Connecticut Hospital Association Mobile Integrated Health Working Group October 17 2017 Scope of the Problem Fragmented system Limited definition of health Homelessness lack of substance abuse treatment other social stressors ID: 1045244
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1. Community Care Teams Carl Schiessl, Director, Regulatory AdvocacyConnecticut Hospital AssociationMobile Integrated Health Working GroupOctober 17, 2017
2. Scope of the ProblemFragmented systemLimited definition of health Homelessness, lack of substance abuse treatment, other social stressors Poor coordination of servicesDisconnect between the hospital and outpatient care Social determinants impact the health and well being of patients and how frequently they come to the hospital Overuse of acute servicesWorsening medical conditions++
3. Consequences Poor Outcomes Wasted Resources Unsustainable Finances Overworked Providers
4. Frequent VisitorsIn 2013, in the United States, 1 of every 8 ED visits was related to a mental health or substance use disorderConnecticut emergency departments treated more than 8,400 patients at least 7 times in 6 months, totaling approximately 58,000 visits
5. Who are the Frequent Visitors? Seven or more visits in a six-month periodDisproportionate rates of mental health and/or substance misuse diagnosesMedicaid or no insuranceHomeless or housing unstableAlcohol misuse diagnosisSeeking controlled substances or pain management Chronic disease or other complex medical conditions
6. One Solution: Community Care Teams A Community Care Team (CCT) is a team of local medical, behavioral health, and social service providers utilizing a wraparound approach to provide patient-centered care, requiring multi-agency partnership and care planning, and the use of traditional and non-traditional supports and services.
7. CCT Structure and Function Broad coalition of service providersMeet regularly to review patient outcomesIdentify frequent visitors to EDsObtain a Release of Information form (ROI)Develop an Intensive Case Management (ICM) plan for each patientConnect the patient to services
8. Who are CCT Stakeholders?AmericaresOpen Door ShelterBeacon Health OptionsMid Fairfield Child GuidanceNorwalk Comm. Health CenterNorwalk HospitalConnecticut Counseling Family and Children’s AgencyGillespie CenterDay Street ClinicNorwalk Police DepartmentConnecticut RenaissanceHomes with HopeLiberation ProgramsConnecticut Counseling Norwalk ProbationDuBois CenterNorwalk Public Defenders OfficePerson to Person
9. Potential Benefits Improve patient healthReduce overcrowding in EDsRelieve pressure on community providersSave millions by reducing ED visitsDemonstrate regional cooperation
10. CCT Challenges Recruit and maintain essential community providers, including EMS providersObtain support from senior management of all community providers, as well as local and state agenciesDedicate sufficient personnel and resources to manage CCTsObtain and manage patient information in accordance with privacy laws
11. Carl Schiessl, CHASchiessl@chime.org203-294-7341