Marge Hanna, MEd February 18, 2014 Community Care Behavioral Health - A ROSC Collaboration with PA Counties Marge Hanna, MEd February 18, 2014 © 2014 Community Care Behavioral Health Organization

Community Care Quick Facts Recovery-oriented behavioral health managed care company Provider owned (UPMC), Licensed as a Risk-Assuming PPO in PA Incorporated in 1996 and headquartered in Pittsburgh, PA Federally tax exempt non-profit 501(c)(3) © 2014 Community Care Behavioral Health Organization

Mission and Vision Improve the health and well-being of the community through the delivery of effective and accessible behavioral health (BH) services Improve the quality of services through a stakeholder partnership focused on outcomes Support high-quality service delivery through a nonprofit partnership with public agencies, experienced local providers, and involved members and families © 2014 Community Care Behavioral Health Organization

Community Care County Partnerships 39 counties, 10 contracts: urban, suburban & rural PA system county-based authorities for: Mental health & developmental disabilities Drug & alcohol services Children & youth social services Aging Health (smaller counties serviced by regional health offices) Criminal justice system County-focused initiatives, collaborations, networks, member advisory groups, quality committees, etc. ROSC focus Individuals have choice of Physical Health MCO plans © 2014 Community Care Behavioral Health Organization

Pennsylvania HealthChoices Contracts © 2014 Community Care Behavioral Health Organization

Our Journey Recovery, Resilience & Whole Health Wellness © 2014 Community Care Behavioral Health Organization

Serving Adults with SMI Peer Voice in Recovery Transformation Statewide Corporate Member Advisory Board Active Involvement in operations and activities Statewide Recovery Institute Consultation with Pat Deegan & Associates on increasing consumer voice & shared decision making Decision Support Centers (DSCs) - CommonGround 12 peer-delivered DSCs in medication clinics & other community settings © 2014 Community Care Behavioral Health Organization

Serving Adults with SMI Implementation of DSCs with recognition by American Psychiatric Association (APA) Results include improved engagement in care & understanding of treatment Recovery learning collaboratives Over 50 agencies involved Implementing Personal Medicine, Power Statement & Decision Support Toolkits Integrating recovery concepts & culture change in BH services with physician outreach Conferences, training, & technical assistance on recovery & transformation themes Supporting CPS and community based recovery supports © 2014 Community Care Behavioral Health Organization

Youth with Emotional Disturbances Promotion of cross-system collaboration Innovative service development with family & provider input (clinical homes in school & other settings) Strong partnerships with providers & counties with input from agencies such as CYF & JPO Focus on meaningful outcomes management, involving members & their families in the processes Learning collaborative Structural family therapy School-wide positive behavioral supports Trauma-informed care Screening & referral for co-occurring disorders © 2014 Community Care Behavioral Health Organization

Serving Members w/ Substance Abuse Training to support co-occurring competency in the workforce Promoting effective use of medication assisted treatment, including development of guidelines for use of buprenorphine and recovery –oriented methadone maintenance Addressing safety concerns associated with use of methadone Promoting evidence-based programs SBIRT, MI, MAT, CBT, etc. Strong efforts to build ROSC Expansion & effective use of certified recovery specialists Support county efforts to expand range of services and encourage effective use and expansion of non-clinical community support services © 2014 Community Care Behavioral Health Organization

Physical Health/Behavioral Health Multiple, nationally-recognized interventions MCO & Provider Collaboration Model Connected Care Community Care Behavioral Health Home Plus Serves individuals with behavioral health challenges and co-occurring physical health conditions 3-year PCORI grant Medicare/Medicaid special needs plan led by BH settings © 2014 Community Care Behavioral Health Organization

Allegheny County Some examples… Assertive Community Treatment - 9 Teams Two Learning Collaboratives on recovery tools plus one with ACT (ACHI Partnership) on Wellness Coaching Children’s Clinical Home learning collaborative - whole health wellness focus (1 in Allegheny) Three Allegheny OPMH operating peer run DSCs CommonGround software with 2 ACT teams (mobile) Several grassroots recovery support agencies CPS/CRS support © 2014 Community Care Behavioral Health Organization

Partners in Transforming Care Recovery-Oriented Systems of Care Partners in Transforming Care © 2014 Community Care Behavioral Health Organization

Recovery, Resilience and Whole Health Wellness Ensuring that our company is fully aligned with ROSC and Recovery Management principles Internal surveys and focus groups Integrated planning for mental health, SUD – adults as well as children and adolescents Providing technical assistance to counties on ROSC and Recovery Management Conferences, workshops, etc. Most county efforts are SUD focused Evidence based programming related Best Practice Guidelines Learning collaboratives © 2014 Community Care Behavioral Health Organization

Pay for Performance Initiatives ROSC Pay for Performance Initiatives County specific Includes cash incentives for implementing interventions that impact on continuing care… Assertive Outreach and Initial Engagement Screening, Assessment, Service Planning, and Delivery Continuing Support and Early Re-intervention Community Connection and Mobilization Learning collaborative approach © 2014 Community Care Behavioral Health Organization

ROSC Center of Excellence Initiative Target larger SUD treatment agencies that provide services throughout the state and our member counties Partnership with treatment providers, county funders and persons with lived experience in development of process and content Advisory Committee more than 51% persons with lived experience from throughout the ten contracts (CRS/CPS and others) Includes HealthChoices and MH representation but primarily SUD Pre meetings with large provider systems © 2014 Community Care Behavioral Health Organization

Initiative Vision & Goals Members will receive the treatment and recovery supports necessary to achieve long-term health and wellness with a meaningful life in the community Recovery, resilience & whole health wellness Increased rate of engagement in treatment for 90 continuous days from initiation of treatment Increase the number of PIR engaged in community based recovery supports pre, during and post acute care Reduce number of AMAs/AFAs © 2014 Community Care Behavioral Health Organization

Participants in the Advisory Committee Will Commit to the Core Values/Principles of a ROSC and Recovery Management Support and model enhancements to treatment to become more fully aligned with elements of a ROSC and principles of Recovery Management Support and model enhancements involving the use of peers pre, during and post acute care to support long term recovery Support and model collaborations/partnerships that enhance recovery outcomes © 2014 Community Care Behavioral Health Organization

Initiative Overview Six months advisory committee work ending June 18, 2014 Statewide conference June 19 showcasing interventions in four domains Assertive outreach & initial engagement Screening, assessment, service planning & delivery Continuing support and early re-intervention Community connection & mobilization Kick-off of ROSC learning collaborative 12-18 months ROSC COE Advisory Committee members as “early adopters” © 2014 Community Care Behavioral Health Organization

Lessons Learned Planning/Laying the Foundation Identifying early adopters Language Coaching Right Incentives Transparency © 2014 Community Care Behavioral Health Organization

Contact Information Marge Hanna, MEd Senior Director, Substance Use Disorder Initiatives, Community Care hanname@ccbh.com Community Care Behavioral Health Organization 1 East Uwchlan Avenue, Suite 300, Exton, PA 19341 610-594-2845 www.ccbh.com