Slide1 l.jpg
This presentation is the property of its rightful owner.
Sponsored Links
1 / 27

Health Homes: What Are They and What Might They Look Like NYAPRS 29 th Annual Conference September 14, 2011 Adele Gregory Gorges PowerPoint PPT Presentation


  • 81 Views
  • Uploaded on
  • Presentation posted in: General

Health Homes: What Are They and What Might They Look Like NYAPRS 29 th Annual Conference September 14, 2011 Adele Gregory Gorges Executive Director, New York Care Coordination Program, Inc. New York Care Coordination Program. NYCCP Strategic Plan for System Transformation.

Download Presentation

Health Homes: What Are They and What Might They Look Like NYAPRS 29 th Annual Conference September 14, 2011 Adele Gregory Gorges

An Image/Link below is provided (as is) to download presentation

Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author.While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server.


- - - - - - - - - - - - - - - - - - - - - - - - - - E N D - - - - - - - - - - - - - - - - - - - - - - - - - -

Presentation Transcript


Slide1 l.jpg

Health Homes: What Are They and What Might They Look Like

NYAPRS 29th Annual Conference

September 14, 2011

Adele Gregory Gorges

Executive Director, New York Care Coordination Program, Inc.


New york care coordination program l.jpg

New York Care Coordination Program


Nyccp strategic plan for system transformation l.jpg

NYCCP Strategic Plan for System Transformation


Timelines for system transformation l.jpg

Timelines for System Transformation


Slide5 l.jpg

  • Listen to the customer……


Slide6 l.jpg

  • Guiding Principles for Person-Centered, Recovery-Focused Services, developed by the Peer and Family Advisory Group of the WNYCCP in 2007

    • The goal is recovery, not just stabilization and maintenance.

    • Hope is necessary and recovery is possible for everyone.

    • Every individual is unique; every recovery different.

    • People have prompt access to compassionate care and services.

    • The system is flexible, wherever possible, to support the person’s recovery.

    • Every plan for recovery is centered on the person’s goals, strengths, and preferences -- not the availability of a particular program or service.


Slide7 l.jpg

  • Guiding Principles for Person-Centered, Recovery-Focused Services (continued)

    • Natural supports, outside the mental health system, are explored and encouraged.

    • Family support is valued and included when appropriate.

    • There is a partnership between individuals and their treatment team, care coordinators, service providers, and their peers and family members, when appropriate.

    • Individuals are educated to make informed choices about their health care and recovery.

    • Peers (people in recovery) are included and involved at all levels in the organization.

    • Everyone is treated with dignity and respect; differences in culture, belief, or language are valued.


Slide8 l.jpg

  • Listen to the customer……

  • Person centered, recovery focused care coordination produces better outcomes for individuals, and lower costs for payers


Person centered recovery focused care coordination adds value l.jpg

Person-Centered, Recovery-Focused Care Coordination adds value

* 2009 Periodic Reporting Form Analysis


Slide11 l.jpg

  • Listen to the customer

  • Person centered, recovery focused care coordination produces better outcomes for individuals, and lower costs for payers

  • Getting those outcomes requires new knowledge, new skills, a new culture – and that is hard work


Slide12 l.jpg

  • It took a massive effort to develop the new knowledge, new skills and the new culture needed for person-centered, recovery-focused care coordination

    • Changing the system to meet the needs of individuals rather than expecting individuals to fit into existing systems

  • It will take an equally massive effort to move to from Targeted Case Management to Health Home Care Coordination


Starting in 2003 and continuing l.jpg

Starting in 2003 and continuing…..


Slide14 l.jpg

  • Listen to the customer

  • Person centered, recovery focused care coordination produces better outcomes for individuals, and lower costs for payers

  • Getting those outcomes requires new knowledge, new skills, a new culture – and that is hard work

  • The Targeted Case Management work force is well positioned to make a successful transition to Health Home Care Coordination


Pilot with monroe plan for medical care l.jpg

Pilot with Monroe Plan for Medical Care

  • Teamed Community Based Intensive Case Managers with Office Based Managed Care Plan Case Managers

  • What we learned

    • The collaboration was effective in finding and serving individuals with serious mental health concerns and serious medical conditions

    • The cultures of behavioral health providers and physical health providers are VERY DIFFERENT - we need to learn to speak each other’s language


Nyccp beacon model for complex care management l.jpg

NYCCP/Beacon Model for Complex Care Management

  • Teams provider-based Targeted Case Manager with MBHO based Complex Care Managers

  • Intensive, flexible/episodic, focusing on physical and behavioral health care for individuals with highest needs -- serious mental illness, complex medical needs, top 10% in total costs.

  • Achieved average length of stay of 6 monthsat the intensive level.


Characteristics of nyccp beacon ccm l.jpg

Characteristics of NYCCP/Beacon CCM

  • Grounded in supporting individuals to attain recovery goals related to life objectives – living, working, socializing.

  • Empowers individuals through development of skills for self-management of physical and behavioral health symptoms

  • Supports individuals in building an integrated, coordinated team of providers of choice

  • Enhances the use of Peer Support services and other natural supports in the community. As generally available in the community, but also purchased using wrap around dollars if necessary for program enrollees. (e.g. Compeer Peer Wellness Coaches for the Well Balanced Program)


Nyccp beacon complex care management can be an effective core for health homes l.jpg

NYCCP/Beacon Complex Care Management can be an effective core for Health Homes

  • Focuses HR/HN populations and episodes of care

  • Based on transition from Targeted Case Management to a practice equivalent to that of a Health Home Care Coordinator

  • Maximizes resources through shorter lengths of stay in higher levels of care coordination and effective linkage with providers of choice

  • Effective linkage to a provider of choice for a “health home” can lead to enhanced self management skills, timely health promotion and prevention services, early intervention, and mind-body health

  • Melds Person-Centered Practice as an underpinning for the initiative AND a managed care focus on an episode of care and movement to recovery.


Slide19 l.jpg

  • Listen to the customer

  • Person centered, recovery focused care coordination produces better outcomes for individuals, and lower costs for payers

  • Getting those outcomes requires new knowledge, new skills, a new culture – and that is hard work

  • The Targeted Case Management work force is well positioned to make a successful transition to Health Home Care Coordination

  • Peer services will be a key to success for Health Homes


Slide20 l.jpg

  • Peer services will be a key to success for Health Homes

    • Experience of the NYCCP/Beacon Complex Care Management Model

      • Critical resource within this model

      • Referral to peer services developed from 2002 to the present

    • NYAPRS Peer Bridger Model

    • NYAPRS collaboration with Optum for CIDP


Slide21 l.jpg

  • Listen to the customer

  • Person centered, recovery focused care coordination produces better outcomes for individuals, and lower costs for payers

  • Getting those outcomes requires new knowledge, new skills, a new culture – and that is hard work

  • The Targeted Case Management work force is well positioned to make a successful transition to Health Home Care Coordination

  • Peer services will be a key to success for Health Homes

  • The Behavioral Health treatment providers are well positioned to be a part of an integrated behavioral/physical health service system


Slide22 l.jpg

  • Partner with Primary Care Based Health Home providers

    • Contracted specialty provider for

      • Individuals with chronic serious mental illness who choose a primary care based health home provider

      • Individuals with serious chemical dependency and co-occurring chronic medical issues who choose a primary care based health home provider

    • Contracted basic level services provider for behavioral health for individuals who qualify for Health Home by virtue of multiple chronic medical and/or chemical dependency issues and have chosen a primary care based health home provider

  • Provide Specialty Behavioral Health Home service


Target populations for specialty behavioral health homes l.jpg

Target Populations for Specialty Behavioral Health Homes

  • Adults with Serious Mental Illness

  • Adults with Serious Chemical Dependency + Co-Occurring Chronic Physical Illness

    Deferred

  • Children with Serious Chemical Dependency + Co-Occurring Chronic Physical Illness

  • Children with Serious Emotional Disturbance


Model for specialty behavioral health home team composition l.jpg

Model for Specialty Behavioral Health Home Team Composition

  • Core Team

    • Individual and family as appropriate

    • Mental Health or Chemical Dependency Primary Therapist (PT)

    • Nurse Practitioner or Primary Care Physician onsite at Behavioral Health Home Provider

    • Care Coordinator -with appropriate qualifications and training for integrated, person-centered work and a team reflecting the need for peer experience and cultural and linguistic competency

  • Plus

    • Psychiatrist

    • Primary Care Physician or Nurse Practitioner

    • Other specialty providers as appropriate

  • Plus Consulting Members of Team

    • Pharmacist

    • Managed Care Plan Case Manager


Slide25 l.jpg

  • Listen to the customer

  • Person centered, recovery focused care coordination produces better outcomes for individuals, and lower costs for payers

  • Getting those outcomes requires new knowledge, new skills, a new culture – and that is hard work

  • The Targeted Case Management work force is well positioned to make a successful transition to Health Home Care Coordination

  • The Behavioral Health treatment providers are well positioned to be a part of an integrated behavioral/physical health service system

  • Peer services will be a key to success for Health Homes

  • BHO’s can add value to Health Home development


Slide26 l.jpg

  • Interface of BHO and Health Homes

    • BHO will facilitate transitions from Inpatient to Health Home

    • BHO will provide data that can be used for practice improvement

    • BHO will provide forum for stakeholder participation and operations


For more information l.jpg

For more information

  • Adele Gregory Gorges

    • Executive Director, New York Care Coordination Program, Inc.

    • C/O Coordinated Care Services, Inc.

    • 1099 Jay Street, Building J, Rochester, NY 14611

    • 585-613-7656

    • [email protected]

    • www.carecoordination.org


  • Login