California Alliance of Child and Family Services’ Annual Conference
Presenters: Senior Vice President of Strategy, Innovation and Growth Eleanor Castillo Sumi, Regional Executive Director of New Business Jacquelyn Harlow Torres and Director of Data Analytics and Innovation Kristopher Stevens
Title: Action-oriented Analytics: Utilizing internal and external data to identify, target, and support high-need, traditionally underserved populations and new, emerging populations during the pandemic, post-pandemic, and beyond
Abstract: According to the Centers for Disease Control and Prevention (CDC), the rates for behavioral health problems among the general population have increased three- to fourfold throughout the pandemic compared to the pre-pandemic rates. Based on these rates, one in every three people may currently be suffering from a behavioral health problem, compared to only one in ten pre-pandemic. These rates are reflective of adults, we do not yet have equivalent data to examine the impacts of the pandemic on youth's behavioral health problems; however, even if we make conservative estimates based on the CDC results, we may have a growing public health and societal problem that could eventually overwhelm behavioral health systems that serve youth. Additionally, the problem may worsen as we come out of the pandemic; research on natural disasters indicates that behavioral health problems resulting from exposure peak about a year after the disaster ended or subsided. As we come out of the pandemic, organizations will have to alter our service delivery strategies to meet the level of need not only among traditionally underserved populations but also among new, emerging populations arising because of the impacts of the pandemic. This will rely heavily on an organization's capacity to make the most out of data and information they have or are able to obtain. This could lead to innovations in programming, business development, and organizational strategies that enhance the services offered to youth and families, as well as organizational sustainability. These innovations could also be key as the industry transitions to a value-based system of care.
Understanding the impact that the pandemic has had, and will have, on the youth and families our organizations support will lead to the development and implementation of efficient and effective services that meet youth and families' behavioral and mental health needs during the pandemic, post-pandemic, and beyond. Additionally, utilizing the analytic techniques presented in this workshop will enhance the availability of, accessibility to, and utilization of services for high-need, traditionally underserved communities as well as new, emerging communities. These techniques will not only lead to better outcomes for consumers and families but also increased sustainability and resiliency for organizations. These techniques, and many others, are key to succeeding in value-based systems of care. Our main goal, or hope, is to stimulate workshop participants and their organizations' “thinking” about the various questions they can ask and the analytic techniques they can employ now and/or in the future to enhance services and organizational wellbeing. To make these concepts salient and useful to participants and organizations, the workshop will: Utilize current research literature on natural disasters and the pandemic to discuss short-term and long-term impacts on vulnerable at-risk youth and families; demonstrate and discuss data analytic methods (i.e., from basic descriptive models to more complicated GIS techniques and classification analysis) for identifying, targeting, and supporting traditionally underserved and new and emerging populations and geographies in a post-pandemic world using organizational and publicly available data (i.e., youth of color, disconnected youth and young adults, foster care youth, LGBTQ+ youth, migrant youth, homeless youth, high-risk schools/students, etc.); demonstrate and discuss how decision-support tools (i.e., dashboards, reports, web applications, etc.) can guide organizations to enhance service availability, accessibility, and utilization for underserved and new and emerging populations in a post-pandemic world; discuss how these methods and tools can be utilized by the organizations in attendance to enhance their service delivery and organizational wellbeing post-pandemic and beyond; discuss how the methods covered could enhance competitiveness and sustainability in a value-based reimbursement system (i.e., how these techniques can lower costs of services); and discuss how this data analytic capacity can be developed and/or supported within the participating agencies/organizations.
Title: Health Home Program (HHP): Enhanced care management (ECM) for youth with complex behavioral and medical needs during the pandemic, post-pandemic, and beyond
Abstract: Roughly 5% of the youth served by community-based behavioral health organizations represent the most acute cases in the Medi-Cal system. These youth experience extremely complex behavioral and medical needs, including chronic physical health problems, severe psychiatric disorders, recent psychiatric hospitalizations, multiple recent visits to the ER, and chronic homelessness. This complexity often results in these youth and their families being involved in multiple systems (i.e., behavioral health, physical health, social services, community resources, etc.); while this involvement is beneficial for some, most of these youth do not gain access to the appropriate services due to failures in assessing and understanding youth's complex behavioral and medical needs within systems and the lack of coordination of care between systems. Additionally, these youth tend to be the highest utilizers within the Medi-Cal system, accounting for a disproportionate number of funds. Thus, there is a need to apply efficient and effective service strategies to address youth's complex behavioral and medical needs; this is not only critical in improving the wellbeing of these youth but also increasing the funding available for other youth who may benefit from Medi-Cal services (i.e., lowering costs of services). The need for efficient and effective service strategies is made more critical by the pandemic; research indicates that the rates of behavioral health problems have increased three to four times above what they were pre-pandemic and that these rates may not peak until one year after the pandemic ends. While it is not yet known how the pandemic has impacted youth experiencing acute, complex behavioral and medical needs, it is possible that the needs they have may have been exacerbated and additional youth have developed or may develop complex needs.
Enhanced care management (ECM) has demonstrated a great deal of promise in supporting youth experiencing acute, complex behavioral and medical needs. ECM utilizes team-based care and in-person care coordination strategies to identify youth with complex behavioral and health needs, engage them and their families in their care, and link youth and their families to appropriate services that address their complex needs. As California transitions to CalAIM and a value-based system of care, the Health Home Program (HHP) will become the benchmark ECM. The proposed workshop will focus on how we can more effectively understand and coordinate services for youth who experience acute, complex behavioral and medical needs not only during the pandemic and post-pandemic, but also as we transition to CalAIM and a value-based system of care. To make these concepts salient and useful to participants and organizations, the workshop will: Discuss the associations between complex behavioral and medical needs for youth; discuss how youth with complex needs enter into the system and their involvement with multiple systems; discuss the impact of pandemic on these associations; identify and discuss barriers for these youth accessing care and making use of supports to address complex needs; identify and address social determinants of care and health that exacerbate associations and serve as barriers to accessing and utilizing supports that can address complex needs; discuss how ECM increases access and utilization of services youth with complex medical and behavioral health needs; discuss the importance of developing collaborative relationships between medical and behavioral health entities; importance of ECM in a post-pandemic world; discuss and demonstrate the implementation and evaluation of an ECM in a community-based behavioral health organization; discuss considerations as the field moves towards a value-based system (CalAIM) and managed-care.