BH Oversight Committee DCF Advisory Work Group

 

DRAFT (BH Committee information only: needs to be sent to the Work Group for final summary)

Meeting Summary May 3, 2005

Chair:  Morgan Meltz

(Next meeting:  May 20th, 3 PM at Riverview Hospital Middletown, conf. RM A/B

 

DCF Work Group Issues

The Work Group identified issues that are being addressed in other work groups and/or are appropriate for the DCF WG (Please see the full list of issues identified in the 1st DCF WG meeting in Appendix A). The following are the issues for the DCF Work Group :

                

·        Client flow                                                               

·        Role of ASO in out-of-home care                           

·        Issues around shifting selected services (intensive home based therapy,

      therapeutic mentoring, behavioral consultation) to a fee for service model 

·        DSS/DCF coordination for kids in DCF custody DCF WG 

·        How the various levels of care management will work together: enhanced and

regular Care Coordination, MSS system, ICMs and System Managers from the ASO.

·        What this new system will look like for families 

·        Voluntary Services eligibility and procedures

·        Access to services for families with no insurance 

·        Ensuring that family involvement and choice are woven throughout.  All WG

·        Therapy provided in home or in a community setting costs more

      (travel time etc.) than that provided in an office, & rates must reflect this.???

·        What happens when different parties (MSS & central DCF) disagree? 

·        MSS system monitoring and quality improvement

·        Discharge criteria and planning interface with system care managers: 

·        Ensuring that treatment plans are implemented ??

·        Where do the Community Collaboratives fit in?

·        Continuity of care issues DCF WG  (CcareWG looking @ MCO/ASO role if diagnosis changes)

·        What triggers the ASO will use, and what the response will beDCF WG & ? QA WG

·        Ensuring that the needs of the entire family are considered

·        Increased costs of bilingual staff in FFS rate setting – DCF WG

·        DCF/DMHAS transition issues

 

DCF WG Issues

WG Comments

Rates

Issues around shifting selected services (intensive home based therapy, therapeutic mentoring, behavioral consultation) to a fee for service model

 

Bilingual services – reduces health disparities

More costly to CGC, unable to recruit bilingual therapists. Needed in home –based services. No differential reimbursement.  Could be part of the enhanced clinic criteria options.

Therapy provided in home or in a community setting costs more

(travel, time etc.) than that provided in an office, & rates must reflect this.

 

Access to services for families with no insurance 

 

Relates to the need to maintain some level of grant dollars for the uninsured/underinsured

Family Involvement & Input

What this new system will look like for families

 

 

Ensuring that family involvement and choice are woven throughout. 

 

All WG

Ensuring that the needs of the entire family are considered in treatment plans

 

Suggestion that ASO prompt question in review process about family health needs, impact of child’s high level BH needs on parents & siblings.  ASO could, with written consent communicate with the PCP, refer family to local family support groups.

DCF System Issues, Coordination within system, with ASO & other agencies

Client flow

 

Role of ASO in out-of-home care                           

 

DSS/DCF coordination for kids in DCF custody

 

How the various levels of care management will work together: enhanced and regular Care Coordination, MSS system, ASO intensive care managers (ICMs) and ASO System Managers

*WG reviewed the work flow sheet . Questions focused on 1) family’s right to when not receiving services: who so they go to? 2) what happens when ‘CB’ services not available.

*The ASO ICM is allocated 20% of their time in local regions & can convene case conferences. Suggested that more time be allocated to local areas.

*ASO System manager can work with local school systems to gradually bring them into the BH program.

*Re Community Collaborative CM:  The ASO ICM would refer clients to these & provide short- term support until CC develops long term relationship with patient/family.

*ASO ICM can intervene to identify service access when there is long wait list for established services.

*System managers will identify local service gaps, recruit new providers.

What happens when different parties (MSS & central DCF) disagree? 

 

The DCF will organize a WG meeting specific to the MSS, uniformity of operations, confidentiality issues.

MSS system monitoring and quality improvement

 

See above

Discharge criteria & planning interface with system care managers

See above

DCF System Issues, Coordination within system, with ASO & other agencies

Ensuring that treatment plans are implemented

*Dually Diagnosed client, enhanced clinics develop this competence as one of the criteria options.

*Discharge planning needs to done in the context of the larger system, including “connect to care” ASO, ASO ICM, can be addressed in BH QA WG as well as monitoring indicator.

Where do the Community Collaboratives fit in

ASO ICM work with the collaboratives care coordinators.

Continuity of care issues

Especially important for high-risk member:  ASO identification of this, apply ICM

DCF/DMHAS transition issues

 

ASO, other system issues

Role of ASO in out-of-home care                            

 

Voluntary Services eligibility and procedures

 

What triggers the ASO will use, and what the response will be

Addressed in both the DCF WG & BH QA WG.  Question: how will the ASO identify “high need” children for ASO intensive care management – what is the criteria?  Providers can contact the ASO for intensive CM for high risk child.

Where & what is the role of the family/adult specialists

There is no intent to replace current CB family advocates.  Family advocates were asked to discuss this and report back to the WG:  options, specialists within the ASO to influence the corporate functions, ASO contract with community family advocates, both.

 

The Chair asked the WG to consider their top 3 priority areas for focus over the next several meetings

 

The DCF Advisory Work Group will meet Friday may 20th, 3 PM at Riverview Hospital in Middletown, conference A/B.

Agenda will include:

 ·        Discussion on how to identify children not being served by the BH system

·        Criteria for the at-risk child

·        Report from Family Advocates on options for Family/Adult Peer Specialists

·        Priority areas


Appendix A

 

Work Group Issues

The Work Group identified issues that are being addressed in other work groups and/or are appropriate for the DCF WG (work group in bold):

 

·        Integration of exit plan demands with KidCare        No WG @ this time   

·        Clinical criteria/management guidelines              Provider Advisory   

·        Client flow                                                                DCF WG

·        Role of ASO in out-of-home care                            DCF WG

·        Acute care/hospital guidelines                                 Provider Advisory

·        Issues around shifting selected services (intensive home based therapy,

      therapeutic mentoring, behavioral consultation) to a fee for service model  DCF WG

·        Issues around pediatricians prescribing psychoactive drugs CCare WG

·        DSS/DCF coordination for kids in DCF custody DCF WG  DCF WG

·        How the various levels of care management will work together: enhanced and

regular Care Coordination, MSS system, ICMs and System Managers from the ASO. DCF WG

·        What this new system will look like for families  DCF WG

·        What will easier access and better accountability look like?  QA WG

·        Voluntary Services eligibility and procedures DCF WG

·        Access to services for non Voluntary Service kids  QA WG

·        Access to services for families with no insurance  DCF WG

·        Ensuring that family involvement and choice are woven throughout  All WG

·        What happens if recommended level of care is unavailable?  Provider Advisory & QA WG

·        Therapy provided in home or in a community setting costs more

      (travel time etc.) than that provided in an office, & rates must reflect this.???

·        HUSKY transportation issues                               CCare WG

·        Interface between mental health care and primary care CCare WG

·        What happens when different parties (MSS & central DCF) disagree?  DCF WG

·        MSS system monitoring and quality improvement DCF WG

·        Discharge criteria and planning interface with system care managers:  DCF WG

·        Ensuring that treatment plans are implemented ??

·        Where do the Community Collaboratives fit in? DCF WG

·        Continuity of care issues DCF WG  (CcareWG looking @ MCO/ASO role if diagnosis changes)

·        What triggers the ASO will use, and what the response will beDCF WG & ? QA WG

·        Ensuring that the needs of the entire family are considered DCF WG

·        Increased costs of bilingual staff in FFS rate setting – DCF WG?

·        Who will be responsible for quality of services provided? QA WG

·        DCF/DMHAS transition issues DCF WG

·        Need to be able to bill for more than one service per day for a child/family. Provider Advisory