OptumHealth to Launch NYC based Peer Bridger Initiatives

A First Step for Behavioral Health, a Giant Leap Forward for Providers and Consumers

by Brian Lombrowski, M.P.P. New York City Field Office BHO Program Specialist and Matthew D. Erlich, MD , Post Doctoral Clinical Fellow and Assistant in Clinical Psychiatry, New York State Psychiatric Institute

Beginning in January 2012, New York State's Office of Mental Health (OMH) and the Office of Alcohol and Substance Abuse services (OASAS) contracted with five regional Behavioral Health Organizations (BHO's) to implement Phase 1 of New York State's Medicaid redesign. In New York City, OptumHealth was selected as its Phase I BHO. Statewide, Phase 2 will begin in 2014 when the state's Medicaid consumers will receive behavioral health services through fully capitated managed care organizations.

For the past 9 months, Optum has been working with inpatient providers to gather information on admission and discharge practices to gain a richer understanding of the operational challenges that confront the current delivery system. Better understanding of systemic issues coupled with BHO resources will help to identify ways to improve transitions from inpatient to community based care.

Moreover, Optum will facilitate BHO Evaluation and System Transformation (BEST) meetings that will convene stakeholders from the provider community, advocates and consumers to focus on lessons learned from our current experience and to foster readiness as we prepare for a full managed care environment. This past spring and early summer, five New York City BEST meetings were held with one meeting in each borough to present first quarter data. OMH's New York City Field Office (NYCFO) has been engaged in this process along with representatives from the OASAS regional office and DOHMH. With the richness of the NYC provider community, the BEST meetings encourage both further understanding of the uniqueness of New York City's behavioral health system and help to identify system-wide solutions and best practices for improving the delivery of services.

The next series of BEST meetings launched this October with a focus on children's inpatient units. The presentation included a panel of inpatient and outpatient providers along with family representation who discussed best practices in transitioning young consumers to outpatient treatment. Some of these practices included telephone communication between the outpatient and inpatient treating psychiatrists and the use of Child & Family Team Networking meetings to enhance discharge planning.

In November, NYC can expect to have two additional BEST meetings, both focused on adult and children's services. These BEST meetings will use data and vignettes to identify and share best practices among the different stakeholder groups and lead to workgroups that will recommend strategies for Phase 2.

In January of 2013, Optum will launch a "peer bridger" initiative in partnership with Baltic Street AEH and Families on the Move of NYC. This initiative will assist to further engage individuals with complex needs at specific hospital sites with a peer worker who can support the person through the transition from inpatient to outpatient care.

The NYCFO, along with OASAS, DOHMH and Optum, looks forward to the opportunity to learn from the provider community as we help to transition services to a managed care environment and continue to endeavor to improve outcomes for the people we serve.