C.A.S.H. and ACCESS 1 Waiting List Management System. Submitted by The CAISI Community Collaborative

Transcription

1 C.A.S.H. and ACCESS 1 Waiting List Management System Submitted by The CAISI Community Collaborative January

2 Table of Contents Part A: Proposal Background Introduction Overview of Client Organizations: CASH and ACCESS What is CAISI What is the CAISI Community Collaborative...4 Part B: The Proposal Overview of Proposal Features Overview of the Waitlist Management Solution Waitlist Management System 8 Steps Details and Screenshots:...10 A. Create or Update Vacancy Template...10 B. Add Vacancy...13 C. Wait list intake (Referral form)...14 D. Review & Accept Wait list intake...15 F. Review & Forward potential vacancy matches...17 G. Review Forwarded vacancy matches...21 H. Maintain Wait list and Generate reports...22 Reports: Proposal Cost Estimates Timelines...25 Appendices Program Application Forms Coordinated Access Requested Report List Coordinated Access RM&R Criteria List Coordinated Access System Notification Requests

3 Part A: Proposal Background 1. Introduction The following proposal describes the CAISI Community Collaborative solution for the development and implementation of an electronic Waitlist Management System for Coordinated Access to Supportive Housing (CASH) and Access 1. As a partnership of community experts, clients, software developers, health care and social service support providers, the CAISI Community Collaborative is confident that it has the expertise and strength to provide the best solution for this system. The proposal is a response to a request for proposals made by CASH and Access 1, both organizations for whom managing large waiting lists of clients and coordinating access to much needed services is a major focus of their work. 2. Overview of Client Organizations: CASH and ACCESS 1 Coordinated Access to Supportive Housing (C.A.S.H.) The Coordinated Access to Supportive Housing project (CASH), provides navigation support for people eligible for mental health supportive housing, streamlining access to over 4500 supportive housing units in Toronto. The supportive housing agencies that make up the CASH partnership have adopted a common application form and wait list to assist those seeking housing to access the full array of supportive housing options available in the Toronto Community. CASH staff help determine the best housing match and work to make sure that people get the information they need to make an informed choice. Access 1 Access 1 is a partnership between support service providers in North Toronto and Scarborough that provide care for individuals seeking mental health supports. The program processes applications for case management or assertive community treatment teams in the Access 1 catchment area. Once an application has been received, clients are contacted to discuss if they are eligible for services. If they are, their application will be placed on a waitlist. Access 1 follows applications until clients are connected with a service providers. 3

4 3. What is CAISI The CAISI Program (Client Access to Integrated Services and Information) develops and implements OSCAR open source case management and integration software for agencies that provide mental health care and social services with an emphasis on agencies that care of those who are marginalized or have difficulty accessing mainstream services. (The section below describes OSCAR Software). CAISI was started as a project at St. Michael's Hospital funded by the City of Toronto and has since expanded into a program that has been supported and enhanced by the Toronto Central LHIN. The program aims to enhance the care of clients through the development and use of state of the art OSCAR case management software and allows clients to enhance their care by accessing and controlling improved electronic integration of the services provided between agencies at the individual and population levels using an open source electronic information system. The program includes: 1) The development of OSCAR open source software for case management and integration. 2) Building community and agency capacity to use OSCAR case management and integration software. OSCAR Case Management Software is open source software developed by a community of providers, clients and software developers and vendors across Canada. The endeavour was started by and is led by a development group in McMaster University. The software is one of the leading electronic case management systems in Canada used by health care providers across the country as well as a growing number of leading social service agencies. The CAISI Program has developed many features within OSCAR specific to social service and case management agencies to help clients control the electronic integration of care they receive. Open source software is owned by the community and can be freely downloaded and enhanced by anyone in the world. 4. What is the CAISI Community Collaborative Support for the use of OSCAR case management software can be obtained from more than a dozen vendors across Canada. The CAISI Community Collaborative is a partnership of social service, case management and housing agencies that aim to continue the CAISI mandate of developing and implementing OSCAR case management software in a not for profit fashion. Advantages of joining the CAISI Community Collaborative include: 1) reduced costs by sharing with partner agencies: cost for custom developments and reports can be shared between agencies that want the same thing. It's likely that custom reports that you are interested in or new features are also desired by other agencies and by sharing the costs of these improvements/custom work 2) faster service for priority items: if you are working with independent contractors or service providers you may have to wait according to when they have time to work on your request. With the collaborative, the agencies oversee the work of our contractor and as such we can determine what work 4

5 is a higher priority without having to pay more etc. 3) fixed low contractor rate: we have a fixed rate of $40/hour for our contractor which won't change. By working together and through our history / partnerships we have at cost rates with leading developers in the OSCAR community which may not be possible for agencies who decide to negotiate their own contracts. We have access to leading developers at a rate of $52/hour. 4) agency collaboration on development/integration: the collaborative is engaged in various collaborative endeavours including multi agency integration, developing key features/reports of interest to the mental health/homeless sector, operational support endeavours etc. that are facilitated through our collaborative partnerships 5) low/no cost of joining collaborative: the collaborative charges on a cost recovery basis only. We will charge you $500/year all of which can go as credit toward customization and support calls. The collaborative determines rates which are intended to be not for profit. Regardless of whether you join the collaborative, OSCAR CAISI is open source software which is guaranteed to remain freely available through the General Public License software (GNU CPL) and to continue to be viable and grow as part of the OSCAR Canada community which is being used by hundreds of medical clinics and agencies across Canada and continually developed and supported by McMaster university and more than a dozen OSCAR Service Provider companies. ( or 5

6 Part B: The Proposal 1. Overview of Proposal Features The proposed wait list management solution provides the state of the art open source web based case management and multi agency integration functionality used by health care and social service providers across Canada along side a newly developed waitlist management system that emphasizes workflow efficiency and an intuitive design. The two main pillars of the system design are ease of use for staff and powerful reporting for managers. The new waitlist management functionality includes the following feature as described in the request for proposals requirements: 1.) Data Collection. The electronic CASH, MH&J, Addictions, and Access1 intake forms built into the system automatically collect the data necessary to produce LHIN, management and supervisory reporting within the system. 2.) Resource Matching and Referral The system features automated matching of candidates with vacancy or service openings provided by partner agencies. The match is based on client criteria provided from the intake form, and partner criteria provided in an agency/program definition record. The system provides the ability to override the automatic selection, enabling staff the to accept changes to match criteria or decision calls based on subjective or narrative criteria. 3.) A multi tiered waitlist. The system provides the ability to manage two main tiers of clients in the main wait list. The first tier tracks who is and is not currently waiting for a vacancy/service opening for each program (Access1, CASH, etc.). The second tier tracks specific placement attempts and the outcome of those attempts. This tier tracks how many times individuals are turned down, or how many services they have received (as in the case of Access 1 providing short term service to some clients prior to long term service.) 4.) Database Portal The partner database portal allows service partners to log in and participate in the application process flow where they can accept, or reject applicants while providing details on decisions made. This highly secure portal restricts database access to client records allowing partner agencies to only view records of clients referred to them while protecting notes belonging to other clients or written by other agencies. 5.) Reporting Reporting is one of the strengths of the OSCAR CAISI system which is built on the MySQL database. All data that is collected can be manually accessed and used for reporting purposes. The proposed system also automate reports that are used on a regular basis. The list of automated reports includes those requested in the RFP. Through the power of open source, additional automated reports can be 6

7 developed. or generated through the powerful report templates feature. Those familiar with SQL can access the entire database or managers can have SQL report templates produced for low at cost rates through the collaborative. 6.) Electronic data entry for referrers. A public access electronic form allows referrers to complete the intake form securely over the internet. 7.) End user notifications. Users are notified when specific actions occur within the database, as well as when wait times exceed the program designated maximum. The list of system notifications are included in the appendix. 7

8 2. Overview of the Waitlist Management Solution This section describes how the high level features are incorporated into the proposed state of the art solution. The solution can be summarized in 8 efficient steps. These steps are summarized below and illustrated in Figure 1. This section is followed by screen shots of the solution that detail the intuitive workflow as seen by users of the system. Waitlist Management System 8 Steps: A. Add / Update Vacancy template the Wait list operator / administrator creates/updates the vacancy template and the partner agency program profiles. These are the profiles that partner housing and service provider agencies use when they generate and send notifications of vacancies that the vacancies or service provider openings would be generated from. B. Add vacancy an Agency case worker adds a new vacancy using an existing template and provides specific requirements that must be met to match a client with the vacancy C. Wait list intake a Referrer, from a public web site, or the Wait list operator, fills out an intake form for a new client, recording the client base line information and all the intake details for the wait list. D. Review & Accept Wait list Intake the Wait list operator reviews intake forms submitted by community Referrers, contacts referrers as required to amend the form, and eventually accepts it to the wait list E. Match the system matches vacancies against the wait list of clients. This is triggered by intake form acceptance or a new vacancy being submitted. The match compares the vacancy requirements to the client intake form information to determine matches. F. Review matches & forward the Wait list operator is presented with, and reviews, a list of new matches. The Wait list operator confirms the need with the client and indicates which matches to take to the next step, i.e. to forward to a partner service providing or housing agency. G. Review forwarded matches a partner Agency case worker reviews forwarded matches and accepts or rejects them H. Maintain Wait list & Generate Reports the Wait list operator reviews and maintains the waitlist by searching and updating wait list entries. The Wait list operator also pulls reports as required. 8

9 Figure 1 Figure 1 Wait list process overview Roles in diagram: Agency (Service Provider) agencies providing housing and other services Wait list system (oscar caisi) system that handles wait list, information flows and matching process Wait list operator co ordinator and case analyst in wait list process Referrer anyone requesting a wait list referral 9

10 3. Waitlist Management System 8 Steps Details and Screenshots: The following section details the 8 waitlist management steps outlined in the previous section. The screenshots illustrate the intuitive design of the system. A. Create or Update Vacancy Template Wait list Operator updates the vacancy template and the overall program profile that can be accessed by partner agencies through their portal. These templates are used by partner agencies to generate vacancy notifications. Figure 2 Step 1. Select program to update template for a specific agency program The participation column in the screenshot above could be replaced by vacancies depending on how CASH and ACCESS 1 wish the system and agency integration to be configured. Clicking on edit next to any program (or clicking on Add Program in the Navigator if the operator wishes to create a new program) produces the screen below in step 2. 10

11 Figure 3 Step 2. Edit program In this screen, the operator provides details of a partner agency program from which vacancies will be generated. The screenshot above includes proposed fields that can be expanded on or edited depending on project needs. Clicking on the vacancy template tab at the top leads user to the next screenshot. 11

12 Figure 4 Step 3. Edit vacancy template In the screen above, the user creates the template for that program by entering the name and template parameters then saving the template by clicking on a save button at the bottom of the screen. 12

13 B. Add Vacancy Partner Agency user logs into system through the portal which opens up the screen below. The user adds vacancy for one of their programs. Figure 5 Step 1. View and select program to add new vacancy By clicking on new vacancy link, the user opens up the vacancy screen below. Figure 6 Step 2. Add vacancy, a tab under the Program 13

14 C. Wait list intake (Referral form) Referrer submits wait list request form (referral form) from a secure and publicly accessible web page. This is called Registration Intake in OSCAR CAISI. The intake form is fully configurable by the system administrator and can be changed over time while preserving any reports that it is based on. Alternatively, Wait list operator enters information from faxed or ed scans of paper forms using same form with a few additional fields for reference of how form was received. For the Wait list operator, the system will force a search against existing clients, while the Referrer will use the form directly every time to generate new referrals. Figure 7 Step 1. Wait list intake form 14

15 D. Review & Accept Wait list intake Wait list Operator reviews new intake forms to determine completeness, assess eligibility and quality of information provided. Wait list Operator works with Referrer as required to update provided intake and to merge information into existing client records. Figure 8 Step 1 Review new intake forms (Clients in Queue column indicates number of REFERRAL forms RECEIVED Figure 9 Step 2 Review Clients in queue: click on I icon (I=Intake) to go to step 3. 15

16 Figure 10 Step 3 Review Client Intake adjust as required In this step, the Wait list Operator opens the intake form in a new window and triggers and displays the results of a search of existing clients for duplicates. The user can then merge information into an existing client intake form or create a new intake form based on the prefilled referral form. 16

17 E. Match vacancy with wait list entry The Wait list System performs a matching process based on pre configured criteria and weights, creating match results per vacancy, with match scores. F. Review & Forward potential vacancy matches Wait list Operator reviews match result lists, if need be records client contact attempts and determines which matches to forward to the Agencies. Figure 11 Step 1. Search Client screen 17

18 Figure 12 Step 2. Proposed matches list By selecting a match, the waitlist operator can forward that match to the relevant vacancy matched agency program in the next screen. Figure 13 Step 3. Forward match (Refer client to agency program). 18

19 By clicking on the All Vacancies link on the main page, a waiting list management user can review the listing of all vacancies in the screen shot below. Figure 14 Step 4: listing of all vacancies 19

20 The Waiting List Management user can search through the waiting list (see last section) and override the automated matches by making a direct referral to an agency program with a declared vacancy. Figure 15 Step 5: Automated Match Override Creating and Forwarding a manual Match 20

21 G. Review Forwarded vacancy matches A Partner Agency gets notified by and by entering the portal reviews forwarded matches to review. The user can then admit or reject matched clients. The matches as presented in the Queue of the program, with ability to open up which vacancy a match (referral) was created for. Figure 16 Step 1. List program queues Figure 17 Step 2. Review clients in queue for agency program Agency staff can view intake forms or view case notes for a potential client. Depending on system configuration, agency staff can add notes to a clients record as part of community case management for that client. 21

22 H. Maintain Wait list and Generate reports The Wait list operator can maintain the wait list and generates reports as required. The advanced search allows the waitlist case manager to bring up multiple lists of clients or quickly search the client record database by multiple different criteria. Figure 18 Step1. Advanced search 22

23 The full details search result produces a client spreadsheet which displays key variables for a client. The spreadsheet can also be used to sort and filter the list of clients by any column variable to help manage the list of clients. The list of variables in the columns can be determined by CASH and ACCESS 1 and might include variables such as: days on waitlist gender / age etc. boundary serious and persistent mental illness residence status etc. Figure 19 Step 2. Full details search result (sample columns) The screenshot above shows the current full search spreadsheet with medical variables displayed in the current OSCAR system. Reports: The system can produce real time reports on demand by clicking individual report buttons and appropriate date ranges or other relevant report criteria as per the report requirements given in the RFP and this RFP appendix. Additional reports can be produced through report templates or by users skilled in SQL, any data can be accessed in the database. Alternatively the CAISI Community Collaborative can produce custom reports at cost as per the support agreement ($40/hour). 23

24 4. Proposal Cost Estimates The proposed system builds on the existing OSCAR CAISI software and as such leverages much of the existing web based functionality. This leveraging in addition to being open source provides significant savings for the community. Item Cost Comments Software Development and Implementation Software Development $35,000 Software Installation $1,000 Software licence $0 Annual CAISI Collaborative Membership $500 Software is licensed under the GPL open source license. The latest version of the software are guaranteed to be available at no cost indefinitely. Membership fee can be put toward support for any of the hourly rate services Suport Costs for CAISI Collaborative Members Training $40 hourly rate Help Desk Support $40 hourly rate Software Additional Customization $40 $52 hourly rate Custom Reports $40 hourly rate Data Migration $40 hourly rate 24 Training for staff is generally done with 5 10 staff at a time and can be done in a 2 3 hour period. It is best done the day before or shortly before going live charged at 15 minute increments. Generally, most help desk support calls occur in the first month or two and then fall down to near zero after staff are used to the system. We encourage agencies proposing and developing improvements to the system which benefits all users. The CAISI Collaborative offers an hourly rate for its roster of developers. Small changes range from a few hours work to several weeks of work depending on the complexity. Templates can be made for the automation of data dumps (report templates) which can then be processsed in excel or depending on the complexity of data migration. Migrating a flat file (e.g. excel database with a single client per row) can be done in 2 3 days. More complex relational databases can take a week or more depending on the complexity of the data and requirements for mapping the fields.

25 5. Timelines Item Weeks review and finalization of requirements and timelines 2 Development 12 User Acceptance Testing and Finalization 4 25

26 Appendices 1. Program Application Forms 2. Coordinated Access Requested Report List 3. Coordinated Access RM&R Criteria List 4. Coordinated Access System Notification Requests 26