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Mark Washington, DHS Assistant Commissioner
“Preparing for Tomorrow Today” Part II
April 23, 2010
FY, FT
The Transforming of a Culture and the
Potential of Partnerships
Where did we begin?
Listening and Accessibility
C P R
Transparency
Vision and Goal Setting
Agreement of Accountability in the Relationship
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Where are we headed?
Setting Goals Together
Managing Performance Both public and private agencies seeking similar
and improved outcomes in safety, permanency and well-being for each child and family we serve.
Identifying the linkages between practice, performance and payment
Buying Outcomes
Community-based Services Growth
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Lifelong Connections for Children and Youth
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QUALITY AND ACCOUNTABILITY•Scorecard•Evidence-Informed Decisions •Performance Focused•Program Evaluation•Fiscal incentives
COMMUNITY AND LOCAL CAPACITY•Transparency with Stakeholders•Community Partnerships•Interagency Relationships•Clear Communications•Unmet need
PRACTICE MODEL DEVELOPMENT•Values-driven•Family-strengths based•Permanency for Children and Youth•Casey Family Programs partnership
CARE MANAGEMENT: SERVICE PROVIDERS•Public/Private Partnership•Shared Risk and Responsibility•Targeted Outcomes and Incentives•Buy Outcomes, Not Beds•Coordinated Prevention/Early Intervention Strategies
CASE MANAGEMENT: DFCSStaff Development and Training •Competency-based Learning•Supervisory Management Development•Central Office Support/Technical Assistance• Communications
TRANSFORMATION
Redefining How We Work Together
Values mean everything.
DFCS has rolled-out several initiatives in the past
year to enhance the collaboration between our
agency and the private providers community and
other external stakeholders.
Our goal is to increase accountability on all fronts
and build a framework wherein all parties
understand the collective goals and understand how
best to manage them.
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Building the Infrastructure
Office of Provider Utilization and Outcomes Management was established in the fall of 2009. This was the remaking of Provider Relations Unit.
With leadership staff in place DFCS continues to enhance the work of this office through the addition of more staff to assist providers and streamlining the traditional activities of monitoring and review.
Monitoring and technical assistance will be the primary focus of this office in the coming year.
Customer service is paramount. OPUOM will be the foundation to ensure that our provider partners have a voice with DFCS.
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Managing for Performance
Provider G meetings have been occurring regularly since November, 2009 and are the cornerstone of our mutual accountability.
They give us an opportunity to review performance and delve deeper into critical issues impacting outcomes while creating a safe environment to discuss the manner in which we measure success and learn from the success of others.
Developing common protocols for defining and measuring success will be a critical goal for us all in the coming year.
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Performance-Based Permanency Initiative
Why? Provide supports and resources for credentialed CCIs and
CPAs to move older youth towards permanency, Develop a broader array of community-based, in-home
services and provide necessary after-care support to families post-permanency.
Because DFCS cannot do this work alone. Every child deserves permanency. Period.
Who? Through April 15th there have been 28 youth enrolled and 44
providers engaged in the work with more being added going forward.
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Performance-Based Contracting
New RBWO contracts will be centered on the principle that we must work together to produce quality outcomes for children and families.
By focusing on key outcome measures and sharing ideas for improvement we will provide better service to children and families.
The over-riding purpose of the performance-based system is to recognize high performance in serving children and families and provide assistance to those who struggle in one or more areas.
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Focus Groups
Why? Transparency and collaborative development Common glossary
Focus groups made up of DFCS staff and private providers were instrumental in the design of the performance-based contracting measures.
Gathering feedback from our provider partners in this way helps redesign our tools and are foundational for our success moving forward.
Continued opportunities to participate in focus groups throughout the upcoming fiscal year (both with PBC review and other initiatives).
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Other Work Ahead
Decisions need to be made regarding how the rescinding of the CMS rule on unbundling will impact service provision of Medicaid-funded mental health services for children moving forward.
While returning to our “old system” will not move us forward there are certainly opportunities that must be explored.
A Public/Private focus group will be established to explore our historical model and examine new ideas to find parts of both that will enhance our work.
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Solving the Puzzle – Behavioral Health and Improved Care Management
Children and youth in foster care require access to quality, family-centered behavioral health assessments, services and treatment
DFCS is working in partnership with DBHDD to develop a framework and foundation to better manage child-specific and provider-specific services delivery Pharmacy Utilization Appropriateness and effectiveness of services
delivered Improved network management and development
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Family-Centered Work Leads to Better Outcomes for Youth
Our ability to align with and engage a child’s family and community supports is central to achieving success with all of our performance indicators.
We need to explore new and innovative ways to make our family-centered case practice model the foundation on which all services are built.
As these philosophical and structural shifts are made within your service model OPUOM will be readily available for technical assistance.
Peer-to-peer learning is also encouraged.13
Future Provider Summits
Two Key Strategies
DFCS can provide learning opportunities and workshops that focus on technical assistance and emerging trends and initiatives. July 2010. Stay tuned for more details.
Provider-led workshops that showcase strategies being utilized to achieve outcomes that are yielding positive results, i.e. keeping children in care safe, moving towards permanency, engaging with birth families, etc.
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PBC – And Beyond
Continuous outcome evaluation
“How did we do?” surveys from families served for providers
Case rate program development based on experiences in Year 1 and results in other states
Targeted build-out of community-based services Early Intervention Services – The Unmet Need Youth
Stronger partnerships between the DFCS, DJJ, DCH and DBHDD agencies at the local and state levels to support
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