January 29, 2013 CBCC Conference Call

Community-Based Collaborative Care Working Group Meeting

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Attendees

• Alex deLeon
• Suzanne Gonzales-Webb CBCC Co-chair
• Adrianne James
• Jim Kretz
• Diana Proud-Madruga
• Richard Thoreson CBCC Co-chair
• Ken Salyards
• Ioana Singureanu
• Serafina Versaggi scribe

Agenda

1. (05 min) Roll Call, Approve Minutes & Accept Agenda
2. (15 min) WGM follow-up (Suzanne & Richard) - deferred until next meeting
   • Three-year Plan:
   • Meeting Minutes - Suzanne to complete & Serafina to review. Minutes to be approved on next Tuesday's CBCC Call (2/5/13) Suzanne to post
   • Work Group Mission and Charter - review with attendees, send to listserve and have approved by DESD before posting
3. (10 min) May Ballot Timeline and Deliverables
   • Submit Notice of Intent to Ballot (NIB) - Deadline: Feb 17
   1. CDA R2 Implementation Guide for Privacy Consent Directive, First Normative ballot
   2. Domain Analysis Model for Behavioral Health, Second Informative Ballot
   3. CDA R2 Implementation Guide - Behavioral Health Summary, First Normative Ballot
4. (15 min)SME Engagement and Terminology Analysis
5. (05 min) FEI Briefing (Ioana)
6. (05 min) Wrap Up, Review Action Items and Propose Agenda Items for Next Week

Minutes

Considerable time spent discussing which level we would ballot our various standards.

• Decision to rename the Domain Analysis Model during this submission to remove Reporting from the title (Previously titled Domain Analysis Model for Behavioral Health Reporting)
• Serafina took Action Item to follow up with headquarters regarding any new rules for ballot levels for DAMs and CDA R2 IGs. This will determine the level at which we ballot.

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Ballot development

Next step: Conduct the SME review of the Core Data Element and Terminology Analysis.

• The purpose of the SME review is to get feedback on the current list of elements and values as well as to elicit any missing / new requirements (additional elements or values) that are not currently included.
• Documents under discussion today can be found on GForge using the following links.
  • Orientation for Subject Matter Experts (.pptx)
    • This is the Overview presentation to orient SMEs to the project and process
  • Core Data Element and Terminology Analysis(.xlsx)
    • This is the Spreadsheet containing the element list and value sets, organized by tab
  • Proposed Behavioral Health Summary Record Content(.docx)
    • This is a document containing additional data elements related to Criminal Justice and Education that Richard has asked to be included on the analysis, information model and implementation guide (ballots)
• Before adjourning today's call, it was decided that Serafina would prepare a final update of the Core Data Element and Terminology Analysis spreadsheet.
• The spreadsheet will be updated based on the information provided in the Proposed Behavioral Health Summary Record Content(.docx) briefly reviewed during today's call and then forwarded to Richard, Steve Daviss and other SAMHSA staff to circulate among the SMEs in advance of the work sessions (schedule below)
• Richard will provide a paragraph / statement that will be incorporated as addendum to the Behavioral Health ballot package regarding the burgeoning aspect of interoperability (electronic communication) between Behavioral Health providers and community service agencies (see Action Items)

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Subject Matter Expert (SME) requirements outreach

The Core Data Element and Terminology Analysis spreadsheet consists of a list of all Behavioral Health elements that have been identified to date, and worksheets containing the set of allowable values associated with each coded element. The tool is intended to be reviewed and validated by subject matter experts from various fields. We are seeking feedback on the current list of elements and values as well as to elicit any missing / new requirements (additional elements or values) that are not currently included.

• Richard, Kate and Dr. Steve Daviss are reaching out to subject matter experts to engage them in this process. (see Action Items)
• Orientation and multiple interactive work sessions have been scheduled in February to encourage SME participation.

Initial walk-through of the current data elements and proposed value sets Thu. Feb. 7th, 2013 @ 11 am EST (90 minutes) Three interactive work sessions are proposed (90 minutes each):

• Tue. Feb. 12th @ 4 pm EST
• Thu. Feb. 14th @ 10 am EST
• Mon. Feb. 18th @ 3 pm EST

Feedback related to data elements and value sets received from each work session will be incorporated in the spreadsheet for the subsequent review

We recommend that you plan to attend:

1. Initial Walk-through
2. One work session
3. Final Review Walk through of the proposed changes on Wed. Feb. 20th @ 1 pm EST

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FEI Briefing - Ioana

• We were unable to get to this item during today's call. Defer to next week (see Action Items)

Errata

• What does "mental health and substance use parity" mean? (Taken from the American Psychological Association (APA) Mental health insurance under the federal parity law website)
  • Mental health and substance use parity means that coverage for mental health and substance use benefits must be at least equal to coverage for physical health benefits. In other words, all of the financial requirements and treatment limitations applied to mental health and substance use benefits may be no more restrictive than those applied to physical health benefits.
  • Financial requirements include lifetime and annual dollar limits, deductibles, copayments, coinsurance and maximum out-of-pocket expenses. Treatment limitations include frequency of treatment, number of visits, days of coverage and other similar limits.
• Minutes were amended to include the following clause in the definition of mental health and substance abuse parity (by Dr. Steve Daviss):
  • Non-quantitative treatment limitations are plan features that are not expressed numerically but may operate to limit the scope or duration of benefits for treatment, such as standards for determining medical necessity, preauthorization requirements, formulary design, determination of usual, customary and reasonable charges, and network standards for provider admission or reimbursement.

Action Items

1. Serafina will contact early adopters of the CDA R2 IG for Consent Directives to obtain feedback based on their implementation experience. Ioana will incorporate feedback into the appropriate May ballot artifacts (IG for Consent Directives and/or Behavioral Health Domain Analysis Model).
2. Serafina to follow up with HQ to determine "new rules" regarding ballot levels for Domain Analysis Models and CDA Implementation Guides.
3. Add statement to the CDA IG for Behavioral Health Summary related to ensuring templates backward compatibility
4. Richard will provide a statement / section that will be incorporated as addendum to the Behavioral Health ballot package to highlight areas within the Domain Analysis that are undergoing development and which are critical to interoperability between Behavioral Health practitioners and other social service and safety net domains (e.g., Criminal Justice, Educational System). The purpose of this statement is to ... (Serafina editorial comment / question: clarify that the Implementation Guide/DAM is a living document and that it is expected to evolve over time. There is a commitment to ensure backward compatibility, but to allow flexibility for incorporating new use cases, data elements and terminology to support interoperability.)
5. Suzanne to forward Phoenix Working Group minutes to Serafina for review prior by Friday. Final Minutes will be forwarded to the list prior to next Tuesday's meeting (2/5) for approval at beginning of call

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Meeting was adjourned at 1:00 PM EST Back to CBCC Main Page