BH-TEDS Update. Prepared by Carol Hyso, MDHHS Contract Analyst, BH-TEDS Coordinator & Phil Chvojka, MDHHS Specialist, BH-TEDS SA Coordinator

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1 BH-TEDS Update Prepared by Carol Hyso, MDHHS Contract Analyst, BH-TEDS Coordinator & Phil Chvojka, MDHHS Specialist, BH-TEDS SA Coordinator

2 Today s Topics Batch Submissions Must & Must Nots Batch Summary Reports Acceptance Rates Preliminary BH-TEDS Reporting Observations Preliminary Encounter Analysis Proposed Changes and New Fields for FY17

3 BH TEDS Reporting Observations: Summary of Reported Data in 1 st Half of FY 2016 NOTES for this series of slides: Extraction occurred April 28, ,145 combined records (41,192 MH M Records and 12,953 SUD A Records) Start or T1 or Admission Records only. End/update records are incomplete There have been subsequent submissions between 4/29/2016 and today, a more complete 1 st Half of FY 2016 Data Set (including End or Discharge Records) will be generated shortly In first year of data collection, all MH records are reported a start records, even if the reported person has been receiving services for years.

4 Batch Submissions Must & Must Nots Batch identifiers must be the same in the header and trailer of the file. Batch IDs must not be used more than once. If you send a subsequent batch with the same Batch ID, the batch will not even process. The EDI record count in the footer must equal the number of data records + 2 (for the header & trailer). For example, if you are submitting 100 M and A records, the EDI record count in the trailer should be 102. There must be a Carriage Return/Line Feed (LF) in addition to a hard return at the end of the trailer record.

5 MILogin BH-TEDS

6 Batch Header Search

7 Sortable & Searchable

8 Sample - Sorted by Payer ID

9 Submission Log Report

10 BH-TEDS M & A File Acceptance Rates % 10/01/15-04/28/ % 60.00% 40.00% 20.00% 0.00% Macomb Oakland Northcare SWMBA Region 10 MidState Lakeshore CMH Ptnshp of SE MI NMRE Detroit/Wayne

11 PIHP A and M Records FY 2016 First Six Months BH TEDS April 28, 2016 Extract [DataSet1] C:\Users\chvojkap\Desktop\BH TEDS YTD.sav PIHP Payer * Client Transaction Type Crosstabulation PIHP Payer Total Macomb R9 Oakland R8 NorthCare R1 SWMBH R4 Region 10 Mid State R5 Lakeshore R3 SE MI R6 Northern MI R2 Detroit-Wayne R7 Client Transaction Type Count % within PIHP Payer 49.1% 50.9% 100.0% % within Client Transaction Type 29.0% 9.5% 14.1% Count % within PIHP Payer 15.6% 84.4% 100.0% % within Client Transaction Type 6.4% 10.9% 9.8% Count % within PIHP Payer 25.1% 74.9% 100.0% % within Client Transaction Type 9.7% 9.1% 9.2% Count % within PIHP Payer 31.4% 68.6% 100.0% % within Client Transaction Type 11.7% 8.1% 8.9% Count % within PIHP Payer 37.5% 62.5% 100.0% % within Client Transaction Type 31.4% 16.5% 20.1% Count % within PIHP Payer 0.0% 100.0% 100.0% % within Client Transaction Type 0.0% 29.3% 22.3% Count % within PIHP Payer 0.0% 100.0% 100.0% % within Client Transaction Type 0.0% 3.1% 2.3% Count % within PIHP Payer 35.0% 65.0% 100.0% % within Client Transaction Type 11.7% 6.8% 8.0% Count % within PIHP Payer 0.0% 100.0% 100.0% % within Client Transaction Type 0.0% 1.0%.8% Count % within PIHP Payer 0.0% 100.0% 100.0% % within Client Transaction Type 0.0% 5.8% 4.4% Count % within PIHP Payer 23.9% 76.1% 100.0% % within Client Transaction Type 100.0% 100.0% 100.0% A M Total

12 1 st Half of FY 2016 BH TEDS Reporting Observations: Kudos Service Setting, Codependent, and Living Arrangements Reported 100% Properly (A vs. M) Legal Status at State Hospital Field is Delivering on its Intended Task (Never been captured in Michigan) Volume of Not Collected Colocation and Not Collected Crisis Only Responses Is Relatively Low (see next slide)

13 Reported Combined Not Collected Colocation and Crisis Only Percentages 1.7% of Pregnant 4.1% of Correction Related Status 7.2% of Mainstream Special Education 5.0% of Education Level 6.2% of School Attendance Status 2.0% of Marital Status 1.8% of Veteran Status 3.2% of Minimum Wage

14 1 st Half of FY 2016 BH TEDS Reporting Observations: Red Flags Use of Not Collected Co-location and Not Collected Crisis only is not intended for SUD A Records. There are A records reporting these codes (in small volume). There may be an edit written to restrict these two responses to only M records, This action would disallow this approach for A records. Pregnancy for SUD Crisis (on any) Services MUST be reported. Pregnant women are a federal (and state) priority population, and all initial services must make this determination of yes or no. (If the proposed edit above is written, this will be a non-issue)

15 1 st Half of FY 2016 BH TEDS Reporting Observations: Red Flags Days Waiting to Enter Services (Time to Treatment): Reported Wait Times in Excess of 900 days (2.5 years), with spikes at 900 days and 995 days An unexpectedly low percentage of Integrated Treatment is currently being reported only 7.6% of MH records and 23.9% of SUD Records for a combined 11.5%.

16 1 st Half of FY 2016 BH TEDS Reporting Observations: SUD Records Preliminary data show 50% of all SUD Admissions report Opiates as Primary Drug 35.3% report primary heroin 14.4% report primary Rx Opiates 0.4% report illicit or street methadone 30.9% report primary alcohol. This is the lowest percentage for alcohol reported in TEDS since Michigan began collecting client records in % (almost 1 in 5 admissions) of SUD records report a residential (subacute) detox setting another historical high water mark

17 1 st Half of FY 2016 BH TEDS Reporting Observations: MH Records Preliminary reporting indicates a priority for submitting I/DD records, with 23.1% of all M records submitted indicating yes on I/DD Designation Almost one quarter of MH records (24.6%) report a primary substance of abuse, with alcohol and marijuana the most prevalent (41.2% alcohol and 35.4% marijuana) Nearly half the records (48.2%) indicate SDA, SSI, or SSDI enrollment Wait times are not interpretable this first year, because not all M records are actual start records

18 1 st Half of FY 2016 BH TEDS Reporting Observations: SUD Records vs. MH Records Homelessness reported in 13.0% of SUD records and in 3.9% of MH records Probation/Parole reported in 28.4% of SUD records and in 6.8% of MH records A recent arrest (30 days) reported in 7.0% of SUD records and 3.4% of MH records 4.5% of SUD records indicate the person is currently in school compared to 21.6% of MH records The percentages of self-referred persons are nearly the same (49.7% for SUD and 53.8% for MH), but Criminal Justice referrals are reported in 14.2% of SUD admissions and only 3.0% of MH start records NOTE: Since all updates in FY2016 are reported as an M (start record for MH), these difference will need to be tracked over time to observe how this FY2016 approach contributes to any disparities.

19 BH-TEDS Encounter Analysis Individuals Served with Encounters Vs. Individuals Served with BH-TEDS Records

FY17 Proposed BH-TEDS Change Integrated Treatment (A051) Integrated Treatment/Co-occurring Problems 1 Yes - client with co-occurring substance abuse and mental health problems is being treated with

20 FY17 Proposed BH-TEDS Change Integrated Treatment (A051) Integrated Treatment/Co-occurring Problems 1 Yes - client with co-occurring substance abuse and mental health problems is being treated with an integrated treatment plan by an integrated team. 2 No - client without co-occurring substance abuse and mental health problems is not being treated with an integrated treatment plan by an integrated team. 3 Client with co-occurring substance abuse and mental health problems is NOT currently receiving integrated treatment.

FY17 Proposed New BH-TEDS Fields - Child Services Related Questions Individual under age 18 is in foster care. 1 Yes 2 No 96 N/A Individual is 18 or older.

21 FY17 Proposed New BH-TEDS Fields - Child Services Related Questions Individual under age 18 is in foster care. 1 Yes 2 No 96 N/A Individual is 18 or older. Individual under age 18 being served by Children s Protective Services (CPS). 1 Yes 2 No 96 N/A Individual is 18 or older. Individual under age 18 has been adopted with a medical subsidy or adoption support subsidy. 1 Yes 2 No 96 N/A Individual is 18 or older.

22 FY17 Proposed New BH-TEDS Fields - Employment Related Questions To address Michigan s employment first policy (Executive Order ) and supports assessing progress and targeting strategy and resources. To address the intent of CMS language/rule: to ensure that individuals receiving long-term services and supports through home and community based service (HCBS) programs under the 1915(c)*, 1915(i) and 1915(k) Medicaid authorities have full access to benefits of community living and the opportunity to receive services in the most integrated setting appropriate To demonstrate DOL concepts of non-competitive employment can in fact be competitive.

23 FY17 Proposed New BH-TEDS Fields - Employment Related Questions To allow for analysis of outcomes by provider, CMHSP, age, level of support need To allow for analysis of outcomes against investments (level of supports, costs) To allow MDHHS to monitor and support implementation of CMS rules, including both participation in integrated community employment and participation in meaningful community engagement activities. To support the emphasis in the Work Innovation and Opportunity Act (WIOA) with our vocational rehabilitation partners (MRS and BSBP) on competitive integrated employment by allowing a clear description of the nature of participant job outcomes

FY17 Proposed New BH-TEDS Fields - Employment Related Questions Employment Status: Full-time, competitive, integrated; Part-time competitive, integrated; Unemployed but looking for competitive,

24 FY17 Proposed New BH-TEDS Fields - Employment Related Questions Employment Status: Full-time, competitive, integrated; Part-time competitive, integrated; Unemployed but looking for competitive, integrated employment; student; unpaid volunteering or community service; Micro-enterprise; enclave/transitional employment; sheltered non-competitive employment In the past two (2) weeks, how many hours did the individual perform work/tasks specific to the identified Employment Status (996=N/A for employment statuses such as discouraged worker, retired, individual receiving services from institutional facility, etc.) In the past two (2) weeks, how much did the individual earn per hour for the work/tasks specific to the identified Employment status (96.96=996=N/A for employment statuses such as discouraged worker, retired, individual receiving services from institutional facility, etc.)

25 Questions???

26 BH-TEDS Contact Information Carol Hyso, MDHHS Contract Analyst, BH-TEDS Coordinator Phil Chvojka, MDHHS Specialist, BH-TEDS SA Coordinator

PIHP Data Quality Meeting Review & Relative Value Unit Methodology

PIHP Data Quality Meeting Review & Relative Value Unit Methodology Presented by: Paul Houchens, FSA, MAAA Jeremy Cunningham, FSA, MAAA May 28, 2015 Phases of Data Quality Review 1. Overall completeness