = 905 hours

• Public Health education campaigns that are performed in conjunction with state or local health departments = 739.75 hours• Wellness Assessments = 310.50 hours• Blank = 682 hours

TOTAL MLR Hours Completed = 4,802.50

APPENDIX D: Corporate Training & Development Annual Report

NOTES

January 16, 2019


Corporate Training & Development

Community Board Annual Report

January 2019Revella H. Nesbit, M.Ed., LPCS, ODCP

Director, Corporate Training & Development

January 16, 2019


Cultural Competency

Diversity & Inclusion

Professional Continuing Education Credits

Learning Management System

Centralized Training

January 16, 2019




Cultural Competency Accomplishments Cultural Competence Provider Monitoring Tool Revision: Provider requested tool revision to allow for more flexibility in

implementing cultural competence

Cultural Competence Provider Monitoring Tool:70.4% of providers scored in the Full and Emerging categories (FY 17-18)

6 Active Cultural Competence Provider Councils: Provider – led & driven councils invested in promoting Cultural Competencethroughout the network

LGBTQ Learning Collaborative: Provider collaborative created to encourage a learning community for best practices in working with members who identify as LGBTQ.

Provider TIP Sheets: Transportation; Interpretation & Translation; Cultural Competence Monitoring; Cultural Humility; LGBTQ+; Culture

Trainings for providers & staff: 12 trainings were offered in 2018 related to Cultural Competency

Training Topics: Hispanic/Latino Culture; African American Trauma; LGBTQ+; Transgender; Ethics of Cultural Competence Pt. 1 & Pt. 2

Advisory Subcommittee for Latino Affairs (ASLA): Internal committee established to support the Latino community & bringawareness to how we serve this community; 1st Latino Forum – May 4, 2019

January 16, 2019



Inclusion @ Cardinal Innovations Appointment of Chief Diversity & Inclusion Officer

Creation of Diversity Leadership Council

Creation of Diversity & Inclusion Statement

Development of Diversity & Inclusion Strategy

January 16, 2019



Continuing Education Credits NBCC = National Board Certified Counselor

NAADAC = The Association for Addictions

Professionals

Credits applied toward re-licensure for

clinicians

Support best practices/emerging practice

January 16, 2019


Continuing Education Credits - 2018 25 NBCC approved trainings

67.5 NBCC credit hours offered

266 NBCC certificates distributed to Cardinal Innovations staff

186 NBCC certificates distributed to stakeholders

1,010 Registrations for NBCC trainings

January 16, 2019

73%Completion


Continuing Education Accomplishments Future addition of web-based and home-based training options

Approved as a NAADAC continuing education provider

LMS integration providing more efficiency

Staff as subject matter experts

41 Trainers (Cardinal staff, providers, community experts)

7 Grand Rounds

Trainings located in all regions

January 16, 2019



Learning Management System Create a culture of learning and empowerment

Provide flexible learning opportunities

Provide on-demand reporting, analytics and dashboards

Automate registration management, tracking and evaluation

Maintain version control of curricula and training materials

Offer & maintain robust and relevant training resources

Centralize eLearning that is available any time/place to all users

Design & implement customizable training that is proprietary to CardinalInnovations

January 16, 2019


The Learning Center FY 17-18 100% of internal staff have used The Learning Center 60% on average internal staff use The Learning Center monthly 1216 = number of courses available 2861 = number of external training registrations 307 = number of CI trainings created 4.18 out of 5 = average course rating

January 16, 2019


External1. Triad Mental Health Awareness Event2. Provider Direct System Administrator Rules and

Regulations3. Starting a Private Practice Forum4. Sustaining Your Business through Medicaid

Reform5. Financial Matters: Understanding Your Business

by the Numbers

Top 5 Trainings Internal1. Compliance Courses2. Diversity and Inclusion

Curriculum 3. Text Messaging Guidelines

for Care Coordination4. Member Home and

Community Safety Practices

5. Blood Borne Pathogens for Healthcare Professionals

January 16, 2019


Consumer Family Advisory Council

CFAC Microsite Launched April 2018 43 CFAC members registered On-line courses completed include:

CFAC OrientationGetting Started in the Learning CenterMeetings that Get Results Upward to Financial Stability

January 16, 2019


The Learning Center Accomplishments Launch of CFAC Microsite Promotion of The Learning Center as an Employee Benefit Promotion of modules in The Learning Center that align with monthly

Communications’ Thematic Calendar 60 topical articles in 411 11 Trainings for users of Learning Center Learning Center Ticketing System created and enhanced to align with Training

Request Tool Automated employee assignments in The Learning Center

(HIPAA Remediation, Diversity & Inclusion, Compliance, New Hire Assignments) Increased reporting & data collection iCal Training Invitations

January 16, 2019



Centralized Training Model

Member/


Care Coordination

Finance

Service Center

Network

Clinical Operations

Quality Management

Compliance

Provider Training

Employee Training


Looking Forward

Centralization of Training Diversity & Inclusion Strategic Plan Latino Forum – May 6, 2019

Caminando en mis zapatos (Walking In My Shoes) CFAC Microsite Provider Microsite Receipt of electronic payment in The Learning Center NAADAC Continuing Education offering More robust data collection, trending, and outcomes

January 16, 2019


An organization’s ability to learn, and translate that learning into action rapidly, is the ultimate competitive

advantage.”

Jack Welch

January 16, 2019

Franklin County Dashboards

FYTD September 2018

County Funded Program Descriptions

Community CollaborativeFunds allocated for utilization through the leadership of System of Care for the coordination of the Community Collaborative to address needs of members with

SED from ages 21 and under

Daymark Funds allocated for the cost associated with Labs and Medications through Daymark Recovery Services in Vance County.

KARTS County funds are allocated for cost of transportation services for members.

Recovery Innovations Facility Based Crisis

County Funded Program

Central Community Services Funds for use as part of a Client Specific Agreement.

County Funded Program Description


FYTD September 2018

Report data as of November 24, 2018. All graphs are county specific unless otherwise noted.

County Funded Programs*

Central Community Services

Community Collaborative

Daymark

KARTS

Recovery Innovations

Total:

*Please see the County Funded Program Descriptions (Pg. 1) for additional detail

FY Budget

Amount

-16.2%

$111,700

0.0%

16.7%

$0

FYTD

Expenses

$0$87

Franklin Funding

$0

$17,808

$1,452

$106,850

0.0%

% Spent

0.0%$1,452

-$301$1,859

Please note that providers have up to 90 days to submit claims and that this will affect the number of members served and expense amounts on this report. The numbers for

the previous months will be updated each reporting period.

$17,507 15.7%

NOTE: County “Maintenance of Effort” funds targeting local behavioral health needs may be managed by Cardinal Innovations or by the county. Data shown here only represents county funds managed by Cardinal Innovations. Some counties manage all of their "Maintenance of Effort" funding.


FYTD September 2018

Registry of Unmet Needs

Number of Members Served by Age and Diagnosis

Number of Members Served All Age and All Diagnosis

265 262291

44 44 47

2 0 00

50

100

150

200

250

300

350

Jul'1

8

Au

g'1

8

Sep

'18

Child Members Served by DiagnosisAges 3 through 17

MH IDD SUD

432 432391

85 82 82126 133 115

0

50

100

150

200

250

300

350

400

450

500

Jul'1

8

Au

g'1

8

Sep

'18

Adult Members Served by DiagnosisAges 18 and over

MH IDD SUD

30 30

32

29

30

31

32

33

Jul'1

8

Au

g'1

8

Sep

'18

Nu

mb

er o

f M

emb

ers

on

Reg

istr

y

Innovations Registry of Unmet Needs

NOTE: Innovations slots and funding are allocated by the state. MCOs have no ability to fund or expand the number of Innovations slots.

697 694 682

129 126 129

128 133 115

0000000000100200300400500600700800

Jul'1

8

Au

g'1

8

Sep

'18

All Members Served Ages 3 and over

All Diagnosis

MH IDD SUD

NOTE: This is a distinct count of members served. Members with multiple diagnosis will only be counted once. The sum of the previous graph will not be equal to the total in this graph.


FYTD September 2018

Service Category Definitions

Community

Psych Rehab

Residential

PRTF

Emergency Department

Service to help adults with psychiatric disabilities manage their illness and their lives with as little professional intervention as possible.

Hospital emergency department.

Intermediate Care Facility for individuals with Intellectual Disabilities.

Intensive In-Home Services - services provided in the person's home by a small team with at least one Licensed Professional.

BH Long Term Residential

Community Support

Medicaid Waiver for individuals with Intellectual Disabilities.

Hospital-based psychiatric care.

Multisystemic Therapy is a family and community-based therapy for juveniles.

Services received in the community including evaluation, therapy, and psychiatric care.

Outpatient ED

Partial Hosp/Day Tx

Mandated service categories effective 7/1/2013.

IIHS

Definition

Additional supports for Medicaid recipients such as Community Guide and Individual Support.

Assertive Community Treatment Team - services received in the community that address functional areas of the identified population.

Services provided in a hospital Emergency Department on an outpatient basis.

A short-term service for acutely mentally ill children or adults designed to prevent hospitalizations or to serve as a step down for those leaving an

inpatient facility.

Crisis Services

A long-term residential program for people with behavioral health needs.

ACTT

ICF

Group settings that serve people across all disability groups.

Psychiatric Residential Treatment Facilities provide residential care to persons under the age of 21 who need 24-hour supervision and specialized

interventions.

Inpatient

MST

Outpatient

Innovations

Services that are provided in the community.

Community based mental health and substance abuse rehabilitation services and interventions.

Services received in a crisis or emergency situation such as Mobile Crisis and Facility-based crisis.

Service Category

1915 (b)(3) Services


FYTD September 2018

Members Served and Expenses by Service Category

Members Served is based on Member's County of Medicaid Eligibility not on the Provider's physical

location.

Expenses by Service Categories is based on the Total Paid Amount.

*Please see the Service Category Definitions (Pg. 4) for additional detail

2

2

6

17

8

14

17

21

27

20

38

44

47

69

95

898

0

1

5

10

11

15

20

25

25

26

32

38

42

68

119

827

0 200 400 600 800 1000

Partial Hosp/Day Tx

MST

PRTF (Psychiatric ResidentialTreatment Facility)

Crisis Services

Community Support


IIHS

ACTT (Assertive CommunityTreatment Team)

ICF

Outpatient ED

Psych Rehab

Inpatient


Innovations


Outpatient

Distinct Members Served - Medicaid Funding

Jul'18-Sep'18 Jul'17-Sep'17

$21,736

$3,250

$156,408

$15,155

$24,330

$126,143

$90,314

$68,685

$1,299,021

$2,213

$113,001

$172,442

$67,449

$846,481

$388,201

$383,709

$0

$4,639

$153,223

$16,479

$45,286

$127,282

$84,287

$90,068

$1,310,426

$2,868

$94,061

$350,814

$41,914

$758,956

$519,307

$382,940

$0 $400,000 $800,000 $1,200,000

Partial Hosp/Day Tx

MST

PRTF (Psychiatric Residential Treatment Facility)

Crisis Services

Community Support


IIHS

ACTT (Assertive Community Treatment Team)

ICF

Outpatient ED

Psych Rehab

Inpatient


Innovations


Outpatient

Expenses by Service Category - Medicaid Funding



FYTD September 2018




Members Served is based on member's County of Residence not on the Provider's physical

location.

0

0

7

8

19

21

24

208

1

1

6

15

18

21

45

234

0 50 100 150 200 250

Community Support

Psych Rehab


Inpatient

Residential

Crisis Services

Community

Outpatient

Distinct Members Served - State Funding


$0

$0

$26,243

$30,288

$123,525

$5,484

$41,145

$51,062

$595

$560

$18,467

$59,215

$166,811

$0

$162,182

$60,320

$0 $50,000 $100,000 $150,000 $200,000

Community Support

Psych Rehab


Inpatient

Residential

Crisis Services

Community

Outpatient

Expenses by Service Category - State Funding



FYTD September 2018


location.


Members Served and Expense Amounts - Facility Based Crisis & Mobile Crisis Management Services

Medicaid Member served for Facility Based Crisis & Mobile Crisis Services are based on the

Consumers Eligibility. Expenses by Facility Based Crisis & Mobile Crisis Services are based on the total Adjudicated

Amount.

5

11

8

3

0

2

4

6

8

10

12

Facility Based Crisis Mobile Crisis Management

Distinct Members Receiving FBC & MCM Crisis ServicesMedicaid


86

21

00

5

10

15

20

25


Distinct Members Receiving FBC & MCM Crisis ServicesState


$6,442

$2,853

$15,379

$1,100

$0

$2,000

$4,000

$6,000

$8,000

$10,000

$12,000

$14,000

$16,000

$18,000


Expenses by FBC & MCM Crisis ServiceMedicaid


$10,799

$653

$23,062

$0

$5,000

$10,000

$15,000

$20,000

$25,000


Expenses by FBC & MCM Crisis ServiceState



FYTD September 2018

Entity Type Definitions

Hospital Non-contracted Hospitals for which we reimburse Emergency Department services and Inpatient services.

Physician's Group of HospitalsA group of physicians, contracting or non-contracting, associated with hospitals but not employed by the facility. Considered non-contracting

unless otherwise specified.

Inpatient Hospital providing contracted behavioral health Inpatient and Emergency Department services.

Comprehensive Community

Clinics

Agency based entities providing a number of services, including assessment, enrollment, Outpatient and Psychiatric services, and serve at least

two disabilities. They are designated points of entry that ensure easy access for members.

Inpatient/Outpatient Hospital providing contracted behavioral health Emergency Department and Outpatient services.

Licensed Independent Practitioner (LIP) Groups are a group of clinicians, Therapists, Psychiatrists, Psychologists, etc. providing outpatient services

such as therapy, psychiatric care, assessment, and testing. They contract with the MCO as a group.

Mandated Entity types effective 11/1/2017.

Entity Type Definition

Agency

Senate Bill 163

Other Other entity not elsewhere defined.

County Agency Public health agency.

Neuro Behavioral Center State

Institution

State run medical and nursing care facility for individuals with severe or moderate developmental disability (IDD) and medical conditions of a

serious or chronic nature requiring 24 hour care.

ICFMR State Institution Intermediate Care Facilities for Persons with Mental Retardation (ICF/MR) - State run Intermediate Care Facility serving IDD Adults and children.

ADATC State InstitutionAlcohol Drug Abuse Treatment Center (ADATC) State Institution-A state run SUD Adult facility which provides medical detox and medically

monitored residential treatment.

Residential Facility located in-catchment but affiliated with another MCO/LME with local Quality Management mandated site visits and limited

oversight required.

Psych State Institution State run Psychiatric care facility for children and adults.

Agencies provide one or more enhanced clinical/therapeutic/rehabilitative/habilitative service to MH, SUD, IDD, or multiple diagnosis groups.

LIPLicensed Independent Practitioner (LIP) - Individual Clinicians, Therapists, Psychiatrists, Psychologists, etc. that are individually contracted with

the MCO. They provide outpatient services such as therapy, psychiatric care, assessment and testing.

LIP Group


FYTD September 2018

*Please see the Entity Type Definitions (Pg. 8) for additional detail

Vision Behavioral Health Services, LLC Comprehensive Community Clinics

At-home Counseling Services, Inc LIP Group

DAYMARK Recovery Services, Inc.(Cabarrus Center) Comprehensive Community Clinics

North Carolina Neuropsychiatry, P.A. LIP Group

Central Community Services, LLC Agency

Triangle Primary Care Associates, PLLC LIP

Therapeutic Resource Associates, PA LIP

Holly Hill Hospital Inpatient

Freedom House Recovery Center, Inc Comprehensive Community Clinics

Vance Recovery, PC Agency

Top 10 Providers by Members Served - Franklin Entity Type

Provider Information

Access Call Center

5,303 5,665 5,068

5 5 5

0

1

2

3

4

5

6

0

2000

4000

6000

8000

Jul'1

8

Au

g'1

8

Sep

'18

Spee

d t

o A

nsw

er (

secs

)

# o

f C

alls

Total Number of Calls and Speed to Answer

2.1% 2.0% 2.2%

0%

2%

4%

6%

8%

10%

Jul'1

8

Au

g'1

8

Sep

'18

Per

cen

t o

f C

alls

Ab

and

on

ed

Call Abandonment Rate

Access HEDIS Benchmark 8.6% Cardinal Innovations Target 5.0%

0101010203030407282937

146191

415868

0 200 400 600 800 1000

Other

Neuro Behavioral Center State Institution

County Agency

ADATC State Institution

Inpatient/Outpatient

ICFMR State Institution

Psych State Institution

Comprehensive Community Clinics

Inpatient

Physician's Group of Hospitals

Hospital

LIP Group

LIP

Agency

Total Providers

All Cardinal Innovations Providers by Entity Type

Note: The Top 10 Providers by Members Served is based on member's County of Medicaid Eligibility not on the Provider's physical location.


FYTD September 2018

Members Served by Age and Diagnosis

Members Served and Expense Amounts by Service Category - Medicaid

Members Served and Expense Amounts by Service Category - State

Members Served and Expense Amounts for Crisis Services


Analysis:

Please note that providers have up to 90 days to submit claims and that this will affect the number of members served and expense amounts on this report. The

numbers for the previous months will be updated each reporting period.

Call Center information in the charts above reflect Cardinal Innovations data and are not county specific.

Medicaid funded Outpatient services were the most utilized services for 1st Qtr FY1819. 1915 (b)(3) services had a 25% increase in utilization (95 to

119) with a 34% increase in expense ($388,201 to $519,307). ICF had the highest expense of $1,310,426 followed by Innovations with an expense

of of $758,956. Inpatient had the largest percentage increase in expense of 103% ($172,442 to $350,814) with two providers accounting for

approximately 75% of the expense.

State funded Outpatient services were the most utilized services for 1st Qtr FY1819. Community services had the largest percentage increase in

utilization of 88% (24 to 45) and in expense of 294% ($41,145 to $162,182). This can be attributed to Peer Support Services, which accounted for

73% of the entire expense for Community Services in the 1st Qtr FY1819.

Medicaid and State funded Facility Based Crisis increased both in utilization and expense for 1st Qtr FY1819. State funded Facility Based Crisis had

the largest percentage increase in utilization of 163% (8 to 21) and in expense of 114% ($10,799 to $23,062). Medicaid and State funded Mobile

Crisis Management decreased in both utilization and expense. State funded Mobile Crisis Management had the largest percentage decrease in

utilization of 100% (6 to 0).

Average speed to answer and call abandonment rate remained consistent for the quarter.

Child MH members served has been gradually increasing, whereas Adult MH members served has ben decreasing.

Granville County Dashboards

FYTD September 2018











FYTD September 2018





Daymark

KARTS


Total:


15.7%$18,778

0.0%

% Spent

0.0%$1,558

-$322$1,990



$0

FYTD

Expenses

$0$93

Granville Funding

$0

$19,100

$1,557

$114,602

-16.2%

$119,800

0.0%

16.7%

FY Budget

Amount



FYTD September 2018


Number of Members Served All Age and All Diagnosis Registry of Unmet Needs

191 200 203

23 23 23

1 1 10

50

100

150

200

250

Jul'1

8

Au

g'1

8

Sep

'18


MH IDD SUD

340364

319

110 112 113128 133 124

0

50

100

150

200

250

300

350

400

Jul'1

8

Au

g'1

8

Sep

'18


MH IDD SUD

26

25

27

24

25

26

27

28

Jul'1

8

Au

g'1

8

Sep

'18

Nu

mb

er o

f M

emb

ers

on

Reg

istr

y



531564

522

133 135 136

129 134 125

0000000000

100

200

300

400

500

600

Jul'1

8

Au

g'1

8

Sep

'18


All Diagnosis

MH IDD SUD



FYTD September 2018


Service Category


ACTT

ICF



interventions.

Inpatient

MST

Outpatient

Innovations






inpatient facility.

Crisis Services



Community Support





Outpatient ED

Partial Hosp/Day Tx


IIHS

Definition



Residential

PRTF






Community

Psych Rehab


FYTD September 2018


location.




2

7

0

9

12

25

18

18

21

9

30

30

20

64

101

733

1

1

2

8

11

15

15

18

19

22

26

30

31

63

120

699

0 200 400 600 800

Partial Hosp/Day Tx


MST


IIHS

Crisis Services

Outpatient ED



Community Support

Inpatient

ICF

Psych Rehab

Innovations


Outpatient



$3,078

$99,050

$0

$73,737

$64,494

$23,964

$1,715

$16,058

$69,333

$40,444

$287,776

$1,496,346

$65,663

$823,951

$409,443

$340,299

$10,020

$45,282

$6,185

$73,511

$43,752

$14,714

$1,601

$16,272

$68,685

$85,320

$135,921

$1,515,805

$80,579

$767,879

$479,525

$351,127

$0 $400,000 $800,000 $1,200,000 $1,600,000

Partial Hosp/Day Tx


MST


IIHS

Crisis Services

Outpatient ED



Community Support

Inpatient

ICF

Psych Rehab

Innovations


Outpatient




FYTD September 2018



location.



0

4

5

16

21

29

131

2

4

5

21

23

45

124

0 50 100 150

Community Support

Inpatient


Residential

Community

Crisis Services

Outpatient



$0

$34,276

$15,875

$90,288

$43,857

$4,926

$24,373

$1,173

$13,484

$15,227

$136,188

$46,385

$8,155

$40,078

$0 $50,000 $100,000 $150,000

Community Support

Inpatient


Residential

Community

Crisis Services

Outpatient




FYTD September 2018




Amount.


location.


9

14

98

0

2

4

6

8

10

12

14

16




13

9

26

19

0

5

10

15

20

25

30




$15,475

$2,303

$13,149

$1,065

$0

$2,000

$4,000

$6,000

$8,000

$10,000

$12,000

$14,000

$16,000

$18,000




$9,127

$1,272

$33,691

$2,303

$0

$5,000

$10,000

$15,000

$20,000

$25,000

$30,000

$35,000

$40,000





FYTD September 2018






LIP Group


oversight required.Senate Bill 163




Institution










Agency






Clinics





FYTD September 2018



Granville Health System-Behavioral Health Services Hospital


Central Community Services, LLC Agency

Carolina Behavioral Care, P.A. LIP Group

Fast Braiin Oxford, LLC LIP Group


Duke University Health System, Inc. dba Duke University HospitalInpatient

Recovery Innovations, Inc. Agency

Vision Behavioral Health Services, LLC Comprehensive Community Clinics

Access Call Center

Top 10 Providers by Members Served - Granville Entity Type


5,303 5,665 5,068

5 5 5

0

1

2

3

4

5

6

0

2000

4000

6000

8000

Jul'1

8

Au

g'1

8

Sep

'18

Spee

d t

o A

nsw

er (

secs

)

# o

f C

alls


2.1% 2.0% 2.2%

0%

2%

4%

6%

8%

10%

Jul'1

8

Au

g'1

8

Sep

'18

Per

cen

t o

f C

alls

Ab

and

on

ed



0101010203030407282937

146191

415868

0 200 400 600 800 1000

Other


County Agency






Inpatient


Hospital

LIP Group

LIP

Agency

Total Providers




FYTD September 2018






Medicaid funded Outpatient services continued to be the highest utilized services for 1st Qtr FY1819. ICF had the highest expense of $1,515,805

followed by Innovations of $767,879. Although Inpatient utilization remained fairly consistent (30 to 26), expense decreased by 53% ($287,776 to

$135,921) from the 1st Qtr FY1718 to the 1st Qtr FY1819. PRTF decreased in utilization by 86% (7 to 1) and in expense by 54% ($99,050 to $45,282).

State funded Outpatient Services was the highest utilized service for 1st Qtr FY1819. Crisis services had the largest percentage increase in

utilization of 55% (29 to 45) and in expense of 66% ($4,926 to $8,155). Inpatient services had the largest percentage decrease in expense of 61%

($34,276 to $13,484). Residential services had the overall highest expense of $136,188 for the quarter.

Medicaid funded Facility Based Crisis remained consistent in utilization, whereas State funded Facility Based Crisis increased in utilization by 100%

(13 to 26) and in expense by 269% ($9,127 to $33,691). Medicaid funded Mobile Crisis Management decreased in utilization by 43% (14 to 8) and

in expense by 54% ($2,303 to $1,065). On the other hand, State funded Mobile Crisis Management increased in utilization by 111% (9 to 19) and in

expense by 81% ($1,271 to $2,303).


Child MH members served has been slightly increasing while Adult MH members served has been slightly decreasing.

Analysis:




Halifax County Dashboards

FYTD September 2018









FYTD September 2018






Total:


FY Budget

Amount

16.7%

$299,500

$0

FYTD

Expenses

$0$253

Halifax Funding

0.0%

% Spent

0.0%$4,219

$49,171$295,028



$49,171 16.4%



FYTD September 2018

Registry of Unmet Needs


Number of Members Served All Age and All Diagnosis

335361 368

16 18 17

3 2 20

50

100

150

200

250

300

350

400

Jul'1

8

Au

g'1

8

Sep

'18


MH IDD SUD

782820

714

151 156 152

144 145 128

0

100

200

300

400

500

600

700

800

900

Jul'1

8

Au

g'1

8

Sep

'18


MH IDD SUD

50

51

50

49

50

51

52

Jul'1

8

Au

g'1

8

Sep

'18

Nu

mb

er o

f M

emb

ers

on

Reg

istr

y



1117 11811082

167 174 169

147 147 1300000000000

200

400

600

800

1000

1200

1400

Jul'1

8

Au

g'1

8

Sep

'18


All Diagnosis

MH IDD SUD



FYTD September 2018


Community

Psych Rehab

Residential

PRTF







Community Support





Outpatient ED

Partial Hosp/Day Tx


IIHS

Definition





inpatient facility.

Crisis Services


ACTT

ICF



interventions.

Inpatient

MST

Outpatient

Innovations




Service Category



FYTD September 2018



location.



3

1

3

6

6

15

33

38

47

35

72

94

79

95

221

1354

0

1

3

7

14

15

31

36

36

37

68

72

78

90

289

1282

0 500 1000 1500

Community Support



MST

Partial Hosp/Day Tx

Crisis Services


ICF

Outpatient ED

IIHS

Innovations

Inpatient

Psych Rehab



Outpatient



$14,982

$70,455

$33,938

$18,623

$37,975

$13,559

$106,915

$1,361,387

$5,603

$186,789

$929,264

$379,224

$193,523

$60,280

$958,289

$470,858

$0

$34,068

$46,576

$41,742

$89,707

$24,757

$111,775

$1,343,903

$4,660

$166,963

$891,785

$359,635

$201,596

$72,373

$1,014,650

$480,167

$0 $400,000 $800,000 $1,200,000 $1,600,000

Community Support



MST

Partial Hosp/Day Tx

Crisis Services


ICF

Outpatient ED

IIHS

Innovations

Inpatient

Psych Rehab



Outpatient




FYTD September 2018





location.

2

10

32

31

30

74

167

2

7

24

30

41

105

189

0 50 100 150 200

Psych Rehab


Crisis Services

Residential

Inpatient

Community

Outpatient



$1,827

$27,214

$6,967

$115,364

$136,500

$149,224

$51,187

$344

$24,623

$6,227

$138,932

$187,393

$194,075

$105,915

$0 $50,000 $100,000 $150,000 $200,000 $250,000

Psych Rehab


Crisis Services

Residential

Inpatient

Community

Outpatient




FYTD September 2018


location.





Amount.

5 5

13

2

0

2

4

6

8

10

12

14




16

5

20

6

0

5

10

15

20

25




$7,850

$825

$24,939

$241$0

$5,000

$10,000

$15,000

$20,000

$25,000

$30,000




$17,991

$481

$31,513

$1,856

$0

$5,000

$10,000

$15,000

$20,000

$25,000

$30,000

$35,000





FYTD September 2018







Clinics








Agency

Senate Bill 163




Institution







oversight required.





LIP Group


FYTD September 2018


RHA Behavioral Health NC LLC Comprehensive Community Clinics

Roanoke Valley Psychiatric Associates, P.A. LIP Group

Statewide Mental Health & Disability Services, PLLC LIP Group

CW Counseling Services, Inc. LIP Group

Halifax Regional Medical Center, Inc. Inpatient

New Beginnings Day Treatment Center, LLC Agency

Edwards' Assessments and Counseling, Inc. Agency

Easter Seals UCP North Carolina & Virginia, Inc. Agency

Structured Family Interventions, LLC Agency

C&M Behavioral Health, PLLC LIP

Top 10 Providers by Members Served - Halifax Entity Type


Access Call Center

5,303 5,665 5,068

5 5 5

0

1

2

3

4

5

6

0

2000

4000

6000

8000

Jul'1

8

Au

g'1

8

Sep

'18

Spee

d t

o A

nsw

er (

secs

)

# o

f C

alls


2.1% 2.0% 2.2%

0%

2%

4%

6%

8%

10%

Jul'1

8

Au

g'1

8

Sep

'18

Per

cen

t o

f C

alls

Ab

and

on

ed



0101010203030407282937

146191

415868

0 200 400 600 800 1000

Other


County Agency






Inpatient


Hospital

LIP Group

LIP

Agency

Total Providers




FYTD September 2018






Analysis:




Medicaid funded Outpatient services continued to be the highest utilized service for 1st Qtr FY1819. Partial Hosp/Day Tx had the largest

percentage increase in utilization of 133% (6 to 14) and in expense of 136% ($37,975 to $89,707). ICF services had the highest expense for 1st Qtr

FY1819 with $1,343,903. 1915(b)(3) Services had the second highest expense of $1,014,650, with a 31% increase in utilization (221 to 289) and only

a 6% increase in expense ($958,289 to $1,014,650).

State funded Outpatient services continued to be the highest utilized services for 1st Qtr FY1819, and utilization increased by 13% (167 to 189) over

the previous fiscal year. Community services had the higest expense of $194,075, with an increase in utilization of 42% (74 to 105) and in expense

of 30% ($149,224 to $194,075) over the previous fiscal year. Expenses for State funded Outpatient services increased by 107% ($51,187 to

$105,915) over the previous fiscal year, some of which can be attributed to an increase of 190% ($25,696 to $74,409) in expenses for Substance

Abuse - Intensive Outpatient services.

Medicaid and State funded Facility Based Crisis increased in both utilization and in expense for 1st Qtr FY1819. Medicaid funded Facility Based

Crisis had the largest increase in utilization of 160% (5 to 13) and in expense of 218% ($7,850 to $24,939). Medicaid funded Mobile Crisis

Management decreased in utilization (5 to 2), whereas State funded Mobile Crisis Management slightly increased in utilization (5 to 6).


Child MH members served have been increasing, whereas Adult MH members served have been decreasing. Both Child and Adult SUD and IDD

members served have remained consistent for 1st Qtr FY1819.

Vance County Dashboards

FYTD September 2018






SED from ages 21 and underCorrectional Behavioral Health

ServicesBehavioral health couneling and support to jail inmates





FYTD September 2018





Correctional Behavioral Health Services

Daymark

KARTS


Total:


13.7%$22,957

0.0%

% Spent

0.0%$2,185

$0$20,400



$0

$140,430

FYTD

Expenses

$0$132

Vance Funding

-$448

$0

$23,405

$2,768

$2,185

16.7%

0.0%

$168,100

-16.2%

0.0%

FY Budget

Amount



FYTD September 2018



327 315 302

24 23 20

10 11 110

50

100

150

200

250

300

350

Jul'1

8

Au

g'1

8

Sep

'18


MH IDD SUD

746809

720

136 140 138285 285 288

0

100

200

300

400

500

600

700

800

900

Jul'1

8

Au

g'1

8

Sep

'18


MH IDD SUD

50 50

51

49

50

51

52

Jul'1

8

Au

g'1

8

Sep

'18

Nu

mb

er o

f M

emb

ers

on

Reg

istr

y



1073 11241022

160 163 158295 296 299

0000000000

200

400

600

800

1000

1200

Jul'1

8

Au

g'1

8

Sep

'18


All Diagnosis

MH IDD SUD



FYTD September 2018


Service Category


ACTT

ICF



interventions.

Inpatient

MST

Outpatient

Innovations






inpatient facility.

Crisis Services



Community Support





Outpatient ED

Partial Hosp/Day Tx


IIHS

Definition



Residential

PRTF






Community

Psych Rehab


FYTD September 2018


location.




2

1

3

3

26

23

26

21

38

49

44

50

57

73

356

1296

1

2

4

7

10

20

23

29

37

42

51

53

55

58

422

1300

0 200 400 600 800 1000 1200 1400

MST

Partial Hosp/Day Tx



Community Support

IIHS

ICF

Outpatient ED


Crisis Services

Psych Rehab

Inpatient

Innovations



Outpatient



$8,924

$10,365

$50,979

$56,120

$58,032

$136,744

$1,208,948

$1,286

$138,342

$43,291

$156,522

$171,194

$853,316

$44,600

$1,556,547

$637,577

$773

$20,008

$10,337

$80,158

$32,383

$84,154

$1,145,760

$2,186

$135,103

$57,647

$166,791

$348,215

$807,420

$38,329

$1,791,118

$717,109

$0 $500,000 $1,000,000 $1,500,000 $2,000,000

MST

Partial Hosp/Day Tx



Community Support

IIHS

ICF

Outpatient ED


Crisis Services

Psych Rehab

Inpatient

Innovations



Outpatient




FYTD September 2018



location.



0

2

3

12

42

56

50

229

3

3

5

5

38

51

66

238

0 50 100 150 200 250

Community Support

Psych Rehab


Inpatient

Residential

Crisis Services

Community

Outpatient



$0

$3,626

$10,044

$54,349

$193,056

$12,336

$133,587

$30,831

$2,280

$3,637

$16,523

$27,988

$228,597

$9,720

$173,191

$88,974

$0 $50,000 $100,000 $150,000 $200,000 $250,000

Community Support

Psych Rehab


Inpatient

Residential

Crisis Services

Community

Outpatient




FYTD September 2018




Amount.


location.


2022

28

18

0

5

10

15

20

25

30




28

9

47

5

0

10

20

30

40

50




$33,654

$2,475

$55,804

$2,853

$0

$10,000

$20,000

$30,000

$40,000

$50,000

$60,000




$33,072

$1,993

$54,199

$1,684

$0

$10,000

$20,000

$30,000

$40,000

$50,000

$60,000





FYTD September 2018






LIP Group


oversight required.Senate Bill 163




Institution










Agency






Clinics





FYTD September 2018





Alliance Rehabilitative Care, Inc Agency

Rehabilitated Support Services, PLLC LIP Group

Henderson Psychological Services, PLLC LIP Group


Women, Children and Family Counseling Services, PLLC LIP Group

Recovery Innovations, Inc. Agency

Carolina Community Support Services, Inc. Agency

Access Call Center

Top 10 Providers by Members Served - Vance Entity Type


5,303 5,665 5,068

5 5 5

0

1

2

3

4

5

6

0

2000

4000

6000

8000

Jul'1

8

Au

g'1

8

Sep

'18

Spee

d t

o A

nsw

er (

secs

)

# o

f C

alls


2.1% 2.0% 2.2%

0%

2%

4%

6%

8%

10%

Jul'1

8

Au

g'1

8

Sep

'18

Per

cen

t o

f C

alls

Ab

and

on

ed



0101010203030407282937

146191

415868

0 200 400 600 800 1000

Other


County Agency






Inpatient


Hospital

LIP Group

LIP

Agency

Total Providers




FYTD September 2018






Medicaid funded Outpatient services continued to be the most utilized services for 1st Qtr FY1819. Community Support had the largest percentage

decrease in utilization of 62% (26 to 10), and also experienced a 44% decrease in expense ($58,032 to $32,383). 1915(b)(3) services had the highest

expense of $1,791,118, with a 19% increase in utilization (356 to 422) over the previous fiscal year. ICF services had the second highest expense of

$1,145,760, followed by Innovations of $807,420.

State funded Outpatient services had the highest utilization for 1st Qtr FY1819. Residential services had the highest cost of $228,597, followed by

Community services of $173,191, with both service categories increasing in expense compared to the previous quarter for FY1718. Inpatient had

the largest percentage decrease of 58% in utilization (12 to 5) and of 49% in expense ($54,349 to $27,988). State funded Outpatient services

experienced an increase in expense of 189% ($30,831 to $88,974) over the previous fiscal year, much of which can be attributed to an increase in

expenses for Opioid Treatment services (from $1,246 to $64,017).

Medicaid and State funded Facility Based Crisis increased in both utilization and expense. State funded Facility Based Crisis had the largest

percentage increase in utilization of 68% (28 to 47) and in expense of 64% ($33,072 to $54,199). Medicaid and State funded Mobile Crisis

Management decreased in both utilization and expense. State funded Mobile Crisis Management had the largest percentage decrease in utilization

of 44% (9 to 5) and only decreased slightly in expense (16% - $1,993 to $1,684).


Both Child MH and Adult MH members served have been on a downward trend for 1st Qtr FY1819.

Analysis:




Warren County Dashboards

FYTD September 2018





Community CollaborativeFunds allocated for utilization through the leadership of System of Care for the coordination of the Community Collaborative to address needs of members

with SED from ages 21 and underCorrectional Behavioral Health

ServicesBehavioral health couneling and support to jail inmates





FYTD September 2018





Correctional Behavioral Health Services

Daymark

KARTS


Total:


11.2%$5,058

0.0%

% Spent

0.0%$586

$0$12,000

Please note that providers have up to 90 days to submit claims and that this will affect the number of members served and expense amounts on this report. The numbers

for the previous months will be updated each reporting period.

$0

$31,110

FYTD

Expenses

$0$35

Warren Funding

-$127

$0

$5,185

$783

$586

16.7%

0.0%

$45,100

-16.2%

0.0%

FY Budget

Amount



FYTD September 2018



87 8680

812

8

2 2 20

10

20

30

40

50

60

70

80

90

100

Jul'1

8

Au

g'1

8

Sep

'18


MH IDD SUD

187208

179

64 66 64

48 4936

0

50

100

150

200

250

Jul'1

8

Au

g'1

8

Sep

'18


MH IDD SUD

18 18 18

0

2

4

6

8

10

12

14

16

18

20

Jul'1

8

Au

g'1

8

Sep

'18

Nu

mb

er o

f M

emb

ers

on

Reg

istr

y



274294

259

72 78 72

50 51 380000000000

50

100

150

200

250

300

350

Jul'1

8

Au

g'1

8

Sep

'18


All Diagnosis

MH IDD SUD



FYTD September 2018


Service Category


ACTT

ICF


Psychiatric Residential Treatment Facilities provide residential care to persons under the age of 21 who need 24-hour supervision and

specialized interventions.

Inpatient

MST

Outpatient

Innovations





A short-term service for acutely mentally ill children or adults designed to prevent hospitalizations or to serve as a step down for those

leaving an inpatient facility.

Crisis Services



Community Support





Outpatient ED

Partial Hosp/Day Tx


IIHS

Definition



Residential

PRTF






Community

Psych Rehab


FYTD September 2018


location.




1

0

3

3

11

2

7

5

17

9

23

13

20

38

67

381

0

1

2

2

3

3

7

8

9

9

9

14

16

37

88

346

0 100 200 300 400 500

Partial Hosp/Day Tx

MST


Community Support

IIHS


Psych Rehab

Outpatient ED

Crisis Services

ICF

Inpatient



Innovations


Outpatient



$597

$0

$17,558

$11,687

$44,352

$143,825

$22,254

$194

$20,270

$418,771

$51,543

$41,471

$9,714

$613,824

$259,055

$126,331

$0

$7,827

$6,037

$1,041

$10,844

$61,796

$22,585

$457

$8,058

$429,395

$84,821

$53,782

$6,657

$606,318

$361,630

$101,745

$0 $100,000 $200,000 $300,000 $400,000 $500,000 $600,000 $700,000

Partial Hosp/Day Tx

MST


Community Support

IIHS


Psych Rehab

Outpatient ED

Crisis Services

ICF

Inpatient



Innovations


Outpatient




FYTD September 2018



location.



1

2

2

14

12

33

85

0

1

3

12

17

30

78

0 20 40 60 80 100

Community Support

Inpatient


Crisis Services

Community

Residential

Outpatient



$2,379

$7,500

$7,452

$4,454

$35,370

$103,570

$28,999

$0

$3,000

$9,072

$2,152

$52,617

$100,409

$42,059

$0 $20,000 $40,000 $60,000 $80,000 $100,000 $120,000

Community Support

Inpatient


Crisis Services

Community

Residential

Outpatient




FYTD September 2018




Amount.


location.


9

8

5

3

0

2

4

6

8

10




12

3

10

3

0

2

4

6

8

10

12

14




$15,569

$2,097

$6,038

$550

$0

$2,000

$4,000

$6,000

$8,000

$10,000

$12,000

$14,000

$16,000

$18,000




$6,254

$1,993

$9,484

$894

$0

$2,000

$4,000

$6,000

$8,000

$10,000





FYTD September 2018



Agencies provide one or more enhanced clinical/therapeutic/rehabilitative/habilitative service to MH, SUD, IDD, or multiple diagnosis

groups.

LIPLicensed Independent Practitioner (LIP) - Individual Clinicians, Therapists, Psychiatrists, Psychologists, etc. that are individually contracted

with the MCO. They provide outpatient services such as therapy, psychiatric care, assessment and testing.

LIP Group

Residential Facility located in-catchment but affiliated with another MCO/LME with local Quality Management mandated site visits and

limited oversight required.Senate Bill 163




Institution



ICFMR State InstitutionIntermediate Care Facilities for Persons with Mental Retardation (ICF/MR) - State run Intermediate Care Facility serving IDD Adults and

children.



Licensed Independent Practitioner (LIP) Groups are a group of clinicians, Therapists, Psychiatrists, Psychologists, etc. providing outpatient

services such as therapy, psychiatric care, assessment, and testing. They contract with the MCO as a group.



Agency






Clinics

Agency based entities providing a number of services, including assessment, enrollment, Outpatient and Psychiatric services, and serve at

least two disabilities. They are designated points of entry that ensure easy access for members.



FYTD September 2018



Freedom House Recovery Center, Inc Comprehensive Community Clinics


Alliance Rehabilitative Care, Inc Agency

Henderson Psychological Services, PLLC LIP Group

Ariel Community Care, LLC Agency

Community Workforce Solutions, Inc. Agency

Beyond Challenges Community Services, LLC Agency

Fast Braiin Oxford, LLC LIP Group

United Support Services, Inc. Agency

Access Call Center

Top 10 Providers by Members Served - Warren Entity Type


5,303 5,665 5,068

5 5 5

0

1

2

3

4

5

6

0

2000

4000

6000

8000

Jul'1

8

Au

g'1

8

Sep

'18

Spee

d t

o A

nsw

er (

secs

)

# o

f C

alls


2.1% 2.0% 2.2%

0%

2%

4%

6%

8%

10%

Jul'1

8

Au

g'1

8

Sep

'18

Per

cen

t o

f C

alls

Ab

and

on

ed



0101010203030407282937

146191

415868

0 200 400 600 800 1000

Other


County Agency






Inpatient


Hospital

LIP Group

LIP

Agency

Total Providers




FYTD September 2018






Medicaid funded Outpatient services were the largest utilized services for 1st Qtr FY1819. IIHS had the largest percentage decrease in utilization of

73% (11 to 3) and in expense of 76% ($44,352 to $10,844). Innovations had the highest expense of $606,318 followed by ICF of $429,395. PRTF

decreased in expense by 57% ($143,825 to $61,796) even though utilization slightly increased (2 to 3). Crisis Services experienced a decrease in

utilization of 47% (17 to 9) and in expense of 60% ($20,280 to $8,058). Even though utilization of Inpatient services decreased by 61% (23 to 9)

over the previous fiscal year, expenses increased by 65% ($51,543 to $84,821). Some of this can be attributed to an increase in the average length

of stay from 10 days in 1st Qtr FY1718 to 19 days in 1st Qtr FY1819.

State funded Outpatient services were the highest utilized services for 1st Qtr FY1819. Residential services had the highest cost of $100,409.

Inpatient services had the largest percentage decrease in expense of 60% ($7,500 to $3,000) with only a slight decrease in utilization (2 to 1).

Expenses for Outpatient services increased by 45% ($28,999 to $42,059) due to increased utilization and expense for Opioid Treatment services.

Medicaid Facility Based Crisis decreased in utilization by 44% (9 to 5) and in expense by 61% ($15,569 to $6,038). State funded Facility Based Crisis

slightly decreased in utilization (12 to 10) but increased in expense by 52% ($6,254 to $9,484). Medicaid funded Mobile Crisis Management

decreased in utilization by 63% (8 to 3) and in expense by 74% ($2,097 to $550). State funded Mobile Crisis Management remained the same in

utilization but decreased in expense by 55% ($1,993 to $894).


Both Child MH and Adult MH members served were on a downward trend for 1st Qtr FY1819.

Analysis:




Five County Community OfficeQuality Management Dashboard

FYTD September 2018

## ##

Medicaid Population - FYTD September 2018

Members

Served

11,498

13,097

8,739

12,554

6,814

% Eligible in

Cardinal

Innovations

Population

24%

33%

19%

23%

12%

Eligible

Population

117,034

159,012

93,531

110,761

8%

9%

11%

11%59,404

% Served

10%

Incidents

The number of Level II Incidents in the Five County Catchment during the 1st Qtr. of FY1819 remained consistent compared to the 4th Qtr. of FY1718 (49 to 52).

The majority (54% - 28/52) of Level II Incidents were Member Behavior Incidents, and AWOL > 3 Hours was the most prevalent incident type in this group.

Southern

Mecklenburg

Triad

Northern Region

Central

11%51,357 5,740Five County 11%

Report data from November 29, 2018

Region

17 16 19

3.32

3.02

3.82

0.00

0.50

1.00

1.50

2.00

2.50

3.00

3.50

4.00

4.50

14.5

15

15.5

16

16.5

17

17.5

18

18.5

19

19.5

Jul'18 Aug'18 Sep'18

Level II Incidents Count & Rate of Incidents Per 1,000 Members Served

Level II Incidents Rate/1,000 Members Served

FYTD: July 2018 - September 2018


FYTD September 2018

Incidents (continued)

There was 1 Restrictive Intervention reported in the Five County catchment area during the 1st Qtr. of FY1819, which was for Physical Restraint - Standing.

Level III Incidents reported in the Five County catchment area in the 1st Qtr. of FY1819 decreased by 43% (from 14 to 8) compared to the previous quarter (4th

Qtr. of FY1718). Much of this can be attributed to a decrease in Member Deaths (from 8 to 2). Both of the Member Deaths reported in the 1st Qtr. of FY1819

were due to Unknown Cause. The remaining 6 Level III Incidents were Abuse, Neglect or Exploitation, all of which were alleged (4 Alleged Sexual

Abuse/Assault/Rape, 1 Alleged Physical Abuse, 1 Alleged Neglect).

4 1 3

0.78

0.19

0.60

0.00

0.10

0.20

0.30

0.40

0.50

0.60

0.70

0.80

0.90

0

0.5

1

1.5

2

2.5

3

3.5

4

4.5


Level III Incidents Count & Rate of Incidents Per 1,000 Members Served

Level III Incidents Rate/1,000 Members Served


1

0.20

0.00 0.00

0.00

0.05

0.10

0.15

0.20

0.25

0

0.2

0.4

0.6

0.8

1

1.2


Restrictive Intervention Count & Rate of Incidents Per 1,000 Members Served

Level II Incidents Level III Incidents Rate/1,000 Members Served



FYTD September 2018

Incidents (continued)

90% (55/61) of the Incidents reported in the Five County catchment area were received within 3 days of learning of the incident during the 1st Qtr. of FY1819.

46% (28/61) of Incidents reported were due to Member Behavior, of which 54% (15/28) occurred in the CMH population and 29% (8/28) occurred in the AMH

population. 73% (8/11) of Member Injuries occurred in the ADD population, of which 4 were Trip/Fall Incidents.

There was 1 Incident reported in Five County in FY1819 which did not have a target population listed, which was a Member Behavior incident.

0

5

10

15

20

25

30

Abuse, Neglect orExploitation

RestrictiveInterventions

Member Behavior Member Death Member Injury Expulsion Fire Medication Error Suspsension

Incidents by Type & Target Population

ADD AMH ASA CDD CMH CSA



FYTD September 2018

15 24 66 33 27

20.6

100%

0

1

Mecklenburg

Catchment

Central

Catchment

Five County

Catchment

13

53

2

6

15

Triad

Catchment

8

2

3

11

0

2

1

2

Piedmont

Catchment

0

1

21

6

0

Total # Grievances Not Against Provider or MCO

0

122

46

0

0

4

11

0

14% 39% 20%

Measure

Total # of Grievances by

Disability

110

Child

Adult

Unknown

Does Not Apply

Total # Grievances by Age Group

Subcategory

MH Only

IDD Only

SUD Only

Multi-Disability

TBI Only

Unknown

Does Not Apply

% Resolved within 30

Days

For Resolved Grievances

Total # Grievances Pending

2

Average Days to

Resolve

00

0

11

0

1

0

11

20.8 22.5

0

13

1

17

7

13

16

50

0

Total # of Grievances

Total # Grievances Against Providers

Total # Grievances Against Cardinal Innovations

0

100%

21.4

168

Total # Grievances Resulting in Investigations

1

8

100%

18.5

0

11

4

0

9%

0

Grievances - FYTD September 2018

7

5

49

0

3

24

All Grievances

62

28

3

3

4

5

11

4

1

5

0

2

1

8

0

0

20

In the Five County Catchment area, the number of Grievances in the 1st Qtr. of FY1819 remained consistent with the number of Grievances in the 4th Qtr. of

FY1718 (from 14 to 15).

0

1

6

13

6

18

0

2

3

20

43 20

Please Note: The State benchmark for grievances requires that 90% of grievances are resolved within 30 days of submission. Three Grievances were Out-

of-Catchment

0

4

20

16%

100%

0 0 0

100%

21.3

100%

2 9 4

0.39

1.70

0.80

0.00

0.20

0.40

0.60

0.80

1.00

1.20

1.40

1.60

1.80

0

1

2

3

4

5

6

7

8

9

10


Grievance Count & Rate of Complaints Per 1,000 Member Served

Grievances Rate/1,000 Members Served



FYTD September 2018

Grievances (continued)

2

2

2

2

3

3

5

6

11

11

0 2 4 6 8 10 12

Ethics

Dispensing Medication

Customer Service (CS) Telephone Responsiveness

Incomplete/Inaccurate Paperwork Issues

Inadequate Treatment

Other Administrative Issues

Potential Fraud

Abuse

Delay in Treatment

Conflict with Provider (disagreement with treatment, diagnosis, etc)

Top 10 Grievances TypesFYTD: September 2018

1

3

3

3

4

5

7

8

8

8

0 1 2 3 4 5 6 7 8 9

Community Guide

Medication Administration

Inpatient

IDD Care Coordination

Assertive Community Treatment Team

Other

Peer Support Services

Residential Services

Outpatient Services

Innovations

Top 10 Services with GrievancesFYTD: September 2018


FYTD September 2018

Please note: Cardinal Innovations Quality Management requires any provider receiving out of compliances on selected review items and trending out of

compliance areas to complete a POC as a standard measure to prevent future out of compliances.

In the 1st Qtr. of FY1819, 5 providers of the 12 reviewed in the Five County catchment area scored 100%. Zero providers scored below the 85% target on their

NC Provider Monitoring Reviews during the 1st Qtr. Of FY1819.

During the 1st Qtr. Of FY1819, there were 373 claims reviewed in the Five County catchment area.

Provider Monitoring Reviews

1

1

1

2

3

4

6

12

12

78

0 10 20 30 40 50 60 70 80 90

POC Follow-up

Self-Audit

EOR

New Unlicensed SiteReview

Clinical Quality Review

Unlicensed AFL Review

Concern Module

Cultural Competency

NC Provider MonitoringReview

Innovations Annual AFLReview

Monitoring Reviews

Jul-Sep'18

98.8% 99.0%92.8% 97.5%

90.9%

0%

25%

50%

75%

100%

Five County Central Mecklenburg Piedmont Triad

NC Provider Monitoring Review Scores

85% Target

July 2018 - September 2018



FYTD September 2018

Provider Monitoring Reviews (All)

Compared to the previous quarter (4th Qtr. Of FY1718), the number of Reviews requiring POC's decreased by 31% (16 to 11).

5

11

0

2

4

6

8

10

12

Jul-Sep'18

Monitoring Review Outcomes

Reviews requiring Paybacks Reviews requiring POC's



FYTD September 2018

56% ($190.65/$339.79) of the paybacks identified in FY1819 have been recouped thus far for the Five County catchment. One provider is responsible for 100%

($149.14) of the amount yet to be recouped for the 1st Qtr. Of FY1819, which was the result of a POC Follow-Up.

Please note: The Identified Payback amount is in the recoupment and reconsideration process.

Provider Monitoring Reviews - Paybacks

$7,456.64

$7,456.64

$190.65

$339.79

$0 $1,000 $2,000 $3,000 $4,000 $5,000 $6,000 $7,000 $8,000

Amount Recouped

Identified Payback

Amount Recouped

Identified Payback

FY

1718

FY

1819

Payback Amounts from Post Payment Reviews

Jul-Sep

2019 five county community board meeting · 2019. 3. 28. · halifax agricultural center. •...

Documents