2. Financing to Support the Behavioral Health System of Care for Justice Involved Youth
June 28, 2016

3. Overview Incremental Change Defining the Attainable Care System
Coordinating Funding to Meet Your Needs
SAMHSA Funding Sources
Other Funding Sources

4. Fundamental Laws of Community Systems and Financing
You cannot divert to or coordinate with services that do not exist.
Services cost money.

5. Components of a Coordinated Behavioral Health Care System
Information sharing
Quality assurance
Support for system coordination
Evaluation
Workforce development and training
Prevention services
Evidence Based Practice Development

6. Creating State and Local Frameworks to Match Dollars to Desired Services
State Level Planning Councils - You have the players here at the table. Your role is to define the best attainable service array, potential funding streams, and to develop the financing framework to enable community service system development.
Medicaid maximization
Using flexible or specialized funding streams for hard to pay for services
Creative use of contracting
Care Management Entities - a centralized vehicle for coordinating the full array of needs for children and adolescents with complex behavioral health issues (often at the local or regional level).
Public agencies
Nonprofit organizations
Health Maintenance Organization (HMOS)

7. Care Management Entity Roles
High-quality wraparound implementation
Development and management of provider networks, including natural supports
Screening, assessment, and clinical oversight
Utilization management and quality improvement
Intensive care coordination
Outcomes management
Information management, including real-time data
Training for CME staff, providers, families, and referring entities
Access to family and youth supports and advocacy
Care monitoring and review
Access to crisis supports

8. Mental Health/ Substance Abuse Block Grants
Flexible state level funds
The Mental Health Block Grant must support community-based services for children or youth with serious emotional disturbances or adults with serious mental illness.
The Substance Abuse Block Grant must support the prevention and treatment of substance abuse.
Can be used for supports and infrastructure that are not covered by Medicaid.
MHBG: $1,051,067
SABG: $6,041,710
MHBG: $19,839,321
SABG: $67,645,777
MHBG: $33,793,628
SABG: $111,379,297
MHBG: $8,532,072
SABG: $34,079,985

10. Takeaways Define Attainable Service Array
Identify/ Develop State Funding Sources
Support development of coordinating entities at the state and local levels
Repeat

11. Resources:
Intensive Care Coordination Using High-Quality Wraparound for Children with Serious Behavioral Health Needs: State and Community Profiles Center for Health Care Strategies (2011) Care management entities: A primer. Washington, DC: Center for Health Care Strategies. Available at: Center for Health Care Strategies (2012) Using care management entities for behavioral health home providers: Sample language for state plan amendment development. Washington, DC: Center for Health Care Strategies. Available at: The Maryland Child and Adolescent Innovations Institute and Mental Health Institute. University of Maryland (2008). The Maryland care management model: Care coordination using high-fidelity wraparound to support the strengths and needs of youth with complex needs and their families. Baltimore, MD. Summary of Key Considerations in the Use of the Health Home & 1915(i) State Plan Amendments for Children & Youth with Intensive Behavioral Health Needs SAMHSA’s Medicaid Handbook: Interface with Behavioral Health Services

12. Contact Information
David de Voursney Chief, Policy Analysis Branch Division of Policy Innovation Office of Policy, Planning, and Innovation Phone: (240) Fax: (240) Choke Cherry Rd. Rockville, MD