LOUISIANA Community Mental Health Services Block Grant ...

Cornerstone Quality Management Initiative
Previous administrations initiated the Cornerstone Project in 2005, as a way of developing and
implementing the infrastructure necessary to move forward with redesigning mental health services
and to address more contemporary service delivery utilization management needs. The four
„Cornerstones‟ listed below continue to provide the overall framework and processes for operations
of the system of care and continue to develop to the present.
Recovery and Resiliency Cornerstone: Under the Cornerstone initiative, the Office of Mental Health
has embraced a recovery and resiliency philosophy of care. Over the past few years, OBH
conducted extensive staff training in this philosophy of care and has also sent staff to observe
programs in other states that have exemplary programs. A major focus of the activities under this
Cornerstone this past year has been further development of peer support services statewide and and
pursuit of efforts to obtain Medicaid funding for these services. Over ?40? Peer Support Specialists
were trained, certified, and are now working within the outpatient clinics of the system. The Local
Governing Entities (LGEs) and the OBH clinics employ these certified Peer Support Specialists as
support staff to assist consumers who arrive for their regular clinic appointments. Employment of
certified peer support specialists significantly advances the recocery/ resiliency philosophy of care.
However, it is noteworthy that the viability of this program has been severely affected by the budget
cuts, and the future of the program is uncertain at this time.
Utilization Management Cornerstone: OBH operates a strong utilization management (UM) system
for the OBH clinics and for those LGEs who wish to participate, and this has become a focus of
current mental health re-design efforts discussed previously. This UM system assures that OBH is
serving persons most in need and assures that persons served receive the right type and amount of
services based on their level of need. OBH has established standardized target population definitions
for service eligibility criteria, service definitions, client profiles, intensity of need criteria, electronic
centralized scheduling, service priority determination, authorization criteria, and service packages as
part of a robust UM system. Productivity standards for service delivery staff have been defined
according to UM standards and are monitored. To assist clinics to use the productivity data to make
data-based decisions for their clinics, OBH utilizes the on-line analytical system, Service Process
Quality Management (SPQM), and monthly staff webinars with David Lloyd, a national accountable
care expert. The current focus has been on service productivity management and improvement and
utilization of Level of Care Utilization System (LOCUS) ratings to determine and assign level of
service (e.g., assign client to medication management clinics vs. specialty service clinics). This is a
major focus of the mental health redesign initiative described in another section of this plan.
All OBH clinics have completed a UM Readiness Survey and a UM Implementation plan, and are
now in the implementation phase of the UM / Accountable Care process. The UM process is under
the direction of the Central Office Division Director for Policy, Standards, and Quality Assurance.
There are UM teams in each OBH Region and a statewide UM committee., The UM Central Office
Director conducts monthly webinars with the Committee and provides ongoing technical assistance
where needed to support the continued implementation of UM / Accountable Care. The UM team is
currently monitoring the implementation of the mental health re-design initiative and the status of the
new service components of access to care, medication management, and specialty clinics.
Credentialing and Privileging Cornerstone: In addition to the traditional credentialing model that has
been utilized in the state psychiatric hospitals, a credentialing plan and competency assessment
PART C LOUISIANA FY 2011 PAGE 65
SECTION II: ADULT & CHILD/ YOUTH
IDENTIFICATION & ANALYSIS OF SERVICE SYSTEM’S STRENGTHS, NEEDS, & PRIORITIES