Outcomes Identification & System Performance

Introduction

The State of Alaska DHSS behavioral health service delivery system has historically struggled with limitations in its ability to conduct ongoing monitoring of the system’s impact on improving the behavioral health of Alaskan residents. In recent years various state initiatives have been undertaken that provide opportunities in addressing this need. These developments include the state initiative to integrate the previously separate Division of Mental Health and Developmental Disabilities and the Division of Alcohol and Drug Abuse into the current Division of Behavioral Health (DBH), and the new behavioral health management information system (AKAIMS Project) that will provide the capacity to measure service delivery and outcomes for the continuum of the behavioral health service delivery system.

In addition, with the new Division of Behavioral Health integrating mental health and substance abuse services to address co-occurring disorders, formation of a new section of Policy and Planning within DBH, and actively implementing the new AKAIMS MIS system, the infrastructure and resources exist to develop this evaluation capacity.

Proposal

The Alaska Mental Health Trust Authority, DBH and other stakeholders proposes the implementation of The Outcomes Identification and System Performance Project. (OISPP).

The OISPP project will include two components: 1) an outcomes measurement and management capacity that will provide accountability and consistency in the evaluation and effectiveness of behavioral health services, and 2) a research capacity to address broader population-based indicators of behavioral health wellness.

The goal of the OISPP project is to develop a continuous quality improvement process to guide policy development and decision making in improving the behavioral health (BH) of Alaskans. The method for implementation will begin with seeking the expertise of an outside contractor for successful implementation of the OISPP. The following is a list of initial goals and objectives:

1. Outcomes measurement and management

1. Develop a data matrix and communication plan to identify the information needs of various stakeholders (ex. Federal Level: funding sources; State Level: DBH, AMHT, legislators, planning boards etc).
2. Definition of appropriate scope of measurement appropriate for program evaluation and quality service delivery.
3. Develop a set of outcome measures for

a. Behavioral health service delivery.
b. For population status with reporting elements related to broader social, public health variables that intersect with behavioral health.
c. These measurements would dovetail with the statewide and national efforts such as the State Healthy Alaskans 2010 or the federal Healthy Communities 2010; and The DHSS/Trust Comprehensive, Integrated Mental Health Plan and the combined ABADA/AMHB Strategic Plan;

4. Develop outcome measures and data collection that balance the need for comprehensiveness with brevity and efficiency.

2. Research capacity

1. Develop a framework designed to provide a foundation for the utilization of information with the goal that outcome information can:

a. provide opportunities for learning and self-correction in decisions regarding service planning;
b. increase service utilization (particularly for hard-to-reach clients);
c. improve service planning and delivery.

2. The research protocol development should encompass the following:

a. Incorporates strict methodological standards:

i. valid sampling methods
ii. valid and reliable measurement tools
iii. standardization of assessment methods
iv. matches methodologies to theory

b. Assesses the practical feasibility of the research
c. Utilizes valuable resources of AKAIMS for data collection across the state
d. Increase multicultural understanding of behavioral health care needs and provisions;
e. Promotes evaluation of current and future programs:

i. external evaluation by independent contractors to review DBH research
ii. evaluation of program implementation and effectiveness for new programs
iii. future cost benefit analyses for existing programs
iv. evaluation of the impact of policy changes (i.e., new Alcohol Tax)