1. Behavioral Health Clinic Quality Measures(BHCQMs)
I-Eval: Time to Initial Evaluation
Next Steps

2. Purpose and Benefits
Able to more quickly engage individuals into services
Provide better care and support of individuals
Enroll individuals in services as they are ready, increases chance that they will be more engaged in services as they go.

3. I-EVAL What Outcome is being measured?
This measure has 2 parts and requires 2 separate calculations:
The percentage of new persons with an initial evaluation provided within 10 business days of first contact
Stratified by age (12-17 and 18 and older) and Payer status (Medicaid, Medicare, Low Income, Uninsured)
The mean number of days until initial evaluation for new individuals

4. What needs to be collected? Tracked?
Business days (M-F excluding state and federal holidays regardless of operation)
Initial Evaluation (routine, not crisis)
New Individual (not seen within the last 6 months)
Provided (received, service must be received or completed not just scheduled)
Provider Entity (The system being measured not individual providers)
Age (12-17 and 18 and older)
Medicaid/Low Income/Uninsured Status
There are not specific definitions of “first contact” or “initial evaluation”
First contact can be telephonic, and is persons “requesting or being referred for BH services” Think initial screening and determination of acuity (crisis)
Can be a walk in appointment or crisis service
Does not include phone calls that are informational gathering in nature (hours of operation, etc.)
This initial screening is FOLLOWED by the initial evaluation and person/family centered diagnostic treatment plan per CCBHC criteria.

5. Initial evaluation Preliminary diagnosis Source of referral
Reason for seeking care
Identification of immediate clinical needs relating to diagnosis
List of current medications and substances
Assessment of risk to self or others
Assessment of need for medical care
Determination of veteran status

6. Specification #1: Percentage of New individuals with an initial evaluation provided within 10 business days of first contact
Denominator: Number of individuals in eligible population
Individuals Identified as contacting provider seeking services during measurement year
Stratified by age (12-17 and 18 and older as of the end of measurement year)
Measurement year excludes last 30 days of measurement year and INCLUDES the 6 months preceding the measurement year.
Numerator: Number of individuals in the eligible population who received an initial evaluation within 10 business days of the first contact during measurement year
Measurement year is measurement year.
Denominator: excluding the last 30 days of measurement year and including the

7. 100 individuals contact the clinic in the first 11 months of the MY
50 were not seen at the clinic in the 6 months preceding MY
Of those, 20 had Medicaid, 15 were uninsured, 15 had other payer source.
Steps in Calculation
Medicaid
Uninsured
Other
Total
1. Number of individuals who contact clinic in first 11 months of MY 50 25
100
2. Number of those NOT seen in 60 months prior to MY 20 15
Denominator Stratified by Payer status

8. Numerator calculation:
Medicaid: 19/20= .95 or 95%
Uninsured: 10/15= .667 or 67%
Other payer source: 7/15= .47 or 47%
Total: 36/50 or .72 or 72%
Repeat steps to stratify by age
Steps in Calculation
Medicaid
Uninsured
Other
Total
Denominator Stratified by Payer status 20 15 25 50
Individuals seen within 10 business days of first contact 19 10 7 36
Numerator stratified by payer status

9. Specification #2: Mean number of days until initial evaluation for new individuals
If 10 individuals are seen during the first 11 months of MY year and not seen in prior 6 months with counts by payer status shown below:
Denominator: The number of eligible individuals
Number of individuals
Medicaid
Uninsured
Other
Total 4 3 10

10. Numerator: Total number of business days between first contact and initial evaluation (stratified by payer):
Individual
Medicaid
Medicare
Neither
Total A 10 B 15 C 8 D
31* E 20 F 13 G 3 H 4 I J
Total Numerator 64 36 38
138
*First contact at the end of the 11th Month and not seen again for initial evaluation

11. Indicates first contact at the end of the 11th month of MY and not seen for initial evaluation
Measuring the Mean (average) days until initial evaluation for new individuals by payer status:
Medicaid: 64/4 = 16 days
Uninsured: 36/3 = 12 days
Other: 38/3= 12.7 days
Total: 138/10 = 13.8 days
Repeat steps to stratify by age

12. Next Steps Updates to the Texas Council intranet site
DEW presentation at the Texas Council annual conference
Got Data! Now What?
Survey Centers to determine needs
Conference calls
Future webinars