Louisiana Child Support Guidelines; Chart - Excel by reb13440


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									OrgID                              OrgName                FSR       Sustainability Plan   QI Plan      1st Condition

TLN     Administrators of Tulane Educational Fund       9/9/2008         9/17/2008        9/9/2008       Depression

CCH     Catholic Charities Archdiocese of New Orleans   9/8/2008         9/8/2008         9/10/2008   Disorder

CHP     Children's Hospital Medical Practice Corp       9/9/2008         9/9/2008         9/9/2008    Palivizumab
CGR     Common Ground Health Clinic                     9/8/2008         9/8/2008         9/15/2008

                                                                                                      Depression &
CVH     Covenant House New Orleans                      9/19/2008        9/19/2008        9/9/2008    Symptoms
DOC   Daughters of Charity Services of New Orleans    8/29/2008   8/29/2008   9/12/2008   Diabetes

EXL   EXCELth                                         9/9/2008    9/9/2008    9/10/2008   Hypertension

JCH   Jefferson Community Health Care Centers, Inc.   9/12/2008   9/12/2008               Hypertension
                                                                                                                                         Use of a
JPH   Jefferson Parish Human Services Authority                      8/26/2008   8/26/2008 - revised 9/11/2008        9/12/2008          substance

LEG   Leading Edge Services Int'l, Inc. D/B/A Family Health Center   9/15/2008            9/15/2008                   9/15/2008          Hypertension
L9W   Lower 9th Ward Health Clinic                                    9/8/2008

LHS   LSU Health Sciences Center (SBHC)                                                    9/8/2008              Request ext till 9/17   Tobacco Use

                                                                                                                                         Patients being
                                                                                                                                         treated with
LHN   LSU Healthcare Network (LSUHN)                                 8/29/2008             9/2/2008                9/8/8 rev 9/19/8      stimulants
MCL    Medical Center of Louisiana at New Orleans         9/18/2008        9/18/2008         9/10/2008         Hypertension
MTR    Metropolitan Human Service District                8/26/2008        8/28/2008         9/16/2008

NOAH   New Orleans Adolescent Hospital                    9/16/2008        9/11/2008   9/9/2008 - not acceptable ADHD
NOHD   New Orleans Health Department                       9/9/2008         9/9/2008

NOM    New Orleans Musicians Assistance Foundation      req. ext 9/12/08   9/8/2008            4/8/08

NOA    NO/AIDS Task Force                                 8/29/2008        8/28/2008          9/8/2008         HIV/AIDS

ODH    Odyssey House Louisiana                            8/28/2008                          9/10/2008         Diabetes
PLQ    Plaquemines Medical                              req. ext 9/12/08
MCF    Sisters of Mercy Ministries D/B/A Mercy Family      9/8/2008        9/8/2008       8/2/08 - version3
STB   St. Bernard Health Center, Inc.                              9/11/2008   9/11/2008   ext.9/15/2008   Hyperlipidemia
STC   St. Charles Community Health Center                          9/19/2008   9/19/2008     9/11/2008

STH   St. Thomas Community Health Center                           8/27/2008   8/27/2008    9/15/2008      Hypertension
      *Blue Highlight denotes C-IBHA participant
      *Orange highlight denotes CIBHA participant for next round
      **Tulane and Musicians have each been divided into two
      sections for C-IBHA only

      Based on ALL CIBHA participants, there are 65 sites
                                                                                                  PCASG Deliverables

                                                     Workflow/                                                                                                         EBG
     2nd Condition         3rd Condition             Algorithm                          EBG 1                            EBG 2                        EBG 3           Review
                                                                                                             September 2006, CDC          Standards of care for
                                                                                                             recommendations for HIV      diabetes for diabetics.
                                                                                                             testing of adolescents and   Diabetes Care 31: S12-54,
          HIV                 Diabetes                                        PHQ-9                          adults.                      2008.

                                            Staff completed a file audit on
                                            clients that were seen            Cognitive Behavioral Therapy
                                            between June 1, 2008 and          for Depression combined
                                            August 31, 2008. The three        with Psychiatry (Medication
Generalized Anxiety                         preferred diagnoses appear        Management) as indicated.
Disorder              Adjustment Disorder   above. (prevalence)               Use PHQ-9

                                                                              Amer Acad Pediatrics
                                                                              Clinical Practice Guidelines
                                                                              for Diagnosis and
                                                                              Management of Bronchiolitis

                                            Spot check of 40 random
                                            client charts, more than half
                                            of the clients reported
                                            depression or depressive
                                            symptoms.                         PHQ-9
                                            The guidelines and measures
                                            that were selected were
                                            determined by the UHF
                                            Foundation for a national
                                            demonstration project from a
                                            subset of AQA starter
                                            measures. They correspond
                                            to mortality/morbidity
                                            statistics for national health
                                            disparities as well as
                                            Lousiana statistics. The UDS
                                            reports confirm that they are                                                           USPSTF Guidelines for
                                            priorities for our local patients ADA Guidelines for Diabetes NIH Guidelines for        Cancer Screening – Breast,
Cardiovascular Disease   Cancer Screening   as well.                          Care                        Hypertension and Lipids   Cervical, Colon

                                                                          Algorithm for Treatment of
Diabetes                 Hyperlipidemia     Prevalence                    HTN
                                                                          Seventh Report of the Joint
                                                                          National Committee on
                                                                          Prevention, Detection,
                                            EMR record search; most       Evaluation, and Treatment of
Diabetes                 STDs               prevalent                     High Blood Pressure
                                                                                  The Matrix Model Intensive
                                                                                  Outpatient Alcohol and Drug
                                                                                  Treatment is a
                                                                                  comprehensive, evidenced-
                                                                                  based, sixteen week
                                                                                  individualized program
                                                                                  designed to give people with
                                                                                  a substance abuse issue the
                                                                                  knowledge, structure, and
                                                                                  support to allow them to
                                                                                  achieve abstinence from
                                                                                  drugs and alcohol and initiate
                                                                                  a long-term program of
Major depression          Bipolar Disorder                                        recovery.
                                                     Determined based on clinic
                                                     most frequently treated newly
                                                     diagnosed and established
                                                     patients seen within the last 6 Laboratory tests of CD4 T-
                                                     months with fewer no-show       lymphocyte load and Plasma
Diabetes                  Primary HIV Infection      visits.                         RNA viral load.

                                                  Each of the conditions has
                                                  been identified by the State of
                                                  Louisiana, Office of Public
                                                  Health as significant for
                                                  Clinical Quality Improvement
                                                  in the care of adolescent
                                                  patients in School Based
                        Overweight/Obesity - High Health Centers. Several are
                        Blood Pressure/           included in their Quality                                                                LA-OPH best practices forms
                        Hypertension and          Improvement review as           LA-Office of Public Health       LA-OPH Best practices   for Hypertension and
Chlamydia STI Screening Diabetes                  “Sentinel Conditions.”          Best Practices guidelines        guidelines              Diabetes Screening

                                                                                  Patients being treated with
                                                                                  stimulants will have their
                                                                                  blood pressure and heart                                 Each visit with a patient with
                                                                                  rate (while seated) measured                             Major Depression must
                                                                                  at each visit beginning when                             include an assessment of
Neuroleptic drug side                                                             the stimulant is prescribed  Movement rating scale       suicidality in the progress
effects                   Major Depression                                        for a baseline measure.      (AIMS)                      note.
                                                                              Seventh Report of the Joint
                                                                              National Committee on
                                                                              Prevention, Detection,
                                                                              Evaluation, and Treatment of
Diabetes                 Heart Failure                                        High Blood Pressure

                                                                              July 2007, American
                                                                              Academy of Child and
                                                                              Adolescent Psychiatry
                                                                              published practice
                                                A query ran in the            parameters for the treatment
                                                ARAMIS/OMH-IIS tracking       of children and adolescents
Depression               Mood Disorder          program                       with ADHD

                                                                              Comprehensive strategy for
                                                                              measuring the full range of
                                                                              performance indicators as
                                                                              provided by HRSA through
                                                                              the HIVQUAL project is being
                                                The agency collected data for implemented with enhanced
                                                the past two weeks;           electronic health records and
Benign Hypertension      Syphilis Unspecified   prevalence.                   patient management system.
                                                Guidelines set forth by the
                                                American Diabetes
                                                Association with further
                                                support coming from the       Guidelines set forth by the
Cardiovascular Disease                          Joslin Diabetes Center        American Heart Association
                                     Evaluated the top 20
                                     conditions, selected the 3
                                     conditions that they felt
                                     adversely affected their
                                     community as a whole, had
                                     evidence-based guidelines                                      i. LDL Screen performed
                                     which would have an             Third Report of the National   ii. LDL-C Results < 130
                                     immediate impact on             Heart, Lung, and Blood         iii. Blood Pressure > 130/90
                                     patients‟ lives, and were       Institute‟s Expert Panel on    iv. Obesity (BMI > 29)
                                     amenable to chronic disease     Detection, Evaluation and      v. Regular exercise
                                     management with available       Treatment of High              vi. Coronary artery disease
Diabetes   Coronary Artery Disease   resources.                      Cholesterol in Adults          on lipid lowering drugs

                                     Providers met in sub groups
                                     to look at various nationally
                                     recognized EBG for each
                                     condition. They then met as
                                     a group and presented           * American Diabetes
                                     recommendations of which        Association 2008 guidelines                                   National Asthma Prevention
                                     EBG to adopt. Then they         * IDF Diabetic Guidelines      JNC Seventh Report for the     and Educations Program
Diabetes   Asthma                    chose the guidelines.           2005                           Joint National Committee       2005 Guidelines
      EBG                                                                                 Planned Staff     Annual
Action Required             Measurement 1                 Measurement 2   Measurement 3     Training      Attestation      Sec   MOU

                                                                                                                        Adult     x


                  * 75% of clients will demonstrate
                  stability supported by a reduction in
                  score on the depression screen
                  and on the formal assessment and
                  self reports.
                  * 75% of clients will report
                  satisfaction at post-test on their
                  satisfaction survey.                                                                                            x

                  1) Goal to identify 100% of the at
                  risk patients for increased
                  hospitalization due to RSV
                  2) Goal to correctly administer
                  Palivizumab prophylaxis to at least
                  90% of the identified at risk infants
                  3) Goal to monitor and adjust if
                  needed for our assumption that
                  80% of the infants born at
                  gestational age 32 to 35 weeks
                  have at least 2 high-risk criteria
                  4) Goal to reduce the number of
                  these at risk children admitted to
                  the hospital for Bronchiolitis or
                  Program evaluation will look at the
                  number of clients from each level
                  of depression severity and evaluate
                  them based on the average
                  improvement of each level and the
                  number of clients whose treatment
                  followed our „optimal treatment
                  guidelines.‟                                                                                                    x
* Percentage of patients with
diabetes with one or more A1C
test(s) conducted during the
measurement year.
* Percentage of patients with
diabetes with most recent A1C
level greater than 9.0% (poor
control).                             * Percentage of women
* Percentage of patients with         who had a mammogram
diabetes who had their blood          during the measurement
pressure documented in the past       year or year prior to the
year less than 140/90 mm Hg.          measurement year.
* Percentage of patients with         * The percentage of adults
diabetes with at least one Low        who had an appropriate
Density Lipoprotein cholesterol       screening for colorectal
(LDL-C) test (or ALL component        cancer.
tests).                               * Percentage of women
* Percentage of patients with         who had one or more Pap
diabetes with most recent LDL-C       tests during the
less than 100 mg/dL or less than      measurement year or the
130 mg/dL.                            two prior years.             x
* % adults with diagnosed
hyptertension whose most recent
BP was <140/90
* % pts with diabetes who had their
blood pressure controlled (<140/90
at last visit) during the
measurement year
* % pts with diabetes who had their
blood pressure controlled (<130/80
at last visit) during the
measurement year.                                                  x

Documentation of treatment
provided according to the selected
guidelines                                                         x
* Decrease in an individual‟s
alcohol and/or substance use
* Increase in participation in
recovery-oriented behaviors and
life satisfaction, which are believed
to support abstinence                                                                                 x

* CD4 count
* Plasma HIV RNA viral load                                                                           x

                                        % of Students Receiving
                                        Comprehensive Exam or
                                        Risk-Assessment that report     % of Students Receiving
                                        sexual activity have            Comprehensive Exam
% of Students Receiving                 documentation of                have documentation of
Comprehensive Exam or Risk-             Chlamydia/gonorrhea             BMI and BMI % at
Assessment that have                    screening within last 12        comprehensive physical
documentation of tobacco use            months. Progression toward      exam visit. Progression
status. Progression toward goal         goal will be monitored          toward goal will be
will be monitored bi- annually via      annually via random chart       monitored bi- annually via
random chart review of sub-set of       review of sub-set of patients   random chart review of sub-
patients (minimum 10 charts) or         (minimum 10 charts) or          set of patients (minimum
electronic database review of           electronic database review of   10 charts) or electronic
patients receiving                      patients receiving              database review of
annual/comprehensive physical           annual/comprehensive            patients receiving
examination or risk behavior            physical examination or risk    annual/comprehensive
screening.                              behavior screening.             physical examination.         x

Will randomly select and audit
medical records on a monthly basis
for MCLNO, and quarterly for
HCSD according to ICD 9
Hypertensive Diagnosis Codes
beginning with 401
i. Diabetic and chronic renal
hypertensive control - BP < 130/80
ii. Heart failure hypertensive control
- BP < 130/85 mmHg
iii. Essential hypertension control –
BP < 130/80
iv. Compelling indications (See
table 2 below)
v. Appropriate use of aspirin in
patients with CVD risk > 10%


                                         Main     x
                                         StAnna   x


                                             x    x

                                             x    x
                                    * Number of Patients with      * Number of patients with
* Average HbA1c for all patients    appropriate BP control         severity assessment
with a Diabetic Diagnosis           * Number of patients with at   * Number of patients with
* Number of Patients with 2 HbA1c   least 2 BP readings in the     appropriate treatment with
in last 12 months                   last year                      anti- inflammatory
* Number of patients with           * Number of patients with      * Number of patients with
documented self management          documented self                documented self
goals                               management goals               management goals
                                                                                                          2                       17
                                                                                                              (9 organizations)

                                                                                                5 organizations originally were participating but have decided "p
                                                                                                CCH, LEG, MTR, NOAH, ODH
                                                                                                Denoted in orange highlight
                                             C-IBHA Deliverables
                                                              Internal      Revised      External        Eval     Technical Sep 16     Oct 15
  Rec'd TA       Rec'd       Revised TA                     Questionnaire   Internal   Questionnaire    Score     Assistance Conf Call Conf Call
Questionnaire    Date       Questionnaire   Revision Date     Review         Review      Review        (max 36)    Provided

      x         8/6/2008          x           8/12/2008           x                                      31                       x

      x         8/6/2008                                          x                                      29

      x         7/18/2008                                         x                                      16

      x         9/25/2008

      x         9/22/2008                                         x                                      34
x   9/18/2008

x   8/15/2008   x   9/9/2008   x   19

x   9/24/2008
x   8/12/2008   x   9/19/2008   x   31   x

x   7/16/2008                   x   20


    x       9/22/2008
    x       7/22/2008                   x            20          x

    x        8/1/2008                   x            29
    x       7/10/2008   x   9/22/2008   x            34

    x       7/8/2008    x   9/19/2008   x   x        31 34

7/15/2008                      x                32

9/23/2008                      x                21           x
                                                    0                                        2   11   1   26.50 26.73   1   5
                                                                         (9 organizations)

iginally were participating but have decided "participant in the next round"

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