adult bh hcbs: the mechanics of successful “lift-off” successful... · • tips to help with...

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Adult BH HCBS: The Mechanics of Successful “Lift-Off” Yves Ades, PhD Daniella Labate, MSW

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Page 1: Adult BH HCBS: The Mechanics of Successful “Lift-Off” Successful... · • Tips to help with implementation ... ‣Assessment tools ... ‣Include HCBS designation on your website

Adult BH HCBS: The Mechanics of

Successful “Lift-Off” Yves Ades, PhD Daniella Labate, MSW

Page 2: Adult BH HCBS: The Mechanics of Successful “Lift-Off” Successful... · • Tips to help with implementation ... ‣Assessment tools ... ‣Include HCBS designation on your website

Housekeeping: • Slides are posted at MCTAC.org

• Questions not addressed today will be: • Reviewed and incorporated into future trainings and presentations

• Added to Q&A resources when possible

• Feedback forms

Reminder: Information and timelines are current as of the date of the presentation

Introduction & Housekeeping

Page 3: Adult BH HCBS: The Mechanics of Successful “Lift-Off” Successful... · • Tips to help with implementation ... ‣Assessment tools ... ‣Include HCBS designation on your website

What is MCTAC? MCTAC is a training, consultation, and educational resource center that offers resources to all mental health and substance use disorder providers in New York State. MCTAC’s Goal Provide training and intensive support on quality improvement strategies, including business, organizational and clinical practices to achieve the overall goal of preparing and assisting providers with the transition to Medicaid Managed Care.

Page 4: Adult BH HCBS: The Mechanics of Successful “Lift-Off” Successful... · • Tips to help with implementation ... ‣Assessment tools ... ‣Include HCBS designation on your website

CTAC & MCTAC Partners

Page 5: Adult BH HCBS: The Mechanics of Successful “Lift-Off” Successful... · • Tips to help with implementation ... ‣Assessment tools ... ‣Include HCBS designation on your website

3/21/2014

Small Business Initiative Partners

Page 6: Adult BH HCBS: The Mechanics of Successful “Lift-Off” Successful... · • Tips to help with implementation ... ‣Assessment tools ... ‣Include HCBS designation on your website

Agenda ‣ How to get HCBS off the ground • Tips to help with implementation ‣ The HCBS Team ‣ Tips to help form a strong team of HCBS service providers ‣ Investing in the future • Tips to help sustainability

Page 7: Adult BH HCBS: The Mechanics of Successful “Lift-Off” Successful... · • Tips to help with implementation ... ‣Assessment tools ... ‣Include HCBS designation on your website

Video Clip ‣ https://drive.google.com/open?id=0B3YlQhfCENzzeUd

nckFIY21welU

Page 8: Adult BH HCBS: The Mechanics of Successful “Lift-Off” Successful... · • Tips to help with implementation ... ‣Assessment tools ... ‣Include HCBS designation on your website

Why HCBS? ‣Facilitate recovery ‣People need services that don’t fit into

traditional models of treatment ‣Community based ‣HCBS provides flexibility

Page 9: Adult BH HCBS: The Mechanics of Successful “Lift-Off” Successful... · • Tips to help with implementation ... ‣Assessment tools ... ‣Include HCBS designation on your website

What is your vision for HCBS? ‣ Planning • What services do you offer? • Where do you offer these services? • Who is on your HCBS development team? ‣ Resources • What expertise do you already have? • What might you need? ‣ Staffing • Who will provide these services?

Page 10: Adult BH HCBS: The Mechanics of Successful “Lift-Off” Successful... · • Tips to help with implementation ... ‣Assessment tools ... ‣Include HCBS designation on your website

Planning ‣ What HCBS services are you designated to provide? ‣ People to consider for your implementation team: • Leadership • Finance • Program • IT • HR • QI • Marketing • Legal

Page 11: Adult BH HCBS: The Mechanics of Successful “Lift-Off” Successful... · • Tips to help with implementation ... ‣Assessment tools ... ‣Include HCBS designation on your website

Workflows ‣Designate tasks • Managing referrals • Participant engagement • Assessments and Service Plan • Authorizations • Provide service(s)

Page 12: Adult BH HCBS: The Mechanics of Successful “Lift-Off” Successful... · • Tips to help with implementation ... ‣Assessment tools ... ‣Include HCBS designation on your website

Readiness ‣ Is everyone in your agency familiar with HCBS and the

services your organization is designated to provide? ‣ Is your EHR ready to document HCBS? • If not, have you created paper forms for documentation?

(Assessment, progress notes, unit utilization, etc.) ‣ Does finance understand reimbursement?

Page 13: Adult BH HCBS: The Mechanics of Successful “Lift-Off” Successful... · • Tips to help with implementation ... ‣Assessment tools ... ‣Include HCBS designation on your website

HCBS providers should be trained in: ‣ What is HARP? ‣ Changes in Medicaid ‣ What is a Health Home? ‣ How to provide recovery-oriented, person-centered,

trauma-informed care ‣ Specific HCBS services ‣ Assessment tools ‣ EHR/Forms

Page 14: Adult BH HCBS: The Mechanics of Successful “Lift-Off” Successful... · • Tips to help with implementation ... ‣Assessment tools ... ‣Include HCBS designation on your website

Marketing basics ‣Offer a valuable service ‣ Identify a target audience ‣Communicate to target audience ‣Make services readily available

Page 15: Adult BH HCBS: The Mechanics of Successful “Lift-Off” Successful... · • Tips to help with implementation ... ‣Assessment tools ... ‣Include HCBS designation on your website

How to market your services ‣ Include HCBS designation on your website ‣ Create flyers and send them to lead health homes and

care management agencies ‣ Update brochures ‣ Education and promotion: Eligibility? Why HCBS? ‣ Build relationships and communicate value! Foster

relationships with Health Homes and MCOs ‣ Be present at networking forums

Page 16: Adult BH HCBS: The Mechanics of Successful “Lift-Off” Successful... · • Tips to help with implementation ... ‣Assessment tools ... ‣Include HCBS designation on your website

Tips ‣Start with HCBS services that are similar

to services you are already providing ‣Involve a variety of roles in your planning ‣Identify staff to provide the services ‣Provide training ‣Market your services

Page 17: Adult BH HCBS: The Mechanics of Successful “Lift-Off” Successful... · • Tips to help with implementation ... ‣Assessment tools ... ‣Include HCBS designation on your website

The HCBS Team

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Video clip ‣ https://drive.google.com/open?id=0B3YlQhfCENzzU0k

5ZElGbUZjS2M

Page 19: Adult BH HCBS: The Mechanics of Successful “Lift-Off” Successful... · • Tips to help with implementation ... ‣Assessment tools ... ‣Include HCBS designation on your website

Think outside the office.

Page 20: Adult BH HCBS: The Mechanics of Successful “Lift-Off” Successful... · • Tips to help with implementation ... ‣Assessment tools ... ‣Include HCBS designation on your website

Things to consider when choosing staff for HCBS ‣Meet HCBS staffing requirements ‣Qualified to provide multiple services ‣Embrace the principles of recovery ‣Work well with others

Page 21: Adult BH HCBS: The Mechanics of Successful “Lift-Off” Successful... · • Tips to help with implementation ... ‣Assessment tools ... ‣Include HCBS designation on your website

Supervision in the field ‣ Go out in the community and “walk in their shoes” ‣ Not a typical clinical setting ‣ Build skills for community based work ‣ Draw on staff strengths • Peer staff can offer shared experiences • Be flexible • Good at engagement • Can build trust

Page 22: Adult BH HCBS: The Mechanics of Successful “Lift-Off” Successful... · • Tips to help with implementation ... ‣Assessment tools ... ‣Include HCBS designation on your website

Lots of moving parts

Page 23: Adult BH HCBS: The Mechanics of Successful “Lift-Off” Successful... · • Tips to help with implementation ... ‣Assessment tools ... ‣Include HCBS designation on your website

Sharing Information

HCBS Provider

MCO Health Home

Bridge the gap

Page 24: Adult BH HCBS: The Mechanics of Successful “Lift-Off” Successful... · • Tips to help with implementation ... ‣Assessment tools ... ‣Include HCBS designation on your website

Tips ‣ Services are delivered in the home or community and

people will feel more comfortable ‣ Avoids stigma sometimes associated with traditional

services ‣ Shift from “case” to person ‣ Think flexibly ‣ Communicate

Page 25: Adult BH HCBS: The Mechanics of Successful “Lift-Off” Successful... · • Tips to help with implementation ... ‣Assessment tools ... ‣Include HCBS designation on your website

Investing in your Future

Page 26: Adult BH HCBS: The Mechanics of Successful “Lift-Off” Successful... · • Tips to help with implementation ... ‣Assessment tools ... ‣Include HCBS designation on your website

Video clip ‣ https://drive.google.com/open?id=0B3YlQhfCENzzd0J1

UW5pdWNNN1U

Page 27: Adult BH HCBS: The Mechanics of Successful “Lift-Off” Successful... · • Tips to help with implementation ... ‣Assessment tools ... ‣Include HCBS designation on your website

Uncertain Times

Medicaid Redesign

Costs are high

No outcomes to show

Page 28: Adult BH HCBS: The Mechanics of Successful “Lift-Off” Successful... · • Tips to help with implementation ... ‣Assessment tools ... ‣Include HCBS designation on your website

Triple Aim Improve Outcomes

Lower Cost

Improve Experience of Care

Page 29: Adult BH HCBS: The Mechanics of Successful “Lift-Off” Successful... · • Tips to help with implementation ... ‣Assessment tools ... ‣Include HCBS designation on your website

Shift from a fragmented to integrated system of care ‣Development of Health Homes, HARP,

DSRIP and HCBS ‣Reimbursement structure is also being

reformed • Value Based Payment • Incentivizing partnerships

Page 30: Adult BH HCBS: The Mechanics of Successful “Lift-Off” Successful... · • Tips to help with implementation ... ‣Assessment tools ... ‣Include HCBS designation on your website

HCBS is person-centered ‣HCBS puts person-centered, recovery-

oriented philosophy into action through innovative service delivery.

‣Concept based on choice and individual recovery

‣Shift from developing a program to developing individual services

Page 31: Adult BH HCBS: The Mechanics of Successful “Lift-Off” Successful... · • Tips to help with implementation ... ‣Assessment tools ... ‣Include HCBS designation on your website

Define Services by Individual ‣ People have complex needs • Numerous appointments • Multiple Sites ‣ Services should be defined by the individual ‣ HCBS brings a personalized network of care to people in

their communities

Page 32: Adult BH HCBS: The Mechanics of Successful “Lift-Off” Successful... · • Tips to help with implementation ... ‣Assessment tools ... ‣Include HCBS designation on your website

Define services by individual

Engagement

Trust HCBS Services

Page 33: Adult BH HCBS: The Mechanics of Successful “Lift-Off” Successful... · • Tips to help with implementation ... ‣Assessment tools ... ‣Include HCBS designation on your website

Whole person care requires collaboration ‣ Creation of a network of care

HCBS Provider

Other HCBS

providers

Other care management

programs

MCO

Lead Health Home

Other systems of care

Criminal justice

Collaborative partners (DSRIP)

Hospitals

Page 34: Adult BH HCBS: The Mechanics of Successful “Lift-Off” Successful... · • Tips to help with implementation ... ‣Assessment tools ... ‣Include HCBS designation on your website

Collaboration and relationships ‣What does it take? • Staff re-allocation • A consistent presence ◦ Join workgroups ◦ Keep commitments

• Awareness of your value

Page 35: Adult BH HCBS: The Mechanics of Successful “Lift-Off” Successful... · • Tips to help with implementation ... ‣Assessment tools ... ‣Include HCBS designation on your website

Collaboration and relationships ‣ Where to begin? ‣ Consider the following: • Outreach to HH Care Coordinators ◦ Present on what HCBS is ◦ Explain Person-centered approach ◦ Suggest a warm hand-off

• Build relationships with Managed Care Reps ◦ Ask them what they want to see in a plan of care

• Develop a One-Pager • Be patient-engagement can take several meetings

Page 36: Adult BH HCBS: The Mechanics of Successful “Lift-Off” Successful... · • Tips to help with implementation ... ‣Assessment tools ... ‣Include HCBS designation on your website

Tips ‣Connect with a range of partners ‣Know the value you bring to the relationship

Page 37: Adult BH HCBS: The Mechanics of Successful “Lift-Off” Successful... · • Tips to help with implementation ... ‣Assessment tools ... ‣Include HCBS designation on your website

Join an HCBS Learning Community! Do you want continued support when implementing HCBS services at your agency? Join monthly learning community meetings. You will receive more information via emal after this workshop series.

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Contact Us Yves Ades, NYAPRS, [email protected] Daniella Labate, NYAPRS, [email protected] Cheryl Bobe, The Coalition, [email protected] (for NYC and LI) John Coppola, ASAP, [email protected]

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Questions and Discussion

Please email additional questions to [email protected] and register for future events at

http://www.mctac.org under “Upcoming Events.”