2005-1328-Minutes for Meeting October 12,2005 Recorded 11/22/2005wgG 2A
p { Deschutes County Board of Commissioners
1130 NW Harriman St., Bend, OR 97701-1947
�' (541) 388-6570 - Fax (541) 388-4752 - www.deschutes.ora
MINUTES OF DEPARTMENT UPDATE —
MENTAL HEALTH DEPARTMENT
DESCHUTES COUNTY BOARD OF COMMISSIONERS
WEDNESDAY, OCTOBER 12, 2005
Commissioners' Conference Room - Administration Building - 1300 NW Wall St.., Bend
Present were Commissioners Tom DeWolf and Dennis R. Luke; Commissioner
Michael M. Daly was out of the office. Also present were Mike Maier, County
Administrator; Dave Peterson, Information Technology; David Givans,
Commissioners' Office; and Greg Canfield and Scott Johnson, Mental Health
Department. No representatives of the media or other citizens were present.
The meeting began at 4:15 p. m.
Please see the agenda and backup documentation (copy attached) for information
on the items discussed.
Concerning the Electronic Medical Records Project, representatives of Information
Technology and Mental Health will survey options and obtain feedback on how the
project is being utilized in Oregon.
No formal action was taken by the Board at this meeting.
Being no further items addressed, the meeting adjourned at 4:45 p.m.
DATED this 12th Day of October 2005 for the Deschutes County Board of
Commissioners.
ATTEST:
Recording Secretary
Tom DeWolf_ Chair
DESCHUTES COUNTY OFFICIAL RECORDS CJ ZO05'1328
NANCY BLANKENSHIP, COUNTY CLERK
COMMISSIONERS' JOURNAL 11/22/2005 04;42;29 PM
IIID I III'lllllllllllllll�l III
200 -1328
Deschutes County Mental Health
BOCC Monthly Meeting - Proposed Agenda
October 12, 2005
Location: Commissioner's office
Electronic Medical Records Project - See attached packet. Dave Peterson,
David Givans, Greg Canfield. Requesting BOCC investment.
2. MHO Business Plan - draft receiving final check for accuracy this coming week.
Referral to the BOCC by October 24. Requesting BOCC work session October 31.
3. Strategic Plan adoption at Advisory Board October 19, 2005. Your adoption will
be requested. Can also discuss on October 31 as needed.
4. Children's System of Care began October 1, 2005.
a. Trillium Family Services treatment foster care contract Monday October, 17
Attached information:
• April 21, 2005 letter / report from Kim Scott, President
• March 1, 2005 Insurance Endorsement
• December 20, 2004 Six- Month Progress Report from Linda Johnson
b. Coordinator needed - may request a time limited full time benefited fte as an
additional "care coordinator". Referrals backing up; funds available.
5. Drug Court Meeting - hosted by Judge Sullivan November 4. Please attend.
Purpose: confirm community support for Drug Court including application to the
Criminal Justice Commission. BOCC, DA, LEA etc support critical to proceeding.
6. Other
a. Federal (SAMSHA) grant application for meth tx. NOT FUNDED; will apply again
b. Federal (OJJDP) grant app. for Family Drug Court. NOT FUNDED.
c. Federal Indirect Rate - critical policy matter. Status?
3
Proposed Electronic
Medical Records Project
• A computer based system for
intake, treatment, discharge, case
notes, evaluation, release of
information and billing etc.
• Critical issue for DCIVIH
• 2005 Internal Auditor Report
• 2005 ABHA Encounters Report
need for better documentation
• 2000 IT Strategic Plan
Critical issue with current
information system
• No complete look in 15 years
• Documentation affects revenue
• Paperwork too time consuming
• Lost files; poor chart tracking
• Efficiency & productivity (direct
services) needs to increase
• Tracking of client benefit
• Tracking of clinician productivity
• Limited control over clinic data
• We need better outcome data
• Numerous remote locations
• We rely heavily on a programmer
Proposed 2006 Project
Scope:
1. Define our system needs
2. Identify product(s) that best meet
our needs
3. Long range financing plan
(hardware, software, training
and support)
Approach
• Shared project DCMH & IT
• Secure contractor
• Cost: up to $75,000, need for
County General Fund investment
To: Deschutes County Board of Commissioners
Mike Maier, County Administrator
From: Scott Johnson and Greg Canfield, Deschutes County Mental Health (DCMH)
Dave Peterson, Deschutes County Information Technology
Date: October 12, 2005
Subj: Request for County Support of Electronic Records Project
Background - DCMH has a critical need to review our current; practices and systems for clinic
management (i.e. scheduling, medical records and business applications) in the Department.
Our current systems are costly and inefficient and in significant needof<""overhaul.
With the advent of electronic medical recdds, many beh
ehave acquired electronic software ackag"s to support trE
processes. Examples include Sages View (as part of
Volunteers in Medicine and other Oregon counties.
Recognizing this need and the County's audit finding
Strategic Plan (Page4) ,with the following reference:
"In cooperation -with IT, forma -,„v
electronic sys"tem for medical r
preferred' package, financing a
treatment planning and billing.
recommendation. Resources ne
Project Outline The>,project will
needing attention
better document encounters
project as a priority with a
)ped ones" to increase the
I health organizations like ours
it, accounting and evaluation
ide Healthcare Community),
incorporated this project into the
roup, to study the feasibility of acquiring and using a new
S.
Develop findings and recommendations including a
insitionplan. Emphasize ease for clinicians and utility for
ire a system by 2007-08. Audit recommendation and staff
for feasibility study and system development."
ude but not be limited to the following:
1. Form a CounrV ork Group including representatives from DCMH and IT.
2. Contract for technical support in IT and behavioral health including but not limited to:
a. An assessment of our system needs incl. integrated treatment, business applications.
b. Identification of the integrated product(s) that best meets our needs.
c. A long range financing plan including hardware, software, training and support.
d. A report with findings and recommendations, incl. a proposed implementation plan.
Request - DCMH and the County's IT Department are currently requesting a County General
Fund investment in this project of up to $75,000. The funds will be used for technical support and
the cost of researching potential systems. We lack the resources to respond to the audit finding
and undertake this project without County assistance.
Cc David Givans
Commissioners / Alpha / Medical records project 10.05.doc
P
Background Information
INTERNAL AUDITOR REPORT
(June 2, 2005)
Finding: "The development of Mental Health's computerized business software requires more
oversight."
"... It is recommended the Mental Health Department periodically review their software needs
and consider whether the internal software is the best choice for their operations. With
advances in software design, it is possible there are pre -developed packages that could be
used. The Department should develop a cost / benefit approach when analyzing potential
software solutions." Page 8
"If the internally developed software continues to be used', it is recommended the system be
improved so it can be sufficient for staff to use without significantinvolve ment of the
programmer. This would include operations manual and documentation ",so staff can resolve
issues and process needed reports." Page 8 `-;
Finding: "Use of computerized business system reports needs
"It is recommended staff develop procedures to provide�wversight 6f,4
116,,Pepartment's activities
as maintained in the computerized business system.v Some of,the proceures identified include:
a) analysis of time lag for receipt of service tickets; b) summary of total services provided, billed,
and paid; c) summary of accounts receivable collections and adjustments; and d) exception
reports identifying problems with client balances and activity.0,11
Deschutes County Information Tectnol'ogy Strategic Plan
;(September 29, 2000)
Strategy: "As applications ne�edlo be replaced, first consider packaged solutions".
This strategy, calls for the County to`favor packaged automation solutions over custom
developed ones. This is not to say that the County should always procure packaged solutions -
when the marketplace doesn't provide the required functionality and sufficient programming
resources are available in the County, custom development may still make sense." Section 4.4
Benefits: 0 PT,' ides the County with a wider set of automation solutions
• Reduces the County's reliance on technologies and skills that will likely
tin
conue�to become more difficult to find over the life of this plan
• Increases productivity through greater capabilities and better business
processes associated with advanced package applications
Strategy: "Emphasize customer service with enhanced focus on training and end-user support".
Benefits: • Increases County's return on IT application investments
• Improves productivity
• Increases customer satisfaction with applications.
Commissioners / Alpha / Medical records project 10.05.doc