36-2917.01. Clinical oversight review committee; duties; annual report

A. The director shall establish an internal clinical oversight review committee to review clinical data specific to agency initiatives and populations identified by the director, including data on behavioral health services for persons receiving behavioral health services administered by the administration.

B. The committee shall include the director or the director's designee and experts within the administration in the areas of quality performance, behavioral health, operations, finance and data analytics.

C. The committee shall do all of the following:

1. Meet at least once every three months.

2. Review clinical data specific to populations and initiatives being undertaken by the administration.

3. Analyze and review clinical quality performance metrics that are indicative of overall system performance and make recommendations on metrics that may enhance system performance, clinical outcomes and member experience.

4. Advise the director on challenges, successes and data trends and identify potential service delivery improvements.

5. For behavioral health services, solicit additional information and perspectives related to the clinical data or clinical quality performance metrics reviewed by the committee from patients, patient advocates and other informed parties.

D. The committee is a review committee of the system pursuant to section 36-2917 and its activities are subject to that section.

E. On or before February 1, 2018 and February 1 of each year thereafter, the administration shall provide a report to the governor, the president of the senate, the speaker of the house of representatives, the chairperson of the health and human services committee, or its successor, in the senate and the chairperson of the health committee, or its successor, in the house of representatives and shall provide a copy of this report to the secretary of state. The report shall include a summary of topics reviewed by the clinical oversight review committee in the preceding year and any recommendations relating to quality performance metrics stemming from the committee's activities.