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Home My WebLink AboutHealth Impact Assessment Presentation.pdfHealthImpactAssessment August2012 Definition Asystematicprocessthatusesanarrayof datasources andanalytic methodsandthat considersinputfromstakeholders to determinethepotentialeffectsofaproposed policy, plan, program, orprojectonthehealth ofapopulationandthedistributionofthose effectswithinthepopulation." --Source: NationalResearchCouncil HealthImpactAssessment (HIA) ItshouldbenotedthatonlyJoinderscantotallyprivatize andmanyJoinderswerestartedaftertheActof1966. TheearlyyearsofMH/MRarenothinglikethecurrent MH/ID/EIenvironment. Only3countiesswitchedfromapublicmodeltoa privatemodeloftheirMH/ID/EIadministration; Lycoming/ClintonJoinder, MercerCounty (leavingMH/ID Administratorwiththecounty) andBerksCounty. WewereunabletofindanyHealthImpactAssessment foranyofthecountieswhoswitchedfromapublicmodel toaprivatemodel. Interviews Lycoming/Clintonjoinderbecameverysuccessful, wereabletobemoreflexiblein adjustingtostateinitiatives, buildanexcellentfinancialbaseandexpandinto otherventuresastheirboardapproved MercerCountymergedMH/IDwiththeirpreviouslyprivateD/ASCAwithgreat success. Theyweremuchbettersituatedtotakeonbehavioralhealthmanaged care, dualdiagnosistreatmentandsomeothernewventures. Theyhavebeen abletoprovidebonusprograms tostaffforsuccessfulventures. Thisnevercould havehappenedundercountygovernment. Initialproviderfearsprovedtobe untrueandbyallindicationsitwasasuccess. BerksCountywasthemostrecentcountytomovetoaprivate model…andthey toofeeltheendresultwasasuccessafteradifficulttransition. Theyhavebeen seenasaleaderinMHprogrammingthroughtherecentdecade Similarfeedbackhasbeengivenbycountieswhohaveprivatizedcase- management…thetransitionisdifficultbuttheendresultismostlyimprovement Recommendation Developanindependentqualityassurance (quasi-HIA) projectthat will: Identifyperformanceindicators, including Customersatisfaction Providersatisfaction StakeholdersatisfactionCYS, JPO, Aging, forensicsystem - satisfaction) priortochangingthemodel Measureindicatorsatbaseline (priortotransition) and periodically atpre-establishedintervalsduringandafterthe transition ReportfindingstotheAdvisoryBoardandtheCommissionersof bothCounties Oneindependent variablewecannotcontrolistheleveloffunding andthisshouldbenotedfromthestartasitwillgreatlyimpactthe outcomes. PossiblePerformanceIndicators MentalHealth: 1. Clientsatisfaction 2. % ofdollarsspentonservicesversusadmin 3. # ofsentinelevents (complaints, critical incidents) 4. Totaldaysofhospitalizationper1,000people and readmissionratestoIPfacilitiesand residential treatmentfacilities (RTF). 5. Staffturnover 6. # daysbetweenfirstcontactandfirstdayof service PossiblePerformanceIndicators IntellectualDisabilities (FromQualityAssurancePlan): 1. Clientsatisfaction 2. % ofdollarsspentonservicesversusadmin 3. Peopleareabusefree 4. Peoplewhochoosetoworkareemployedinthe community 5. Peoplearesafeandrestraintfree 6. Peoplelivewheretheychoose 7. # daysbetweenfirstcontactandfirstdayofservice Possible Performance Measures EarlyIntervention: 1. Parentsatisfaction 2. % ofdollarsspentonservicesversusadmin 3. # ofintakes 4. # ofcontractedproviders 5. #/diversityofreferralsources 6. # ofclientswhodropoutofservice 7. # daysbetweenfirstcontactandfirstdayofservice