A Service Delivery Strategy for Colorados System of Care Draft July 11, 2012

An organizational entity that serves as a centralized accountable hub to coordinate all care for youth with complex behavioral health challenges who are involved in multiple systems and their families (Center for Health Care Strategies, Inc., 2011). Draft July 11, 2012

Improve clinical and functional outcomes Enhance system efficiencies and control costs Foster resiliency in families and youth By: Improving access to appropriate services and supports Reducing unnecessary use of high cost services- out of home and lengths of stay Using health information technology to support service decision making Engaging youth and families as partners in own care Draft July 11, 2012

Children and youth with severe behavioral health challenges In or at risk of residential placement On multiple psychotropic medications In, or at-risk of involvement with, child welfare In other out of home settings, e.g., therapeutic group homes Frequent emergency room visits or admissions to psychiatric hospitals Draft July 11, 2012

High quality wraparound Screening, assessment and clinical oversight Intensive care coordination Information management, including real time date Access to family and youth supports/advocacy Access to crisis supports Development of provider networks including natural and culturally relevant supports Draft July 11, 2012

Utilization management and quality improvement Outcomes management Training for CME staff, providers, families and referring entities Case monitoring and review Draft July 11, 2012

All families and youth should have access to peer support. Each of the existing care management entity models, e.g., NJ, MD, Dawn Project, Wraparound Milwaukee, includes a partnership with a family/youth support organization. Draft July 11, 2012

Public Agency New nonprofit with no other role Existing nonprofit that delivers direct services Nonprofit HMO Nonprofit with direct service that formally partners with community organization Draft July 11, 2012

Medicaid Options Child Welfare- Title IV-E Waiver Juvenile Justice Mental Health and Substance Abuse Education Others Draft July 11, 2012

Improved Clinical and Functional Outcomes Significant Cost Savings Promotes Health Homes Concepts Supports Comprehensive System of Care Approach Examples from states/communities: Reduction in placement disruption in child welfare from 65% to 30% (Milwaukee) 60% reduction in recidivism rates for delinquent youth/1 yr. (Milwaukee) School attendance for child welfare-involved children improved from 71% days attended to 86% attended (Milwaukee) Reduction in psychiatric inpatient days from 5000 days per year to less than 200 (Milwaukee) 30% net reductions in Medicaid spending-decreases in PRTF and inpatient with increases in TCM and home and community services (Maine ) Draft July 11, 2012

Children and adolescents with a serious emotional disturbance who are in, or at imminent risk of, placement in institutional care. Institutional care is defined as a living situation for 10 or more children including, but not limited to, residential treatment facilities. Draft July 11, 2012

Care Management Entity Family and Youth Support Organization (Peer Support) System of Care Values and Principles Trauma-Informed Integrated Service and Support Delivery Model DRAFT Behavioral Health Transformation Council Local Guiding Group State Oversight Body (Committee of BHTC) Draft July 11, 2012

Feedback Common Standards with local delivery-different variations on state. regional, community Use existing regions i.e. BHO, RCCOs Consumer Voice at all phases Legislation informed by demonstration site Draft July 11, 2012

Analysis of various care management models – Tracy Kraft-Tharp PowerPoint by Bruce Kamradt, Wraparound Milwaukee Care Management Entities: A Primer - Sheila Pires Model Draft July 11, 2012

Sheila Pires, Partner, Human Service Collaborative Bruce Kamradt, Director, Wraparound Milwaukee Tracy Kraft-Tharp, Co-Project Manager Draft July 11, 2012