supercharge crisis services - lawrence goldman (natcon15)

“Supercharge Your Crisis Services to Next Generation Status in 90 Days”

A view from the management perspective

Dr. Lawrence GoldmanSVP, Government Relations

Beacon Health Options

Beacon Health Options: Who We Are

• A health improvement company that specializesin mental and emotionalwellbeing and recovery

• A mission-driven company singularly focused on behavioral health

• Largest privately-held behavioral health company in the nation

Who We Are

• We are a company passionate about helping people with mental illness and addiction live their lives to the fullest potential

• We focus on the recovery and resilience of our members and their families

• We are people with shared experiences who work to help our members every day

Our Mission

We help people live their lives to the fullest potential.

This shared mission guides our purpose.

Everything we do matters and how we do it helps us improve the lives of those we serve.

About US

• Headquartered in Boston; more than 70 US locations and a London office

• 4,300 employees nationally and in the UK serving more than 45 million people

• 225 employer clients, including 45+ Fortune 500 companies

• Partnerships with more than 90 health plans

Programs serving Medicaid recipients in 25 states and the District of Columbia

Serving 8.6 million military personnel, federal civilians and their families

Leader serving dual-eligible beneficiaries in six states

Accreditation by both URAC and NCQA

Our National Footprint

A population based, total health management strategy designed to:

– Promote healthy behavior

– Effectively manage chronic illness

– Eliminate barriers to treatment

– Increase service coordination and provider collaboration

– Contain health care costs

Focus on the physical, behavioral, and psychosocial environment needs of the population, instead of a fragmented “silo” approach

Proactive identification, outreach, and assessment to intervene as early as possible along the wellness/ disease continuum

Our Vision

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Behavioral Health in Primary Care

• PCPs furnish over half of all mental health treatment• 25% of all primary care patients have

diagnosable mental disorders• 50-70% of a PCP’s caseload consists of patients

whose medical ailments are psychologically related

• Most patients receiving referrals to specialty

mental health do not follow through with the referrals• 40% to 60% of people who complete suicide

have seen a PCP in the preceding month

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Integration is the Foundation

Care integration

Provider integration

Data, analytic and outcomes integration

Financial integration

Systems integration

“Plans” integration (Medicaid/Exchange)

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Spectrum

• Member Centered 360° View of Health• Information Aggregator

of Multiple Data Sources • Customizable Look and Feel• Secure Role Based Access• Diverse Users – Providers,

Members, Care Managers

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Copyright 2014 ValueOptions.® All rights reserved.

Crisis Services

Crisis response value points *

• Person-centered • Establish sense of personal safety• Look at the whole person

• The person in crisis is credible

• Recovery and Resilience• Prevention

* - Practice Guidelines: Core Elements in Responding to Mental Health Crises; SAMHSA, 2009

Military OneSource

• Military OneSource• A confidential Department of Defense-funded program • Providing comprehensive information on every aspect of military life • No cost to active duty, National Guard, and reserve members, and

their families.• Information includes, but is not limited to:

– deployment – reunion – relationships – grief– spouse employment and education – parenting and childhood services

Massachusetts Emergency Service Program (ESP) - Mission

Deliver high-quality, culturally competent, clinically and cost-effective, integrated community-based behavioral health crisis assessment, intervention, and stabilization

services that promote resiliency, rehabilitation, and recovery.

21 ESPs serve the 21 statewide catchment areas

for full state coverage

Massachusetts Emergency Service Program (ESP)

• ESP will provide– Onsite, face to face responses, including short term

counseling

– Psychiatric consultation and urgent Rx intervention, prn

– Solution focused/strengths oriented crisis intervention

– Access to the full continuum of services available, both physical and behavioral

Massachusetts Behavioral Health Access Website

• Designed to – enable behavioral health health care providers to locate openings

in mental health and substance use services– for the purpose of referring individuals to available services

• Searchable services include– Emergency Service Program/Mobile crisis– Community Crisis Stabilization– And many others

MABHA Website Example

Questions?MABHA Website

ESP Search Results

Texas – Northstar Crisis Response

• All network providers must provide crisis• It’s a crisis, if the member says it is• Mobile Crisis

– Front Door system at local private psychiatric hospital– 24/7/365 ER, 23 hour observation unit and inpatient– Peer navigators

• Crisis intake calls warm transferred

Texas Northstar Crisis ServicesLEVEL OF CARE AGE ELIGIBILITY

ADULTSELIGIBILITYCHILDREN

PROVIDEDBY

CRISIS SERVICES  

Mobile Crisis Children & Adults Medicaid & All Indigent

Medicaid & All Indigent Credentialed Providers

Crisis Stabilization (Hospital-based, 1-3 days)

Children & Adults Medicaid & Indigent SMI

Medicaid & All Indigent Credentialed Providers

Crisis Stabilization (Community-based, 1-3 days)

Children & Adults Medicaid & Indigent SMI

Medicaid & All Indigent Credentialed Providers

23 Hour Observation/Treatment (Hospital-based)

Children & Adults Medicaid & Indigent SMI

Medicaid & All Indigent Licensed Facilities

Illinois Mental Health Collaborative

• Crises are emergent and urgent• Emergent

– Engage the caller– Activate second clinical care manager– Stay with caller until emergency arrives/confirmed

• Urgent– Determine the need; make a connection to care– Warm transfer to treating provider– Document

A Real World Crisis Access Model

• Georgia Collaborative ASO – built on experience– Crisis and access to the system– A public line

• 24 hours per day• Live answer at all times• Available to all regardless of individual resources

– A provider line• Direct connection with crisis providers• Coordinate referrals• ACD used to route calls as needed

Real Time View of Crisis Episodes

• Track location of mobile crisis dispatches statewide• Information includes

– status (in-transit, arrived, assessment, linkage) – how long the team has been in that status

• Activity and performance in real time – number of active dispatches– location of crises – average response time by region for the day and month to date

Live Dispatch Monitor

Real Time View of Active Referrals and Crisis Bed Availability

• Software tracks– bed availability in real time to – a live census that shows exactly which consumer is in

which bed• Crisis units can

– report pending discharges so the – show when next available bed is visible

• Real time data shows– who is waiting for a bed– where they are waiting– how long they have waited– where an how many beds are open statewide

Live Crisis Beds Inventory Status

Informed Crisis Care

• Integration of the ValueOptions Care Connect System and Georgia’s Crisis System operated by BHL will add vital information to inform crisis care– The collaboration adds a whole new dimension- enrollment and

other clinical data– The information provides allows connection to the person’s

provider

• Which allows for a safer and more robust system/safety net.

Then Crisis Episodes Become Part of the Record

With crisis episodes (either crisis calls or mobile crisis visits)

integrated into the system and real time information shared,

everyone caring for that individual is more informed

Q & AQ & A

Lawrence.Goldman@beaconhealthoptions.com757 348 3883