SB19-195 Enhancing Children and Youth Behavioral Health Services - - PowerPoint PPT Presentation
SB19-195 Enhancing Children and Youth Behavioral Health Services Susanna C. Snyder Child and Youth Behavioral Health Program Manager Maternal Child Health Policy Andrew Gabor Director of Child, Youth, and Family Behavioral Health Dec-19 1
Enhancing Children and Youth Behavioral Health Services
Susanna C. Snyder Child and Youth Behavioral Health Program Manager Maternal Child Health Policy Andrew Gabor Director of Child, Youth, and Family Behavioral Health
1
Dec-19
while demonstrating sound stewardship of financial
2
3
Objectives: 1.Explain components of SB19-195 2.Share updates from HCPF and OBH 3.Share next steps 4.Gather public comment
4
building -> Bill drafting
5
Youth who are high intensity utilizers of mental health services are involved in multiple systems and have complex needs. Analysis of CO data showed:
Division
different service systems Multi-system involvement leads to disjointed care, which is difficult to navigate, stressful, and inefficient.
Johnson Nagel, N., & Fox, D. (2015). Colorado's High-Intensity Mental Health Service Utilizers: Overlap with Child Welfare, Juvenile Justice, Substance Abuse, and Developmental and Intellectual Disabilities Services. Report submitted to the Colorado Department of Human Services, Office of Behavioral Health.
6
7
0% 5% 10% 15% 20% 25% 30% 35% 40% Behavioral/Mental Health Complexity Physical Health Complexity Percentage of Health First Colorado Clients Foster Care Non-Foster Care
Gritz, Mark. (2019). Comparison of Complexities between Foster Care and Non-Foster Care Population. From the HCPF-Farley Health Policy Center Analytics Project.
8
was more that 5 times greater for the top spending 10% of youth than the remaining 90%
within the group
additional system (up to three systems) in which a youth is involved
Fox, D., Johnson Nagel, N., Gallagher, K., & Brock-Baca, A. (2014). Youth with High Behavioral Health Needs in Colorado: Cross-System Utilization Patterns. Report submitted to the Colorado Department of Human Services, Office of Behavioral Health.
9
Dept of Health Care Policy & Financing
Requirements Deadline High Fidelity Wraparound (HFW) as part of System of Care
eligible children and youth at risk of out-of- home placement or in out-of-home placement—through RAEs, may be contracted
(RAEs included) Seek Federal Authority July 1, 2020 (Sent letter to CMS in Oct 2019) Integrated Funding Pilot
behavioral health (BH) intervention and treatment services across the state
Design and Recommend July 1, 2020
10
Dept of Human Services – Office of Behavioral Health
Requirements Deadline High Fidelity Wraparound
Standardized Assessment Tool
identify BH issues & other related needs in children and youth
Select and plan July 1, 2020 (CANS work) Standardized Screening Tools
competent statewide BH screening tools for primary care providers and primary caregivers
Select July 1, 2020 Statewide referral and entry point
referral and entry point for children and youth who have positive BH screening and needs identified through assessment
Develop a plan July 1, 2020
HCPF
$$$
integrated funding pilot
11
DHS - OBH
to come from HCPF
SAMHSA funding for 15 Communities of Excellence
Behavioral Health System: Capitation
High Fidelity Wraparound & Family Support Services (Enhanced PMPM)
Child Welfare
Traditional care coordination (PMPM)
High Fidelity Wraparound Defined:
An evidence-based process led by a facilitator where multiple systems come together with the child, youth, and family to create a highly individualized plan to address complex emotional needs
(National Wraparound Initiative, 2018)
RAE
RAE Contracted FFS Providers Referrals Referrals Criminal Justice Juvenile Justice
Department
Other Child/Family Serving Systems
Intensive CoordinationGraphic by J. Miracle and C. Zundel
(System of Care) State Population Served Authorities Other Details
Texas (Youth Empowerment Services)
1915(c) CANS assessment to determine LOC Four levels of care Recently moved from FFS to Managed Care New Jersey (Children’s System of Care)
1115 waiver 2703 Health Home SPA Targeted Case Management CANS assessment Wraparound Milwaukee
1915(a) CANS assessment Milwaukee county Capitation + Case Rates
14
Wraparound Milwaukee, (200). What are the pooled funds? Milwaukee, WI: Milwaukee County Mental Health Division, Child and Adolescent Services Branch
15
16
Formal timeline for high fidelity wraparound implementation pending CMS conversations
17
18
Screening Tools Assessment Tools Single Entry Point Services Funders Crisis Services or Mobile Response
culturally competent tools
caregivers in the perinatal period including postpartum women
19
Subcommittee
status
about-the-approved-masshealth-screening- tools
20
assessment tool to facilitate identification of behavioral health issues and other related needs.
programmatic utilization
Care, Counties, Service Providers, Families
21
Subcommittee
Act
22
23
Child and Adolescent Needs and Strengths (CANS)
and Strengths (CANS)
system collaboration
Collaborative Outcomes Management
single statewide referral and entry point
positive screening or whose needs are identified through the standardized assessment
24
Subcommittee
25
26
27
Susanna C. Snyder Child and Youth Behavioral Health Program Manager Maternal Child Health Policy Susanna.Snyder@state.co.us Andrew Gabor Director of Child, Youth, and Family Behavioral Health Andrew.Gabor@state.co.us Brett Snyder Child and Youth Behavioral Health Stakeholder Specialist Brett.Snyder@state.co.us
28