Building Whole-System Change CT Recovery Purchasing Project

1. Building Whole-System Change CT Recovery Purchasing Project Sponsored by The Robert Wood Johnson Foundation October 15, 2008

2. Background of Project Three state agencies in Connecticut were funding the same residential substance abuse programs for adults: • Court Support Services Division of the Judicial Branch (CSSD) • Department of Correction (DOC) • Department of Mental Health and Addiction Services (DMHAS)

3. Background of Project Two state agencies were funding the same Multi-Systemic Therapy (MST) programs for children: • Court Support Services Division of the Judicial Branch (CSSD) • Department of Children and Families (DCF)

4. Background of Project As a result: • Each state agency needed to manage a separate contract • Each state agency needed to ensure quality • Each provider needed to report multiple times for the same program • Each provider and state agency negotiated rates individually for the programs

5. Project Goal The Connecticut Recovery Purchasing Project is a collaborative that, through administrative efficiencies, ensures that existing funding is effectively used to support direct services.

6. What are the Project’s Objectives? • To test models of collaboration where common modalities of service are employed. • To develop and implement an interagency collaborative management structure.

7. What are the Collaborative Models? For adult residential substance abuse services, a blended contracting model was employed • Funding from two state agencies, CSSD and DOC, was transferred to DMHAS for 12 common providers. • DMHAS managed the contract and provided the quality improvement services. • Reports from providers were shared with the two state partners. • Reconciliation processes were put in place to ensure each partner received appropriate levels of services.

8. Former CT Design DMHAS DOC CSSD Residential Provider Residential Provider Residential Provider Residential Provider

9. Current CT Administrative Design DOC DMHAS CSSD Residential Provider Residential Provider Residential Provider Residential Provider

10. What are the Collaborative Models? (continued) For children’s MST services, a parallel contracting model was employed. • Two state agencies, CSSD and DCF, created identical contract documents but did not blend funding for 2 common providers. • The two agencies did develop a blended funding model for provision of the quality improvement services required for MST.

11. Former CT Design DCF Contract CSSD Contract MST Provider MST Provider

12. Current CT Design DCF/CSSD Common Contract DCF/CSSD Common Contract MST Provider MST Provider

13. What are the Collaborative Models? (continued) For outpatient services, a local collaborative was developed. • The four state agencies jointly funded a supervision consultant to work with 20 supervisors from 7 providers. • Focused on the need for improved clinical supervision and improved family therapy.

14. Outpatient Collaborative Design

15. What is the Interagency Collaborative management structure? • Steering Committee – Representatives of the state agencies only • Operations Committees – Representatives of the state agencies and service providers • Project Manager

16. What are the Results? • Reduced administrative workload for state agencies and private providers. • Improved quality improvement management processes. • Increased interest in sharing information.

17. What are the lessons learned? • Champions in two agencies made it work. • Early success was very helpful. • Availability of staff time aided success. • There are limits to collaboration.