SUMMARY OF PROCEEDINGS

Transcription

1 SUMMARY OF PROCEEDINGS QUALITY IMPROVEMENT (QI) / UTILIZATION MANAGEMENT (UM) COMMITTEE KERN HEALTH SYSTEMS 9700 Stockdale Highway 1st Floor Conference Room Bakersfield, California Thursday, August 28 th, :00 A.M. All agenda item supporting documentation is available for public review at Kern Health Systems in the Administration Department, 9700 Stockdale Highway, Bakersfield, during regular business hours, 8:00 a.m. 5:00 p.m., Monday through Friday, following the posting of the agenda. Any supporting documentation that relates to an agenda item for an open session of any regular meeting that is distributed after the agenda is posted and prior to the meeting will also be available for review at the same location. Meeting called to order at 7:04 A.M. by Chandrakala Gowda, M.D., C.M.O. COMMITTEE MEMBERS PRESENT: Jennifer Ansolabehere, P.H.N.; Felicia Crawford, R.N.; Bill Redman; Bruce Taylor, D.O. COMMITTEE MEMBERS ABSENT: Satya Ayra, M.D.; Nilesh Shah, M.D.; Rahul Sharma, M.D. KHS STAFF PRESENT: Remington Brooks; Amy Daniel; Chandra Gowda; Jake Hall; Deborah Murr; Jeff Pollock; Jada Salamatian; Nathan Scott; Isabel Silva. CONSENT AGENDA/OPPORTUNITY FOR PUBLIC COMMENT: ALL ITEMS LISTED WITH A "CA" ARE CONSIDERED TO BE ROUTINE AND NON- CONTROVERSIAL BY KERN HEALTH SYSTEMS STAFF. THE "CA" REPRESENTS THE CONSENT AGENDA. CONSENT ITEMS WILL BE CONSIDERED FIRST AND MAY BE APPROVED BY ONE MOTION IF NO COMMITTEE MEMBER OR AUDIENCE WISHES TO COMMENT OR ASK QUESTIONS. IF COMMENT OR DISCUSSION IS DESIRED BY ANYONE, THE ITEM WILL BE REMOVED FROM THE CONSENT AGENDA AND WILL BE CONSIDERED IN LISTED SEQUENCE WITH AN OPPORTUNITY FOR ANY

2 Summary of Proceedings QI/UM Committee Page 2 MEMBER OF THE PUBLIC TO ADDRESS THE COMMITTEE MEMBERS CONCERNING THE ITEM BEFORE ACTION IS TAKEN. STAFF RECOMMENDATION SHOWN IN CAPS PUBLIC PRESENTATIONS 1) This portion of the meeting is reserved for persons to address the Committee Members on any matter not on this agenda but under the jurisdiction of the Committee Members. Committee Members may respond briefly to statements made or questions posed. They may ask a question for clarification; make a referral to staff for factual information or request staff to report back to the Committee Members at a later meeting. Also, the Committee Members may take action to direct the staff to place a matter of business on a future agenda. SPEAKERS ARE LIMITED TO TWO MINUTES. PLEASE STATE AND SPELL YOUR NAME BEFORE MAKING YOUR PRESENTATION. THANK YOU! VISITOR FRANK LANGE, MD, ASSOCIATE MEDICAL DIRECTOR & HIV SPECIALIST FROM CLINICA SIERRA VISTA INTRODUCED HIMSELF, AND STATED HE WAS HERE FOR INTEREST IN KHS PROCESSES. COMMITTEE MEMBER ANNOUNCEMENTS OR REPORTS 2) On their own initiative, Committee Members may make an announcement or a report on their own activities. They may ask a question for clarification, make a referral to staff or take action to have staff place a matter of business on a future agenda (Gov. Code Sec [a]) 3) Announcements DR. GOWDA ANNOUNCED DR. BROOKS FINAL DAY AT KHS WILL BE ON AUGUST 29, 2014, AS HE IS MOVING ON TO ANOTHER POSITION. CA-4) Summary of Proceedings for KHS QI/UM Committee meeting on June 26 th, 2014, APPROVED CA-5) Summary of Proceedings for KHS Physician Advisory Committee meetings on June 4 th, CA-6) Summary of Proceeding for KHS Pharmacy and Therapeutics Committee meeting on June 4 th, 2014 APPROVED CA-7) Summary of Proceedings for KHS Public Policy Committee meeting on April 15 th 2014, APPROVED

3 Summary of Proceedings QI/UM Committee Page 3 CA-8) Pharmacy TARs June and July 2014 CA-9) KHS Policy 2.22 Facility Site Reviews: Update of Appendices RECEIVED AND FILED CA-10) KHS Policy #2.45-I Delegations of Quality Improvement (revision) RECEIVED CA-11) KHS Policy DM Program Financial Outcomes Reporting (draft) RECEIVED CA-12) KHS Policy Outcomes Reporting for DM (draft) CA-13) KHS Policy Ethics Training for DM Staff (draft) CA-14) KHS Policy Staffing (draft) CA-15) Report on Critical Elements Monitoring, Focus Review Quarter Ending June 30, 2014 CA-16) Report on IHA Monitoring, Focus Review Quarter Ending June 30, 2014 CA-17) Report on IHEBA Monitoring, Focus Review Quarter Ending June 30, 2014 CA-18) Report on CCS Monitoring, Focus Review Quarter Ending June 30, 2014 CA-19) Report on Perinatal Care Monitoring, Focus Review Quarter Ending June 30, 2014 CA-20) Report on Asthma Monitoring, Focus Review Quarter Ending June 30, 2014 CA-21) Report on Diabetes Monitoring, Focus Review Quarter Ending June 30, 2014 CA-22) Report on Site Review Summary Quarter Ending June 30, 2014 RECEIVED CA-23) Disease Management Report 2 nd Q 2014 APPROVED 24) Report from Chief Medical Officer APPROVED

4 Summary of Proceedings QI/UM Committee Page 4 Taylor-Felicia: All Ayes 25) CAP Close out Letter for DHCS Medical Audit Redman-Felicia: All Ayes 26) CAP Close out Letter for 1115 Waiver SPD Enrollment Survey RECEIVED Redman-Felicia: All Ayes 27) HEDIS interventions INFORMATIONAL 28) Committee vacancies INFORMATIONAL 29) 2Q 2014 Combined UM Reporting APPROVED 30) 2014 Hepatitis C Guidelines APPROVED 31) KHS Internal Criteria for Hospital Bed APPROVED 32) KHS-CCS Monthly JOC Meeting ) KHS-CCS Monthly JOC Meeting ) KHS-CCS Monthly JOC Meeting ) Report on Health Education Activities Quarter Ending June 30th, 2014 APPROVED Crawford-Ansolabehere: All Ayes 36) 2nd Q 2014 Grievance Summary Report APPROVED Taylor-Redman: All Ayes 37) 2nd Q 2014 Tabulated Grievance Report APPROVED Taylor-Redman: All Ayes 38) 1st Q 2014 Credentialing Report APPROVED 39) 2nd Q 2014 Credentialing Report APPROVED Meeting adjourned at 8:05 A.M. by Chandrakala Gowda, M.D., C.M.O.

5 Summary of Proceedings QI/UM Committee Page 5 Next regular meeting is scheduled for October 30 th, 2014 AMERICANS WITH DISABILITIES ACT (Government Code Section ) The meeting facilities at Kern Health Systems are accessible to persons with disabilities. Disabled individuals who need special assistance to attend or participate in a meeting of the Board of Directors may request assistance at the Kern Health Systems office, 9700 Stockdale Highway, Bakersfield, California or by calling (661) Every effort will be made to reasonably accommodate individuals with disabilities by making meeting material available in alternative formats. Requests for assistance should be made five (5) working days in advance of a meeting whenever possible.