New federally financed drug research reveals a stark disparity: children covered by Medicaid are given powerful antipsychotic medicines at a rate four times higher than children whose parents have private insurance. And the Medicaid children are more likely to receive the drugs for less severe conditions than their middle-class counterparts, the data shows.
Tuesday, December 15, 2009
Wednesday, November 25, 2009
Please join the WMHN on Wednesday, December 2nd at the MSPCC offices at 335 Chandler Street as it hosts Mary Bartholomew of Lutheran Social Services of New England. Mary will be speaking about the mental health needs of refugee children in the greater Worcester area. The program will begin at 4:30 p.m. and we hope to see as many as can make it.
Samuel Leadholm, Esq.
Health Law Advocates
30 Winter Street, Suite 1004
Boston, MA 02108
Wednesday, November 18, 2009
Caring Across Communities Briefing Kit: Addressing Mental Health Needs of Diverse Children and Youth
from Robert Wood Johnson Foundation
Recognizing the unique mental health challenges facing growing numbers of immigrant and refugee children, the Robert Wood Johnson Foundation launched a national program to reduce emotional and behavioral health problems among school children in low-income, immigrant and refugee families. The program, Caring Across Communities: Addressing Mental Health Needs of Diverse Children and Youth, includes $4.5 million in grants awarded to 15 projects across the country that will work to bring school connected mental health services to children in need, particularly those from immigrant and refugee families. The 15 projects are operated by a partnership involving schools, families, students, mental health agencies and other community organizations to build effective, easily-accessed services for children and youth. To access the briefing kit visit, http://www.rwjf.org/pr/product.jsp?id=49488.
Tuesday, November 10, 2009
Save The Date:
CMHC Supporters' Meeting 11/17
Please join us on Tuesday, November 17 from 9:30-11am in the 9th floor conference room at 30 Winter Street for the next CMHC supporters' meeting.
At this meeting, we will hear from Vic DiGravio, President of the Association for Behavioral Health (formerly the Mental Health and Substance Abuse Corporations of MA) who will talk about implementation of CBHI from his agency's perspective.
We will also be discussing legislative and budget strategies for FY 2011.
If you have any questions or suggestions, please contact Matt Noyes at firstname.lastname@example.org.
CMHC Sign-On Letter:
Ask Commercial Insurers To Pay Their Fair Share of MCPAP
The CMHC Executive Committee has prepared a letter to commercial insurers in Massachusetts, asking them to pay their fair share of the cost of the Massachusetts Child Psychiatric Access Project (MCPAP).
MCPAP is a fully state-funded program that provides telephonic mental health consultations to pediatricians, regardless of their insurance status. Since 2004, 63% of children served by MCPAP are on private insurance.
In the current budget crisis, it is imperative that commercial insurance companies pay their fair share for the benefits they get from the program.
To add your organization to the list of singers, please contact Matt Noyes at email@example.com or 617-275-2939.
The deadline to sign on to the letter is noon on Friday, November 20.
Saturday, November 7, 2009
- Blue Cross/ Blue Shield put out a paper on the status of the mental health workforce in Massachusetts that is worth reading here.
- Lesley Alderman had a nice piece in the New York Times on how patients should think about mental health parity, which kicks into play on January 1.
- All of the "Rosie D" remedy services under the CBHI have now kicked into play, except for Crisis Management Services, which has not been approved by CMS. The new CMS Administrator is likely to be appointed after the health reform debate is done; one wonders how this is affecting the negotiations on this point.
Monday, October 26, 2009
Beginning October 1, 2009, as part of the Children’s Behavioral Health Initiative (CBHI), outpatient providers serving youth under the age of 21 who are enrolled in MassHealth Standard and CommonHealth will be responsible for assuming the role of “clinical hub,” and will play a key role in the coordination of three new “hub dependent” services for their clients.
Therapeutic Mentoring, In-Home Behavioral Services, and Family Support and Training are new services available to youth under age 21 with behavioral health needs who are enrolled in MassHealth Standard and CommonHealth. As with all CBHI services, these services are designed to promote Systems of Care values and ensure that the care provided is:
• Family-Driven, Child-Centered, and Youth Guided
• Culturally Responsive
• Collaborative and Integrated
• Continuously Improving
This Alert includes information on all six CBHI services so that outpatient providers are aware of the entire CBHI continuum.
Role of the Clinical Hub
Clinical Hub providers are responsible for coordinating care and collaborating with other service providers (e.g., making regular phone calls to collaterals, holding meetings with the family and other treatment providers, or convening care planning teams for ICC). Clinical Hub services in order of intensity are: Intensive Care Coordination (ICC), In-Home Therapy (beginning November 1, 2009), and Outpatient Therapy. When more than one Clinical Hub service provider is involved with a family, care coordination is provided by the most intensive service. Clinical Hub providers may refer for services that require a hub (i.e., “hub dependent” services). These services include: Therapeutic Mentoring, In-Home Behavioral Services, and Family Support and Training. Hub dependent services require a referral from one of the three Clinical Hubs (i.e., outpatient, In-Home Therapy, Intensive Care Coordination) and will not be authorized as a “stand-alone” service. There must be a goal identified on the existing outpatient or IHT treatment plan, or on the individual care plan (ICP) for youth in ICC, which corresponds directly with the need for a “hub dependent” service. It is the responsibility of the Clinical Hub provider to regularly connect with those “hub dependent” service providers to which you make referrals in order to coordinate care and obtain and provide updates on the youth’s progress.
Outpatient providers will be reimbursed for coordination activities related to their Clinical Hub responsibilities including participation in care plan team meetings and collateral contacts. Providers can be reimbursed by billing for Case Consultation or Collateral Contacts. See Provider Alert #74, dated August 20, 2009, on MBHP expanding the parameters for case consultations.
Thursday, October 22, 2009
INTERAGENCY REVIEW TEAMS Under Chapter 321 of the Acts of 2008
Prepared by Samuel Leadholm, Staff Attorney at Health Law Advocates – October 2009
Landmark legislation passed in August of 2008 entitled “An Act Relative to Children’s Mental Health” (“Act”) restructures how the Commonwealth oversees, provides and coordinates children’s behavioral health services. Among other things, the Act creates Interagency Review Teams (“Interagency Teams”) and a hearing process to improve coordination of services for children with complex needs. The Act defines children with complex needs as those individuals under age 22 who are disabled or have special needs and may qualify for services from multiple state agencies, i.e., DMH, DCF or DDS.
These Interagency Teams must be geographically-based and consist of necessary state agency representatives from departments within the Commonwealth’s Executive Office of Health and Human Services, the Department of Early Education and Care, and the Department of Elementary and Secondary Education according to the needs of the child. If appropriate and where consent is provided, the Interagency Teams may include representatives from schools. An Interagency Team may be convened upon the request of a state agency, the juvenile court, or a parent or legal guardian.
The role of the Interagency Team is to determine what services are appropriate to the child. In doing so, the Interagency Team may evaluate whether the current services are sufficient and whether case management is needed. However, the Act does not create any new services provided by the agencies. If you are seeking a service that the agencies do not already provide, the Interagency Teams may not be helpful. The Interagency Team must listen to parents and other treatment providers before reaching any decision, which must be reached by consensus.
The Act provides that where an Interagency Team cannot reach a decision by consensus or where parents or legal guardians disagree with a decision, those decisions must be reviewed by regional directors of the respective agencies for resolution. Those regional directors must convene within 10 business days of the referral and arrive at a decision within 3 business days thereafter.
The Act also provides a right of appeal with the state’s Division of Administrative Law Appeals and that nothing in the Act limits the rights of parents or children under state and federal special education laws and regulations.
If you need additional assistance accessing these multi-agency teams, please contact: Samuel Leadholm at (617) 275-2982 or firstname.lastname@example.org, Jennifer Honig, Staff Attorney at Mental Health Legal Advisors Committee (“MHLAC”) at (617) 338-2345 x. 25 or email@example.com, or MHLAC’s intake line on M.W.F between 8:30-1 p.m. at (617) 338 2345 x. 20.
Friday, October 16, 2009
You Are Cordially Invited
The Department of Children and Families
With Commissioner Angelo McClain
Date: Tuesday, November 3, 2009
Time: 2:30pm to 4:30pm for DCF Providers
Location: Regional Conference Room
Central Regional Office
121 Providence Street, Suite 300
Worcester, MA 01604
Come hear about:
*The Integrated Casework Practice Model and What it Means for You
*A Current Status Report on the Department’s Budget
RSVP by October 28, 2009
Lani Geselius at 508-929-2132 or
Friday, October 9, 2009
MassHealth Rolls Out Two More Community-Based Services: In-Home Behavioral Services and Therapeutic Mentoring
Two new community-based behavioral health services for MassHealth-enrolled children and youth under age 21 began on October 1, 2009. In-Home Behavioral Services provides support to children and youth with challenging behaviors. Therapeutic Mentoring Services provides a therapeutic mentor to work one-on-one with a child. The mentor supports and coaches the child or youth learn social skills, such as better ways to communicate with other children and adults, how to deal with different opinions and how to get along with others.
How to Access These Services:
To access In-Home Behavioral Services or Therapeutic Mentoring, a child or youth must be receiving services from a “clinical hub”, either: outpatient therapy, In-Home Therapy, or Intensive Care Coordination (ICC). The child’s treatment plan, developed by one of these “clinical hub” providers, must include a goal which requires one of the new services to address. Families should talk to their child’s behavioral health provider about these services, or they can call the customer service department of their MassHealth Health Plan. (These numbers are listed at the end of this notice.) Lists of providers of the new services can be found on any of the MassHealth Health Plan’s websites.
In-Home Therapy Will Become Available Nov. 1, 2009
In-Home Therapy (IHT) provides intensive therapy for a child and family to treat the child’s behavioral health needs and help the family support the child in the home. Contact information for In-Home Therapy providers may be found on any of the MassHealth Health Plan’s websites. Families may contact IHT providers directly, or they may call the customer service department of their MassHealth Health Plan for assistance.
CSAs Serving Over 1,600 Children and Youth
The MassHealth Managed Care Entities (MCEs) have reported over 1,691children and youth are currently being served by the 32 Community Service Agencies (CSAs) located across the state. The CSAs began delivering services to MassHealth-enrolled children and youth under age 21 on June 30, 2009. They provide two of the five new MassHealth behavioral health services, Intensive Care Coordination (ICC) and Family Support and Training (Family Partners), to children and youth with serious emotional disturbance (SED). Referrals to the CSAs have remained steady at approximately 200 per week.
Mobile Crisis Intervention Teams Delivering Needed Services
Emergency Service Providers (ESPs) began delivering round-the-clock Mobile Crisis Intervention services on June 30, 2009. Since that time, Mobile Crisis Intervention Teams have recorded over 2,040 mobile crisis interventions or “encounters” with MassHealth-enrolled children and youth under age 21. The MassHealth Managed Care Entities (MCE) and Mobile Crisis Intervention providers are presently working within their communities to educate families, caregivers and others about the availability of crisis services in the home and community. Many people are still accustomed to the previous practice of crisis service delivery through the hospital emergency room.
MCEs Continue to Support Provider Implementation
The MassHealth Managed Care Entities (MCEs) continue to work closely with Intensive Care Coordination (ICC) and Mobile Crisis Intervention providers to implement these two new services. Upcoming MCE plans call for a regional meeting structure that will initially consist of ICC and Mobile Crisis providers and eventually include other service providers to support regional practice. The Massachusetts Behavioral Health Partnership (MBHP) also continues to provide technical assistance to Mobile Crisis Intervention providers through a contract with a leading national expert on this service. Last month, the MCEs hosted a conference for In-Home Behavioral Services, Therapeutic Mentoring and In-Home Therapy providers. The day-long conference included presentations by MCE staff on program specifications and medical necessity criteria as well as presentations by nationally known clinical leaders with expertise in each new service.
Wednesday, October 7, 2009
ABC soup for Children’s Mental Health- www.ppal.net
CAFAS Child & Adolescent Functional Assessment
CANS Child and Adolescent Needs and Strengths
CASPP Child and Adolescent Services Planning Principles
CBAT Community Based Acute Treatment
CFFC Coordinated Family-Focused Care
CHBI Children’s Behavioral Health Initiative
CHINS Children in Need of Services
CMS Centers for Medicare & Medicaid Services
CPT Care Planning Team
CSA Community Service Agency
CSP Community Support Program
DCF Department of Children and Families
DMH Department of Mental Health
DDS Department of Disability Services
DOE Department of Education
DYS Department of Youth Services
DSM IV Diagnostic and Statistical Manual, Version IV
EMH Emergency Mental Health
EOHHS Executive Office of Health & Human Services
EPSDT Early, Periodic Screening, Diagnosis and Treatment
ESP Emergency Services Program / Provider
FST Family Stabilization Team
FS & T Family Support and Training
IAP Individual Action Plan
ICC Intensive Care Coordination
ICP Individual Care Plan
IDEA Individuals with Disabilities Education Act
IEP Individualized Education Program
IVR Interactive Voice Registration
IT Information Technology
IHBT In Home Behavior Therapy
LEA Local Educational Agency
LOC Level of Care
MBHP Massachusetts Behavioral Health Partnership
MCPAP Massachusetts Child Psychiatry Access Project
MCE Managed Care Entity
MCI Mobile Crisis Intervention
MCT Mobile Crisis Team
MCO Managed Care Organization
M-CHAT Modified Checklist for Autism in Toddlers
MHSPY Mental Health Services Program for Youth
MYR Motivating Youth Recovery
PCC Primary Care Clinician
PCP Primary Care Physician / Provider
PHP Partial Hospital Program
PEDS Parents’ Evaluation of Developmental Status
PSC Pediatric Symptom Checklist
RESC Regional Emergency Service Center
SAMHSA Substance Abuse & Mental Health Services Administration
SED Serious Emotional Disturbance
SOC System of Care
TM Therapeutic Mentoring
TTS Therapeutic Training and Support
UCC Urgent Care Center
Federation of Children with Special Needs- FCSN
NAMI- National Alliance of the Mentally Ill
PAL- Parent/ Professional Advocacy League
Friday, September 25, 2009
The WMHN has scheduled a planning meeting on Wednesday October 21st at 4:30 at Bowditch and Dewey to draw up a short list of the people WMHN members would like to invite to come and speak on various topics of interest. Suggestions have touched on inviting someone to speak to about the implementation of CBHI. Other suggestions entail finding someone to speak about incorporating the provision of crisis stabilization and hospital diversion services in the public schools.
Please come and weigh in on the topics you are interested in hearing more about. The WMHN wants to hear your suggestions.
Samuel Leadholm, Esq.
30 Winter Street, Suite 1004
Boston, MA 02108
Wednesday, September 23, 2009
Tuesday, September 22, 2009
Community Service Agencies Engage Over 1,200 Families
During the first two months of implementation of Community Service Agencies (CSAs) and Intensive Care Coordination services (ICC), more than 1,200 children have applied and are being actively assessed for ICC. Many have been provided Family Partners to assist them in the assessment process. By the end of August, referrals to ICC had increased to over 200 per week.
CSAs have approached staffing decisions quite differently. Some have only hired the minimal number of staff: three service coordinators and one family partner. Others have hired many more coordinators and partners. Overall, as of the end of August, there were 127 care coordinators, 33 senior care coordinators, 74 family partners, and 27 senior family partners. Despite pre-implementation concerns about workforce challenges, CSAs have had a significant number of applications for each ICC position.
All service coordinators have caseloads at or below the maximum number of eighteen. The Court will consider and decide on the defendants' challenge to the Monitor's recommendation on caseload limits, data collection, and monitoring at the next status conference, scheduled for September 28, 2009.
Training and coaching for ICC teams by the new wraparound training provider, VandenBerg and Associates, begins this month.
According to the Center for Public Representation, progress is being made:
MA CANS Facts: August 2009
Number of: May June July August
MA CANS trained clinicians 7,639 8,067 8,282 8,328
MA CANS trained certified clinicians
7,123 7,322 7,780 7,827
MA CANS records in CANS data base
4,555 7,322 10,008 13,038
Organizations submitting CANS records
136 169 188 199
Progress indeed. But how are the kids doing? Only time will tell.
Monday, September 21, 2009
Friday, September 18, 2009
Youth with serious emotional disorders are a high-utilizing and high-cost Medicaid population that is not well served by traditional approaches to care. Managed care organizations (MCOs) are uniquely positioned to deliver more appropriate and cost-effective care that addresses the complex needs of these children and young adults.
The Collaborative on Improving Managed Care Quality for Youth with Serious Behavioral Health Needs, an initiative designed by CHCS and made possible by the Annie E. Casey Foundation, worked with nine health plans to test a number of approaches to better serve this population. This toolkit, which summarizes the participating plans' experiences, presents:
- Promising practices implemented by the plans, and the resulting impact on access, care, and avoidance of unnecessary services and costs;
- Challenges identified and addressed by the plans, and lessons learned; and
- Opportunities for continued innovations in care for children and youth with serious behavioral health needs.
The toolkit is a valuable resource for MCOs, policymakers, state agencies, families, and others interested in innovative approaches to improve behavioral health care for youth.
Thursday, September 17, 2009
Thursday, September 10, 2009
WRAPAROUND IS HERE!
Wraparound Care planning is now available for children & youth with complex behavioral health needs who have MassHealth Standard and CommonHealth. This new offering will be provided by a network of local agencies called Community Service Agencies (CSAs)
WRAPAROUND HELPS: Wraparound is based on the youth’s and family’s strengths, and develops a team to help the youth and family reach their goals, no matter how tough things become
WRAPAROUND INCLUDES: Wraparound builds families who are the foundations of our communities and draws on the strengths of many helpers in the community: doctors, educators, therapists, family members, faith communities, neighborhood and community organizations
JOIN US Crowne Plaza Worcester Hotel
Wednesday - September 23, 2009
6:00 pm – 8:00 pm
10 Lincoln Square, Worcester, MA
LEARN MORE ABOUT WRAPAROUND: If you’re interested in learning about how Wraparound can help children and families who have MassHealth in your region, come join us for a public presentation by a national expert Michele Stewart-Copes, MSW.
You will need to RSVP by September 15th to Susan Whitaker, VVDB Administrative Assistant, who is based in the Boston area. Her her email address is: firstname.lastname@example.org and phone is 617-827-7300.
Wednesday, September 9, 2009
Tuesday, September 8, 2009
Thursday, September 3, 2009
The District 1 Connecticut, Massachusetts& Rhode Island American Academy of Pediatrics’ (AAP) Chapters
“Navigating the Mental Health System from the Pediatrician’s Office”
Friday, November 13 and Saturday, November 14, 2009to be held at the Biltmore Hotel, Providence, Rhode Island
Friday, November 13th
10:00 am - 12:45 pm – Registration
12:00 pm – 12:40 pm – Lunch
12:40 pm – 12:45 pm - Welcome – Elizabeth Lange, M.D., FAAP – AAP Rhode Island Chapter President
12:45 am – 2:00 pm – General Session #1 - Panel Discussion - “How to Discuss Issues on Sexuality with GLBT Youth in the Pediatrician’s Office” - Moderator - Carole Allen, M.D., FAAP, AAP Massachusetts Chapter President
2:00 pm – 3:00 pm – Concurrent Workshops
- Workshop #1 - “Early Identification of Emotional and Behavioral Problems in Primary Care Settings”– Mary Margaret Gleason, M.D., FAAP, - Assistant Professor, Tulane University School of Medicine, Departments of Psychiatry and Neurology of Pediatrics, Associate Training Director, Child Psychiatry and Triple Board Program
- Workshop #2 – “Mental Health Care in the Pediatric Office: Integrating a Co-Location Model” –
Jean Marconi, M.D., FAAP, Private Practice Pediatrician, Center for Advanced Pediatrics, Norwalk, CT and Andrew Lustbader, M.D., FAAP, Pediatrician and Child and Adolescent Psychiatrist, Medical Director, Child Guidance Center of Mid-Fairfield County, Norwalk CT
3:00 pm – 4:00 pm – Break – Exhibit Hall
4:00 pm – 5:00 pm - General Session #2 - “The Little Black (Pill) Box: A Comprehensive Approach to Pharmacology in Child and Adolescent Psychiatry” – Dr. Andrew Lustbader, M.D., FAAP
- Workshop #3 – “The World is Not Flat: Mechanisms of Social Development in Two-Year-Olds and the Absence Thereof in Autism”– Warren Jones, Ph.D., Co-Director, Laboratory of Social Neuroscience, Yale Child Study Center, Yale University School of Medicine
- Workshop #4 –“Sleepy, Dopey, and Grumpy: Sleep and Sleep Disorders in Adolescents”– Judith Owens, M.D., MPH, FAAP, Director of the Pediatric Sleep Disorders Clinic at Hasbro Children’s Hospital and Associate Professor of Pediatrics at Brown Medical School
6:00 pm – 7:15 pm –Reception - AAP Community Access to Child Health (CATCH) Grant Presentations and Updates on Health Care Reform – Invited guests include Representative Patrick Kennedy and Senator Jack Reed (both of Rhode Island) and AAP President Judy Palfrey, M.D., FAAP
7:15 pm – Dinner on your own
Saturday, November 14th
7:30 am – 8:30 am – Breakfast - Regional Chapter Highlights
8:30 am – 9:30 am – General Session #3 – “The (Inter) Active Child: Facebooking, Sexting and the Electronic Bully”– Michael Rich, M.D., MPH, FAAP, Director, Center on Media and Child Health (CMCH), Director, Video Intervention/Prevention Assessment (VIA), Children’s Hospital Boston, Associate Professor of Pediatrics, Harvard Medical School, Associate Professor of Society, Human Development, and Health, Harvard School of Public Health
9:45 am – 10:45 am – Concurrent Workshops
- Workshop #5 –“ABC’s for the Primary Care Pediatrician”– Mary Margaret Gleason, M.D., FAAP
- Workshop #6 – “Preventive Interventions for Disruptive Behavior Disorders in the Office” – Ellen Perrin, M.D., MA, FAAP, Professor of Pediatrics, Director, Developmental-Behavioral Pediatrics, Floating Hospital for Children at Tufts Medical Center
10:45 am – 11:00 am - Break
11:00 pm – 12:00 pm - General Session #4 – “The Invisible Casualties of War at Home” – Elizabeth Slater, Ph.D., Psychologist, (SOFAR) Program, Cambridge, MA
12:00 pm – 1:00 pm – Concurrent Workshops
- Workshop #7 - “GHB the prototypical ‘Date Rape’ Drug and Ecstasy” – Angela Anderson, M.D., FAAP, Associate Professor of Emergency Medicine and Pediatrics, Warren Alpert Medical School of Brown University
- Workshop #8 - “Maternal Depression. The Why and How of Screening in Primary Care” – Ardis Lee Olsen, M.D., FAAP, Associate Professor of Pediatrics and of Community and Family Medicine, Dartmouth Medical School
1:00 pm – Conference ends
The Massachusetts Chapter of the American Academy of Pediatrics designates this educational activity for a maximum of 8.25 AMA PRA Category 1 Credits™. Physicians should only claim credit commensurate with the extent of their participation in the activity.
This program meets the criteria of the Massachusetts Board of Registration in Medicine for risk management study for 3 credits.The MCAAP is accredited by the Massachusetts Medical Society to provide continuing education for physicians.
Wednesday, September 2, 2009
Monday, August 31, 2009
- "They focus on the whole situation, the whole family, not just the child in front of you".
- "They have be really helpful in sorting out the services that my sons need"
- "For single mothers especially those without much of an outside support system, they are wonderful"
Saturday, August 29, 2009
About 20 years ago, Senator Pete Domenici, a Republican from New Mexico, found out that his daughter Clare was schizophrenic. Domenici and his wife, Nancy, struggled to get help for Clare, and Domenici became an advocate for families of children and adults with mental illness.
Thirteen years ago, Domenici and Paul Wellstone, the liberal senator from Minnesota, teamed up to sponsor a mental health parity bill, so that people with a mental illness would be treated the same as those with a physical illness. After Wellstone was killed in a plane crash, Domenici asked Kennedy to step in as the bill’s cosponsor. Because of his sister Rosemary’s condition, Kennedy was always empathetic to those with mental disabilities, and he quickly agreed.
As the legislation’s progress waxed and waned, whenever Ted Kennedy saw Pete Domenici, he would ask one question: “How’s Clare?’’ And then they would talk about getting the bill through. Last year, when President Bush signed the bill into law, Ted Kennedy called his old friend Pete Domenici. Kennedy was in Hyannis Port, four months after being diagnosed with brain cancer, and Domenici was in Washington, about to retire from the Senate because he has a progressive form of brain disease.
Wednesday, August 26, 2009
Building the CBHI is a process, and the key to that process is the collaboration that will happen in the Systems of Care Committee meetings (times and dates for Worcester County are listed to the right)
I went to a Systems of Care Committee meeting today. It was crowded in the Conference Room, with people from Worcester, Southbridge, Webster and Milford congregated in a room, to see how the South Central CSA is doing. It is a big district, stretching from Ware to Franklin across Massachusetts’ southern border with Eastern Connecticut and Rhode Island, and it is great that they were able to get this many people in one place. We introduced each other; there were parents, providers and even a school district represented at the table. Then we got down to business.
Initially, it was mundane; time and place of meeting, can we get phone access to the meeting, who else do we need to be here? The group is in the “forming” stage and we were all trying to understand what each of us are trying to do. The programs are in place, both emergency mobile services and intensive care coordination and family partners are up and running. Several community agencies (schools, practices, parents) expressed confusion about when to call the different types of services and asked for more guidance in organizing themselves to address the services. We also spoke of the upcoming “change in initials” for programs like FST, which is morphing into In-home behavioral health therapy. Change is hard, and at least part of it is that it is new.
The group was very interested in the process, and people had concrete suggestions for ways in which this can work. First was getting the information out: Make the literature more clear. Create multiple ways of disseminating the message. Clarify the roles that all of the players are clear as to their names, agencies and roles. Then was communication: There are overlapping roles with DCF, DMH, the school, the FST program have sometimes created logjams, with parents confused as to who is involved in various specific cases. All of this is complicated by the need for releases from the family to allow inter agency communication.
The South Central CSA got 60 referrals in the first month; they reported fewer referrals in August to date. Some of this reflected the level of staffing; the CSA is hiring the people and it is hard to find folks with the right skill set who are willing to travel as much as is required in this area. Some of this, however, reflects the culture of the area. Folk down here don’t like to air their family problems in public, and they don’t trust outsiders in their homes. It will take time to build trust, that this program is really going to be responsive to their needs and not to the needs of DCF or some other government agency. Finally, some of this reflects the newness of the program- people are going to need to hear about this program over and over again before the implications actually sink in.
So what is our vision? Collaborative care, creating a system that families can understand? We kicked it around for a while, but it came down to struggling with the central question of the CBHI: How do we fit this model of wraparound into the culture of South Worcester County? This group is actively engaged in that process. I hope that the other meetings are going as well.