1. Slide 1 Florida SIPP Quarterly Meeting Presenter: Jolene Rasmussen, MS Healthcare Analyst, PIP Review Team March 23, 2011

2. Slide 2 Presentation Topics Collaborative Validation Results Statistical Testing Proposed PIP Topics

3. Slide 3 Collaborative PIP Validation Results Address deficiencies in next submission –Compliance with recommendations more important than initial score –Technical assistance available

4. Slide 4 FY 2011 Performance Improvement Project Validation Results (N=18 PIPs) Study Stage Activity Percentage of Applicable Elements Met Partially Met Not Met Design I. Appropriate Study Topic* 85% (71/84) 2% (2/84) 13% (11/84) II. Clearly Defined, Answerable Study Question(s) 100% (28/28) 0% (0/28) 0% (0/28) III. Clearly Defined Study Indicator(s)* 69% (41/59) 22% (13/59) 8% (5/59) IV. Correctly Identified Study Population* 87% (26/30) 7% (2/30) 7% (2/30) Design Total 83% (166/201) 8% (17/201) 9% (18/201) Implementation V. Valid Sampling Techniques (if sampling was used)Not Applicable VI. Accurate/Complete Data Collection 51% (73/144) 30% (43/144) 19% (28/144) VII. Appropriate Improvement Strategies 79% (23/29) 21% (6/29) 0% (0/29) Implementation Total* 55% (96/173) 28% 49/173) 16% (28/173) Outcomes VIII. Sufficient Data Analysis and Interpretation* 54% (28/52) 35% (18/52) 12% (6/52) IX. Real Improvement Achieved††† X. Sustained Improvement Achieved††† Outcomes Total* 54% (28/52) 35% (18/52) 12% (6/52) Overall Percentage of Applicable Evaluation Elements Scored Met 68% (290/426) *Total for activity or stage may not equal 100 percent due to rounding. † The PIP had not progressed to this point; therefore, the activity was not assessed.

5. Slide 5 Process for Disputing Validation Score The plan must submit its dispute via formal letter to HSAG and cc AHCA Contract Manager The letter should outline the evaluation element/comment being disputed and the plan’s rationale for why the score should be changed All responses should be e-mailed to ddriscoll@hsag.com no later than April 1, 2011 The HSAG PIP Review Team will review the dispute and respond to the plan with a decision within seven (7) business days

6. Slide 6 Statistical Testing using GraphPad Refer to statistical testing document on myforidaeqro.com http://www.graphpad.com/quickcalcs/index.cfm Select - o Categorical data Fisher's, Chi square, McNemar's, Sign test, CI of proportion, NNT (number needed to treat). o Press Continue o Fisher's and chi-square. Analyze a 2x2 contingency table. o Press Continue

7. Slide 7 GraphPad Example NumeratorDenominator minus Numerator Baseline15280 Remeasurement 110315 Select - o Fisher's exact test (recommended) o Two-tailed (recommended) o Calculate

8. Slide 8 GraphPad Results NumeratorDenominator-NumeratorTotal=Denominator Baseline15280295 Remeasurement 110315325 Total25595620 Fisher's exact test The two-tailed P value equals 0.2250 The association between rows (groups) and columns (outcomes) is considered to be not statistically significant

9. Slide 9 Proposed PIP Topics

10. Slide 10 Approved Topics Achieving and Maintaining a Healthy Weight in SIPP Population

11. Slide 11 Approved Topics with Modifications Decreasing Childhood Obesity While in Residential Treatment Enhancing the Effectiveness of our Token Economy System Increasing Family Participation in Treatment Minimizing Weight Gain of Youth in a Residential Setting Reducing Percentage of Overweight/Obese Patients Reducing Physically Aggressive Behavior in Members Reducing Risks from Aggressive Behavior Reducing Significant Weight Change Related to Medication Side-Effects Staff Initiated Timeouts Youth Satisfaction with Food During Their Stay at SIPP

12. Slide 12 Not Approved Topics Competency Based Training of Community Counselors to Carry Out the Behavioral Analysis Requested by Therapist Impact of Trauma Informed Care Impact on Dietary and Nutritional Practices Improve Standardized Method for Measuring Progress Improving Member Satisfaction Increasing Post-discharge Follow-up Response Rates Increasing SIPP 60 Day Survey Completion Nursing Recruitment and Retention Reducing Employee Turnover RN Satisfaction Transition Room

13. Slide 13 HSAG Contacts: For any PIP questions or to request technical assistance contact: Christi Melendez, RN, CPHQ cmelendez@hsag.com 602-801-6875 Denise Driscoll ddriscoll@hsag.com 602-801-6882

14. Slide 14 Questions and Answers

15. Slide 15 Upcoming EQR Activities Wednesday, March 23, 2011 Presenter: Yolanda Strozier, MBA Associate Director, State and Corporate Services

16. Slide 16 Upcoming EQR activities The next EQR Quarterly Meetings: –Wednesday, June 8, 2011 (AHCA Offices) One-on-one TA sessions Tuesday, June 7, 2011 –Week of September 26, 2011 (Webinar) –Wednesday, January 11, 2012 (AHCA Offices) One-on-one TA sessions Tuesday, January 10, 2012 –Week of March 19, 2012 (Webinar)

17. Slide 17 Upcoming EQR activities Finalization of PIP Validation Reports (April 2011). Annual PIP Summary Report and Strategic Summary Report (April–June 2011).

18. Slide 18 Upcoming EQR activities Next Steps PIPs are submitted to AHCA/DOEA— August 2011 MCOs will receive HSAG’s “Statement of Intent” (SOI) survey on Wednesday, August 10, 2011. Completed SOI’s due to HSAG on Monday, August 29 th.

19. Slide 19 External Quality Review Quarterly Meeting THANK YOU FOR YOUR PARTICIPATION!