Report to the Transition Sub-Committee May 5, 2006

Operations Update Hiring –100% of Key Positions Dr. John Swanson, Associate Medical Director Dr. Jeffery Gottlieb, Associate Medical Director Ann Phelan, MA, VP of Clinical Operations –88% Overall 3 Peer/Family Specialists 2 IT/Reporting 1 Quality Management

Operations Update, con’d Level of CareTotal Auths/CCRs RTC1400 GH 237 GH 185 Inpatient Psych635 Inpatient Detox73 OBS17 PRTF66 IOP/PHP366 Total2679

Operations Update, con’d Pre-cert and Concurrent Call Volume –1997 calls in April (increase of 70% from March) –Range of time on the phone: 17 seconds to 56 minutes –Average time on the phone: 28 minutes Riverview on line June 1, 2006 ED Interface –Opportunities to improve notification/communication –Tracking of members –Drafting educational Alert Next Phase: EDT 6/1/2006 Home-Based Psychiatric Services: 7/1/2006 IVR/Web technology 8/2006

Call Management/Customer Service

CT BHP Call Management April, 2006 Week Ending Total Calls Total % Abando n Day Staff Calls # Abandons Day Staff % Abandon After Hours Calls # Abandons After Hours % Aband on Membe r Calls Provide r Calls Crisis Calls After Hours Membe r After Hours Provide r 4/1/2006 Partial Week90.00% /8/ % % % /15/ % % % /22/ % % % /29/ % % % /30/2006 Partial Week 00.00% Total Monthly % % % INCLUDES ALL CALLS WITH NO THRESHOLDS, <5% ABD IS TARGET

CT BHP CALL MANAGEMENT Incoming Calls Totals: April 2006 Total 3,868 (Total Call Volume in March: 2,852, a 36% increase in April) Member Calls: 1511 Provider Calls: 2228 Crisis Calls: 129

Types of Inquiries April, % - Provider Referrals for Members 23% - Member Eligibility Verification 39% - Provider Related/Authorization/Enrollment/Billing 5% - General Information 38% = Member Inquiries Note:.06% = Inquiries initiated due to provider status changing from in network at the MCO to out of network with new system Note: Discrete MCO lines have been established and will be live and reportable for the June meeting Note: Creation of a warm line transfer with the 211 Perinatal initiative

The Network

CT BHP Provider Network (TYPE) - SERVICE DESCRIPTIONS 12/12/0505/01/06 01/40 - (General Hospital) - Psychiatric Hospital – Under /42 - (General Hospital) - Psychiatric Hospital – Aged23 01/49 - (General Hospital)- Psychiatric Hospital - Outpatient23 01/78 - (General Hospital)- Inpatient /79 - (General Hospital) - Outpatient47 06/40 - (State Institution) - Psychiatric – Under /42 - (State Institution) - Psychiatric - Aged43 06/49 - (State Institution) - Psychiatric - Outpatient22 06/50 - (State Institution) – Mental Health Clinic43 12/3F - (Special Services) - Psychiatric Residential Treatment Facility 05

CT BHP Provider Network (TYPE) - SERVICE DESCRIPTIONS 12/12/0505/01/06 12/3D - Residential Treatment Center063 12/3I - Group Home /3K - Group Home /5B - (Community Clinic) - FQHC Medical Clinic /5C -(Community Clinic) -FQHC Mental Health Clinic78 50/23 -(Community Clinic) - Methadone Maintenance Clinic * change due to merging of multiple vendor locations under one unique provider number189 50/50 -(Community Clinic) - Mental Health Clinic * change due to merging of multiple vendor locations under one unique provider number /60 -(Community Clinic) -Medical Clinic * change due to merging of multiple vendor locations under one unique provider number /68 -(Community Clinic) -Rehabilitation Center88 57/78 - (Alcohol and Drug Abuse Center) - Inpatient /79(Alcohol and Drug Abuse Center) - Outpatient /67 - (Home Health Agency) - Home Health Agency8889

CT BHP Provider Network (TYPE) - SERVICE DESCRIPTIONS 12/12/0505/01/06 20/26 - (Physician, MD) - Psychiatry /26 - (Physician MD Group) - Psychiatry /26 - (Nurse Practitioner) - Psychiatry /26 - (Nurse Practitioner - Group) - Psychiatry /9A - (Behavioral Health Clinician) - License Clinical Social Worker (LCSW) /9B - (Behavioral Health Clinician) - License Marriage and Family Therapist (LMFT)694 81/9D - (Behavioral Health Clinician) - License/Certified Alcohol & Drug Abuse Counselor (LADC)221 81/9E - (Behavioral Health Clinician) - License Professional Counselor (LPC)256 81/92 - (Behavioral Health Clinician) - Psychologist /9A - (Behavioral Health Clinician Groups) - License Clin. Social Worker Group130 86/9B - (Behavioral Health Clinician Groups) - License Marriage and Family Therapist Group /9D - (Behavioral Health Clinician Groups) - License/Cert Alcohol & Drug Abuse Counselor Group15 86/9E - (Behavioral Health Clinician Groups) - License Professional Counselor Group /92 - (Behavioral Health Clinician Groups) - Psychologist Group2331

CT BHP Provider Network (TYPE) - SERVICE DESCRIPTIONS12/12/0505/01/06 12/3G - (Special Services) – Community Services 02 12/3L - (Special Services) – Group Home /37 – (Physician, MD) Osteopath06 06/60 – (State Institution)

Network Status  CMAP providers: 1,722 –Increase of 595 providers since 12/12/06 –Addition of Rehab services within the SA continuum –Providers in process with EDS –Add/Change report adds per week changes per week –DCF Network -110 RTC and Group Home providers (increase of 24 providers since 11/2005)

Inquires/Complaints/Grievances

Inquiries and Complaints and Grievances January – April inquiries about providers no longer in network, 1 complaint filed, referrals given to the other complaints - 20 closed provider enrollment appointment scheduling member choosing to continue care with OON provider referrals to MCO pharmacy - 2 open c/o access to MD within 10 miles who will provide therapy as well as medication management c/o facility calling on weekend said our phone message said we were closed. Provider has not called back to verify phone # called.

Inquiries and Complaints and Grievances January – April Grievances - 3 closed - 1 open * Open Case: Member is seeing OON provider and wants direct payment to reimburse provider. Saw IN provider but language of provider was a reported barrier

Community Outreach

April –Schools Meeting to occur in May with Cheryl Resha –Systems Managers 167 DCF, Provider, Collaborative and MSS meetings in April 289 Meetings year to date –Peer/Family Meetings 30 Family forums, informational meetings, DCF and Collaborative meetings –ICM cases: 60 mid-long term cases 65 short-term, high risk cases (some overlap) –Peer/Family Outreach/Coordination: 37 family/peer consultations

Questions?