Maternal Infant Health Program (MIHP)

September 2015 Coordinator TrainingsMIHP Program Updates

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ICD-10 Billing Codes are coming!• ICD-10 billing codes will be effective on 10/1/15. 

• Claims submitted with ICD-9 codes for dates of service on and after October 1, 2015 will be rejected.

• A virtual billing training is available on the CHAMPS website and scheduled for September 17, 2015. http://www.michigan.gov/mdch/0,1607,7-132-2945_42542_42543_42546_42552_42696-256928--,00.html

• We encourage you to test your system via the CHAMPS website to ensure that you are ready for this significant billing change.

• Additional training may be requested from CHAMPS provider support.

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8.5 Service Acceptability, General Information for Providers (Medicaid Provider Manual)

Consultants are monitoring:

• Agencies that don't transfer complete records within 10 working days. Necessary to provide appropriate, quality care to beneficiaries.

• Agencies  that make additional visits after a transfer request has been received.

• Such practices are out of compliance with Medicaid policy on Service Acceptability and not acceptable.

• Failure to comply with certain provisions in this policy may result in disenrollment from Medicaid.

• Effective Cycle 6

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Program updates

RN and SW Licensure

• Agencies should begin to collect verification of licensure, a copy of the license as well as the staff member’s resume which are required to be kept in the personnel file. 

• Verification alone is not sufficient.

• Requirement for Cycle 6 certification.

• Credentials include “Licensure” status

MIHP requires a Double-Locking System When MIHP Staff Take Records

into Their Homes

Records must be stored “two locks away from anyone who is not authorized to see the beneficiary’s PHI, in order to prevent inadvertent exposure.”

If no one else has access to the house, records can be stored in a locked office in the locked house.

MIHP requires a Double-Locking System When MIHP Staff Take Records

into Their Homes

If other people (including family and friends) have access to the house, records can be stored in a locked cabinet in a locked office or in a locked briefcase in a locked cabinet.

As providers you are to abide by the Health Insurance Portability & Accountability Act (HIPAA) at all times.

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Updates, Updates, & more Updates!

• Coordinator emails will be sent on the 3rd Tuesday of every month.  Alerts may be more frequent  and will typically  be associated with IT

• Specialty designation on the personnel roster should be utilized for special populations you may serve

• New MIHP overview module (formerly Billing and overview training)

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Risk Identifier & POC

• Importance of staff seeing the entire RI printout, not just the score sheet, so they can see the beneficiary’s whole story.

• Birth health-now scoring on the infant risk identifier is a One-time snapshot of babe’s status at birth based on gestational age, weight, etc.-No POC is needed.

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Ages & Stages Developmental Tool

• HV Team at the state level will purchase ASQ:SE 2 for MIHP providers

• Also Included in the purchase-User Guides for the ASQ-3

• ASQ:SE 2 must be in use by Cycle 6 but we recommend you begin using the new tool as soon as it is available

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Healthy Babies are Worth the Wait®

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PREVENTING EARLY ELECTIVE DELIVERY

• One of the key strategies and goals in the Michigan Infant Mortality Reduction Plan

• One of the home visiting priorities to eliminate medically unnecessary deliveries before

39 weeks gestation

• Educational course available-Prevention of Early Elective Delivery

• MIHP care coordination staff that are providing services to Michigan Medicaid mothers and infants

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PREVENTING EARLY ELECTIVE DELIVERY

• Target audiences are nurses, social workers, infant mental health specialists, and registered dietitians.

• A total of 1.00 Nursing contact hour is awarded for this activity by the Michigan Public Health Institute (MPHI)* Continuing Education Provider Unit (CEPU).  Health professionals can print the Certificate of Completion which will indicate the number of educational hours.

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PREVENTING EARLY ELECTIVE DELIVERY

• The course (#E0200) can be found at: https://courses.mihealth.org/PUBLIC/cm710/home.html?orgid=Public

 

• You may also visit the MIHP website, Provider Training, Additional MIHP Provider Trainings, 39 Week Early Delivery Module, found at the following link:  http://www.michigan.gov/mihp/0,5421,7-311-66378_66386_66388---,00.html

 

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Future Projects

• IT testing across the state

• General MIHP questions-MIHP mailbox; mihp@michigan.gov

• Revision of the personnel rosters

• Discharge Summary Review

MIHP QUALITY IMPROVEMENT

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Quality Improvement

In the MIHP Certification Tool, #66a.5) requires that the agency’s Internal Quality Assurance Protocol:

• Describes how staff works with the beneficiary to identify her needs at program entry and periodically asks beneficiary if services being provided are meeting her needs

 

CLIENT SATISFACTION

• MIHP has developed a guidance document expanding on why an Internal quality process for client satisfaction is important

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MIHP Quality Improvement Client Satisfaction continued

Asking about Satisfaction with Home Visiting Services is Important

An excerpt from the MIHP Operations Guide

The biggest hurdle to success in in-home visit programs is parents' reluctance to participate, and continue participating. It is very hard to keep families in programs. The drop-out rate for most programs is 50 to 60 percent. Deborah Daro, Chapin Hall at the University of Chicago

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MIHP Quality Improvement Client Satisfaction continued

Studies indicate that what keeps a parent participating in a home visiting program depends on:

A particular combination of participant characteristics Home visitor characteristics Program and agency characteristics Community characteristics

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MIHP Quality Improvement Client Satisfaction continued

Signs of disengagement:A string of no-show appointments often indicates that a parent has disengaged and is dropping out. Collecting data can tell the story!

Parents are savvy….Ongoing cost-benefit analysis at every visit

Is this really worth it to me?Do I feel encouraged?Tangible benefitsMeaningful Assistance

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It Matters . . .

This happens through improving:

Support for patient engagement

Cultural competence, including assessing health literacy of patients, patient-centered communication, and linguistically appropriate care

Care provision that is evidence-based

Coordination of care with other parts of the larger health care system

We need to meet the clients' needs and expectations!

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As our understanding and practice of quality matures, so will the MIHP program fidelity.

This fidelity is vital to the survival of the MIHP program by providing accountability to stakeholders.

Improved quality improves the health and well-being of Medicaid eligible pregnant women and infants.

Infamous words from our Quality Improvement Coordinator

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MIHP continues to make a difference!

The most recent MIHP research has been published and indicates that infants participating in the population based MIHP have reduced probabilities of death in the first year of life.

The article is in the August 1st edition of Pediatrics and can be accessed at:

http://pediatrics.aappublications.org/content/136/2/334.full.html

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MIHP continues to make a difference!

The article includes the most recent MIHP research showing with any MIHP participation, infants had: • reduced odds of death in the first year of life; • infant death odds reduced both among black

infants and infants of other races; • neonatal death and post neonatal death odds

reduced; and• further reduced infant mortality odds when

mothers were screened and enrolled in MIHP by the end of the second trimester and with at least 3 additional prenatal MIHP contacts.

Meghea CI, You Z, , Raffo JE, Leach RE, Roman LA. Statewide Medicaid Enhanced Prenatal Care Programs and Infant Mortality. Pediatrics Vol. 136 No. 2 August 1, 2015 pp. 334 -342 (doi: 10.1542/peds.2015-0479)

Certification

Update Cycle 5 MIHP Certification Data

November 1, 2014 – July 15, 2015

• Total Certification Reviews 76• Total Full Certification Status 55• Reviews with Zero “Not Mets” AWESOME 4

• Caring and Sharing Family Life Services• Ionia County Health Department• Sparrow MIHP• District Health Department #2

• Total Conditional Certification Status 16

• Total Discontinued Agencies 5

• Reviews in process-July and August 25

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Top 10 "Not Met" IndicatorsNovember 1, 2014 - July 15, 2015

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MIHP Certification DataNovember 1, 2014 – July 15, 2015

• Most Commonly Missed Non-Critical Indicator: #3 Signed Consents 48 Not Mets

• Most Commonly Missed Critical Indicator: #56 Discharge Summaries Accurate and

Complete 45 Not Mets

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Corrective Action Plans (CAP)

Please Remember to:

• Acknowledge receipt of the email

• Include all of the reviewer's comments - Word for Word Include the findings Include what is supposed to go in the CAPHave improved since the last training

• Submit CAP as one single document in Word format

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Corrective Action Plans (CAP)

• Be specific and clear in your plan Specify frequency of chart review for ongoing

compliance Include dates How you’re going to improve your process How you’re going to assure documentation is in

personnel or client charts

• Include how you will provide continuous monitoring of the “Not-Met” indicators (ongoing compliance)

• Make the plan specific to each indicator (do NOT cut and paste statements from one page to the next)

MIHP IT Updates

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Single-Sign On SystemVerifying Your Browser • Acceptable browsers for MIHP SSO use is IE 8 or

IE11, Firefox and Chrome.  You cannot use IE 9 or 10.  Occasionally, Internet Explorer (IE) will auto-update to another level (IE 8 increases to 9 or 10), and you may not know if you have not disabled the auto-update function. 

• You should always check the printed version of your risk identifier and discharge summary for accuracy. 

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IT continued

To check your browser on Internet Explorer:

• 1. Open Internet Explorer

• 2. Click on the “tools” button in the top far right corner of your screen

• 3. Go to “About Internet Explorer” to verify which version you are operating

• 4. Uncheck/Disable the box, (if need be) that asks “Install new versions automatically”

MIHP DATA UPDATES

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Data Requests

• Contact your consultant for any data requests• When requesting data you may be asked to complete

and submit a data request form depending on the complexity of the data request

• The completed data request form will be reviewed and approved or denied based on: date information is needed reason data is being requested MIHP staff availability to complete the request availability of the data requested

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Quarterly Report DataInformation in the quarterly reports that can assist with Quality and Utilization Management in YOUR agency:

Referrals

Screens completed

Discharges completed

Demographics

Education provided

Breastfeeding information

Risk screening domain scores

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MIHP Data Reports

• MIHP Quarterly Data Reports – First quarter data from 10/01/2014– 12/31/2014 is now available in your CHAMPS inbox.

• These reports have taken the place of the MIHP File Transfer data reports.

• Archived data reports from FY 2013 and FY 2014 will remain available on the MIHP File Transfer area. Going forward, your agency MIHP quarterly data reports will be available via CHAMPS.

• The second quarter fiscal year 2015 reports should be available in mid October.

Coordinator email #9

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MIHP Data Enhancements

Reactivations & Deletions• State staff can reactivate de-activated screens or

discharges

• State staff cannot delete incomplete screens or discharges- agencies must delete them.

• State staff can only delete completed screens or discharges

• For Infant risk identifiers created prior to 3/27/15, MIHP providers must search under the inquiry function- not the incomplete function to find a record.

• For Infant risk identifiers created after 3/27/15, the agency may delete an incomplete or complete record (not tied to a discharge) within 30 days of creation.

Please allow 72 hours for follow-up for any deletion or reactivation requests to the state.

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MIHP DATA ENHANCEMENTS

CURRENT PROJECTSAccess Database

FUTURE PROJECTS

Top Four Priorities:

1. Add Multiples Button to Infant Discharge Summary; certain areas on the discharge will grey out.

2. Add a box at the top of the discharge that says: “No Services Received.”

3. Add “Father” to drop down box on IRI

4. Add Breastfeeding Duration to IDS

MIHP RESOURCES

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Perinatal Mood Disorders (PMD) Coalition

• MI Statewide Perinatal Mood Disorders (PMD) Coalition new web site: 

• http://mipmdcoalition.org/

• MIHP PERINATAL MOOD DISORDERS: RESOURCES FOR CONSUMERS AND HEALTH CARE PROVIDERS has been updated with assistance from Nany Roberts, MI Statewide Perinatal Mood Disorders Coalition, and is posted on the web site.

• The Coalition's 10 regions correspond to the Governor's Prosperity Regions.

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Perinatal Mood Disorders (PMD) Coalition

• Click on "Get Help" for lists of support groups and PMD specialists by region.

• Join with others in your region to support women and families experiencing perinatal mood disorders, including depression, anxiety and others.

• Mini-grants available to start support groups, promote public awareness of PMD, etc. 

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Perinatal Mood Disorders (PMD) Coalition cont.

Perinatal Mood Disorders: What Every Care Provider Must Know

• Nancy Roberts, Spectrum Health, Grand RapidsContact: 616 391-2561

• Fri Sept 18 2015, 9 am to 12:30 pm

• No fee

• Free Nursing and SW Contact Hours

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MI Home Visiting Initiative Conference

Engage, Educate, & Empower

Michigan Home Visiting Conference, Aug 6-7, 2015, had excellent plenaries and workshops. PowerPoint presentations are available on the conference landing page- https://events.mphi.org/michigan-home-visiting-conference/

Recordings and webcasts will be added soon

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MI Home Visiting Initiative Conference

At the Collaborative Improvement and  Innovation Network (CoIIN) - Maternal Depression workshop at the HV

Conference

Oakland NFP said they trained all their staff on Motivational Interviewing and their data showed it helped create an open dialogue with clients who screened + for depression but had refused to seek treatment

Guess where they got their MI training?

The MIHP WEBSITE!

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MIECHV UPDATE• Discussion at the Home visiting conference.

• MIECHV funding for the HUBs (centralized access points) ends Oct 1, 2015. 

• Each HUB was asked to develop a sustainability plan so they could continue when the funding for the pilot projects ended.

• Some HUBs will be continuing and some will not.

• If there is a HUB in your area, contact the Hub coordinator to find out if the project will

continue.                          

 

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MIHP RESOURCES…

• Early On has developmental wheels in English, Spanish and Arabic and are FREE!

• HEALTHY MICHIGAN PLAN http://www.michigan.gov/documents/mdch/DCH-1317_Healthy_Michigan_Plan_Brochure_452129_7.pdf

• Text for Baby cards are still available through your consultant.

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Important Dates to Remember• New Forms and New Forms instructions

will be available on 11/1/2015; required date 2/1/2016

• Updated Operation’s guide will be available on 11/1/2015

• Cycle 6 certification begins May 1, 2016

• 2016 Coordinator’s Training-June

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MPHI

• CE’s

• Survey

• September 2016 training

• Other pertinent information

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Conclusion