Tuesday, January 17, 2012

Texas Upgrading Systems

The state of Texas hired Public Consulting Group (PCG) a privately held consulting firm, to conduct a comprehensive analysis of their public behavioral health system as required by Texas 2011 legislature. PGC will conduct a comprehensive study of the current behavioral health system and provide short and long term recommendations to upgrade the system. The main purpose is to provide future direction on behavioral health services in the state.

To accomplish the study, the Texas Health and Human Services Commission (HHSC) and the Department of State Health Services (DSHS) are currently holding six public stakeholder forums conducted by PCG that started in December 2011 and continuing through January. Stakeholders are providing feedback on topics such as access to services, service delivery models, current services available, general strengths and weaknesses of the system, and funding issues.

One of the key topics under discussion includes the integration and coordination of care in the state. The people in Texas people want to see better coordinated care between physical, mental health, and substance abuse issues. Issues under discussion include barriers to receiving coordinated care within the current service delivery system and what strategies are needed by the state to achieve high quality and efficient coordinated care.

In-depth discussions are focusing on the various service delivery models in the state. Texas is a large state where behavioral health services are provided through various service delivery models across the state through mental health authorities, substance abuse providers, and NorthSTAR. To make it more complicated, Medicaid benefits are managed both through a traditional Medicaid Fee for Service model and numerous Medicaid managed care programs.

The stakeholders ideas and thoughts will be reviewed and PCG will do an in-depth review of the financial structure of the current behavioral health system to understand the current and existing sources of funding to pay for the services. In addition, PCG will look at other states and how their behavioral health systems operate in order to identify potential options on how Texas can improve their system.

Information from the initial discussions at the forum will be analyzed thoroughly and a comprehensive report will be made to DSHS. At this point, PCG will work on the second phase of the analysis to provide recommendations on how to effectively improve access, service utilization, patient outcomes, and system efficiencies, and how to accomplish these goals with the funding available now and in the future.

According to the Texas HHSC newsletter, ‘InTouch”, the state is embarking on a modernization project to upgrade the state’s eligibility system to meet the needs of the future and to provide the software and hardware that the local offices will need to implement the system.

The first step is to obtain feedback on the project and then develop ideas for improvements based on best practices from other states and from within HHSC. The second step will be to undergo further scrutiny by the HHSC staff and the third step will be to try out the new processes and technology tools in a nonproduction environment. These steps are needed to make sure that the project’s vision actually plays out successfully in high volume use often incurred in eligibility offices.

To keep up with the needs of eligibility offices, the network infrastructure will be built around state-of-the-art hardware and software capable of running multiple virtual server processes simultaneously. This means that if one data-serving process goes down or needs to be serviced, the work can temporarily be shifted to others without affecting the ability to work.