HEALTH HOMES: CARE COORDINATION FOR CHILDREN, YOUTH AND FAMILIES May 16, 2016 Dr. David Goldstein Chair, CBC Children’s Committee 1

Agenda I.Coordinated Behavioral Care II.Preparation for Children’s Health Home III.Network Development IV.Health Information Technology Solutions V.Policy and Procedure Analysis VI.Workforce Training Issues 2

Coordinated Behavioral Care CBC is a not-for-profit organization launched in 2011 by many of New York City’s most well- respected behavioral health providers, leaders in New York’s medical, behavioral health, rehabilitation and supportive housing service systems. We are dedicated to realizing the unprecedented opportunities under Medicaid redesign to improve the quality of care for members and their families, while reducing potentially preventable inpatient and emergency services use by people with serious mental illness, chronic health conditions and/or substance use disorders. CBC serves over 20,000 New Yorkers by operating a lead health home for individuals with chronic health and behavioral health conditions living in all five boroughs; a health coaching program for individuals at-risk of developing serious health conditions; and a program for individuals with serious mental illness who are transitioning from the hospital back to their community. CBC will serve children in the health home program in October, CBC also operates an Independent Practice Association. 3

Coordinated Behavioral Care Health Home 4 An estimated 20,000 shelter and supported housing beds with supportive services More than 20 home care programs A full continuum of other mental health programs including PROS, ACT and Clubhouses, and a suite of home and community based services Over 100 comprehensive medical clinics; Approximately 60 licensed SA treatment programs 44 Care Management Agencies inclusive of ACT programs;

Not Re-Inventing Wheels Diverse Expertise—Most of the Care Management Agencies were Targeted Case Management, COBRA, MATS and CIDP providers with community ties and strong provider relations. Policies and Procedures Manual —CBC’s Policies and Procedures are based on lessons-learned from converting programs; also informed by evidence-based practices, outreach programs. Community Presence — The remainder of the CBC Care Management Agencies are Non-Converting programs and offer unique expertise in additional areas such as housing, outreach, and shelter operations. Promulgating Successes—Committee structure creates a feedback loop to disseminate lessons-learned. 5

Preparation and Anticipation: An Overview Leverage existing staff and committees, identify new staff and resources to devote to Children’s HH Development Gap Analysis: IT Capacity, Network Capacity, Workforce Capacity, Training, billing, etc. Identify unique needs for young people and families in Model of Care Prepare HH and Network for Go-Live 6

Children’s Network Development Children’s Committee CBC is Provider-Led Members represent a diverse group of providers with experience touching all corners of the children’s system Helps to identify network gaps HH Development ◦Legal documentation & Network Connectivity (BAA’s, DEAA’s, MMIS, NPI, OID, etc.) Health Information Technology Training Program Planning Fiscal Projections 7

Developing the Children’s Network Program TypeAmountProgram TypeAmount Total Number of Organizations in the Children’s Network62Acute Psychiatric Inpatient Programs4 Active Health Home Network Partners who will Serve Children 49Community Residences9 New Children’s Network Providers13Group Homes/Rapid Intervention Centers6 Total Number of Care Management Agencies in the Network Serving Children 30Comprehensive Psychiatric Emergency Programs7 Active Care Management Agencies who will Serve Children as a CMA 19Home Based Crisis Intervention Programs8 New Care Management Agency11Early Intervention Programs3 Converting TCM Providers10Head Start/Day Care/Pre-K Sites58 Former COBRA Providers as CMAs for Children6Young Adult Housing Programs7 Former MATS Providers as CMAs for Children2Medical Hospitals17 Foster Care Agencies providing Care Management7Outpatient Medical Facilities58 Agencies with an OMH SED Waiver Program4Afterschool/Youth Development Programs121 Agencies with an OCFS Bridges 2 Health Waiver Program3Runaway and Homeless Youth Drop-In Centers2 CMA’s Co-Located with Medical Services6 Schools (Including Day Treatment Programs, Charter Schools, & Transfer Schools) 13 Article 31 Clinics/Article 28 Outpatient Mental Health Clinics 87State Inpatient Hospital Sites3 Article 32 Clinics12Residential Treatment Centers2 Potential Home & Community Based Services Sites112Residential Treatment Facilities3 8

Health Information Technology Considerations Special consideration for unique needs of young people who are also married and/or parents. “Lockbox” capability will protect select member PHI, while allowing parents and guardians to access other member PHI. CBC CMAs will have SSO (Single Sign On) for adults and children Establish HIT needs of Agencies Review of technology solutions for engagement, care planning with young people 9

Policies and Procedures Existing Policy and Procedure manual will incorporate age and/or family specific policies. Children’s Quality Management Team to review our current Policy & Procedure manual to adapt it for children’s specific requirements and to consider policy guidance for child specific innovations such as the Family Network meeting and Family Care Managers. 10

Workforce Training and Development Identify Training and Retention needs Review Experience of Adult HH Additional focus of Trauma-Informed Care Caseload size, intervention frequency Review Training Needs Innovations in Care 11

For More Information 12