Quality Improvement Council Meeting

Slide Note

The Quality Improvement Council Meeting on October 4th, 2023, focused on various updates and initiatives within behavioral health services, federal compliance, and quality management. Discussions included updates on CMS BH quality measures, performance bonus programs, and efforts to reduce disparities. The meeting also touched on the preparation for MichiCANS soft-launch and planning, alongside Independent Facilitation recommendations to enhance person-centered planning services. Overall, the meeting highlighted ongoing efforts to improve the quality of care and support for individuals receiving behavioral health services in Michigan.

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Quality Improvement Council Meeting October 4th, 2023

Agenda 1. Welcome and Introductions (10:00-10:05) 2. Behavioral Health Updates (10:05-11:25) 3. Current Initiatives/Workgroup Updates (11:25-11:55) 4. Closing Remarks (11:55-12:00)

Behavioral Health Updates Federal Compliance HCBS Site Review Team SIS-A Replacement EVV Waiver Renewal 1915 iSPA HSW 372 Report CIR CRM

Behavioral Health Updates (continued) Division of Contracts and Quality Management Update on CMS BH quality measures MMBPIS Codebook update FY24 Performance Bonus Incentive quality program IET focus on reducing racial/ethnic disparities SAA-AD FY24 Data Validation BHTEDS SDOH outcomes measurement BHTEDS employment and housing outcomes data analysis Quality program overhaul Background Goal & Objectives Timeline Next Steps

Behavioral Health Updates (continued) Bureau of Children s Coordinated Health Policy and Supports MichiCANS soft-launch preparation and planning in motion slated to begin 01/01/2024; continuing to work on full state implementation plan. Working with Jane Shank to develop focus groups for UA testing and feedback regarding the MI Kids Now dashboard. Piloting an artwork contest for children and youth with lived experience, and their parents and guardians, to feature on the MI Kids Now dashboard.

Practice Improvement Steering Committee (PISC) Evidence Based Practices: LOCUS, DBT, IDDT and TIC Topics covered at last PISC meeting.

Independent Facilitation Overview of recent activity: The Independent Facilitation (IF) Stakeholder Group is finalizing its recommendations with the following materials: IF agreement and invoice templates, Medicaid Provider Manual IF language, and recommended qualifications and training requirements. Information on the IF service rates (amount paid, what is included, etc.) is also included in the recommendations. The Stakeholder Group recommends incorporating these recommendations into the Person-Centered Planning Technical Guidance MI-DDI recorded a brief video with people who use IF, those who are trained IFs, and a Supports Coordinators/Case Managers describing their experience with IF. The video will be used for IF training and technical assistance, shared on social media, etc. How this work improves the lives of people served (quality): The Michigan Developmental Disabilities Institute (MI- DDI) will continue to offer IF General Awareness trainings. The next webinar will be scheduled for December 2023. The recommendations will be incorporated into future IF trainings. Impacts on PIHPs and CMHSPs operations: Monitor the utilization of IF services by the MDHHS encounter code (H0032-WQ) and the quality of person-centered planning processes Next steps: Present the recommendations to MDHHS and key stakeholder groups (PIHPs, CMHSPs, DDPIT, etc.) and Independent Facilitators

Developmental Disabilities Practice Improvement Team (DD-PIT) Overview of recent activity: 1915i enrollments: MDHHS/BPHASA shared updates (Aug, Sep) on the enrollment progress. There were concerns about how a lack of enrollment may impact the individuals. HCBS C Waiver Feedback Sessions: Members promoted and participated in the feedback sessions. CMS has a proposed rule requiring state agencies to have an advisory committee of people who receive HCBS. MDHHS asked the DDPIT to form an Advisory Committee of People with Living Experience. Conflict Access and Planning (CFAP): MDHHS plans to launch educational and information sessions for beneficiaries and a provider survey. The workgroup reviewed initial feedback from the listening sessions, comments highlighted the information needs of individuals who receive behavioral health services. How this work improves the lives of people served (quality): DDPIT offered assistance in developing a tip sheet to inform individuals served if their enrollment was not complete (what it means, what to do, etc.) by the deadline. Impacts on PIHPs and CMHSPs operations: The 1915i enrollment process was a critical yet time-consuming task. This task highlighted opportunities that could improve administrative requirements leading to quality improvement. Next steps: Upcoming meetings - 10/11, 11/8

National Core Indicators Overview of recent activity: The 2022-2023 NCI survey process was completed with 670 surveys (goal: 660) and the data was submitted to the Human Services Research Institute (8/10). Michigan is preparing for the next survey process (2023-2024), these activities include updating the NCI Advisory Council and CMH NCI Liaison membership lists, preparing for CMH NCI Liaisons for the pre-survey process (9/28), and training NCI interviewers (11/10). How this work improves the lives of people served (quality): The NCI Advisory Council met on 9/28 to discuss how NCI data can be used to inform future performance measures on the topics of Person-Centered Planning, Self- Determination, and Guardianship. The NCI Advisory Council will prioritize the needs for these topics, propose intervention strategies, and suggest measurements for improvement post-intervention. Impacts on PIHPs and CMHSPs operations: The recommendations of the NCI Advisory Council will be shared with the Quality Improvement Council and the Developmental Disabilities Practice Improvement Team for comment. Michigan s NCI 2021-2022 state data report should be available soon. It will disseminate on MI-DDI s NCI webpage. Next steps: NCI Advisory Council meetings for 2024: 1/25, 4/25, 7/25, 10/24 A random sample is drawn for the FY 2023-2024 survey process CMH NCI Liaisons will collect NCI participant pre-survey and background information for all eligible respondents (Timeline: 10/16/23 - 12/15/23)

Conflict-Free Access and Planning Overview of recent activity: Workgroup has reviewed initial feedback summary MDHHS plans to launch educational and informational sessions for beneficiaries and a provider survey MDHHS Leadership is reviewing the project timeline How this work improves the lives of people served (quality): Supporting MDHHS decision on implementation of CMS Final Rule Implements a system of checks and balances for access to services and service delivery, free of conflict Impacts on PIHPs and CMHSPs operations: Ongoing involvement of workgroup members Refocuses operations in a conflict free environment Next steps: MDHHS to launch educational/information sessions and provider survey MDHHS to define project timeline MDHHS to design a web page for beneficiaries to access information and resources Next meeting is October 16thfrom 11:00a-12:00p The dedicated project email is open for questions, Mdhhs-ConflictFreeAccess@michigan.gov

Person Centered Planning Overview of recent activity: The body of knowledge work is complete, and work to improve quality on the person-centered planning process continues and will start to feed into developing a statewide fidelity model. How this work improves lives of people served (quality): A fidelity model and the foundational information in the body of knowledge will give us the jumpstart needed for real person-centered plans that lead to meaningful lives for the people we serve along with meaningful outcomes for people who work in the system. This will improve quality in all areas of our system by focusing on the lives of the people we serve. Impacts on PIHP or CMH operations: The work of this group and beyond will support operations to be more person-centered in a consistent, yet still individualized way. Next steps: Help support the field with training and fidelity. Quality Measures will be part of Site Review and quality person centered planning will be an expectation throughout the state. In addition, we will use the information gathered in our Person-Centered Planning Technical Guidance.