How to Finance the Expansion and Sustainability of Systems of Care

(“Financing”)*

 

 

 

 

Facilitators:  Sheila Pires, Human Service Collaborative; Suzanne Fields, The Institute for Innovation & Implementation; Doreen Cavanaugh, Georgetown University; and Beth Stroul, Management and Training Innovations

 

Location:  Johns Hopkins Gaithersburg Campus

 

Date:  September 9-10, 2015

 

Duration:  2 days

 

Maximum Number of Participants:  55 (8-9 grantees/states)

 

Participants: Teams should include representatives from Medicaid (Medicaid behavioral health director and/or Medicaid managed care director); Child Welfare (director, fiscal director, IV-E waiver coordinator, other); Behavioral Health (child behavioral health director, fiscal director, SOC grant Principal Investigator and/or Project Director); Juvenile Justice (director, fiscal director); and statewide family organization (director or administrator).

 

Description: This meeting will be structured as a practical, how-to meeting for strategically selected teams from state and local grantees. Teams will explore a range of financing issues and strategies to integrate systems of care within larger delivery systems as a primary sustainability strategy.  The goal for grantees is to develop their own tailored financing approaches to expand and sustain the principles and central operating components of systems of care statewide. Sessions will address such topics as:

 

• How to analyze expenditures and utilization across systems to identify:

  • disproportionalities and disparities based on region, race/ethnicity, gender, and aid category in Medicaid (TANF, foster care, SSI/disabled),

  • “poor outcome-high cost” spending, 

  • opportunities for redirection and for maximizing federal match in Medicaid and Title IV-E,

  • gaps and strengths in financing for evidence-informed home- and community-based services, and

  • opportunities to create more coordinated financing approaches;

 

• How to make effective and efficient use of Medicaid and health reform opportunities, covering such areas as:

  • benefit design, waivers and options important for children with behavioral health challenges,

  • enrollment strategies, and

  • quality efforts;

 

• What to include within Medicaid managed care RFPs and contracts to ensure appropriate customization for children with behavioral health challenges and children in child welfare such as:

  • evidence-informed service array,

  • provider network requirements,

  • quality processes informed by families and youth,

  • appropriate care coordination, including intensive care coordination using Wraparound,

  • use of family and youth peer support, and

  • process and outcome measures;

 

• Cross-agency financing of effective home- and community-based services, including integrating system of care and child welfare IV-E waiver initiatives, school-linked supports, use of TANF monies, and opportunities within juvenile justice systems, interagency compacts, and social impact bonds;

 

• Cross-agency financing of intensive care coordination using Wraparound, including integration within Medicaid, development of bundled and population case rates, and opportunities for redirection of existing dollars to improve cost and quality of care;

 

• Financing family-run and youth-run organizational capacity to support an array of activities; and

 

• Using financing and utilization data to establish the return on investment from systems of care.

 

 

 

*Logistical support for this meeting provided by the American Institutes for Research.