Regional Planning Consortiums RPCs NYS Conference of Local

Regional Planning Consortiums (RPCs) NYS Conference of Local Mental Hygiene Directors 1

CLMHD - Who We Are & What We Do Ø NYS Conference of Local Mental Hygiene Directors Ø Statewide organization – Directors of Community Services (DCS) of the 58 Local Governmental Units (LGU’s) in the state Ø Under MHL, the DCS oversees, manages and plans for services and supports for adults and children with mental illness, substance use disorders and/or developmental disabilities in their LGUs.

LGU - Explaining Role & Relationships LGUs are embedded in the community and have linkages that extend across all systems & for the entire population. • Hospitals, 9. 39 s, Comprehensive Psychiatric Emergency Program (CPEP), state-operated PCs & ATC • Adult services providers - treatment & support • Children’s services, & schools • Housing & Shelters • DSS - Child & Adult protective services, Foster Care • Juvenile & Adult Probation/Parole • Law Enforcement & Jail Administrative and Clinical Staff • Judges (Criminal & Family Courts) & District Attorneys 3

LGU Role – Establishing Context • LGU contracts with Community Based Providers to ensure that necessary services and supports are available. • Adult & Children’s SPOA (Single Point of Access) (Every LGU has a SPOA Coordinator) • Access to ACT services (LGU oversees the front door, waiting list and back door) • Assisted Outpatient Treatment (AOT) – court ordered outpatient mental health treatment (Every LGU has AOT Coordinator) • 9. 45 s – DCS & their designees can authorize transport by law enforcement to hospital for observation & evaluation • LGU oversees the system for everybody – not just for those individuals with Medicaid coverage 4

Setting the Stage Ø Health & Behavioral Health is being transformed to meet the Triple Aim via NY-SHIP Better Care Better Population Health, Lower Cost Ø Medicaid Transformation projects will have significant & lasting impact on the community behavioral health system & the people we serve

What is a Regional Planning Consortium? Ø Idea behind the RPC Ø CMS Approved Ø Unified Support From State Agencies Ø Shared Ownership Ø An Opportunity for the Local Voice to Shape Public Policy

Solutions are in the Community! Ø Ø Priorities for a Transformed BH System Ensure Local Voice is heard & community needs are recognized & acted upon Community Representation means Representation from all Stakeholders Alignment of Initiatives LGU’s will use their expertise and knowledge of the local layout to guide the process 7

Agreement, Alignment and Necessity Ø We all agree WHY the System needs Transforming Ø It’s WHAT the System needs to Transform Successfully Ø The RPC will track HOW the implementation impacts the Behavioral Health System and - more importantly, how it affects the People and Families we serve requires Continuous and Vigilant Attention. 8

Regional Planning Consortiums The RPC is a multi-stakeholder group which reflects natural patterns of access to care and is comprised of: Consumers LGUs Adult & child services providers Hospitals & primary care prvdrs. OMH/OASAS/DOH/OCFS Families & Youth MCOs & HARPS Housing LDSS/LHD PPS/PHIP Reps The RPC will function as the vehicle through which issues are identified, discussed, brainstormed and resolved through a collaborative governance model. 9

Possible RPC Agenda Items The Scope of the RPC will encompass: Ø The Behavioral Health Transformation Agenda Transition of Adults & Children into MA Managed Care/HH Downsizing of State Psychiatric Center Footprint Ø Behavioral Health-Related DSRIP Projects Ø Stability and Capacity of the Provider System Ø Interaction with Social Services (DSS, Foster Care etc. ) Ø System Transformation 10

The Power of Local Reconnaissance Ø The RPC is the early warning system for issues occurring on the ground that the data won’t necessarily show. Ø Such as; Ø timely access to appropriate level of services Ø gaps in services and provider capacity Ø timeliness of eligibility determinations & evaluations (Inter. RAI) for HARP/HCBS, & HH care coordination services Ø engagement or disengagement in care etc. 11

Collaboration & System Improvement Ø Monitor and improve communication between consumers, providers, LGUs, HH, MCOs & PPSs Ø Monitor and improve timeliness of actions by the MCO/HARP/HH for Medicaid enrollees throughout the system (eligibility determinations for services, access to needed services, enrollment, utilization review, etc. ) Ø Monitor and improve case finding & engagement/continuous enrollment of HARP and non-HARP eligibles in Health Homes Ø Monitor MA utilization (outpt. , ED & inpt. ) and warning signs of enrollees who are not eligible for HARP/HCBS services. (prevent failing-up) Ø Monitor and improve connections between justice-involved Medicaid enrolled adults & youth, jail release, probation, SPOA, HARP/HCBS services, housing and health home 12

The Objective of this Process The RPC is where collaboration, problem solving and system improvements for the integration of mental health, addiction treatment services and physical healthcare can occur in a way that is data informed, person and family centered, cost efficient and results in improved overall health for adult and children in our communities. 13

RPC – Informed Decision Making Ø DSRIP Performance Metrics can be directly linked to issues and solutions in the community, which occur outside of the hospital setting. Ø SOCIAL DETERMINANTS & OTHER FACTORS - The RPC provides intensive focus on mental health and substance use disorder across all systems and in the context of all other factors influencing recovery such as: -Housing -Peer Supports -Crisis Services -Quality Discharge Planning -Timely Access to all Services -Diversion from ED -Collaboration with Criminal Justice 14

RPC Board of Directors Establishment & Governance 15

Clinton Franklin St. Lawrence Essex Jefferson RPC Regional Map Hamilton Lewis Warren Herkimer Oswego Niagara Orleans Wayne Monroe Genesee Erie Onondaga Cayuga Ontario Wyoming Livingston Seneca Yates Schuyler Chautauqua Cattaraugus Washington Oneida Allegany Steuben Chemung Madison Cortland Tioga Otsego Chenango Tompkins Saratoga Fulton Broome Montgomery Schenectady Rensselaer Albany Schoharie Greene Delaware Columbia Ulster Dutchess Sullivan Orange Putnam Westchester Rockland Bronx New York Nassau Queens Richmond Kings WESTERN NEW YORK REGION Allegany Cattaraugu s Chautauqu a Erie Genesee Niagara Orleans Wyoming FINGER LAKES CENTRAL REGION Chemung Livingsto n Monroe Ontario Schuyler Seneca Steuben Wayne Yates Cayuga Cortland Madison Oneida Onondaga Oswego SOUTHERN TIER REGION Broome Chenango Delaware Tioga Tompkins TUG HILL SEAWAY REGION Jefferson Lewis St. Lawrence MOHAWK VALLEY REGION Fulton Herkimer Montgomer y Otsego Schoharie Suffolk CAPITAL REGION NORTH COUNTRY REGION MIDHUDSON Albany Columbia Greene Rensselaer Saratoga Schenectady Clinton Essex Franklin Hamilton Warren Washington Dutchess Orange Putnam Rockland Sullivan Ulster Westcheste r REGION NEW YORK CITY REGION Bronx Kings New York Queens Richmond LONG ISLAND REGION Nassau Suffolk

Collaborative Governance is an internationally accepted and replicated form of governance which is based on the premise that through collaborative governance, leaders engage with all sectors – public, private, non-profit, citizens and other – to develop effective, lasting solutions to public problems that go beyond what any one sector could achieve on its own. 17

Board Co-Chairs: 1. LGU – Selected by LGU members 2. Other – Selected by majority vote of the individual Board members, excluding LGUs. Committee Chairs: Selected from Board membership & approved by majority vote of the individual Board members. Standing Committees: Additional members from the region included & no size limit Children & Families (Add foster care, schools, family court, juvenile justice etc. ) Data and metrics Access and integration (example) Training and Education (example) Ad Hoc Committees: Created to respond to regional priorities RPC BOARD OF DIRECTORS GOVERNANCE STRUCTURE Collaborative Governance with Consensus Decision Making Board Representative(s) Stakeholder Role Institutional Providers Group Hospital Primary Care/FQHC Health Home Lead Community Based Providers Group Mental Health SUD Housing Children & Youth Rehab & HCBS Care delivery & coordination Regional services providers Up to 5 reps. 20% Community services and supports provider Up to 5 reps. 20% Peer/Family/Youth Group Advocacy & client voice for programs & services LGU Group MCO/HARP Group Non-voting State Government Other stakeholders Total Local Gov’t. , Mental Hygiene System Oversight & Planning, Payer Service authorization & payment Reinvestment (i. e. demonstration programs under RFQ) Quality and process measures OMH/OASAS/DOH/OCFS PHIP, PPS, LHD, LDSS # of Reps. Up to 5 DCSs % of vote 20% At least 1 rep. from child/youth serving agency Up to 5 reps. 20% At least 1 rep. from each: MH, SA, and Youth Up to 5 reps. 20% 1 from each agency At least 1 from each PHIP(s) & PPS(s) in the region 25 Voting + 8 others 0% 0% 100% 18

RPC Board of Directors The Conference developed the membership and governance of the board based on the following considerations: Ø Board size must be large enough to represent stakeholder voices, yet small enough to reach consensus. The RPC boards will include 25 voting representatives Ø Ensure that all components of behavioral healthcare specialty are represented Ø Ensure hospitals and primary care represented 19

Fostering Healthy Discourse Critical factors for successful collaboration & consensus building: Ø Face to Face Dialogue Ø Trust Building Ø Development and Commitment to shared understanding of the interests of other parties Ø Shared Goals Ø Leadership 20

Shared Responsibility It is the responsibility of all of us to come to the table and collaborate on these complex problems to make improved outcomes a reality for the people and families who are counting on us to get it right. 21

Next Steps & How to Get Involved in the RPC Process: Please go to www. clmhd. org and click on the REGIONAL PLANNING CONSORTIUMS tab, then click on your region for a brief survey (3 questions).

Interest and Involvement Survey

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