Financing Team Based Coordinated Services: Examples from First Episode Psychosis Programming-Presentation Slides

Presentation Slides

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The Clinical Support System for Serious Mental Illness (CSS-SMI) is a funded initiative implemented by the American Psychiatric Association (APA) aimed at providing comprehensive and coordinated care for individuals with serious mental illness (SMI). The initiative focuses on the treatment of first episode psychosis and emphasizes the importance of early intervention, evidence-based treatment, and coordinated specialty care (CSC) in improving outcomes for individuals with psychotic disorders.<br /><br />CSS-SMI acknowledges the cost challenges associated with implementing evidence-based treatment for SMI and highlights the domains of cost-effectiveness in early treatment, including direct treatment costs, costs to families and caregivers, and costs to society. Medicaid fee-for-service reimbursement only covers 40% of program costs, leaving many components of CSC unfunded, such as community outreach, supported education and employment, and team-based care. The initiative explores various financing strategies, including amending the state plan, using Medicaid managed care, utilizing SMI/SED Medicaid waivers, and adopting Comprehensive Community Behavioral Health Centers (CCBHC) financing.<br /><br />Several studies have shown that CSC improves outcomes in terms of educational and employment outcomes, reduced hospitalization, improved quality of life, decreased suicide risk, improved family relationships, and decreased substance abuse. It is also cost-effective in terms of reducing acute healthcare costs, decreasing lifetime healthcare costs, and increasing lifetime productivity. Fidelity certification is an important consideration in securing public and private financing for CSC programs.<br /><br />The initiative also provides examples of states that have successfully implemented financing strategies, such as Illinois, Connecticut, and Maine. The post outlines the steps taken by these states, including passing legislation, negotiating contracts with commercial insurers, and utilizing Medicaid funding.<br /><br />Overall, CSS-SMI aims to address the funding challenges associated with implementing effective and comprehensive care for individuals with SMI. It emphasizes the importance of financing strategies that cover the full range of CSC components, ensure cost-effectiveness, and promote improved outcomes and quality of life for individuals with psychosis.

Keywords

Clinical Support System for Serious Mental Illness

American Psychiatric Association

comprehensive care

serious mental illness

first episode psychosis

early intervention

evidence-based treatment

coordinated specialty care

cost-effectiveness

financing strategies