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25 <br />^ How much money is already being spent on this service and on this <br />population? <br />^ What are the unmet needs in the community? <br />^ Is the service considered best practice or evidence-based practice? <br />Is the service considered a promising practice (in other words, a <br />new service that has shown good outcomes in early use)? <br />If this request for an increase in service to specific individuals, has <br />the Care Management Department reviewed the request 'and <br />confirmed that it meets the medical necessity criteria? <br />^ If this is a request from a provider for an increase in the contract, <br />does this provider have a record of showing good outcomes and <br />complying with monitoring requirements? <br />• Expand provider monitoring to include ^ 'a targeted review of Person <br />Centered Plans (PCP) and Crisis P/ar-s "''~s well as first responder <br />capabilities. , `' ~. <br />Target Date: July 1, 2007 and on-goir'ig~ ~~~ ~ ~_~, <br />Responsible Parties and Stakeholders: Q.l/PR Department, Care Management <br />Department, Provider Community, CFAC, Community Collaboratives <br />As OPC continues to develop and improve its providermanitoring processes, we will <br />incorporate reviews of PCPs, Crisis Plans and first responder capabilities to promote <br />the basic goals of system reform. <br />• Review and make_ -nprovements as needed in any of the above objectives <br />as a part of a continuous quality improvement plan. <br />Target Date:-June 30, 2010 <br />Responsible Parties, and' Stakeholders: Senior Management <br />_ , <br />Resource Allocation ~ ~' <br />,, <br />The entire Quality Improvement/P.rovider Relations Department consists of 7.9 FTEs, <br />6.15 of which are devoted to the Provider Relations function. These positions are <br />broken down as follows: <br />• Director - .5 FTE <br />• Provider Community Manager -1 FTE <br />• Provider Relations Representative - 2 FTEs (1 position filled, 1 posted) <br />• Provider Monitoring Team Leader - .4 FTE <br />• Accreditation and Credentialing Specialist -1 FTE <br />• Clinical Specialist -1 FTE <br />• Administrative Assistant - .25 FTE <br />According to the cost model, OPC would be allowed 8.4 FTEs to fulfill this function. The <br />variation from fihe cost model is mainly due to the relocation of the contracting function <br />2s <br />