Management Information Report ______
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Management Information Report 2000-2001 Fiscal Year
Site
1st 2nd 3rd 4th Year GENERAL INFORMATION Qtr Qtr Qtr Qtr Total 1. Unduplicated Users 2. # Hours Clinic Open 3. # Hours Patients Seen 4. School Enrollment (1ST quarter only) 5. Total Encounters
REGISTRATION INFORMATION 6. Number of new registrants
ENCOUNTERS BY HEALTH INSURANCE STATUS DURING FIRST AND LAST QUARTERS
7. Medi-Cal Not Covered 8. Medi-Cal Covered 9. Medi-Cal Sensitive Services Only 10. Medi-Cal HMO 11. Private Insurance 12. Healthy Families 13. CHDP 14. California Kids 15. Other (i.e. FPACT) 16. Unknown 17. None 18. TOTAL ENCOUNTERS BY HEALTH INSURANCE STATUS
1 9/14/00 ENCOUNTER INFORMATION - Patient Visit by Age and 1st 2nd 3rd 4th Year Gender Qtr Qtr Qtr Qtr Total FEMALE 0 to 5 6 to 13 14 and 15 16 and 17 18 and 19 Over 19
19. TOTAL FEMALE
MALE 0 to 5 6 to 13 14 and 15 16 and 17 18 and 19 Over 19 20. TOTAL MALE TOTAL ENCOUNTERS BY GENDER 0 to 5 6 to 13 14 and 15 16 and 17 18 and 19 Over 19 21.TOTAL PATIENT ENCOUNTERS BY GENDER
2 9/14/00 TOTAL PATIENT ENCOUNTERS BY RACE AND ETHNICITY 1st 2nd 3rd 4th Year Qtr Qtr Qtr Qtr Total
Asian/Pacific Islander Black Hispanic White Other 22. TOTAL ENCOUNTERS BY RACE AND ETHNICITY
ENCOUNTERS BY PRIMARY PROVIDER Case Manager Dietician Health Educator Mental Health Provider Nurse (RN, LVN) Nurse Practitioner/Physician Assistant Physician 23. TOTAL ENCOUNTERS BY TYPE OF PROVIDER
AVERAGE LENGTH OF ENCOUNTER BY TYPE OF PROVIDER Case Manager Dietician Health Educator Mental Health Provider Nurse (RN, LVN) Nurse Practitioner/Physician Assistant Physician 24. TOTAL LENGTH OF ENCOUNTERS BY TYPE OF PROVIDER
ENCOUNTERS BY PRIMARY DIAGNOSIS (see detailed 1st 2nd 3rd 4th Year definitions) Qtr Qtr Qtr Qtr Total
3 9/14/00 Abuse Allergies Cardio/Respiratory Dental/Oral Health Dermatology Endocrine/Obesity ENT Gastroenterology Gynecology/Sexuality-related Hematology Infections Injuries-Orthopaedic/Poisonings Mental Health Neurology Ophthalmology Substance Use/Abuse Urologic Well-Child Exams Other 25. TOTAL ENCOUNTERS BY PRIMARY DIAGNOSIS
ENCOUNTERS BY ALL DIAGNOSIS BY DETAIL CHILD/ADOLESCENT ABUSE Child Neglect Emotional Abuse Physical Abuse Sexual Abuse/Assault
1st 2nd 3rd 4th Year Qtr Qtr Qtr Qtr Total
4 9/14/00 Rape Other
ALLERGIES All Diagnoses
CARDIAC Heart Murmer - functional Other Pathology
DENTAL Carries Maloclusion Sealants Other
DERMATOLOGY Acne Other
DRUG AND ALCOHOL SERVICES Prevention Addiction counseling Other
ENDOCRINE/OBESITY Diabetes mellitus Obesity Other
ENT (EAR/NOSE/THROAT) Hearing loss 1st 2nd 3rd 4th Year Qtr Qtr Qtr Qtr Total Otitus Media Tonsilitis
5 9/14/00 Other
GASTROENTEROLOGY All Diagnoses
GYNECOLOGY/REPRO-SEXUALITY RELATED Abnormal Pap Breast irregularities Cervititis Chlamydia Epididymitis Gonorrhea Male genitourinary Menstrual irregularities Menstrual pain Ovarian cyst Urethritis Vaginitis Other
HEMATOLOGY Anemia Sickle cell anemia Other
IMMUNIZATIONS Vaccinations given PPDs given Positive PPDs 1st 2nd 3rd 4th Year Qtr Qtr Qtr Qtr Total Other
INFECTIONS
6 9/14/00 Lice Impetigo Streptococcal pharyngitis Tinea ("all") Tuberculosis-INH Viral infections Warts Other
INJURY/ORTHOPEDIC Dislocation, sprain, strain Laceration or open wound Joint pain Poisoning Scoliosis Other
MENTAL HEALTH/SOCIAL WORK Adolescent Disorders Anxiety Disorders Attention-Deficit Hyperactivity Disorder Feeding and Eating Disorders Mood Disorders Substance Use/Abuse Other Disruptive Behavior Disorders
NEUROLOGY 1st 2nd 3rd 4th Year Qtr Qtr Qtr Qtr Total Epilepsy Headache Migraine Other
7 9/14/00 OPTHALMOLOGY Conjunctivitis-allergic Myopia Sty Other
RESPIRATORY Asthma Bronchitis/Pneumonia Other
UROLOGIC Proteinuria Urinary tract infection Hydrocele Variocele Enuresis Other
WELL-CHILD/ADOLESCENT CARE Dietary surveillance and counseling Health and sexuality counseling Screening/Annual Paps Smears Sports Phys/Camp Phys/Routine Phys Other (including PPD placements/tests) 26. TOTAL ENCOUNTER BY DIAGNOSIS
1st 2nd 3rd 4th Year Qtr Qtr Qtr Qtr Total 27. TOTAL IMMUNIZATION ENCOUNTERS
28. TOTAL NUMBER OF CHDP SCREENS
SEXUAL HEALTH
8 9/14/00 CONTRACEPTION/BARRIERS DISPENSED Female Barrier Encounters Male Barrier Encounters Emergency Contraceptives Pill + Condom Encounters Depo Provera + Condoms Norplant + Condoms
29. TOTAL CONTRACEPTION/BARRIERS DISPENSED
NUMBER OF PREGNANCY TESTS Number Positive Number Negative 30. TOTAL NUMBER OF PREGNANCY TESTS
31. REFERRED FOR PRENATAL CARE
NUMBER OF HIV TESTS Number Positive Number Negative 32. TOTAL NUMBER OF HIV TESTS
NUMBER OF STI TESTS Number Positive Number Negative
33. TOTAL NUMBER OF STI TESTS
1st 2nd 3rd 4th Year Qtr Qtr Qtr Qtr Total HEALTH EDUCATION Classroom/Assembly Presentations (# of students/# of presentations) Contraceptive counseling
HIV Counseling
9 9/14/00 Groups (# of people/# of groups) Individual Encounters Other (e.g. parenting counseling) 34. TOTAL HEALTH EDUCATION ENCOUNTERS
35. Number of child abuse reports filed
36. Number of referrals made (e.g. dental, etc.)
10 9/14/00 37. LIST OF STAFF EACH QUARTER ASSIGNED TO CLINIC FOR CLINIC-RELATED SERVICES FTE FTE FTE FTE
MANAGEMENT INFORMATION REPORT DICTIONARY
11 9/14/00 The following definitions have been developed to assist in consistency district wide in the collection of data concerning the School-Based Health Clinic program. Each definition follows the number(s) that it applies to on the Management Information Report (MIR). If services are provided at more than one school, data for each school is to be included.
Global definitions include:
Clinic Year - All encounter data is based on the definition of clinic year as July 1st through June 30.
Health Insurance – Source of payment for services, available through an outside (third party) payor. Health insurance information is to be provided in the first and fourth quarters only, with the intent that information provided includes that of latest encounter of the clinic year.
Primary Provider – Health Educator, Mental Health Professional, Nurse (including RN and LVN), Nurse Practitioner, Physician.
Mental Health Provider – LCSW, Substance Abuse Specialist, Psychologist.
Definitions by section in the Management Information Report:
1. Unduplicated User – The first encounter made in a clinic year by a student.
2. Hours Clinic Open – Total number of hours the clinic is open per quarter.
3. Hours Patients Seen – Total number of hours, per quarter, the clinic is open to see patients. Does not include hours open for staff meetings, in-service, etc. These hours are included in #2.
4. School Enrollment – Number of students enrolled at the beginning of the school year.
5. Encounter – Face-to-face visit between a patient and a provider. Encounter information is to be reported quarterly unless otherwise noted.
6. New Registrant – Student for whom a chart has been opened, or for whom a consent form has been received, in a clinic year.
7. Medi-Cal - Not Covered - Services such as health education that are provided to Medi-Cal recipients.
8. Medi-Cal Covered – Those students who have full scope or managed care coverage through Medi-Cal.
9. Medi-Cal Sensitive Services Only – refers to confidential medical services e.g. pregnant teens.
12 9/14/00 10.Medi-Cal HMO coverage - coverage through a Medi-Cal managed care plan such as L A Care.
11.Private Insurance – Third Party Payor such as Blue Cross, Kaiser, a PPO, IPA, etc.
12.Healthy Families – Is a public low-cost medical health insurance program for children ages 1 – 19.
13.CHDP – Children’s Health and Disability Prevention Program is a free health preventive program for children aged birth – 21. It provides free immunization shots and regular health check-ups.
14.California Kids – Is a low-cost private health insurance program for children ages 2-19, regardless of immigration status.
15.Other – Coverage other than those listed in numbers 7 trough 12, such as FPACT (Family PACT., Medi-Medi, Medicare, etc.)
16.Unknown – Use if it is not possible to determine that a source of health insurance coverage exists.
17. None – Use if it is known that there is nor source of health insurance coverage.
18.Total of all Encounters by health insurance status. If calculated correctly, this number should equal the total in #5, #21 and #22.
19.Total encounters by female patients.
20.Total encounters by male patients.
21.Total encounters by all patients. Total should equal total for item # 5, #18 and #22.
22.Total encounters by race and ethnicity. Total should equal total for item # 5, #18 and #21.
23.Total number of encounters by primary provider.
24.Average time for visit per type of provider – on a quarterly basis – i.e. – average visit time for a Mental Health Professional, Nurse, etc.
25.Encounters based on Primary Diagnoses which are based on ICD-9 Codes.
26. Encounters based on all diagnoses, as detailed in the MIR, and as based on ICD-9 codes. If there are specific criteria, it is specified by the specific diagnosis below:
Allergies – includes allergic reaction and allergic rhinitis, not dermatology or opthalmology related allergies which are included separately.
Classroom/Assembly presentations – those done within the confines of the school – do not
13 9/14/00 include health fairs.
HIV Counseling – counseling for both prevention and results. Encounters must be counted as one (1) for each (prevention and results).
Well Child/Adolescent Visit – includes both health screening and preventive care.
27.Number of encounters for immunizations, not number of vaccinations given.
28.Total number of CHDP screens performed each quarter.
29.Total number of barriers and contraceptive medications/devices dispensed during the quarter.
30.Number of positive and negative pregnancy tests performed during the quarter.
31.Total number of pregnant patients referred for prenatal care.
32.Number of positive and negative HIV tests performed during the quarter.
33.Number of positive and negative STI tests performed during the quarter.
34.Total number of individuals and groups reached through Health Education counseling and/or workshops in the quarter.
35.Total number of child abuse reports filed, as opposed to number of abused children for whom care is provided someone else may have filed (reports).
36.Total number of referrals made to outside caregivers, i.e. dentists.
37.Staffing number depicts all those employees who are currently working, including those on sick and vacation leave. Number does not include those on extended absence (i.e. maternity leave).
14 9/14/00