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HomeMy WebLinkAbout2223-9 Behavioral Health Practices Improvement (Final 9-6-23)Health Services – Behavioral Health Practices Improvement #22/23-9 September 2023 Health Services – Behavioral Health Practices Improvement To request this information in an alternate format, please call (541) 330-4674 or send email to internal.audit@deschutes.org Deschutes County, Oregon The Office of County Internal Audit Elizabeth Pape, CIA, CFE – County Internal Auditor, current David Givans, CPA, CIA – County Internal Auditor, former Aaron Kay – Performance Auditor Audit committee: Daryl Parrish, Chair - Public member Jodi Burch – Public member Joe Healy - Public member Summer Sears – Public member Stan Turel - Public member Patti Adair, County Commissioner Charles Fadeley, Justice of the Peace Lee Randall, Facilities Director Take survey by clicking HERE Recommendations 9 Health Services – Behavioral Health Practices Improvement #22/23-9 September 2023 Table of Contents: 1. INTRODUCTION .......................................................................................................................................... 1 1.1. BACKGROUND ON DEPARTMENT ................................................................................................................. 1 Funding .................................................................................................................................................................. 1 Structure ................................................................................................................................................................ 2 Organization .......................................................................................................................................................... 3 Staffing ................................................................................................................................................................... 3 Staffing Challenges ............................................................................................................................................... 4 Culture .................................................................................................................................................................... 6 1.2. BACKGROUND ON PRODUCTIVITY MONITORING SYSTEMS ..................................................................... 6 2. FINDINGS AND OBSERVATIONS ................................................................................................................ 7 2.1. FINDINGS ......................................................................................................................................................... 8 2.2. OBSERVATIONS ............................................................................................................................................ 20 3. MANAGEMENT RESPONSE ....................................................................................................................... 22 Health Services Department ............................................................................................................................ 22 APPENDIX A: OBJECTIVE, SCOPE, AND METHODOLOGY ............................................................................. 29 I. OBJECTIVES AND SCOPE .................................................................................................................................. 29 II. METHODOLOGY .............................................................................................................................................. 30 Health Services – Behavioral Health Practices Improvement #22/23-9 September 2023 HIGHLIGHTS Why this audit was performed: Behavioral Health remains concerned about improving and ensuring the consistency of productivity among clinicians across the division. What was recommended: Recommendations include: • going through the process to develop appropriate productivity measures; • reviewing the accuracy of the data contributing to measures; • creating a library of smart tools; • evaluating onboarding processes; • clarifying the policy for intern supervision; and • optimizing fleet utilization at downtown Bend locations. Behavioral Health – Practices Improvement The review focused on developing an understanding of practices used by highly productive Behavioral Health clinicians to leverage best practices to improve overall productivity. Additionally, it included reviewing the supporting operational systems, client workflows, scheduling, and division productivity measures. What was found: The Behavioral Health division currently utilizes many effective performance measures. However, there is room within the division’s productivity measures system to improve the following areas: • developing appropriate productivity measures for staff; • clarifying expectations for the staff; • accurately reflecting the time clinicians spend on client care; • equitably distributing cases within teams; and • enhancing the division's ability to identify community needs for resource allocation. EPIC, Behavioral Health's electronic health records system, features a collection of documentation aids collectively known as smart tools. Broadening the promotion, utilization, and training on these tools could greatly assist with the documentation requirements faced by all clinicians in the division. The division could refine its onboarding processes for new employees and provide clearer guidelines regarding the supervision of interns. When clinicians in downtown Bend need to provide services outside their workplace and division fleet vehicles aren't readily available nearby, their productivity is affected as they spend time finding and using alternative transportation options. Deschutes County Internal Audit Health Services – Behavioral Health Practices Improvement #22/23-9 September 2023 Page 1 1. Introduction Audit Authority The Deschutes County Audit Committee authorized the assessment of the Behavioral Health division within the Health Services Department in the Internal Audit Program Work Plan for 2022- 2023. Audit objectives, scope, and methodology can be found in Appendix A. 1.1. BACKGROUND ON DEPARTMENT The Deschutes County Health Services Department includes the Deschutes County Behavioral Health (Behavioral Health) division, which operates as the Community Mental Health Program for the County. Behavioral Health plays a vital role in promoting mental health, supporting recovery, and providing compassionate care to individuals coping with behavioral health challenges, substance use disorders, as well as intellectual and developmental disabilities. Its programs and services encompass assessment, therapy, crisis intervention, case management, psychiatric evaluations, medication management, and more. These services support the community’s most vulnerable and acute populations who are not able to be served by other outpatient providers. Collaboration with other local agencies, medical providers, social service organizations, and community partners is common to create a comprehensive support network. Funding Behavioral Health receives the greatest share of its revenue from the state of Oregon through grant programs and contracts, as well as services provided to Oregon Health Plan members (Capitation and fee-for-service). Additionally, it actively participates in the federal Certified Community Behavioral Health Clinic (CCBHC) grant program, facilitating care coordination to assist individuals in navigating behavioral health care, physical health care, social services, and other systems they are engaged with. General fund transfers tend to fluctuate but typically remain at approximately 10% of funding resources, and these transfers are primarily allocated to the highest acuity clients, such as those in crisis and older adults. Health Services – Behavioral Health Practices Improvement #22/23-9 September 2023 Page 2 Graph I Trend in revenues and expenses for Behavioral Health FY19-FY23 Table I Programmatic areas and their associated teams Structure Behavioral Health operates through six programmatic areas, subdivided into twenty-four specialized teams dedicated to specific projects or initiatives. Teams in bold were included in the audit. Teams were chosen through discussions with the division based on areas of interest or needing improvement. Health Services – Behavioral Health Practices Improvement #22/23-9 September 2023 Page 3 Diagram I Organizational workforce structure Graph II Trend of FTE1 growth by select program areas and division total FY19-FY23 Organization Behavioral Health’s programs are led by managers and are organized into a hierarchy. Clinical staff (clinicians) are overseen by a team supervisor. Clinical staff consists of qualified mental health professionals (QMHP),also known as Behavioral Health Specialist II (BHS-II), who play a pivotal role in providing behavioral health services (therapy) to mitigate the impact of mental and emotional client disturbances. The State requires BHS-II to hold either a license or certification. Additionally, Behavioral Health Specialist I (BHS-I) are State-certified qualified mental health associates (QMHA) who deliver services under the guidance of QMHPs. Teams also comprise of administrative and peer support staff; however, they were not included in the audit. Organizational Growth Behavioral Health has seen a 29% increase in staffing in recent years, growing from 191 FTE in Fiscal Year 2019 to 269 in Fiscal Year 2023. The growth primarily stems from bolstering the Crisis & Stabilization team to support the 24/7 Mobile Crisis Assessment Team and the Deschutes County Stabilization Center, which opened in 2020. 1 FTE – Full time equivalent Program Manager Team Supervisor QMHP (BHS-II) QMHA (BHS-I) Crisis & Stabilization has grown 285% since FY19. Health Services – Behavioral Health Practices Improvement #22/23-9 September 2023 Page 4 Graph III Trend of BHS-I and BHS-II staffing and the service hours for those staff. Evolution of Clinical Care The division has shifted from a traditional office-based outpatient care provider to a more community-oriented approach, delivering a diverse range of services to meet the evolving needs of the community. While this shift has undoubtedly brought about valuable improvements in outreach and engagement, it is worth noting that it may not have directly resulted in a substantial increase in billable services. Billable Services Billable client care refers to medical services, treatments, or procedures that can be billed to the patient's insurance company or directly to the patient. These services are typically reimbursed by a third-party payer, such as private health insurance, government programs like Medicare or Medicaid, or the patient themselves if they are paying out-of-pocket. Billable client care could include individual therapy sessions, crisis support, skills building, or case management. The division’s allocation of resources to Crisis has not correlated to increased service hours. Health Services – Behavioral Health Practices Improvement #22/23-9 September 2023 Page 5 Graph IV Trend of employee turnover for the County compared to Behavioral Health FY19-FY23 Non-billable client care is considered as part of the overall client care process, and their costs are most often covered by the division’s operational budget. Non-billable care could include tasks like travelling to the client, clinicians co-facilitating a group therapy, or providing services to a potential client who is not currently enrolled. The clear distinction between billable and non-billable client care is essential for the division to accurately track and manage their finances, comply with billing regulations, and provide transparent billing information to patients and insurance companies. It also helps ensure that patients receive the necessary care while managing the financial aspects of healthcare provision. Staffing Challenges Staff retention and recruitment has been an issue for Behavioral Health in recent years. The division has experienced a higher rate of turnover within the County workforce, as depicted in Graph IV. This is not specific to Deschutes County, as shortages in behavioral health workers are a common concern across the country.2 2 Behavioral Health Workforce Report to the Oregon Health Authority and State Legislature, Feb. 1,2022, OHSU Behavioral Health has seen turnover rates higher than the County workforce in four of the last five years. Health Services – Behavioral Health Practices Improvement #22/23-9 September 2023 Page 6 Culture The division's clinicians are focused and dedicated to serving their clients. They operate in a challenging environment, dealing with the often-unpredictable emotions, thoughts, and behaviors of individuals. Most clients live in a state of perpetual instability, where constant threats to their most fundamental needs require clinicians to coordinate with multiple service providers in addition to individual therapy. Many clients experience co-occurring disorders, as mental health issues intertwine with substance abuse or physical health problems, further complicating the treatment process. Despite these challenges, each clinician's impact on a client can be life-changing, making a positive difference in the lives of individuals, families, and the community. 1.2. BACKGROUND ON PRODUCTIVITY MONITORING SYSTEMS System A productivity monitoring system is a tool used by organizations to track and measure the productivity and efficiency of their employees and the services they provide. The system typically consists of three phases: data collection, analysis, and response. It is one of many tools used by organizations to measure overall performance towards its goals and objectives. Productivity monitoring may include the following: • Inputs – resources of the organization Example: tracking employee payroll hours • Workload – amount of work to be done Example: measuring the number of client appointments • Output – services provided Example: counting the number of client assessments completed • Adjustments – corrections to workload based on difficulty of the work Example: factoring in client acuity (severity of illness) or adjusting appointment for client no-shows/ late cancelled appointments Health Services – Behavioral Health Practices Improvement #22/23-9 September 2023 Page 7 • Efficiency – typically workload divided by the inputs Example: the divisions service hour tool (see below) • Outcome – did the output achieve the intended result? Example: measuring the reduction in suicide rates due to crisis interventions • Productivity – analysis of the combination of efficiency and outcome Example: overall assessment of cost per client case alongside client satisfaction levels to gauge productivity Workload measures and productivity measures are quite different. Workload measures focus on quantifying the amount of work, tasks, or activities that need to be accomplished within a specific timeframe. These can be captured as either volume or distribution at the individual, team, or division level. Productivity measures, on the other hand, focus on assessing the efficiency and effectiveness of the work being performed. These measures analyze the output or results achieved in relation to the input or resources used. Department’s System Behavioral Health’s productivity measures are derived largely from an electronic health records system, EPIC, to document client services and record client care time. The division has created a service hour tool which measures the efficiency of an employee’s time spent on client care, recorded in EPIC, as a percentage of the employee’s payroll hours, recorded in the County’s time management system. The service hour tool adjusts for clients failing to show up for appointments and includes documented non-billable client care time. Most teams within the division use the service hour tool calculation to measure efficiency, however the ACCESS team counts units of services provided to reflect each clinician’s output. 2. Findings and Observations The audit included limited procedures to understand the systems of internal control around Health Services – Behavioral Health Practices Improvement #22/23-9 September 2023 Page 8 clinician job performance and the supporting systems. No significant deficiencies were found in this audit. A significant deficiency is defined as an internal control issue that has the potential to negatively impact the entity's capacity to achieve its objectives, safeguard assets, and provide comprehensive and accurate information in line with financial, compliance, or performance reporting goals. The findings noted were primarily compliance and efficiency matters. Audit findings result from incidents of non-compliance with stated procedures and/or departures from prudent operation. The findings are, by nature, subjective. The audit disclosed certain policies, procedures and practices that could be improved. The audit was neither designed nor intended to be a detailed study of every relevant system, procedure, or transaction. Accordingly, the opportunities for improvement presented in the report may not be all-inclusive of areas where improvement may be needed and does not replace efforts needed to design an effective system of internal control. Management has responsibility for the system of internal controls, including monitoring internal controls on an ongoing basis to ensure that any weaknesses or non-compliance are promptly identified and corrected. Internal controls provide reasonable but not absolute assurance that an organization’s goals and objectives will be achieved. 2.1. FINDINGS Behavioral Health’s system of productivity measures needs additional development. Current clinician productivity measures are ineffective. The division set individual productivity targets for clinicians based on their team and role. However, targets determined by the service hour tool's calculated percentage seem to be low. Health Services – Behavioral Health Practices Improvement #22/23-9 September 2023 Page 9 Image I Excerpts of performance measures reported by the division3. For instance, crisis clinicians are expected to spend over 30% of their time on client care.7 Despite the low target threshold, 73% of all clinicians (including both efficiency and output productivity) were not meeting their target as of February 2023. Conversations from supervisors and staff indicate confusion about the division’s expectations, and there are no consequences for employees who do not meet the target. The division has multiple performance measures, some effective measures are highlighted in Image I. Useful performance measures, including productivity, are ones which will help the division identify if they are moving in the right direction. Crafting meaningful performance measures entails a systematic approach, starting with a clear definition of the division's overarching objectives, followed by identifying key data sources essential to achieving these objectives and selecting appropriate analytical formulas that align with the nature of the division's operations. Subsequently, the measures must be monitored for accuracy and analyzed for valuable insights. If the analysis reveals negative outcomes, such as poor productivity, it serves as a strong indicator for the necessity of implementing changes and improvements. 3 FY24 Health Services Budget Committee Briefing 7 Client care calculation includes billable hours, non-billable hours, and credit for no-show clients. Health Services – Behavioral Health Practices Improvement #22/23-9 September 2023 Page 10 Graph V Average composition of clinician efficiency4 as measured by the service hour tool. Clinician Quote: “It’s hard to set a standard for an unpredictable crisis.” Ineffective productivity measures can have several effects on an organization: • Resources may be misallocated based on incomplete information. • Employee motivation can be reduced without a sense of purpose and direction. • Employee evaluations may not accurately represent individual contributions. • Promoting output over outcome can occur. Since 2015, the division has measured clinician productivity. In 2021, they created the current service hour tool to improve the measurement and set new clinician targets. Even though the division started with a clear objective while developing the tool, the low target levels suggest the design was misaligned with the nature of the operation. The service hour tool derived targets may not be realistic for some clinicians, like case managers and crisis workers. These clinicians don't have much control over how much time they spend with clients, which can make it hard for them to reach the targets in their roles. Additionally, the recent trend in employee turnover has made supervisors reluctant to correct underproducing clinicians to avoid potential loss of staff. Consequently, there is a need for a comprehensive reassessment of productivity measurement methodologies to ensure alignment with the changing demands of clinical care and to empower employees to meet realistic and achievable targets. It is recommended Behavioral Health go through the process to develop appropriate productivity measures as well as clarify expectations for staff. 4 Limited to those clinicians included in the audit but excluding the ACCESS team who have output targets not measured by the service hour tool. The service hour tool indicates the average efficiency of clinicians at 33% of their worked hours. Health Services – Behavioral Health Practices Improvement #22/23-9 September 2023 Page 11 Graph V (repeated) Average composition of clinician efficiency5 as measured by the service hour tool. Graph VI Composition of clinician activities as reported during the study. The service hour tool does not reflect the time clinicians spend on client care. A one week work study8 provided insight into clinician workload and utilization of time. The study revealed comprehensive client care requires more time than the current service hour tool measures. The EPIC data, on which the service hour tool is based, lacks a record of the time spent on client care documentation. Shown in Graph VI, client care accounted for 76% of their workload compared to the 28% average calculated by the service hour tool. Accurate productivity measures are vital for effective resource allocation, capacity planning, and workload optimization. They help managers understand distribution of work, enable realistic goal setting, facilitate efficient time management, and contribute to high-quality outcomes. 5 Limited to those clinicians included in the audit but excluding the ACCESS team who have output targets not measured by the service hour tool. 8 See Appendix A for methodology and audit procedures. Client care in work study – 76% Client care in service hour tool – 28% Health Services – Behavioral Health Practices Improvement #22/23-9 September 2023 Page 12 During interviews, 40% reported not documenting all non-billable client care and 20% of clinicians mentioned working on billable documentation outside of work hours. This suggests there are internal pressures to complete billable documentation without reporting the payroll hours, leading to potential falsification of measures derived from the service hour tool. Additionally, this situation increases the risk of creating a work-life imbalance for the employee and raises potential labor law issues for the employer. The current measure does not provide managers with a complete picture of the efforts of clinicians. Several key data points are missing or lack sufficient controls ensuring accuracy. Currently, the division is not tracking time spent on documenting client care. The service hour tool measure is dependent on data from EPIC to measure efficiency, which is susceptible to several problems: • Clinicians have discretion in documenting non-billable services. • Delays in documentation hinder the tool's ability to provide timely data. • The tool relies on a third-party system to access payroll hours, requiring manual adjustments by the division, which impacts its accuracy. It is recommended Behavioral Health review the accuracy of the data contributing to clinician workload measures. The caseload distribution system is not functioning effectively. Conversations with clinical staff on some teams suggested a perception of unequal distribution of cases within the team. There were notable disparities in BHS-II caseloads among four of the eight teams, with some clinicians carrying double the number of cases than others. Clinicians assigned to the Crisis and Access teams do not carry cases as their primary function but may see regular clients as part of their assigned duties. Health Services – Behavioral Health Practices Improvement #22/23-9 September 2023 Page 13 Diagram II Example of two teams with contrasting BHS-II caseload distributions.6 Source: Division reporting as of June 2023. The division is required by law and contract to enroll all eligible individuals regardless of capacity. The divisions Intake and First Treatment Appointment Procedure outlines how new cases are distributed through open first treatment appointment (FTA) slots in BHS-II schedules. The team supervisor has the authority to modify the distribution to accommodate client complexity9 or clinician feedback on caseload levels. Balancing caseloads involves equitably distributing work to prevent individuals from becoming overwhelmed or underutilized, considering factors such as client complexity, staff experience, and resource allocation. When the division consistently assigns a disproportionately high volume of work to certain employees compared to others, those employees face a higher risk of burnout and fatigue. This imbalance can result in resentment, decreased cooperation, and reduced teamwork, ultimately impacting productivity across the team. Balancing caseloads among staff to accommodate the continuous influx of new clients into their team poses a challenge for supervisors, particularly for those teams serving broader 6 Newer employees, who usually build caseload gradually, were excluded from the results as were part-time clinicians. 9 While individual client complexity does impact clinician workload, no significant correlation was found between individual clinician caseload and their average client acuity within the same team. The Adult Outpatient team consists of 10 clinicians with some clinicians carrying twice the caseload of other teammates. CSS has team of 5 clinicians with very similar case distribution. Health Services – Behavioral Health Practices Improvement #22/23-9 September 2023 Page 14 populations. Teams such as CSS provide treatment to clients with serious persistent mental illness. These clients frequently receive ongoing County services, which makes it easier to manage clinician caseloads since clients are less likely to be discharged. However, regardless of the team’s purpose, clients who are not participating in services should be discharged according to division policy. Nevertheless, BHS-IIs might choose to keep them active, anticipating potential crises and avoiding the resulting reenrollment back into services. Furthermore, apart from active supervisor monitoring, there are no controls within EPIC’s scheduling feature to prevent BHS-IIs from using existing cases to fill FTA slots. The 2012 internal audit report, Client access to services, partially raised this concern and noted the new electronic record system could provide data to aid in the development of a caseload distribution system. The division has several productivity measures in place for caseload distribution, but it appears the division is not effectively using the measures to adjust practices. It is recommended Behavioral Health strengthen the controls for first treatment appointment assignment and client discharge. It is recommended Behavioral Health use the caseload measures to promote a more equitable distribution of work within teams. Specialization limits the efficiency of the division. The division has created specialized teams to support specific client populations, expanding services but restricting the division’s flexibility to adapt as the community’s need for service change. The preference of individual therapists to work with specific demographics or specialize in certain treatment techniques also creates boundaries in placement options for potential clients seeking care. Health Services – Behavioral Health Practices Improvement #22/23-9 September 2023 Page 15 Clinician Quote: “Matching clinical techniques to client needs leads to more efficient outcomes.” The purpose of a Community Mental Health Program is to provide a system of appropriate, accessible, coordinated, effective, efficient, trauma-informed behavioral health and substance use treatment services to meet the needs of community members10. Equitable access to care is a key objective in the division’s strategic plan, ensuring vulnerable populations have access to necessary care regardless of their socio-economic background. Specialization can negatively impact efficiency as it results in bottlenecks, narrowing of focus, and a lack of versatility. The bottlenecks are most evident for adult clients who are currently scheduling FTAs with a therapist for up to two months in advance at SOCO11. The division is actively looking into delays with FTAs, and initial findings indicate that clients are frequently being rescheduled to earlier appointments. Specialized care is a common practice within the healthcare field. It’s important to note, while specialization can have limitations, it also plays a crucial role in delivering advanced and specialized care to patients. Care provided by a community program is generally not able to be as specialized as private providers. The key lies in finding the right balance between specialization and the need for comprehensive, coordinated care to ensure optimal productivity and patient outcomes. The 2012 internal audit report, Client access to services, provided several strategies to counter the effects of specialization and bottlenecks. One strategy suggested, “Staffing can be more flexible to be able to target areas that are taking too long to obtain service.” It is recommended Behavioral Health re-evaluate the division’s flexibility to actively respond to the broader needs of the community. 10 Health Services Budget Reference Manual FY2024 11 Behavioral Health First Treatment Appointment Overview Dashboard – Previous 12 months report Health Services – Behavioral Health Practices Improvement #22/23-9 September 2023 Page 16 Opportunity exists for Behavioral Health to improve practices. Technology can be leveraged more effectively. Writing clinical notes from scratch significantly increases the time and effort required to complete documentation. Clinicians often must rely on their own initiative to discover shortcuts for documenting into the EPIC system. Many clinicians have created templates outside of EPIC, which they must manually copy into the system, adding extra steps. Productivity relies heavily on speed. Completing tasks quickly allows for more availability to perform others. It is essential to consider technology as a means to enhance productivity. The EPIC system offers smart tools that can substantially reduce the clinical writing process. These smart tools provide clinicians with pre-written documentation formatted for convenience. Many therapy techniques follow a repeatable structure, making them ideal for an organized format meeting the legal requirements for clinical documentation. The division currently utilizes smart tools within EPIC. Some examples are: • Smart forms are used for client assessments. • Smart text is used for goal, intervention, response, progress, and plan (GIRPP) notes. • Smart links are used for client screenings. • Smart lists are dropdown menus of pre-programmed options, such as a scale of 1 – 10. • Several clinicians have smart phrases approved by the division for regular usage to document client encounters. Compared to technology-enabled processes, manual processes are more prone to errors, resulting in delays, rework, and reduced productivity. Repetitive manual documentation consumes valuable time that could be better utilized in other tasks. Health Services – Behavioral Health Practices Improvement #22/23-9 September 2023 Page 17 Only the system administrator can create smart text, links, and forms in EPIC. The promotion of smart phrases as a productivity technique relies largely on the clinician’s team and is not widely endorsed by the division. Engaging employees in the process of designing and evaluating smart tools can also increase their acceptance and effectiveness. It is recommended Behavioral Health create a comprehensive library of division-approved smart tools to improve clinical documentation efficiency and provide training to clinicians on how to use them. The onboarding procedures for new therapists could be strengthened. During interviews, 50% of clinicians who had not interned within the division expressed concern over receiving extensive EPIC training before understanding how to use the system in their job. 23% of clinicians also believed they would benefit from more direct supervision and job shadowing to develop a better understanding of the position’s requirements. Although direct supervision occurs during onboarding, only 6 out of 125 (5%) new BHS-I and BHS-II employees have received two-month evaluations since 2019. The division’s Employee Orientation and Onboarding Procedure mandates new employees to spend their first two weeks attending Welcome Week, receiving EPIC training, and shadowing staff. Upon completion of these activities, the employee is activated in EPIC. Additionally, the procedure recommends conducting two-month employee performance evaluations. Employee evaluations serve as a tool to enhance employee engagement, satisfaction, and retention. Unless they were previously interns with the division, new employees often undergo substantial training on an unfamiliar medical system. They are left to familiarize themselves with the system while on the job, resulting in delayed proficiency and hindering productivity. Health Services – Behavioral Health Practices Improvement #22/23-9 September 2023 Page 18 Graph VII Distribution of interns by job class. New employees also miss the opportunity for formal supervisor feedback that effectively communicates expectations. The current onboarding procedure prioritizes clinicians receiving caseloads over adequate training time. There is a sense of urgency within the division to swiftly train staff and engage clients because of the demand for services. The procedure for supervisors to provide two- month evaluations is only recommended, not required, demonstrating a lack of support to assure new employees get the feedback they deserve. It is recommended Behavioral Health evaluate the onboarding content, procedures, and supervision to better integrate new employees. The division’s policy on supervision of interns lacks clarity. In 2023, the responsibility of supervising interns was distributed among one manager, four supervisors, one lead worker, one nurse, and five BHS-IIs. However, during interviews, BHS-IIs handling these extra duties mentioned they received no additional compensation or adjustments to productivity expectations. The Behavioral Health internship program has been highly effective in recruiting individuals for the division, with many current clinical staff having started as interns. While their contributions to client care remain the primary value, clinician job descriptions offer an optional duty for intern supervision. The division policy assigns the responsibility for supervising interns to clinical supervisors or lead workers only. Health Services – Behavioral Health Practices Improvement #22/23-9 September 2023 Page 19 The discrepancy between policy and job descriptions creates confusion and potential conflicts regarding the responsibility for overseeing interns. Staff members are given additional duties but are still expected to produce at the required levels, leading to additional stress. The division’s policy lacks clear guidance on the methodology for distributing intern supervision duties or the role of clinical staff in supervising them. It is recommended Behavioral Health clarify the policy for supervision of interns. The availability of vehicles is an obstacle for some clinicians. Clinicians assigned to the downtown Bend locations12, whose primary responsibilities involve travel, face challenges in scheduling vehicles to fulfill their duties. With only 32 available vehicles to accommodate the needs of 62 clinicians working at those locations13, the average daily utilization over the last three months based on a five-day workweek was quite high at 79.38%. However, some clinicians' work schedules may not align with that standard workweek, so the utilization rate could be higher. The County's Light Fleet policy, GA-22, lays out a fleet management strategy including guidelines for acquiring, retaining, and replacing light vehicles. The strategy includes viable solutions to address short-term needs by utilizing a motor pool, commercial rental cars, and employee mileage reimbursement. When vehicles needed to travel to clients are unavailable, it hampers the clinician’s ability to efficiently provide essential services to clients. Time spent seeking alternative travel accommodations directly impacts clinician productivity, as well as leading to delayed or 12 These include the Wall Street Services Building, Mike Maier Building, and Downtown Clinic. 13 The audit work was limited to clinicians and did not calculate the number of other staff assigned to the downtown Bend locations. Health Services – Behavioral Health Practices Improvement #22/23-9 September 2023 Page 20 reduced assistance for those in need. The division has faced challenges in coping with the growing staff size and ensuring sufficient fleet resources. Limited fleet parking at the downtown locations poses a constraint, potentially making it difficult to accommodate additional vehicle purchases to meet demands. The downtown campus fleet parking includes vehicles from the State of Oregon DHS office and the nearby County departments. Due to the ongoing limitations, a County downtown campus parking study is currently underway, which may alter the number of fleet spaces in the future. Data on the utilization of the other six County departments with fleets located in downtown Bend was unavailable. It is recommended Behavioral Health coordinate with the Road and Facilities Departments to explore solutions for the downtown Bend locations’ fleet needs. This could include a location-based motor pool incorporating other departments nearby. 2.2. OBSERVATIONS Methods utilized by highly productive clinicians that could be promoted to increase productivity for all clinicians. Top performing clinicians have effectively applied the following strategies to use their time to the fullest. All clinicians reported using aspects of these strategies, but not consistently and proactively. The strategies are ranked in order of prevalence: 1. Schedule dedicated time during the day to focus on documentation and establish clear boundaries around that time. This strategy recognizes the extensive documentation requirements for clinicians and highlights its importance. By allocating specific time within the workday for documentation, the potential for working outside of paid hours is reduced. Health Services – Behavioral Health Practices Improvement #22/23-9 September 2023 Page 21 2. Anticipate the documentation requirements of annual assessments and schedule accordingly. As one clinician stated, "Annuals are awful," emphasizing their significant time commitment compared to other services, approximately 15 times longer than typical documentation. By making scheduling adjustments to accommodate this commitment, the assessments can be less overwhelming. 3. Document encounters as soon as possible after completing them, even if they are only partially documented. By minimizing the time between the encounter and documentation, the need to recall session details or refer to notes is reduced, enhancing both quality and efficiency. The division's policy of completing documentation within one business day emphasizes the importance of acting promptly. 4. Stay concise with documentation. Adding unnecessary information from a clinical perspective by overwriting the details of the encounter provides little benefit to the client. 5. As previously recommended, utilize smart phrases to reduce the writing burden. Most clinicians employ smart phrases in some form, with the top performers incorporating them regularly and effectively to enhance the conciseness of their documentation. 6. Utilize smart phrases for non-billable events. Since there are no regulations pertaining to non-billable documentation, frequently recurring events can contain nearly identical content. Health Services – Behavioral Health Practices Improvement #22/23-9 September 2023 Page 22 3. MANAGEMENT RESPONSE Health Services Department, Janice Garceau, Health Services Director And Holly Harris, Behavioral Health Director September 6, 2023 To: Aaron Kay, Performance Auditor; Elizabeth Pape, Deschutes County Auditor From: Holly Harris, Behavioral Health Director; Janice Garceau, Health Services Director Re: MANAGEMENT’S RESPONSE to 2023 Behavioral Health Practices Improvement Audit Enclosed you will find our response to the internal audit conducted by the County Internal Auditor’s team during summer 2023. Overall, we are in full agreement with and support of the findings of this report. The Auditor assigned to this project conducted a process that felt thoughtful, thorough, data- based and collaborative. His treatment of staff throughout the process was respectful and we believe contributed to sound results that go deep into many of the phenomenon we have observed and struggled to address over the years. The findings validate clinician experience, illuminate some of the core challenges of documenting clinician productivity and provide a framework and recommendations to begin problem-solving. A couple of realities have bearing on DCHS’ ability to fully address all of the recommendations. Services are captured through processes driven by Center for Medicaid Services (CMS) and Coordinated Care Organization (CCO) practices related to antiquated and burdensome Medicaid billing and documentation requirements. A great deal of work that clinicians must perform is not billable and as a result not easily captured. The audit time study demonstrated how that manifests, finding that Health Services – Behavioral Health Practices Improvement #22/23-9 September 2023 Page 23 Health Services Department continued clinicians spend 75% of their time doing work on behalf of clients, but can capture far less than that in the productivity tool. This has morale and fiscal consequences. In addition, the complex structure of CMHP funding mechanisms in Oregon – CMS to CCOs to CMHPs with a dash of direct OHA contracts, Federal Grants and commercial insurance – results in a morass of fidelity requirements, conflicting compliance guidance and practice hoops to jump through that often slow and impede the work. Primary to this report is the phenomenon of fidelity, grant and contract requirements that set caseloads/workloads for some teams against a backdrop in which the CMHP must serve all eligible members within 7 days. We share these realities in order to set realistic expectations around our ability to directly impact some of the system drivers of impacts on clinician productivity. In fact, the time study’s revelation of how much time our staff manages to find ways to serve within this context was ultimately reassuring. They are our heroes and we hope this audit’s ultimate result will be to help us better align our processes to meaningfully incentivize what they do every day on behalf of the community. Recommendation: It is recommended Behavioral Health go through the process to develop appropriate productivity measures as well as clarify expectations for staff. a) Management position concerning recommendation: Concur b) Comments: It was clear to us before the audit that time spent on behalf of clients was not being captured in EPIC. The time study confirmed this for us with data. It is also clear that we need to rethink how clinician’s work is measured and evaluated while continuing to find a way to hold staff accountable to agency expectations regarding caseload management and documentation standards. Our plan to move forward on this recommendation is to formulate a workgroup comprised of representation from staff, leadership, and administrative services to create a new process and target based on clinical outcomes. We plan to immediately stop evaluating staff on the current productivity targets. c) Estimated date completed January 2025. Health Services – Behavioral Health Practices Improvement #22/23-9 September 2023 Page 24 Health Services Department continued d) Our current targets are intended to help the organization remain fiscally viable by leveraging reimbursement and especially enhanced reimbursement such as PPS payment through CCBHC. Moving away from a traditional productivity target poses the risk of financial losses. However, until we land on a tool that adequately and accurately reflects the work of staff, that risk must be balanced against integrity of the data and staff morale. Recommendation: It is recommended Behavioral Health review the accuracy of the data contributing to clinician workload measures. a) Management position concerning recommendation: Concur b) Comments: Similar to the comments above, it is clear that time spent providing care for clients is not accurately reflected in EPIC. In addition, time spent documenting services that is done outside of work hours is misrepresenting the outputs provided by the service hour tool since that is based on payroll. The DHCS Data Analytics Team will conduct a review of this and provide an analysis of the impact. The administrative burden associated with documentation is likely contributing to this phenomenon. We are currently working internally to find efficiencies in the system and will be working to implement smart tools within EPIC to assist clinicians in documenting more easily. In addition, DCHS is actively engaged at the State level in a collaborative project with the OHA to Tackle Administrative Burden (TAB). The TAB workgroup developed recommendations provided to Legislators and OHA in January 2023 and is now working actively with OHA staff to carry out focused efforts to reduce administrative micro-regulation that gets in the way of care. c) Estimated date completed January 2025. d) Estimated cost to implement recommendations are unknown but could include enhancements to EPIC to allow more flexibility to make need changes as well as Data Analytics time to complete the analysis of the current system. Health Services – Behavioral Health Practices Improvement #22/23-9 September 2023 Page 25 Health Services Department continued Recommendation: It is recommended Behavioral Health strengthen the controls for first treatment appointment assignment and client discharge. a) Management position concerning recommendation: Concur b) Comments: The audit clearly revealed that FTA’s are not consistently utilized across the Department which is also contributing to imbalanced caseloads. Leadership will evaluate the current process and work with Supervisors to ensure FTA’s are being utilized for their intended purpose. We will also be analyzing what is available to us in EPIC to limit access to those slots. c) Estimated date of completed July 2024. d) Estimated cost to implement recommendation is unknown at this time but a there could be a cost associated with any adjustments to EPIC. Recommendation: It is recommended Behavioral Health use the caseload measures to promote a more equitable distribution of work within teams. a) Management position concerning recommendation: Concur b) Comments: The data revealed in the audit related to this recommendation validated what staff reported in their interviews. Inconsistencies in caseloads amongst teams can lead to burnout and team morale issues. Correcting the FTA issues will likely impact this recommendation, but we will also work with supervisors to develop a strategy for ensuring a balanced distribution of cases and require that team member caseloads be balanced. Managers and Supervisors will work to create that strategy and process for continued monitoring. c) Estimated date of completed July 2024. d) No estimated cost is anticipated. Health Services – Behavioral Health Practices Improvement #22/23-9 September 2023 Page 26 Health Services Department continued Recommendation: It is recommended Behavioral Health re-evaluate the division’s flexibility to actively respond to the broader needs of the community. a) Management position concerning recommendation: Concur b) Comments: We do not agree that we can reduce specialization to the degree recommended in the report, as DCHS is mandated by rules and contract to provide specialty behavioral health care to certain sub-populations of clients. For example, those with Serious and Persistent Mental Illness (SPMI) and forensic involvement, or children with serious emotional disturbance. However,, we agree that we can and should improve our ability to enhance the competencies of clinicians who have a desire to do so or who work in a setting that requires them to serve a broader span of individuals, i.e. our outpatient hub locations and Crisis teams. We also agree that by doing this, we could more efficiently utilize the resources available to us when a need arises that was unexpected. DCHS uses a training through consultation model that could easily be utilized to focus on specialty populations (i.e. young children, older adults, psychosis, etc.) to expand the skills of clinicians not comfortable working with some individuals. In addition, we can utilize the specialists we do have to provide consultation to others who may be taking cases that are outside of their comfort zone. c) Estimated date completed July 2024 and ongoing. d) Estimated cost to implement recommendation is minimal but could include loss of revenue while staff attend training. Recommendation: It is recommended Behavioral Health create a comprehensive library of division-approved smart tools to improve clinical documentation efficiency and provide training to clinicians on how to use them. a) Management position concerning recommendation: Concur b) Comments: This recommendation is extremely helpful and we completely agree. We will immediately begin work on creating a library of smart tools based on what clinicians are Health Services – Behavioral Health Practices Improvement #22/23-9 September 2023 Page 27 Health Services Department continued currently using that is working well. We are also exploring many other smart tools within EPIC that could help increase the efficiency of documentation. c) Estimated date completed January 2025. d) Estimated cost to implement recommendation is unknown but there could be a cost to make enhancement to EPIC to make this work possible. Recommendation: It is recommended Behavioral Health evaluate the onboarding content, procedures, and supervision to better integrate new employees. a) Management position concerning recommendation: Concur b) Comments: We acknowledge that the amount of information to onboard a new employee is extensive and that we could improve our process to check in earlier with new staff on their progress implementing and understanding all that they have learned in the first two months. We have developed a revised two month check in to improve onboarding of new employees early in their process. The two-month Job Duties & Expectations document and process is now complete and embedded in New Supervisor Training scheduled for all leadership in October and December. c) Estimated date completed January 2024. d) No Estimated cost to implement recommendation. Recommendation: It is recommended Behavioral Health clarify the policy for supervision of interns. a) Management position concerning recommendation: Concur b) Comments: This work is already underway. Stipends for staff who supervise interns will be available in the next few months. In addition, the current policy regarding supervision will be Health Services – Behavioral Health Practices Improvement #22/23-9 September 2023 Page 28 Health Services Department continued amended to include a section regarding supervision of interns. c) Estimated date completed January 2024. d) Estimated cost to implement recommendation is significant, but is currently being paid for out of workforce incentive funds through OHA. It is estimated to be approximately $50,000-70,000 per year, a fraction of the total behavioral health budget. We include these efforts as part of a multi-pronged strategy to improve recruitment and retention of staff. Recommendation: It is recommended Behavioral Health coordinate with the Road and Facilities Departments to explore solutions for the downtown Bend locations’ fleet needs. a) Management position concerning recommendation: Concur b) Comments: We have known of this issue for some time and have elevated the parking issues downtown for years. We appreciate the creative problem solving of this recommendation and fully support its implementation. Health Services will immediately begin coordinating with Road and Facilities on this matter. c) Estimated date completed July 1, 2024 but is really outside of Health Services control and more likely up to Road and Facilities to move this forward. d) Estimated cost to implement recommendation is likely significant but unknown. I would defer to Road and Facilities for this information. Health Services – Behavioral Health Practices Improvement #22/23-9 September 2023 Page 29 Appendix A: Objective, Scope, and Methodology The County Internal Auditor was created by the Deschutes County Code as an independent office conducting performance audits to provide information and recommendations for improvement. “Audit objectives” define the goals of the audit. i. OBJECTIVES and SCOPE Objectives included: 1. Identify causes and potential reasons for performance below established divisional levels with some clinicians. a. Develop criteria: Assess for clinicians (with good documentation) the skills and approaches supporting reasonable service hours. Productive clinicians should be meeting the > 50% service hour target as currently measured. b. Assess the how and why clinicians are falling short of the service hour target. To a lesser extent, why they may or may not have adequate documentation. Understand the role of supervisors and supporting systems and workflow in supporting these clinicians. 2. Be aware of any issues with compliance with federal and state regulations and requirements, as may be applicable. Scope and timing The overall assessment work commenced in March and ran through August 2023. The assessment included clinicians classified as Behavioral Health Specialist I, Specialist II, Leads, and Supervisors providing outpatient services. Audit work was limited in the following areas: • Division derived measures that were applicable to the audit objective; • Clinician selection was developed in discussions with the division after analysis of metrics and work performance; • Sample size for both the criteria group and the group with lessor service hours; and • Time studies comprised one week of data collection from all working clinicians and supervisors. Health Services – Behavioral Health Practices Improvement #22/23-9 September 2023 Page 30 ii. METHODOLOGY “Audit procedures are created to address the audit objectives.” Audit procedures included: • Interviews of selected divisional management and staff; • Developing an understanding client workflow; • Developing an understanding and analyzing current metric tools and service hours across Health Services; • Developing and collecting a tool to capture clinician work tasks and hours for a one-week period. Analyzing the resulting data including comparison to current metric tools; • Selecting clinicians to be used for best practices as the top performers. Identifying supervisors for these clinicians; • Selecting clinicians having difficulty meeting the expected metrics to understand obstacles. Identifying supervisors for these clinicians; • Developing an understanding of how clients are managed with the systems and anticipated workflow; • Developing an understanding through interviews on how clinicians perform and document work; • Developing an understanding through interviews on how supervisors oversee and manage work; • Assembling and developing themes for potential improvement areas; and • Interviews and observation of employees, assistance from IT staff in Health Services, and other procedures as deemed necessary. We conducted this performance audit in accordance with generally accepted government auditing standards. Those standards require that we plan and perform the audit to obtain sufficient, appropriate evidence to provide a reasonable basis for our findings and conclusions based on our audit objectives. We believe that the evidence obtained provides a reasonable basis for our findings and conclusions based on our audit objectives. (2018 Revision of Government Auditing Standards, issued by the Comptroller General of the United States.) Health Services – Behavioral Health Practices Improvement #22/23-9 September 2023 Page 31 {End of Report} Please take a survey on this report by clicking on the attached link: https://www.surveymonkey.com/r/2223-9 If you would like to receive future reports and information from Internal Audit or know someone else who might like to receive our updates, sign up at http://bit.ly/DCInternalAudit.