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Oklahoma Administrative Code (Last Updated: March 11, 2021) |
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TITLE 450. Department of Mental Health and Substance Abuse Services |
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Chapter 27. Standards and Criteria for Mental Illness Service Programs |
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Subchapter 9. Behavioral Health Home |
SECTION 450:27-9-24. Performance measurement and quality improvement
Latest version.
- (a) There shall be an ongoing performance improvement program designed to objectively and systematically monitor, evaluate and improve the quality of consumer care related to BHH operations.(b) The BHH performance improvement activities must:(1) Focus on high risk, high volume, or problem-prone areas.(2) Consider incidence, prevalence, and severity of problems.(3) Give priority to improvements that affect behavioral outcomes, client safety, and person-centered quality of care.(c) Performance improvement activities must also track adverse client events, analyze their causes, and implement preventive actions and mechanisms.(d) The program must use quality indicator data, including client care, and other relevant data in the design of its program.(e) The BHH must use the data collected to monitor the effectiveness and safety of services and quality of care and identify opportunities and priorities for improvement.(f) The functions and processes outlined in (a) through (e) shall be evidenced in an annual written plan for performance improvement activities. The plan shall include but not be limited to:(1) Outcomes management processes which include measures required by CMS and the State and may also include measures from the SAMHSA National Outcomes Measures, NCQA, and HEDIS as required to document improvement in population health.(2) Quarterly record review to minimally assess:(A) Quality of services delivered;(B) Appropriateness of services;(C) Patterns of service utilization;(D) Treatment goals and objectives based on assessment findings and consumer input;(E) Services provided which were related to the goals and objectives;(F) Patterns of access to and utilization of specialty care; and(G) The care plan is reviewed and updated as prescribed by policy.(3) Review of critical incident reports and consumer grievances or complaints.(g) Compliance with this Section will be determined by a review of the written program evaluation plan, program goals and objectives and other supporting documentation provided.