Cultural Competence Standards in Managed Care Mental Health Services for Asian and Pacific Islander Americans

Decision Support and Management Information Systems

 

Standard

The Health Plan shall develop and maintain a database which shall track utilization and outcomes for APIAs across all levels of care. It shall also develop and manage databases of social and mental health indicators on the covered APIA populations and the community at large. The database shall include qualitative and quantitative data that accurately reflects the APIA populations and shall be collected and interpreted in a culturally competent manner at national, state, and local levels. Findings from these data shall be used in a culturally competent manner to continually assess, improve, and inform strategic planning for services to APIA consumers and families. For purposes of accountability, the Health Plan shall report to the governing entity, in a regular and timely manner, performance and outcome data specific to APIA consumers and families.

 

 

Implementation Guidelines

  1. Aggregated data linkages by ethnicity with primary care plan, public health, substance abuse, developmental disability, education, courts, corrections, and juvenile justice shall be established at Federal, state and local levels, to provide cross-system utilization information on the mental health status of APIA consumers.
  2. Data shall be current, accurate, and include gender, age, ethnicity, socioeconomic status, linguistic proficiency, geographic area, sexual orientation (at the consumer’s option), and health insurance status.
  3. The APIA ethnicity categories shall be broad and inclusive, including a capacity to code all and multiple APIA subgroups and those of mixed race/ethnicity. The APIA category shall be distinct and monitored separately even when consistent with U.S. Census Bureau practice.
  4. The Health Plan shall track aggregated diagnostic and assessment information (collected independently from billing data), as well as service utilization trends, drop-outs, and service costs (using standardized units of measurement), and behavioral and functional outcomes, for APIA consumers across modalities.
  5. Individual consumer data shall be kept confidential with data sets coded in such a manner that client shall not be readily identified.
  6. Data shall include formal input from APIA consumers' community on adequacy of proportional mix of culturally competent Mental Health Specialists, including adequacy of APIA culturally competent staff.

 

Recommended Performance Indicators

  1. Presence of a data system inclusive of the above mentioned elements.
  2. Use of a unified clinical record across all levels of care that legally allow for sharing of information to facilitate data collection and tracking for APIAs.
  3. Regular reporting to the governing entity of performance and outcome indicators related to mental health care to APIAs.


Recommended Outcomes

  1. Timely and accurate consumer data which provides for tracking across age and race/ethnicity, including APIAs.
    Benchmark: Real time authorizations for services
  2. Timely transition of data to enhance continuity of care for APIAs.
    Benchmark: Real time authorizations for services
  3. Focused preventive and service planning for APIA consumers.
    Benchmark: Increased specialized and preventive services to at-risk consumers