CCBHC Provider Webinar
Certification/Data/PPS
Ju ly 29 2016
By
Ju stin H ard in g-Project D irector
D an n y Silb ert-Project M an ager
Rich ard Sh erm an -D ata an d Rep ortin g G rou p Ch air
Certification
 Certification Ch eck list set to b e released first w eek of
Au gu st
 Cu rren tly it en tails th e m ost essen tial criteria th at is
n eed ed for in itial CCBH C certification
 Ap p roxim ately 50 p ages in len gth
 Will ask for Yes/N o resp on ses, alon g w ith su p p ortive
n arratives/d ocu m en ts
 Will h ave 4 w eek s to com p lete
Certification
 Ch eck list w ill b e review ed b y ID H S Bu reau of
Accred itation , Licen su re & Certification (BALC)
 In itial review w ill p rovid e a p rovision al certification
 Fu tu re on site review w ill b e con d u cted p rior to th e
D em on stration Ph ase to en su re com p lian ce of criteria
 Fin al CCBH C certification w ill b e b ased u p on on site
review
PPS
 D M H an d H FS are w ork in g togeth er to id en tify Sp ecial
Pop u lation s for h igh er PPS rates
 PPS cost rep ort com p letion an d tech n ical assistan ce
w ill b egin after SAM H SA id en tifies th e states th at w ill
p articip ate in th e d em on stration p rogram
Data and Reporting
 Im p ortan ce of q u ality of care m easu re d ata collection an d rep ortin g
in su p p ort of an y d ecision to exten d th e fed eral CCBH C p rogram
after th e tw o-year d em on stration p rogram
 In m id -Ju n e, 2016 SAM H SA d istrib u ted th e CCBH C q u ality m easu re
tech n ical sp ecification s to th e 24 states th at received p lan n in g gran ts
 Th e total n u m b er of q u ality m easu res h as b een red u ced from 32 to
21. H ow ever, on e m easu re w as sp lit in to tw o, m ak in g it a total of 22
req u ired q u ality m easu res
 Th ree of th e origin al q u ality m easu res th at w ere p reviou sly in th e
CCBH C grou p , h ave b een m oved to th e state lead grou p . In
su m m ary, th ere are n ow 9 m easu res in th e CCBH C grou p an d 13 in
th e state lead
Data and Reporting
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Th e State is recom m en d in g 2 m easu res an d req u irin g 3 m easu res of th e on es
SAM H SA h as om itted (2 collected b y th e CCBH C an d 1 collected b y th e State)
Th e State is recom m en d in g th e follow in g m easu re b y th e CCBH C:
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Th e State is req u irin g th e follow in g m easu res b y th e CCBH C:
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D iab etes Care for Peop le w ith Seriou s M en tal Illn ess: H em oglob in A1c (H b A1c)
Poor Con trol (>9.0%) (SM I-PC)
Blood con trol m on itorin g
Blood p ressu re on all con su m ers
N u m b er of Su icid e D eath s b y Patien ts En gaged in Beh avioral H ealth (CCBH C)
Treatm en t
Th e State w ill track on e m easu re:
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N u m b er of Su icid e Attem p ts Req u irin g M ed ical Services b y Patien ts En gaged in Beh avioral
H ealth (CCBH C) Treatm en t
Data and Reporting
 Th e tech n ical m an u als in clu d e d etailed sp ecification s for calcu lation
of th e d en om in ator an d n u m erator of each m easu re. Several of th e
m easu res in clu d e stratification (e.g. b y clien t age) an d in clu d e cou n ts
of clien ts w h o are d u ally en rolled in M ed icaid an d M ed icare
 CCBH C an d state d ata system s m u st b e estab lish ed th at h ave th e
cap ab ilities to com p ly w ith fed eral CM S an d SAM H SA q u ality
m easu re d ata collection an d rep ortin g exp ectation s th at are d etailed
in th e tw o tech n ical sp ecification volu m es
 In gen eral, each of th e tw o d em on stration gran t years w ill b e
con sid ered a m easu rem en t p eriod for p u rp oses of q u ality m easu re
d ata collection an d rep ortin g
Data and Reporting
 Fed eral CM S req u ires th at CCBH Cs m u st ach ieve state-estab lish ed
targets for each of six of th e q u ality m easu res to b e eligib le for
q u ality b on u s p aym en ts. States h ave th e op tion to in clu d e
ach ievem en t of ad d ition al q u ality m easu re targets for CCBH Cs to b e
eligib le for th e p aym en ts
 CCBH Cs w ill h ave u p to 9 m on th s after th e en d of each m easu rem en t
year to su b m it th eir q u ality m easu re d ata. States w ill h ave u p to 12
m on th s after th e en d of th e m easu rem en t year to su b m it d ata for th e
13 q u ality m easu res for w h ich th ey are resp on sib le
 Th ere w ill b e a fed eral CCBH C cross-site evalu ation th at m ay req u ire
ad d ition al d ata collection an d rep ortin g req u irem en ts of th e
CCBH Cs an d /or th e p articip atin g states
Data and Reporting
Exam p les of CM S/SAM H SA Req u ired Q u ality
M easu res
 Ch ild an d ad olescen t m ajor d ep ressive d isord er (M D D ):
Su icid e Risk Assessm en t (SRA-BH -C) - CCBH C
Resp on sib ility, Req u ired Q BP M easu re
 Ad u lt m ajor d ep ressive d isord er (M D D ): Su icid e risk
assessm en t (SRA-A) - CCBH C Resp on sib ility, Req u ired
Q BP M easu re
 In itiation an d en gagem en t of alcoh ol an d oth er d ru g
d ep en d en ce treatm en t (IET-BH ) - State Resp on sib ility,
Req u ired Q BP M easu re
Data and Reporting
Con ten t Section s of M easu re Tech n ical
Sp ecification s
 Section A: D escrip tion - Provid es a n arrative d efin ition of th e
m easu re, gu id an ce for rep ortin g, stratification , d ata sou rce, an d th e
m easu rem en t p eriod
 Section B: D efin ition s - Provid es d efin ition s of k ey term s
 Section C: Eligib le Pop u lation - Provid es criteria (e.g. age an d
d iagn osis) an d req u irem en ts for in clu sion
 Section D : M easu re Sp ecification s - Provid es d en om in ator an d
n u m erator in clu sion sp ecification s b ased on d ata sou rce (e.g. EH R or
ad m in istrative claim /en cou n ter d ata
 Section E: Ad d ition al N otes – Provid es in form ation on m easu re
Data and Reporting
Ch ild an d ad olescen t m ajor d ep ressive d isord er (M D D ):
Su icid e Risk Assessm en t (SRA-BH -C)
 Percen tage of con su m er visits for th ose con su m ers aged 6 th rou gh 17
years w ith a d iagn osis of m ajor d ep ressive d isord er w ith an
assessm en t for su icid e risk
 D en om in ator - All con su m er visits for th ose con su m ers 6–17 years of
age w ith a d iagn osis of m ajor d ep ressive d isord er
 N u m erator - Th e n u m b er of con su m er visits w ith an assessm en t for
su icid e risk
 M easu rem en t Period - Th e m easu rem en t p eriod for b oth th e
d en om in ator an d th e n u m erator is th e m easu rem en t year
Data and Reporting
Ad u lt m ajor d ep ressive d isord er (M D D ): Su icid e risk
assessm en t (SRA-A)
 Percen tage of con su m ers aged 18 years an d old er w ith a d iagn osis of
m ajor d ep ressive d isord er (M D D ) w ith a su icid e risk assessm en t
com p leted d u rin g th e visit in w h ich a n ew d iagn osis or recu rren t
ep isod e w as id en tified
 D en om in ator - All con su m er visits for th ose con su m ers aged 18 years
an d old er w ith a d iagn osis of m ajor d ep ressive d isord er
 N u m erator - Th e n u m b er of con su m er visits w ith a su icid e risk
assessm en t com p leted d u rin g th e visit in w h ich a n ew d iagn osis or
recu rren t ep isod e w as id en tified .
 M easu rem en t Period - Th e m easu rem en t p eriod for b oth th e
d en om in ator an d th e n u m erator is th e m easu rem en t year
Data and Reporting
In itiation an d en gagem en t of alcoh ol an d oth er d ru g
d ep en d en ce treatm en t (IET-BH )
 Percen tage of con su m ers age 13 an d old er w ith a n ew ep isod e of
alcoh ol or oth er d ru g (AO D ) d ep en d en ce w h o in itiated treatm en t
w ith in 14 d ays of d iagn osis, an d w h o h ad tw o or m ore ad d ition al
visits w ith in 30 d ays of th e in itiation visit
 D en om in ator – N u m b er of con su m ers in th e eligib le p op u lation
b ased on criteria in Section C
 N u m erator – N u m b er of eligib le con su m ers w h o satisfy th e
treatm en t in itiation an d /or en gagem en t sp ecification s in Section D
 M easu rem en t Period – Both th e d en om in ator an d th e n u m erator
h ave tw o m easu rem en t p eriod s
Q &A
Resources and Communication
 h ttp ://w w w .d h s.state.il.u s/p age.asp x?item =85713
 Em ail CCBH C gen eral in b ox at D H S.CCBH C@illin ois.gov
 Em ail D an n y Silb ert at d an iel.silb ert@illin ois.gov