Mission Statement
To promote and support the use of quality management principles to improve the quality, accessibility and delivery of care provided by Behavioral Health Services (BHS). To ensure program compliance with all Federal, State and Local regulations.
To assist BHS by providing training and support to users regarding BHS’ Electronic Health Record (EHR), called the Integrated Records Information System (IRIS). To ensure the accuracy and integrity of data is maintained and in line with industry standards of care.
To encourage continuous monitoring, modification and enhancement of beneficiary services. To improve the delivery of effective, culturally diverse, timely, appropriate, safe and accessible healthcare services throughout BHS. To promote advocacy, empowerment, and education to consumers and their families about their rights within the behavioral health system of care. To ensure the delivery of services are made with responsibility and respect to all.
Department Support
Quality Management Services (QMS) is a BHS function area that supports programming in the other two MHRS function areas: Adult and Older Adult Behavioral Health (AOABH) and Children & Youth Services (CYS). It supports BHS’ two managed care programs, the Behavioral Health Plan (BHP) and the Drug Medi-Cal Organized Delivery System (DMC-ODS) as well as their other mental health and Substance Use Disorder (SUD) programming.
QMS is comprised of three parts, the QMS Support Teams division, the QMS Data Support teams, and Patients' Rights & Advocacy Services (PRAS). The QMS Support division includes the Certification Designation Support (CDS), Inpatient Designation Support (IDS), AOABH Support, CYS Support, Managed Care Support, and SUD Support Teams. The Data Support teams in QMS include the IRIS Liaison, Office Coordination and Health Information Management (HIM). Patients’ Rights & Advocacy Services is a standalone team in QMS.
The QMS Support Teams division participates in a variety of quality improvement and compliance activities across the BHS divisions. One of their responsibilities is assisting with implementation of BHS Quality Improvement (QI) Work Plan after its approval by the California Department of Health Care Services (DHCS) Mental Health and Substance Use Disorder (MHSUD).MHSUD expects BHS to engage in continuous QI activities. QMS also has responsibility for coordinating all MHSUD audits and implementing the mandates of the Medicaid and Children’s Health Insurance Program (CHIP) Managed Care Final Rule published by Centers for Medicare and Medicaid Services (CMS) on May 6, 2016.
The QMS Data Support teams assist BHS by providing training and support to users regarding BHS’ Electronic Health Record (EHR), called the Integrated Records Information System (IRIS). The IRIS system is the billing system for all BHS County and Contract operated Mental Health and SUD programs. It is the documentation platform for all BHP Outpatient County operated programs. These teams are tasked with ensuring the integrity of data within IRIS, appropriately responding to data and patient record requests, and supporting BHS implementation of State required Performance Outcome Measures.
The PRAS team is a state mandated program under Division 5, Part 1, Chapter 6.2 of the Welfare and Institution Code that requires the County Behavioral Health Plan to have advocates protect the rights of people receiving mental health services in Orange County. They do this by monitoring mental health facilities, services and program for compliance with patient’s rights laws, regulations and policies. They also provide education to patients about their rights and serve as advocates for patients as applicable.