Bureau of Quality & Integration

Evaluation: Case File Review

This process includes a review of the client's behavioral health record for the past twelve months of services inclusive of the enrollment and assessment/evaluation processes, service planning, service delivery and progress, inpatient services, coordination of care with the primary care physician, other agencies serving the same client, and with the family, discharge planning, medication prescription and monitoring, and psychiatric services. The three clinical bureaus (BPSMI, BCS and BSAGMH) staff the case file review in every RBHA at least annually with a sample of cases selected to meet specific criteria for inclusion in the review.

A software program created in-house at DBHS is used by RBHA and DBHS reviewers each quarter to collect the case file review information. Reports are generated which depict the result of the reviews. The results are used in the quarterly monitoring of the RBHAs as well as annually during the Operational and Financial Review of each RBHA. As part of the case file review process, in Maricopa County (GSA6) interviews of the client, family (if involved), provider and case manager occur for the population of adults with serious mental illness. During FY 1999 the software program was converted to a format that is Y2K compliant and enhanced reporting utilities were created for the use of the RBHAs and DBHS.