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CBH Overview

CBH Overview. Presentation to DBHDS State Board November 29, 2010. CBH Basics. James City, Poquoson, Williamsburg, York 192 employees 7 direct service locations Total Budget of $13.3M [ $600K (4.3%) over 2 years] Served 4,352 persons in FY 2010 (+26% over 2 yrs)

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CBH Overview

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  1. CBH Overview Presentation to DBHDS State Board November 29, 2010

  2. CBH Basics • James City, Poquoson, Williamsburg, York • 192 employees • 7 direct service locations • Total Budget of $13.3M[$600K(4.3%) over 2 years] • Served 4,352 persons in FY 2010 (+26% over 2 yrs) • Lowest CSB Medicaid consumer population (23%) • Payer mix - 58% medically indigent (51% in FY09) • Local government support vital and welcome

  3. Areas of Focus - CBH • Regional services and involvement • Recovery Works! • Child and Adolescent Services • Integration with Primary Health Care • Jail Diversion service needs

  4. Regional Services & Involvement • HPR V working regionally for over 30 years • Region managing $14.45 million currently • Processes and services related to: • Private acute inpatient and crisis stabilization svcs. • Downsizing of SEVTC and of ESH • Community-based crisis stabilization • Acute inpatient access and competency restoration • Geriatric Services

  5. Recovery Works! Effecting Change – 1 Person at a Time Lacanas James CBH Staff Community Services Associate I

  6. Child & Adolescent Services • CBH History - not an active service provider • A primary area of focus for CBH since 2004 • 2007 – Community identified 3 major local issues in developing a Systems of Care model: • Inconsistent information on service availability, eligibility, etc. • Many uncoordinated and fragmented services ; & • Gaps in service continuum

  7. Child & Adolescent Services • CBH selected by local agencies to administer Greater Williamsburg Child Assessment Center (GWCAC) (2008) • Coordination of behavioral health information and access, and “warm hand-off” to local providers • Centralized intake and assessment function for children’s behavioral health in CBH service area • Designed to coordinate access and information for parents, providers, schools, etc. • “Case-by-case” needs assessment tool for funders

  8. GWCAC Services Provided • Psychosocial assessment • Parental capacity assessment • Psychological testing and ADHD assessment • CANS assessment (pre-FAPT) • Expedited access to child psychiatry • Transition from residential and inpatient programs • Autism assessment services (being planned) • http://gwcac.va.networkofcare.org/mh/home/index.cfm (first site of its’ kind in U.S.) • Data collection and sharing

  9. Primary/Behavioral Health Integration • Chronic Care Collaborative (Foundation-led) • CBH, free clinics, local private health clinic, Rx Partnership, local hospital • Formed to improve services to persons with chronic disease (asthma, diabetes, COPD, etc.) • Mental illness included as chronic disease • Providers ranked MH issues as #2 overall need

  10. Behavioral Health Results to Date • Training to primary care staff (2 years) • Embedding of CSB psychiatrists in 2 clinics • Embedding of LCSWs in 2 clinics • Development of clinical protocols in use by all partners • Depression screening and treatment, • Management of metabolic syndromes among atypical antipsychotic patients

  11. Additional Results • Posting of clinical “breakthroughs” by clinic staff members in relation to clinic process and/or direct patient benefits • Mobile primary healthcare services underway at main CBH campus on a weekly basis • Initiation of telemedicine by CBH to extend consultative services to providers and patients • Opportunity to share model with HRSA

  12. Jail Diversion Service Needs • CIT planning team in place; cross-systems mapping completed; grants submitted in each of past 2 years • Not yet successful in securing CIT funding to date • Local law enforcement - CIT requires a local “alternative treatment site” • 18% reduction in MH jail population locally already • Have consulted with New River Valley, Charlottesville, Hampton/Newport News CITs • Need also present for “behavioral health” court (combo of MH and drug courts) – not yet pursued

  13. Significant Challenges - Services • Needs of population more acute and complex • Need for expanded community resources to sustain bed reductions at ESH • Need to build community capacity (e.g., crisis stabilization) for ID/DD populations to support downsizing and/or closure of training centers • Increased referrals of both children and adults with autism spectrum disorders

  14. Significant Challenges - System • Existence of 3 discrete systems (facility, community, forensic) creates winners & losers • Budget woes affecting all systems at once • Increased competition for CSB-sustaining Medicaid revenues • Uncertainty related to Virginia’s approach to Medicaid and Health Reform • Uncertain future of regional efforts in new state and federal environments

  15. Thank You • For your leadership for DBHDS and the Commonwealth • For your advocacy for those we serve and those we employ • For taking time to meet with us here tonight QUESTIONS?

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