Report to the Operations Sub-Committee November 3, 2006

Network Operations

Web Registration Security Access/User ID Requests –1,921 User Id’s generated as of 10/27/06 14 Requests currently in process Winfax – Non Web/Paper Registrations –81 providers currently using paper registration –34 providers transitioned from paper to web since 9/1/06 Security Access – No Response –498 EDS/Medicaid Providers –Provider Alerts sent to those 498 providers on 9/19/06 –Response received from 213 providers Requesting Registration ID’s or Winfaxes

Web Registration – Totals Completed Web Registrations as of 10/23/06 Outpatient Services………….…..17,253 Methadone Maintenance…….…...1,143 Ambulatory Detoxification…………….58 Family Support Team………………..113 ( Home Based Service) Psychological Testing…………….…..12

Web Registration Continued 18,579 - Registrations completed as of October 23, 2006 Registration timeline had been extended for an additional 61 days. –Providers were given until October 31, 2006 to enter Web- Registrations for September 1, 2006 dates of service and ongoing. –The 21 day registration time limit began November 1, 2006 All fields for web registration are required effective November 1, –Provider Alerts 10/9 & 10/10 –Updated User Manual will be posted to the week of November 6, 2006 –Updated Winfax Forms were sent to non Web enabled providers on 10/30/2006.

Provider Relations Phone Stats (September 10, October 21, 2006) 1030 calls received  Web Registration Inquiries  General Provider Inquiries

PDV’S Received1,230 PDV’S Keyed1,230 # of new providers added from Add /Change Report 227 # of changes completed from Change Report 488 # of PDV’s mailed to date 2,956 Provider Data Verification Stats Aggregate since January 2006

Clinical Operations

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 Result: more intuitive process, decrease burden System to be 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 close to completion, currently in testing (tracking system and CANs tool) Training with John Lyons, PhD held October 23, 2006, 120 people trained Follow up training program under development Provider file information being updated Anticipated transition 12/1/06

Members who Access 24 hour Care by LOC October 2006 ADR/IPD: Inpatient detox/rehabilitation GHA/GHC Group home 1.0/2.0 IPF: Inpatient Psychiatric Facility PRTF: Psychiatric Residential Tx Facility RTC: Residential Treatment Facility

Authorization and Concurrent Review Update October, 2006 Level of Care October (Total auths/CCRs) DeniedTotal YTD (Total auths/CCRs) RTC GH GH Inpatient Psych/Detox Freestanding Detox/Rehab OBS441 PRTF IOP/PHP EDT HBS OTP Total7, ,850

10% of children in an Inpatient settings are defined as Discharge Delay this represents a decrease from 17% last month  53% are awaiting placement in Residential and/or PRTF  7% are awaiting Community Services  20% are awaiting Group Home placement  14% are awaiting Placement: other or unspecified  Average length of stay in Delayed status is 47 days 11% of children in Residential Treatment Centers are defined as Discharge Delay  39% are awaiting Group Home placement  7% are awaiting Foster Care placement  54% are awaiting Placement: other or unspecified (primarily community based services – training continues re. to code selection) Inpatient/PRTF Discharge Delay Status October, 2006

ED Delay Tracking: October 2006 Location / ED # of Members Age Range DCF Identified Ave. Days Stuck Actual Disposition NBGH114Y5Admitted to Inpatient CCMC – DCF 3 – Non-DCF 29 – Admitted to Inpatient 1 – Returned to home/placement Middlesex 316 – 172- DCF 1 – Non-DCF 3.52 – Admitted to Inpatient 1 – Returned to home/placement Midstate215 – 172 – DCF22 – Admitted to Inpatient

ED Delayed Discharge Activity Overview: –May: 6 cases, average LOS 3.5 days –June: 5 cases, average LOS 7.2 days (1 outlier) –July: 10 cases, average LOS 2.9 days –August: 11 cases, average LOS 1.1 days –September: 26 cases, average LOS 2.0 days –October: 16 cases, average LOS 3.1 days

ICM TRACKING REFERRAL SOURCE MONTHLY REPORT REFERRAL SOURCEJANFEBMARAPRILMAYJUNEJULYAUGSEPTOCTNOVDEC ED INPATIENT HOSPITAL MCO DCF SELF REFERRAL INTERNAL RESI/GROUP DAY DISCHARGE DELAY *02812 COMMUNITY TOTAL RECEIVED DISCHARGES Data source 10/1/06-10/24/06 YTD Referrals Recieved: 727 *

ICM Activity All “delayed status” members currently in inpatient settings are assigned (October 23, down from 30 in September) Coordinating Collateral meetings to determine barriers to appropriate disposition for acute levels of care Attending MSS mtg’s with System Managers Identifying cases from daily census reports in MSS mtg’s in order to facilitate appropriate treatment planning Contacting ED’s and Area offices for updates on a daily basis Working with Systems Managers to coordinate meetings with each Hospital ED in Connecticut Monthly MCO meetings/trainings including reviews of co- medically managed cases

Customer Service/Call Center Activity

2006 Call Volume YTD

Calls answered in < 30 seconds YTD

CT BHP CALL MANAGEMENT Incoming Calls Totals: September, 2006 Member Calls: 2035 Provider Calls: 3040 Crisis Calls: 145 Total 5220

Types of Inquiries September, % - Provider Referrals for Members 27% - Member Eligibility Verification 21% - Provider Related/Authorization/Enrollment/Billing 9% - General Information 52% = Member Inquiries

Quality Management

Quality Initiatives Data analysis, Mercer prep, QI work, integrating work with all departments Satisfaction Surveys  Data collection began in early fall. Preliminary Provider Survey has been received and will now be analyzed. Member Survey continues with interviews.  Reports complete and analyzed by January of 2007

Complaints

Total Number of Complaints Monthly 2006

Total Number of Complaints Quarterly 2006

Adult Complaints Quarterly 2006

Child Complaints Quarterly 2006

Adverse Incidents Quarterly 2006

Grievances No Grievances filed in October of 2006

System’s Management

 Three LADPs were approved by the Departments in September 2006  Six LADPs were approved by the Departments in October 2006  Six LADPS are due for review by the Departments on November 15 th  Dissemination of the approved plans have begun and a process has been established to disseminate additional copies (Glenys Rios or System’s Management Update

Of the approved LADPs the following themes have been highlighted:  Increasing access to therapeutic support staff and other services  Increasing access to reliable transportation services  Enhancing the availability of cultural competence/linguistic services  Increasing specialized services (i.e. services for children and youth with sexually acting out behavioral problems and eating disorders

 Enhancing communication between families, schools and other systems/providers  Increasing family participation in the collaboratives  Increasing support for the development of community collaborative infrastructure Themes continued….

Community Interaction: Peer/Family Services

Peer Support Unit  Peer and Family Peer Specialists worked with 90 CT BHP members and/or families in October.  Peer and Family Peer Specialists attended:  14 Community Outreach Meetings  11 Community Collaborative Meetings  CT BHP Consumer and Family Advisory Sub-Committee Meeting  2 School Meetings

Peer Support Unit, continued  5 Home visits with members  1 Prospective placement visit with a family  6 Treatment/Discharge Planning Meetings with members/families  1 Meeting with member and nurse to collaborate on the co-management of a medically complicated case in order to be of support to member  1 Visit with member at the hospital  57 Referrals were given for various agencies and organizations

Referrals to FAVOR, its Family Organizations and Support Groups  FAVOR Advocate Program: 5 families  FAVOR Family–to-Family Program: 2 families  AFCAMP: 3 families  Families United for Children’s Mental Health: 7 families  Tri State Support Network for Families Raising Children with Bipolar-The Connecticut Group: 2 families  North Star Support Group in Ansonia: 1 family CT BHP Peer and Family Peer Specialists differ from the FAVOR Family Advocates in that we provide primarily community education, support and linkages rather than traditional advocacy support

Examples of Other Referrals Given  Bereavement Support Group at Middlesex Hospital  The Connecticut Association for Children and Adults with Learning Disabilities  Connecticut Autism Spectrum Resource Center  Alanon  Connecticut Employment and Training Services  Connecticut Family Support Network  Department of Mental Health and Addiction Services (DMHAS)  Dubois CenterThompson  Ecumenical Empowerment Group (TEEG)  Grandparents Raising Grandchildren Support Group  Groton Community Support Group  Middletown Estuary Counsel of Seniors  Office of the Child Advocate  Office of Protection and Advocacy  Parent Leadership Training Institute (PLTI)  Positive Alternatives for Children and Teens, Inc. (PACT)  Special Education Resource Center (SERC)  Care Coordination with the Systems of Care  Youth Services Bureau

Outreach Activities for Peer and Family Peer Specialists  Meeting with the Clergy Association in Middletown  Meeting with the Middlesex Coalition for Children  Dialogue with parents and teens at two high schools in Meriden  Family Forum Presentation to Foster and Adoptive Parents Program in Middletown  Booth at NAMI-CT Annual Conference  Co-sponsor with the Eastern CT Cooperative Workgroup to host two workshops; one for parents on Educational Advocacy held in Putnam and one for parents and professionals on The CT Family to Family Health Information Project held in Norwich