1. www.chcs.org November 21, 2014 Dayana Simons, CHCS Dana McCrary, Georgia DBHDD Creating and Supporting Family Run Organizations: Don’t Forget the Foundation…and the Vision!

2. CHIPRA Quality Improvement Collaborative Goal: Improve health and social outcomes for children with serious behavioral health needs by: ► Implementing/expanding a Care Management Entity (CME) model to improve the quality and control the cost of care for children with serious behavioral health challenges who are enrolled in Medicaid or the Children’s Health Insurance Program Participating states: Georgia, Maryland (lead), Wyoming CHCS is coordinating entity and lead TA provider 2

3. CME Core Services Intensive Care Coordination (at low ratios) Family and Youth Peer Support Mobile Crisis Response and Stabilization Intensive In-Home Services

4. Why Do We Need To Have This Discussion?

5. Facts about Children’s Mental Health One in 10 young people experience a period of major depression. Even very young children may show early warning signs of mental health concerns. These mental health problems are often clinically diagnosable, and can be a product of the interaction of biological, psychological, and social factors. Half of all mental health disorders show first signs before a person turns 14 years old, and three quarters of mental health disorders begin before age 24. Mental Health Gov. http://www.mentalhealth.gov/basics/myths-facts/

6. Facts about Children’s Mental Health Less than 20% of children and adolescents with diagnosable mental health problems receive the treatment they need. Early mental health support can help a child before problems interfere with other developmental needs.

7. What Do We Want? Valuable Support & Resources Made Available to Families Whether They Are Receiving Services or Not!!

8. Balancing Family Peer Support Billable Non Billable Families Making sure that families have access

9. How Are Family Organizations Different Family Support Group/Organization May or May not be a non- profit Little or No requirements Focus is driven by families Rules are governed by families Family & Group Activities Access to Continuous Support for the entire life cycle Medicaid Provider of Family Peer Support/Family Organization Subject to Medicaid Requirements Board 501c3 Staff Insurance Accreditation Auditing Limit on how many hours that you can provide peer support

10. What They May Have In Common Peer Support Education Advocacy Training Mentoring

11. What They Both Have The Ability To Offer These things are priceless! Connection to other parents/families Breaking bread together Learning together Deal with feelings “Link arms” with each other understanding Validation Decreasing feeling of Isolation Learning new resources Sharing strategies Sharing wisdom Helping others while helping yourself Long term connections Group activities Eliminates stigma Creates a place for Professional Peers to get supported too

12. Some Of the Challenges Lack of Planning - Doing Your Homework Respecting The Talents of Your Peers Not Creating Partnerships - Outreach ► Professionals ► Child Serving Agencies ► Other Family Organizations – Competitiveness Engaging State Partners in Support to Developing and Maintaining Viable Organizations - Grant Opportunities Reluctance to Hit The RESET BUTTON Family Support Organizations Are Struggling to Sustain!!!!!

13. Planning For A More Balanced Approach Identify Your Niche! Parents With Younger Children Foster Parents Transition Age Youth Special Focus to School Education Your Local Community We Can All Have A Valuable Role, Support Each Other and Stay Connected – Building A Network

14. Opportunities through the Affordable Care Act CMS/SAMHSA Joint Information Bulletin: Coverage of Behavioral Health Services for Children, Youth, and Young Adults with Significant Mental Health Conditions (May 7, 2013) Intensive Care Coordination: Wraparound Approach Peer Services: Parent and Youth Support Services Intensive In-Home Services Respite Services Mobile Crisis Response and Stabilization Services Flex Funds (Customized Goods and Services) Other Home and Community-Based Services http://www.medicaid.gov/federal-policy-guidance/downloads/CIB-05-07-2013.pdf

15. Homework & Research Medicaid Financing for Family and Youth Peer Support: A Scan of State Programs http://www.chcs.org/resource/medicaid-financing-for-family-and-youth-peer- support-a-scan-of-state-programs-3/ Funder: Centers for Medicare & Medicaid Services Author: Center for Health Care Strategies May 2012 | Technical Assistance Tool

16. Medicaid Financing for Family Peer Support State Plan:  Alaska, Arkansas, Arizona, Kentucky, Massachusetts, Oklahoma, Washington Waiver: 1915(c) Home and Community Based Services  PRTF: Georgia, Indiana, Maryland, Montana, South Carolina  SED: Michigan Kansas

17. Homework & Research Becoming a Medicaid Provider of Family and Youth Peer Support: Considerations for Family Run Organizations http://www.chcs.org/resource/becoming-a-medicaid-provider-of-family-and-youth- peer-support-considerations-for-family-run-organizations/ Funder: Centers for Medicare & Medicaid Services Author: Jane Kallal, Family Involvement Center; Jane Walker, Family-Run Executive Director Leadership Association; Lisa Conlan Lewis, Family Support Network of Rhode Island; Dayana Simons, CHCS; Jessica Lipper, CHCS; Sheila Pires, Human Service Collaborative

18. Making Some Decisions  Share Space  Share Resources/Partners  Share Goals  Shared Experience  Shared History  Shared Burdens

19. Questions? Discussion

20. Resources Medicaid/CMS: ► Clarifying Guidance on Peer Support Services Policy http://www.medicaid.gov/Medicaid-CHIP-Program-Information/By-Topics/Benefits/Downloads/Clarifying- Guidance-Support-Policy.pdf ► Joint CMCS and SAMHSA Informational Bulletin (May 7,2013) http://www.medicaid.gov/federal-policy-guidance/downloads/CIB-05-07-2013.pdf ► Medicaid Waivers http://www.medicaid.gov/Medicaid-CHIP-Program-Information/By-Topics/Waivers/Waivers.html CHCS: ► Intensive Care Coordination Using High-Quality Wraparound for Children with Serious Behavioral Health Needs: State and Community Profiles http://www.chcs.org/resource/intensive-care-coordination-using-high- quality-wraparound-children-serious-behavioral-health-needs-state-community-profiles/http://www.chcs.org/resource/intensive-care-coordination-using-high- quality-wraparound-children-serious-behavioral-health-needs-state-community-profiles/ ► Becoming a Medicaid Provider of Family and Youth Peer Support: Considerations for Family Run Organizations http://www.chcs.org/publications3960/publications_show.htm?doc_id=1261625 ► Medicaid Financing for Family and Youth Peer Support: A Scan of State Programs http://www.chcs.org/resource/medicaid-financing-for-family-and-youth-peer-support-a-scan-of-state- programs-3/ http://www.chcs.org/resource/medicaid-financing-for-family-and-youth-peer-support-a-scan-of-state- programs-3/ Family-Run Executive Director Leadership Association: http://fredla.org/resources-publications/parent-to-parent-resources/

21. Contact Information Dana McCrary CHIPRA Parent and Youth Peer Coordinator Georgia Department of Behavioral Health and Developmental Disabilities 404-232-1427 Dana.McCrary@dbhdd.ga.gov Dayana Simons Senior Program Officer Center for Health Care Strategies 609-528-8400 dsimons@chcs.org