1. Child and Adolescent Ambulatory Care Restructuring Project Kristin Riley, OMH Deputy Commissioner Heather Lane, OMH System of Care Coordinator November 30,2010

2. Historical Context to Change Agenda 2006 Achieving the Promise for NY’s Children and Families 2007Clinic Restructuring Begins 2008(April) Ambulatory Restructuring Begins 2008(October) The Children’s Plan 2010(October) New Clinic Treatment Regs.

3. Child and Family Ambulatory Care Restructuring Original Focus:  Day Treatment  Case Management  Waiver  Partial Hospitalization Stakeholders: Family, Youth, Providers, County/City MH, Advocates, State Agencies Extensive Dialogue Required to Reach Consensus on Program Purpose and Structure June 2009 Consensus Paper with Programmatic Recommendations Issued  “Restructuring the New York State Ambulatory Care System for Children and their Families”

4. Child and Family Ambulatory Care Restructuring Expansion of Mission 2009-2010  Subcommittee explored a broader Waiver program  Subcommittees reviewed and made recommendations PACC (Pre-Admission Certification Committee – RTF) SPOA (Single Point of Access for children) (Spring 2010) added Community Residence/Family Based Treatment with a focus on entry into these programs

5. Where do we go from here?  All Subcommittees have completed their charge.  CR, FBT, and PACC recommendations/observations will move forward upon completion of Waiver, Case Management and SPOA recommendations to be implemented.

6. Where do we go from here Case Management and Waiver? OMH with the input from SPOAs, providers, families, youth and community directors will be: reviewing recommendations /observations for Case Management and Waiver, crafting models with the assistance of national consultants utilizing recommendations/observations as the underpinnings for program and fiscal design, sharing programs models with stakeholders for review and comment first quarter 2011.

7. Subcommittee Observations/Reccomendations Specific to SPOA

8. SPOA Recommendations/Observations  Family/Youth are active participants in the planning process.  Level of care decisions should always be based on child/family needs.  SPOA is part of a larger system of care within each county/borough.

9. SPOA Recommendations/Observations  Level of care decisions for intensive community based and OMH licensed residential (with the exception of inpatient) programs will remain the function of the SPOA.  Consistency and standardization for certain functions of the SPOA throughout New York State.

10. Recommendations/Observations For Consistency/Standardization  Clinical Documentation  Common Assessment Tool  Community Check-In Process  Data Collection

11. Clinical Documentation Because SPOAs review youth for the most intensive community based and residential (with the exception of inpatient) OMH regulated or licensed programs, specific clinical documentation to support level of care decisions within certain timeframes is necessary and will assist SPOAs in the decision making process.

12. Common Assessment Tool That:  Identifies a child and families strengths and needs across multiple domains,  Is able to give communities a snapshot of the needs of their consumers,  Would ideally, aligned with sister agencies.

13. Community Check-In Process To ensure that all youth who have accessed intensive community based or residential services (with the exception of inpatient) are still in need of those services, providers at certain time intervals will touch base with the SPOA.

14. Data Collection Meaningful  To assist SPOA Coordinators in the day to day functions of their work Manageable  A data entry input process that isn’t arduous to the user Measureable  Able to measure outcomes at the child specific, county/borough and state level

15. Where do we go from here? OMH with the input from providers, families, youth, community directors and you will be:  reviewing recommendations /observations for SPOA,  crafting detailed narrative utilizing your feedback as an underpinning,  sharing process specifics to all stakeholders for review and comment first quarter 2011.