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					California Department of Mental Health                                           MHSA Capital Facilities and Technological Needs

                                                          Enclosure 3
                                                           Exhibit 2
                              Technological Needs Assessment
County Name:        Kern

Project Name:       Kern County Information Technology Projects
                      See attached Exhibits 3



Provide A Technological Needs Assessment Which Addresses Each Of The Following Three Elements

1. County Technology Strategic Plan Template
   (Small Counties have the Option to Not Complete this Section. )

    This section includes assessment of the County's current status of technology solutions, its long-term
    business plan and the long-term technology plan that will define the ability of County Mental Health to
    achieve an Integrated Information Systems Infrastructure over time.

    Current Technology Assessment

           List below or attach the current technology Systems In Place.


    1.1    Systems Overview
    Kern County is currently using an EHR system from Anasazi Software, Inc. The system provides the Practice
    Management and Clinical Notes capabilities defined by DMH as "EHR Lite." The system provides support for
    3rd Party Claiming, including Medi-Cal and MediCare, billing interface with Organizational Contract Providers,
    interfaces with all State Reporting requirements, scheduling, client registration, client assessment tools and
    Treatment Planning capabilities. The EQRO ISCA tool has been provided as Attachment 1 to Exhibit 2 for
    reference. The history of Kern's EHR Implementation Project is also included as Attachment 4 to Exhibit 2.

           List Or Attach A List Of The Hardware And Software Inventory To Support Current Systems.

    1.2    Hardware
    See Exhibit 2, Attachment 2




    1.3    Software
    See Exhibit 2, Attachment 3




    1.4    Support (i.e., Maintenance and/or Technical Support Agreements)

    Vendor Support Agreements are in place for all Mission Critical Applications (reference Exhibit 2, Attachment 3).




Enclosure 3, Exhibit 2 - Technological Needs Assessment       Page 1 of 7                                       October 30, 2008
California Department of Mental Health                                                  MHSA Capital Facilities and Technological Needs



    Plan To Achieve An Integrated Information Systems Infrastructure (IISI) To Support MHSA
    Services
    Describe the plan to obtain the technology and resources not currently available in the county to
    implement and manage the IISI. (Counties may attach their IT Plans or complete the categories below.)


    1.5 Describe how your Technological Needs Projects associated with the Integrated
    Information System Infrastructure will accomplish the goals of the County MHSA Three-Year Plan.

    Project 1: Network Infrastructure Modernization
    Providing a communications infrastructure capable of supporting the requirements of an EHR is critical to the
    success of that application. With the implementation (or in Kern's case, the expansion) of an EHR system, staff
    are being required to change their mode of operation. If the infrastructure does not permit efficient and timely
    access to the system, staff resistance is inevitable. This project will overcome those barriers to system use.

    Project 2: Technology Refresh
    The quality of the equipment on the user's desktop is an additional factor in the success of an EHR project. A
    large percentage of the currently deployed equipment has passed it's useful life. Updating that equipment
    enhances the potential for a successful EHR implementation.

    Project 3: e-Prescribing
    Computerized Physician Order Entry (CPOE) is a required element of a compliant EHR. This project provides
    that capability.

    Project 4: Recovery Oriented Treatment Plan
    This project supports the goals of transformation of the experience of our consumers. The Treatment Plan
    should be a critical element in providing services that meet the needs of Wellness and Recovery. The
    Treatment planning requirements currently in effect are focused on Medical Necessity rather then Recovery.
    The intent of this project is to change that paradigm and create a treatment plan that can fulfill both sets of goals.

    Project 7: Personal Health Record (PHR)
    The PHR is another required element of a compliant EHR. This project encompasses a partnership with the
    software vendor to develop the critical elements of a PHR. Based on the expectations of this project, Health
    Information Exchange (Interoperability) practices will also be developed and implemented.

    The following projects are not directly associated with the Integrated Information System Infrastructure:

    Project 5: Consumer/Family Computer Facilities
    This project will create two new computer facilities and modernize a third facility specifically for the use of
    Consumers and their families.

    Project 8: Network of Care Web Site
    Provide for on-going availability of this critical on-line source of information.

    Project 9: MHSA/DCR Batch Interface
    Integrate the MHSA/DCR data collection tool into the EHR system, provide an electronic "batch" feed to the
    States Data Base.

    Project 6: Tele-Psychiatry Communications Improvements
    This project has been consolidated with Project 1.




Enclosure 3, Exhibit 2 - Technological Needs Assessment        Page 2 of 7                                             October 30, 2008
California Department of Mental Health                                        MHSA Capital Facilities and Technological Needs


    1.6 Describe the new technology system(s) required to achieve an Integrated Information System
    Infrastructure.

    Based on the current status of Kern County's EHR implementation, no "new" system is required to achieve the
    goal of an Integrated Information System Infrastructure. Rather, the proposed projects involve enhancements to
    the existing system to achieve that goal.



    1.7 - Note the Implementation Resources Currently Available.

             Oversight Committee:                         Yes     No

             Project Manager                              Yes     No

             Budget:                                      Yes     No

             Implementation Staff in Place:               Yes     No

             Project Priorities Determined:               Yes     No


    1.8 - Describe Plan To Complete Resources Marked “No” Above.

    The need for an Oversight Committee specific to MHSA-Technology projects is minimal based on the Risk
    Factors associated with each individual project. It is therefore expected that the Department's existing
    Management Team will provide Project Oversight. This team consists of the Department's Executive
    Management, all Clinical Administrators and representatives from QID, Finance, ITS and Psychiatry.


    1.9 - Describe the Technological Needs Project priorities and their relationship to supporting the
    MHSA Programs in the County.

    The Technology Project Priorities were determined by feedback from the various Stakeholder meetings held in
    late 2008. These meetings were attended by Clinical Staff, Consumers, Consumer family members and
    administrative staff. Staff in attendance represented both the Department and the Contract Provider community.
    The projects are listed in priority order.




Enclosure 3, Exhibit 2 - Technological Needs Assessment         Page 3 of 7                                  October 30, 2008
California Department of Mental Health                                        MHSA Capital Facilities and Technological Needs



2. Technological Needs Roadmap Template

This section includes a Plan, Schedule, and Approach to achieving an Integrated Information Systems
Infrastructure. This Roadmap reflects the County's overall technological needs.

Complete a Proposed Implementation Timeline with the Following Major Milestones.
  2.1     List Integrated Information Systems Infrastructure Implementation Plan and Schedule or
          Attach a Current Roadmap (example below).
    Kern County began this process in early 2003 with the creation of a Technology Needs Assessment. In July,
    2003 we participated in the California Behavioral Systems (CBS) Coalition to create an RFP and to evaluate
    responding software vendors. Anasazi Software was selected by Kern County as our vendor of choice in
    September, 2004. We completed contract negotiations and obtained Board of Supervisor approval in May,
    2005. On July 1, 2006, the Department began the full use of the new system. Training was carried out on a
    team-by-team basis over the next 8 months. A more complete history of the vendor selection and
    implementation process is attached as Exhibit 2, Attachment 4.

    Kern's actual Roadmap is attached as Exhibit 2, Attachment 5.




    2.2      Training and Schedule (List or provide in Timeline Format…Example Below)




Enclosure 3, Exhibit 2 - Technological Needs Assessment   Page 4 of 7                                        October 30, 2008
California Department of Mental Health                                             MHSA Capital Facilities and Technological Needs

    2.3      Describe your communication approach to the Integrated Information Infrastructure with
             Stakeholders (i.e., Clients and Family Members, Clinicians, and Contract Providers).
    At the time that the department performed the Technology Needs Assessment, a Communications Plan was
    also created. This communications plan defined techniques and methodology for communicating with
    administrative staff, clinical staff and Organizational Contract Providers. The Plan is attached as Exhibit 2,
    Attachment 6. Although this plan was not implemented in its entirety, it provided the foundation for our
    communications approach throughout the implementation project. Some of the aspects of the plan that were
    utilized include:
    o Standing agenda item for
      o Quarterly All-Staff meetings
      o Quarterly Contract Provider CEO meetings
      o Monthly Expanded Management (all supervisors) meetings
      o Weekly Management Team Meetings
    o A unique section of the Department’s Intranet web site (MH Net)
      o FAQ’s
      o Training Schedules
      o Quick Guides (Focused User’s Guides)
    o Messages Posted at System Sign-in
    o Department-wide e-mail broadcasts of changes and new features

    2.4      Inventory of Current Systems (May include System Overview provided in County
             Technology Strategic Plan).
    o Anasazi Software
       o Client Data
       o Assessment & Treatment Plan
       o Scheduling
       o Managed Care
    o Data Systems International Client-Track System
       HUD required Homeless Management Information System
    o SeQuest TIER System
       Personnel and training tracking system
    o Various locally developed systems
       o Chart Tracker
       o Jail Medication Management
       o Grievance Tracking
       o View-only access to Legacy System Data (i.e., data collected prior to implementation of Anasazi)
       o Payroll Register/Cost Accounting
       o Emergency Contacts Telephone Tree
    See EQRO ISCA - Exhibit 2, Attachment 1 and Software Inventory - Exhibit 2, Attachment 3.

    2.5      Please attach your Work Flow Assessment Plan and provide Schedule and List of Staff and
             Consultants Identified (May complete during the Implementation of the Project or RFP).
    Workflow assessment and re-design is included as a set of tasks in the standard Anasazi Implementation
    Project Plan. During this phase of the Implementation, the Clinical Implementation Team:
    o Created flow charts for all existing work processes
    o Proposed changes where appropriate
    o Performed a department-wide forms inventory
    o Analyzed existing forms, made changes as required for implementation in an electronic format
    o Worked directly with all levels of the organization (Management, administrative, clinical and support staff) to
    obtain approval of revised work processes and forms
    Samples of the Work Flow diagrams are attached in Exhibit 2, Attachment 7.




Enclosure 3, Exhibit 2 - Technological Needs Assessment      Page 5 of 7                                          October 30, 2008
California Department of Mental Health                                               MHSA Capital Facilities and Technological Needs

    2.6       Proposed EHR component purchases [May include information on Project Proposal(s)].
    The components of the Anasazi Software product that are already purchased are
    o Client Data
    o Assessment & Treatment Plan
    o Scheduling
    o Managed Care
    A future module that will be purchased as an MHSA-IT Project is the “Dr’s Home Page” which includes
    functionality for e-Prescribing. See Project Plan 3 for details. Additionally, Project Plan 7 includes the
    development of Interoperability functionality and PHR functionality.

    2.7       Vendor Selection Criteria (Such as Request for Proposal).
    Kern County participated in the creation and evaluation of the CBS Coalition RFP. This was the primary tool
    used by the County to select our vendor. Details of this process are attached as Exhibit 2, Attachment 4.




    2.8       Cost Estimates associated with achieving the Integrated Information Systems
              Infrastructure.
    Our current software vendor supports functionality in all of the areas identified in the MHSA-IT Guidelines as
    required for a “Full EHR” with the exception of e-Prescribing, Interoperability and a Personal Health Record
    (PHR). Since no known Behavioral Health software vendor currently supports interoperability and PHR
    functionality, and since accepted standards for this functionality do not yet exist, it is challenging to estimate the
    costs required to develop this functionality.

    Kern County intends to submit proposals for the development of these features. The costs for e-prescribing are
    identifiable and are addressed in Project Plan number 3. The PHR project is preliminary and the scope of this
    project includes the development of Requirements Specifications to address the required functionality. Since
    Interoperability is a key component of a PHR, a single project will be submitted to address the preliminary
    specifications for both functions. Until the initial phase of this project is completed (i.e. the design phase), it is
    impossible to explicitly define implementation costs. The cost estimates related to the currently proposed project
    plans are:

    1.    Communications Infrastructure Upgrade            $ 800,400
    2.    Technology Refresh                               $ 650,000
    3.    e_prescribing                                    $ 198,684
    4.    Recovery Oriented Treatment Plan                 $   75,000
    5.    Consumer Computer Labs                           $ 69,840
    6.    Tele-Psychiatry Infrastructure                   Combined with Project 1
    7.    Personal Health Record                           $1,450,000
    8.    Network of Care                                  $ 81,000
    9.    MHSA FSP Data Collection                         $ 86,020
          Total                                            $3,410,944




Enclosure 3, Exhibit 2 - Technological Needs Assessment       Page 6 of 7                                           October 30, 2008
California Department of Mental Health                                           MHSA Capital Facilities and Technological Needs


3.       County Personnel Analysis (Management and Staffing)
         (Small Counties have the Option to Not Complete this Section.)

                                                                                                   Estimated
                                                                                   Position Hard #FTE Needed
                                                                   Estimated          to Fill?   in addition to
                                                                     #FTE            1 = Yes         #FTE
     Major Information Technology Positions                        Authorized         0 = No       Authorize

                                A. Information Technology Staff (Direct Service)




                                                     Subtotal A


                                         B. Project Managerial and Supervisory

CEO or Manager Above Direct Supervisor                                      1              0                              0

Supervising Project Manager                                                 1              0                              0

Project Coordinator                                                         1              0                              0

Other Project Leads                                                         2              0                              0

                                                     Subtotal B             5              0                              0

                                              C. Technology Support Staff

Analysts, Tech Support, Quality Assurance                                   7              0                              0

Education and Training                                                      3              0                              0

Clerical, Secretary, Administrative Assistants                              1              0                              0

Other Support Staff (Non-Direct Services)                                   0              0                              0

                                                     Subtotal C             11             0                              0


                                Total County Technology Workforce (A + B + C)

                                                                            16             0                              0




Enclosure 3, Exhibit 2 - Technological Needs Assessment       Page 7 of 7                                       October 30, 2008
Information Systems Capabilities Assessment


                                        (ISCA)


               California Mental Health Plans

                                        FY 2007
                                        Version 6.1
                                       August 2, 2006




This document was produced by the California EQRO in collaboration with the California Department
of Mental Health and California MHP stakeholders.




                                                                           004 ISCA - 2008.doc
    Information Systems Capabilities Assessment (ISCA)
                         FY2007
                     California Mental Health Plans
General Information

This information systems capabilities assessment pertains to the collection and
processing of data for Medi-Cal. In many situations, this may be no different from how a
Mental Health Plan (MHP) collects and processes commercial insurance or Medicare
data. However, if your MHP manages Medi-Cal data differently than commercial or other
data, please answer the questions only as they relate to Medi-Cal beneficiaries and
Medi-Cal data.

•   Please insert your responses after each of the following questions. If information is
    not available, please indicate that in your response. Do not create documents or
    results expressly for this review. Be as concise as possible in your responses.

•   If you provide any attachments or documents with protected health information
    (“PHI”), please redact or remove such information.

•   Return an electronic copy of the completed assessment, along with documents
    requested in section F, to CAEQRO for review by (Desired Deadline Date Here)

Contact Information

Insert MHP identification information below. The contact name should be the person
completing or coordinating the completion of this assessment.




                                                 1                      004 ISCA - 2008.doc
MHP Name:
                               APS fills in here

ISCA contact name              Dan Walters, Manager Technology Services
and title:                     Ross Kremsdorf, Quality Improvement Division Administrator
                               Russell Liesch, Administrative Services Officer

Mailing address:               PO Box 1000
                               Bakersfield, CA 93301
Phone number:
                               661/868-6710
                               661/868-6708
                               661/868-6617
Fax number:                    661/868-6666
E-mail address:
                               dwalters@co.kern.ca.us
                               rkremsdorf@co.kern.ca.us
                               rliesch@co.kern.ca.us
Identify primary               M. Daniel Walters
person who
participated in                Technology Services Manager
completion of the
ISCA (name, title):
Date assessment
                               1/9/2009
completed:


Note: This document is based on Appendix Z of the External Quality Review Activity Protocols developed by the
Department of Heath and Human Services Centers for Medicare and Medicaid Services (Final Protocol, Version 1.0, May
1, 2002). It was developed and refined by the California EQRO in collaboration with the California Department of Mental
Health and California MHP stakeholders.




                                                                2                             004 ISCA - 2008.doc
ISCA OVERVIEW
PURPOSE of the Information System Capabilities Assessment (ISCA)

Knowledge of the capabilities of a Mental Health Plan (MHP) information system is
essential to evaluate effectively and efficiently the MHP’s capacity to manage the health
care of its beneficiaries. The purpose of this assessment is to specify the desired
capabilities of the MHP’s Information System (IS) and to pose standard questions to be
used to assess the strength of a MHP with respect to these capabilities. This will assist
an External Quality Review Organization (EQRO) to assess the extent to which an
MHP’s information system is capable of producing valid encounter data1, performance
measures, and other data necessary to support quality assessment and improvement,
as well as managing the care delivered to its beneficiaries.

If a prior assessment has been completed by private sector accreditation or performance
measures validation, and the information gathered is the same as or consistent with
what is described in this assessment, it may not be necessary to repeat this assessment
process. However, information from a previously conducted assessment must be
accessible to EQRO reviewers.

OVERVIEW of the Assessment Process

Assessment of the MHP’s information system(s) is a process of four consecutive
activities.

Step one involves the collection of standard information about each MHP’s information
system. This is accomplished by having the MHP complete an Information System
Capabilities Assessment (ISCA) for California Mental Health Plans. The ISCA is an
information collection tool provided to the MHP and developed by the EQRO in
cooperation with California stakeholders and the California Department of Mental Health.
The California Department of Mental Health defined the time frame in which it expects
the MHP to complete and return the tool. Data will be recorded on the tool by the MHP.
Documents from the MHP are also requested through the tool and are summarized on
the checklist at the end of this assessment tool. These are to be attached to the tool and
should be identified as applicable to the numbered item on the tool (e.g., 1.4, or 2.2.3).

Step two involves a review of the completed ISCA by the EQRO reviewers. Materials
submitted by the MHP will be reviewed in advance of a site visit.

Step three involves a series of onsite and telephone interviews, and discussion with key
MHP staff members who completed the ISCA as well as other knowledgeable MHP staff
members. These discussions will focus on various elements of the ISCA. The purpose of
the interviews is to gather additional information to assess the integrity of the MHP’s
information system.

1
  “For the purposes of this protocol, an encounter refers to the electronic record of a service
provided to an MCO/PIHP [MHP] enrollee by both institutional and practitioner providers
(regardless of how the provider was paid) when the service would traditionally be a billable
service under fee-for-service (FFS) reimbursement systems. Encounter data provides
substantially the same type of information that is found on a claim form (e.g., UB-92 or CMS
1500), but not necessarily in the same format.” – Validating Encounter Data, CMS Protocol, P. 2,
May 2002.



                                                    3                       004 ISCA - 2008.doc
Step Four will produce an analysis of the findings from both the ISCA and the follow-up
discussions with the MHP staff. A summary report of the interviews, as well as the
completed ISCA document, will be included in an information systems section of the
EQRO report. The report will discuss the ability of the MHP to use its information system
and to analyze its data to conduct quality assessment and improvement initiatives.
Further, the report will consider the ability of the MHP information system to support the
management and delivery of mental health care to its beneficiaries.

INSTRUCTIONS:

Please complete the following ISCA questions. For any questions that you believe do not
apply to your MHP, please mark the item as “N/A.” For any ISCA survey question, you
may attach existing documents which provide an answer. For example, if you have
current policy and procedure documents that address a particular item, you may attach
and reference these materials.

Please complete this survey using Microsoft Word. You may supply your answers
in the areas indicated by tabbing through the fields.




                                                4                      004 ISCA - 2008.doc
Section A – General Information

1. List the top priorities for your MHP’s IS department at the present time.

        Complete Phase II of the EMR system, including the implementation of a
 Structured Treatment Plan
 Enhance the capabilities of the EHR system by leveraging available MHSA
 Technology funding. Create and submit road map for attaining full EHR functionality.
 Support the integration of the information contained in the EMR system into the
 decision making process throughout the Department
 Continue to support new and existing technology including network and desktop
 hardware and other critical software applications
 Implement the CalOMS system as an integrated part of the EHR. Train all Substance
 Abuse Providers on full use of the EHR including standard assessments, Progress
 Notes and Tx Plans.

2. How are mental health services delivered?

   Note: For clarification, Contract Providers are typically groups of providers and
   agencies, many with long-standing contractual relationships with counties that deliver
   services on behalf of an MHP and bill for their services through the MHP’s Short-
   Doyle/Medi-Cal system. These are also known as organizational contract providers.
   They are required to submit cost reports to the MHP and are subject to audits. They
   are not staffed with county employees, as county-run programs typically are.
   Contract providers do not include the former Medi-Cal fee-for-service providers
   (often referred to as network providers) who receive authorizations to provide
   services and whose claims are paid or denied by the MHP’s managed care
   division/unit.

   Of the total number of services provided, approximately what percentage is provided
   by:
                                                         Distribution
       County-operated/staffed clinics                       64%
       Contract providers                                    35%
       Network providers                                     1%
                                                 Total      100%


   Of the total number of services provided, approximately what percentage is claimed
   to Medi-Cal:
                                             Medi-Cal       Non-Medi-Cal          Total
       County-operated/staffed clinics          71%                29%              100%
       Contract providers                       86%                14%              100%
       Network providers                        100%                0%              100%




                                            4                           004 ISCA - 2008.doc
3. Provide approximate annual revenues/budgets for the following:

                                          Medi-Cal       Non-Medi-Cal           Total
    County-operated/staffed
    clinics                              $22,914,489      $36,940,429        $59,854,918
    Contract providers                                                       $37,219,195
                                         $17,658,657      $19,560,538
    Network providers                                                          $21,000
                                          $21,000               $0
    Total                                $40,594,146      $56,500,967        $97,095,113


4. Please estimate the number of staff that use your current information system:

                                                           Estimated
                      Type of Staff
                                                         Number of Staff
    MHP Support/Clerical                                        75
    MHP Administrative                                          50
    MHP Clinical                                                500
    MHP Quality Improvement                                      8
    Contract Provider Support/Clerical                          45
    Contract Provider Administrative                            20
    Contract Provider Clinical                                  200
    Contract Provider Quality Improvement                        5

5. Describe the primary information systems currently in use.

The following several pages allow for a description of up to four of the most critical and
commonly used information systems. For clarification, certain terms used in this part are
defined below:

   Practice Management – Supports basic data collection and processing activities for
   common clinic/program operations such as new consumer registrations, consumer
   look-ups, admissions and discharges, diagnoses, services provided, and routine
   reporting for management needs such as caseload lists, productivity reports, and
   other day-to-day needs.

   Medication Tracking – Includes history of medications prescribed by the MHP and/or
   externally prescribed medications, including over-the-counter drugs.

   Managed Care – Supports the processes involved in authorizing services, receipt
   and adjudication of claims from network (formerly fee-for-service) providers,
   remittance advices, and related reporting and provider notifications.

   Electronic Health Records – Clinical records stored in electronic form as all or part of
   a consumer’s file/chart and referenced by providers and others involved in direct
   treatment or related activities. This may include documentation such as
   assessments, treatment plans, progress notes, allergy information, lab results, and
   prescribed medications. It may also include electronic signatures.


                                            6                           004 ISCA - 2008.doc
Master Patient Index – The function to search and locate patients using an index
mechanism. The index synchronizes key patient demographic data including name,
gender, social security number, date of birth and mother’s name. The
synchronization of data is crucial to sharing information across systems.




                                      7                        004 ISCA - 2008.doc
Current information system 1:


 Name of product: Anasazi                   Name of vendor/supplier: Anasazi Software, Inc.

 When was it implemented? (An estimate is acceptable)          Month: July Year: 2006


 What are its functions? (Check all that currently are used)

    Practice Management           Appointment Scheduling               Medication Tracking

    Managed Care                  Electronic Health Records            Data Warehouse/Mart

    Billing                       State CSI Reporting                  MHSA Reporting

    Staff Credentialing           Grievances & Appeals                 Master Patient Index

    Other (Describe)


 Who provides software application support?

                     Health
    MHP IS                              County IS          Vendor IS            Contract Staff
                     Agency IS

    Other (Describe)


 Who is responsible for daily operations of the system?

                     Health
    MHP IS                              County IS          Vendor IS            Contract Staff
                     Agency IS

    Other (Describe)


 What type of Short-Doyle/Medi-Cal claims does it currently produce?

    SDMC proprietary             HIPAA 837                No claims or N/A


 Does this system interface or exchange data with other systems? If so, please list them.

 Not at this time




                                               8                          004 ISCA - 2008.doc
Current information system 2:


 Name of product: Tier                      Name of vendor/supplier: SeQuest, Inc

 When was it implemented? (An estimate is acceptable)          Month: Jan Year: 2000


 What are its functions? (Check all that currently are used)

      Practice Management          Appointment Scheduling              Medication Tracking

      Managed Care                 Electronic Health Records           Data Warehouse/Mart

      Billing                      State CSI Reporting                 MHSA Reporting

      Staff Credentialing          Grievances & Appeals                Master Patient Index

      Other (Describe) H/R and Training tracking


 Who provides software application support?

                       Health
      MHP IS                            County IS          Vendor IS            Contract Staff
                       Agency IS

      Other (Describe)


 Who is responsible for daily operations of the system?

                       Health
      MHP IS                            County IS          Vendor IS            Contract Staff
                       Agency IS

      Other (Describe)


 What type of Short-Doyle/Medi-Cal claims does it currently produce?

      SDMC proprietary             HIPAA 837              No claims or N/A


 Does this system interface or exchange data with other systems? If so, please list them.

 No




                                               9                          004 ISCA - 2008.doc
Current information system 3:


 Name of product: Homeless
                                            Name of vendor/supplier: Client Track.NET
 Management Information System

 When was it implemented? (An estimate is acceptable)          Month: March Year: 2006


 What are its functions? (Check all that currently are used)

    Practice Management           Appointment Scheduling               Medication Tracking

    Managed Care                  Electronic Health Records            Data Warehouse/Mart

    Billing                       State CSI Reporting                  MHSA Reporting

    Staff Credentialing           Grievances & Appeals                 Master Patient Index

    Other (Describe) Tracking of Homeless population and services throughout the County.
    Required for HUD Grants


 Who provides software application support?

                     Health
    MHP IS                              County IS          Vendor IS            Contract Staff
                     Agency IS

    Other (Describe)


 Who is responsible for daily operations of the system?

                     Health
    MHP IS                              County IS          Vendor IS            Contract Staff
                     Agency IS

    Other (Describe)


 What type of Short-Doyle/Medi-Cal claims does it currently produce?

    SDMC proprietary             HIPAA 837                No claims or N/A


 Does this system interface or exchange data with other systems? If so, please list them.

 N/A




                                               10                         004 ISCA - 2008.doc
Current information system 4:


 Name of product:                           Name of vendor/supplier:

 When was it implemented? (An estimate is acceptable)          Month:        Year:


 What are its functions? (Check all that currently are used)

    Practice Management           Appointment Scheduling                Medication Tracking

    Managed Care                  Electronic Health Records             Data Warehouse/Mart

    Billing                       State CSI Reporting                   MHSA Reporting

    Staff Credentialing           Grievances & Appeals                  Master Patient Index

    Other (Describe)


 Who provides software application support?

                     Health
    MHP IS                              County IS          Vendor IS            Contract Staff
                     Agency IS

    Other (Describe)


 Who is responsible for daily operations of the system?

                     Health
    MHP IS                              County IS          Vendor IS            Contract Staff
                     Agency IS

    Other (Describe)


 What type of Short-Doyle/Medi-Cal claims does it currently produce?

    SDMC proprietary             HIPAA 837                No claims or N/A


 Does this system interface or exchange data with other systems? If so, please list them.




                                               11                         004 ISCA - 2008.doc
6. Selection and Implementation of a new Information System:

   Mark the box that best describes your status today and respond to the associated
   questions.

         A) No plans to replace current system

         B) Considering a new system
         What are the obstacles?



         C) Actively searching for a new system
         What steps have you taken?


         When will you make a selection?



         D) New system selected, not yet in implementation phase
         What system/vendor was selected?


         Projected start date
         Go live date
         Projected end date
         Please attach your project plan.

         E) Implementation in progress
         What system/vendor was selected?
         Anasazi Software, Inc
         Implementation start date     5/1/2005
         Go live date                  7/1/2006
         Projected end date            6/1/2009
         Please attach your project plan.




                                            12                     004 ISCA - 2008.doc
7. Implementation of a new Information System

   If you marked box D, or E in 6 above, complete the following questions.
   Otherwise, skip to Section B.

   7.1. Describe any strategies or safeguards you plan to use to ensure timely and
        accurate continuation of Medi-Cal claims and CSI reporting during the transition
        to a new system.

        On the July 1st "Go-Live" date, the entry of all services was switched
        from the legacy system into the new system. Services performed prior
        to July 1st, but not entered into the legacy system as of that date were
        entered into the legacy system. Supplemental MediCal claims
        continued to be generated based on this old data. CSI data was
        scrubbed and verified prior to the cutover and a snapshot of data at that
        time was archived. This strategy was successful, claims and CSI data
        are now being generated from Anasazi and were not impacted by the
        transition.

   7.2. If you are converting/transferring data from a legacy system, describe your
        conversion strategy, such as what general types of data will be transferred to the
        new system and what data will be left behind or archived.

        Anasazi provided the ability to load standard demographic, client and
        financial data. Extracts were taken from the legacy system to be
        converted into the new system. Additional customized data load utilities
        were created to support California-specific data elements. Service data
        was not converted and will be maintained in an MS-SQL archive data
        base in perpituity. Client data that was inactive in the legacy system for
        prior to January of 2006 was also not converted and is supported in the
        Archive Data Base. Again, this strategy was successful. Prior year
        reports have been available when and as needed.

   7.3. Will the new system support conversion of the existing consumer identifier as
        the primary consumer identifier?

                                        Yes         No

      7.3.1. If No, describe how the new system will assign a unique identifier (you
             may identify the number as the consumer ID, patient ID, medical record
             number, unit record number) to new consumers.



   7.4. Describe what features exist in the new system to prevent two or more unique
        identifiers being assigned to the same consumer by mistake (“duplicate charts”).

        The system uses the First and Last name (and, optionally, the middle
        name) to create what is called the "Sort Name." The sort name must be
        unique. Additionally, the Social Security number must be unique. The
        client’s Date of Birth is also used as a further check of uniqueness.



                                               13                     004 ISCA - 2008.doc
   7.5. Specify key modules included in the system:

    What are its functions? (Check all that are currently planned)

        Practice Management            Appointment Scheduling            Medication Tracking

        Managed Care                   Electronic Health Records         Data Warehouse/Mart

        Billing                        State CSI Reporting               MHSA Reporting

        Staff Credentialing            Grievances & Appeals              Master Patient Index

        Other (Describe)




   7.6 What departments/agencies will use the system? (Check all that apply)

                  Mental Health
                  Mental Health Contract Providers
                  Alcohol and Drug
                  Public Health
                  Hospital

Section B – Data Collection and Processing

Policy and Procedures
1. Do you have a policy and procedure that specifies the timeliness of data entered into
   the system?

                                         Yes         No

   1.1. If Yes, describe your recent experience using any available data collected on
       timeliness.

         The Policy addressing Timeliness and accuracy of Data Entry (9.1.4) is
         scheduled for a complete re-write due to the implementation of the new
         information system. Additionally, timeliness of data entry is a
         contractual requirement for all contract providers. As of December,
         2008, this Policy has not been updated. However, reports indicating
         timeliness of data entry are generated and monitored. In general, due
         to the shift to a suspended services methodology, although the services
         are initially entered in a timely manner, additional time is required to
         deal with those services that have been suspended.



                                             14                      004 ISCA - 2008.doc
2. Do you have a policy and procedures specifying the degree of accuracy required for
   data entered into the IS?

                                        Yes        No

   2.1. If Yes, describe your recent experience using any available data collected on
       data accuracy.

         The Policy addressing Timeliness and accuracy of Data Entry (9.1.4) is
         scheduled for a complete re-write due to the implementation of the new
         information system. As of December, 2008, this Policy has not been
         updated. However, reports are generated and monitored. One of the
         major paradigm shifts resulting from the Anasazi Implementation is the
         concept of suspended services, i.e., inappropriate services are
         suspended prior to being added to a claim to any pay source. The
         emphasis on monitoring these suspended services provides a direct
         correlation to the accuracy of service data entered into the system.

3. Does your MHP perform periodic verification of data in the IS compared to the
   medical record, such as ethnicity, language, birth date, and gender?

                                        Yes        No

   3.1. If Yes, please provide a description of your current policy and procedure or a
          report of a past data validity review.

         A technical Compliance Audit Procedure has been implemented by QID
         that requires verification of data (including demographic data) within the
         EHR. This procedure requires that the data be verified within the first
         60 days after admission, 90 days after admission and annually therafter.

4. Do you have a policy and procedures for detection and reporting of fraud?

                                        Yes        No




   4.1. If Yes, describe your procedures to monitor for fraud.

               Policy 11.1.9 (Corporate Compliance) addresses these
         procedures.

5. Describe any recent audit findings and recommendations. This may include EPSDT
   audits, Medi-Cal audits, independent county initiated IS or other audits, OIG audits,
   and others.

         Recent EPSDT audit included in attachments

System Table Maintenance



                                            15                         004 ISCA - 2008.doc
6. On a periodic basis, key system tables that control data validations, enforce business
   rules, and control rates in your information system must be reviewed and updated.
   What is your process for management of these tables?

         Primary responsibility for system table maintenance resides with the
         Anasazi Support Team within the Technology Services Division. This
         team consists on one Senior Systems Specialist, a Senior Systems
         Analyst and three support staff. Table maintenance associated with
         financial processes (e.g. Billing Modalities) are maintained by the Billing
         team within the Financial Services Division. Depending on the nature of
         the specific data included in each table, various workgroups within the
         Clinical, Administrative and Financial areas of the Department are
         assigned to provide guidance for this process. In all cases, the Quality
         Improvement/Compliance Division has oversight on the decision
         process leading up to specific table maintenance activities. In early
         2007, a “Senior EHR Analyst” position was added to the IT staff. This
         individual was previously a Supervising MH Clinician with an MFT
         license.

   6.1. Are these tables maintained by (check all that apply):

           MHP Staff
           Health Agency Staff (“Umbrella” health agency)
           County IS Staff
           Vendor Staff

7. Who is responsible for authorizing and implementing the following system activities?

             Activity              Who authorizes?           Who implements?
                                  (Staff name/title or       (Staff name/title or
                                committee/workgroup)       committee/workgroup)
    Establishes new
                                   QID, Executive
    providers/reporting                                    Anasazi Support Team
                                    Management
    units/cost centers
    Determines allowable
                                   QID, Executive
    services for a                                         Anasazi Support Team
                                    Management
    provider/RU/CC
    Establishes or decides     Administrative Services
    changes to billing rates   Officer, Deputy Director
                                   for Admin/Fiscal,             Billing Team
                                Department Director,
                                Board of Supervisors
    Determines information
                                         QID                         N/A
    system UR rules
    Determines                 Administrative Services
    assignments of payer       Officer, Deputy Director          Billing Team
    types to services              for Admin/Fiscal
    Determines staff billing    Technology Services
    rights/restrictions                Manager,
                                                           Anasazi Support Team
                               Administrative Services
                                        Officer



                                            16                         004 ISCA - 2008.doc
             Activity             Who authorizes?           Who implements?
                                 (Staff name/title or       (Staff name/title or
                               committee/workgroup)       committee/workgroup)
     Determines level of        Technology Services
     access to information      Manager, Executive       Anasazi Support Team
     system                         Management
     Terminates or expires      Technology Services
     access to information      Manager, Executive       Anasazi Support Team
     system                         Management
Staff Credentialing
8. Who ensures proper staff/provider credentialing in your organization for the following
   groups of providers?

                                                   Human Resources (see Policy
    County-operated/staffed clinics
                                                   3.1.2)
    Contract providers                             Contractor/Contract Monitoring
    Network (formerly fee-for-service) providers

9. Are staff credentials entered into your information system and used to validate
   appropriate Medi-Cal billing by qualified/authorized staff?

                                        Yes        No

Staff Training and Work Experience
10. Does your MHP have a training program for users of your information system?

                                        Yes        No

   10.1. If Yes, please check all that apply.

                                                               One-On-        New Hires
                                 Classroom      On-the-Job
                                                              One Trainer       Only

    Clerical/Support Staff
    Quality Improvement
    Staff
    Program Manager

    Billing/Fiscal Staff

    Administration Staff

    Managed Care Staff

    Clinical Staff

    Medical Staff




                                           17                         004 ISCA - 2008.doc
11. Describe your training program for users of your information system. Indicate
    whether you have dedicated or assigned trainers and whether you maintain formal
    records of this training. If available, include a list of training offerings and frequency,
    or a sample of a recent calendar of classes.

          During the implementation phases currently taking place, multiple
          classes are presented each week. Training is currently being presented
          by four dedicated staff from the Anasazi Support Team plus
          approximately ten staff working part time on the project. Once all
          implementation phases are complete, on-going training will be provided
          on a monthly basis by the Anasazi support team. Sample agendas for
          Phase I and Phase II trainings are included with the attachments.
          Formal attendance records are maintained for this training.



12. What is your technology staff turnover rate since the last EQRO review?

           Number of IS Staff       Number - New Hires           Number - Retired,
                                                              Transferred, Terminated
                    16                         0                         0

Access to and analysis of data
13. Who is the person(s) most responsible for analyzing data from your information
    system? Describe the working relationship between this person(s) and your QI unit. If
    there is no such person, please state “NONE.”

         Staff Name/Title         Organization/Dept/Division        Describe relationship to
                                                                      QI unit or “None”
                                      Quality Improvement
         Ross Kremsdorf                                                   Administrator
                                            Division
                                      Quality Improvement
        Donna Robinson                                                         Staff
                                            Division
                                      Quality Improvement
           Aaron Birch                                                        None
                                            Division
                                      Quality Improvement
         Other QID Staff                                                       Staff
                                            Division

14. Considering the reports and data available from your information system, list the
    major users of this information (such as billing department, program clerical staff, QI
    unit, management, program supervisors, etc).

     Management, Clinical Deputy Director, Program/Clinical Supervisors, Direct Service
     Staff, Program Clerical Staff, etc.

     Administrative Managers, Department Director, Deputy Director for Fiscal/Admin,
     Patient Rights, QID staff, etc.

     Financial Services Division, Billing Team


15. Does your information system capture co-occurring mental health and substance
    abuse diagnoses for active consumers?

                                               18                           004 ISCA - 2008.doc
                                       Yes          No

   15.1. If Yes, what is the percent of active consumers with co-occurring diagnoses?
         (See attached Dual-Dx report)
                     %

16. Does your information system maintain a history of diagnoses, as they are changed
    over time during an episode of care?

                                       Yes          No




Staff/Contract Provider Communications
17. Does your MHP have User Groups or other forums for the staff to discuss
    information system issues and share knowledge, tips, and concerns?

    Please complete all     Meeting frequency        Who chairs meetings?      Meeting
    that apply              (weekly, monthly,        (name and title)          minutes?
                            quarterly, as needed)                              (Yes/No)
    Clerical User Group
    Clinical User Group            Monthly               L. Kerley, SR. EHR        Yes
                                                               Analyst
    Financial User Group
    Contract Providers
    IS Vendor Group             Semi-Annual                   Anasazi              Yes
    Other (Expanded               Monthly                    Gil Madrid            Yes
    Management
    Meeting)

18. How does your organization know if changes are required for your information
    system in order to meet requirements of the State Medi-Cal Program?

         Both the County and the vendor monitor DMH/ADP web sites,
         DMH/ADP Memos and attend (whenever possible) DMH-IT committee
         meetings

19. How are required State and local policy changes communicated to the staff or
    vendor responsible for implementing the policy change in the information system?

         Via e-mail and via formal Change Request Process with Vendor

20. Does your organization use a Web server, intranet server, shared network
    folders/files, content management software, or other technology to communicate
    policy, procedures, and information among MHP and contract provider staffs?


                                          19                          004 ISCA - 2008.doc
                                       Yes        No


   20.1 If Yes, briefly describe how this is used and managed. Include examples of
        information communicated.

        The department's Intranet site (MH Net) is an extensive information
        resource including access to Policies, Procedures, Dept Numbered
        Memos, various handbooks, on-line forms, employee information,
        Personnel Information, Training Guides, Training Calendars, etc. The
        site is maintained primarily by end-users utilizing web-based content
        management software.

Other Processing Information
21. Describe how new consumers are assigned a unique identifier (you may identify this
    number as the consumer ID, patient ID, medical record number, unit record number).

The EHR system automatically assigns new clients with the next available Case
number.


22. Describe how you monitor missed appointments (“no-shows”) and provide a brief
    report or any available data regarding your rate of missed appointments.

      Within the EHR, one of the data elements associated with each service is the
"Appointment Type." This data element allows values such as Scheduled,
Unscheduled, Cancelled by Client, Cancelled by Center and No Show. Service reports
are generated based on this data element (see example in attachments).


23. Does your MHP track grievances and appeals?

                                       Yes        No


   23.1 If Yes, is it automated or manual?

          Automated – Integrated into primary information system
          Automated – Separate system
          Manual
          Please describe: Grievances and appeals are tracked quarterly and
          annually through the Quality Improvement Division and the Patient
          Rights Advocate Office (PRA) directly to Administration and the System
          Quality Improvement Committee. Each provider has a designated
          Consumer Service Representative that logs each grievance and
          submits it to QID and PRA who track it for completeness of process
          and produce required reports.




                                             20                     004 ISCA - 2008.doc
24. How does your MHP plan to address MHSA reporting requirements for Full Service
    Partnerships?

            Integrate into primary information system, by vendor or in-house staff
            Use separate on-line system developed by DMH
            Use separate system developed by in-house staff
            Use separate system developed by vendor
            Have not decided

Section C - Medi-Cal Claims Processing

1. Who in your organization is authorized to sign the MH1982A attestation statement for
   meeting the State Medi-Cal claiming regulatory requirements?
   (Identify all persons who have authority)

    Name: James Waterman                       Title: Interim Director
    Name: Russell Liesch                       Title: Administrative Services Officer
    Name: Carol Massey                         Title: Deputy Director, Fiscal/Admin
    Name:                                      Title:

2. Indicate normal cycle for submitting current fiscal year Medi-Cal claim files to DMH.

        Monthly           More than 1x month             Weekly          Daily          Other

3. Provide a high-level diagram depicting your monthly operations activity to prepare a
   Medi-Cal claim. Note the steps your staff takes to produce the claim for submission
   to DMH.

         See Attachment

4. If your IS vendor controls some part of the claim cycle, describe the Medi-Cal claim
   activities performed by your information system vendor.

         N/A

5. Does your MHP use a standard review process for claims before submission?

                                         Yes            No




   5.1. If yes, please describe the claims review process. What criteria are used to
        ensure that a claim is accurate before submission to DMH?

         Compile MediCal Test Claim and review for errors and corrective action.
         Compile Production Claim after all known corrections are made.
         Prepare State Invoice in formats prescribed by the Department of
         Mental Health.




                                            21                             004 ISCA - 2008.doc
6. Briefly describe your strategy to implement the National Provider Identifier (NPI), as
   required by HIPAA.

           Once the HIPAA Companion Guide was published providing the
         details of how to include the NPI as part of the 837P and 837I claim
         formats, Anasazi created and released enhancements to the system to
         comply with the Companion Guide. These enhancements have been
         functioning properly since April, 2008..

7. Please describe how beneficiaries’ Medi-Cal eligibility is stored and updated within
   your system in order to trigger Medi-Cal claims. Include whether automated matches
   to the State’s MMEF file are performed for the purpose of mass updates to multiple
   consumers.

         Anasazi enhanced their system to include a Utility that will load the
         MMEF File in its raw form into an Anasazi File such that is readily
         accessible by the native capability of the Anasazi system. To this end,
         only the MMEF data elements that potentially have some usage will be
         loaded. This Utility automatically updates the Agency’s Client Coverage
         information from the data in the MMEF file. This utility will first attempt
         to determine which of the Members in the MMEF file are Clients of the
         Agency by categorizing the MMEF records as Matches, partial matches
         or non-matches. The partial match information can be viewed and
         edited in order to create a match situation and therefore update the
         Client Coverage Information.

8. What Medi-Cal eligibility sources does your MHP use to determine monthly
   eligibility? Check all that apply

          IS Inquiry/Retrieval from MEDS                 POS devices
          MEDS terminal (standalone)                     AEVS
          MEDS terminal (integrated with IS)             Web based search
          MMEF                                           FAME
          Eligibility verification using 270/271         Other: 270/271 functionality now
          transactions                                   in place

9. When checking Medi-Cal eligibility, does your system permit storing of eligibility
   information – such as verification code (EVC), county of eligibility, aid code of
   eligibility, share of cost information?

                                          Yes       No

    9.1. If Yes, identify which of these fields are stored and describe if a user needs to
         enter this information manually, or if the process is automated (system does it).

         The process is automated, the following data elements are stored:

         Eligibility Year
         Eligibility Month
         Primary Aid Code
         County of Responsibility
         Eligibility Status


                                             22                         004 ISCA - 2008.doc
         Share of Cost Amount
         Special Program Aid Code 1
         Special Program Aid Code 2
         Special Program Aid Code 3
         Healthy Families In/Out Day
         Medicare Status
         Other Coverage Status

10. Does your MHP use the information system to create ad hoc reports on Medi-Cal
    claims and eligibility data?

                                         Yes         No

   10.1 If Yes, please indicate the software reporting tools used by your staff and
   include a brief description of a recent ad hoc report.

         Anasazi has dozens of reports available, the majority of these reports
         can be customized by the end user by specification of selection criteria
         (e.g. by age range, by diagnosis, by claim information, etc.).
         Additionally, many of the reports also allow the selection of which data
         elements should be included on the report (i.e., choosing the columns
         and column layout). Therefore, Ad Hoc reports are created by the end-
         users directly. An example of such a report would be a report of a
         Treatment Teams case load indicating "exception" diagnoses such as
         NOS Diagnoses.




11. Describe your most critical reports for managing your Medi-Cal claims and eligibility
    data.

         Again, there are dozens of reports available to manage the claiming
         process. Some of these reports include: 3rd party eligibility reports,
         Services by Pay Source reports, Suspended Services reports, etc.

12. Do you currently employ staff members to extract data and/or produce reports
    regarding Medi-Cal claims or eligibility information?

                                         Yes         No

13. Please describe your MHP’s policy and procedure and timeline for reviewing the
    Error Correction Report (ECR).

         The Error Correction Handbooks provided by DMH are used. A quick
         review of all Error Correction Reports is done upon receipt of the ECR.
         A check for other health coverage such as Medicare is completed and
         policies are entered in system if needed. Before a correction is made
         on the ECR, the claim line is checked for accuracy in the local system,
         following State billing rules, MediCal eligibility is verified, and in some
         cases, medical records are reviewed.


                                             23                         004 ISCA - 2008.doc
14. Please describe your MHP’s policy and procedure for reviewing the Medi-Cal
    Explanation of Benefits (EOB or 835) that is returned to the MHP.

         The 835 is downloaded from the ITWS web site and loaded into the
         local system for payment application. The State's EOB reporting
         system is also used to monitor ajudication of the claims that have been
         submitted.

15. What percent of Medi-Cal claims were denied during:

                 FY 2004    1%                FY 2005     1%

Section D – Incoming Claims Processing

Note: “Network providers” (commonly known as fee-for-service providers or managed
care network providers) may submit claims to the MHP with the expectation of payment.
Network providers do not submit a cost report to the MHP.

1. Beginning with receipt of a Medi-Cal claim in-house, provide a diagram of the claim
   handling, logging, and processes to adjudicate and pay claims.

         N/A

2. How is Medi-Cal eligibility verified for incoming claims?

         N/A

3. How are claims paid to network providers billed to Short-Doyle/Medi-Cal?

         N/A

4. Have any recent system changes influenced, even temporarily, the quality and/or
   completeness of the Medi-Cal claims data that are collected? If so, how and when?

         N/A




5. What claim form does the MHP accept from network providers?

          CMS 1500
          UB-92
          837I
          837P
          MHP specific form (describe): N/A




                                            24                       004 ISCA - 2008.doc
6. Please indicate which code sets are required by your MHP on claims received from
   network providers.

                        Inpatient         Inpatient     Outpatient         Outpatient
    Coding Scheme
                        Diagnosis        Procedure      Diagnosis          Procedure
    ICD-9-CM

    CPT-4

    HCPCS
    UB Revenue
    Code
    DSM-IV-TR
    MHP Internal
    Code
    Other

7. Please indicate whether you require the following data elements on claims submitted
   by network providers.

    Data Elements                               Yes or No
    Patient Gender                             Yes      No
    Patient DOB/Age                            Yes      No
    Diagnosis                                  Yes      No
    Procedure                                  Yes      No
    First date of service                      Yes      No
    Last date of service                       Yes      No
    Financial Responsibility                   Yes      No
    Provider Specialty                         Yes      No
    MHP consumer identification number         Yes      No
    Place of service                           Yes      No

8. How does your MHP monitor the accuracy and productivity of individual staff
   members who have responsibility for adjudicating incoming Medi-Cal claims from
   network providers?

         N/A


9. What is the average length of time between claim receipt and payment to network
   provider? (An estimate is acceptable.)

         N/A

10. Does your MHP maintain provider profiles in your information system?

                                      Yes        No




                                          25                         004 ISCA - 2008.doc
   10.1. If Yes, please describe what provider information is maintained in the provider
         profile database (e.g., languages spoken, special accessibility for individuals
         with special health care needs).



11. Please describe how network provider directories are updated, how frequently, and
    who has “update” authority.

         N/A

12. Does your MHP use a manual or an automated system to process incoming claims,
    and adjudicate and pay claims?

          Manual           Automated             Combination of Both

   If you marked either “Automated” or “Combination of Both,” complete the
   following questions. Otherwise, skip to Section E.

13. What percent of claims are received electronically?           %

14. What percent of claims are auto adjudicated?           %

15. How are the fee schedule and network provider compensation rules maintained in
    your IS to assure proper claims payment by your MHP? Who has “update” authority?



16. Does the system generate a remittance advice (e.g., EOB)?

                                        Yes         No

   16.1. If Yes, does your system generate a HIPAA transaction for the remittance
       advice?

                                        Yes         No

17. Does the system generate an authorization advice (i.e., letter)?

                                        Yes         No



   17.1. If Yes, does your system generate a HIPAA transaction for the authorization
       letter?

                                        Yes         No

Section E – Information Systems Security and Controls

1. Please describe the frequency of back-ups that are required to protect your primary
   Medi-Cal information systems and data. Where is the back-up media stored?


                                            26                         004 ISCA - 2008.doc
          Data is backed up incrementally on a daily basis with a full backup
          weekly. The backups are stored in a climate controlled and secure
          facility off-site from the system hardware.
2. Describe the controls used to assure that all Medi-Cal direct services are entered
   into the system (e.g., control numbers, daily audits, and/or service activity logs).

         The system maintains a system of control numbers associated with
         each service entered into the system. Since most services are entered
         directly by the service provider (i.e., clincian), there is no need of activity
         logs as were used in mainframe oriented systems with centralized data
         entry.

3. Please describe your policy and procedure for password control on your Medi-Cal
   system(s). For example, how often do you require passwords to be changed?

         Passwords must be a minimum of 8 characters and must include both
         alpha and numeric characters. Repeating characters and characters
         mirroring the user id are prohibited. Passwords expire every 60 days.

4. Please describe the provisions in place for physical security of the computer
   system(s) and manual files. Highlight provisions that address current HIPAA security
   requirements.

   4.1. Premises
         All of the MHP facilities are secure with limited access to staff areas and
         utilize alarm systems with remote monitoring and electronic key-card
         access points.

   4.2. Documents
         All documents containing PHI are maintained in double locked cabinets
         and/or storage areas. Paper documents are disposed of in locked
         containers then shredded by a secure disposal service. Hardcopy
         Medical Records are stored in protected record rooms with a barcode
         based tracking system. Key access to protected areas is limited to a
         maximum of three designated staff per DMH contract and MHP policy
         requirements.

   4.3. Computer room/server room
         All wiring closets and server facilities are locked with restricted key
         access within the security perimeter of the card-key access system.

   4.4. Workstation access and levels of security
         The workstation passwords are synchronized with the Network
         passwords. Only users with valid network passwords are able to
         access either the network, the primary information system or the
         workstation.

5. Describe how your MHP manages access for users. Do you use templates to
   standardize user access? Is so, describe the levels of access for both MHP and
   contract provider staffs.



                                              27                           004 ISCA - 2008.doc
         Security levels are role based and apply to both the MHP and to
         contract providers. In all cases, access to information is based on need
         to know. Roles have been defined for Management Reporting, System
         Administration, Clinical staff, support staff, Medical staff (M.D.'s and
         nurses) and Crisis-E/R staff.

6. Describe your procedures to remove/disable access for terminated users. Explain
   the process for both MHP and contract provider staffs. Include frequency it is done
   for both groups of users.

         Information regarding terminated staff internal to the MHP is received by
         ITS from the Personnel office on a bi-weekly basis. This information is
         used to remove system access for staff no longer employed by the
         MHP. Contract Providers are required to submit information regarding
         terminations when said terminations occur. Additionally, reports can be
         executed to determine the amount of time since last login. It is planned
         to utilize these reports on a monthly basis as a cross check for inactive
         users. Once a user has been inactive for 60 days, their user id's will be
         disabled until a written request for re-activation is received.




                                           28                         004 ISCA - 2008.doc
Section F – Additional Documentation

1. Please provide the documentation listed in the table below. Documentation may be
   submitted electronically or by hardcopy. Label documents as shown under the
   “Requested Documents” column.

       Requested Documents                                     Description
A. Organizational chart               The chart should make clear the relationship among key
                                      individuals/departments responsible for information
                                      management.
B. County-operated programs and       A list of those who can bill Medi-Cal, including name,
clinics                               address, and type of program (i.e., outpatient, day
                                      treatment, residential, and inpatient).
C. Contract providers                 A list of those who can bill Medi-Cal, including name,
                                      address, and type of program (i.e., outpatient, day
                                      treatment, residential, and inpatient).
D. Procedures to monitor accuracy     Provide copies of the current policies and procedures, desk
and timeliness of data collection     procedures, and/or other written instructions to the staff and
                                      providers that address standards for data collection
                                      accuracy and timeliness.
E. Procedures to determine            Provide copies of the current policies and procedures, desk
consumer/beneficiary eligibility      procedures, and/or written instructions to the staff and
status                                providers that describe how to determine
                                      consumer/beneficiary eligibility status.
F. Procedures to produce Medi-Cal     Provide copies of the current policies and procedures,
claims and review error/denied        operations manual, flowchart, calendar, and/or written
claims                                instructions that document production of the Medi-Cal claim
                                      and resolving error/denied claims.
G. Procedures to monitor              Provide copies of the current policies and procedures, desk
timeliness of claims processing       procedures, and/or other written instructions to the staff and
and payments to network providers     providers that describe standards for monitoring timely
                                      claims processing/payment.
H. Procedures for the following       Provide a copy of the current policies and procedures, desk
topics: new user authorization,       procedures, and/or other written instructions to the staff and
disable user accounts, password       providers for these activities.
standards, data security standards,
unattended computers, electronic
security audits.
I. Prior Internal Audits              If you have recently done an internal audit of your Medi-Cal
                                      claims submissions or your Medi-Cal claims adjudication
                                      from network providers, please attach a copy for review.
J. Ethnicity/race, language code      Provide a cross-reference list or table showing what codes
translations                          are used internally by the staff on source documents for
                                      data entry and how they are translated into valid codes for
                                      Medi-Cal claims and CSI reporting.
K. Crosswalk from locally used        Provide a crosswalk for mapping codes used to record
service/procedure codes to            services to codes used to bill Medi-Cal. Include those used
CPT/HCPCS codes used in the           by network providers.
Medi-Cal claim.
L. Index of your Reports Manual       If available, provide a list of all current vendor-supplied and
                                      internally developed reports and report titles. Do not include
                                      ad hoc reports developed to meet temporary or one-time
                                      needs.




                                                    29                        004 ISCA - 2008.doc
Hardware Inventory: Kern County Mental Health
Computers
1021 4th St, Taft                       21
1111 Columbus Ave                       87
1315 Silect Ave                          2
1401 L St                               26
1415 Truxtun                             3
1415 Truxtun - Jail                      3
1415 Truxtun 4th floor                   9
1600 East Belle Terrace                 21
1721 Westwind                           41
17635 Indust. Farm Rd - Lerdo Jail      17
1831 Ridge Rd                            6
2151 College Ave                        74
2300 S. Union                            6
2525 N. Chester                        107
2621 Oswell                             53
3300 Truxtun                           120
3550 Q St.                               3
3715 Columbus                           13
5121 Stockdale Hwy                      72
7900 Niles St                           18
930 F st Wasco                          18
DHS                                      6
Shafter Courts                           1
Total Computers                        727

Network Accounts                       694

Routers and Switches                    77

Servers:
Taft                                     1
Columbus                                 1
L Street                                 1
Truxtun                                  1
Belle Terrace                            1
Westwind                                 1
College                                  1
North Chester                            1
Oswell                                   1
Truxtun Ave                             24
3301 Truxtun                             1
Columbus                                 1
Stockdale                                2
Niles                                    1
Wasco                                    1
Server Total                            39
Mission Critical Applications
Application Name and General Description:
      Anasazi is the Department’s EHR. It provides support for entry of client data,
      service data, clinical documentation and billing to multiple pay sources.

      Type of Application:
      Anasazi is a COTS system, the vendor is Anasazi Software, Inc. based in Phoenix
      AZ.

      Number of Users, Number of Support Staff (FTE’s):
      There are approximately 400 users within the Department and an additional 200
      users from Contract Provider Organizations. Support staff consists of 6 FTE’s.

Application Name and General Description:
      Client Track is a Homeless Management Information System (HMIS). This
      application is 80% funded by a HUD Grant. It is a requirement for any agency
      receiving HUD funding to utilize an HMIS system. Currently, the Kern County
      Homeless Continuum of Care utilizes this system, hosted by the MH Department.

      Type of Application:
      Client Track is a COTS system, the vendor is Data Systems International. It is a
      dot-Net application, access is via internet browser.

      Number of Users, Number of Support Staff (FTE’s):
      100 active users in 11 agencies
      Support staff is one FTE.

Application Name and General Description:
      Tier – used for personnel information (various staff demographics data, licensure,
      training statistics, etc.). The department phone list (on our IntraNet web site) is
      linked to this SQL data base.

      Type of Application:
      Tier is a COTS system, the vendor is SeQuest Technologies.

      Number of Users, Number of Support Staff (FTE’s):
      Approximately 20 users with full access, another 80 with selected view rights.
      Support from about 30% of one FTE




Exhibit 2, Attachment 3                                                          Page 1 of 3
Other Applications
Application Name and General Description:
      MH Net – this is the Department’s Intranet system. It is based on Content
      Management software allowing each division to enter “Articles” on the web page
      specific to their needs. In addition to Department news, some of the content
      includes commonly used forms, an interactive phone directory, User Guides for
      computer applications, etc.

      Type of Application:
      The Content Management software is a product called Article Manager from
      Interactive Tools. Other web-based programming and web page templates are
      developed and supported internally

      Number of Users, Number of Support Staff (FTE’s):
      700 users – including internal staff and Contracted Provider staff.
      Approximately 25% of one FTE

Application Name and General Description:
      Chart Tracker – this is a SQL data base with an Access front end that provides the
      ability to locate a client’s chart anywhere within our 14 locations. The clinical
      locations typically maintain at least one chart room, this system performs a check-
      out/check-in function using bar code information on each physical chart. The
      system can identify if charts are in transit to another location, checked out to a
      specific clinician and the location of the chart in a specific chart room.

      Type of Application:
      Internally developed

      Number of Users, Number of Support Staff (FTE’s):
      Approximately 50 users
      Approximately 10% of one FTE

Application Name and General Description:
      KernOMS. The State Department of Alcohol and Drug Programs (ADP) requires
      reporting of client and service data to their centralized data base. Currently, the
      Department uses an internally developed system to collect this data. It is planned
      for early 2009 to convert this system into Anasazi and curtail the use of the internal
      system. This system also interfaces with CJIS, that portion of the application will
      continue to be used. The system is a SQL database with an Access front-end.

      Type of Application:
      Internally developed by programmer working for the Court system.

      Number of Users, Number of Support Staff (FTE’s):
      200 users, primarily from contracted provider organizations.
Exhibit 2, Attachment 3                                                            Page 2 of 3
      40% of one FTE (from Court)


Application Name and General Description:
      Track-it - Help desk call logging and dispatching system

      Type of Application:
      COTS – Vendor is Intuit

      Number of Users, Number of Support Staff (FTE’s):
      14
      No support required


Application Name and General Description:
      Various County supported systems:
         o Buy Speed
         o Auditor Controller Travel systems
         o County FMS, including payroll

      Type of Application:
      County supported and mandated Systems

      Number of Users, Number of Support Staff (FTE’s):
      50 to 100 for all systems. About 10% of one FTE for training and access
      monitoring.


Application Name and General Description:
      Various State web sites
         o POQI – State Outcomes Survey (semi-annual). Requires manual entry of
             around 2,000 to 5,000 multi-page survey forms
         o MHSA Data Collection System – demographic, service and outcome data on
             all clients served by MHSA programs. This is planned to be imbedded in
             Anasazi at which time data will be extracted and sent to state via XML files
             rather then using (duplicate) hand data entry.
         o ITWS – State supported web site used for dissemination of “official”
             information and for submission of Medi-Cal claims files

      Type of Application:
      State supported and mandated Web sites

      Number of Users, Number of Support Staff (FTE’s):
      50 to 100 for all three systems. About 10% of one FTE for training and access
      monitoring.




Exhibit 2, Attachment 3                                                         Page 3 of 3
                 County of Kern – Technology Planning
                     EHR Implementation History


Overview and History
In order to present a complete picture of the Roadmap that Kern County is using to
implement an Electronic Health Record (EHR), it is necessary to also present a short
history of the efforts that have already taken place.


Technology Needs Assessment
KCMH began this process in early 2003 with the creation of a Technology Needs
Assessment in conjunction with the Gartner Consulting Group, a national leader in the
field.
o     The Needs Assessment consisted of interviews with Key Stakeholders, two
      Strategic Workshops and a detailed Requirements Analysis Workshop. The
      identified needs were categorized and prioritized.
o     The requirements Workshop translated the identified high-level needs into specific
      functionality required of the Information System
o     A detailed Communications Plan was formulated


RFP Creation and Vendor Evaluation
Kern County participated in the California Behavioral Systems (CBS) Coalition to create
an RFP and to evaluate responding software vendors. The CBS coalition consisted of
representatives from 26 Counties. More then 150 individuals participated in the overall
proposal and product demonstration evaluation. Some highlights of this process are:

Phase I
   o Request for Proposal (RFP) Published July, 2003
   o Responses Scored August/September, 2003
        o Kern County Evaluation Team Leads:
                    Clinical Supervisor in Kern Linkage Program
                    Administrator in Adult Clinical Program
                    Senior Information Specialist, IT
                    Billing Supervisor
                    Managed Care Supervisor, Managed Care
                    Supervisor, Medical Records
                    Technology Manager, Technology Services Division
   o Identified “Short List” of eight Vendors based on the proposal scoring:
        o Each Proposal was given an extensive review by Coalition members. All
             scores were compiled for each vendor. A full coalition, two-day meeting
             (September 15-16, 2003) was held in Sacramento to select a group of
             vendor finalists. A total of 7 software products and 8 vendors were
             selected as vendor finalists. The vendor finalists were unanimously
             selected. The vendors selected by the Coalition conformed exactly with
             the rankings developed by the Kern County evaluation teams.


Exhibit 2, Attachment 4                                                 Page 1 of 4
                 County of Kern – Technology Planning
                     EHR Implementation History
   o Scripted Product Demonstrations
        o Specific and detailed scenarios were developed for each area of
            functionality. Each “finalist” vendor was asked to perform these scripted
            demonstrations.
                   They took place via teleconference and web-conference and lasted
                   approximately three hours for each vendor for each of the seven
                   functional categories.
                   In addition to the seven team leads and the team members that
                   evaluated the proposals, other interested staff were invited to view
                   the demonstrations. The scoring was calculated by each team lead.
                   The input from other staff was used (by each team lead) to
                   determine their final score for each vendor.
                   Approximately 40 KCMH staff participated in the demonstrations.
                   An additional “subjective” score was submitted by each team leader
                   addressing their area of responsibility.
        o The total of these scores were weighted and compiled.

   o Billing Clarification Questions
           o A series of 29 questions were developed by a Billing sub-workgroup
             consisting of three staff from the Finance Division and one from
             Information Technology. These questions were devised specifically to
             evaluate the vendor’s ability to create a valid claim for Medi-Cal and other
             funding sources.
                    The Billing Clarification Questions were submitted to the eight
                    finalist vendors as an addendum to the original CBS RFP in April
                    2004.
                    The responses were scored and weighted by four staff from the
                    Finance Division and one from Information Technology in May
                    2004.
Phase II
   o The second phase of the CBS Coalition evaluation focused on specific
     functionality in the areas of Clinical, Billing and Managed Care workflows. The
     workflows were designed by the CBS Coalition members to evaluate gaps from
     the original product demonstrations.
   o The CBS Coalition isolated critical functionality from the RFP document and
     created workflow diagrams indicating how each of these critical processes should
     work in the context of an ideal Information System. The vendors were given the
     challenge of demonstrating how their system would perform each of these
     functions. These demonstration sessions were held in person (versus the
     teleconference method used for Phase I demonstrations) allowing a more
     interactive presentation and the ability to ask pertinent questions. Each vendor
     was allocated 2 full days to perform these demonstrations.
   o The CBS Coalition narrowed the field to four vendors based on the Phase I all-
     county scoring. The finalist list of four vendors matched the four top vendors in
     Kern’s scoring as well.


Exhibit 2, Attachment 4                                                 Page 2 of 4
                 County of Kern – Technology Planning
                     EHR Implementation History
   o Based on the Billing Clarification Questions scoring and the Phase I scoring,
     Kern included five vendors in the Phase II evaluation process (The additional
     vendor scored first in the Billing Clarification Questions, but fifth overall).
   o These demonstrations were scored on four criteria:
        o Functionality
        o Ease of Use
        o Navigation
        o Configurability

Overall Results
The scores from the three primary evaluation categories were averaged together (with
equal weighting) to calculate the overall evaluation scores.


Final Vendor Selection/Contract Negotiations
   o Anasazi Software was selected by Kern County in September, 2004
   o Completed contract negotiations and obtained Board of Supervisor approval in
     May, 2005


California Enhancements
One of the requirements of the CBS Coalition RFP was for vendors new to California to
enhance their application to address specific needs of Counties in the State. To meet
that requirement, Kern County identified six staff members to work with the vendor to
identify the details of those requirements. This Enhancement Design Team consisted
of:
    o Administrator, Technology Services
    o Clinical Supervisor
    o Billing Supervisor
    o Senior Accountant
    o Quality Improvement Division Analyst
    o Authorizations Unit Supervisor (also an RN)
This team plus senior design staff from Anasazi (including their CEO) spent more then
ten months discussing and documenting the required enhancements. Although the
focus was on MediCal claiming and Mandated State Reporting, issues related to clinical
practices, State regulatory needs, Managed Care, MediCal Eligibility, etc. were also
included.


Implementation Preparation
In August of 2005, the Implementation Project was begun in earnest. Two primary
Implementation teams were formed, the Billing Implementation team and the Clinical
Implementation team. These teams consisted of a total of 30 staff representing all
aspects of the organization and all levels of staff. Included on these teams were
Executive Managers, Psychiatrists, administrative and support staff, clinical supervisors,


Exhibit 2, Attachment 4                                                 Page 3 of 4
                 County of Kern – Technology Planning
                     EHR Implementation History
clinical line staff and clinical support staff. Seminars were held to identify configuration
data required for the system in the following areas:
    o Management Forms and workflow
    o Service Codes
    o Unit/Sub-unit structure
    o Managed Care
    o Diagnosis Codes
    o Electronic Data Conversion


Implementation
On July 1, 2006, the Department began the full use of the new system. Training was
carried out on a team-by-team basis over the next 8 months. Data was collected on
paper forms and entered into the system by a central “Core” team of Super Users until
each team was trained and therefore able to enter their own data. Initial training
included the following basic topics:
    o Basic System Navigation
    o Client Look-up
    o Client Intake/demographics
    o Scheduling
    o Diagnostic Review
    o Financial Review (UMDAP)
    o Reporting
    o Progress Noting
As of February, 2007, all internal Department teams had completed their training. In
August, 2007, training for Phase I (as above) was begun for the Department’s Contract
Providers and Phase II training was started for internal staff. Phase II includes other
forms included in the Electronic Record such as Consent forms, Release of Information
forms, Screening forms and forms specific to treatment areas such as the forms
required by the AB2726 program.




Exhibit 2, Attachment 4                                                    Page 4 of 4
                                             Kern County
                                 Roadmap to an Electronic Health Record




      2003            2004          2005      2006            2007            2009           2011      2012



Department       RFP &         California      Practice        EHR “Lite”    Ordering       Full EHR      Fully
Technology       Vendor      Enhancements     Management                                               integrated
  Needs         Selection                                       Clinical                     PHR        EHR and
Assessment                                      Billing I/F     Notes       e-Prescribing                 PHR
             2.1)            Implementation    Reporting
                               Preparation        (CSI)
                                               Scheduling
                                                Providers




             Exhibit 2, Attachment 5
                  Kern County
           Department of Mental Health



          KCMH Integrated Information System
             (MHIIS) Acquisition Phase




             Project Communication
                 Plan (Version 1.1)



                  December 5, 2003

                           DRAFT

                           Prepared by:


                        Gartner Consulting
                2870 Gateway Oaks Drive, Suite 150
                      Sacramento, CA 95833




Gartner
                                   KCMH Integrated Information System (MHIIS) Acquisition Phase
                                                        Project Communication Plan (Version 1.1)




                                    APPROVALS


   Project Name: KCMH Integrated Information System (MHIIS) Acquisition Phase

   Document Name: Project Communication Plan

   Approval Signatures:




          Department of Mental Health Director – Diane Koditek, MHIIS Project
          Sponsor
          Date:


          KCHM IT Steering Committee Chair – Donald Terleski, MHIIS Project
          Director
          Date:


          Technology Services Manager – Dan Walters, MHIIS Project Manager
          Date:


    Revision History      Date                    Description                          Creator
    Draft Version 1.0     September 17, 2003      Initial Draft                        Gartner
    Draft Version 1.1     December 5, 2003        Contains Department input            IT Steering




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                                                         KCMH Integrated Information System (MHIIS) Acquisition Phase
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                                                    TABLE OF CONTENTS



1.            OVERVIEW .......................................................................................................................1
      1.1     Purpose ..........................................................................................................................1
      1.2     Objectives ......................................................................................................................2
      1.3     Potential Barriers to Effective Communication Plan Implementation ...................3
      1.4     Expected Benefits .........................................................................................................3
      1.5     Success Factors............................................................................................................3
      1.6     Assumptions ..................................................................................................................4
      1.7     Overview of Approval Process....................................................................................5
2.            PROJECT STAKEHOLDERS ..............................................................................................6
      2.1     Introduction ....................................................................................................................6
      2.2     Internal Stakeholders ...................................................................................................6
      2.3     External Stakeholders ..................................................................................................8
      2.4     MHISS Project Committees and Teams ...................................................................9
3.        MESSAGE TYPES (WHAT) .............................................................................................10
      3.1 Message Types ...........................................................................................................10
4.        COMMUNICATIONS MEDIA (HOW) .................................................................................11
      4.1 Introduction ..................................................................................................................11
      4.2 Communications Methods .........................................................................................11
5.        MEDIA MATRIX...............................................................................................................13
      5.1 Media Matrix ................................................................................................................13
APPENDIX A – PROJECT ORGANIZATION CHART ........................................................................17
APPENDIX B – CONTRACTOR LIST ...............................................................................................18
APPENDIX C – VENDOR CONTACT LIST .......................................................................................19
APPENDIX D – COUNTY BOARD OF SUPERVISORS AND BEHAVIORAL HEALTH BOARD
CONTACT LIST ...............................................................................................................................20
APPENDIX E – MANAGEMENT TEAM CONTACT LIST ...................................................................22
APPENDIX F – IT STEERING COMMITTEE CONTACT LIST ............................................................24
APPENDIX G – PROJECT TEAM CONTACT LIST ...........................................................................25
APPENDIX H – STAKEHOLDER ADVISORY COMMITTEE CONTACT LIST ......................................26
APPENDIX I – PROPOSAL EVALUATION TEAM CONTACT LIST ....................................................27




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                                   KCMH Integrated Information System (MHIIS) Acquisition Phase
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                                        1. OVERVIEW

1.1 PURPOSE

The Kern County Department of Mental Health (KCMH) is currently undertaking a
system selection process to integrate its information systems. The following systems
are part of the integration process:

   •   GISMO
   •   MONSTR
   •   TIER
   •   Numerous stand-alone programs and databases

The Department’s proposed solution is to redevelop, to the extent possible, several
existing information systems into a single, coherent, enterprise-wide system that
combines the functionality currently performed by these multiple systems. The Kern
County Mental Health Integrated Information System (MHIIS) Project, is intended to
meet the following program objectives:

   •   Provide comprehensive and accurate mental health and substance abuse
       program, demographic, diagnostic, pharmaceutical, authorization and billing
       information
   •   Provide an integrated data system that supports the service delivery system
   •   Increase staff effectiveness
   •   Assist with the implementation of consistent clinical procedures
   •   Improve service delivery
   •   Provide more effective, efficient customer care
   •   Capture more codified data for analysis and reporting
   •   Enhance user system productivity
   •   Facilitate electronic communications
   •   Implement a modern and flexible technical architecture

The MHIIS Project is typical of information technology projects in that it involves some
degree of change. When staff and participants are affected by project-related changes,
they typically have many questions and concerns, and are curious and often uncertain
about how the changes will impact their jobs. A formal communications program
benefits the project by educating and communicating to stakeholders (including
Department staff, contract providers, consumers and family members): the need for
change; details regarding the new system; the resulting impact on individual roles; and
changes in staff and contractor work processes.



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                                    KCMH Integrated Information System (MHIIS) Acquisition Phase
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A formal communications program defines the specific task assignments and schedule
for communications including: the current and desired situation and environment; the
participants involved; information needs; and the most effective communications media.
This plan details a specific and realistic approach to sharing information in a timely
fashion with all participants during the acquisition phase of the MHIIS project.

1.2 OBJECTIVES

The following are specific objectives of the Communication Plan:
      Inform Internal and External Participants
      •   Provide participants with timely and factual information about the system
          selection
      •   Formalize a process that will allow the MHIIS Acquisition Project Team
          members to share information, strategy, status updates, and milestones to
          interested parties
      •   Communicate the system selection schedule
      •   Provide a mechanism to document challenges as well as achievements
      Engage Participants and Promote Change
      •   Communicate the benefits and challenges that the technical solution will
          present, the consequences of not succeeding in this effort, and the program
          participant roles in making it successful
      •   Continue to strengthen project partnerships
      •   Encourage acceptance by helping individuals understand the effects of
          change
      Address Unchanneled Communication and Rumors
      •   Manage participant perceptions and expectations of the project outcomes and
          requirements
      •   Reduce fears, uncertainty, and rumors
      Obtain Feedback from Participants
      •   Develop a process allowing program participants to provide feedback,
          communicate concerns, and discuss and resolve issues relating to system
          selection
      •   Provide a forum for two-way communication
      •   Identify and direct issues to appropriate arenas for resolution
      Generate Project Support
      •   Acknowledge/celebrate progress and the success of the system selection


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1.3 POTENTIAL BARRIERS TO EFFECTIVE COMMUNICATION PLAN IMPLEMENTATION

It is important to recognize and overcome the following potential barriers to successful
communication plan implementation:
      Lack of demonstrated participant support for the project
      Insufficient Project Management and staffing for a task
      Differing levels of understanding technical issues
      Negative responses to identified problems
      Recent change in government administration and policy
      Failure to develop unique customer specific responses
      General resistance to change

1.4 EXPECTED BENEFITS

The following are expected benefits of successfully implementing the communication
plan:
      Acceptance of change as a result of open, honest education regarding the status
      of system selection
      Communications that respond directly to participant information needs, roles, and
      responsibilities
      Development of a method to identify and track the resolution of issues related to
      any part of the project
      Recognition of project successes as well as an enhanced understanding of the
      challenges and the opportunities
      Increased internal team effectiveness

1.5 SUCCESS FACTORS

The following factors contribute to the success of the communication plan:
      Awareness - Communication about the project must occur. If participants are not
      informed of the MHIIS Project’s objectives, outcomes, and the associated
      impacts, they will not be prepared for the changes or support the changes around
      them.
      Content - Communication must be relevant, meaningful, and at an appropriate
      level of detail for the targeted audience. The message should convey realistic
      expectations by dealing openly with the impact of change. Communication
      strategies should also be based on participants’ needs and feedback.

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                                   KCMH Integrated Information System (MHIIS) Acquisition Phase
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      Timeliness - Information must be shared in a timely manner to allow participants
      opportunities to digest messages and react.
      Context - All communications should demonstrate and reinforce management
      support and commitment by clearly indicating that the program sponsors and
      project managers are the sources of information. Furthermore, communications
      should emphasize the programmatic need.
      Format and Media - All communications must be developed and delivered in a
      format that is consistent, efficient, understandable, and easily accessible. As
      much as possible, existing communication methods should be used.
      Communication Flow – The MHIIS Project Acquisition Team will be responsible
      for reviewing communications to ensure MHIIS Project correspondence conforms
      to MHIIS Project format guidelines. In addition, the review will verify continuity,
      wherever possible, of the Project’s message to participants and external
      agencies. This will ensure the message conveyed to the project’s interested
      parties is consistent with the MHIIS Project’s goals and objectives. The Project
      Organization Chart in Appendix A depicts the parties responsible for the
      continuous flow of communications.
      Effectiveness - To ensure effective communications, regular assessments of the
      communication plan and process must be conducted. An issue tracking log will
      be used to track issues and record resolutions. This is the tool that will be used
      to track communication issues and resolutions along with all other issues related
      to the project. The MHIIS Project Acquisition Team will use the issue log to
      ensure effective follow-up on communication issues.

1.6 ASSUMPTIONS

The successful execution of the Communication Plan is dependent upon the following
assumptions:
      Participation from resources including the:
      •   Department of Mental Health Director’s Office, Deputy Director’s Office,
          Financial Services Division, Quality Improvement Division and Information
          Technology Services.
      •   Mental Health and Substance Abuse Divisions Administrators and Subject
          Matter Experts (SMEs)
      •   Kern County IT Division; and
      •   KCMH’s current contractors.
      Adequate administrative support        for    the   development,      production,     and
      distribution of communications.



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                                  KCMH Integrated Information System (MHIIS) Acquisition Phase
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1.7 OVERVIEW OF APPROVAL PROCESS

All communications related to this MHIIS Acquisition Project will be developed in
accordance with the guidelines provided in this plan. To ensure consistency and that
different project teams or members are not duplicating messages, external
communications should be submitted to the MHIIS Project Team. The MHIIS Project
Team will review and approve messages for content and format. The MHIIS Project
Manager and the Project Director will be responsible for all external communication
approvals unless they determine that other individuals or agencies must be included in
the approval process.




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                                     KCMH Integrated Information System (MHIIS) Acquisition Phase
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                                 2. PROJECT STAKEHOLDERS

2.1 INTRODUCTION

Involving stakeholders, those directly or indirectly affected by the Department’s actions,
is a critical step in developing effective communication. Numerous MHIIS project
participants have been identified. Some of these groups will only need periodic review
of key milestones, findings, and decisions. Others will require very detailed and
frequent communications as their roles are directly affected by process changes.

2.2 INTERNAL STAKEHOLDERS

Internal participants that have been identified for the project include:

2.2.1 MHIIS Project Sponsor

The Project Sponsor is the leader of the Management Team and is responsible for
facilitating the direction setting and decision-making process related to the MHIIS
project. The Project Sponsor will support the project working with the Management
Team and IT Steering Committee to ensure appropriate resources and time allocation
are available to support the project and that the Management Team fully participates in
the communication and change management processes necessary to ensure project
success. The Project Sponsor will approve all status reports to the Board of
Supervisors and the Behavioral Health Board and their representatives.

2.2.2 MHIIS Project Director

The Project Director is one of the key decision-makers of the project. The Project
Director is Chair of the IT Steering Committee and works with the Committee to resolve
issues and scope changes that cannot be resolved by project management.


2.2.3 Financial Services Division

KCMH’s Financial Services Division will be responsible for budget approval, contract
oversight and payments. Financial Services Division manager will participate as a
Steering Committee member. The Financial Services Division will coordinate with Legal
regarding contractual items including, scope, deliverables, payments, and intellectual
property rights. All status reports to the Board of Supervisors, Behavioral Health Board
or their representatives will be reviewed and approved for financial content and potential
financial consequences by the Financial Services Division manager prior to submission
to the Project Sponsor for approval. The Financial Services Division will coordinate as
needed with the County Purchasing Department regarding all procurement processes.


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2.2.4 Legal

KCMH’s Financial Services Division will be responsible for coordinating legal
consultation with the Office of County Counsel regarding intellectual property rights to
the MHIIS Project Team. A Financial Services Division representative will advise
Steering Committee members as appropriate.


2.2.5 Technology Services

KCMH’s Technology Services Division will be responsible for providing technical
information related to the existing departmental systems and technology assessment
assistance during the selection phase of the MHIIS project. The Technology Services
Manager will be the MHIIS Project Manager and participate on the IT Steering
Committee. Technology Services representatives will participate as Project Team
members as appropriate.


2.2.6 Kern County Mental Health (KCMH)

KCMH’s entire organization will be impacted by the MHIIS. Staff will participate in
identifying program and system requirements needed for selection of the system.
Subject matter experts (SMEs) will participate as members of sub-teams and
workgroups as appropriate. Effective communication will ensure staff members
embrace the changes that will occur as a result of the MHIIS implementation.


2.2.7 MHIIS User Groups

MHIIS will utilize a number of different user groups to perform specific functions during
the project. Specific user groups may include:

      1.      Clinical group
      2.      Pharmacy group
      3.      Records management group
      4.      Reports group
      5.      Financial group
      6.      Administrative group
      7.      Technical group

Members from these groups will develop system requirements definitions and some will
participate on the proposal evaluation team.




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2.3 EXTERNAL STAKEHOLDERS

External Stakeholders need to be identified for the project from the following areas:

2.3.1 Contractors

All contractors will be impacted by the implementation of the MHIIS (see Appendix B for
list of contractors). Effective communication will ensure contractors will embrace the
change that will occur as a result of the System implementation. The Project Team will
be responsible for releasing documents to this group as appropriate.

2.3.2 KCMH Vendors

KCMH vendors will be impacted by implementation of a new MHIIS. (See Appendix C
for the list of KCMH vendor contacts.) Effective communication will ensure vendors
support the system implementation. The MHIIS Project Team will be responsible for
releasing documents to this group as appropriate.

2.3.3 Persons Served/Family Members

Persons served include individuals and groups who participate in KCMH programs.
Family members are the parents, spouses and community supports for these program
participants. Effective communication will ensure persons served support the MHIIS
implementation and understand how it will improve access to program services. The
Clinical Group will be responsible for releasing documents to this group as appropriate.

2.3.4 County Board of Supervisors and Behavioral Health Board


The County Board of Supervisors and Behavioral Health Board are to be kept informed
about the project’s direction and progress.         It is important, therefore, that
representatives from the Boards receive routine status reports of the project, and any
issues that may impact procurement. (See Appendix D for the list of County Board of
Supervisors and Behavioral Health Board contacts.)


2.3.5 Kern County IT Division

It is expected that the Kern County IT Division will support the integration of technology
and serve as a resource for coordination between County systems and the MHIIS
system (Reference chapter 7 of the Kern County Policy and Procedures Manual). It will
be important to have Kern County IT Division representatives participate in all phases of
the Project to ensure the system can be effectively supported by the IT Division
technical infrastructure and staff. Representatives will participate as members of sub-
teams as appropriate.


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2.4 MHIIS PROJECT COMMITTEES AND TEAMS

The following describes the communications roles and responsibilities of the MHIIS
Project Committees and Teams. (See Appendix C for the Project Organization Chart.)

2.4.1 Management Team

The Management Team will be responsible for providing executive sponsorship and
oversight, and removing barriers to Project implementation. (See Appendix E for the list
of Management Team members.) The Management Team will communicate the
importance of the Project to internal and external stakeholders as appropriate. The
Management Team will be briefed about critical milestones by the IT Steering
Committee and Project Team on no less than a monthly basis.

2.4.2 IT Steering Committee

The Steering Committee consists of KCMH Program and Technology key stakeholders
and a representative from the Kern County IT Division. The Steering Committee will
make key project decisions including scope control, schedules, stakeholder issues,
project oversight evaluations, and risk assessment reviews; monitor the achievement of
key project milestones; resolve critical issues related to system acquisition; and, serve
as a liaison to related participants and respective committees. (See Appendix F for the
list of Steering Committee members.)


2.4.3 MHIIS Project Team

The Project Team will be responsible for communicating messages in a timely fashion
to participant groups, coordinating daily activities and monitoring the progress for the
MHIIS Project, as well as identifying and bringing critical issues to the Steering
Committee for resolution. The Project Team includes Technical Services and program
representatives. (See Appendix G for the list of Project Team members.)

2.4.4 Stakeholder Advisory Committee

Key Contractors and other external stakeholders impacted by MHIIS will be asked to
participate in a Project Stakeholder Advisory Committee. The Stakeholder Committee
will be kept informed of project progress and asked for input as appropriate. (See
Appendix H for the list of Stakeholder Advisory Committee members).

2.4.5 Proposal Evaluation Team

The Proposal Evaluation Team will be responsible for defining proposal evaluation
criteria, conducting confidential vendor discussions, reviewing and rating proposals
against defined criteria, and recommending an MHIIS vendor to the Sponsor. (See
Appendix I for the list of Proposal Evaluation Team members.)

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                                 3. MESSAGE TYPES (WHAT)

3.1 MESSAGE TYPES

Message types refers to the content of communications that have been identified for the
successful acquisition of the MHIIS system. To ensure accurate and timely transmittal
of the latest version of any and all project documents, all message types will be
transmitted via email to appropriate parties, regardless of hardcopy submission. Where
appropriate, messages will be posted on MH Net. The message types that have been
identified include:

 Message Type                                   Description
 Calendar of       The Project Team will publish a Calendar of Events with the high-level
 Events            schedule of project phases, team schedules, internal/external meetings
                   and regular project publications.
 Frequently        The Project Team will publish and disseminate the answers to
 Asked             frequently asked questions to participants when appropriate.
 Questions
 General Project   The Project Team will make general project information available to all
 Information       participants via the MHIIS Web site for external stakeholders and the
                   intranet site for internal stakeholders. General information includes
                   project scope and charter, list of project partners and deliverables,
                   project organization chart, answers to frequently asked questions, the
                   calendar of events and interesting information about the project.
 General           General updates regarding project status, policy and other direction
 Updates           changes, etc. will be published and disseminated to participants as
                   necessary.
 Program           The Project Team will keep program participants informed regarding
 Participant-      vendor and system selection and conduct two-way discussions to
 Specific Issues   identify and resolve participant issues as appropriate.
 Project Status    The Project Team will complete monthly status reports. The Project
                   Team will publicize project status on an on-going basis and as
                   appropriate.
 Schedules         The Project Team will inform all participants of the specific schedules
                   appropriate to them.




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                                 4. COMMUNICATIONS MEDIA
                                         (HOW)

4.1 INTRODUCTION

The communications media are the means or channels for delivering messages to the
targeted audience. Not all channels or methods are appropriate for all audiences and
depending on the length or format of the message, some channels are not effective or
viable. However, as previously noted, to ensure accurate and timely transmittal of the
latest version, all types of project communication will be transmitted via email as a back
up, regardless of the original communication method used.

4.2 COMMUNICATIONS METHODS

The communication methods identified as appropriate for the MHIIS Project are
described below:

 Communication
                                                 Description
    Media
 Meetings           Meetings are an important vehicle through which the Project Team
                    will communicate with external stakeholders and internal team
                    members. The MHIIS Team will host internal and external meetings.
                    A list of internal and external meetings that have been identified and
                    their descriptions has been included in the media matrix in Section 6.
                    It provides more detail regarding how these meetings will present
                    timely information about the status of the project, and share
                    information with internal and external stakeholders.        Complete
                    minutes will be taken and made available for each meeting.
 Electronic Mail    MHIIS Project stakeholders will communicate information by
                    electronic mail. E-mail will be used as often as possible to facilitate
                    timely communication, and will be used as a backup for all types of
                    written communication.
 Reports            Status reports, project data, and status sheets will be issued
                    periodically to report the status of significant accomplishments, issues
                    raised, issues resolved and significant accomplishments anticipated
                    for the next report.




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 Communication
                                              Description
    Media
 Web Site and    Publications on the MHIIS Web site and Intranet site are intended to
 Intranet Site   share project information with external and internal project
                 stakeholders and other interested parties. Pages on the site include
                 the project scope, charter and status with several project deliverables.
                 Deliverables posted on the Web site will be subject to the
                 Configuration Management Plan; the MHIIS Project Team must
                 approve all other documents, pages and links. The web site will be
                 updated on a regular basis and updates will be made through the
                 assigned project team resource to ensure version control. The Web
                 site is a practical approach to meeting customer service
                 requirements, obtaining feedback from our end users, providing
                 efficiency for the customer and using technology to improve
                 communication.
 Interviews      The Project Team will conduct interviews with subject matter,
                 technical, and functional experts and others as needed for information
                 gathering and validation.
 Work Group      The Project Team will convene work group sessions that will include
 Sessions        subject matter, functional, and technical experts. These sessions will
                 be conducted for activities such as: developing program
                 requirements, designing future work processes, understanding
                 statewide database requirements, and evaluating vendor proposals.
 Presentations   The Project Team as well as other MHIIS Team members will be
                 available to make formal and informal presentations at internal and
                 external meetings.     This communication plan identifies several
                 external meetings where providing project status and other important
                 project information would be appropriate.
 Project         Project management will communicate project status through the
 Management      output of project management tools such as the Issue Log and MS
 Tools           Project schedule.
 Traditional     Traditional forms of communication (e.g. U.S. mail, Memoranda,
 Communication   signs, brown bag lunches, etc.) are a low-tech approach to delivering
                 MHIIS Project information and will be used whenever necessary and
                 to ensure those who do not have access to the web site or e-mail
                 receive important information.




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                                                       5. MEDIA MATRIX

5.1 MEDIA MATRIX

The following chart describes the format, frequency, tone, level of detail, purpose, and target audience for each media that
will be used regularly by the MHISS Project Team:

Communications                     Tone and Level                       MHISS Project                             Target
                      Frequency
   Media                              of Detail                         Use for Media                            Audience
Meetings (Internal)   Weekly       Formal meeting      This forum will give the MHIIS Project Team the        Leadership from
IT Steering                                            opportunity to provide project updates, share          KCMH, and
Committee Meeting                                      information, and assess project status. This group     representatives
                                                       will provide oversight and direction in regards to     from County IT
                                                       scope, schedule, stakeholder issues, budgeting         Division
                                                       issues, and risk assessment reviews.

Meetings (Internal)   Weekly       Formal meeting      Members of the IT Steering Committee will report       Leadership from
Management Team                                        project progress to the Management Team. They          KCMH
                                                       will also use this forum to discuss and resolve
                                                       issues as appropriate. A status update item is a
                                                       standing agenda item at these meetings.
Meetings (Internal)   Weekly or    Formal and          Members of the Project Team will meet formally         Project Team
MHIIS Project Team    as needed    informal meetings   once a week to share information, discuss project
Status Meeting                                         issues, etc. They will also meet informally on an as
                                                       needed basis.




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Communications                       Tone and Level                     MHISS Project                             Target
                       Frequency
   Media                                of Detail                       Use for Media                            Audience
Meetings (Internal)    Monthly or    Formal meeting   Members of the IT Steering Committee and Project       Managers and
Managers and           as needed                      Team will provide project updates and share            Supervisors
Supervisors Meeting                                   information.
(Expanded
Management)
Meetings (Internal)    Every other   Formal meeting   This forum will be used to keep all staff advised of   All staff
Bi-monthly All Staff   month                          the project status and make any announcements
Meeting                                               all staff should be aware of related to project
                                                      activities.
Meetings (External)    As needed     Formal meeting   This forum will be used to keep stakeholders           Key contractors
Stakeholder                                           advised of the project status and to discuss any       and other
Advisory Committee                                    concerns. It will also be used to obtain feedback      external
Meeting                                               from Stakeholders regarding System requirements.       stakeholders
                                                                                                             impacted by
                                                                                                             MHISS
Meetings (Internal)    As needed     Formal meeting   This forum will be used to define the proposal         Proposal
Proposal Evaluation                                   evaluation criteria, to obtain clarifications as       Evaluation Team
Meeting                                               needed from vendors in a confidential setting, and     Members,
                                                      to evaluate proposals and select a vendor(s).          Vendors
                                                                                                             Participating in
                                                                                                             Vendor
                                                                                                             Discussions
Electronic             As needed     Formal and       The MHIIS Project Team will use electronic             All stakeholders
Communication                        informal MHIIS   communication (e.g., e-mail, voice mail, fax phone,
                                     communications   etc.) to communicate with stakeholders.




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Communications               Tone and Level                         MHISS Project                              Target
                 Frequency
   Media                        of Detail                           Use for Media                             Audience
Workshops        As needed   Formal meeting to     This meeting will provide the MHIIS Project Team a KCMH staff and
                             discuss MHIIS-        forum to communicate requirements and project      contractors
                             related information   schedule, as well as address specific technology
                             and issues            issues.
Memoranda        As needed   Formal                The MHIIS Project Team will communicate                 KCMH staff and
                             Memoranda             important project information (e.g., status, requests   contractors
                                                   for information, etc.) via memorandum from the
                                                   program sponsors or MHIIS Project Acquisition
                                                   Team.
Monthly Status   Monthly     Formal project        MHIIS Project Team will produce monthly status          County Board of
Reports                      reports that          reports that will include accomplishments for the       Supervisors,
                             provide status and    month and raise issues that may impact system           KCMH
                             outstanding issues    selection.                                              Management
                                                                                                           Team, IT Steering
                                                                                                           Committee
Traditional      As needed   “Low tech”            The MHIIS Project Team will communicate via             Potentially all
Communication                methods of            traditional communication methods (e.g., mail,          stakeholders and
                             communication         brown bag lunches, meetings, signs, etc.)               stakeholder sub-
                                                   wherever possible. For instance, when something         groups
                                                   must be formally disseminated, it will be distributed
                                                   via e-mail (by mail for those without access to e-
                                                   mail) or if communications must be made to a
                                                   small group, the MHISS Project Team may hold a
                                                   brown bag lunch meeting.




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                                                               KCMH Integrated Information System (MHIIS) Acquisition Phase
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Communications                Tone and Level                          MHISS Project                             Target
                 Frequency
   Media                         of Detail                            Use for Media                            Audience
Web Site         Updated      Informational site     The Web site will provide a central means of          All stakeholders
                 monthly or   that will be easy to   disseminating project information to stakeholders.
                 as needed    follow/read            Information available on the web site would include
                                                     general information about the project, status
                                                     updates, documentation, answers to commonly
                                                     asked questions and points of contact.
Intranet Site    Updated      Informational site     The Web site will provide a central means of          All staff
                 monthly or   that will be easy to   disseminating project information to stakeholders.
                 as needed    follow/read            Information available on the web site would include
                                                     general information about the project, status
                                                     updates, documentation, answers to commonly
                                                     asked questions and points of contact.
Change           Varies       Formal half-day        This forum will keep the MHIIS Project Team           All stakeholders
Management                    meeting                informed of upcoming changes in legislation that
Meetings and                                         may affect the system selection and development,
Workshops                                            and provides a forum for MHIIS presentations and
                                                     demonstrations.




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                                APPENDIX A – PROJECT
                                ORGANIZATION CHART



                                 KCMH Management Team


                                   IT Steering Committee


                                   MHIIS Project Director


                                    MHIIS Project Team


                Kern County IT Division


Proposal Evaluation Team      Stakeholder Advisory Committee                      KCMH Staff




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                  KCMH Integrated Information System (MHIIS) Acquisition Phase
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          APPENDIX B – CONTRACTOR LIST


Name         Contact Information
                   Mental Health
insert       Contact Information
             Title
             XXX-XXXX
             email
insert       Contact Information
             Title
             XXX-XXXX
             Email




                 Substance Abuse
insert       Contact Information
             Title
             XXX-XXXX
             Email




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               APPENDIX C – VENDOR CONTACT
                           LIST



Organization      Contact
Echo              Contact?
                  Title
                  XXX-XXXX
                  email
Sequest           Contact?
                  Title
                  XXX-XXXX
                  Email
Insert            Contact?
                  Title
                  XXX-XXXX
                  email




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                        APPENDIX D – COUNTY BOARD
                            OF SUPERVISORS AND
                         BEHAVIORAL HEALTH BOARD
                               CONTACT LIST


Name                      Contact Information
                        County Board of Supervisors
insert                    Contact Information
                          Title
                          XXX-XXXX
                          email
Esther Torres             Contact Information
                          Title
                          XXX-XXXX
                          Email
Rick Benson               Contact Information
                          Title: Deputy County Administrative Officer
                          XXX-XXXX
                          Email

                           Behavioral Health Board
Alisha M. Caster (S.D. 1)  Contact Information
                           Title
                           XXX-XXXX
                           Email
Jerry Wallace (S.D. 1)     Contact Information
                           Title
                           XXX-XXXX
                           Email
Joe Ciriello (S.D. 1)      Contact Information
                           Title
                           XXX-XXXX
                           Email
Gregory Goldstein (S.D. 2) Contact Information
                           Title
                           XXX-XXXX
                           Email
Jacob Daniel Hudson (S.D. Contact Information
2)                         Title
                           XXX-XXXX
                           Email

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                                    KCMH Integrated Information System (MHIIS) Acquisition Phase
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Name                           Contact Information
Percy Robinson (S.D. 3)        Contact Information
                               Title
                               XXX-XXXX
                               Email
Ethel Nona Tolentino (S.D.     Contact Information
3)                             Title
                               XXX-XXXX
                               Email
Frank Allen Welcome (S.D.      Contact Information
3)                             Title
                               XXX-XXXX
                               Email
Eugene Couture (S.D. 4)        Contact Information
                               Title
                               XXX-XXXX
                               Email
Janice Lundy (S.D. 4)          Contact Information
                               Title
                               XXX-XXXX
                               Email
Lurie L. Flohr (S.D. 4)        Contact Information
                               Title
                               XXX-XXXX
                               Email
William Rector – Vice Chair    Contact Information
(S.D. 5)                       Title
                               XXX-XXXX
                               Email
Vikki Del Pellegrino – Chair   Contact Information
(S.D. 5)                       Title
                               XXX-XXXX
                               Email
Esther Torres – Board of       Contact Information
Supervisors Representative     Title
                               XXX-XXXX
                               Email
Diane Koditek - Director       Mental Health Director
Lily Alvarez – Liaison         Board Liaison
Cindy Coe – Coordinator        Board Coordinator




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                              APPENDIX E – MANAGEMENT
                                 TEAM CONTACT LIST


Organization                   Contact
KCMH                           Diane G. Koditek, M.F.T., M.S.
                               Director
                               (661) 868-6609
                               DKoditek@co.kern.ca.us
KCMH                           Donald Terleski, PhD.
                               Deputy Director
                               (661) 868-6604
                               DTerleski@co.kern.ca.us
Adult Outpatient Services      Brad Cloud, PhD.
Division                       Administrator
                               (661) 868-6818
                               BCloud@co.kern.ca.us
Children’s System of Care      Deanna Cloud, L.C.S.W.
Division                       Administrator
                               (661) 868-6707
                               DCloud@co.kern.ca.us
Kern Linkage Division          Bill Drakos
                               Administrator
                               (661) 868-1856
                               BDrakos@co.kern.ca.us
Financial Services Division    Marvin J. Felli
                               Administrative Services Officer
                               (661) 868-6622
                               MFelli@co.kern.ca.us
Quality Improvement            Fred Hawley, R.N.
Division                       Administrator
                               (661) 868-6708
                               FHawley@co.kern.ca.us
Clinic                         H.T. Mohan, M.D.
                               Clinical Medical Director
                               (661) 868-8089
                               HMohan@co.kern.ca.us
Outreach and Crisis            Bill Walker, M.F.T.
Division                       Administrator
                               (661) 868-8155
                               BWalker@co.kern.ca.us



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Organization             Contact
Technology Services      Dan Walters
                         Technology Services Manager
                         (661) 868-6710
                         (661) 868-6666 (fax)
                         DWalters@co.kern.ca.us
Adult System of          Jim Waterman, PhD.
Care/Judicial Services   Administrator
Division                 (661) 868-6117
                         JWaterman@co.kern.ca.us
Children’s Outpatient    Alexis Woods
Services Division        Administrator
                         (661) 868-6754
                         AWoods@co.kern.ca.us
Psychiatry               Tai Yoo, M.D.
                         Chair of Psychiatry
                         (661) 868-8045
                         TYoo@co.kern.ca.us




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                              APPENDIX F – IT STEERING
                              COMMITTEE CONTACT LIST


Organization                  Contact
KCMH                          Donald Terleski
                              Chair
                              MHISS Project Director
                               (661) 868-6604
                              DTerleski@co.kern.ca.us
Financial Services Division   Marvin J. Felli
                              Administrative Services Officer
                              (661) 868-6622
                              MFelli@co.kern.ca.us
Quality Improvement           Fred Hawley
Division                      Administrator
                              (661) 868-6708
                              FHawley@co.kern.ca.us
Kern Linkage Division         Lamar Kerley
                              Supervisor for Dual Diagnosis
                              (661) 868-1870
                              LKerley@co.kern.ca.us
Kern County IT Division       John Devlin
                              Technical Services Supervisor
                              868-2051
                              Devlinj@co.kern.ca.us
Administrative Coordinator    Lynette Canas
                              Administration
                              (661) 868-6739
                              LCanas@co.kern.ca.us
Deputy Director’s Office      Carolyn Forster
                              Office Services
                              (661) 868-6616
                              CForster@co.kern.ca.us
Technology Services           Dan Walters
                              Technology Services Manager
                              (661) 868-6710
                              (661) 868-6666 (fax)
                              DWalters@co.kern.ca.us




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                      APPENDIX G – PROJECT TEAM
                            CONTACT LIST



Organization            Contact
Technology Services     Dan Walters
                        MHISS Project Manager
                        (661) 868-6710
                        (661) 868-6666 (fax)
                        DWalters@co.kern.ca.us
Technology Services     Chuck McCartney
                        Technical Lead
                        (661) 868-6624
                        (661) 868-6666 (fax)
                        CMcCartney@co.kern.ca.us
Managed Care            Judy Newman
                        Managed Care Administrator
                        (661) 868-6605
                        (661) xxx-xxxx (fax)
                        JNewman@co.kern.ca.us
Gartner                 Sean Thakkar
                        Gartner Engagement Manager
                        (818) 710-5941
                        (818) 710-1467 (fax)
                        sean.thakkar@gartner.com
Gartner                 Phoebe Cameron
                        Gartner Project Manager
                        (916) 921-3114
                        (916) 649-7107 (fax)
                        phoebe.cameron@gartner.com




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                APPENDIX H – STAKEHOLDER
               ADVISORY COMMITTEE CONTACT
                           LIST



Organization     Contact
Insert           Contact?
                 Title
                 XXX-XXXX
                 email




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                  APPENDIX I – PROPOSAL
               EVALUATION TEAM CONTACT LIST



Organization      Contact
TBD               TBD
                  Title
                  XXX-XXXX
                  email




Gartner                                                          December 5, 2003
                                                                         Page 27
Medication Review




                                          Prepare Forms for                                             Make Next
                  Check-in Client
                                          Chart (List forms:)                                          Appointment




 Support Staff
                                                                                                            No                                         No


                                                                                     Any Med         Write Prescription    Any Dx or Tx          Update Dx or Tx     Progress Note
                                                                 Discuss/Evaluate              Yes                                        Yes
                                                                                    CHanges?               (F15)          Plan Changes?         Plan (Fxx and Fyy)       (F20)




 M.D.
                                                                                                          Call In
                                                                                                          Rx, Fax
                                                                                                           TAR




 Nurse
                        Forms:
                        F10:Short Doyle authorization
                        F11: MD appointment card
                        F12:Psych. Eval (MD)
                        F13: Diagnosis change from
                        F14: CalMAP




 Authorizations
                        F15: Prescription form
                        F16: Med. consent
                        F17: Med. sheet
                        F18:Contact Sheet (support staff)
                        F19: Lab Sheet
                        F20: Progress note - psych. Eval. Note
                        F21: PCP release
                        F22: Lab sheet
                        F23: Log of injections
Pysch Evaluation/Prescriptions


                                                                                                                                              Assist with Forms
                                        Prepare Chart with                                                                                       F10 thru F23
                  Schedule Psych             Forms:                                                                                              (Define which                      Make Next
                                                                                                                               Discharge
                    Evaluation           Forms F10 thru                                                                                       forms done by MD                     Appointment
                                               F23                                                                                              versus Support
                                                                                                                                                     Staff)




 Support Staff
                                                                                                                                               Progress Note
                                                                  Perform Pysch     Meds           Fill-in Forms F12,         Progress Note     (F20) plus all    Write Prescription
                                                                                              No                                                                                            Injectable?   Yes   Clorazil?
                                                                    Evaluation    Required?             F13 & F14                 (F20)        forms F10 thru           (F15)




 M.D.
                                                                                                                                                    F23

                                                                                                                        Yes
                                                                                                                                                                                                 No



                                                                                                                                                                                             Call In
                                                                                                                                                                                             Rx, Fax
                                                                                                                                                                                              TAR




 Nurse
                         Forms:
                         F10:Short Doyle authorization
                         F11: MD appointment card
                         F12:Psych. Eval (MD)




 Authorizations
                         F13: Diagnosis change from
                         F14: CalMAP
                         F15: Prescription form
                         F16: Med. consent
                         F17: Med. sheet
                         F18:Contact Sheet (support staff)
                         F19: Lab Sheet
                         F20: Progress note - psych. Eval. Note
                         F21: PCP release
                         F22: Lab sheet
                         F23: Log of injections
Intake at Access Center



                                            Yes                                  Client Stabilized
                                                       Crisis Stabilization                                   Progress Note
                                                                                 then referred to
                                                               Unit                                         Triage Form (F??)
                                                                                     Access
      Phone call or Walk                               Refer to screener
             In                   Crisis?                                        Call Back/Walk In           AZ Index Card
                                                  No   HIPAA/Consumer                                                                       Add Interim
                                                                                    Slip (F300)                 Pre-Intake
                                                       Handbook (F12)                                                                       Service Log
                                                                                                            Refer to Screeners

                                                                                                                                                                             Discuss Informed
                                                                                                                                                          Client requests        Consent            Perform Screening         Release of
                                                                                                                                                                               HIPAA Policy          in TIER (F301)        Information (F2)   1
                                                                                                                                                           MH services
                                                                                                                                                                                  (F12)
                                                                                                                            Screener Receives
                                                                                                                               contact info.                                                                Gate
                                                                                                                                                       Client requests SA     Refer to GATE                Assess
                                                                                                                                                            services              (CAC)                     ment


                                            Yes            Enter
                                                                               Financial Review/
                                                       Demographic,                                   Schedule Client for         GT 5              NOA-E (F304)                                                                    Assess
                                                                              3rd Party Insurance                                               Y                                                            Screening
                                                       Assignment to                                     Assessment               Days                                      Quality Review
                                                                                                                                                                                                           Progress Note             ment
                                                        1000/1001                                                                                                            (Supervisor)
              1                 Services?                                                                                                               N
                                                                                Linkage to                                    Single Contact
                                                        Community                                    Informed of Crisis                               Call Logged
                                                                                Community                                    Progress Note,
                                                         Referral                                         Services
                                                                                 Referral                                    close pre-intake
                                            No




          Assessed               Authorized/Denied                                         Assessment
                                                            Assigned/Referred
                                                                                          Progress Note




               F2:     Release of Information
               F9:     UMDAP                                                                                                                                                                 Orientation
               F12:    HIPAA Privacy                                                                                                                                                         F306, F307
               F300:   Access Walk-in
               F301:   Initital Screening
               F302:   Client Registration
               F303:   Episode Open/Close
               F305:   Orientation Progress Note
               F306:   Rights/Resp
               F307:   Client Supp Info Face Sheet
               F402:   NOA-E

				
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