Sixteen State Performance Indicator Study
June 20, 2000 Conference Call
Minutes reported by Ellen Sparks, South Carolina
States Present: AZ, CO, CT, DC, IL, IN, MO, OK, RI, NY, SC, UT, VA, VT, WA, TX, Nancy Callahan, Marie Danforth, Ted Lutterman, Olinda Gonzalez, and Ron Manderscheid.
Marie Danforth reviewed the upcoming meetings for the Sixteen States and the Planners. The Sixteen States will be meeting on July 10 and 11. If there are problems with arrangements, leave a voice mail message at 301-443-4257. People will be coming for the Planners meeting on July 29. Two state people (data and planner) and two planning council representatives have been invited. The agenda is still being finalized but may include a plenary regarding data efforts. This could include Decision Support 2000+, the Sixteen State Pilot, Dr. Berry’s uniform data system, and Ron’s estimates regarding prevalence. There may also be a workshop regarding stakeholder involvement presented by a panel of states. Marie invited Judy Hall also to a data presentation.
A workgroup has begun to discuss the Consumer/Family Involvement by reviewing information from the States. They are planning a conference call for 6/28 at 1:00. Marie will be in touch on that. They have devised a survey and hope that some states can complete it prior to the 7/10 meeting. Steve Reeves noted that NASMHPD has state profile information from 1998 that includes some of this information. Ted stated that every state should have gotten updated profile sheets and that responses were due back 6/16. The information, including how states are organized, hospitals, beds, consumer relationships in planning etc., will be put on the web site.
Ron reviewed the agenda items for the meeting on July 10 and 11. These items include:
I. Development of goals for the next year (like we did last year).
II. Role of NASMHPD in the project for the next year.
III. How NASMHPD and ORYX indicators will be integrated.
IV. Presentation on how stakeholders are involved in the project. Each state will prepare a one page report on how stakeholder involvement has been implemented and how it is working. An e-mail will be sent to everyone and will describe the information needed.
Also a checklist will be developed listing the 32 indicators and asking for information on where the States are with each indicator. This will be a one page table showing status of each indicator by State.
V. The NASMHPD Children’s Group has been chaired by Randy Koch and includes participants from the Sixteen States and the Roundtable. They have been working on recommended operational definitions for children and will be meeting next Tuesday (6/27).
Ron asked for additional agenda items. These suggestions included:
VI. Research and confidentiality issues (raised by Randy Koch).
VII. Ted asked the question of what the final report is going to look like and what are some of the associated technological issues.
IX. The question was raised about the future funding of these efforts.
X. Fred Hobbs raised the question about how the project’s activities fit in with the data collection efforts by Dr. Berry and what the implications are for each project.
Indicator Discussion:
Indicators to be completed in Year 2:
Penetration Rates (John Pandiani)
Copies are available of data that was presented at the national conference. John will continue to collect data for FY 2000 for State Hospitals and Community Services, work will continue on regional breakdowns. The hypothesis that more community service is connected to less hospital utilization will be tested.
Consumer Surveys (Judy Hall)
Judy also has handouts of data that was presented at the national statistics conference. The group is continuing to collect data. All states are now piloting some form of the survey. Next steps include risk adjustment, comparisons with John’s numbers, making some comparisons with BASIS 32 to test the validity of the outcome domain and reporting on the data.
Contact within 7 Days (Steve Davis)
We continue to need all the states reporting on this indicator, and will compare additional years of data as they become available. Some states may not have data until year 3 but data for those states able to report will be provided.
Readmission within 30/180 Days (Sudha Mehta)
Sudha continues to work with states that have not yet submitted data. It is hope that data for all the states will be available by the end of year 2.
Cost (Nancy Callahan)
There is data on clients, units and dollars for the five states in the cost work group; More information will be presented at the July 10 meeting.
Indicators to be tested in Year 2:
Children’s Survey (Randy Koch)
The children’s survey is being piloted in Virginia and Colorado. Utah will begin data collection July 1. Texas will be piloting the instrument, but hasn’t established a time line, and Washington State hasn’t collected their data as yet.
Consumers Linked to Primary Health (Deb Kupfer)
Questions have been added to the Child and Family Surveys and the Adult Survey, and 7 states will be able to report this data. Deb will post the questions on the list serve so that others may add the questions. A few states such as Vermont can collect this data from Medicaid databases.
Employment (Chair is open, report given by Steve Davis)
Some states can obtain this data using self report but the discussion has been around matching data with Employment Security Commission which can provide quarterly data on wages and employment. Data linkages are made by social security number. The Employment Security Commission charges in some instances for the matching service. Ron stated that this indicator will become more important and that there may be future grant monies tied to employment. Twan Nuyen (consultant) and Denny Geertsen also joined the workgroup.
Mortality (Craig Colton) (Steve Davis reporting for Craig)
Looking at crude mortality, standardized rates and average number of years of life lost by matching data are proposed. Six states are currently working on this. The counts that have been obtained thus far depend on the number of years matched. For example in Oklahoma for five years there was a 9-10% match of the people who had been hospitalized. Vermont noted about 8%. Any additional states interested in participating can contact Steve or Craig.
Living Situation (Nancy Callahan)
The workgroup continue to work on operational definitions. Ron suggested contact with the CMHS homeless program for federal definitions.
Criminal Justice (Lucille Schacht)
The workgroup is compiling more information from states regarding time frames etc. Five states in the workgroup can do matching and 3 states have active data.
Administrative Cost (Eva Jacuba)
Eva surveyed 12 states and 9 were in favor of dropping this indicator. Ted noted an expenditure study on what administration is spending in states from the MHSIP Report Card. This information is difficult to get in the public sector. A final decision on whether to keep this indicator will be made on July 10.
ACT and Supported Employment (John McGrew)
John has developed a checklist and wants to test the instrument. The checklist has been revised somewhat and John will send out the revised list. He would like to use 50-60 sites to pilot the checklists. Please let John know if you have any sites that can participate in the pilot.
Level of Functioning (Mary Smith)
The workgroup met at the statistics conference. At the July meeting, they will be asking for data to analyze, but will e-mail information to people beforehand.
Recovery (Vijay Ganju)
The workgroup is in the process of putting together the information and the recovery items selected from the meeting in May. Information will be sent out before the July meeting.
Reduced Substance Abuse (Dick Ellis)
A meeting was held at the statistics conference. The workgroup will begin surveying what states are collecting as a first step. States were asked to bring tools or other pertinent information to the July 10 meeting.
Atypical Medications (Amy Elliott)
Amy has followed up with the states that have not sent in responses. Ten states are able to report data for consumers hospitalized and 9 can report on those in the community. A conference call is scheduled for next week and the group will begin to request data. Four out of ten states are already reporting this measure to ORYX. There was a question regarding consumers having been prescribed the medication vs. having received it. This will need to be clarified when the data is sent provided.
ORYX (Ted Lutterman)
Data for Seclusion and Restraint have been reported to Commissioners. They are working on risk adjustment for seclusion and restraint as well as 30 day readmissions. Reports of technical definitions will be available to the group for the July meeting as well as the names of states that are reporting seclusion and restraint.
Ron noted that the goal of the group is that by the end of year 3 we will have covered the list and have data from every state. On the 10th and 11th, we will lay out using time lines from the group leaders with the goal getting as close to the goal as possible.
The meeting is scheduled for July 10 and 11 at the Key Bridge Marriott. It will be held from 9 to 5 on the 10th and 9 to 3 on the 11th.
Olinda noted that the Mental Health US 2000 article is finalized and thanked the authors for their excellent contributions. The article will be circulated to the group.
Ron reminded the group of the request which will be sent by e-mail for two items to complete prior to the meeting:
1. One page report on the state’s stakeholder involvement
2. Matrix (checklist) listing all indicators and state status with each indicator. The checklist may include other specified responses. (Input on the creation of the matrix can be sent to Ron or Olinda. It was suggested that the grid that Vijay provided last year might be helpful.)
A final comment was made that the requests for information that go to commissioners also be sent to planners or data people so that they know the requests have been made. This comment will be forwarded to NASMHPD.