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CME Implementation Committee March 2010 C ARE M ANAGEMENT E NTITIES IN G EORGIA ’ S S YSTEM OF C ARE.

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Presentation on theme: "CME Implementation Committee March 2010 C ARE M ANAGEMENT E NTITIES IN G EORGIA ’ S S YSTEM OF C ARE."— Presentation transcript:

1 CME Implementation Committee March 2010 C ARE M ANAGEMENT E NTITIES IN G EORGIA ’ S S YSTEM OF C ARE

2 C ARE M ANAGEMENT E NTITIES  Role of CMEs in Georgia’s System of Care  What is a CME?  High Fidelity Wraparound as the practice model  How CMEs embody the Collaborative priorities for the SED population  Key Findings of initial evaluation report  Ongoing opportunities and challenges  Inter-agency on the ground: the DFCS crosswalk

3 SOC: T HE BIG P ICTURE  SOC as framework and value base  Cluster of organizational change strategies based on values and principles intended to shape policies, regulations, funding mechanisms and services & supports  Involves complex system change  Three familiar pictures to illustrate how CME fits into SOC approach

4 Youth and family neighborhood Community and recreation vocationalPublic health Faith community school Extended family and friends DFCSDJJDBHDDhealth SYSTEM OF CARE AT THE INDIVIDUAL LEVEL We want families in a SOC approach to experience: Family driven Youth guided No wrong door Collaboration Combination of natural and professional

5 Philosophy Infrastructure Services and Supports The CME is an element of SOC infrastructure SUSTAINING SYSTEMS OF CARE

6 PREVALENCE UTILIZATION TRIANGLE TARGET POPULATIONS IN A SYSTEM OF CARE Intensive Services 60% of $$$ Early Intervention Home & Community- based; school-based 35% of $$$ Prevention & Universal health promotion 5% of $$$ CMEs are the top of the triangle, targeting the highest risk youth in restrictive, costly placements 2-5% 15% 80%

7 W HAT IS A CME?  Set of identifiable structures & processes to support the organization, management, delivery and financing of services and supports across multiple providers & systems.  CME creates a single locus of accountability to serve youth and families in the community, in the context of Georgia’s System of Care (SOC).  It is a quantifiable entity, with staff, minimum standards, funding streams, outcomes.  Is our SOC achieving outcomes for youth with SED and their families? The CME is the place this will be answered

8 C OMMON E LEMENTS OF CME  Child and Family Teams, responsible for development, coordination, and monitoring of individualized plans developed in a family-driven model;  Intensive Coordination of formal, informal and natural supports;  Quality Assurance to assess and improve the implementation of wraparound and adherence to values;  Utilization Management to support real time analysis of services and the cost and effectiveness of services;  Provider Network Management, with responsibility for network recruitment, organization and oversight;  Evaluation, including outcomes for youth and families served across life domains.

9 CME P RACTICE M ODEL  High fidelity Wraparound is the core practice  If it’s easy, you’re probably not doing wraparound!  Care Coordinator is NOT a Case Manager and is NOT doing things FOR a family. The skill being developed is facilitation of the Child and Family Team process  What makes it “high fidelity?”  Caseload size  Constant monitoring, observation, feedback, coaching  Skill sets for Wrap Supervisors, Family Support Partners, Care Coordinators

10 CME AS MIRROR OF C OLLABORATIVE FOR SED  Collaborative has 5 Committees (priorities)  Family and Youth Involvement  Interagency Collaboration  Workforce Development  Financing  CBAY  The CME embodies these functions for the target population

11 CME S IN G EORGIA  Competitive selection process, state named 4 CMEs :  CHRIS Kids, Inc.  GRN Community Service Board  Lookout Mountain Community Services  MAAC (Multi Agency Alliance for Children)  Since Aug., 2009: Hired staff, trained on new practice model, implemented minimum standards, developed a database to match the practice of wraparound (building on KidsNet success), established eligibility and target population, serving youth and families  Almost 300 multi-agency high risk youth and families enrolled in CME (waiver and non-waiver)

12 E ARLY F INDINGS FROM E VALUATION REPORT  EMSTAR Research just completed 6 month evaluation of implementation  Referrals from variety of pathways:  Community partners (mh, parents, schools)  KNIS  DFCS  CSPs  CBAY  Common criteria: High risk for out of home placement, Average initial CAFAS scores 131 (non-waiver) & 153 (CBAY)

13 E ARLY F INDINGS FROM E VALUATION REPORT  Fidelity to the Wraparound model:  meeting timelines for contact w/in 48 hours (91%),  Families choosing meeting locations (initial 92%; first CFT 80%)  Strong evidence of inclusion of natural supports, and revisions to the Wraparound Action Plan  ALOS in wrap is 12 – 14 months - outcome data not available, but improved reports of improved functioning and satisfaction (families and youth) evident in early stage

14 O PPORTUNITIES A HEAD  OPPORTUNITIES  Partnership with DBHDD and growing with DFCS  Great commitment from staff and CME Directors  Advancing from fidelity to minimum standards to quality  CHIPRA federal grant (technical assistance and focus on Family Support Partner role)  Continued training from MD partners and developing Master Trainers in state  CME Implementation as “learning organization”

15 C HALLENGES AHEAD  CHALLENGES  SUSTAINING - Billable functions and non-billable essentials  Incorporating new CMEs  Incorporating new target populations  Expected attrition of front line staff  Unknowns with administration change  Database development  Provider network management- CME is dependent upon viable, high quality provider network!

16 P LEASE N OTE  CMEs are in their infancy stage…learning wraparound, learning CME functions.  Success only if administration (local, state, regional) supports wraparound  CMEs make sense if recognize the shared problems:  Silo funding  restrictive placements  Families must drive decisions  Goal: Producing desired outcomes across life domains through effective development and utilization of formal and informal resources

17 T HE DFCS C ROSSWALK  Why we conducted the crosswalk between CFT process in high fidelity wraparound and DFCS Family Team Meetings  Findings and implications of the crosswalk  What is happening in practice for youth in the CME

18 F INAL NOTES  CME as vehicle for change in SED  What’s different?  High fidelity wraparound (Facilitating a Team- based strengths-based and family driven process)  Development of natural and informal supports  Still need high quality providers  Accountability  Requires inter-agency commitment to high risk youth to sustain

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