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General Questions

What do you mean by consumers and family members?

CQT defines a consumer as someone who has lived with mental illness and substance use disorder family member as someone who has a family member or close relative of a consumer. Read more about our staff and organization.

What do you mean by funding/oversight agency?

Within the public mental health system, there are several departments, administrations and organizations that are responsible for funding, monitoring, credentialing, licensing, providing administrative support to and resolving problems with mental health services providers in any given area. CQT uses funding/oversight agency to denote the organization with these responsibilities in a particular situation. The Core Service Agency is the funding/oversight agency for PRPs in a jurisdiction.

What do you mean by provider associations?

Like in most fields, there are professional associations in the field of mental health services. Provider associations in Maryland include the Community Behavioral Health Association of Maryland (CBH) and the Maryland Association of Resources for Family and Youth (MARFY). These organizations advocate for, and provide support and technical assistance to their members.

CQT includes representatives from provider associations at Feedback Meetings to give input on consumers requests, suggestions and concerns from the providers point of view. Concerns and suggestions brought up at this meeting have also inspired new agenda items, work groups and training initiatives to be created by provider associations to address program and system issues.

This link provides information on the Local Addictions Authority (LAA) in each of Marylands 24 jurisdictions.

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CQT Process and Reporting

Can I read a copy of the Site Visit Report for my agency?

CQT Site Visit Reports are not public documents and are only sent to designated agency staff. For site visits to PRPs, reports are sent to the PRP Director, Executive Director/CEO of the program and the CSA. For inpatient facilities, reports are sent to the unit staff, building director, division director, CEO of the facility and the child-adolescent division of BHA.

CQT publishes an Annual Report detailing our activities and findings for each fiscal year.

What types of changes have you seen in programs?

The most drastic changes CQT has seen involve the removal of abusive staff. Other changes include new classes, better food, a new van service and other quality of life improvements. Check out our Success Stories for examples of how CQT helped ensure that services met the expressed needs of consumers.

How does CQT handle confidentiality?

If a consumer brings up a specific problem they are having, CQT asks permission to use their name in reporting the problem. CQT can report the consumers name and request to multiple levels within the system (senior staff at the program/unit/building and/or and the CEO, CSA, Rights Advisor or Behavioral Health Administration). Consumers names are only shared with the specific comments for which they gave permission, and CQT makes every effort to honor consumers' wishes about how and with whom that information is shared.

In cases where a consumer reports risk of harm, misconduct or abuse, CQT teams must report this with the consumers name to the appropriate agency. Consumers are informed of this mandate before they interview. CQT maintains the utmost discretion and concern for the safety and well-being of the individual consumer.

The Site Visit Report includes an Index of all consumer comments from interviews during the site visit. No names are ever used in the written report comments are anonymous. If a comment contains identifying information, it is modified or excluded.

What follow-up does CQT do with individual consumers?

Every consumer interviewed receives contact information for CQT and is encouraged to contact the team if their issue is not addressed. Facility staff, CEOs and/or the CSA are able to follow up with those individual consumers who gave permission for their name to be shared with agency staff. CQT visits most sites 3-6 times each fiscal year, so consumers can choose to interview with CQT to discuss the progress of a previously reported issue.

Are there problems that cannot be resolved through CQT?

CQT does not resolve problems; we report issues to the oversight and funding agencies in the public behavioral health system that have the capacity and authority to resolve problems. Our process of site visits, written reports and Feedback Meetings ensures that consumers suggestions, concerns and requests are referred to the appropriate agency.

There are requests, concerns or complaints that are not able to be resolved as the consumer would like. Often this is because the agency providing services does not have the power to make such a change, or because there are not viable alternatives to the current situation. Issues that may not be able to be resolved through CQT include such things as:

However, all requests are recorded during the interview, included in the Site Visit Report and addressed at the Feedback Meeting.

How often do interviewers alert the CSAs or CEOs about issues?

CQT meets with the CSAs every month at the Feedback Meeting and the CEO of the program receives a copy of the Site Visit Report. If there are issues needing immediate attention, CQT alerts the CSA or CEO the day of the visit.

Can a program "opt-out" of being visited? Does CQT ever stop visiting programs? Is there a quota on the number of visits?

CQT makes 3-6 site visits to selected programs each fiscal year on an ongoing basis. CSAs and BHA determine the programs in a jurisdiction that will be visited. CQT does not stop visiting programs unless directed to do so by the CSA or BHA.

CQT teams understand the daily challenges and unexpected situations that can arise on any given day in behavioral health programs. If a crisis situation arises during an announced or unannounced site visit, CQT teams will end the visit early and return another day.

CQT visits programs regularly in an effort to give a complete, real-time report of consumers satisfaction with the services they receive. Programs change the style and content of their programming, and both staff and consumers leave and join the program over time. CQT Site Visit Reports are a tool for monitoring consumers' satisfaction and improving the quality of services over time.

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Improving Quality:

Does CQT do audits or investigations?

The purpose of a CQT site visit is to help address issues for individual consumers and provide immediate feedback in real time to facilities. CQT teams listen non-judgmentally to what consumers share about their experiences and their needs, and report this accurately to the funding/oversight agencies along with facility staffs responses and CQT teams observations. CQT does not verify consumers comments. Comments or complaints are investigated and verified by the program staff, CEO, CSA or BHA and their findings reported back to CQT during Feedback Meetings.

Does CQT analyze data about the public mental health system?

CQT uses qualitative interviews to hear about consumers level of satisfaction with the services they receive and their overall quality of life. CQT does not use a standardized data collection instrument or generate scientific findings based on a random sample of a population. CQT does not validate the information given by consumers. The information collected reflects the feelings and beliefs of the individuals who choose to be interviewed on any given day; thus it should not be used as an independent tool to evaluate a provider or a program. CQT publishes an Annual Report each year highlighting the top issues, both positive and negative, that consumers reported.

Doesn't Maryland have enough oversight and quality assurance programs?

There are very conscientious oversight and quality assurance programs in Maryland that measure outcomes and general satisfaction in the Behavioral Health System as well as individual programs/facilities. BHA performs an annual Consumer Perception of Care survey, the Office of Health Care Quality monitors health and safety conditions, the Outcomes Measurement System (within Beacon Health Options Maryland) collects information on the efficacy of services, and most agencies implement their own quality assurance and improvement measures. Some use annual surveys, some use interviews or site visits, and some rely on submitted reports of concerns. These kinds of evaluation, oversight and quality assurance programs are always necessary.

Many of these activities are year-end or one-time evaluations, looking backward to find out if a program or activity met expectations. What these kinds of evaluation activities arent able to capture are the specific, unmet needs of an individual and how and why consumers are or are not satisfied with the service they receive.

CQT, in contrast, offers immediate, real-time and ongoing feedback about emerging issues as well as recommendations, suggestions and explanations from the very users of the services.

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