Behavioral Health

Enterprise Information System (EIS) - EIS Communicator - Febuary 14, 2005

EIS The Maine Documentation
Issue 23 - February 14, 2005

Remember for help: Techsupport DHHS – 287-8400 or
e-mail the Techsupport DHHS and copy Terry Sandusky

It has been a loooooong time since the last issue of the MR EIS Communicator. There have been many exciting updates and changes with more to come.

Moving Alerts Now Appearing
Most users are now aware that moving alerts are visible in the EIS header. These alerts let the user know of current or impending events involving the EIS. The feedback on these has been very positive. Using some of the feedback the color of the moving alerts was changed to make them more visible.

Search Issue
All clients need certain functional information in the system in order to run tracking reports and conduct other EIS functions. One piece of information that must be present is a “Legal Address.” The legal address is the client’s place of residence and contact. Without a legal address, the “Search Function” will not list the client as the result of a search. Every consumer must have a “Legal Address” not just a mailing address, MRMIS address, or temporary address. Updating reports will be coming to office that indicate which consumers need a legal address entered.

System Access from Home and Other Sites
There is little good news on this front. The move of the system inside the state firewall has virtually eliminated the use of dial-up Internet services to access the system. While there have been a substantial number of complaints, little can be done to assist. The flexibility of work locations and time are severely compromised and no longer is a promise that can be delivered.

Presently there seem to be only two almost sure options available:

  1. Invest in broadband (Cable or DSL) service at home at your own expense, or
  2. Have a department notebook computer and SecureID Card issued to you in place of your office desktop.

Any other option would be simply hit or miss. Should you encounter problems with access, always call the Techsupport Desk to register your problem. The reason for reporting is that some other system problem may be occurring that is creating your problem and Techsupport is unaware of the existence of this system problem. In the future, we may or may not publish minimum configurations that should work in the use of the EIS when you are out of the office. When and if they become available, they will be published immediately. If you are one of the unlucky folks for whom this change has affected, then option 1or 2 may well be what you will need to pursue. Remember always start with your supervisor if you need to request a change in equipment.

Ticklers Have Arrived!!!
This week many of us have been greeted with MR Crisis Contact Note ticklers in our EIS Inbox on our My Events Page. The tickler announces to us the entry of a crisis contact note as a result of a crisis contact. The tickler signifies a crisis team member entered a contact note into the system. Ticklers now allow the use of a leaner one-write notification and documentation process, in which the crisis worker can now write the note once and not worry about additional notifications because the tickler will notify everyone automatically.

Ticklers do not always indicate an immediate crisis but do indicate crisis team members have had contact with a consumer or someone involved with the consumer. Because the EIS cannot discriminate between consumers in immediate crisis from routine crisis work notes, each tickler must opened to the contact note to determine nature of the crisis team contact.

Beginning in January, a campaign began that focuses on timeliness of notes. The tickler arrival now increases the need for crisis notes to be entered promptly. There are still crisis notes coming into the system for November, December and January and the tickler again is unable to discriminate between current crisis and old contact information.

As the clearing up old notes is completed, the system will be reach a status where current events are being immediately entered. By reach this status of current action, case management and regional management staff will be helped in their daily decision-making. Thus, crisis is the critical word and suggesting immediate action and intervention. The tickler greatly enhances everyone’s work by giving that immediate notification to others and reducing the number actions a crisis worker now takes in sending notifications.

Tickler feedback is positive even for the one or two minor problems that occurred but were quickly corrected. Two testimonials that we received were:

  • I came in this morning and have 37 crisis messages from around the state that I can look at. This is very exciting and will give me more information in a timely manner and most of all I hope, make peoples jobs easier. Thanks to all who have made this happen. B”
  • I, too, have crisis messages available on my "tickler.'' I am so pleased. R”

Please keep in mind the ticklers follow this order notification: the assigned Individual Support Coordinator or Community Case Manager, the Regional Supervisor, the MR Crisis Team Supervisor, Bill Hughes, Assistant Program Manager and Jeff Lee, MR Public Guardianship Manager.

Please click on this link to Crisis Contact Tickler Instructions to download a copy of the instructions:
http://www.maine.gov/dhhs/bh/EISinstructions/MR/instructions/index.htm

Case Management Service Encounter Billing a Success
The January Case Management Billing was the first successful billing of all regional offices through the EIS. We hit a 69 percent level of billing. Through the concept of “do one-time and one-time only’, ISC’s are able to write the billable encounter note and by checking two boxes complete the information needed for billing. There were only a few problems. The largest problem was late or non-entered notes by ISC’s. There are a few that had technical problems. Finally there was a group that simply waited till end of January or early February to write all their notes for the month. The performance goal for case management billing is to climb into the 90 percent range of billing for those who are MaineCare recipients. This first billing was a success because we have proved that it can be done with the system. All of the time ISC’s used to prepare manual, hand written billing can now be diverted into other consumer activities and EIS documentation on behalf of their consumers.

Coming Attractions: Person Centered Plans
A disc with 427 plans is being examined for uploading into the EIS. Gould Health Systems (GHS) has completed the keying of these plans and a test load is underway. It is possible these plans will be available for use in the system by February 24th or earlier. Everyone is eager to see the fruits of this long laborious process. Once these plans become active, staff will begin entering MR Plan Notes for work and activities related to plans. With these two items activated, the system will draw nearer to a complete record system that contains not only case management, crisis activities, reportable events and funding authorizations, but will have the action plan that supports all the decisions regarding services. Be looking for more information and refreshers as these elements come online.

Funding Authorization (Service Packages)
Again we are engaged a challenging set work functions to add the approval and prior authorization of consumer services to the EIS. EIS programming staff and our Regional Resource Coordinators along with Earl Babcock are engaged in solving the riddle on how to make prior authorization work. Right now the new MaineCare funding program expects to receive from EIS the service code, the approved rate, the number of approved service units and the identity of service provider. This must be done before the provider will receive payment for claims submitted for services provided. A larger barrier in this process occurred due to the inability to match providers to MaineCare (MECMS) provider ID numbers. This is why providers are having claims rejected at this time. Considerable activity is underway to see that providers receive some payment. Also everyone is focused on resolving the organization connection problem. Should anyone receive complaints or questions from providers please direct them to your team leaders and resource coordinators for the latest information. They should contact their DHHS Provider Relations Specialist for current information related to MECMS.

NEW EIS Release Update
A new update release of the EIS is now in testing and should be released soon. You can expect several corrections as well as new features. Here are the major changes in the release.

  • The issue of receiving error messages when cancelled notes are displayed will be fixed.
  • As we prepare to make PCP action plans operational, the problem of planning notes not carrying forward to new versions of the plans has been fixed.
  • The ability to enter town names has been stopped so that only the drop down can be used. This eliminates the double entry and incorrect entry (misspelling, etc.) of towns in the system. Users will be able to request from Techsupport the addition of town names if needed.
  • System Timeout has been the single largest complaint of all users. Many efforts have and continue to be made to prevent inappropriate timeouts from happening. System Timeout has not been operating as advertised - System timeout value was successfully changed to 30 minutes in all the relevant hardware locations. To date, only one piece of hardware was identified to be causing problems and therefore caused users to time out too soon. Some users report being 'kicked off' the system prematurely. We believe this to be caused by issues other than the timeout value in the system.
  • MY EVENTS Staff Coverage - Cancel button will be fixed on the My Events screen.
  • Organization Location displayed incorrectly - The display will show only the actual service location and not its home (Main/Billing Office) location unless the service location is the same as the home location. This has been an ongoing struggle between business/accounting/contract staff that want to see the main billing office information and the case management/program staff that want the service location information. The EIS has a difficult time knowing which information to provide to who and when.
  • Log Off & Security - Users will be prevented from using the BACK button to get back into EIS screens after they have logged off. This closes a security loophole.
  • Several security / access issues will be resolved based on users reports. All of the following issues have been addressed.
    1. ISC relationship is there but end-user can't get access to the client - resolved.
    2. Security coordinators reported the number of clients accessible drops when the "SAVE" button is pressed in the user Access - applicable only to security coordinators.
    3. Start and end dates of relationships will control when users may access clients.
    4. Users will have access to clients if they 'created' the client and no other associations or relationships have been created.
  • Users frequently complain that reports do not print well or that it is hard to read them on the screen. This primarily due to the HTML reporting format. Users will have Adobe PDF presented as the default report format to solve this problem. HTML is still available, but just not as the default.
  • Reports will be listed alphabetically on the Reports List Page.

Data Management and Cleaning
Since the beginning of 2005, an Internal Performance Memorandum has been issued weekly. It outlines the documentation of service performance by the various systems of MR Services – Case Management, Crisis Intervention and Reportable Events. There has been some challenge in conducting these measurements due to the timeliness, completeness and accuracy of the information in the EIS. Beginning this week, regional supervisors will receive a series of reports to help guide them in overseeing the data cleaning that is necessary to improve the quality of the data in the EIS . The first reports will focus on the following data issues:

1. Update MR Service and Supports Assessments V.5 – This has been the tool used to request funding and support from executive branch leadership and the legislature. It is critical that information be correct in the assessment in order to properly request the funding support needed. Over 1/3 of the V.5’s have not changed since their creation on June 1, 2004. This is worrisome as we attempt to answer many different questions. One of the latest questions was “How many consumers are waiting to receive case management?” Through the Rancourt reports, the correct answer is 9, but when the V.5’s were queried the answer was 122. When examined, over 100 of these listed consumers had an assigned state ISC or had moved to inactive status and no longer needed a state ISC. The conclusion was the V.5’s were not properly updated and information was untrustworthy. Thus, a real push to get the V.5’s updated now with ongoing updating is what will be happening over the next two months. The data in this assessment is too important to the people we serve to be left in a state of inaccuracy.

2. Legal and Mailing addresses continue to present problems. A list of those consumer records that need correction will be sent in the near future.

3. Guardian addresses need to be entered. There are many guardians for whom addresses have not been entered. The last effort to do a mailing to guardians was derailed by the lack of addresses.

4. Enrollment Information needs to be entered on a number of individuals. Again a report will be sent to each office listing all consumers who do not having a formal enrollment listing in the EIS.

Data quality is important as MR Services becomes more reliant on the EIS for answers to many questions. In the short run, users may see these requests for data correction and addition as a challenge to time and energy. However, many users have seen the number of “hurry-up get a count from ISC’s on ____” questions significantly decline this year because the system is producing the answers to those questions. This is freeing regional staff from those terribly disruptive “question and answer” challenges with only minutes to find the answer that everyone has experienced in years past. There is lots of excellent information in the system but there are critical points of information that we must tackle to bring full confidence to the reported data.

New Users Logging On

Community Case Management System
The pilot of the Aroostook County Community Case Managers has been a success. They have had the same problems as state staff in learning the EIS, but they have not experienced any technical failures or errors in the use of the program. With this success, the rest of the community case management system will be coming online by May 2005. In March, Regions 2 and 3 will train and log on to the system. In April, Region 1 will follow. This is an exciting endeavor and will ultimately bring the state and community systems closer together as shared expectations for service are met through the sharing of the same electronic case record and data system.

Office of Advocacy
We are now in the final stages of building a prototype set of assessments that will allow the Office of Advocacy to fully use the EIS. A presentation of the prototype will be made in March and following any adjustment that may be needed, the advocates should be online in April. They have continued to rely on the MRMIS and we wonder who has kept that up to date since it was shut off in most offices in September 2002. Their need for up to date information is critical and their entry into the EIS should solve that problem.

BEAS Complaint System
After a series of meetings and presentations, a decision was made to develop for BEAS a complaint system (reportable events in our lingo) using the EIS. Terry Sandusky and Rae Ann Brann delivered preliminary prototype and the review of that work was quite favorable. Over the spring, a full design and implementation of the project will hopefully be completed. BEAS staff has brought excellent ideas to the table and as a result some very positive tweaking of our reportable events system will be conducted. This is a good move as MR adult protective services and the legacy DHS adult protective service merges and remaining adult MR Services and BEAS programs move closer together. Look for more news on this development in the future.

PCP Facilitators
Training of PCP Facilitators will begin in July as they prepare to begin logging on to the system to enter the PCP information. Right now this information is being prepared for the system by Gould Health Systems but this is a temporary arrangement. PCP facilitators will be learn to enter the attendance information, the Essential Response Tool, the action plan, routine services and MR Plan Notes. This training process may last through September in order to reach the goal of having upwards of 70 to 80 facilitators statewide using the system by October 1st.

All of this system expansion is exciting not because of the system is growing in size but exciting because of the common sharing of information. Both department staff and community providers will look at the same consumer plans, and document plan implementation on the same electronic record as department staff. When worked right, the synergy of this effort should improve services for consumers while smoothing information sharing and understanding between state and community providers.

Thank you to everyone who took time to call or write with comments and suggestions. The system continues improve because of your interest. As said in the old days, always keep those cards and letters coming, however today e-mail is just fine.