Transcript Erie County RFP Presentation

Community Care
A Non-profit Behavioral Health Managed Care Company
NYAPRS 7th Annual Executive Seminar on Systems Transformation
Integration Strategies for Behavioral Health:
Managing Care, Outcomes, and Costs
While Preserving our Recovery Vision
James Gavin, MSW, President and CEO, Community Care
Albany, NY, April 28, 2011
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About Community Care
• Behavioral health managed care company founded in
1996; part of UPMC and headquartered in Pittsburgh.
• Federally tax exempt non-profit 501(c)(3).
• Major focus is publicly-funded behavioral health care
services; currently doing business in PA and NY.
• Licensed as a Risk-Assuming PPO in PA; NCQAAccredited Quality and Disease Management Programs.
• Recipient of the Moffic Ethics Award from the American
Association of Community Psychiatrists.
• Serving over 1.3 million individuals in 36 counties through
a statewide network of over 1,800 providers.
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Mission and Vision
• Improve the health and well-being of the community
through the delivery of effective and accessible
behavioral health services.
• Improve the quality of services for members through a
stakeholder partnership focused on outcomes.
• Support high-quality service delivery through a
not-for-profit partnership with public agencies,
experienced local providers, and involved members
and families.
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Strengths of Community Care
• Innovative, clinically competent, and recovery focused.
• Responsive and accountable partner.
– Community Care has over 12 years experience in providing public
sector care coordination through a variety of contracts with counties,
the states of Pennsylvania and New York.
• Innovation in physical health and behavioral health
collaboration
– Participating in Innovations for SMI Populations Project to coordinate
physical health and behavioral health services, supporting Pat
Deegan’s tool kit to incorporate personal wellness for physical health;
implementing disease management programs for smoking cessation
and weight management, developing health homes in rural
Pennsylvania using teams that include peers, nurses, and other rehab
and physical health specialists to support individuals with more
complex physical and behavioral health care needs.
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Strengths of Community Care
• Systemic Improvement
– Commitment to input by individuals receiving services, their
families and other stakeholders; developing evidence-based
practices and school-based accountable homes; promoting
provider engagement, including benchmarking; increasing the
number and enhancing the scope of drug and alcohol
providers.
• Integrated Systems Development
– Supporting an array of local innovative practices, including
collaborations between FQHCs and CMHCs; foster families and
physical/behavioral health exchanges, co-locations of
behavioral health staff in primary care settings, health centers
and schools. Participating in emergency room diversion
activities. Building on local strengths and resources.
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Strengths of Community Care
• Linkage with Non-Medical Supports
– Participated in the closing of three state hospitals with county
partners, assisted in identifying and linking community supports
for individuals leaving hospitals as well as for those who might
have used them. Assisted in the development of supported
housing priority for 23 rural counties. Participated with Allegheny
County to support nationally recognized mental health and
criminal justice initiative.
• Commitment to Peer Initiatives
– We are committed to changing the clinical approach and culture
of clinical systems to support recovery; celebrate individuals
through an annual Recovery Institute; promote a shared
decision-making focus; support a Learning Collaborative model;
offer Steps of Hope, which focus on wellness; and support a
Statewide Corporate Member Advisory Board.
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In Summary…
• Responsive and accountable partner.
• State-of-the-art information technology used to further the
aims of the program.
• Fiscally accountable – good steward of public resources.
• Commitment to collaboration with human services,
providers, members, and cross-systems coordination.
• Innovative, clinically competent, and recovery focused.
• Specialized care management for high-risk/high-need
consumers, including coordination of care with communitybased services.
• Strong leadership team with many years of experience in
the public sector in PA.
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Opportunities for New York
• Build on strengths of consumer and family voice to
ensure healthcare models grounded in recovery and
resiliency principles.
• Support specialized needs of individuals with serious
mental illness and substance use; focusing on persons
with highest risk.
• Create high-risk care management practices to ensure
linkages between inpatient and outpatient services.
• Coordinate with local systems to enhance access to
local supports.
• Develop integrated health homes for individuals with
complex physical and behavioral health needs.
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Absolutes for Transformation
• Member drives delivery accountability.
• Recovery orientation dominance.
• Outcomes consistent with member-influenced
standards for positive change.
• Financial model adaptation (Best Practice).
– Workforce is competent and stable.
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Contact Information
James Gavin, MSW
President and Chief Executive Officer
Community Care Behavioral Health Organization
One Chatham Center, Suite 700
112 Washington Place
Pittsburgh, PA 15219
412-454-2120; www.ccbh.com
[email protected]
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