1. Report to the Transition Sub-Committee June 2, 2006

2. Operations Update Hiring –100% of Key Positions –Developed new Clinical Support Position to support improved efficiency in the Clinical Dept. –94% Overall Peer Specialists Clinicians Clinical Support Staff 1 IT Analyst

3. Level of Care4/24 – 5/28 (Total auths/CCRs) Total To Date (Total auths/CCRs) RTC3811781 GH 23067 GH 148133 Inpatient Psych/Detox 13411976 Freestanding Detox/Rehab 107180 OBS1633 PRTF73139 IOP/PHP9461312 EDT113 Total3,0555,734 Authorization and Concurrent Review Update

4. Operations Update, con’d Riverview: effective 6/1/06 prior auth by ASO now required for all admissions (exception, court ordered admissions) EDT authorizations went “live” 6/1/2006 Home-Based Psychiatric Services: 7/2006 Inpatient Auth to Claims: projected 7/1/2006 IVR/Web technology 8/2006-9/2006 –Web technology likely in August 2006 –Interim plan (possibly winfax) as temporary alternative to IVR –IVR tentatively September 2006

5. Operations Update, con’d Pre-cert and Concurrent Call Volume: –2854 calls in May (increase of 30% from April) We continue to work to improve efficiency Under reported as clinicians have been giving out their direct extensions ICM Cases: –79 mid-long term cases, 72 short-term, high risk (some overlap) ED Interface –Alert sent to CHA 5/11/2006 Delay in Discharge (Inpatient, PRTF, Residential): –We continue to “Scrub” the census report –22%: Family requesting add’t care –21%: Awaiting PRTF –8%: Awaiting Group Home

6. EDM/FAgeDCFDiagnosisDays Stuck Identified Disposition needed Actual Disposition St. Francis M12YesPTSD Major Depression, recurrent 4PRTF Review due 6/1 Hartford Hospital F9YesPTSD Depressive Disorder 3InpatientIOL BackusM13NoBipolar, Manic 1InpatientBoarded at Backus, stabilized, d/c home St. Raphael’s F13YesODD4InpatientSt. Raphaels Day Kimball M14NoPsychotic Disorder Asperger’s 6PRTFLeft AMA w/ outpt. appointment St. Mary’sM7YesBipolar, ADHD 3PRTFBoys and Girls Village, Safe Home Stuck ED Volume, May 2006

7. Call Management/Customer Service

8. CT BHP Call Management May, 2006 *Please note: Enclosed data includes reporting period 5/1/2006 – 5/27/2006 Week Ending Tota l Calls Total % Aban don Day Staff Calls # Aband ons Day Staff % Aband on After Hours Calls # Aband ons After Hours % Aband on Memb er Calls Provid er Calls Crisis Calls After Hours Memb er After Hours Provid er MCO Calls 211 Perina tal Depres sion 5/6/2006 Partial Week11210.18%106620.19%5500.00%38365825253 10 5/13/200611010.18%105910.09%4212.38%44758428240 30 5/20/200612380.40%119550.42%4300.00%48368032043 20 5/27/200612100.25%113610.09%74 2 2.70%42369122173 1 0 Total Monthly46770.26%445690.20%21431.40%173626131075209 70

9. Types of Inquiries May, 2006 37% - Provider Referrals for Member 20% - Member Eligibility Verification 34% - Provider Related/Authorization/Enrollment/Billing 9% - General Information 46% = Member Inquiries (Increase from April - 38%of total calls) Note: 0.06% = Inquiries initiated due to provider status change from IN to OON 7 MCO calls, 211 Initiative not yet live, but discrete phone line operational

10. CT BHP CALL MANAGEMENT Incoming Calls Totals May 2006 Total 4677 Note: Increase of 17% since April Member Calls: 1741 Provider Calls: 2822 Crisis Calls: 112

11. The Network

12. Network Status –CMAP Network –Increase of 628 providers since 12/12/05 (increase of 33 providers since April report) MD and MD Groups: 40 LCSW: 260 LMFT: 104 LPC: 70 –Add/Change report: 20-30 adds per week, 10-20 changes –DCF Network -110 RTC and Group Home providers (increase of 24 providers since 11/2005)

13. Rapid Response Team Findings Cycle Date 042106 we have identified the following (2) issues: –90 Claims denied for Prior Authorization Number Invalid All 90 claims were prior to CTBHP authorizing services; –Outreach calls were provided to the high level denial providers Cycle date 051906 we have identified the following issues: –16 inpatient providers put data in auth line –7 IOP/PHP providers submitted claims without prior authorization Outreach calls were provided to the high level denial providers

14. Provider Handbook May 16 th –Draft resubmitted to the state, incorporating edits from May 2nd. May 25 th –State approved draft with one final edit Incorporate the 4/11/06 LOC Guidelines for Children and Adolescents Present – Formatting final version for website posting

15. Quality Management

16. Quality Initiatives Clinical Studies – one focused on adults and another focused on children – both proposals are with the State for review Reporting – coordination occurring with the State re. priority reports, time frames for production, analysis Quality Control of documentation for clinicians and provider relations staff, examples include: –Authorization letters –Daily Census Report

17. Quality Initiatives, con’d Satisfaction Surveys –Member, Member with Complex Needs and Provider Surveys –Data collection will begin in June and July and conclude in late summer, early Fall – completed via phone interviews –Report complete Fall of 2006

18. Complaints and Grievances January – May 2006 Complaints: 4 in May (25 year to date) –2 Providers (length of auth process) –2 Member (OON providers) Grievances: 0 in May (3 year to date) –2 related to OON status, 1 related to slow processing of credentialing packet and subsequent payment concerns All Complaints and Grievances were resolved within standard timeframes

19. Community Outreach

20. May, 2006 –Systems Managers 177 DCF, Provider, Collaborative and MSS meetings in May 462 Meetings year to date –Peer/Family Meetings 51 Family forums, informational meetings, DCF and Collaborative meetings (an increase of 85% from April) –Peer/Family Outreach/Coordination : 28 Open family/peer consultations in May 17 Family/peer consults completed in May Example: * Peer assisted a member post discharge with arranging mtg with DCF for services and the housing authority to stabilize living situation

21. Provider Trainings May 22 nd & May 30 th –Overview and Q&A following EDS Provider Forums May 25 th –Provider Training – Hill Health, New Haven June 5 th –Clinical Director’s Overview, CCPA, Rocky Hill June 17 th –Provider Training - New Britain General Hospital June 21 st –Provider Training – Family Care/VNA, Stratford In process –Scheduling 5 Provider Forums for July & August –Follow up meeting with State Dept. of Ed for joint training in the Fall (next meeting June 23 w/ Cheryl Resha)

22. Questions?