Child and Adolescent Ambulatory Care Restructuring Project

Kristin Riley, OMH Deputy Commissioner

Heather Lane, OMH System of Care Coordinator

November 30,2010

Historical Context to Change Agenda

2006 Achieving the Promise for NY’s Children and Families

2007 Clinic Restructuring Begins

2008 (April) Ambulatory Restructuring Begins

2008 (October) The Children’s Plan

2010 (October) New Clinic Treatment Regs.

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”

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

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.

Where do we go from here Case Management and Waiver?OMH with the input from SPOAs, providers, families, youth andcommunity 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.

Subcommittee Observations/Reccomendations

Specific to SPOA

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.

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.

Recommendations/Observations ForConsistency/Standardization

Clinical Documentation Common Assessment Tool

Community Check-In Process

Data Collection

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.

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.

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.

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

Where do we go from here?

OMH with the input from providers, families, youth, communitydirectors 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.