Exhibit 10 - MH Audit Tool.xlsx

XLSX spreadsheet 155 KB Posted Jul 13, 2026

Attached to: Medical and Mental Health Services
Solicitation number: 1301
Issued by: Idaho

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Written by GovTribe AI · Aug 31, 2026

Exhibit 10 - MH Audit Tool Summary

Exhibit 10 is a Contract Performance Measure Audit Tool developed by the Idaho Department of Correction (IDOC) to evaluate mental health services delivery across all departmental facilities. The document establishes a comprehensive six-audit framework with an overall performance threshold of 95% and assigns weighted performance measures across multiple service categories: Mental Health Screening (6% weight), Restrictive Housing (2% weight), Acute Mental Health Units (3% weight), Outpatient Needs (2% weight), Psychiatric Medication Services (6% weight), and Multidisciplinary Team Meetings (3% weight). Each audit category contains multiple Key Performance Indicators (KPIs) with specific measurement criteria, data collection requirements, and compliance standards. The audit tool specifies that the IDOC Data Integration Group (DIG) will provide detailed resident reports including facility names, resident identifications, dates of service encounters, and documentation of clinical contacts. Performance indicators measure compliance with timeframes such as mental health screening upon arrival, follow-up assessments within 24 to 72 hours, and clinician reviews within specific timeframes ranging from 7 to 30 days depending on the service category and level of care assigned.

The audit tool currently displays multiple calculation errors (#DIV/0!) throughout the spreadsheet, indicating that performance data has not yet been populated or calculated for the audit periods. The tool incorporates data from multiple IDOC facilities including ISCI, PWCC, SBWCC, ISCC, MVTC, and IMSI, with specific audit requirements for Acute Mental Health Units, Restrictive Housing Units, and various outpatient settings. Additional audit elements include chart review protocols requiring review of 30 to 40 resident records for clinical compliance with assigned levels of care, medication administration compliance tracking, and quality improvement plan requirements if medication compliance falls below established thresholds. The tool establishes accountability mechanisms such as mandatory quality improvement plans if more than 45% of patients miss over 20% of mood stabilizing or antipsychotic medication dosing during an audit period.

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Summary Idaho Department of Correction Contract Performance Measure Audit

Summary of Audit Information

Audit Period

	Overall Score	ERROR:#DIV/0!
		Threshold	Audit Results
1	Mental Health Screening	95%	95%
2	Restrictive Housing	95%	ERROR:#DIV/0!
3	Acute Mental Health Units	95%	ERROR:#DIV/0!
4	Outpatient Needs	95%	ERROR:#DIV/0!
5	Psychiatric Medication Services	95%	ERROR:#DIV/0!
6	Multidisciplinary Team Meeting	95%	ERROR:#DIV/0!

_x000D_&1#&"Calibri"&10&K000000 IDOC Data Sensitivity Classification - L3 Restricted

01 MH Screening

Idaho Department of Correction Value Based Care Audit
Audit No:	1	Mental Health Screening	Audit Date:
Threshold:	95%		Audit Type:	MH - Bi-Annual
Weight:	6%		Auditor:
Receiving and Diagnostic Unit: ISCI, PWCC, SBWCC

The IDOC DIG will provide a report detailing all residents who entered Idaho Department of Correction custody via the RDU (ISCI, PWCC, SBWCC) in the relevant audit period. The report shall include, at minimum, the IDOC facility, resident name, IDOC number, date of arrival in RDU, date/time of initial mental health screen.

	KPI	1. RDU: Mental Health Screen - Medical			Percentage Based Score
		Percentage of residents who entered IDOC custody via RDU and subsequently received a mental health screen (completed by a licensed medical staff member) upon arrival.	97%		Indicator	Score	Weight
		Total number of residents who entered IDOC custody via RDU who subsequently received a mental health screen (completed by a licensed medical staff member) upon arrival	680		1	97%	15.00%
		Total number of residents who entered IDOC custody via RDU	700		2	100%	15.00%
	Inter-Institutional Transfers: All
The IDOC DIG will provide the names of all residents who transferred to an IDOC facility (excluding CRCs) in the relevant audit period. The report shall include, at minimum, the “receiving” IDOC facility, resident name, IDOC number, date of transfer, date/time of (transfer) mental health screen.				3	98%	15.00%
	KPI	2. Transfer: Mental Health Screen - Medical			4	90%	25.00%
		Percentage of residents who transferred to an IDOC facility and subsequently received a mental health screen (completed by a licensed medical staff member) upon arrival.	100%		5	92%	15.00%
		Total number of residents who transferred to an IDOC facility and subsequently received a mental health screen (completed by a licensed medical staff member) upon arrival.	2490		6	94%	15.00%
		Total number of residents who transferred to an IDOC facility.	2500		Weighted Average:		95%
	Restrictive Housing Unit (RHU): All

The IDOC DIG will provide the names of all residents admitted to a restrictive housing unit at an IDOC facility (excluding CRCs) in the relevant audit period. The report shall include, at minimum, the IDOC facility, resident name, IDOC number, date of admission to the RHU, date/time of corresponding mental health screen.

KPI	3. RHU: Mental Health Screen - Medical
	Percentage of residents who had a mental health screen completed by a licensed medical staff member immediately prior to admission to RHU.	98%
	Total number of residents who had a mental health screen completed by a licensed medical staff member immediately prior to admission to the RHU.	490
	Total number of residents admitted to the RHU.	500
Positive Screens/Refusals: All

The IDOC DIG will provide the names of all residents at an IDOC facility (excluding CRCs) who refused to answer, or answered “yes”, to the suicide risk screening questions on the Mental Health Screening form during the relevant audit period. The report shall include, at minimum, the IDOC facility, resident name, IDOC number, date/time of mental health screen, dates/times of risk assessments/suicide risk assessments/suicide disposition, and shall identify any resident who refused to answer, or answered “yes”, to the suicide risk screening questions.

KPI	4. Positive Suicide Risk Screen/Screen refusal
	Percentage of residents who refused to answer the suicide risk screening questions or indicated a positive suicide risk who subsequently received appropriate follow-up by nursing staff (i.e. placement on suicide watch or referral for a risk assessment by a clinician) as evidenced by a documented risk assessment or suicide risk assessment (completed by a clinician) or a suicide watch disposition encounter (completed by a licensed medical staff member) within 24 hours of screen completion	90%
	Total number of residents who refused to answer the suicide risk screening questions or indicated a positive suicide risk who subsequently received appropriate follow-up by nursing staff (i.e. placement on suicide watch or referral for a risk assessment by a clinician) as evidenced by a documented risk assessment or suicide risk assessment (completed by a clinician) or a suicide watch disposition encounter (completed by a licensed medical staff member) within 24 hours of screen completion	45
	Total number of residents who refused to answer the suicide risk screening questions or indicated a positive suicide risk	50
Administrative Review by Clinician:

The IDOC DIG will provide the names of all residents who transferred to MVTC or ISCC in the relevant audit period or who were admitted to the restrictive housing unit at ISCC in the relevant audit period. The report shall include, at minimum, the “receiving” IDOC facility, resident name, IDOC number, date of transfer, date of admittance into ISCC RHU, date/time of (transfer or RHU) mental health screen, date/time of clinician review.

KPI	5. Clinician Review: Mental Health Screen - Transfer
	Percentage of residents who transferred to MVTC or ISCC and received a mental health screen (completed by a licensed medical staff member) upon arrival, whose mental health screen was administratively reviewed by a clinician within 24 hours of screen completion	92%
	Total number of residents who transferred to MVTC or ISCC and received a mental health screen (completed by a licensed medical staff member) upon arrival, whose mental health screen was administratively reviewed by a clinician within 24 hours of the screen completion	550
	Total number of residents who transferred to MVTC or ISCC and received a mental health screen (completed by a licensed medical staff member) upon arrival	600
KPI	6. Clinician Review: Mental Health Screen - RHU
	Percentage of residents who received a mental health screen (completed by a licensed medical staff member) immediately prior to admission to the ISCC RHU whose mental health screen was reviewed by a clinician within 24 hours of the screen completion	94%
	Total number of residents who received a mental health screen (completed by a licensed medical staff member) immediately prior to admission to the ISCC RHU whose mental health screen was reviewed by a clinician within 24 hours of the screen completion	750
	Total number of residents who had a mental health screen (completed by a licensed medical staff member) immediately prior to admission to the ISCC RHU	800

02 Restrictive Housing

Idaho Department of Correction Value Based Care Audit
Audit No:		2	Restrictive Housing	Audit Date:
Threshold:		95%		Audit Type:	MH - Bi-Annual
Weight:		2%		Auditor:
The IDOC DIG will provide a report detailing the names of all residents admitted to the Restrictive housing Unit (RHU) at ISCC in the relevant audit period. The report shall include, at minimum, the IDOC facility, resident name, IDOC number, date of admission to the RHU, date of RHU Mental Health Screen, mental health level of care, psychotropic medications prescribed at time of RHU assignment, date of discharge from the RHU (if applicable), and dates of restrictive housing encounters completed by a clinician.
KPI	1. Mental Health Assessment - No LOC - conducted within 14 days						Percentage Based Score
	Percentage of residents with a current prescription for psychotropic medication and no current assigned level of care, who are admitted to the RHU and subsequently receive a mental health assessment (completed by a clinician) within 14 days of admission to the RHU.					ERROR:#DIV/0!	Indicator	Score	Weight
	Total number of residents with a current prescription for psychotropic medication and no current assigned level of care, who are admitted to the RHU and subsequently receive a mental health assessment (completed by a clinician) within 14 days of admission to the RHU.						1	ERROR:#DIV/0!	50.00%
	Total number of residents with a current prescription for psychotropic medication and no current assigned level of care, who are admitted to the RHU.						2	ERROR:#DIV/0!	50.00%
KPI	2. Weekly Mental Health Contacts						Weighted Average		ERROR:#DIV/0!
	Percentage of residents housed in the RHU for at least 7 days evaluated by a clinician at least once per calendar week (Sunday to Saturday) while in the RHU.					ERROR:#DIV/0!
	Total number of residents housed in the RHU for at least 7 days evaluated by a clinician at least once per calendar week (Sunday to Saturday) while in the RHU.
	Total number of residents housed in the RHU for at least 7 days.

03 AMHU

Idaho Department of Correction Value Based Care Audit
Audit No:	3	Acute Mental Health Units	Date of Audit:
Threshold:	95%		Type of Audit:	MH - Bi-Annual
Weight:	3%		Auditor:
The vendor will provide a report detailing all residents housed in the AMHUs at IMSI and PWCC during the relevant audit period on or before the 15th day of the month following the relevant audit period. The vendor’s report shall include, at minimum, the IDOC facility, resident name, IDOC number, date of admission to the AMHU, date of discharge from the AMHU.

All residents admitted to an AMHU during the relevant audit period shall be included in the audit sample. In addition to residents admitted to the AMHU, at least 10 percent of the remainder of residents housed in the AMHU will be randomly selected and included in the audit sample. If all admissions and 10% of AMHU population equals less than 30 residents, the percentage of residents sampled will be increased to achieve a total of 30. If all admissions to the AMHU meet or exceed a total of 30, 10% or 10 (whichever is greater) of the remainder of residents housed in the AMHU will be randomly selected and included in the audit sample, not to exceed a total of 40 resident reviews.

In cases where the resident was admitted prior to the relevant audit period, standards 1-3 below are not applicable.

Residents admitted to and housed in a designated Acute Mental Health Unit receive timely and appropriate Mental Health Services reflected in the EHR by the following:

Admission: Face-to-face encounter with a psychiatric provider occurred within 14 days of admission to the AMHU (14 days before or after placement meets this standard).

Admission: Face-to-face initial clinical contact with a mental health clinician occurred and was documented with a SOAP note within 72-hours of admission to the AMHU.

Admission: Treatment Plan completed or updated by a mental health clinician within 30 days of resident admission to the AMHU

Face-to-face mental health assessments were completed by a clinician in accordance with resident's assigned level of care

Treatment plan update(s) were completed by a clinician in accordance with the resident's assigned level of care

Face-to-face clinical contact with a clinician occurred at least every 30 days (including group notes if applicable)

Psychiatric provider notified mental health clinical supervisor of any new or discontinued mental health medication(s)

In addition to the above requirements, residents with a MH 6 ACMHS level of care shall receive additional psychiatric contacts.

LOC of MH 6 ACMHS: Face-to-face encounter with a psychiatric provider within 7 days following the new MH 6 ACMHS level of care assignment.

Chart Review:

Yes

Total

Report (Vendor):

Yes

Denom

Dashboard (IDOC):

ERROR:#DIV/0!

SITE

NAME

IDOC#

LOC

(Highest)

INFO

Admit

Date

Discharge Date

Admit

Psych Encounter

Admit

72 hr Clinician

Admit

30 day

TX Plan	MH Assmt. Accord to LOC	Tx Plan
Accord to LOC	Clinical Contact
Q 30 Days	Notify Start/Stop Med	MH6 ACMHS PSYCH

7 days

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04 Outpatient

Idaho Department of Correction Value Based Care Audit
Audit No:	4	Outpatient Needs	Audit Date:
Threshold:	95%		Audit Type:	MH BI-Annual
Weight:	2%		Auditor:
KPI 1-2: The IDOC DIG will provide a report detailing all residents who are housed at ISCC, MVTC, or PWCC (not captured in Performance Indicator 3) with a Level of Care (LOC) of MH 3 CMHS1 or higher and all residents (regardless of LOC or facility) for whom a psychotropic medication prescribed by a mental health provider was initiated, discontinued, or actively prescribed during the relevant audit period. The report shall include, at minimum, the IDOC facility; resident name; IDOC number; date of arrival at ISCC, MVTC, or PWCC Unit 3, if applicable; level of care (to include blank/non for those not assigned); date of level of care; date of medication start/stop; medication name; and name of prescribing provider.

The term “psychotropic” is defined as formulary or non-formulary medication prescribed by a psychiatric provider that affects brain activities associated with mental processes and behavior. These medications include, but are not limited to, those in the following categories: anti-psychotic, anti-depressant, anxiolytic, and mood stabilizing.

	KPI	1. Psychiatric Medication Notification - All facilities
		Percentage of initial and discontinued antipsychotic and/or mood stabilizing medication prescriptions sent to the appropriate clinical supervisor for notification and review.						ERROR:#DIV/0!
		Total number of initiated and discontinued psychotropic medication prescriptions sent to clinical supervisor for review
		Total number of initial and discontinued psychotropic medication prescriptions
	KPI	2. Psychiatric Medication, No LOC, Mental Health within 14 days - ISCC, MVTC, PWCC Only
		Percentage of residents with an active or initiated prescription for psychotropic medication during the audit period, who had no current assigned level of care, and subsequently received a mental health assessment (completed by a clinician) within 14 days of arrival to the facility or 14 days of medication initiation.						ERROR:#DIV/0!
		Total number of residents with an active or initiated prescription for psychotropic medication during the audit period, who had no current assigned level of care, and subsequently received a mental health assessment (completed by a clinician) within 14 days of arrival to the facility or 14 days of medication initiation.
		Total number of residents with an active or initiated prescription for psychotropic medication during the audit period, who had no current assigned level of care.
	Individual Chart Review: From the DIG report provided, the IDOC MH team will select the names of 40 residents housed at ISCC, MVTC, or PWCC (not captured in Performance Indicator 3) with a Level of Care of MH 3 CMHS1 (or higher) who received or should have received mental health services in accordance with the assigned Level of Care from a clinician during the relevant audit period.
		Residents receive timely and appropriate MH services (ISCC and MVTC only)
	Q1	Face-to-face mental health assessments were completed by a clinician in accordance with resident's assigned level of care.
	Q2	Treatment plan update(s) were completed by a clinician in accordance with the resident's assigned level of care.
	Q3	Face-to-face clinical clinical contact with a clinician occurred in accordance with the resident's assigned level of care.
		Chart Review:		Yes			Total	0
		Report (Vendor):		No			Denom	0
		Dashboard (IDOC):		Yes			%	ERROR:#DIV/0!
	SITE		NAME	IDOC#	LOC	Q1	Q2	Q3
						MH Assmt.
Accord to LOC	Tx Plan
Accord to LOC	Clinical Contact

Q 30 Days

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Percentage Based Score
Indicator	Score	Weight	AVG	% OV/UND
1	ERROR:#DIV/0!	33.30%	ERROR:#DIV/0!	ERROR:#DIV/0!
2	ERROR:#DIV/0!	33.30%
3	ERROR:#DIV/0!	33.30%
Weighted Average		ERROR:#DIV/0!

05 Psych Med Serv

Idaho Department of Correction Value Based Care Audit
Audit No:		5	Psychiatric Medication Services			Audit Date:			Percentage Based Score
Threshold:		95%				Audit Type:	MH BI-ANNUAL		Indicator	Score	Weight
Weight:		6%				Auditor:			KPI 1	ERROR:#DIV/0!	14.29%
The medical vendor shall submit facility specific Long-Acting Injectable (LAI) rosters on or before the 15th day of the month following the relevant audit period. The LAI roster shall include, at minimum, the following information: IDOC facility, resident name, IDOC number, LAI medication information (name, dosage and frequency), prescribing provider, and dates the LAI was administered. When applicable, rosters shall indicate residents who receive an LAI as part of the Idaho Security Medical Program (ISMP) or involuntary medication order.									KPI 2	ERROR:#DIV/0!	14.29%
									KPI 3	ERROR:#DIV/0!	14.29%
									KPI 4	ERROR:#DIV/0!	14.29%
									KPI 5	ERROR:#DIV/0!	14.29%
									KPI 6	ERROR:#DIV/0!	14.29%
KPI	1. LAI log and administration compliance								KPI 7	ERROR:#DIV/0!	14.29%
		LAI LOG SUBMITTED AND COMPLETE			LAI ADMINISTERED AS PRESCRIBED				Weighted Average		ERROR:#DIV/0!
FACILITY		JAN	FEB	MAR	JAN	FEB	MAR
PWCC									Percentage Based Score
ICIO									Indicator	Score
MVTC									INFO 8	ERROR:#DIV/0!
ISCC									INFO 9	ERROR:#DIV/0!
SBWCC									If more than 45% of patients missed over 20% of mood stabilizing medication or antipsychotic dosing over the relevant audit period, the vendor shall develop a quality improvement plan and submit to the IDOC within 30 days of receipt of the audit results.
IMSI
ISCI
SICI
Chart Review:			No				Num	0
Report (Vendor)			Yes				Denom	0
Dashboard:			Yes				%	ERROR:#DIV/0!
The IDOC DIG will provide a report of all residents who arrived in RDU (ISCI, PWCC, SBWCC) with a prescription for psychotropic medication, IDOC facility, resident name, IDOC number, medication information (name, dosage, frequency), prescribing provider, date of arrival, date the prescription was entered into the medical record, date of first administration, date of initial psychiatric provider visit.

KPI	2. Psychotropic Medications - RDU
	Percentage of residents who arrived in RDU with a prescription for oral antipsychotic and/or mood stabilizing medication and received their first dose within 24 hours of the bridge order being entered	ERROR:#DIV/0!
	Total number of residents who arrived in RDU with a prescription for psychotropic medication and received their first dose of essential psychotropic medication within 24 hours of the bridge order being entered
	Total number of residents who arrived in RDU with a prescription for psychotropic medication
KPI	3. Psychiatric Visit - Initial - RDU
	Percentage of residents who arrived in RDU with a prescription for psychotropic medication and were evaluated by a psychiatric provider within 30 days of arrival.	ERROR:#DIV/0!
	Total number of residents who arrived in RDU with a prescription for psychotropic medication and were evaluated by a psychiatric provider within 30 days of arrival.
	Total number of residents who arrived in RDU with a prescription for psychotropic medication.
The IDOC DIG will provide a roster of all residents housed at all IDOC facilities (excluding CRC’s) with a prescription for psychotropic medication in the medical record and active for at least 30 consecutive days. The report with include, at minimum, IDOC facility, resident name, IDOC number, medication information (name, dosage, frequency), prescribing provider, date of arrival, active date of the prescription, date of most recent psychiatric provider visit, date of most recent AIMS, date of most recent HbA1c result, date of last lipid panel result, and compliance percentage.

Excludes residents captured in KPI 3 above.

KPI	4. Psychiatrist visit with 90 days
	Percentage of residents prescribed psychotropic medication for at least 30 consecutive days who had an encounter with a psychiatric provider within the last 90 days	ERROR:#DIV/0!
	Total number of residents prescribed psychotropic medication for at least 30 consecutive days who had an encounter with a psychiatric provider within the last 90 days.
	Total number of residents prescribed psychotropic medication for at least 30 consecutive days.
KPI	5. AIMS within last 180 days
	Percentage of residents prescribed an antipsychotic medication for at least 30 consecutive days within the audit period and received an AIMS evaluation in the last 180 days.	ERROR:#DIV/0!
	Total number of residents prescribed an antipsychotic medication for at least 30 consecutive days within the audit period and received an AIMS evaluation in the last 180 days.
	Total number of residents prescribed an antipsychotic medication for at least 30 consecutive days within the audit period.
KPI	6. HbA1c
	Percentage of residents prescribed an antipsychotic medication for at least 30 consecutive days within the audit period who had an HbA1c drawn and resulted within the last 365 days.	ERROR:#DIV/0!
	Total number of residents prescribed an antipsychotic medication for at least 30 consecutive days within the audit period who had an HbA1c drawn and resulted within the last 365 days.
	Total number of residents prescribed an antipsychotic medication for at least 30 consecutive days within the audit period.
KPI	7. Lipid Panel
	Percentage of residents prescribed an antipsychotic medication for at least 30 consecutive days within the audit period who had a lipid panel drawn and resulted within the last 365 days.	ERROR:#DIV/0!
	Total number of residents prescribed an antipsychotic medication for at least 30 consecutive days within the audit period who had a lipid panel drawn and resulted within the last 365 days.
	Total number of residents prescribed an antipsychotic medication for at least 30 consecutive days within the audit period.
INFO	8. Missed Medication - Mood Stabilizing
	Percentage of residents prescribed a mood stabilizing medication for at least 30 consecutive days who missed more than 20% of their mood stabilizing medication over the duration of the audit period	ERROR:#DIV/0!
	Total number of residents prescribed a mood stabilizing medication for at least 30 consecutive days who missed more than 20% of their mood stabilizing medication over the duration of the audit period
	Total number of residents prescribed a mood stabilizing medication for at least 30 consecutive days during the audit period
INFO	9. Missed Medication - Antipsychotic
	Percentage of residents prescribed an oral antipsychotic medication for at least 30 consecutive days who missed more than 20% of their antipsychotic medication over the duration of the audit period	ERROR:#DIV/0!
	Total number of residents prescribed an oral antipsychotic medication for at least 30 consecutive days who missed more than 20% of their antipsychotic medication over the duration of the audit period
	Total number of residents prescribed an oral antipsychotic medication for at least 30 consecutive days during the audit period

06 MDT

Idaho Department of Correction Value Based Care Audit
Audit No:	6	Multidisciplinary Team Meeting	Date of Audit:
Threshold:	95%		Type of Audit:	MH - Bi-Annual
Weight:	3%		Auditor:
On the first business day of each month, IDOC DIG will provide a list to the vendor of all residents currently with an MH 5 ICMHS or higher level of care, and/or assigned to a MHU, and/or on an LAI antipsychotic, who are expected to release within the next 90 days per the Parole Hearing Date, Tentative Parole Date, or Full Term Release Date in the resident management system. In the event IDOC does not provide the vendor with sufficient notice of resident release (minimum 35 days), the resident’s chart will be exempt from the audit.

No less than 30 days prior to the date of release, the vendor will participate in a Release Planning MDT to work towards a smoother transition of care for these individuals. The Release Planning MDT shall include, at minimum, mental health, physical health, IDOC reentry and case management. The IDOC Mental Health auditor will conduct chart reviews of all individuals meeting the criteria for a Release Planning MDT who release in the relevant audit period.

	Residents who require a specialized discharge plan shall be referred to a multi-disciplinary team and their medical record reflects the following:
	Q1	Documentation of team presence for MDT meeting
	Q2	Plan for follow-up care for psychiatric needs with outreach to community provider documented
	Q3	Plan for medication follow-up if on LAI
	Q4	MDT/discharge summary sent to IDOC Reentry team
		Chart Review:		Yes					Total	0
		Report (Vendor):		No					Denom	0
		DIG Report		Yes					%	ERROR:#DIV/0!
	SITE		NAME	IDOC#	LOC	Q1	Q2	Q3	Q4
						MDT MEETING	PLAN PSYCH COMM F/U	LAI
PLAN	COPY DISCHARGE SUMMARY
	1
	2
	3
	4
	5
	6
	7
	8

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