Webinar on Section 223 Demonstration CCBHCs and State Collected Measures

Introduction

• Speaker: Peggy O'Brien from SAMHSA's Center for Behavioral Health Statistics and Quality.
• Audience: Staff from Section 223 demonstration CCBHCs interested in state-collected quality measures.

Overview of State Collected Measures

• Purpose: Quality measures collected and reported by demonstration states.
• Impact: Performance affects state-reported measures and potentially quality bonus payments.

Key Points:

State Collected Measures Overview

• Number of Measures: 12 required measures and 2 optional measures starting in 2025.
• Use in Evaluation: Part of national evaluation and quality improvement programs.

Categories of Measures

• Medication Related: Includes management of antidepressant medication, adherence to antipsychotic medications, pharmacotherapy for opioid use disorder, and follow-up care for ADHD medications.
• Follow-Up Related: Follow-up after hospitalization or emergency department visits related to mental illness or substance use.
• Physical Health: Includes hemoglobin A1c control.
• Client Experience: Patient and family experience of care.
• Optional Measures: Related to youth prescribed antipsychotic medications.

Detailed Measure Descriptions

Medication-Related Measures

1. Antidepressant Medication Management (AMM)

   • Applies to ages 18+ with major depression.
   • Measures retention in antidepressant treatment.
   • Two rates: acute phase (12 weeks) and continuation phase (6 months).

2. Adherence to Antipsychotic Medications for Individuals with Schizophrenia (SAA)

   • Applies to ages 18+ with schizophrenia or schizoaffective disorder.
   • Measures retention in antipsychotic medication treatment.
   • Focus on adherence and addressing medication adherence issues.

3. Use of Pharmacotherapy for Opioid Use Disorder (OUD)

   • New required measure.
   • Applies to ages 18-64 with opioid use disorder.
   • Measures use and access to FDA-approved medications for OUD.

4. Follow-up Care for Children Prescribed ADHD Medication

   • Applies to ages 6-12.
   • Two rates: initiation (30 days) and continuation (10 months).

Follow-Up Related Measures

1. Follow-Up After Hospitalization for Mental Illness

   • Adult and child measures.
   • Focus on follow-up visits within 7 and 30 days post-discharge.

2. Follow-Up After Emergency Department Visit for Mental Illness

   • Adult and child measures.
   • Follow-up visit can be on the same day as the ED visit.

3. Follow-Up After Emergency Department Visit for Substance Use

   • Applies to ages 13-17 for children.
   • Focus on follow-up visits or pharmacotherapy within 7 and 30 days.

4. Initiation and Engagement of SUD Treatment (IET)

   • Encourages initiation and engagement post-episode identification.
   • Rates for initiation (14 days) and engagement (34 days post-initiation).

5. Plan All-Cause Readmissions

   • Measures unplanned readmissions within 30 days of discharge.

Other Measures

• Hemoglobin A1c Control for Patients with Diabetes

  • Applies to ages 18-75.
  • Measures A1c levels, focus on control (<8%) and poor control (>9%).

• Experience of Care Surveys

  • Assess client experience of care delivery.

Optional Measures

1. Use of First-Line Psychosocial Care for Children on Antipsychotics
2. Metabolic Monitoring for Children on Antipsychotics

Comparative Rates

• Provided state-reported ranges for 2022.
• Emphasized variability and non-comparability with CCBHC rates.

Resources

• Technical Specifications: 2024 specifications and reporting templates.
• Value Set Directories: For adult and child core sets.
• Comparative Rates Source: 2022 core chart packs for state-level data.

Conclusion

• Contact Information: Send questions to [email protected].
• Final Note: Importance of understanding and improving quality measures.