The Quality Department at BHARP works in collaboration with Community Care Behavioral Health as a part of a continuous quality improvement process to ensure that HealthChoices members in the BHARP region receive the highest quality services. The department is staffed by a Quality Director, two Quality Clinicians, a Special Projects Manager, a Consumer/Family Satisfaction Team (C/FST) Director, a Stakeholder Engagement Specialist (SES), and a Clinical Coordinator.
Various quality activities ensure compliance with all quality related HealthChoices Program Standards and Requirements (PS&R) and relevant state and federal regulations. Specifically, the team monitors complaints, grievances, provider quality reviews, member feedback, C/FST surveys, clinical cases, significant member incidents, clinical service and program development, and special projects designed to improve the HealthChoices program. An active BHARP Quality Committee comprised of BHARP member counties, C/FST vendors, Community Care and other stakeholders supports oversight and monitoring functions.
The following philosophy, mission and guiding principles were developed by the BHARP Quality Committee and set the standards for quality activities in the BHARP HealthChoices region:
The PHILOSOPHY of the BHARP Quality Committee and Department is to define, monitor, review and promote a high standard of quality in all services delivered using an individualized, integrative, impactful, and collaborative approach:
- Individualized – HealthChoices activities are member/individual, BHARP member county, provider, and stakeholder specific, focusing on cultural awareness, responsiveness, and holistic approaches.
- Integrative – Data is considered from multiple sources such as Consumer/Family Satisfaction Teams (C/FST), provider chart and site reviews, member satisfaction, and clinical information to create a comprehensive picture. Feedback is provided to stakeholders.
- Impactful – HealthChoices Members/ Individuals benefit from quality activities.
- Collaborative – Solutions are developed in a way which includes viewpoints from sources closest to the issue while maximizing provider and member strengths and BHARP committee and stakeholder input.
The MISSION of the BHARP Quality Committee and Department is to monitor the impact of quality measures of excellence throughout the contract and to ensure full satisfaction and self-determined wellness for each member/individual in services.
BHARP Quality Committee and Department Guiding Principles:
- Nothing About Us Without Us – Services are driven by members, individuals, and families, evaluated through C/FST processes, monitored by providers, local communities, counties and BHARP and developed collaboratively with Community Care Behavioral Health. The value of C/FSTs, peer-driven services, Certified Peer Support Services and Certified Recovery Specialists’ first-hand expertise is recognized and influences all system design.
- Coordinated Care – Evidence of team meetings to include all stakeholders with a focus on unified, holistic planning. Examples include Integrated Care Plans with physical health insurance programs, aftercare planning, and consideration for Social Determinants of Health effects on member outcomes.
- Quality-Quantity Balance – Funding including pay for performance and value-based purchasing which promotes outcomes focused care.
- Clinical Model Driven – Application of evidence-based practices and promising practices are evident in member care.
- Trauma-Informed – Evidence of trauma principles are woven into the service delivery and practice.
- Staff/Career Development Opportunities – Career pathway/recruitment and retention activities to support a stable workforce with opportunities for growth are embedded in the service delivery system. Provider satisfaction is integrated into quality activities. Staff are compensated commensurate with professional and/or lived experience.
- Engagement – Technology/connectivity/engagement/retention in treatment is prioritized.
- Contextually Focused – Natural supports and family systems theory are integrated into services, partnership development, and self-determined wellness, maximizing strengths of the member and provider.
- Responsive – Admissions are processed and evaluations are completed timely and treatment is guided by the member.