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This information can be used when obtaining informed consent from families and scheduling MPR reviews.

Consent & Scheduling Instructions

The bulk of work that providers do in advance of an MPR review centers around obtaining informed consent, getting documentation signed appropriately, and scheduling interviews. This document walks providers through this process.

MPR Consent and Scheduling Instructions and Consent and Scheduling steps Overview.

Letter to Families from CBHI

Review this letter with families upon their selection for the MPR. Copies of this letter are mailed to each provider site prior to selecting families for participation.

Link to Letters to Families, organized English first, then Alphabetical in other languages

MPR Brochure for Families

Use this brochure to help explain the MPR to families when obtaining consent. Copies of this brochure are mailed to each provider site prior to selecting families for participation. Contact TAC if you need additional hard copies.

Link to Brochures, organized English first, then Alphabetical in other languages

Consent Forms

link to page with forms - English first, then Alphabetical

Consent forms are required for all MPR reviews. The appropriate documentation must be signed and returned to TAC prior to the review day.

  • Include:
    • Screen shots of instructions on completing the Consent forms (from PPT)
    • Helpful Tips and Talking Points for Obtaining Consent

Link to Consent Forms, organized English first, then Alphabetical in other languages

  • Also include:
    • Screen shots of instructions on completing the Consent forms (from PPT)
    • Helpful Tips and Talking Points for Obtaining Consent

Releases of Information

Release of Information (ROI) forms are required for all persons the caregiver/young adult (over 18) authorizes to be interviewed, INCLUDING the care coordinator or IHT clinician. ROIs must be signed and returned to TAC prior to the review day.

Link to ROIs, organized English first, then Alphabetical in other languages

  • Also include
    • Screen shots of instructions on completing the ROI form (from PPT)
    • Information on the MPR for Other Formal Providers
    • Formal Service Provider Contact Info Sheet

Tracking Declines

The MPR is a vital tool in assessing the quality of ICC/IHT practice and family satisfaction with services. Therefore, agencies are expected to explain the MPR in a thoughtful manner and encourage families to have their voice heard. To help incentivize families, a $25 Target Gift Card will be given to caregivers upon the completion of their interview.

That said, the MPR is voluntary for families and some may choose to decline participation. If a family declines, you must notify TAC with the following information within 2 days:

  • Name of youth
  • Reason why the family declined - We are required to track ALL declines and report on them.

Names, DOB, and MMIS #s of all declining youth will be sent to the MCEs for chart reviews.

Scheduling

Scheduling the MPR review day is critically important to the success of a review. Note the following:

  • The Record Review and all interviews must occur on the assigned review day.
  • The Record Review should occur before any of the interviews. This is generally slated from 9-11, but the schedule you are given will include the exact time.
  • Scheduling involves communication with the family and all identified interviewees.
  • Interviews should be scheduled at times and in locations most convenient to the interviewee.
  • Interview times cannot overlap, nor can they be held at the same time as the Record Review.
  • Travel time needs to be accounted for in all schedules.
  • Reviewers use a completed scheduled as their guide throughout the day.  
  • Record Review Information
  • Example MPR Schedule (your specific schedule will be emailed)
  • Information for the MPR for Other Formal Providers
  • Formal Service Provider Contact Info Sheet

Record Review  

The review day should begin with an approximately 2-hour, in-depth review of the youth's clinical record. Detailed instructions on preparing for the Record Review can be found here.

Link to Record Review Information