2017-703-E Health - National Assn of State Mental Health Directors service agreement

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DocuSign Envelope ID:CAABEAFA-9919-4207-B5CD-58E618EA747E Orange County in the past. NRI believes that implementing SOC programmatic changes should be accompanied by an evaluation component—and we feel that the QSR is the best mechanism to accomplish the County's goals. Rather than implementing one point-in time assessment, the QSR delivers a continuous quality improvement approach embedding constant evaluation of programmatic changes. To test the utility of the QSR, NRI proposes piloting the Integrated Care QSR in Alliance Zones 4 and 5. Establishing a pilot phase offers several benefits. First, the QSR approach used during the pilot in Zones 4 and 6 may uncover minor modifications that would be beneficially before County-wide rollout. Second, a County-wide QSR assessment would require several reviewer dyads. The pilot phase would provide ample opportunity to train future reviewers. These reviewers would be recruited as volunteers from stakeholder groups such as the School systems, the Departments of Social Service and Public Health, potentially Cardinal Innovations, family members, local JCPC representatives. By choosing reviewers from this group, a cadre of trained QSR reviewers will be established enabling the County to maintain their own SOC evaluations over time, which is far more cost-effective than hiring paid reviewers. A third benefit of a pilot phase is that the process may yield SOC recommendations that are generalizable across the County, which could be included in an initial plan of programmatic improvements. The Integrated Care QSR pilot would be conducted on six randomly selected cases in each of Zones 4 and 6 over a period of one month. A small number of cases (6) can ably illustrate how the system is functioning and how the children in that system are faring given that level of functioning. We would be able to uncover systemic strengths and weaknesses and in so doing be able to adjust the QSR and respond to the findings in our rollout plans for the other Zones. The pilot phase would also be used to train future QSR reviewers. Results of the data analysis, along with the findings from Deliverable 2 described above, would be used to provide recommended changes to the SOC. Finally, NRI would lay out an implementation schedule for recommended programmatic changes, incorporating a County-wide QSR plan for years 2-5. The result would be a robust, continuous quality improvement approach. It is proposed that QSR be used to establish a baseline in Alliance zones 4 and 5 and be used subsequently in years 2-5, expanding to other Alliance zones as desired, to determine the progress made year by year by the involved systems and their ability to utilize the feedback via the lessons suggested above to adjust and adapt those systems to the needs of the children and adolescents in their care. The approach described above is highly dependent on support from the school and related public systems. The QSR approach requires the schools to identify randomly selected youth cases to be reviewed and individuals that should be included in case interviews or focus groups. Page 15 NRI • 3141 Fairview Park Drive • Suite 650• Falls Church, VA• 22042 • 703-738-8160 •www.nri-inc.org