3/11/2016. HMG Centralized Access Point 1. Maine Child Health Improvement Partnership (ME CHIP)

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1 1 Maine Child Health Improvement Partnership (ME CHIP) Mission To optimize the health of Maine children by initiating and supporting measurement based efforts to enhance child health care by fostering public/private partnerships. Vision All practices providing health care to children will have the skills, support, and opportunities for collaborative learning needed to deliver high quality health care. ME CHIP is part of the National Improvement Partnership Network (NIPN) 2 HMG Centralized Access Point 1

2 Today s Agenda Welcome and Introductions Brief overview of DSI work and Help Me Grow Review functions of the centralized access point component (pp , 31 plus handout on the Functions of a HMG Call Center ) Call center Resource inventory Staffing of care coordinators Client tracking system Share some state examples of this component (UT, DE, WA, CT) (pp. 44,45) presentation what they current do and the differences between 211 and a HMG system Identify and schedule other I&R presentations 3 Background on Developmental Screening Work Developmental Screening Quality Metric on CMS CHIPRA list in 2010, ME/VT CHIPRA five year grant in 2010 IHOC work IHOC/First STEPS pilot in 2012: 12 sites Developmental Screening Integration (DSI) Project started in 2012 Health Homes/PCMH practices required to implement developmental screening as of Jan 2014 Claims based rates on MaineCare Utilization Review (UR reports) Fall 2013 First STEPS/DSI/SIM did trainings in 2014: 77 primary care practices trained and 9 did full MOC project SIM/Health Homes 22 practices trained in Spring 2015, ongoing technical assistance DSI project led Developmental Screening Community Initiative in 2015: Waterville, Bangor, MidCoast QC is now exploring the Help Me Grow Model 4 HMG Centralized Access Point 2

3 Developmental Screening data on the MaineCare Utilization Review (UR) Report 5 Data Matters: Population based data on screening using MaineCare billing has increased since start of QI work 6 HMG Centralized Access Point 3

4 Problem Statement EXPERTS AGREE Early detection and connection to services leads to the best outcomes for children with developmental or behavioral challenges Identifying and linking all vulnerable children to community-based supports as early as possible is essential to optimal child development HOWEVER Families, child health providers, and other professionals often have difficulty recognizing when children show early signs of developmental delays or behavioral health issues Even when needs are identified, accessing programs designed to address those needs can be confusing and time-consuming 4 Assumptions of Help Me Grow 1. Children with developmental/behavioral problems are eluding early detection 2. Many initiatives exist that provide services to young children and their families 3. Child health providers, early care education professionals, and others who work with children face challenges in connecting vulnerable children with needed services 4. Children and their families benefit from Help Me Grow, a coordinated, statewide system of early detection and intervention for vulnerable children HMG Centralized Access Point 4

5 Click to edit Master title style Help Me Grow Vision All states have comprehensive Help Me Grow systems so that Families Child Health Care, Early Care & Education, Human Service Providers Knowledge of and access to services Support in learning about child development Support in making connections Identify at-risk children Partner with families to promote healthy development Public officials and other key stakeholders Understand gaps in supports and services Know how to ensure system capacity to meet needs Maine Help Me Grow Community Meeting Survey Results It is clear to me why Maine is exploring the Help Me Grow system. Strongly agree Agree Neither agree nor disagree Disagree Strongly disagree 66.6% 29.6% 3.70% 0% 0% Should Maine implement the Help Me Grow system? Yes No I don t know 70.4% 0% 29.6% If yes, how strongly do you support Maine moving forward with implementing the Help Me Grow system? Strongly favor Somewhat favor Neither favor nor oppose Somewhat oppose Strongly oppose 78.9% 21.1% 0% 0% 0% This table of percentages is from a total of 27 survey responses. HMG Centralized Access Point 5

6 Maine Community Meeting: The Help Me Grow System Maine Stakeholder Findings Through the course of the site visit, the National Center Team also learned that: Maine s early childhood system is rich with caring and dedicated people who are making a meaningful difference across the state. The DSI leadership team is highly efficient and respected among early childhood programs and services across the state. Maine has an active and wide-spread United Way system. ME CHIP is a successful partnership with complementary goals to HMG The Help Me Grow System Core Components 1 Centralized telephone access point for connecting children and their families to services and care coordination 2 Child health care provider outreach to support early detection and intervention Structural Requirements 3 Community outreach to promote use of HMG and facilitate networking for families and service providers 4 Data collection to understand all aspects of the HMG system, including gaps in and barriers to services Organizing Entity Plan for Statewide Expansion Continuous Quality Improvement HMG Centralized Access Point 6

7 CORE COMPOENNT 2 Child Health Provider Outreach Child health care and education provider outreach to support early detection and intervention Maine Community Meeting: The Help Me Grow System How HMG Provider Outreach Works HMG staff conduct outreach to child health providers on using developmental surveillance at every visit using a valid, reliable developmental screening tool at 9, 18, and 24 months (American Academy of Pediatrics 2006 recommendation) connecting children to services using Help Me Grow, a free, confidential resource that will save you time HMG Centralized Access Point 7

8 7 Information loops back to provider from HMG 1 Well-child visits (Surveillance & Screening) 2 Provider solicits family concerns 6 Family connected to resources Help Me Grow in 7 Steps 3 Identify behavioral and/or developmental concern 5 HMG Care Coordinator provides resources 4 Provider or family contact Help Me Grow Barriers to Surveillance & Screening and How Help Me Grow Eases Them Lack of system for linkage to community-based referral resource No time to learn the range of resources available Unfamiliarity with screening tools Insufficient time Help Me Grow is a FREE service that links children to community-based resources Help Me Grow maintains a comprehensive, up-to-date resource directory Help Me Grow can provide trainings on screening tools HMG streamlines the referral process Concerns about cost HMG is a FREE service for all Sponsored by the Florida Developmental Disabilities Council, Inc. and The Florida Department of Education, Office of Early Learning HMG Centralized Access Point 8

9 CORE COMPOENNT 3 Community & Family Outreach Community outreach to promote HMG & provide networking events for families and service providers Maine Community Meeting: The Help Me Grow System Why do Community & Family Outreach? A community presence encourages support for and participation in the Help Me Grow system. Regularly meeting with service providers helps build the HMG resource directory and keep it up-to-date. Examplesof Community & FamilyOutreach Networking meetings for regional service providers Trainings & events for community, parents and child health providers Partnerships with familyfriendly organizations HMG Centralized Access Point 9

10 The Community Outreach Liaison Facilitates Community Networking Meetings Maintains listserv Is an expert on programs, services, and initiatives in regions a living resource directory Provides trainings for parents, child health providers, early care and education professionals, and the community Supports telephone care coordinators Identifies gaps and barriers CORE COMPOENNT 4 Data Collection & Analysis Data collection to understand all of the HMG system, including gaps in and barriers to service HMG Centralized Access Point 10

11 Maine Community Meeting: The Help Me Grow System Tools for Data Collection & Analysis Results Based Accountability All performance indicators can fit into any of the following categories How much did Help Me Grow do? How well is Help Me Grow doing? Is anyone better off as a result of using Help Me Grow? (Friedman, 2005) HMG Common Indicators Data Collection is in the following four areas: 1. Help Me Grow demographics 2. Nature of presenting issues 3. Referrals by Help Me Grow to service/programs 4. Help Me Grow outcomes * Definitions and Categories provided by Help Me Grow National Help Me Grow Demographics Data from 12 States Number of Children 31,022 children Who contacted HMG? Caregivers: Mothers Providers: Healthcare Mental Health care Early Intervention HMG Centralized Access Point 11

12 Top 5 Presenting Issues/Concerns Top 5 in order: 1. Communication Issues 2. Behavioral Issues 3. Developmental Concerns 4. Developmental Information & Resources 5. Educational Needs & Resources Outcomes, Impact & Effectiveness Cost Benefits of De-medicalizing Childhood Developmental and Behavioral Concerns Help Me Grow Promotes Optimal Child Development by Enhancing Protective Factors Policy briefs available at HMG Centralized Access Point 12

13 CORE COMPOENNT 1 Centralized Access Point Centralized access point to connect children and their families to services and care coordination Maine Community Meeting: The Help Me Grow System Connecting Families to Services Care Coordinators link families with children to appropriate services and supports. CARE COORDINATORS PROVIDE assessment of needs and referrals to services education on development, behavior management, programs ongoing developmental monitoring & developmental screening advocacy and follow up HMG Centralized Access Point 13

14 There are no wrong doors Sponsored by the Florida Developmental Disabilities Council, Inc. and The Florida Department of Education, Office of Early Learning Maine Community Meeting: The Help Me Grow System Functions of a Help Me Grow Call Center Answer requests for assistance by families, health care providers, child care providers, and others who touch young children and their families Maintain, in real time, a community resource directory Within the geographic area served, have visibility among: - Health care providers Child care providers Other community based agencies Families network and communities Collect data, via an automated client-tracking system, on calls handled by Help Me Grow care coordinators, including: Caller demographics How caller heard of service Reason for call Actions taken Outcomes as a result of contacting the call center. Common Indicators established by the National Center HMG Centralized Access Point 14

15 Maine Community Meeting: The Help Me Grow System Three Structural Requirements An organizing entity QC is well positioned to initially fill the role of organizing entity. They are highly organized, well networked throughout the state, and have common goals with HMG. Strategy for expanding statewide over time A plan for statewide expansion and sustainability will need to be developed. Implementation of a continuous quality improvement plan A continuous quality improvement plan will need to be developed. Data collection and analysis will be the foundation of the quality improvement plan. Transportation Child Care Parenting Education Alzheimer s Resources Crisis Intervention Legal Assistance Veteran s Services Basic Needs Food Clothing Shelter Elder Care HIV/AIDS Energy Assistance Domestic Violence Programs Financial Assistance Suicide Prevention Substance Abuse Resources Mental Health Resources Transportation Alzheimer s Resources Crisis Intervention Legal Assistance Child Care Basic Needs Food Clothing Shelter Elder Care Adoption Energy Assistance Domestic Violence Programs Financial Assistance Suicide Prevention Substance Abuse Municipal Resources Transportation Child Care Alzheimer s Resources Municipal Resources Legal Assistance Veteran s Services Legal Assistance Food Clothing Home Care HIV/AIDS Energy Assistance Child Care Support Groups Disabled Resources Tax Assistance Maternal Health Services Crisis Intervention HMG Centralized Access Point 15

16 What is 2-1-1? A partnership between The Opportunity Alliance, United Ways of Maine and the State of Maine Three-digit phone number reserved nationwide for health and human service information and referral (I&R) I&R: linking people in need with appropriate services Maine includes a statewide database, Benefits of 2-1-1: What It Means For Maine A centralized, statewide database Easy to remember and simple to use 24 / 7 / 365 phone coverage by live I & R Specialists Emergency response support focal point Statewide community planning tool Link for volunteers and agencies Identification of unmet needs to report back to the communities HMG Centralized Access Point 16

17 2-1-1: Nationally UW Atlanta: first call center (1997) Connecticut: state-wide system (1998) FCC approval (2000) is currently operational in all 50 states, Washington D.C. and Puerto Rico. Maine: 33 rd state with service & 15 th state to have statewide coverage (July 2006) HMG Centralized Access Point 17

18 2-1-1 Maine, Inc. Organizational Structure 211 Maine, Inc. (Board of Directors) Project Sponsor United Way of Greater Portland Call Center The Opportunity Alliance Resource Coordinators Call Center Located at The Opportunity Alliance 13 Call Specialists (including a Team Leader and a Contact Center Manager) Number of staff answering calls depends on the shift: Days ~ up to 5 Call Specialists Afternoons and Evenings ~ up to 5 Call Specialists Overnight ~ 1 Call Specialist HMG Centralized Access Point 18

19 Flow of a Call 1. Call Specialists ask how they can help the caller. This may include a more in-depth conversation to determine exactly what the need is. 2. They will ask for the city and zip code of where the caller is calling from. 3. They will enter keywords and the zip code into the Tapestry resource database to begin their search. 4. The database brings up a listing of available resources that corresponds to keywords entered. 5. The Call Specialist will then begin to go through the list and talk with the caller to help determine the most appropriate referrals. 6. Once the call is completed, they will complete the documentation in the system and be prepared to answer the next call. Resource Coordinators 6 Resource Coordinators throughout State of Maine: Lewiston United Way of Androscoggin County Androscoggin, Oxford Presque Isle Waterville United Way of Mid-Maine Kennebec, Somerset, Franklin Bath United Way of Mid-Coast Maine Lincoln, Knox, Sagadahoc Lewiston Bath Bangor Waterville Bangor United Way of Eastern Maine Penobscot, Piscataquis, Waldo, Washington, Hancock Presque Isle United Way of Aroostook Aroostook Kennebunk United Way of York County York Portland Resource Manager: Nancy Berg (Statewide) Resource Coordinator Manager: Judie O Malley (Cumberland, Statewide) Multicultural Coordinator: Biljana Cuparic(Statewide) HMG Centralized Access Point 19

20 What does a Resource Coordinator do? Networks, researches and connects with community providers to find services throughout the counties. Connects with each agency to explain Maine and its function. Works with agencies to understand all programs and services run by the agency. What does a Resource Coordinator do? (continued ) Assists agencies to complete clear, concise profile forms and returns them in a timely manner to the area Resource Coordinator. Adds profiles to the Maine database and edits them before making them active. Connects with agencies once profiles are live to assure information is accurate. HMG Centralized Access Point 20

21 What does a Resource Coordinator do? (continued ) Maintains contact with agencies for updates, contact changes, etc. Performs a yearly update of each agency in their catchment area. Distributes print material to interested agencies and individuals. Resource Coordinators connect with Call Specialists Resource Coordinators: Must be able to prioritize depending on seasonal needs (school supplies, holiday meals, tax assistance, flu clinics) or emergency situations (weather disasters such as Aroostook County flooding and the ice storms of December, 2008 and December, 2013). Develop resources based on caller demand and unmet needs, as reported by Call Specialist documentation some of these include housing and financial assistance. Respond to and correct database issues reported by Call Specialists these issues are most often discovered while utilizing profiles for caller referrals. Are available to Call Specialists for further consultation when all database resources have been exhausted (for possible in progress resource additions or little known services offered by local agencies). HMG Centralized Access Point 21

22 Multicultural Coordinator Works with outside agencies to obtain multicultural resource information and enters it into the database. Provides outreach to new American communities about Maine. Provides assistance and training to Resource Coordinators and Call Specialists. Why Call 2-1-1? You have recently moved to Maine and you would like to find an afterschool program for your children. After years of unhealthy drinking, you would like to locate an Alcoholics Anonymous support group in your community. Your partner is abusive and you are frightened and confused. Finding the right 800 number is stumping you and you need to talk to someone immediately. You make less than $54,000 and you would really like some help completing your income tax forms. You just saw a news story about the flooding in Lewiston and would like to help out by volunteering. HMG Centralized Access Point 22

23 Crisis and 911 calls Crisis We provide a warm transfer to the appropriate crisis line in the state. We attempt to inform the Crisis Center of the nature of the crisis is if we are able to do so calls can be transferred, although this is not our preference. We assess if the caller is able to hang up and dial 911 first. If not then we do a warm transfer using the back door numbers provided to us by the State of Maine Emergency Services Bureau. We have an agreement to contact the appropriate dispatching center to ensure that the caller received assistance. Use of other forms of communication TTY for the Deaf To utilize TTY service, a caller simply dials 211. Each station is equipped with a TTY machine and all Call Specialists are trained on how to use it. Many callers now use 711 relay service rather than TTY. Interpreting Services We utilize a telephone interpreting services to handle calls from people who do not speak English. This is a 3-way call between the Call Specialist, the caller and the interpreter. HMG Centralized Access Point 23

24 Access to On-line Database Click on the SEARCH NOW icon in the center of the webpage. Enter the zip code of the area where you are looking for services and select a category to drill into more a specific listing of subject areas. You can also search by zip code and keyword which can include a program name, service name or a word that best describes the service you want to locate and click Search. If choosing to search by keyword selecting Advanced Search will allow you to get more specific with your search. In the Distance From Zip Code, add the zip code you are searching and a keyword and click search. By clicking on the links for the service name, you can obtain additional information including a description, eligibility, location and how to contact them. HMG Centralized Access Point 24

25 Sub-categories within Icon categories HMG Centralized Access Point 25

26 Further detail within sub-categories Further subcategories HMG Centralized Access Point 26

27 Volunteer Opportunities and Donations We link callers to Volunteer Maine for easy access to volunteer opportunities throughout the State and if someone is interested in donating an item to an agency. Go to or call your local United Way if you do not have internet access. Disaster Preparedness We have a memorandum of understanding in place with the Maine Emergency Management Agency (MEMA) on Statewide disaster planning. We continue to work with County Emergency Management Agency Directors on more localized disaster planning. We have our own internal disaster plan in place. HMG Centralized Access Point 27

28 What s in this relationship for ME? Simple to Remember, Single Access to Services Warm Transfer of Crisis Calls Disaster Communications Identification of Unmet Needs Database Directory Volunteer Recruitment Find Help Accessibility: By telephone, cell phone or digital phone Utilize TTY for the Deaf and Tele-Interpreter services for callers who do not speak English Through the website In-state/out-of-state toll free number to assist family members looking for resources for relatives living in Maine From a rotary phone: Contact information: Dial 211 (TTY accessible) or Fax: (207) info@211maine.org Mailing address: Maine 50 Lydia Lane South Portland, ME HMG Centralized Access Point 28

29 Next Meetings April 15 th, 2016, 12:30 2 Hanley Conference Room/QC May 6 th, 2016, 9 11 Hanley Conference Room/QC June 3 rd, 2016, 9 11:00 Hanley Conference Room/QC Presentation to State Leaders at DSI Meeting on Wed., July 20 th from at Cross Building 57 IHOC and DSI Funding Statements CHIPRA/IHOC Quality Demonstration Grant Funding: February 2010 to February 2016: The Improving Health Outcomes for Children (IHOC) work is conducted under a Cooperative Agreement between the Maine Department of Health and Human Services and the Muskie School of Public Service at the University of Southern Maine and is funded by a grant from the Centers for Medicare and Medicaid Services (CMS) through Section 401(d) of the Child Health Insurance Program Reauthorization Act (CHIPRA). This document was developed under grant CFDA from the U.S. Department of Health and Human Services, Centers for Medicare & Medicaid Services. However, these contents do not necessarily represent the policy of the U.S. Department of Health and Human Services, and you should not assume endorsement by the Federal Government. For more information, please contact the IHOC Project Director, Kim Fox, MPA, IHOC Project Director, Muskie School, University of Southern Maine at kimberley.s.fox@maine.edu. DSI Funding: Supported by the Maine DHHS through funding from the US CDC Preventive Health and Health Services Block Grant 3B01DP HMG Centralized Access Point 29

30 Contact Information Amy Belisle, MD, Director of Child Health Quality Improvement, Maine Quality Counts (207) , x1002 Chris Beaudette, new DSI Project Manager as of March 1 st (207) x 1027 cbeaudette@mainequalitycounts.org Sue Mackey Andrews, Consultant to QC for Kids on DSI Project (207) sdmandrews@aol.com Sue Butts Dion, QC for Kids Quality Improvement Specialist (207) sbutts@maine.rr.com Deb Gilbert, QC for Kids Administrative Coordinator O: (207) , x 1017 F: (207) dgilbert@mainequalitycounts.org 59 HMG Centralized Access Point 30