Quality & Compliance
The quality improvement (QI) team is a group of individuals within an organization who are tasked with carrying out continuous improvement efforts to ensure policies and systems are in place to provide the highest quality services to our clients. The Inyo County Division of Behavioral Health QI analyst team falls under HHS Administration- Program Integrity and Quality Assurance program.
Compliance statement:
Inyo County Behavioral Health will comply with all applicable laws, regulations, rules or guidelines governing the provision of mental health services. All employees and contractors, who provide and receive payment for mental health services, are expected to conduct themselves honestly, fairly, and with a high degree of integrity.
Accordingly, the County has a Compliance Officer to ensure to the extent reasonably possible, that all employees invoke a high degree of business honesty and integrity required of healthcare professionals and providers. In addition, this program has been instituted as a means of preventing fraud, abuse and false billings to any third-party payer.
Strict adherence to the Compliance Standards is expected of all applicable employees and contractors.
Purpose: QIC monitors the service delivery system with a goal of improving the processes of providing care and better meeting the needs of clients. QIC members identify opportunities for improvement and decide on which opportunities to monitor through the QI Work Plan. QIC also evaluates the 24/7 access line by gathering information from test calls to improve services. The Quality Improvement Committee (QIC) assumes the activities of the following committees - the Performance Improvement Project (PIP) Committee and the Cultural Competency Committee (CCC), to include development and monitoring of the PIPs and Cultural Competency Plan (CCP). Tasks include reviewing and evaluating timeliness, access and quality of services delivered by Inyo County Behavioral Health Services, and considers projects designed to look at ways to improve daily services.
Frequency: Quarterly meetings will be held the month following the end of the quarter under review (January, April, July, and October). Two meetings will be held at ICHHS-BH during our Behavioral Health “staffing” meetings to ensure internal stakeholder input, and the other two will be community based meetings held at Wellness Center or with one of our partner organizations. The committee will make efforts to have one meeting a year in South County.
Members: Internal Stakeholders (Staff), Consumers & Family, Community Partners (Internal & External); members should be reflective of the community including county management level and line staff, clients and family members from ethnic, racial, and cultural groups, providers, community partners, contractors, and other members as necessary.
Expectations of Members and Meetings: Ability to meet quarterly, in person or by phone. Tasks include reviewing and evaluating timeliness, access and quality of services delivered by Inyo County Behavioral Health Services, and considers projects designed to look at ways to improve daily services as well as review policies, procedures, and practices.
The QI team meets regularly with internal and external stakeholders to review performance data, identify areas in need, enhancement or revision, and then carries out and monitors progress efforts. For these activities, the team uses a variety of approaches and tools, including the Quality Improvement Work Plan. Activities also include data collection and analysis, workflow mapping, assessments of current practice, revisions of policies and procedures, audits and feedback, benchmarking, and best practices research and implementation. QI works on systems and processes with the overall focus on enhancing the quality of the services we provide to all of our clients, improving services to Behavioral Health Clients, Families, and Caregivers, in an efficient, effective and appropriate manner.
The Department of Health Care Services (DHCS) conducts triennial oversight reviews of each county Mental Health Plan (MHP) to determine compliance with federal and state regulations as well as the terms of the MHP contract. DHCS works closely with each MHP to ensure compliance and to identify opportunities for improvement. Using a collaborative and educational approach, DHCS provides guidance and technical assistance if it determines that the MHP is out of compliance. At the conclusion of the review, DHCS identifies strength-based practices of the MHP and provides feedback on areas of noncompliance. DHCS provides the MHP with a written report of findings which includes a description of each finding, a description of any corrective action(s) needed, and timeframes required for the MHP to come into compliance.
The State of California Department of Health Care Services (DHCS) contracts with 56 county Medi-Cal mental health plans (MHPs) to provide Medi-Cal-covered specialty mental health services (SMHS) to Medi-Cal beneficiaries under the provisions of Title XIX of the federal Social Security Act.
These reports present the findings of the external quality review (EQR) of Inyo County by the California External Quality Review Organization (CalEQRO), Behavioral Health Concepts, Inc. (BHC). A Performance Improvement Project (PIP) is defined by CMS as “a project designed to assess and improve processes, and outcomes of care that is designed, conducted, and reported in a methodologically sound manner”. Each PIP is designed to produce beneficiary-focused outcomes. There must be 2 valid PIP’s per MHP. The PIPs must be initiated, underway, or completed during the reporting year.
Inyo County Health and Human Services Behavioral Health (ICHHS-BH) is committed to promoting each person’s voice, creating a culture of balance and healing for all persons receiving services, integrating families and natural support systems into services, whenever possible. Services are individualized to meet each person’s needs and reflect cultural sensitivity to promote outcomes and reduce stigma. We work with our American Indian communities and the Latino population through outreach and coordinating services with other community agencies.
The Quality Improvement Committee assumes the activities of the Cultural Competency Committee (CCC).
1. Participates in overall planning and implementation of services at the county
2. Provides reports to the Quality Improvement Program
3.Review policies, procedures, and practices that assure members of the CCC will be reflective of the community including county management level and line staff, clients and family members from ethnic, racial, and cultural groups, providers, community partners, contractors, and other members as necessary