Issue Brief 42 - Policy & Community Level Strategies for Integrating Children's Behavioral Health Services

November 16, 2015

Policy and Community Level Strategies for Integrating
Children’s Behavioral Health Services

Children and adolescents with serious and complex behavioral health needs are at risk for significantly compromised health and educational outcomes. Many of these youth become involved with and receive services from one or more public systems including: Medicaid, behavioral health, child welfare, juvenile justice, and special education. Navigating behavioral health services across multiple systems with different eligibility criteria, funding streams and treatment options is challenging for many families, particularly for those in distress or with language barriers. The result is missed opportunities for early identification and intervention for children who need behavioral health services and supports.

Bridging Silos
Many states, including Connecticut, are finding new ways to make it easier for families to access behavioral health services. Through two related initiatives -- the Connecticut Network of Care Transformation (CONNECT) and the Care Management Entity (CME) – Connecticut is developing innovative approaches to ensure that youth with behavioral health needs have access to a well-coordinated, effective, and cost efficient system of services and supports, as envisioned in the 2014 Children’s Behavioral Health Plan.

The CONNECT Initiative
Through a four-year federal grant from the Substance Abuse and Mental Health Services Administration (SAMHSA), CONNECT is creating a “No Wrong Door” approach to the delivery of behavioral health care. The goal of CONNECT is to develop an integrated statewide network of care that ensures children and their families receive effective and coordinated behavioral health services regardless of the system or systems in which they are involved.

Youth and families are playing a critical role in determining how Connecticut’s statewide network of care will be implemented and sustained. Partnerships between families, communities, state agencies and service providers have been established, including regional teams and six statewide committees: family engagement, data integration, network of care analysis, workforce development, cultural and linguistic competency, and social marketing. The CONNECT initiative is developing an online dashboard for families to monitor community level data on children’s mental health indicators, as well as training them to be family champions for their communities.

CONNECT also is working to identify and address gaps in care and to train and support staff from child-serving agencies to work in an innovative service delivery system. The CONNECT grant is administered through a statewide partnership between the Department of Children and Families (DCF), ValueOptions, and family advocacy organizations (AFCAMP and FAVOR). CHDI serves as the Coordinating Center and The Consultation Center at Yale University provides external evaluation for the grant.

The Care Management Entity
To further support the “No Wrong Door” approach, the Children’s Behavioral Health Plan called for a new statewide infrastructure, a Care Management Entity (CME), to begin to integrate funding and management of behavioral health services. This integrated approach allows care coordinators and clinicians the flexibility to match children and families with the right treatment and services. Connecticut’s Care Management Entity (CME) was created in 2015 at ValueOptions, Inc., with blended funding from the CONNECT grant and the state.

Connecticut’s CME coordinates care for children with serious behavioral health needs and their families, including children in DCF congregate care settings seeking to transition to home or community setting and frequent users of emergency departments for behavioral health diagnoses. The CME uses the high-fidelity Wraparound model, a national best practice approach to improve the coordination of care for children and families served by multiple systems.

In Connecticut, families served by the CME are matched with a Family Peer Specialist who provides family advocacy, assistance with navigating services, and empowerment through education and skill building. Families also work with an Intensive Care Coordinator to access and coordinate services and create an integrated support network. Other services include child and family team meeting facilitation; screening, assessment and clinical oversight; and connection to community–based services and natural supports. The CME is also responsible for providing “realtime” data for care, quality improvement and model fidelity to the Wraparound values and principles for systems of care. The CME’s long-term goal is to expand services to all Connecticut children with behavioral health needs and their families.

Outlook
Full implementation of CONNECT and the CME, along with other system reform efforts, will reduce fragmentation, improve efficiencies and coordination of care, reduce costs, and improve the clinical and functional outcomes and resilience among Connecticut youth - no matter how they are insured or through which door they enter.

For additional information, visit www.CHDI.org or contact Jeana Bracey at bracey@uchc.edu or 860-679-1524.

 

PRINTABLE VERSION