2019 Triad Community Advisory Board Meeting · Any citizen may address the Community Advisory Board. Tim Gallagher, Guest, presented a flyer to the Board regarding a community event

2019 Triad

Community Advisory

Board Meeting

January 10, 2019

TRIAD COMMUNITY ADVISORY BOARD MEMBERS NAME PHONE EMAIL

Davie County Terry Renegar (336) 416-4158 [email protected]

Julie Whittaker (336) 751-5441 [email protected]

Laurie Cruse (336) 655-2465 [email protected]

Forsyth County Don Martin (336) 339-8064 [email protected]

David Mount (573) 489-5535 [email protected]

Mark Serosky (336) 749-4676 [email protected]

Rockingham County Reece Pyrtle (336) 932-4409 [email protected]

Ron Norwood (336) 613-3570 [email protected]

Felissa Ferrell (336) 342-1394 [email protected]

Stokes County Ronnie Mendenhall (336) 293-3359 [email protected]

Leon Inman, Chair (336) 575-3157 [email protected]

Pamela Tillman (336) 813-2051 [email protected]

CFAC Matthew Potter, Vice Chair (336) 409-3096 [email protected]

TRIAD COMMUNITY BOARD AGENDA January 10, 2019 Dinner (SERVED AT 5:00 p.m.)

SPEAKER PAGE PURPOSE 1. Call to Order- Matters of the

PublicLeon Inman, Chair 1 Information

2. Opening Remarks Leon Inman, Chair 2 Information

3. Approval of October 17, 2018Meeting Minutes

Leon Inman, Chair 3 Action

4. Local CFAC Update Matthew Potter 6 Information

5. Presentations

A. Community Relations Report

Melissa Bunker 7 Information

B. Network Management Adequacy and Accessibility Analysis

Leslie Gerard 8 Information

C. Community Operations Annual Report

Melissa Bunker 9 Information

D. Corporate Training & Development Annual Report

Revella Nesbit 10 Information

6. Community Updates Leon Inman, Chair 11 Information

7. Closing Remarks Leon Inman, Chair 12 Information

Adjournment

TRIAD AGENDA ITEM

MEETING DATE: January 10, 2019 AGENDA ITEM: 1

SUBJECT: Call to Order – Matters of the Public

BRIEF SUMMARY: The public may address the Board.

REQUESTED ACTION: None

ATTACHMENTS: No

1

TRIAD AGENDA ITEM


SUBJECT: Opening Remarks

BRIEF SUMMARY: Leon Inman, Chair, will provide opening remarks.

REQUESTED ACTION: Information Only

ATTACHMENTS: No

2

TRIAD AGENDA ITEM


SUBJECT: Approval of the October 17, 2018 Meeting Minutes

BRIEF SUMMARY: The minutes for the October 17, 2018 Triad Community Advisory Board

Meeting are attached for approval.

REQUESTED ACTION: Approve the minutes for the October 17, 2018 Triad Community Advisory

Board Meeting as presented.

ATTACHMENTS: Yes

3

Triad Community Advisory Board Meeting Minutes October 17, 2018

Members Present: Leon Inman, Chair, Donald Martin, Ron Norwood, Matthew Potter, Mark Serosky,

and Julie Whittaker

Members Absent: Laurie Cruse, Felissa Ferrell, David Mount, Ronnie Mendenhall, Reece Pyrtle, Terry Renegar, and Pamela Tillman

Staff Present: Ronda Outlaw, Melissa Bunker, Jill Queen, and Ruth Michel

Guests: Sarah Potter and Tim Gallagher

1. Call to Order – Leon Inman, Chair, called the meeting to order at 5:35 p.m.

Matters of the Public Any citizen may address the Community Advisory Board. Tim Gallagher, Guest, presented a flyer to the Board regarding a community event focused on IDD initiatives being held at the Dash Stadium on March 30, 2019.

2. Opening Remarks

Opening remarks by Leon Inman, Chair. Leon Inman, Chair welcomed Community Advisory Board Members and guests to the meeting.

3. Approval of the July, 12, 2018 Meeting Minutes

The minutes from the Thursday, July 12, 2018 Triad Community Advisory Board meeting were reviewed.

Leon Inman, Chair, motioned to approve the minutes as presented. Ron Norwood seconded the motion.

All in favor. Motion carried.

4. Local CFAC Update

Matthew Potter, CFAC Representative, provided updates to the Community Advisory Board on the CFAC Two-Day Summit.

Matthew Potter motioned the Community Advisory Board to request a copy of a "health council" presentation that was previously presented at the most recent Cardinal Innovation Corporate Board Meeting and loosely shared during the October CFAC Conference. This presentation has possible implications for how Cardinal Innovations Community Governance structure currently operates. Ron Norwood seconded the motion.

4

All in favor. Motion carried. 5. Special Presentations

A. Community Relations Report Ronda Outlaw, Senior Community Executive, presented the Community Relations Report. She announced her retirement as the Senior Community Executive to the Community Advisory Board. Ronda Outlaw introduced Melissa Bunker as her successor. Leon Inman, Chair, opened the floor to Melissa Bunker for comment.

B. Annual Fiscal Year County Dashboard Ronda Outlaw, Senior Community Executive, reviewed the Annual Fiscal Year County Dashboard.

C. Quality Assurance Annual Performance Improvement Plan Jill Queen, Quality Manager, reviewed the Quality Assurance Annual Performance Improvement Plan.

D. Quality Management Annual Report Jill Queen, Quality Manager, discussed the Quality Management Annual Report.

6. Community Updates

Leon Inman, Chair, requested community updates from the Board. 7. Closing remarks

Leon Inman, Chair, provided closing remarks.

Julie Whittaker motioned to adjourn the meeting. Matthew Potter seconded the motion.

All in favor. Motion carried.

Meeting adjourned at 7:37 p.m.

Community Board Clerk Date

5

TRIAD AGENDA ITEM


SUBJECT: Local CFAC Update

BRIEF SUMMARY: Matthew Potter, CFAC Representative, will provide local CFAC updates.

REQUESTED ACTION: Information only

ATTACHMENTS: No

6

TRIAD AGENDA ITEM

MEETING DATE: January 10, 2019 AGENDA ITEM: 5.A.

SUBJECT: Community Relations Report

BRIEF SUMMARY: Melissa Bunker, Senior Community Executive, will present the Community

Relations Report.


ATTACHMENTS: Appendix A

7

TRIAD AGENDA ITEM

MEETING DATE: January 10, 2019 AGENDA ITEM: 5.B.

SUBJECT: Network Management Adequacy and Accessibility Analysis

BRIEF SUMMARY: Leslie Gerard, Network Development and Field Director, will present the

Network Management Adequacy and Accessibility Analysis.


ATTACHMENTS: Appendix B

8

TRIAD AGENDA ITEM

MEETING DATE: January 10, 2019 AGENDA ITEM: 5.C.

SUBJECT: Community Operations Annual Report

BRIEF SUMMARY: Melissa Bunker, Senior Community Executive, will present the Community

Operations Annual Report.


ATTACHMENTS: Appendix C

9

TRIAD AGENDA ITEM

MEETING DATE: January 10, 2019 AGENDA ITEM: 5.D.

SUBJECT: Corporate Training & Development Annual Report

BRIEF SUMMARY: Revella Nesbit, Corporate Education Training Director, will present the

Corporate Training & Development Annual Report.


ATTACHMENTS: Appendix D

10

TRIAD AGENDA ITEM


SUBJECT: Community Updates

BRIEF SUMMARY: Leon Inman, Chair, will request community updates from the Community

Board.


ATTACHMENTS: No

11

TRIAD AGENDA ITEM


SUBJECT: Closing Remarks

BRIEF SUMMARY: Leon Inman, Chair, will provide closing remarks.


ATTACHMENTS: No

12

APPENDIX A: Community Relations Report NOTES

13

14

January 10, 2019

Copyright © 2016 Cardinal Innovations Healthcare. All rights reserved.

TRIAD COMMUNITY ADVISORY BOARD Community Relations Report

January 10, 2019

Melissa M. Bunker

Senior Community Executive

July 20, 201719, 2017

15


Information provided in this presentation pertains only to the counties in the Cardinal Innovations Healthcare service area. This information is specific to the Cardinal Innovations service area and may not apply to other organizations, providers, stakeholders or individuals outside the Cardinal Innovations service area.

Presentation slides are brief, bullet-points of information and should not be used out of context.

Disclaimer

January 10, 2019


People are my PassionDo Something RealAuthentic Customer Service

• Be Present• Listen• Advocate• Follow Up

Increase Utilization of Behavioral Health Urgent Care

2019 Goals

January 10, 2019

16


Successful NCQA* AccreditationNational Review of MCO Functions

• Measures MCO Management of ServiceDelivery System (providers, services, admin functions)

• Cardinal Outcomes• MBHO* Accreditation Score: 98.21 out of 100

(first public MCO in NC to hold this accreditation!)

• LTSS* Distinction Score: 100 out of 100 (one of onlytwo public MCOs in NC to hold this accreditation)

January 10, 2019

* NCQA = National Committee for Quality Assurance; MBHO = Managed Behavioral Healthcare Organization; LTSS = LongTerm Services and Supports


New Provider Network Services

“Rapid Response Services” New Medicaid “in lieu of” Service Definition*

• Developed for Highland Behavioral Health Urgent Care

• Triage, Assessment & Crisis Stabilization

• In Medically & Psychiatrically Monitored 24/7 Facility

• Population: Child/Adult; MH and/or SUD

• Time: Maximum 23 Hours and 59 Minutes

January 10, 2019

* “In Lieu Of” Service = Service approved outside the state Medicaid Services array; allows Medicaid billing

17


Community Needs Assessment

January 10, 2019

• January 17• 2-Week Window• Helps determine need and

capacity of providers todeliver services


Wellness Centers

• Exercise is BACKo Zumbao Tai-Chio Stretch and Tone

• Stokes – move to bigger location• Calendars - monthly

January 10, 2019

18


“County 360” Project

….to Become the Tailored Plan of Choice How?

Best ServicesBest People

Best Processes

January 10, 2019


“County 360” ProjectGoals

• Understand County Perceptions & Needs• Enhance Relationships w/ Key County Leaders• Deliver on Expectations

Action Steps• County Leader Interviews 10/18 - 3/19• Develop Improvement Plan to Address Findings

January 10, 2019

19


SB 630 a.k.a. “the Crisis/IVC Bill”Coordinated Community Response IVCLocal Area Crisis Services Plans

• MCO Defines Number/Geographic Boundaries• Non-Hospital Assessment as Best Option• Includes County IVC Transportation Plan

January 10, 2019

* IVC = Involuntary Commitment; legal process for clinical assessment when hospitalization may be needed


SB 630 a.k.a. “the Crisis/IVC Bill”

Local Area Crisis Services Plans MCO Leads Plan Development • Planning Committee• Plan Identifies Facilities to Provide Behavioral

Health and Physical Assessment

January 10, 2019


20


SB 630 a.k.a. “the Crisis/IVC Bill”

County IVC Transportation Plan • Counties and Cities Retain Responsibility for

Custody and Transportation• Adoption of Plan Required• Mandatory Participation in Planning• Included in Area Crisis Services Plan

January 10, 2019



Child Residential Services Pilot

Goals of Triad Pilot Proposal • Reduce Child Trauma Induced by Frequent

Residential Moves• Support Children & Foster Families with

Trauma-Informed Crisis Response & Training• Align Mandates of Departments of Social

Services & Cardinal Innovations

January 10, 2019

21


Status• Legislative Support from Senators Phil Berger

and Joyce Krawiec • Consult Funded by Cardinal Innovations

• Refine proposal for sustainability post-reform

• Draft language for bill for legislation & funding

• Advocacy at state level

January 10, 2019

Child Residential Services Pilot


Community Highlights

January 10, 2010

22


Forsyth County

• 4th Annual Global Peer Support Celebration• Sponsored Integrating Faith Communities, First

Responders Event• MH/SUD and IDD Advisories Award Local

Grants • Rooted in Advocacy Conference – 3/29/2019• Field of Dreams Event – 3/30/2019

January 10, 2019


Stokes County

Opioid Awareness Event 10/25/18o Hosted by Senator Phil Berger in Pine Hallo Speakers, Panel Discussion, Community

Dialogue o Attendees: Law enforcement, EMS, DSS,

Hospital, Treatment Providers, Individuals in Recovery, Families, Non-Profits

o Total Attendees 81

January 10, 2019

23


Stokes County

Paper Tigers Screeningo Trauma and Impacto Collaboration

•

January 10, 2019


Davie CountyVeterans Socialo Presentation by Bob Scofieldo Available Serviceso Wellness Center

Community Partners donate to Just Hope

January 10, 2019

24


Rockingham County

Voting Rights for IDD Members & FamiliesSchool Employees - Trauma

Informed Training

Upcoming! Cone Health Partnership

MedAssist Event March 30, 2019

January 10, 2019


Rockingham County

Transformations and Innovations Conferenceo March 2019o NC School Based Health Alliance o 4 High School Health Centers o $1,500 Sponsorship of Conferenceo Kevin Hines – Key Note Speaker

January 10, 2019

25

Copyright © 2016 Cardinal Innovations Healthcare. All rights reserved.January 10, 2019

COMMUNITY

OPERATIONS

Community Engagement

Community Relations

Member Engagement

Questions

26

APPENDIX B: Network Management Adequacy and

Accessibility Analysis NOTES

27

28


Triad Community Board Network Management Adequacy and

Accessibility Analysis

Leslie Gerard Netowrk Development and Field Director

January 10, 2019


AGENDA

January 10, 2019

• Cardinal Innovations Adequacy and AccessibilityAnalysis for FY1819

• Network Management Development Plan

• Community Operations Efforts


2018 Adequacy and Accessibility Analysis Timeline

• November, 2017: Community Operations conducted NeedsAssessment Survey

• March 6, 2018: JCB #278 notification that the due date for theAdequacy and Accessibility Analysis would be September 21,2018

• Analysis based on reporting period of July 1, 2016-June 30,2017and on contracted providers as January 1, 2018

• December 21, 2018: Received pending approval of the 2018Adequacy and Accessibility Analysis

January 10, 2019


2018 Adequacy and Accessibility Analysis

• Assures that there is a choice of 2 providers for Medicaid and 1 for Statefunded services within the access standards- if not met at 100% there is agap

• Access standards are 30 miles/30 minutes for Urban and 45 miles/45minutes for Rural (as determined by the State per NC Office of State Budget& Management)

Urban counties- Mecklenburg, Davie, Forsyth, Stokes Rockingham, Alamance, Orange, Cabarrus, Davidson, Rowan, Union, Franklin, Person, Chatham

Rural Counties: Stanly, Caswell, Granville, Halifax, Vance, Warren

• Includes identified needs gathered via the Needs Assessment Survey

January 10, 2019



2018 Adequacy and Accessibility Analysis

January 10, 2019

• Identified Gaps for Triad area:• Child and Adolescent Day Treatment (Medicaid and State)

• Opioid Treatment (Medicaid and State)

• Residential Level 2 other than TFC (State)

• Residential L2 TFC (State)

• Residential L4 (Medicaid and State)

• SACOT (Medicaid and Sate)

• SA Non-medical Community Residential-all counties (Medicaid and State)


2018 Needs Assessment

• 2,880 responses; all counties represented; all disabilities represented• Top service barriers: lack of employment, lack of reliable transportation, medical issues,

homelessness/housing issues, no insurance/cannot pay for services, lack of support fromfamily

• Top service needs: Improved provider staff competency, stability and quality of work;Improved availability of services during non-traditional hours, flexibility in scheduling,decreased wait time between appointments (particularly related to out-patient services);Increased provider choice and accessibility, especially for substance use services andmedication management; decreased perception of wait lists; Increased treatment options forchildren and youth (e.g., ages 3-6; SUD for adolescents); increased focus on person centeredthinking; Increased treatment options for dually diagnosed members (I/DD and MH);increased respite options; increased availability of non-English speaking services; increasedavailability of Innovations services; increased understanding of service continuums and howto access them

January 10, 2019


2018 Network Management Development Plan

January 10, 2019

1. Increase residential options for members with co-occurring disorders (Mental Health/Intellectual Developmental Disabilities).

2. Increase availability of Applied Behavioral Analysis (ABA) and other research-based treatment options for children with Autism Spectrum Disorder(ASD).

3. Provide training opportunities for providers to improve their ability to offer treatment for members with co-occurring disorders (MH/IDD).


2018 Network Management Development Plan Con’t.

January 10, 2019

4. Increase (b)(3) psychiatric consultation services in both the Five County region and Person County.

5. Increase utilization of Cardinal Innovations In-Lieu Of ACTT-Step Down services.

6. Align contracts and service delivery by Substance Use Disorder residential providers with American Society of Addiction Medicine (ASAM) Criteria.

7. Support Cardinal Innovations Psychiatric Residential Treatment Facilities (PRTF) project.


2018 Network Management Development Plan Con’t.

8. Assure follow up within seven (7) days of discharge from an acute care setting for a minimum of 40% of MH and SUD members.

9. Monitor quality and assure capacity for services identified to supportTransitions to Community Living (TCL) members (Assertive Community Treatment Team (ACTT); Individual Placement and Support- Supported Employment (IPS-SE); Community Support Team (CST); Transition Management Services (TMS); Peer Support Services (PSS); and Individual Support Services).

10. Expand the network for Innovations Supported Living.

January 10, 2019


Community Operations

Overarching General Initiatives across Entire Footprint:• Actively engaged in community planning regarding both the Stepping Up

initiative and opioid-related initiatives across all participating counties in our footprint.

• Developing measureable outcomes for tracking social needs• Working with registry team to assess members waiting and additional

supports that may be available to them while waiting (community resourcesand Medicaid services)

• Targeting certain community members who could benefit from Cardinaleducation and support to better understand Cardinal’s role, limitations andoperational/community efforts.

January 10, 2019


Community Operations Triad Efforts

January 10, 2019

1. Community Reinvestment: Successful program and project implementationthat meets goals and outcomes set forth within individual proposals.

2. Law Enforcement Partnership: Continue to patriciate in planning andimplementation of a Forsyth County deferred prosecution program, anincentive based treatment alternative to incarceration for those withbehavioral health conditions, primarily SUD.

3. Stokes County Relationship Management: Maintain gains made (i.e.successful completion of formal Corrective Action Plan FY18) in countyperception of services and supports offered by Cardinal Innovations.

.


Community Operations Triad Efforts Con’t.

4. Child Residential: In collaboration with Triad DSS Directors, County Managers andelected officials, support securing funding and implementation of pilot programs in Triad to improve residential care for children (via parallel Community Reinvestment and legislative tracks).

5. Rockingham County Relationship Management: Strengthen relationships withRockingham County management /leaders; improve perception of CardinalInnovations through excellent customer service and timely response.

January 10, 2019

30

APPENDIX C: Community Operations Annual Report NOTES

31

32

July 1, 2017 – June 30, 2018

Community Operations End of Fiscal Year Report2017 - 2018



July 1, 2017 – June 30, 2018

FY 2017 – 2018: A total of 19,688 people were trained by Community Engagement employees during a total of 508 trainings.Community Engagement team members attended a total of 541 community events (excluding training) throughout all regions that we currently serve.

242 177 4 85

6512

7130

2062

3984

279 159 0 103

Northern Southern Statewide Triad

Total Community Engagement Trainings

Total Training Attendees

Total Other Events

FY 2017 ‐ 2018

128 106 63

22012059

1212

257 283 256

Northern Southern Triad

Total Community Engagement Trainings

Total Training Attendees

Total Other Events

FY 2016 ‐ 2017Total Trainings by Region

33



July 1, 2016 – June 30, 2017

FY 2016 – 2017: A total of 5,472 people were trained by Community Engagement employees during a total of 297 trainings.Community Engagement team members attended a total of 796 community events (excluding training) throughout all regions that we currently serve.

128

28

45

70

26

MHFA CIT QPR Cardinal Overview Other77

31

6

111

6

26

44

35

32

Cardinal Overview

CIT (Crisis Intervention Training)

Innovation Waiver Overview

MHFA (Mental Health First Aid)

Other

Psychosis Simulation

QPR (Question, Persuade, Refer)

Stigma

Trauma

FY 2016 ‐ 2017FY 2017 ‐ 2018Total Trainings by Type


Narrative outcome data is available upon request and may be accessed directly via SharePoint

A Champion Connection is a community stakeholder achievement that positively benefits or enhances services and supports to members or that contributes to various CIH business objectives.

There were a total of 72 Champion Connections during FY 2017 ‐ 2018. Please note that this data was not yet being captured in Q1.

Community Relations Champion Connections

41

8 7

3

23

2 3

13

4 5

27

7

25 4 4

22

Central Five County Mecklenburg Piedmont Triad

Q1 Q2 Q3 Q4

Cumulative

July 1, 2017 – June 30, 2018

34

Copyright © 2017 Cardinal Innovations Healthcare. All rights reserved.July 1, 2017 – June 30, 2018

6

11

4

23

79

2

22

9 10

4

20

Company Branding Political Gain Positive Media Exposure Strategic Alliance

Q2 Q3 Q4Company Branding: CR speaking opportunity and/or logo visibilityPolitical Gain: Interface results in positive connection or alignment with elected officialsPositive Media Exposure: CIH positively referenced in an article, news outlet or social mediaStrategic Alliance: Interface w/ key partners to promote CIH or community education

A Champion Connection is a community stakeholder achievement that positively benefits or enhances services and supports to members or that contributes to various CIH business objectives.

Community Relations Champion Connections by Impact Type


0

1

0 00

1

0 00 0

1 1

0

1

3

1

Central Northern Southern Triad

Q1 Q2 Q3 Q4

Community Relations Legislative Inquiries

35


Community Relations Performance Highlights

1. Participated in Community Empowerment Initiatives2. Organized Health Care Agreement consensus in Halifax Integrated Healthcare Coalition3. Assisting with procedure development focusing on treatment v. placement at YFS4. Participated in Charlotte Observer interview related to First Responder Data Collaborative focus to reduce MHSUD

crisis calls for service to 911 5. Hand delivered Narcan Kits to key stakeholders across all communities6. Coordinated Mecklenburg FQHC meetings to support integrated care partnership and development of SUD

programming7. Initiated Business Associate Agreement with Community Care Services to support transitional and coordination of

care for high risk/need individuals with SPMI and prescribed an anti‐psychotic medication8. Participated in STEP Treatment Court Leadership with county contracted providers9. Facilitated development of the FY17‐18 Crisis Continuum Work plan with new/modified goals10. Participated in co‐meetings with County Behavioral Health Division to support development of a specialized

provider network to support youth and families in custody


Member EngagementTotal Prevention Strategies Presented

July 1, 2017 – June 30, 2018

614

370

33

447 456

50

FY 2016 – 2017 = 997FY 2017 – 2018 = 1,970

183139

11

348

279

37

36


Training Type Total Trainings

Achieving a Better Life Experience (ABLE Act) 6

Cardinal Innovations Healthcare Overview for Members 13

Guardianship and Alternatives for Intellectual/Developmental Disabilities and Mental Health 8

Member Engagement Overview 9

Peer Support Specialist 11

Prime for Life (Now That I Am 18) 6

Upward to Financial Stability 11

Wellness Recovery Action Plan (WRAP) 75

Whole Health Action Management (WHAM) 24

Other 85

Member Engagement Total Trainings = 248


Member Engagement Medical Loss Ratio (MLR) activities and hours completed

• Any quality reporting and related documentation in non‐electronic form for wellness and health promotion activities = 498.75 hours

• Coaching or education programs and health promotion activities designed to change member behavior and conditions (i.e., smoke or obesity) = 1,666.50 hours

• Coaching programs designed to educate individuals on clinically effective methods for dealing with specific chronic disease or condition = 905 hours

• Public Health education campaigns that are performed in conjunction with state or local health departments = 739.75 hours• Wellness Assessments = 310.50 hours• Blank = 682 hours

TOTAL MLR Hours Completed = 4,802.50

37

38

APPENDIX D: Corporate Training & Development

Annual Report NOTES

39

40

January 10, 2019


Corporate Training & Development

Community Board Annual Report

January 2019Revella H. Nesbit, M.Ed., LPCS, ODCP

Director, Corporate Training & Development

January 10, 2019

41


Cultural Competency

Diversity & Inclusion

Professional Continuing Education Credits

Learning Management System

Centralized Training

January 10, 2019


42

Copyright © 2016 Cardinal Innovations Healthcare. All rights reserved.December 19, 2018


Cultural Competency Accomplishments Cultural Competence Provider Monitoring Tool Revision: Provider requested tool revision to allow for more flexibility in

implementing cultural competence

Cultural Competence Provider Monitoring Tool:70.4% of providers scored in the Full and Emerging categories (FY 17-18)

6 Active Cultural Competence Provider Councils: Provider – led & driven councils invested in promoting Cultural Competencethroughout the network

LGBTQ Learning Collaborative: Provider collaborative created to encourage a learning community for best practices in working with members who identify as LGBTQ.

Provider TIP Sheets: Transportation; Interpretation & Translation; Cultural Competence Monitoring; Cultural Humility; LGBTQ+; Culture

Trainings for providers & staff: 12 trainings were offered in 2018 related to Cultural Competency

Training Topics: Hispanic/Latino Culture; African American Trauma; LGBTQ+; Transgender; Ethics of Cultural Competence Pt. 1 & Pt. 2

Advisory Subcommittee for Latino Affairs (ASLA): Internal committee established to support the Latino community & bringawareness to how we serve this community; 1st Latino Forum – May 4, 2019

January 10, 2019

43



Inclusion @ Cardinal Innovations Appointment of Chief Diversity & Inclusion Officer

Creation of Diversity Leadership Council

Creation of Diversity & Inclusion Statement

Development of Diversity & Inclusion Strategy

January 10, 2019

44

Copyright © 2016 Cardinal Innovations Healthcare. All rights reserved.Janurary 10, 2019


Continuing Education Credits NBCC = National Board Certified Counselor

NAADAC = The Association for Addictions

Professionals

Credits applied toward re-licensure for

clinicians

Support best practices/emerging practice

Januray 10, 2019

45


Continuing Education Credits - 2018 25 NBCC approved trainings

67.5 NBCC credit hours offered

266 NBCC certificates distributed to Cardinal Innovations staff

186 NBCC certificates distributed to stakeholders

1,010 Registrations for NBCC trainings

January 10, 2019

73%Completion


Continuing Education Accomplishments Future addition of web-based and home-based training options

Approved as a NAADAC continuing education provider

LMS integration providing more efficiency

Staff as subject matter experts

41 Trainers (Cardinal staff, providers, community experts)

7 Grand Rounds

Trainings located in all regions

January 10, 2019

46



Learning Management System Create a culture of learning and empowerment

Provide flexible learning opportunities

Provide on-demand reporting, analytics and dashboards

Automate registration management, tracking and evaluation

Maintain version control of curricula and training materials

Offer & maintain robust and relevant training resources

Centralize eLearning that is available any time/place to all users

Design & implement customizable training that is proprietary to CardinalInnovations

January 10, 2019

47


The Learning Center FY 17-18 100% of internal staff have used The Learning Center 60% on average internal staff use The Learning Center monthly 1216 = number of courses available 2861 = number of external training registrations 307 = number of CI trainings created 4.18 out of 5 = average course rating

January 10, 2019


External1. Triad Mental Health Awareness Event2. Provider Direct System Administrator Rules and

Regulations3. Starting a Private Practice Forum4. Sustaining Your Business through Medicaid

Reform5. Financial Matters: Understanding Your Business

by the Numbers

Top 5 Trainings Internal1. Compliance Courses2. Diversity and Inclusion

Curriculum3. Text Messaging Guidelines

for Care Coordination4. Member Home and

Community SafetyPractices

5. Blood Borne Pathogens forHealthcare Professionals

January 10, 2019

48


Consumer Family Advisory Council

CFAC Microsite Launched April 2018 43 CFAC members registered On-line courses completed include:

CFAC OrientationGetting Started in the Learning CenterMeetings that Get Results Upward to Financial Stability

January 10, 2019


The Learning Center Accomplishments Launch of CFAC Microsite Promotion of The Learning Center as an Employee Benefit Promotion of modules in The Learning Center that align with monthly

Communications’ Thematic Calendar 60 topical articles in 411 11 Trainings for users of Learning Center Learning Center Ticketing System created and enhanced to align with Training

Request Tool Automated employee assignments in The Learning Center

(HIPAA Remediation, Diversity & Inclusion, Compliance, New Hire Assignments) Increased reporting & data collection iCal Training Invitations

January 10, 2019

49



Centralized Training Model

Member/


Care Coordination

Finance

Service Center

Network

Clinical Operations

Quality Management

Compliance

Provider Training

Employee Training

50


Looking Forward

Centralization of Training Diversity & Inclusion Strategic Plan Latino Forum – May 6, 2019

Caminando en mis zapatos (Walking In My Shoes) CFAC Microsite Provider Microsite Receipt of electronic payment in The Learning Center NAADAC Continuing Education offering More robust data collection, trending, and outcomes

January 10, 2019


An organization’s ability to learn, and translate that learning into action rapidly, is the ultimate competitive

advantage.”

Jack Welch

January 10, 2019

51

52

Rockingham County Dashboards

FYTD September 2018

County Funded Program Descriptions

County Funded Program

Daymark Recovery Services """Safety net"" provider serving adults with serious mental health and/or substance use issues through a broad continuum of services. "

County Funded Program Description

Various Community Collaborative-KARTS

Various Community Collaborative-KARTS

53


FYTD September 2018

Report data as of November 24, 2018. All graphs are county specific unless otherwise noted.

County Funded Programs*

Daymark Recovery Services

Various

Various

Total:

*Please see the County Funded Program Descriptions (Pg. 1) for additional detail

23.5%$77,950

25.0%

% Spent

0.0%$10,000

$0$10,000

Please note that providers have up to 90 days to submit claims and that this will affect the number of members served and expense amounts on this report. The numbers for

the previous months will be updated each reporting period.

$0

FYTD

Expenses

$77,950$311,800

Rockingham Funding

0.0%

$331,800

FY Budget

Amount

NOTE: County “Maintenance of Effort” funds targeting local behavioral health needs may be managed by Cardinal Innovations or by the county. Data shown here only represents county funds managed by Cardinal Innovations. Some counties manage all of their "Maintenance of Effort" funding.

54


FYTD September 2018

Number of Members Served by Age and Diagnosis

Number of Members Served All Age and All Diagnosis Registry of Unmet Needs

409 414392

25 18 23

0 0 10

50

100

150

200

250

300

350

400

450

Jul'1

8

Au

g'1

8

Sep

'18

Child Members Served by DiagnosisAges 3 through 17

MH IDD SUD

688730

588

163 162 166217 225 200

0

100

200

300

400

500

600

700

800

Jul'1

8

Au

g'1

8

Sep

'18

Adult Members Served by DiagnosisAges 18 and over

MH IDD SUD

118

113

115

110

111

112

113

114

115

116

117

118

119

Jul'1

8

Au

g'1

8

Sep

'18

Nu

mb

er o

f M

emb

ers

on

Reg

istr

y

Innovations Registry of Unmet Needs

NOTE: Innovations slots and funding are allocated by the state. MCOs have no ability to fund or expand the number of Innovations slots.

1097 1144980

188 180 189217 225 201

0000000000

200

400

600

800

1000

1200

1400

Jul'1

8

Au

g'1

8

Sep

'18

All Members Served Ages 3 and over

All Diagnosis

MH IDD SUD

NOTE: This is a distinct count of members served. Members with multiple diagnosis will only be counted once. The sum of the previous graph will not be equal to the total in this graph.

55


FYTD September 2018

Service Category Definitions

Service Category

1915 (b)(3) Services

ACTT

ICF

Group settings that serve people across all disability groups.

Psychiatric Residential Treatment Facilities provide residential care to persons under the age of 21 who need 24-hour supervision and specialized

interventions.

Inpatient

MST

Outpatient

Innovations

Services that are provided in the community.

Community based mental health and substance abuse rehabilitation services and interventions.

Services received in a crisis or emergency situation such as Mobile Crisis and Facility-based crisis.

A long-term residential program for people with behavioral health needs.

A short-term service for acutely mentally ill children or adults designed to prevent hospitalizations or to serve as a step down for those leaving an

inpatient facility.

Crisis Services

Services provided in a hospital Emergency Department on an outpatient basis.

BH Long Term Residential

Community Support

Medicaid Waiver for individuals with Intellectual Disabilities.

Hospital-based psychiatric care.

Multisystemic Therapy is a family and community-based therapy for juveniles.

Services received in the community including evaluation, therapy, and psychiatric care.

Outpatient ED

Partial Hosp/Day Tx

Mandated service categories effective 7/1/2013.

IIHS

Definition

Additional supports for Medicaid recipients such as Community Guide and Individual Support.

Assertive Community Treatment Team - services received in the community that address functional areas of the identified population.

Residential

PRTF

Emergency Department

Service to help adults with psychiatric disabilities manage their illness and their lives with as little professional intervention as possible.

Hospital emergency department.

Intermediate Care Facility for individuals with Intellectual Disabilities.

Intensive In-Home Services - services provided in the person's home by a small team with at least one Licensed Professional.

Community

Psych Rehab

56


FYTD September 2018

Members Served is based on Member's County of Medicaid Eligibility not on the Provider's physical

location.

Expenses by Service Categories is based on the Total Paid Amount.

*Please see the Service Category Definitions (Pg. 4) for additional detail

Members Served and Expenses by Service Category

4

11

26

13

22

44

15

28

33

42

38

32

70

100

102

1581

0

9

13

15

22

24

25

29

32

33

37

62

71

101

121

1553

0 500 1000 1500 2000

MST

Community Support


PRTF (Psychiatric ResidentialTreatment Facility)

Partial Hosp/Day Tx

Outpatient ED

Crisis Services

Psych Rehab

ACTT (Assertive CommunityTreatment Team)

IIHS

ICF


Inpatient

Innovations


Outpatient

Distinct Members Served - Medicaid Funding

Jul'18-Sep'18 Jul'17-Sep'17

$24,144

$5,055

$219,574

$260,928

$100,651

$5,095

$9,678

$62,980

$116,959

$238,644

$1,393,372

$64,838

$246,211

$1,351,230

$77,924

$368,878

$0

$8,343

$114,655

$326,337

$94,206

$2,788

$14,381

$69,313

$115,339

$194,672

$1,395,888

$273,557

$333,347

$1,512,015

$78,362

$462,070

$0 $400,000 $800,000 $1,200,000 $1,600,000

MST

Community Support


PRTF (Psychiatric Residential Treatment Facility)

Partial Hosp/Day Tx

Outpatient ED

Crisis Services

Psych Rehab

ACTT (Assertive Community Treatment Team)

IIHS

ICF


Inpatient

Innovations


Outpatient

Expenses by Service Category - Medicaid Funding


57


FYTD September 2018


Members Served is based on member's County of Residence not on the Provider's physical

location.



0

7

42

47

40

53

443

1

4

31

40

48

54

387

0 100 200 300 400 500

Community Support


Community

Inpatient

Crisis Services

Residential

Outpatient

Distinct Members Served - State Funding


$0

$7,776

$144,235

$154,197

$25,053

$173,725

$41,199

$2,065

$3,888

$104,933

$123,463

$26,585

$164,038

$42,593

$0 $50,000 $100,000 $150,000 $200,000

Community Support


Community

Inpatient

Crisis Services

Residential

Outpatient

Expenses by Service Category - State Funding


58


FYTD September 2018

Members Served and Expense Amounts - Facility Based Crisis & Mobile Crisis Management Services

Medicaid Member served for Facility Based Crisis & Mobile Crisis Services are based on the

Consumers Eligibility. Expenses by Facility Based Crisis & Mobile Crisis Services are based on the total Adjudicated

Amount.


location.


3

12

5

19

0

5

10

15

20

Facility Based Crisis Mobile Crisis Management

Distinct Members Receiving FBC & MCM Crisis ServicesMedicaid


9

21

9

23

0

5

10

15

20

25


Distinct Members Receiving FBC & MCM Crisis ServicesState


$5,165

$2,234

$10,297

$2,131

$0

$2,000

$4,000

$6,000

$8,000

$10,000

$12,000


Expenses by FBC & MCM Crisis ServiceMedicaid


$9,578

$3,849

$16,771

$2,818

$0

$2,000

$4,000

$6,000

$8,000

$10,000

$12,000

$14,000

$16,000

$18,000


Expenses by FBC & MCM Crisis ServiceState


59


FYTD September 2018

Entity Type Definitions

Psych State Institution State run Psychiatric care facility for children and adults.

Agencies provide one or more enhanced clinical/therapeutic/rehabilitative/habilitative service to MH, SUD, IDD, or multiple diagnosis groups.

LIPLicensed Independent Practitioner (LIP) - Individual Clinicians, Therapists, Psychiatrists, Psychologists, etc. that are individually contracted with

the MCO. They provide outpatient services such as therapy, psychiatric care, assessment and testing.

LIP Group

Residential Facility located in-catchment but affiliated with another MCO/LME with local Quality Management mandated site visits and limited

oversight required.Senate Bill 163

Other Other entity not elsewhere defined.

County Agency Public health agency.

Neuro Behavioral Center State

Institution

State run medical and nursing care facility for individuals with severe or moderate developmental disability (IDD) and medical conditions of a

serious or chronic nature requiring 24 hour care.

ICFMR State Institution Intermediate Care Facilities for Persons with Mental Retardation (ICF/MR) - State run Intermediate Care Facility serving IDD Adults and children.

ADATC State InstitutionAlcohol Drug Abuse Treatment Center (ADATC) State Institution-A state run SUD Adult facility which provides medical detox and medically

monitored residential treatment.

Licensed Independent Practitioner (LIP) Groups are a group of clinicians, Therapists, Psychiatrists, Psychologists, etc. providing outpatient services

such as therapy, psychiatric care, assessment, and testing. They contract with the MCO as a group.

Mandated Entity types effective 11/1/2017.

Entity Type Definition

Agency

Hospital Non-contracted Hospitals for which we reimburse Emergency Department services and Inpatient services.

Physician's Group of HospitalsA group of physicians, contracting or non-contracting, associated with hospitals but not employed by the facility. Considered non-contracting

unless otherwise specified.

Inpatient Hospital providing contracted behavioral health Inpatient and Emergency Department services.

Comprehensive Community

Clinics

Agency based entities providing a number of services, including assessment, enrollment, Outpatient and Psychiatric services, and serve at least

two disabilities. They are designated points of entry that ensure easy access for members.

Inpatient/Outpatient Hospital providing contracted behavioral health Emergency Department and Outpatient services.

60


FYTD September 2018

*Please see the Entity Type Definitions (Pg. 8) for additional detail

YOUTH HAVEN SERVICES, LLC Agency

DAYMARK Recovery Services, Inc.(Cabarrus Center) Comprehensive Community Clinics

The Moses H. Cone Memorial Hospital Inpatient

Faith in Families, Inc. Agency

Neuropsychiatric Care Center, PLLC LIP

Morehead Memorial Hospital Hospital

Successful Transitions LLC Agency

UMAR Services, Inc. Agency

Monarch Comprehensive Community Clinics

DAYMARK Recovery Services, Inc. - Mobile Crisis Management / After Hours EmergencyAgency

Access Call Center

Top 10 Providers by Members Served - RockinghamEntity Type

Provider Information

5,303 5,665 5,068

5 5 5

0

1

2

3

4

5

6

0

2000

4000

6000

8000

Jul'1

8

Au

g'1

8

Sep

'18

Spee

d t

o A

nsw

er (

secs

)

# o

f C

alls

Total Number of Calls and Speed to Answer

2.1% 2.0% 2.2%

0%

2%

4%

6%

8%

10%

Jul'1

8

Au

g'1

8

Sep

'18

Per

cen

t o

f C

alls

Ab

and

on

ed

Call Abandonment Rate

Access HEDIS Benchmark 8.6% Cardinal Innovations Target 5.0%

0101010203030407282937

146191

415868

0 200 400 600 800 1000

Other

Neuro Behavioral Center State Institution

County Agency

ADATC State Institution

Inpatient/Outpatient

ICFMR State Institution

Psych State Institution

Comprehensive Community Clinics

Inpatient

Physician's Group of Hospitals

Hospital

LIP Group

LIP

Agency

Total Providers

All Cardinal Innovations Providers by Entity Type

Note: The Top 10 Providers by Members Served is based on member's County of Medicaid Eligibility not on the Provider's physical location.

61


FYTD September 2018

Members Served by Age and Diagnosis

Members Served and Expense Amounts by Service Category - Medicaid

Members Served and Expense Amounts by Service Category - State

Members Served and Expense Amounts for Crisis Services


Medicaid funded Outpatient services were the most utilized services for 1st Qtr FY1819. 1915 (b)(3) services had the largest increase in utilization

of 94% (32 to 62) and in expense of 322% ($64,838 to $273,557). Overall, Innovations had the highest expense of $1,512,015 followed by ICF

$1,395,888 for this quarter. BH Long Residential services experienced a decrease in utilization of 50% (26 to 13) and a decrease in expense of 48%

($219,574 to $114,655) compared to the 1st Qtr FY1718.

State funded Outpatient services had the highest utilization for 1st Qtr FY1819 while Residential services had the highest expense with $164,038.

Inpatient had the second highest expense for this quarter of $123,463, which was a 20% decrease ($154,197 to $123,463) from same quarter last

fiscal year.

Medicaid funded Facility Based Crisis (3 to 5) and Mobile Crisis Management (12 to 19) both had increases in utilization for 1st Qtr FY1819, with

Mobile Crisis having the largest increase of 58%. State funded Facility Based Crisis utilization remained consistent for this quarter but had a 75%

increase ($9,578 to $16,771) in expense. Much of this increase can be attributed to the addition of a new Facility Based Crisis provider in October

of 2017, just after the end of Q1 FY1718.

Average speed to answer and call abandonment rate remained consistent for the quarter.

Both Child MH and Adult MH members served have been decreasing for 1st Qtr FY1819. Child and Adult IDD and SUD members served have

remained consistent.

Analysis:

Please note that providers have up to 90 days to submit claims and that this will affect the number of members served and expense amounts on this report. The

numbers for the previous months will be updated each reporting period.

Call Center information in the charts above reflect Cardinal Innovations data and are not county specific.

62

Davie County Dashboards

FYTD September 2018


County Funded Program County Funded Program Description

63


FYTD September 2018



Total:


FY Budget

Amount

FYTD

Expenses

Davie Funding



% Spent

$0 $0


64


FYTD September 2018

Registry of Unmet Needs


Number of Members Served All Age and All Diagnosis

166175

153

17 14 12

5 5 40

20

40

60

80

100

120

140

160

180

200

Jul'1

8

Au

g'1

8

Sep

'18


MH IDD SUD

163

140

109

86 87 87

66 66 65

0

20

40

60

80

100

120

140

160

180

Jul'1

8

Au

g'1

8

Sep

'18


MH IDD SUD

79

77

75

73

74

75

76

77

78

79

80

Jul'1

8

Au

g'1

8

Sep

'18

Nu

mb

er o

f M

emb

ers

on

Reg

istr

y



329 315

262

103 101 99

71 71 69

0000000000

50

100

150

200

250

300

350

Jul'1

8

Au

g'1

8

Sep

'18


All Diagnosis

MH IDD SUD


65


FYTD September 2018


Residential

PRTF







Community Support





Outpatient ED

Partial Hosp/Day Tx


IIHS

Definition




Psych Rehab



inpatient facility.

Crisis Services

Inpatient

MST

Outpatient

Innovations




Community

Service Category


ACTT

ICF



interventions.

66


FYTD September 2018



location.



2

1

11

2

3

4

16

3

16

12

11

31

18

37

53

453

0

3

4

4

4

6

6

8

9

14

15

15

16

25

51

460

0 100 200 300 400 500

Community Support

Psych Rehab

Crisis Services

MST

Partial Hosp/Day Tx


Outpatient ED


IIHS



Inpatient

ICF


Innovations

Outpatient



$7,634

$132

$3,906

$8,973

$10,738

$14,255

$1,659

$67,286

$54,222

$26,456

$125,081

$73,504

$710,094

$21,235

$738,789

$146,303

$0

$5,447

$4,383

$25,514

$2,977

$21,383

$769

$151,820

$48,408

$30,688

$105,049

$88,740

$628,045

$14,390

$728,053

$158,971

$0 $200,000 $400,000 $600,000 $800,000

Community Support

Psych Rehab

Crisis Services

MST

Partial Hosp/Day Tx


Outpatient ED


IIHS



Inpatient

ICF


Innovations

Outpatient



67


FYTD September 2018





location.

0

1

15

19

23

21

70

0

0

14

17

17

23

89

0 20 40 60 80 100

Community Support

Partial Hosp/Day Tx

Residential

Crisis Services

Inpatient

Community

Outpatient



$0

$1,323

$44,666

$5,860

$70,985

$42,453

$5,736

$0

$0

$53,312

$7,814

$62,287

$42,035

$4,923

$0 $20,000 $40,000 $60,000 $80,000

Community Support

Partial Hosp/Day Tx

Residential

Crisis Services

Inpatient

Community

Outpatient



68


FYTD September 2018


location.





Amount.

1

11

2 2

0

2

4

6

8

10

12




1

14

6

10

0

2

4

6

8

10

12

14

16




$2,085$1,822

$4,177

$206

$0

$500

$1,000

$1,500

$2,000

$2,500

$3,000

$3,500

$4,000

$4,500




$2,141$3,162

$9,597

$1,615

$0

$2,000

$4,000

$6,000

$8,000

$10,000

$12,000




69


FYTD September 2018







Clinics








Agency

Senate Bill 163




Institution







oversight required.

LIP Group





70


FYTD September 2018



Novant Medical Group, Inc. dba Rowan Psychiatric Associates Hospital


Wake Forest University Health Sciences Physician's Group of Hospitals

County of Davie Office of Finance Agent dba Davie County Health DepartmentLIP

Addiction Recovery Medical Services, PLLC Agency

Milling Manor, Inc. Agency

Forsyth Memorial Hospital, Inc. dba Novant Health Forsyth Medical CenterInpatient

The Neil Group, Inc. LIP Group

North Carolina Baptist Hospital Inpatient

Top 10 Providers by Members Served - Davie Entity Type


Access Call Center

5,303 5,665 5,068

5 5 5

0

1

2

3

4

5

6

0

2000

4000

6000

8000

Jul'1

8

Au

g'1

8

Sep

'18

Spee

d t

o A

nsw

er (

secs

)

# o

f C

alls


2.1% 2.0% 2.2%

0%

2%

4%

6%

8%

10%

Jul'1

8

Au

g'1

8

Sep

'18

Per

cen

t o

f C

alls

Ab

and

on

ed



0101010203030407282937

146191

415868

0 200 400 600 800 1000

Other


County Agency






Inpatient


Hospital

LIP Group

LIP

Agency

Total Providers



71


FYTD September 2018






Analysis:




Medicaid funded Outpatient services continue to be the highest utilized services. For expense, Innovations had the highest expense ($728,053)

followed by ICF ($628,045). Crisis services had the largest percentage decrease in utilization of 64% (11 to 4). PRTF had the largest increase in

utilization of 167% (3 to 8) and in expense of 126% ($67,286 to $151,820).

State funded Outpatient services were the highest utilized in 1st Qtr FY1819, with a 27% increase (70 to 89) over the 1st Qtr FY1718. Inpatient had

the highest in expense ($62,287) followed by Residential services ($53,312).


Both MH Child and MH Adult members served were on a downward trend for 1st Qtr FY1819. Child and Adult IDD and SUD have remained fairly

consistent.

Both Medicaid and State funded Facility Based Crisis increased in utilization and in expense. State funded Facility Based Crisis had the largest

increase in utilization of 500% (1 to 6) and in expense of 348% ($2,141 to $9,597). Much of this increase can be attributed to the addition of a new

Facility Based Crisis provider in October of 2017, just after the end of Q1 FY1718. Mobile Crisis Management services decreased in utilization and

expense for both Medicaid and State funding for 1st Qtr FY1819. Medicaid funded Mobile Crisis had the largest decrease in utilization of 82% (11

to 2) and in expense of 89% ($1,822 to $206).

72

Stokes County Dashboards

FYTD September 2018


County Funded Program County Funded Program Description

73


FYTD September 2018



Total:


$0

% Spent



FYTD

Expenses

Stokes Funding

$0

FY Budget

Amount


74


FYTD September 2018



216231 236

17 18 11

3 4 30

50

100

150

200

250

Jul'1

8

Au

g'1

8

Sep

'18


MH IDD SUD

264288

243

89 90 91

89 92 97

0

50

100

150

200

250

300

350

Jul'1

8

Au

g'1

8

Sep

'18


MH IDD SUD

82

78

77

74

75

76

77

78

79

80

81

82

83

Jul'1

8

Au

g'1

8

Sep

'18

Nu

mb

er o

f M

emb

ers

on

Reg

istr

y



480519

479

106 108 102

92 96 100

0000000000

100

200

300

400

500

600

Jul'1

8

Au

g'1

8

Sep

'18


All Diagnosis

MH IDD SUD


75


FYTD September 2018


Service Category


ACTT

ICF



interventions.

Inpatient

MST

Outpatient

Innovations






inpatient facility.

Crisis Services



Community Support





Outpatient ED

Partial Hosp/Day Tx


IIHS

Definition



Residential

PRTF






Community

Psych Rehab

76


FYTD September 2018


location.




2

0

6

10

10

13

13

14

7

37

30

12

34

44

59

628

1

1

6

8

11

12

14

17

18

20

20

24

32

42

58

652

0 100 200 300 400 500 600 700

Community Support

MST



ICF


Crisis Services

Psych Rehab


Outpatient ED

Partial Hosp/Day Tx

IIHS

Inpatient


Innovations

Outpatient



$2,908

$0

$72,965

$33,695

$418,193

$125,033

$2,028

$36,239

$4,597

$3,969

$286,578

$74,618

$188,788

$35,547

$736,961

$188,990

$2,511

$3,093

$163,824

$31,103

$465,875

$142,439

$12,965

$39,796

$33,069

$2,230

$205,280

$138,855

$127,226

$30,496

$756,741

$232,393

$0 $200,000 $400,000 $600,000 $800,000

Community Support

MST



ICF


Crisis Services

Psych Rehab


Outpatient ED

Partial Hosp/Day Tx

IIHS

Inpatient


Innovations

Outpatient



77


FYTD September 2018



location.



1

2

9

17

15

28

164

1

2

12

13

15

30

175

0 50 100 150 200

Partial Hosp/Day Tx


Residential

Inpatient

Crisis Services

Community

Outpatient



$1,720

$1,296

$24,757

$74,392

$5,535

$42,999

$27,997

$2,412

$3,888

$34,362

$41,471

$4,545

$37,188

$27,271

$0 $20,000 $40,000 $60,000 $80,000

Partial Hosp/Day Tx


Residential

Inpatient

Crisis Services

Community

Outpatient



78


FYTD September 2018




Amount.


location.


7

13

0

7

0

2

4

6

8

10

12

14




5

10

0

10

0

2

4

6

8

10

12




$9,087

$2,028 $2,028

$0

$1,000

$2,000

$3,000

$4,000

$5,000

$6,000

$7,000

$8,000

$9,000

$10,000




$9,014

$1,409 $1,100

$0

$2,000

$4,000

$6,000

$8,000

$10,000




79


FYTD September 2018






LIP Group


oversight required.Senate Bill 163




Institution










Agency






Clinics




80


FYTD September 2018



YOUTH HAVEN SERVICES, LLC Agency





Insight Human Services Agency

PQA Healthcare, Inc. Agency


Creative Counseling and Wellness Center Corporation LIP Group

Access Call Center

Top 10 Providers by Members Served - Stokes Entity Type


5,303 5,665 5,068

5 5 5

0

1

2

3

4

5

6

0

2000

4000

6000

8000

Jul'1

8

Au

g'1

8

Sep

'18

Spee

d t

o A

nsw

er (

secs

)

# o

f C

alls


2.1% 2.0% 2.2%

0%

2%

4%

6%

8%

10%

Jul'1

8

Au

g'1

8

Sep

'18

Per

cen

t o

f C

alls

Ab

and

on

ed



0101010203030407282937

146191

415868

0 200 400 600 800 1000

Other


County Agency






Inpatient


Hospital

LIP Group

LIP

Agency

Total Providers



81


FYTD September 2018






Medicaid funded Outpatient services were the most utilized services for 1st Qtr FY1819 and 1915(b)(3) services had the largest increase in

utilization of 157% (7 to 18). Innovations had the highest expense of $756,741 followed by ICF with $465,875. PRTF remained consistent in

utilization but had a 125% increase in expense ($72,965 to $163,824).

State funded Outpatient services were the highest utilized service for 1st Qtr FY1819. Although Inpatient was the highest expense for this quarter,

utilization decreased by 24% (17 to 13) and expense by 44% ($74,392 to $41,471). Community services had the second highest expense of $37,188

for this quarter.

Both Medicaid (7 to 0) and State (5 to 0) funded Facility Based Crisis utilization decreased to 0 members served for this quarter. Medicaid funded

Mobile Crisis Management utilization decreased by 46% (13 to 7) but expense remained consistent. There was no change in utilization for State

funded Mobile Crisis Management but expense slightly decreased.


Child MH members served were increasing while Adult MH members served were decreasing for 1st Qtr FY1819.

Analysis:




82

Forsyth County Dashboards

FYTD September 2018


County Funded Program

Advisory CommitteesTriad Region community members, family and self-advocates, area providers who meet monthly- funded by Forsyth County offering grants to local non-profit

organizations and support problem solving gaps in services.

County Funded Program Description



Enrichment CenterArts-based day program for individuals with IDD; includes innovative geriatric program offering a “retirement option” for individuals who are at/near retirement

age

Horizons Residential and respite services for medically fragile individuals

Monarch Major provider with a broad continuum of services

School Health Alliance Integrated medical/behavioral services in WS/FC Schools

UNC-G / Family Partners A “Family Partner”, a parent/relative of a youth receiving services, provides information and support to other families.

83


FYTD September 2018



Advisory Committees



Enrichment Center

Horizons

Monarch

School Health Alliance

UNC-G / Family Partners

Total:


20.8%$320,639

0.0%$5,000

$253,106$1,012,425



8.8%

$0

$200,000

$65,000

$25,000

FYTD

Expenses

$2,000$30,000

Forsyth Funding

$25,833

$4,167

$33,333

$0

$155,000

$50,000

16.7%

6.7%

% Spent

25.0%

$1,542,425

0.0%

16.7%

8.3%

$2,200

FY Budget

Amount


84


FYTD September 2018



1123 1160 1200

121 104 110

24 26 220

200

400

600

800

1000

1200

1400

Jul'1

8

Au

g'1

8

Sep

'18


MH IDD SUD

2191 2161

1885

785 786 788

693 706 652

0

500

1000

1500

2000

2500

Jul'1

8

Au

g'1

8

Sep

'18


MH IDD SUD

786

768

757

740

745

750

755

760

765

770

775

780

785

790

Jul'1

8

Au

g'1

8

Sep

'18

Nu

mb

er o

f M

emb

ers

on

Reg

istr

y



3314 33213085

906 890 898

717 732 674

0000000000

500

1000

1500

2000

2500

3000

3500

Jul'1

8

Au

g'1

8

Sep

'18


All Diagnosis

MH IDD SUD


85


FYTD September 2018


Service Category


ACTT

ICF



interventions.

Inpatient

MST

Outpatient

Innovations





inpatient facility.

Crisis Services



A long-term residential program for people with behavioral health needs.BH Long Term Residential

Community Support





Outpatient ED

Partial Hosp/Day Tx


IIHS

Definition


Residential

PRTF






Community

Psych Rehab

86


FYTD September 2018


location.




0

20

27

26

76

49

93

72

59

125

172

285

333

267

353

506

4471

1

16

18

32

58

61

67

80

82

125

175

182

301

336

373

498

4380

0 1000 2000 3000 4000 5000

Community

Community Support

MST


Psych Rehab


Partial Hosp/Day Tx

IIHS

Crisis Services

ICF


Outpatient ED

Inpatient



Innovations

Outpatient



$0

$27,872

$164,878

$552,344

$175,878

$484,686

$385,394

$358,898

$21,584

$5,039,130

$591,280

$31,325

$1,133,235

$539,990

$269,360

$7,389,114

$1,221,723

$7,496

$18,433

$93,550

$712,039

$141,234

$672,371

$256,342

$425,621

$63,071

$5,148,432

$609,747

$15,381

$1,213,808

$540,695

$353,470

$7,369,946

$1,321,402

$0 $2,000,000 $4,000,000 $6,000,000 $8,000,000

Community

Community Support

MST

PRTF (Psychiatric Residential Treatment Facility)

Psych Rehab


Partial Hosp/Day Tx

IIHS

Crisis Services

ICF

ACTT (Assertive Community Treatment Team)

Outpatient ED

Inpatient



Innovations

Outpatient



87


FYTD September 2018



location.



2

0

0

26

18

135

111

234

227

1362

0

2

2

17

19

117

184

208

280

1299

0 500 1000 1500

IIHS

Community Support

Psych Rehab

Partial Hosp/Day Tx


Residential

Crisis Services

Inpatient

Community

Outpatient



$10,586

$0

$0

$31,095

$38,878

$409,743

$68,052

$1,161,670

$430,848

$363,651

$0

$4,642

$3,857

$14,158

$45,034

$418,119

$79,466

$1,018,543

$401,276

$251,479

$0 $500,000 $1,000,000 $1,500,000

IIHS

Community Support

Psych Rehab

Partial Hosp/Day Tx


Residential

Crisis Services

Inpatient

Community

Outpatient



88


FYTD September 2018




Amount.


location.


8

55

17

62

0

10

20

30

40

50

60

70




9

45

59

88

0

20

40

60

80

100




$12,132$9,452

$41,141

$8,730

$0

$5,000

$10,000

$15,000

$20,000

$25,000

$30,000

$35,000

$40,000

$45,000




$10,029 $6,083

$93,355

$14,367

$0

$20,000

$40,000

$60,000

$80,000

$100,000




89


FYTD September 2018






LIP Group

Senate Bill 163




Institution







oversight required.





Agency






Clinics




90


FYTD September 2018






Insight Human Services Agency


North Carolina Baptist Hospital Inpatient


Alexander Youth Network, Inc. Agency

Top Priority Care Services, LLC Agency

Access Call Center


Top 10 Providers by Members Served - Forsyth Entity Type

5,303 5,665 5,068

5 5 5

0

1

2

3

4

5

6

0

2000

4000

6000

8000

Jul'1

8

Au

g'1

8

Sep

'18

Spee

d t

o A

nsw

er (

secs

)

# o

f C

alls


2.1% 2.0% 2.2%

0%

2%

4%

6%

8%

10%

Jul'1

8

Au

g'1

8

Sep

'18

Per

cen

t o

f C

alls

Ab

and

on

ed



0101010203030407282937

146191

415868

0 200 400 600 800 1000

Other


County Agency






Inpatient


Hospital

LIP Group

LIP

Agency

Total Providers



91


FYTD September 2018






Medicaid funded Outpatient services were the highest utilized service for 1st Qtr FY1819. Outpatient ED had the largest decrease In utilization of

36% (285 to 182) and in expense of 51% ($31,325 to $15,381). Innovations had the highest cost of $7,369,946 followed by ICF of $5,148,432 for

this quarter.

State funded Outpatient services had the highest utilization for 1st Qtr FY1819. Crisis Services had the largest increase in utilization of 66% (111 to

184) when compared to the same quarter last fiscal year. Inpatient had the highest expense of $1,018,543 which was actually a decrease of 12%

($1,161,670 to $1,018,543) from the same quarter previous fiscal year.


Child MH members served have been increasing while Adult MH members have been decreasing for 1st Qtr FY1819. Both Child and Adult IDD and

SUD members served have remained consistent.

Analysis:




Facility Based Crisis and Mobile Crisis Management increased in both utilization and expense for Medicaid and State funding for 1st Qtr FY1819.

State funded Facility Based Crisis had the largest increase in utilization of 556% (9 to 59) and in expense of 831% ($10,029 to $93,355). Much of

this increase can be attributed to the addition of a new Facility Based Crisis provider in October of 2017, just after the end of Q1 FY1718. This

provider accounted for 62% ($57,917/$93,355) of State funded Facility Based Crisis expenses in Q1 of FY1819. Medicaid funded Facility Based Crisis

had a 113% increase (8 to 17) and for expense a 239% increase ($12,132 to $41,141). State funded Mobile Crisis Management had a 96% increase

in utilization (45 to 88) and a 136% increase in expense ($6,083 to $14,367).

92

Triad Community OfficeQuality Management Dashboard

FYTD June 2018

## ##

% Served

10%

Incidents

Medicaid Population - FYTD September 2018

Members

Served

11,498

13,097

8,739

12,554

6,814

% Eligible in

Cardinal

Innovations

Population

24%

33%

19%

23%

12%

Eligible

Population

117,034

159,012Mecklenburg

11%51,357 5,740Five County 11%

93,531

110,761

11%59,404

The number of Level II Incidents reported in the Triad catchment area remained consistent with the previous quarter, with 121 Incidents during the 4th Qtr. of

FY1718, and 115 Incidents during the 1st Qtr. of FY1819. 77% (89/115) of the incidents in the 1st Qtr. of FY1819 were Member Behavior Incidents.

NOTE: Starting in December of 2017, any Abuse/Neglect/Exploitation incident naming a staff member was automatically classified as Level 3.

Report data from November 29, 2018

Triad

Northern Region

Central

Region

Southern

8%

9%

11%

43 34 38

5.57

4.35

5.21

0.00

1.00

2.00

3.00

4.00

5.00

6.00

0

5

10

15

20

25

30

35

40

45

50

Jul'18 Aug'18 Sep'18

Level II Incidents Count & Rate of Incidents Per 1,000 Members Served

Level II Incidents Rate/1,000 Members Served

FYTD: July 2018 - September 2018

95


FYTD June 2018

Incidents (continued)

The number of Restrictive Interventions reported in the Triad catchment area during the 1st Qtr. of FY1819 decreased 26% (15 to 11) since the previous quarter.

There was one Level III Physical Restraint Seated during the 1st Qtr. of FY1819. Of the 10 Level II Restrictive Interventions, all 10 were Physical Restraint

Standing.

Level III Incidents reported in the Triad catchment area during the 1st Qtr. of FY1819 remained consistent with the previous quarter (4th Qtr. of FY1819).

Starting in December of 2017, any Abuse/Neglect/Exploitation incident naming a staff member was automatically classified as Level III. As a result, the number

of Level II incidents decreased, and the number of Level III incidents increased, even though the combined number of incidents remained consistent. There were

18 Level III Alleged Abuse Incidents in the 1st Qtr. of FY1819. (9 Sexual Abuse, 8 Physical Abuse, and 1 Neglect) Of the 4 Level III Member Deaths in the 1st

Qtr. of FY1819, 3 were due to an Unknown Cause and 1 due to Accident. In the 4th Qtr., there were 2 Member Behavior Incidents. (1 Illegal Act and 1 AWOL > 3

Hrs.) In the 1st Qtr. FY 1819, there was 1 Consumer Injury reported. (1 auto accident)

8 13 4

1.04

1.66

0.55

0.00

0.20

0.40

0.60

0.80

1.00

1.20

1.40

1.60

1.80

0

2

4

6

8

10

12

14


Level III Incidents Count & Rate of Incidents Per 1,000 Members Served

Level III Incidents Rate/1,000 Members Served


5 5

1

0.78

0.00

0.69

0.000.100.200.300.400.500.600.700.800.90

0

1

2

3

4

5

6

7


Restrictive Intervention Count & Rate of Incidents Per 1,000 Members Served

Level II Incidents Level III Incidents Rate/1,000 Members Served


96


FYTD June 2018

In the Triad catchment during the 1st Qtr., 100% (11/11) of the Restrictive Interventions occurred in the CMH population. The ADD and CMH population

accounted for 73% (8/11) of the Injury incidents of which the majority were due to Trip/Fall Incidents (50% - 4/8).

88% (133/151) of the Incidents reported in the Triad catchment area were received within 3 days of the incident being learned during the 1st Qtr. of FY1819.

The majority (54% 82/151) of Incidents reported during FY1819 were due to Member Behavior, of which 88% (72/82) occurred with the CMH population. In

FY1819 21% (32/151) of Incidents reported were due to Abuse, Neglect or Exploitation. The CMH population accounted for 72% (23/32) of the incidents for this

category.

Incidents (continued)

0

10

20

30

40

50

60

70

80

90

Abuse, Neglect orExploitation

Restrictive Interventions Member Behavior Member Death Member Injury Medication Error Suspsension

Incidents by Type & Target Population

ADD AMH ASA CDD CMH CSA


97


FYTD June 2018

15 24 66 33 27

Piedmont

Catchment

Mecklenburg

Catchment

Central

Catchment

Five County

Catchment

13

53

2

6

15

Triad

Catchment

8

2

3

11

0

2

1

2

Measure Subcategory

Does Not Apply

01

0

1

21

6

0

Total # Grievances Not Against Provider or MCO

0

Total # of Grievances by

Disability

110

Child

Adult

Unknown

Does Not Apply

Total # Grievances by Age Group

MH Only

IDD Only

SUD Only

Multi-Disability

TBI Only

Unknown

Total # Grievances Against Providers

Total # Grievances Against Cardinal Innovations

0

11

Total # Grievances Resulting in Investigations

14% 39%

0

122

46

2

0

9%

0

Average Days to

Resolve% Resolved within 30

Days

For Resolved Grievances

Total # Grievances Pending

0.0 0.0

4

0

0

4

11

0

0

11

0

0%

0.0

8

0

4 13

1

17

7

13

16

50

20

0

01

0

11

0

1

1

0%

0.0

16%

0.0%

0 0 0

0%

0.0

0%

Grievances - FYTD September 2018

7

5

49

0

3

24

All Grievances

62

28

3

3

4

5

11

4

1

58

0

2

1

0

20

In the Triad catchment area, the number of Grievances reported decreased 39% (44 to 27) from the 4th Qtr. FY 1718 to the 1st Qtr. of FY1819. The Decrease in

grievances can be attributed to a decrease in Grievances under the category "Lack of Choice/Provider Availability." 79% (14/3). Other areas that had decreases

were "Conflict with Provider" 33%(12/8).

0

1

6

13

6

18

0

2

3

20

43 20

0.0

0%

0

Total # of Grievances 20%

Please Note: The State benchmark for grievances requires that 90% of grievances are resolved within 30 days of submission. Three Grievances were

Out-of-Catchment.

168

7 9 11

0.91

1.15

1.51

0.00

0.20

0.40

0.60

0.80

1.00

1.20

1.40

1.60

0

2

4

6

8

10

12


Grievance Count & Rate of Complaints Per 1,000 Member Served

Grievances Rate/1,000 Members Served


98


FYTD June 2018

Grievances (continued)

In the Triad catchment area, the number of Grievances reported decreased 39% (44 to 27) from the 4th Qtr. FY 1718 to the 1st Qtr. of FY1819. The Decrease in

grievances can be attributed to a decrease in Grievances under the category "Lack of Choice/Provider Availability." 79% (14/3). Other areas that had decreases

were "Conflict with Provider" 33%(12/8).

Opioid Treatment saw a decrease of 79% (14/3), in the 1st Qtr. FY 1819 after a spike in grievances in the 4th Qtr. of FY1718. The primary grievances this Qtr. for

opioid treatment, were 1 lack of choice/provider availability, 1 Conflict with provider, and 1 Staff unavailable. Another service that had a decrease in grievances for

the 1st Qtr. FY 1819 was Outpatient Services by 63% (8/3). Of the 3 grievances reported for Outpatient Services, 2 involved Customer Services(CS)-Telephone

Responsiveness, and 1 Conflict with provider.

1

1

1

1

1

2

3

3

4

8

0 2 4 6 8 10

Delay in Treatment

Inadequate Treatment

Other Quality of Care Issues

Potential Fraud

Incomplete/Inaccurate Paperwork Issues

Staff Unavailable to Provide Services

Customer Service (CS) Telephone Responsiveness

Lack of Choice/Provider Availability

Neglect

Conflict with Provider (disagreement with treatment, diagnosis, etc)

Top 10 Grievances TypesFYTD: September 2018

1

1

1

2

2

2

3

3

3

7

0 1 2 3 4 5 6 7 8

Child Adolescents Day Treatment

Transition Management Services

Peer Support Services

Substance Abuse Intensive…

Inpatient

Innovations

Assertive Community Treatment Team

Opioid Treatment

Outpatient Services

Residential Services

Top 10 Services with GrievancesFYTD: September 2018

99


FYTD June 2018

During the 1st Qtr. Of FY 18/19, 96% of the overall Annual AFL reviews took place for the Triad catchment area.

Provider Monitoring Reviews

Please note: Cardinal Innovations Quality Management requires any provider receiving out of compliances on selected review items and trending out of

compliance areas to complete a POC as a standard measure to prevent future out of compliances.

In the 1st Qtr. of FY1819, only 1 provider of the 12 reviewed scored 100%. Two providers scored below the 85% target on their NC Provider Monitoring Reviews

during the 1st Qtr. of FY1819 in the Triad catchment area. (72.5%, 70.5%).

1

1

5

7

12

12

23

0 20 40

Unlicensed AFL Review

Clinical Quality Review

New Unlicensed SiteReview

Concern Module

Cultural Competency

NC Provider MonitoringReview

Innovations Annual AFLReview

Monitoring Reviews

Jul-Sep'18

98.8% 99.0%92.5% 97.5%

90.9%

0%

25%

50%

75%

100%

Five County Central Mecklenburg Piedmont Triad

NC Provider Monitoring Review Scores

85% Target

July 2018 - September 2018


100


FYTD June 2018

Provider Monitoring Reviews (All)

The number of reviews involved in paybacks or POC's have increased during the 1st Qtr. of FY1819.

8

10

0

2

4

6

8

10

12

Jul-Sep'18

Monitoring Review Outcomes

Reviews requiring Paybacks Reviews requiring POC's

July 2018 - September 2018 by

101


FYTD June 2018

87% ($17,648.60/$20,281.69) of the paybacks identified in FY1819 have been recouped thus far. The total identified paybacks for the Triad catchment area have

increased by 31% ($14,022.77 to $20,281.69) during the 1st Qtr. of FY1819 in comparison to this same period of time in FY1718. 13% ($2,633.09/$20,281.69) of

the paybacks in FY1819 have not been recouped. The amount that still needs to be recouped was a result of 4 providers, one of which is currently pending OAH

Review.

Please note: The Identified Payback amount is in the recoupment and reconsideration process.

Provider Monitoring Reviews - Paybacks

$14,022.77

$14,022.77

$17,648.60

$20,281.69

$0 $5,000 $10,000 $15,000 $20,000 $25,000

Amount Recouped

Identified Payback

Amount Recouped

Identified Payback

FY

1718

FY

1819

Payback Amounts from Post Payment Reviews

Jul-Sep

102

Documents

2019 Triad Community Advisory Board Meeting · Any citizen may address the Community Advisory Board. Tim Gallagher, Guest, presented a flyer to the Board regarding a community event