Overview of Plans for Measurement of Performance Outcomes

The Western New York Care Coordination Program seeks to provide a new level of care coordination and improved outcomes for high need individuals diagnosed with serious mental illness. We intend to measure our success in this endeavor by tracking a few critical performance outcomes.

We intend to learn about:

Access

Access covers a variety of dimensions, including timeliness of service, emergency help, scheduling, the range of services and specific services (service coordination, vocational services, etc.). Two general sources of measure are applicable here. First, the time from referral to service enrollment (especially for individuals coming from hospital or jail settings) can be measured by tracking the time between these dates. Second, recipient ratings of access issues can be measured using the Mental Health Services Survey (MHSS), an assessment of care instrument developed and piloted by the State Office of Mental Health.

Appropriateness

Appropriateness of care received covers a variety of issues including respectful treatment, staff willingness to listen to recipient needs, staff belief in recipients' recovery, cultural competency, and opportunity for recipient to take charge of her/his care. These and other appropriateness dimensions are addressed in the MHSS discussed above.

Recovery, Wellness and Quality of Life

Recovery, wellness and quality of life cover dimensions relating to symptom management, risk behaviors, empowerment, skill building, independence, work status, community status and self-esteem.

Outcomes around work, educational status (and activity), living situation and contact with the criminal justice system may be measured using an instrument such as the Recipient Characteristics and Status Form. Alternatively, existing data systems that capture similar information may be revised to ensure data consistency across the WNYCCP system and then used to capture these specific data. This information may then be electronically extracted for measurement purposes.

Skills and abilities, symptom issues, risk factors, interpersonal relationships and quality of life have two main data sources: service coordinators and recipients. Service Coordinators may use the Clinician's Assessment of Functioning instrument developed by the OMH to collect data on these dimensions. Recipient self-ratings of these dimensions are available through the Self-Assessment instrument previously developed by the partners and through the MHSS.

Empowerment and confidence is another recipient self-rating and may be measured by the Self-Confidence Scale (Knight and Carpinello).

Service Utilization and Fiscal Outcomes

The goal of WNYCCP is to serve a high need population that has not always connected well with the mental health system. The Minimum Data Set is available as a mean of collecting a system profile of enrollees at system entry. This data set provides enrollee identifiers, documents if new enrollees connect with services, and provides a profile of enrollees that shows whether the system is serving the intended population.

The decrease in the use of hospital services has the multiple benefit of conserving fiscal resources and/ or diverting them to community services as well as less disruption in the lives of recipients. Data from the Medicaid system and other existing data systems may be employed to measure the number of hospitalizations, total patient days in hospital, cost of hospital services and the cost of services generally.

Instruments to be Used in Performance Outcomes Measurement

We plan to use the following instruments to measure outcomes:

Schedule for Use of Performance Measures

The implementation schedule for the use of these performance measures is as follows:

		Frequency
Instrument	Completed by	Enrollment	Discharge	Quarterly while enrolled	Annually while enrolled
Clinician Assessment of Functioning	Service coordinator	X	X		X
Self Assessment	Service coordinator & Recipient	X	X		X
Periodic Reporting Form	Service coordinator	X	X	X
Mental Health Services	Survey Recipient				X
Adult SPOA Data Set	TBD	X