Presentation on theme: "1 Community Care A Non-profit Behavioral Health Managed Care Company NYAPRS 7th Annual Executive Seminar on Systems Transformation Integration Strategies."— Presentation transcript:
1 Community Care A Non-profit Behavioral Health Managed Care Company NYAPRS 7th Annual Executive Seminar on Systems Transformation Integration Strategies for Behavioral Health: Managing Care, Outcomes, and Costs While Preserving our Recovery Vision James Gavin, MSW, President and CEO, Community Care Albany, NY, April 28, 2011
2 About Community Care Behavioral health managed care company founded in 1996; part of UPMC and headquartered in Pittsburgh. Federally tax exempt non-profit 501(c)(3). Major focus is publicly-funded behavioral health care services; currently doing business in PA and NY. Licensed as a Risk-Assuming PPO in PA; NCQA- Accredited Quality and Disease Management Programs. Recipient of the Moffic Ethics Award from the American Association of Community Psychiatrists. Serving over 1.3 million individuals in 36 counties through a statewide network of over 1,800 providers.
3 Mission and Vision Improve the health and well-being of the community through the delivery of effective and accessible behavioral health services. Improve the quality of services for members through a stakeholder partnership focused on outcomes. Support high-quality service delivery through a not-for-profit partnership with public agencies, experienced local providers, and involved members and families.
4 Strengths of Community Care Innovative, clinically competent, and recovery focused. Responsive and accountable partner. –Community Care has over 12 years experience in providing public sector care coordination through a variety of contracts with counties, the states of Pennsylvania and New York. Innovation in physical health and behavioral health collaboration –Participating in Innovations for SMI Populations Project to coordinate physical health and behavioral health services, supporting Pat Deegan’s tool kit to incorporate personal wellness for physical health; implementing disease management programs for smoking cessation and weight management, developing health homes in rural Pennsylvania using teams that include peers, nurses, and other rehab and physical health specialists to support individuals with more complex physical and behavioral health care needs.
5 Strengths of Community Care Systemic Improvement –Commitment to input by individuals receiving services, their families and other stakeholders; developing evidence-based practices and school-based accountable homes; promoting provider engagement, including benchmarking; increasing the number and enhancing the scope of drug and alcohol providers. Integrated Systems Development –Supporting an array of local innovative practices, including collaborations between FQHCs and CMHCs; foster families and physical/behavioral health exchanges, co-locations of behavioral health staff in primary care settings, health centers and schools. Participating in emergency room diversion activities. Building on local strengths and resources.
6 Strengths of Community Care Linkage with Non-Medical Supports –Participated in the closing of three state hospitals with county partners, assisted in identifying and linking community supports for individuals leaving hospitals as well as for those who might have used them. Assisted in the development of supported housing priority for 23 rural counties. Participated with Allegheny County to support nationally recognized mental health and criminal justice initiative. Commitment to Peer Initiatives –We are committed to changing the clinical approach and culture of clinical systems to support recovery; celebrate individuals through an annual Recovery Institute; promote a shared decision-making focus; support a Learning Collaborative model; offer Steps of Hope, which focus on wellness; and support a Statewide Corporate Member Advisory Board.
7 In Summary… Responsive and accountable partner. State-of-the-art information technology used to further the aims of the program. Fiscally accountable – good steward of public resources. Commitment to collaboration with human services, providers, members, and cross-systems coordination. Innovative, clinically competent, and recovery focused. Specialized care management for high-risk/high-need consumers, including coordination of care with community- based services. Strong leadership team with many years of experience in the public sector in PA.
8 Build on strengths of consumer and family voice to ensure healthcare models grounded in recovery and resiliency principles. Support specialized needs of individuals with serious mental illness and substance use; focusing on persons with highest risk. Create high-risk care management practices to ensure linkages between inpatient and outpatient services. Coordinate with local systems to enhance access to local supports. Develop integrated health homes for individuals with complex physical and behavioral health needs. Opportunities for New York
9 Member drives delivery accountability. Recovery orientation dominance. Outcomes consistent with member-influenced standards for positive change. Financial model adaptation (Best Practice). –Workforce is competent and stable. Absolutes for Transformation
10 Contact Information James Gavin, MSW President and Chief Executive Officer Community Care Behavioral Health Organization One Chatham Center, Suite 700 112 Washington Place Pittsburgh, PA 15219 412-454-2120; www.ccbh.com email@example.com