Report to the Operations Sub-Committee December 8, 2006

Network Operations

Web Registration Security Access/User ID Requests 2,034 User Id’s generated as of 12/4/ Requests currently in process Winfax – Non Web/Paper Registrations 104 Providers currently using paper registration

Web Registration – Totals Completed Web Registrations as of 12/4/06 Outpatient Services………….…..21,963 Methadone Maintenance…….…...1,230 Ambulatory Detoxification…………….77 Family Support Team………………..128 ( Home Based Service) Psychological Testing…………….…..32

Web Registration Continued 23,430 - Registrations completed as of December 4, 2006 Registration 21 day timely limit began November 6, 2006 –Providers have 21 days from the initial visit to register CT BHP clients for Registered Services All fields for web registration required as of November 1, 2006 –Race & Ethnicity (Optional)

Provider Relations Phone Stats October November Calls Web Registration Inquiries General Provider Inquiries

PDV’S Received1259 PDV’S Keyed1259 # of new providers added from Add /Change Report 270 # of changes completed from Change Report 574 # of PDV’s mailed to date 3132 Provider Data Verification Stats Aggregate since January 2005

Rapid Response Team Findings Reviewed authorization related claims issues for 30 providers Provider outreach letters sent to providers to offer assistance in the authorization process

Rapid Response Team Provider Outreach Correspondences 15 – PH.D. level 9 – MD level 6 – APRN level Provider Site Visits 1 Group Practice 3 Facilities

Clinical Operations

Average Length of Inpatient Stay not including Riverview (not including discharge delays)

Percent Per Facility of Discharge Delays

Discharge Delay Reason Codes

10% of children in an Inpatient setting are defined as Discharge Delay - represents a decrease from 17% last month  37.5% are awaiting placement in Residential and/or PRTF  9.4% are awaiting Community Services  12.5% are awaiting Group Home placement  12.5% are awaiting Placement: other or unspecified Inpatient Discharge Delay Status November, 2006

ED Delayed Discharge Activity Started trending ED cases, source, length of stay, and disposition Despite increased numbers of members presenting to EDs, overall lengths of stay are trending down (3 outliers in November negatively impacted LOS) Members presenting to EDs are more likely to be DCF involved than not Members presenting to the ED are more likely to be discharged to an Inpatient level of Care than any other option

ICM TRACKING REFERRAL SOURCE MONTHLY REPORT November 2006

Timeliness of Pre-cert and CCR Process Analysis of current forms/process- complete Re-ordering/re-working of existing forms - complete Deletion of redundant information - complete System was reprogrammed mid-November Clinician orientation and re-tooled forms on web site week of November 13, 2006 Revised format implemented week of November 20, 2006

Residential Care TeamTransition IT infrastructure complete (tracking system/CANs) Follow up training occurring via web John Lyons training CSSD Final revisions to provider information Census reporting has improved to better support matching Transition occurred 12/1/06

Customer Service/Call Center Activity

2006 Call Volume YTD

Calls answered in < 30 seconds YTD

Types of Service Connect Inquiries November, % - Provider Referrals for Members 15% - Member Eligibility Verification 36% - Provider Related/Authorization/Enrollment/Billing 8% - General Information 49% = Member Inquiries No Inquiries initiated due to provider status change from IN to OON

CT BHP CALL MANAGEMENT Incoming Calls Totals: November, 2006 Total 5813 Member Calls:2550 Provider Calls:3241 Crisis Calls:22

Quality Management

Quality Initiatives Adult and Child Studies underway Final analysis of Provider Satisfaction survey underway Member Satisfaction close to completion Mercer Post-Implementation evaluation scheduled for January 3-5, 2007 Continues to support all departments at the CT BHP

Total Number of Complaints Monthly 2006

Complaints The complaint categories identified do not have enough volume to suggest a trend at this time All complaints will continue to be monitored Complaints documented at VO’s Helpdesk related to Web Registration will be transferred to CT BHP data base

Percent of Denials- Administrative and Medical Necessity

Appeals Overall appeal rate is less than 1% of authorizations A typical denial (>90%) is generated by failure to adhere to administrative process rather than Medical Necessity determination

Grievances No Grievances filed in November of 2006

System’s Management

System Management Update System Managers held numerous community meetings to finalize assigned LADPs for submission in November The final Six LADPs were submitted and approved by the Departments in November

System Management Update con’d System Managers have established local oversight bodies for the implementation and monitoring of the LADPs System Managers whose plans were approved in October began the implementation process in November and have convened and facilitated meetings with their respective oversight bodies

System Management Update con’d Statewide themes and regional variations across all 15 plans are being compiled for future presentations and strategic planning purposes All System Managers were trained and began the initial phase of utilizing project management to monitor, track and prepare for reporting on the status of each plan

System Management Update con’d System Managers presented approved LADPs to local Community Collaboratives, Local Department of Children Area Advisory Councils and Managed Service System members System Managers continue to actively participate in community meetings and initiatives across the state Requests for LADPs are currently being tracked

Community Interaction: Peer/Family Services

Peer Support Unit The Peer and Family Peer Specialists worked with 68 CT BHP members and/or families in November. Peer and Family Peer Specialists attended:  9 Community Collaborative Meetings  16 Community Outreach Meetings  1 CT BHP Consumer and Family Advisory Sub-Committee Meeting  2 Home visits with members  1 Visit at ED with member  1 Child Specific Team Meeting  3 Treatment/Discharge Planning Meetings with members/families  17 Referrals were given to various agencies and organizations

Outreach Activities for Peer Unit  Help Me Grow Breakfast in Waterbury  In-Service Training to the Middletown Adult Education Teachers  Presentation to the Even Start Program  Meeting with the Middlesex Coalition for Children  Attended Provider Presentation on Respite Services in South Central Region  Co-Hosted Provider Fair for School District and DCF Personnel with the NE Collaborative Members  Eastern Connecticut Cooperative Workgroup Meeting to Plan Spring Workshops  Attended the Families United Support Group in Plainville

Examples of Referrals Given by Peer Unit  Worked with MCO to resolve a transportation issue for member  Department of Mental Health and Addiction Services (DMHAS)  Connecticut Autism Spectrum Resource Center  Access Agency  Office of Protection and Advocacy  DCF Ombudsman  Children’s Law Center  Legal Aid  Statewide Legal Services  North Star Support Group  Tri-State Support Network for Families Raising Children with Bipolar- The Connecticut Group  AFCAMP, Families United, PAP, NAMI-CT  FAVOR Advocate