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VACSB QL Committee

Executive Summary August and September 2015

DISCUSSION ITEMS: THE FOLLOWING ARE ITEMS THE COMMITTEE IS WORKING TOWARD OR DISCUSSING

EHR BEST PRACTICES AND CONCERNS:


- Updating diagnosis for ICD 10/DSM 5
o Discussed merits of having clinical staff complete documentation for updated diagnosis vs. just making the switch
o Shared policies regarding diagnosing
o Discussed the need to update NOS dx to a specific dx instead of unspecified dx. Magellan has
expressed they will not pay for services for unspecified dx long term.

RECENT AUDITS/REVIEWS:

Type CSB Focus/Findings

Magellan
Treatment
Record
Review Goochland Referred to clinical guidelines for TRR from Magellan

Finding regarding ISP’s and shared planning.


DMAS ID
Audit Goochland Auditor disagreed with combined treatment plan for all services

Licensure Arlington Not having client signatures on quarterly review documents

DMAS ID
Audit Henrico In Progress

- Magellan cited provider for not having elements in their orientation packet – no definition of
what specifically should actually be in the orientation packet.
- DBHDS has postponed the 360 licensure reviews

PERFORMANCE CONTRACT WORK GROUP:

- Basic outline for the performance contract tool is completed. Subcommittee continues to refine based on new
performance contract. Draft is attached.

NAME CHANGE:

- The group has voted to change their name to VACSB Quality Leadership- this reflects the idea of being on the
forefront of quality practices and implementation.
ITEMS REQUESTING FOLLOW UP: THE FOLLOWING ARE ITEMS IN WHICH THE VACSB QM REQUESTS ED/VACSB FOLLOW UP
OR SUPPORT .

Consistent Communication Regarding Provider Calls

- Previously we requested that documentation from the Friday Magellan Provider calls be provided. DMAS denied
request.
- QL committee is asking the VACSB Regulatory committee to look at a process in which they take the questions from
the calls, transcribe to the discussion board and verify answers on their weekly call.
- QL has concerns regarding the fact that many members have been told that current answers on the Regulatory
Discussion Board will not be honored.

Regional QL Representation

- The QL group is identifying regional representation for the Regional ED group. The QL group would ask that the
Regional ED groups invite the QL representatives to meetings as necessary.

Mental Health Skill Building Regulations Public Comment Period

- The Quality Leadership group has discussed the MHSB regulations and as a group will post public comments
regarding the following concerns:
o Concern over LMHP having to write ISP
o Inconsistency in language on units (regs language states an hour unit structure and economic report states 15 min
structure)
o Concern over full SSPI language every 6 months referenced in one section and in another secti on is references just a
review by LMHP for continued services
o 15 day grace period noted for review of ISP in definitions- this is inconsistent with other sections (although the group is
in favor of the 15 day grace period)
o Inconsistency in language around Crisis Stab and Crisis Intervention Authorization vs. Registration
- The QL group will distribute comments to CSB’s and encourage them to post them individually as well as add any
additional comments.