BH Oversight Committee DCF Advisory Work Group

Meeting Summary:  May 20, 2005

Chair:  Morgan Meltz

(Next meeting: June 9 @ 6:30 PM at Riverview Hospital)

Attendance:  Morgan Meltz* (Families United FCMH), Stacey Gerber & Karen Andersson (DCF), Mark Schaeffer (DSS), Kathy Carrier* (Families United FCMH), Chet Brodnicki (CGC Clifford Beers), Phil Guzman (Child Guidance, Bridgeport), Dan Lyga (Children’s Center of Hamden), Deirdre Stowe (Yale CSC), Gerardo Sorkin (UCFS), Molly Cole (FAVOR), Irv Jennings (Family & Children’s Aid), Catherine Holahan (Greater Hartford Legal Aid), Doug DeCerbo (Boys & Girls Village), Sherry Perlstein (CGC S.Central), Liz Collins (YNH Hospital), Beth Klink (YNHPH), Barbara Sheldon* (NAMI-CT), Cathy Adamczyk* (NAMI-CT), Tim Kearney (Community Health Center), Elizabeth Cannata (Wheeler Clinic), Joy Molsberry* (FFP-Danbury)Mariette McCourt (Medicaid MCC).  * = Family member

Review of Work Group Topics

ü      Changing select services to fee-for-service (FSS) model.  In order to expand services, rate adjustments are needed.  A small group began working with Scott McWilliams (DCF) identifying rates; information will brought to the larger group.  Agencies will be meeting with CCPA June 14^th to address ICAPS issues.  Morgan Meltz suggested family representatives be involved in these processes and DCF agreed. 

ü      Managed Service System: special meeting with Peter Mendelson (DCF) has been confirmed for Thursday June 2nd from 10:00am -noon at the Training Academy at DCF Central Office in Hartford.

Intensive Care Management (see attachment distributed at previous meeting)

This discussion continued from the last meeting. The ASO Intensive Care Management (ICM) will support, not duplicate other care coordination entities, identifying service barriers, treatment difficulties with the CC, and suggest options.  The ASO ICM will also be available to those ineligible for the system of care or voluntary services coordination. Comments/questions included:

·        Is there enough money allocated to the system to support the various care management functions and services?  Dr. Schaefer stated this will come under administrative dollars that has a 75% federal match.  Under the BH carve-out, there is MCO administrative dollars and the Governor added $9.8M in her budget proposal, some of which would be allocated to expanding the ASO functions and the rest for service growth.

·        Member may not know they can ask specifically for ASO ICM – what words or actions from members would trigger an ICM referral?

·        Mark Schaefer will be sending a letter to CCPA 5/23 with updated outpatient rate configuration.

·        The federal match dollars usually go into the State General Fund.  There has been an exception of some percentage of the FMAP allocated to the Mental Health Strategy board.  It was suggested this be considered in the BH restructured system.

·        The ICM is key to managing the child/HUSKY adult’s care.  The DMHAS model, applied to the SAGA BH population has demonstrated a reduction of high cost services, & readmissions for clients with high utilization/ high risk factors. The scope of the ASO ICM will be identified in the DSS/DCF/ASO contract.  The ICMs report to the clinical director in the ASO.

ASO System Managers

System managers will be assigned to geographic areas defined by the DCF regions.  One function of the managers will be to work with providers to identify local service gaps, develop a local action to fill these gaps.  The ASO will recruit/strengthen the community providers’ capacity to meet the local needs, one the ASO performance measures.

• Providers expressed concern about recruitment – balancing the need for ‘new’ providers and the need for new services that could be provided through further development of existing provider system.
• Families see broadening the provider network as expanding family choice, in particular for specialty services within their community.
• Can VOI develop the provider network and do provider development? Dr. Schaefer stated that the company has effectively done this in MA; the contractual provisions are key to ensuring the ASO understands and performs according to State & stakeholder expectations.
• The ASO will have a mechanism for single case agreements/expedited enrollments to obtain needed but presently unavailable services in a timely manner.

See “ASO Network Development” meeting handouts:

Enhanced Care Clinics

The agencies propose a 25% rate increase to the clinics that meet criteria (details to be defined).  This is comparative to the Mental Health Strategy Board proposals.

Comment: there has been considerable focus on the ‘high-end utilizers’, less on early intervention.  Dr. Schaefer noted that the dollars proposed through the budget would allow for service growth, enhanced clinics, and more timely early access to BH treatment.

Family Advocacy: within the ASO?

Following the last meeting the Family Advocacy groups discussed where peer family specialists should be: within the ASO or outside the ASO.  There was agreement that the peer family & adult specialists should remain in the ASO and be liaisons with community advocates.  The community advocates could also take a strong role in training the VOI peer specialists.  If there are problems with the peer specialists utilization in the ASO, then the process can be reviewed and altered.

The Work Group will meet Thursday June 9 at 6:30 PM at Riverview.