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CMHB Presentation 8-24-06

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Kris Vilamaa, ACHE
Kris Vilamaa, ACHE

The document discusses Alabama's Substance Abuse Systems Improvement Initiative which aims to better serve Alabamians impacted by substance abuse. It outlines the initiative's goals of improving access to treatment and prevention services across the state through standardized screening, assessment and data collection procedures, expanded service options, enhanced human resources, and improved technical assistance and training. The initiative also seeks to enhance revenue and claims processing to improve cash flow for providers.

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Alabama Substance AbuseAlabama Substance Abuse Systems ImprovementSystems Improvement InitiativeInitiative Presentation to Conference ofPresentation to Conference of Community Mental Health BoardsCommunity Mental Health Boards August 24, 2006August 24, 2006
PanelistsPanelists â–ºKent Hunt, Associate Commissioner forKent Hunt, Associate Commissioner for Substance Abuse ServicesSubstance Abuse Services â–ºSarah Harkless, Executive Assistant to theSarah Harkless, Executive Assistant to the Associate Commissioner for SubstanceAssociate Commissioner for Substance Abuse ServicesAbuse Services â–ºBob Wynn, Director of Treatment ServicesBob Wynn, Director of Treatment Services for Substance Abusefor Substance Abuse â–ºKristopher Vilamaa, Director of InformationKristopher Vilamaa, Director of Information Services for Substance AbuseServices for Substance Abuse
SummarySummary ► HistoryHistory ► PreventionPrevention ► TreatmentTreatment  StandardsStandards  Screening and EnrollmentScreening and Enrollment  Standardized AssessmentStandardized Assessment  Waiting List ManagementWaiting List Management ► Claims and Revenue EnhancementsClaims and Revenue Enhancements ► Data Collection and ReportingData Collection and Reporting
HistoryHistory
HistoryHistory ►Prevention:Prevention:  Children’s Policy Council surveysChildren’s Policy Council surveys  Alabama specific youth surveysAlabama specific youth surveys  Majority of prevention activities are not focusedMajority of prevention activities are not focused on priority populationson priority populations  All areas of Alabama are under fundedAll areas of Alabama are under funded  No formal collaboration in many areasNo formal collaboration in many areas
HistoryHistory ►TreatmentTreatment  Alabama Treatment Needs AssessmentAlabama Treatment Needs Assessment  National Survey of Drug Use and HealthNational Survey of Drug Use and Health  Gap between those needing treatment andGap between those needing treatment and those getting treatmentthose getting treatment  DemandDemand  Waiting listsWaiting lists
HistoryHistory ►Treatment continued:Treatment continued:  Assessment and placementAssessment and placement  CollaborationCollaboration  Inadequate fundingInadequate funding  Clinical monitoringClinical monitoring  Fiscal monitoringFiscal monitoring  Length of treatmentLength of treatment
HistoryHistory ►General:General:  Priority populationsPriority populations  Science and evidenced based practicesScience and evidenced based practices  Capacity managementCapacity management  Core servicesCore services  Advocacy supportAdvocacy support  Outcome measurementOutcome measurement  Maximization of fiscal resourcesMaximization of fiscal resources
HistoryHistory ►Why do we need a Systems ImprovementWhy do we need a Systems Improvement Initiative?Initiative?  Alabama citizens deserve the best system theAlabama citizens deserve the best system the resources will provideresources will provide  It is our responsibility to meet this expectationIt is our responsibility to meet this expectation
TreatmentTreatment â–ºRevised StandardsRevised Standards â–ºContract ReviewersContract Reviewers â–ºNew StaffNew Staff â–ºCo-Occurring DisordersCo-Occurring Disorders
PreventionPrevention ►Revision of StandardsRevision of Standards ►New Rate StructureNew Rate Structure  Emphasis on Community-Based Process andEmphasis on Community-Based Process and Environmental StrategiesEnvironmental Strategies ►Focus on Targeted InterventionsFocus on Targeted Interventions
Alabama Substance AbuseAlabama Substance Abuse Information System (ASAIS)Information System (ASAIS) ► Meets all federal reporting requirements, whichMeets all federal reporting requirements, which are not being met todayare not being met today  Unique Identifier for all clientsUnique Identifier for all clients  All required admission and discharge elements collectedAll required admission and discharge elements collected ► Allows for active management of waiting lists andAllows for active management of waiting lists and access to care information across the stateaccess to care information across the state ► Timely processing of claims will help improve cashTimely processing of claims will help improve cash flowflow
Screening and EnrollmentScreening and Enrollment â–ºAll clients, across the system, will goAll clients, across the system, will go through a brief screening process and athrough a brief screening process and a unique identifier will be assigned, orunique identifier will be assigned, or reported if the number already existsreported if the number already exists â–ºThe screening information will be availableThe screening information will be available to any future service provider working withto any future service provider working with that clientthat client
Standardized AssessmentStandardized Assessment ►All clients will have minimum informationAll clients will have minimum information reported and collected from theirreported and collected from their standardized assessmentstandardized assessment  SASD is still exploring options to allow providersSASD is still exploring options to allow providers to share the full assessment through ASAISto share the full assessment through ASAIS ►The assessment information will beThe assessment information will be available to any future service provideravailable to any future service provider working with that clientworking with that client
Waiting List ManagementWaiting List Management â–ºReferrals will be sent through ASAIS toReferrals will be sent through ASAIS to other locationsother locations â–ºInformation on waiting lists for all providersInformation on waiting lists for all providers will be available in ASAISwill be available in ASAIS
Claims and Revenue EnhancementsClaims and Revenue Enhancements ►All enrolled clients will be checked forAll enrolled clients will be checked for Medicaid eligibility on a monthly basisMedicaid eligibility on a monthly basis ►Claims that have a Medicaid eligible serviceClaims that have a Medicaid eligible service paired with a Medicaid eligible client will bepaired with a Medicaid eligible client will be sent to Medicaid for paymentsent to Medicaid for payment ►There will be either a Medicaid or BlockThere will be either a Medicaid or Block Grant/State Funds check-write every weekGrant/State Funds check-write every week after go live – providers can receiveafter go live – providers can receive payments weekly, if desiredpayments weekly, if desired
Our GoalOur Goal To serve Alabamians impacted by substanceTo serve Alabamians impacted by substance abuse…betterabuse…better
To Serve…To Serve… ►To work for…To work for… ►To be of assistance to…To be of assistance to… ►To promote the interest of…To promote the interest of…
AlabamiansAlabamians ►50% of all admissions to SASD funded50% of all admissions to SASD funded programs live in 5 Alabama countiesprograms live in 5 Alabama counties ►Nearly one-third of Alabama’s counties haveNearly one-third of Alabama’s counties have no substance abuse treatment servicesno substance abuse treatment services ►Pregnant women account for less than 3%Pregnant women account for less than 3% of admissions to SASD funded treatmentof admissions to SASD funded treatment programsprograms ►The community impact of SASD fundedThe community impact of SASD funded prevention services is unknownprevention services is unknown
Alabamians…Alabamians… All who are impacted by Substance AbuseAll who are impacted by Substance Abuse
Better…Better… ►Not bestNot best ►A continuous processA continuous process ►Each day providing a new opportunity toEach day providing a new opportunity to exceed the one beforeexceed the one before
Better…Better… ► Access to CareAccess to Care  Treatment and Prevention Services in Every CountyTreatment and Prevention Services in Every County  Easy access to information and referralEasy access to information and referral  Specialized services to meet targeted needsSpecialized services to meet targeted needs ► Detox ServicesDetox Services ► Medication Assisted TreatmentMedication Assisted Treatment ► Adolescent ServicesAdolescent Services ► Low Intensity Housing ServicesLow Intensity Housing Services ► Vision, language, and hearing accommodations routineVision, language, and hearing accommodations routine ► Children’s ServicesChildren’s Services
Better…Better… ► ServicesServices  Expanded treatment modalities that match the ASAMExpanded treatment modalities that match the ASAM levels of carelevels of care  A variety of services to aid in treatment planningA variety of services to aid in treatment planning available under each level of careavailable under each level of care  All treatment programs co-occurring capable, manyAll treatment programs co-occurring capable, many enhancedenhanced  Treatment services based upon ongoing assessment ofTreatment services based upon ongoing assessment of client needsclient needs  Prevention services based upon ongoing assessment ofPrevention services based upon ongoing assessment of community needscommunity needs  Evidence-based treatment and prevention servicesEvidence-based treatment and prevention services  Reimbursement processes for services providedReimbursement processes for services provided
Better…Better… ►Human ResourcesHuman Resources  Improved organization to enhance customerImproved organization to enhance customer serviceservice
Better…Better… ►Technical Assistance and TrainingTechnical Assistance and Training  Based upon assessment of the needs of ourBased upon assessment of the needs of our customerscustomers  Full access to our in-house resources as well asFull access to our in-house resources as well as TA and training available through our State andTA and training available through our State and Federal PartnersFederal Partners  Routine program monitoring in addition toRoutine program monitoring in addition to certification site visitscertification site visits
Better…Better… ► CollaborationCollaboration  Clients and their familiesClients and their families  Contract ProvidersContract Providers  Certified ProvidersCertified Providers  Other Divisions within DMH/MROther Divisions within DMH/MR  Other state agenciesOther state agencies  Community agenciesCommunity agencies  The Alabama State LegislatureThe Alabama State Legislature  The Governor’s OfficeThe Governor’s Office  Federal and State funding sourcesFederal and State funding sources  Medical CommunityMedical Community  Private IndustryPrivate Industry  Etc. Etc.Etc. Etc.
Better…Better… ►DataData  ASAISASAIS  Alabama Epi Work GroupAlabama Epi Work Group
Better…Better… Outcomes:Outcomes: Individuals getting wellIndividuals getting well Families reunitingFamilies reuniting Communities stopping the devastation ofCommunities stopping the devastation of substance abusesubstance abuse
Alabama Department of MentalAlabama Department of Mental Health and Mental RetardationHealth and Mental Retardation Substance Abuse Services DivisionSubstance Abuse Services Division http://www.mh.alabama.govhttp://www.mh.alabama.gov

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CMHB Presentation 8-24-06

  • 1. Alabama Substance AbuseAlabama Substance Abuse Systems ImprovementSystems Improvement InitiativeInitiative Presentation to Conference ofPresentation to Conference of Community Mental Health BoardsCommunity Mental Health Boards August 24, 2006August 24, 2006
  • 2. PanelistsPanelists â–ºKent Hunt, Associate Commissioner forKent Hunt, Associate Commissioner for Substance Abuse ServicesSubstance Abuse Services â–ºSarah Harkless, Executive Assistant to theSarah Harkless, Executive Assistant to the Associate Commissioner for SubstanceAssociate Commissioner for Substance Abuse ServicesAbuse Services â–ºBob Wynn, Director of Treatment ServicesBob Wynn, Director of Treatment Services for Substance Abusefor Substance Abuse â–ºKristopher Vilamaa, Director of InformationKristopher Vilamaa, Director of Information Services for Substance AbuseServices for Substance Abuse
  • 3. SummarySummary â–º HistoryHistory â–º PreventionPrevention â–º TreatmentTreatment  StandardsStandards  Screening and EnrollmentScreening and Enrollment  Standardized AssessmentStandardized Assessment  Waiting List ManagementWaiting List Management â–º Claims and Revenue EnhancementsClaims and Revenue Enhancements â–º Data Collection and ReportingData Collection and Reporting
  • 5. HistoryHistory â–ºPrevention:Prevention:  Children’s Policy Council surveysChildren’s Policy Council surveys  Alabama specific youth surveysAlabama specific youth surveys  Majority of prevention activities are not focusedMajority of prevention activities are not focused on priority populationson priority populations  All areas of Alabama are under fundedAll areas of Alabama are under funded  No formal collaboration in many areasNo formal collaboration in many areas
  • 6. HistoryHistory â–ºTreatmentTreatment  Alabama Treatment Needs AssessmentAlabama Treatment Needs Assessment  National Survey of Drug Use and HealthNational Survey of Drug Use and Health  Gap between those needing treatment andGap between those needing treatment and those getting treatmentthose getting treatment  DemandDemand  Waiting listsWaiting lists
  • 7. HistoryHistory â–ºTreatment continued:Treatment continued:  Assessment and placementAssessment and placement  CollaborationCollaboration  Inadequate fundingInadequate funding  Clinical monitoringClinical monitoring  Fiscal monitoringFiscal monitoring  Length of treatmentLength of treatment
  • 8. HistoryHistory â–ºGeneral:General:  Priority populationsPriority populations  Science and evidenced based practicesScience and evidenced based practices  Capacity managementCapacity management  Core servicesCore services  Advocacy supportAdvocacy support  Outcome measurementOutcome measurement  Maximization of fiscal resourcesMaximization of fiscal resources
  • 9. HistoryHistory â–ºWhy do we need a Systems ImprovementWhy do we need a Systems Improvement Initiative?Initiative?  Alabama citizens deserve the best system theAlabama citizens deserve the best system the resources will provideresources will provide  It is our responsibility to meet this expectationIt is our responsibility to meet this expectation
  • 10. TreatmentTreatment â–ºRevised StandardsRevised Standards â–ºContract ReviewersContract Reviewers â–ºNew StaffNew Staff â–ºCo-Occurring DisordersCo-Occurring Disorders
  • 11. PreventionPrevention â–ºRevision of StandardsRevision of Standards â–ºNew Rate StructureNew Rate Structure  Emphasis on Community-Based Process andEmphasis on Community-Based Process and Environmental StrategiesEnvironmental Strategies â–ºFocus on Targeted InterventionsFocus on Targeted Interventions
  • 12. Alabama Substance AbuseAlabama Substance Abuse Information System (ASAIS)Information System (ASAIS) â–º Meets all federal reporting requirements, whichMeets all federal reporting requirements, which are not being met todayare not being met today  Unique Identifier for all clientsUnique Identifier for all clients  All required admission and discharge elements collectedAll required admission and discharge elements collected â–º Allows for active management of waiting lists andAllows for active management of waiting lists and access to care information across the stateaccess to care information across the state â–º Timely processing of claims will help improve cashTimely processing of claims will help improve cash flowflow
  • 13. Screening and EnrollmentScreening and Enrollment â–ºAll clients, across the system, will goAll clients, across the system, will go through a brief screening process and athrough a brief screening process and a unique identifier will be assigned, orunique identifier will be assigned, or reported if the number already existsreported if the number already exists â–ºThe screening information will be availableThe screening information will be available to any future service provider working withto any future service provider working with that clientthat client
  • 14. Standardized AssessmentStandardized Assessment â–ºAll clients will have minimum informationAll clients will have minimum information reported and collected from theirreported and collected from their standardized assessmentstandardized assessment  SASD is still exploring options to allow providersSASD is still exploring options to allow providers to share the full assessment through ASAISto share the full assessment through ASAIS â–ºThe assessment information will beThe assessment information will be available to any future service provideravailable to any future service provider working with that clientworking with that client
  • 15. Waiting List ManagementWaiting List Management â–ºReferrals will be sent through ASAIS toReferrals will be sent through ASAIS to other locationsother locations â–ºInformation on waiting lists for all providersInformation on waiting lists for all providers will be available in ASAISwill be available in ASAIS
  • 16. Claims and Revenue EnhancementsClaims and Revenue Enhancements â–ºAll enrolled clients will be checked forAll enrolled clients will be checked for Medicaid eligibility on a monthly basisMedicaid eligibility on a monthly basis â–ºClaims that have a Medicaid eligible serviceClaims that have a Medicaid eligible service paired with a Medicaid eligible client will bepaired with a Medicaid eligible client will be sent to Medicaid for paymentsent to Medicaid for payment â–ºThere will be either a Medicaid or BlockThere will be either a Medicaid or Block Grant/State Funds check-write every weekGrant/State Funds check-write every week after go live – providers can receiveafter go live – providers can receive payments weekly, if desiredpayments weekly, if desired
  • 17. Our GoalOur Goal To serve Alabamians impacted by substanceTo serve Alabamians impacted by substance abuse…betterabuse…better
  • 18. To Serve…To Serve… â–ºTo work for…To work for… â–ºTo be of assistance to…To be of assistance to… â–ºTo promote the interest of…To promote the interest of…
  • 19. AlabamiansAlabamians â–º50% of all admissions to SASD funded50% of all admissions to SASD funded programs live in 5 Alabama countiesprograms live in 5 Alabama counties â–ºNearly one-third of Alabama’s counties haveNearly one-third of Alabama’s counties have no substance abuse treatment servicesno substance abuse treatment services â–ºPregnant women account for less than 3%Pregnant women account for less than 3% of admissions to SASD funded treatmentof admissions to SASD funded treatment programsprograms â–ºThe community impact of SASD fundedThe community impact of SASD funded prevention services is unknownprevention services is unknown
  • 20. Alabamians…Alabamians… All who are impacted by Substance AbuseAll who are impacted by Substance Abuse
  • 21. Better…Better… â–ºNot bestNot best â–ºA continuous processA continuous process â–ºEach day providing a new opportunity toEach day providing a new opportunity to exceed the one beforeexceed the one before
  • 22. Better…Better… â–º Access to CareAccess to Care  Treatment and Prevention Services in Every CountyTreatment and Prevention Services in Every County  Easy access to information and referralEasy access to information and referral  Specialized services to meet targeted needsSpecialized services to meet targeted needs â–º Detox ServicesDetox Services â–º Medication Assisted TreatmentMedication Assisted Treatment â–º Adolescent ServicesAdolescent Services â–º Low Intensity Housing ServicesLow Intensity Housing Services â–º Vision, language, and hearing accommodations routineVision, language, and hearing accommodations routine â–º Children’s ServicesChildren’s Services
  • 23. Better…Better… â–º ServicesServices  Expanded treatment modalities that match the ASAMExpanded treatment modalities that match the ASAM levels of carelevels of care  A variety of services to aid in treatment planningA variety of services to aid in treatment planning available under each level of careavailable under each level of care  All treatment programs co-occurring capable, manyAll treatment programs co-occurring capable, many enhancedenhanced  Treatment services based upon ongoing assessment ofTreatment services based upon ongoing assessment of client needsclient needs  Prevention services based upon ongoing assessment ofPrevention services based upon ongoing assessment of community needscommunity needs  Evidence-based treatment and prevention servicesEvidence-based treatment and prevention services  Reimbursement processes for services providedReimbursement processes for services provided
  • 24. Better…Better… â–ºHuman ResourcesHuman Resources  Improved organization to enhance customerImproved organization to enhance customer serviceservice
  • 25. Better…Better… â–ºTechnical Assistance and TrainingTechnical Assistance and Training  Based upon assessment of the needs of ourBased upon assessment of the needs of our customerscustomers  Full access to our in-house resources as well asFull access to our in-house resources as well as TA and training available through our State andTA and training available through our State and Federal PartnersFederal Partners  Routine program monitoring in addition toRoutine program monitoring in addition to certification site visitscertification site visits
  • 26. Better…Better… â–º CollaborationCollaboration  Clients and their familiesClients and their families  Contract ProvidersContract Providers  Certified ProvidersCertified Providers  Other Divisions within DMH/MROther Divisions within DMH/MR  Other state agenciesOther state agencies  Community agenciesCommunity agencies  The Alabama State LegislatureThe Alabama State Legislature  The Governor’s OfficeThe Governor’s Office  Federal and State funding sourcesFederal and State funding sources  Medical CommunityMedical Community  Private IndustryPrivate Industry  Etc. Etc.Etc. Etc.
  • 28. Better…Better… Outcomes:Outcomes: Individuals getting wellIndividuals getting well Families reunitingFamilies reuniting Communities stopping the devastation ofCommunities stopping the devastation of substance abusesubstance abuse
  • 29. Alabama Department of MentalAlabama Department of Mental Health and Mental RetardationHealth and Mental Retardation Substance Abuse Services DivisionSubstance Abuse Services Division http://www.mh.alabama.govhttp://www.mh.alabama.gov