Engaging in Strategies That Address State-Level Changes
Amie Miller, PsyD., Executive Director
At last week’s Board of Directors meeting, President Luke Bergman – Director of Behavioral Health Services for San Diego County – spoke to the timely statewide issues we’re all thinking about: the state’s budget deficit, upcoming changes from the passage of Proposition 1, and counties’ need for a cohesive set of change management activities.
He posed some compelling questions: How do we shift to being organizations that feel more like a health plan? How can we have our hands on the tools that managed care plans have in order to ensure the strongest outcomes?
At CalMHSA, we see pathways where we are uniquely situated to help counties of all shapes and sizes make these all-important transitions.
Case in point: the Healthcare Effectiveness and Data Information Set (HEDIS) measurements for behavioral health. To ease your burden, CalMHSA has taken on the work of interpreting measure specifications, calculating measures on behalf of participating counties and seeking clarification from the Department of Health Care Services on reporting expectations and contesting its methodology
The HEDIS measurements are a highly complex set of requirements. Our team has aggregated data across several sources and multiple years, amounting to millions of rows of data. We’ve written thousands of lines of code to clean, de-duplicate, aggregate and analyze the data.
And now, for 15 counties (with 15 more in review), we’re calculating nine measures annually for counties that run Mental Health Plans and Drug Medi-Cal Organized Delivery System Plans, and five measures for counties that run Mental Health Plans and Drug Medi-Cal State Plans.
Additionally, CalMHSA has just begun a collaboration with the State to provide technical assistance on the implementation of Prop. 1, and we’ll be representing the county perspective at a statewide behavioral health demonstration collaborative. Led by DHCS in partnership with the Institute for Healthcare Improvement, the collaborative aims to enhance coordination between the Medi-Cal plans and improve timeliness of follow-up for members who present to Emergency Departments for mental illness/substance use conditions.
These are just some of the ways that we continue to look for opportunities to assist you within the changing statewide landscape. As behavioral health in California becomes ever more complicated and challenging – in terms of requirements, funding and expectations — CalMHSA stands ready to create new strategies that lessen your load.
May 30, 2024