Health Care Reform Forum

“Children and Families at the Nexus of Health Care Reform” Forum Sheds Light on a Hopeful Future for Collaborative Care

On Wednesday, we joined the Fordham University Graduate School of Social Service to welcome more than 200 leaders and stakeholders at our first ever Policy and Practice Forum, funded with support from the NY Community Trust. Together we began to unpack the complex changes and evolving priorities of the health care system that are having a deep impact on the lives of the vulnerable children and families we serve.

Our Collaborative – and the forum – emerged in response to a system that has fallen short. The data is clear, showing that children and families in greatest need of comprehensive care are not receiving the support they need, when they need it, in order to be healthy and successful in the long term. Instead, chronic illness persists and emergency room visits are frequent.

Yet the prevailing sentiment at Wednesday’s forum was one of hope and a sense of confidence in our ability to change systems and outcomes for families by working together. Take a look at some of the top takeaways from a day of knowledge-sharing, dialogue, and progress.

 

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Person-Centered Care

One-size-fits-all health care is not working. Panelists told us that they had seen the most success when caregivers acknowledged the specific trauma, needs, and experiences of each individual. They were effective when they worked with children and families as equals or as fellow humans, not as anonymous patients exhibiting a list of symptoms.

“If the opposite of poverty is justice, then the opposite of trauma is presence,” said Jacob Ham, PhD, Director of the Center for Child Trauma and Resilience at the Icahn School of Medicine at Mount Sinai. “Being witness to their suffering and their experiences, knowing that you could have been in their shoes, that’s the basis of technical practice. It has to start from the heart.”

Euphemia Adams, Executive Director at Families on the Move, emphasized the importance of peer-to-peer support. Who better to provide person-centered care than a peer who can personally relate?

Social Determinants of Health

The definition of health is changing, and it’s a good thing. It is broadening to include mental, social, behavioral, economic, family, and community health. Until symptoms are addressed in each of these areas, children and families cannot achieve sustained, total well-being.

As Rahil D. Briggs, PsyD put it, “There is no health care without mental health care. And there is no child mental health without parent mental health.”

As Director of Pediatric Behavioral Health Services at Montefiore, she has seen first-hand how collocating behavioral health and pediatric services for high-risk moms and their young children can significantly improve health outcomes for both.

“We need to start asking, ‘What happened to you?’ not, ‘What’s wrong with you?’” added Jane Golden, SVP and Chief Program Officer at Sheltering Arms, introducing the idea that trauma is the root cause of diseases which will persist, despite medical treatment, until trauma is addressed.

Kerron Norman, Vice President and Chief Program Officer at ANDRUS, qualified that idea. “Some of the symptoms we see are in fact related to food insecurity or housing insecurity. That instability would make anyone anxious,” she said. The typical formula for treating anxiety won’t work for the family Kerron describes. Until the family receives social supports and access to stable food or housing, the mental health symptoms will persist. The solution lies in a holistic view of health and treatment.

Gary Belkin, MD, MPH, PhD, Executive Deputy Commissioner, NYC Department of Health and Mental Hygiene, also sees the solution in linking community and mental health services. “Investing in economic development, education, and public health, those are mental health policies,” he said.

Healthy Workers, Healthy Families

Caring for those who have been traumatized or who feel “Underserved and undervalued by providers,” as Kerron Norman puts it, is stressful for caregivers.

“Staff have to feel safe, welcomed, and known,” said Virginia Strand, DSW, Professor and Co-Director of the National Center for Social Work Trauma Education & Workforce Development.

When her staff were getting “harmed on the job” and experiencing trauma themselves, Lina Pasquale, Division Director at Good Shepherd Services, turned to “The four Rs of trauma: rules, roles/responsibility, respectful communication, and relationships.”

Virginia Strand also encouraged organizations to consider staff support and retention now, even if HR is in the early stages of building a staff of care managers. “Ask yourselves what kinds of career ladders you’re going to build for these people. How will you diversify your workforce? How will you support them?”

Shared Benefits, Shared Responsibility

The benefits of working together to better serve the same families are clear. We can avoid duplicating services, provide more accurate diagnosis, pool resources, and prevent crisis which put a strain on both families and the staff and systems which support them. How we will work together is less clear. Our panelists and speakers helped us imagine how integrated care will look and how it has worked in existing collocated or managed care programs.

For Khalid Khan, MD, Director of Mental Health Services at New Alternatives for Children, collocation has eliminated the need for many outside referrals to labs and other services, which are so often the source of misdiagnosis, or the point at which families disengage.

Nevertheless, audience members pointed out that collocating all programs and services is not realistic for many agencies and providers. Fortunately, that’s where the Health Home’s Care Managers will come in, said Alan Mucatel, Chair for the Collaborative for Children & Families.

“Referring to another provider across the hall is not real integration,” echoed Monica Cierrici, Project Management Director of Bronx Partners for Healthy Communities at St. Barnabas Hospital. “Collocation is a precursor to collaborative care. It’s a continuum.”

Janna Heyman, PhD, Professor and Chair of the Henry C. Ravazzin Center, Fordham University Graduate School of Social Services, introduced the importance of breaking down silos between disciplines and departments.

“In the interest of breaking down silos, we have to stop building them in the first place,” added Sergio Matos, Executive Director at the Community Health Worker Network.

On a practical level, Monica Cierrici, suggested “Making IT part of everyone’s job so workflows support data-sharing,” as well as good communication.

Similarly, Lana Earle, Deputy Director at the Office of Health Insurance Programs for the NYS DOH, pointed to the shared value that will come with billing for services together, but also the shared risk and responsibility.

In his closing remarks, Mucatel also acknowledged that integrating care will require some sacrifices, but the forum gave us myriad reasons to be confident in the success of our children’s health home, the Collaborative, and the entire movement to give children and families a real chance at complete, sustained wellbeing.

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Fordham School of Social Service

The CCF to Host a Policy Forum on Health Care Reform

The CCF, along with the Fordham University Graduate School of Social Service, is proud to host a full-day policy forum entitled, “Children and Families at the Nexus of Health Care Reform” on June 22, 2016, in the Pope Auditorium on Fordham’s Lincoln Center Campus in Manhattan. The forum will start at 8:30AM and conclude at 4:30PM.

The forum will explore the revolution in health care delivery and access issues confronting the CCF, other organizations, and the children and families marginalized from the safety net as they adapt to changes in the health care market place. It will educate the entire child and family-serving community on health care changes affecting service delivery and build relationships among CCF members and organizations including; schools of social work, nursing and public health, health care providers, managed care organizations advocacy groups, foundations and the media.

CCF Healthcare Reform Policy Forum

The focus will be on Medicaid-eligible children and families who have an opportunity to receive improved access to and coordination of their health care and human service needs in a dramatically shifting service system. Together, we will explore how we ensure that they receive the right service at the right time and bring value to their lives.

Content for the forum includes expert speakers who will cover the following topics:

  • The challenge of caring for children most in need of care in the midst of health care and Medicaid reform: the view from community-based providers.
  • Integrating behavioral and medical care delivery and preparing these systems to handle children who have experienced trauma.
  • Preparing for value-based care.

Discussion panels will also address:

  • Integrating primary and behavioral care to serve the child and family.
  • Caring for children and families with adverse experiences (trauma).
  • Building a health home workforce that can help families negotiate the shifting health care system.

If you would like additional information regarding the forum please email us at info@CCFHH.org.

Children on Medicaid join the CCF Health Home

Welcome Jodi Saitowitz, Our First Executive Director

Jodi Saitowitz Headshot
We are pleased to announce the appointment of Ms. Jodi Saitowitz as its first Executive Director. Beginning in February 2016, Saitowitz will be leading the collaborative‘s first initiative as a Children’s Health Home serving children and Families in New York City, Westchester, Suffolk, and Nassau counties.

“CCF’s board and 30 member organizations are happy to welcome Jodi Saitowitz as our first Executive Director,” said Alan Mucatel, Chair of the Collaborative for Children and Families and Executive Director of Leake & Watts Services, Inc. “As a Health Home, we must provide an unprecedented level of care, collaboration, and vision. We are confident that Ms. Saitowitz is the leader we need to drive these important changes for New York State.”

Saitowitz has worked with some of the most impoverished communities throughout the USA and abroad. Her specialty has been working with disabled children and their families in child welfare for over twenty-five years. As a clinician, Saitowitz worked as a psychotherapist in one of the largest residential treatment facilities in the state of Maryland.

“I am thrilled to join CCF and work with such an impressive network of leaders across New York,” said Saitowitz. “Children in the Medicaid system deserve the best, but far too often, they aren’t able to access the support they need. In partnership with CCF’s member agencies, I’m looking forward to implementing innovative programs that improve the lives of tens of thousands of vulnerable children.”

As Executive Director, Saitowitz will lead CCF’s efforts to evolve and expand service provision for children in New York’s Medicaid program. The CCF Health Home is a premiere initiative intended to coordinate care among multiple caregivers, which reduces health care costs and improves long-term health outcomes. Saitowitz will facilitate collaboration across CCF’s 30 member agencies, which covers the vast majority of children in New York’s foster care and family preservation services, and city and community organizations to implement the Health Home model.

Saitowitz has a proven track record of improving business processes, such as increasing operating efficiencies and improving client service delivery outcomes as an Associate Executive Director of one of the city’s most specialized non-profit child welfare agencies. In addition, Saitowitz is a trauma, risk, and crisis management expert, certified in human resource management and clinical social work. Saitowitz is a member of the NY State Medicaid Redesign Children subcommittee and closely partners with the Office of Mental Health (OMH), the Office of Children and Family Services (OCFS), and the Office of People with Developmental Disabilities (OPWDD) to improve supports for children with special needs.

Saitowitz is an accomplished public speaker and trainer on child welfare, adoption, and mental health issues for children & families. Saitowitz has an undergraduate degree in social work from Colorado State University and a Masters in clinical social work from the University of Maryland.

About the Collaborative for Children and Families
Founded in early 2014, the Collaborative for Children and Families (CCF) was formed in anticipation of changes in the delivery of health care services to children eligible for New York State’s Medicaid program. The CCF is a New York State nonprofit comprised of 30 member agencies that serve children and families throughout the five boroughs of New York City and Westchester, Nassau, and Suffolk Counties. The CCF offers comprehensive services to children and families in a more coordinated manner than could be achieved individually.

NY Family on Medicaid

The CCF Receives a Grant From The New York Community Trust to Build Capacity for Comprehensive Child Welfare

The Collaborative for Children and Families (CCF) has received a grant of $100,000 from the New York Community Trust. The grant will allow CCF to improve quality of care and save costs for the child welfare sector by identifying and sharing proven practices.

CCF was formed to respond to many changes in New York’s Medicaid system. Experts agree that children need thorough solutions to live healthier, fuller lives, rather than isolated efforts, The grant from the New York Community Trust taps CCF’s vast expertise in child welfare, mental health, and education programs in order to improve health outcomes. Specifically, The Trust’s support will help CCF to create an extensive database of services, develop strategies for cross-agency collaboration and integration, create economies of scale for administrative functions, and hold a forum to build awareness of best practices.

“We are thrilled that the New York Community Trust – one of New York’s leading philanthropic institutions – is standing with the Collaborative for Children and Families to improve the lives of more than 30,000 children,” said Alan Mucatel, chair of the Collaborative for Children and Families and executive director of Leake & Watts Services, Inc. “We have an immense opportunity to transform the child welfare sector by scaling proven solutions, and we look forward to working with The Trust and other funders to achieve this goal.”

Last week, CCF announced that it was designated as a Health Home by the New York State Department of Health. The Health Home care management service model allows CCF to coordinate holistic care for Medicaid enrollees. As a Health Home, CCF will be able to utilize the expertise of its 33 member agencies and its diverse network of community partners to positively affect the majority of New York’s foster care and preventive services population, in addition to other children in need. In the coming year, CCF hopes to work with philanthropic partners to enact the recommendations that will be surfaced by the NYCT grant, and conduct additional policy forums to spread knowledge across the state.

The Collaborative for Children and Families

The Collaborative for Children & Families is Designated as a NYS Health Home!

The Health Home designation provides a model for the CCF to comprehensively address health needs for more than 30,000 high-need children annually

The Collaborative for Children and Families (CCF) announced today that it has been designated as a Health Home authorized to serve children by the New York State Department of Health. CCF is comprised of 33 leading nonprofit agencies serving children, which are based throughout New York City, Long Island, and Westchester.

Health Homes coordinate care among multiple caregivers, and the CCF’s breadth of services and knowledge is ideal to improve long-term health outcomes for children and their families. As a Health Home, CCF is uniquely qualified to coordinate comprehensive care for a vast population of children in challenging circumstances, such as youth in foster care and preventive services, and to address health issues ranging from social emotional disorders to chronic conditions.

“The evolving and diverse health needs of children in New York requires an inclusive and harmonized approach,” said Alan Mucatel, Chair of the Collaborative for Children and Families and Executive Director of Leake & Watts Services, Inc. “We are looking forward to leveraging the vast knowledge and expertise of CCF’s member agencies to improve access to quality health care and ultimately improve outcomes for children across the state.”

Together, CCF member organizations, through their currently existing programs, have partnerships with community organizations and health care providers across New York City and surrounding areas. Member agencies also work closely with juvenile justice and education systems. To further the long-term effect of the Health Home model, the CCF plans to establish cross-agency taskforces and learning forums to strengthen population-serving strategies, services, and capacity. CCF will spend the coming months expanding their network of agencies to ensure that the complex needs of all children can be met.

About the Collaborative for Children and Families
Founded in early 2014, the Collaborative for Children and Families (CCF) was formed in anticipation of changes in the delivery of health care services to children eligible for New York State’s Medicaid program. The CCF is a New York State nonprofit comprised of 33 member agencies that serve children and families throughout the five boroughs of New York City and Westchester, Nassau, and Suffolk Counties. The CCF offers comprehensive services to children and families in a more coordinated manner than could be achieved individually. Member agencies as of June 16, 2015 can be found here.