Welcome to the Residential Care Team

1. Welcome to the Residential Care Team

2. The Residential Care Team (RCT) • Overview: Dr. Peter Mendelson • CT BHP Introduction: Lori Szczygiel, CEO • RCT Process: Lynne Ringer, LCSW, RCT Team Lead • Questions & Answers

3. OVERVIEWDr. Peter Mendelson, Ph.D., Director of BH and Medicine CPT Transition • Goal: to integrated the current CPT process within new ASO structure. • Combine ASO technology and management tools with knowledge and experience of CPT staff. • Residential Care Team: New unit dedicated to RTC and Group Home placements. • Last phase of planned transition.

4. OVERVIEW Why Change the Process? • Residential and Level II Group Homes are the costliest and most restrictive services DCF funds. • CPT staff process over 2000 requests for placement annually (Area Office, CSSD and Parole) • Request for RTC and Group Home placements far exceed available resources.

5. OVERVIEW Why Change the Process continued? • ASO utilizes sophisticated information technology that captures clinical data on an identified child and can match that child’s needs to an appropriate program that has an immediate or anticipated vacancy. • Increased efficiency allows us to expedite appropriate placements and identify and make alternative plans for children for whom no immediate or anticipated vacancies exist. • CANS provides the basis for submitting clinical information about the child into this new IT system.

6. OVERVIEW Local Focus • New process will give referring office a greater role in coordinating care with providers. • Increased initial contact will support better provider communication throughout the child’s stay.

7. OVERVIEW Role of CPT Staff • CPT Staff will become part of the Residential Care Team. • Provide consultation and technical assistance to staff and providers as we transition to the new system. • Handle non-routine referrals • Participate in clinical rounds to help provide additional expertise as “Matches” are reviewed and approved.

8. CT BHP IntroductionLori Szczygiel, CEO, CT BHP ASO • CT BHP Partnership Goals • What is the Administrative Service Organization (ASO)? • Role of the ASO • How will the ASO operate?

9. Partnership Goals • Ensure an integrated behavioral health system with a full continuum of services • Support access to community based services to prevent unnecessary institutional care • Enhance communication and collaboration within the behavioral health delivery system • Improve network access and quality of services • Recruit and retain traditional and non-traditional providers

10. What is the Administrative Service Organization (ASO)? • The ASO is an organization with special expertise in behavioral health service management that is contracted by DSS and DCF to authorize and monitor various types and levels of care, track payment, and collect data on consumers and providers who are enrolled in the CT BHP

11. Role of the ASO • Provide Administrative Assistance to the Departments in the areas of: • Clinical Management • Utilization Management • Quality Management

12. How will the ASO operate? • Staffing Model: • Customer Service Representatives • Care Managers • Intensive Care Managers • System Managers • Peer Specialists

13. Residential Referral WorkflowLynne Ringer, LCSW, RCT Team Lead REGISTRATION DCF Area Office/Juvenile Services faxes Registration form* to CT BHP. 1 (866) 434-7681 *Drafts of Forms located in Packet Forms will be available on the CT BHP website: www.ctbhp.com

14. Residential Referral Workflow cont. REGISTRATION NUMBERCT BHP phones Area Office/JS within two (2) business days to indicate approved Level of Care and a Registration Number will be given at that time.

15. Residential Referral Workflow cont. CANS CANS packet is faxed to CT BHP at 860-263-2181 within five (5) business days of receipt of registration number. CANS forms will be available on the CT BHP website: www.ctbhp.com

16. Residential Referral Workflow cont. LEVEL OF CARE REVIEWCT BHP notifies Area Office by phone within two (2) business days of CANS receipt to set up time to do clinical review. Area Office/JS provides clinical information to CT BHP Care Manager to justify level of care.

17. Residential Referral Workflow cont. PRIORITIZATION PROCESSResidential Care Team determines prioritization in collaboration with Dr. Peter Mendelson.On a weekly basis, CT BHP notifies the Area Offices of the prioritization status related to referred members.Area Office/Juvenile Services will report status change to CT BHP.

18. Residential Referral Workflow cont. MEDIUM CASESIntermediary or alternative planning will be initiated by Area Office/Juvenile Services. Referral to CT BHP Intensive Care Manager (ICM), if appropriate.

19. Residential Referral Workflow cont. URGENT/HIGH CASESRounds are conducted 2x/week and always within three (3) business days of LOC determination. Matches are made to current and anticipated openings.Out of State placements are approved during Rounds by Dr. Peter Mendelson.If match is out of state, BHPD is contacted for approval within one (1) business day of Rounds.

20. Residential Referral Workflow cont. RTC/GROUP HOME MATCH Area Office is informed of program match from the CT BHP Residential Care Team. Area Office sends CANS and supplemental material to designated program. (See Supplemental Materials Attachment) Area Office schedules pre-placement planning conference. Conference takes place within five (5) business days of match.

21. Residential Referral Workflow cont. ADMISSION CONFIRMATION Program faxes written documentation to Area Office/CT BHP regarding decision of referral acceptance.If not accepted, Residential Care Team re-reviews during Rounds and new match is made.

22. Residential Referral Workflow cont. TARGET ADMISSION DATEDCF/Family/Program agree on target admission date, and CT BHP is informed.AUTHORIZATION Program contacts the CT BHP when member arrives.Authorization is completed.