Minutes of the Meeting of the
Integration of Care Committee
Veronica Fortunato & Steve Hemraj, IOC Co-Chairs
Wednesday, May 31st, 2023
Deborah J. Greene
Adrianna E. Meiering
Agenda Item 1: Welcome, Roll Call & Moment of Silence
The meeting was opened with introductions (name, pronouns) and a quick check in about what committee members did during the holiday weekend (Memorial Day). Mr. Schoepp led the moment of silence.
Agenda Item 2: Behavioral Directive Line-by-Line Editing
Mr. Caponi volunteered to read the directive, starting where the committee left off. Highlights from the editing include:
- Ms. Newman asked if the Council has the purview to determine how many agencies should deliver services to people with complex mental health needs.
- Mr. Harriman noted that the Council does have the ability, based on needs data, to determine how many agencies are required to deliver specific types of services.
- Mr. Hemraj asked if the recipient will allow multiple agencies to work together to apply for funding – where a bilateral arrangement permits two or more agencies to provide the required services.
- Mr. Harriman noted this is permissible in RWPA and noted that agencies should work together to provide the comprehensive spectrum of services.
- Ms. Goldberg raised the question of how agencies would work together – would it be by subcontract?
- Brief discussion of difference between agency satellite sites versus sub contracted agencies.
- Question of how to build capacity of agencies without overwhelming or detracting from the competency with which they deliver services.
- Ms. Farley noted that accessing 2-day appointments is not feasible due to the lack of capacity in the system.
- State guidelines require in patient mental health patients to have an appointment within 3-5 days of discharge.
- Article 31’s are supposed to see these patients within a specific time but are managing 3-month waitlists – many agencies are moving to modalities that do not have the same oversight.
- The crisis in mental health care is unprecedented.
- Can we ask agencies to perform above the average wait time of securing appointments for the system overall?
- When clients are discharged, are advised of appointment, but care home is not flagged. Directive seeks to wrap care around clients who are discharged – language made clearer.
- PSYCKES can be useful but requires consent.
- Requires a lot of training to be useful.
- RHIO also requires consent.
- Both are just reflective of Medicaid claims data.
- Agencies that don’t know how to use these systems.
- RHIO provides real time flags – more useful than PSYCKES in identifying clients in real time who need support. PSYCKES great for understanding population data.
- Inexpensive to access ($500/yr.) – can get thousands of alerts each week.
- Is it better to have each agency parsing through RHIO data, or one agency conducting this service for the portfolio?
- Need agency level consent – this is the challenge.
- Matched RW data to RHIO data to understand correlation – DOHMH could send RW service data to the RHIO – which would be helpful in making the RHIO more robust – would also require consent.
- Strengthened and clarified language to support PWH with complex behavioral needs or SMI.
- Peers with SMI are highly effective at supporting others with SMI or complex care needs.
- Having someone to advocate for you – even a friend, increases likelihood of success in accessing needed services.
- Clarified services available to PWH with complex behavioral health needs.
- Harm reduction versus substance use – harm reduction does not include all substance use treatments. Not all substance use services are harm reduction.
- Included recovery to comprehensively define services.
- Discussed inclusion of treatment adherence, inclusive of HIV and medical and behavioral health medications
- Medical is reflective of other medical care needs beyond and inclusive of HIV.
- Discussed quality of life measures
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|Brenda Starks-Ross||Food & Nutrition Services, Short-Term Housing, Health Education/Risk Reduction, Family Stabilization and Supportive Counseling, Harm Reduction|
|Deborah Greene||Harm Reduction|
|Janet Goldberg||Medical Case Management, Harm Reduction, Food & Nutrition Services|
|Ronnie Fortunato||Food & Nutrition Services|