COUNTY OF LOS ANGELES - DEPARTMENT OF MENTAL HEALTH

Program Support Bureau - MHSA Implementation & Outcomes Division

Outcome Measures Application (OMA) Users’ Group

July 30, 2012 Meeting Minutes

DRAFT

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In Person:
John Flynn, DMH MHSA Implementation
Mychi Hoang, DMH MHSA Implementation
Robin Ramirez, DMH MHSA Implementation
Miguel Juarez, DMH MHSA Implementation
Odre Miller, DMH MHSA Implementation
Michael Villaescusa, DMH MHSA Implementation
Keri Pesanti, DMH MHSA Implementation
Dawn Meggerson, DMH MHSA Implementation
Joshua Cornell, DMH MHSA Implementation
Irma Ramirez, SFVCMHC
Berta Soto, SFVCMHC
David Lopez, SFVCMHC
Robert Levine, DMH Office of Integrated Care Clinical Operations
Alex Silva, DMH Office of Integrated Care Clinical Operations
Jennifer Cochran, ENKI Pico Union
Diana Pena, ENKI Pico Union
Tatyana Dozortsev, DMH CSOC
Omar Vasquez, CIOB
Veronica Quintana, OASOC
George Eckart, DMH MHSA Implementation
Rosalie Finer, DMH ASOC
Ken Sholders, DMH CSOC
Urmi Patel, DMH ASOC / Via Webinar:
Katy Rader, Foothill Family Services
Sonya Hines, Child Net Youth and Family Services
Sylvia Kimball, SSG
Lorena Rodriguez, Community Guidance Center
Claudia Cervantes, Community Guidance Center
Kelly Colantuano, MHALA
Cristina Nolf, DMH CSOC
Jayne Millstein, Crittenton
Lucy Mendoza, Crittenton
Veronica Gamboa, Stars Inc.
Debbie Copple, Stars Inc.
April Tucker, Pacific Clinics
Wendy Fleicus, Pacific Clinics
Olimpia Alanouf, Stars Inc.
Agenda Item # / Description / Discussion / Action
2 / Review of Minutes and Action Items from 5/22/12 Meeting (Mychi Hoang) /
  • Followed up with action items from the last meeting.
/ Corrections should be addressed with Mychi:
3 / Application Development Update (Omar Vasquez) /
  • FSP/FCCS OMA
  • We are developing version 3.4; adding validations for Discontinuation Validation and developing wizards for Baselines and Key Event Changes, KECs.
  • Given priorities to other projects in our department, our applications resources are limited and development of version 3.4 has been put on hold.
  • We expected development to resume at the end of July but that is being pushed back by about three weeks.
  • We are adding additional development work to version 3.4.
  • Current release is estimated for the week of Sept. 17 -21.
  • Question: Will version 3.4 address the issue of FCCS outcomes where providers are using the same episode for two different sets of FCCS outcomes? We also have the issue with retro FCCS.
  • Answer: Yes, version 3.4 will address the issue where users are using one episode for more than one FCCS Partnership. We added additional bug fixes to both FSP and FCCS OMAs.
  • PEI OMA
  • There hasn’t been any change. Phase 2 is still on hold due to lack of resources.
  • We are working on bringing in contract developers.
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4 / MHIP Application Roll-out (Alejandro Silva and Robert Levine) /
  • DMH and DHS joined forces to integrated behavioral health and primary care services.
  • The MHIP – Mental Health Integration Program is an evidence-based service delivery model that incorporates an evidence-based practice.
  • It’s a collaborative step-care approach where the clinician is collaborating with the primary care provider, as well as, the consulting psychiatrist in order to make treatment adjustments if needed.
  • You can use different EBPs within the model. DMH is using PHQ-9, GAD-7, and PCLC for adult programs.
  • This is a set of services that is going to be part of the PEI OMA, not FSP or FCCS OMA.
  • We are currently piloting MHIP in PEI OMA with four contract providers.
  • Roll-out is scheduled for early September and trainings will be given by John Flynn.

5 / PEI OMA Data Correction (John Flynn) /
  • There are a couple of errors that providers continually make when it comes to PEI OMA:
  • The wrong Start Date
  • Client put under the wrong EBP
  • Send in a request similar to a Data Change/Deletion Request for FSP and FCCS OMA but this is for PEI (make sure you have the correct form by checking the header for PEI OMA)
  • You can also call in a HEAT Ticket. This allows you to check the status of your request once it’s been called in.

6 / PEI Updates (Keri Pesanti and Dawn Meggerson) /
  1. PEI Matrix Update
  2. The updated matrix is posted on the wiki:
  3. The target date listed is also for the quarterly provider meeting at the end of August.
  4. Getting some of the measures translated into the 13 threshold languages.
  5. BASIS-24 has been removed as a specific measure for CORS. We are in the process of identifying the specific measure we are going to use. The requirement is still the same (OQ measure should be administered and collected and entered into PEI OMA).
  6. We are in the process of developing protocol. Whenever a practice is selected to be implemented, it is a rigorous process where a lot of research is done. We look at easy of use, time of administration, the psychometrics behind the measure, etc., to make sure we are using the appropriate practice.
  7. PEI Outcome Measures Training Update
  8. We are moving away from having rounds of trainings every couple of months to on-going streaming trainings. PEI training schedules can be found here:
  9. We are offering a combined GAD-7 and PHQ-9 training where you only have to register for this one training instead of two individual trainings.
  10. Individual trainings are still available.
  11. DERS has been extended an extra half hour and is going to be a 3-hour training.
  12. DERS is for Directly Operated providers only.
  13. GAD-7 is produced by MHIP so it’s for Directly Operated, as well.
  14. Learning Network Update
  15. We are working on the 2nd round of the Learning Networks. First one coming up is for Incredible Years.

7 / Reports (Robin Ramirez) /
  1. Pre-Post Employment by FSP Program Report
  • Shows Pre-Post comparison and the percent in change in days
  • Employment types are taken off of what is reported on the Baseline
  • This shows where the client was before FSP enrollment (pre) and what was reported on the baseline or if they completed a Key Event Change (post).
  • Available at provider and program level.
  • If you’d like reports for your agency, contact Robin Ramirez at
  • This report shows only a small percentage of our FSP clients because we have so many FSP clients that were excluded so we don’t have a complete picture and that’s where the Exceptions Report comes into play. The Exceptions Report helps us correct a lot of the Baselines that have been excluded from the Pre-Post report.
From what we can currently see, there appears to be a 26% increase in competitive employment in terms of days reported. That’s a good sign considering this report only captures about 40% of our FSP clients.
8 / Open Forum /
  • Question: How often can we do updates on clients for PEI?
  • Answer: Clinicians are allowed updates whenever they want or deem it necessary. There will always be an update with a MHIP visit, as long as it is a therapy session; that includes phone sessions. You will want to be mindful of the measure and what the administration fidelity says for that measure as to how many times it can be administered and still be valid and reliable. If you are in an EBP that extends beyond six months, it is expected that you complete and update at the 6-month mark. Once you’ve acknowledged all the pre questionnaires, you’ll have access the updates and enter as many as you’d like as long as it maintains fidelity to the measure.
  • Question: If they missed out on getting pre measures done, can they input them as an update?
  • Answer: Yes. You have to acknowledge the pre questionnaire with an “Unable to Collect” value and then use the scores that were secured when you administered that questionnaire beyond the 14-day period and use that as the update. You can use that update to compare with the post information so that you can see the progress was made in the course of treatment.
  • Question: Regarding the 14-day period, is that 14 calendar days or 14 business days?
  • Answer: 14 calendar days, weekends included
  • Question: I have a FCCS client who disenrolled then later came back under the same Episode. How do I establish this? Would I enter a new Baseline?
  • Answer: The rule is, you can only have one Baseline and one set of outcomes per Episode. That’s how the system was built but that’s not the way that clinics deal with things. The software needs to be updated so that you can enter more than one set of outcomes/Baseline per Episode. That’s one of the changes that is part of the FCCS OMA Update.
  • Question: Regarding PEI OMA, we received a few OMA that have the first session on 1/5/12, after the day of intake of 12/14/11. The administration date of the measure is 12/14/11. Is this the correct format? Should the administration date be after the date of the first session? We have yet to enter these measures because of this.
  • Answer: Date of Intake is the first thing that happens. It does not directly refer to PEI services. It’s just the date the client starts at your clinic. Almost always when an intake happens you will do some kind of assessments. The intake does not directly connect to the EBP. The Date of First Session is the first day you bill for PEI EBP services and the day the client receives the first session of the EBP. The 14-day window period starts on the day you report your first EBP session.
  • Question: Part of our intake is that we do a YOQ, can we use that YOQ?
  • Answer: If you use the YOQ for this example, that would be past the 14-day window and what we are looking at is the Baseline for the EBP because we are looking at pre and post measures. If the date precedes the date of first session of the EBP, you will get an error message. These measures have clinical utility so it’s a good thing to use them at intake so that we can gather information about the appropriateness for the client in an EBP and the impact that the EBP has on the client. That’s one of the reasons why it is important to administer these measures at intake and then re-administer them at the beginning of the EBP so that we have something to compare them to. So the administration date should be on or after the date of first session. The sequence is: Intake, first session, and then administration date (on or after but directly within the 14 days of the date of first session).
  • Question: Will the FCCS Baseline follow the rule of the FSP Baseline after September, meaning no new Baseline within 365 days?
  • Answer: FCCS Baselines are different than FSP because you can open and close them multiple times during a single year. Every set of FCCS outcomes will have their own baselines, updates, and termination update.

9 / Next Meeting /
  • Wednesday, September 19, 2012 from 10:00 – 11:30am, Location: 695 South Vermont Ave., 15th Floor Glass Conference Room or via WebEx.
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  • Email John Flynn at if you would like to participate via WebEx.

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