Organizational history, background, and structure
The Brien Center’s Community Service Agency (CSA) Program has joined an array of existing services at the Brien Center for Mental Health and Substance Abuse Services (“The Brien Center”), a community-based, non-profit agency with over a 95-year history of providing a continuum of care for children, adolescents, adults and families with serious and persistent Behavioral Health (BH)
disorders. The Brien Center’s treatment approach incorporates recovery, resiliency, and rehabilitation principles; promotes individual and family choice; is evidence based; and uses family, team, and natural supports that promote stabilization, recovery, and wellness through a person’s life journey. Each year, the Brien Center serves approximately 10,000 Berkshire County residents, including 4,000 children.
The Brien Center’s Child and Adolescent Division provides a full range of community based services
to youth and families including: the Community Service Agency (CSA); Children’s Behavioral Health Initiative (CBHI) programming; Intensive Community Based Acute Treatment (ICBAT) and Community Based Acute Treatment (CBAT) residential care; Outpatient Behavioral Health services and Substance Abuse Prevention and Treatment Programs; Child and Adolescent Psychiatry; Therapeutic Day Services; and The Continuum Service.
The Brien Center CSA Program provides intensive care management services, helping members with high behavioral health needs to discover inherent personal strengths, for the member and their family to be well connected to behavioral health and medical providers, area school systems and other community based organizations to promote wellness and to help maintain members in the community. The CSA is overseen administratively by the Child and Adolescent Division Director and is managed by a Program Director and Program Supervisors. Family Partners are provided to Brien via a sub-contract with a partner agency, Berkshire Children and Families. Our CSA Program works closely with Brien Center programs at 27 locations throughout Berkshire County as well as area primary care physicians, Accountable Care Organizations (ACOs)/Managed Care Organizations (MCOs) , community based organizations (CBOs) and other critical community, regional and state partners to provide comprehensive health services.
The Brien Center CSA program has been successful in recruiting and maintaining staff at a pace that results in minimal wait times for new referrals. A challenge for the CSA and the Brien Center is the struggle involved when competing for staff with area medical hospitals, state agencies, and schools who can offer highly competitive salaries. Additionally, because Berkshire County is located in a rural area there is a limited pool of qualified candidates and it can be difficult to attract candidates outside the county to relocate away from metropolitan areas.
Performance on Development Plan
The Brien Center has demonstrated strong performance to date on our Development Plan. In the
last several months, the Brien Center’s CSA reported multiple successful outcomes to the Executive Office of Health and Human Services (EOHHS).One development plan goal has been focused on improving CSA documentation with emphasis on the accuracy of diagnoses and their origins, appropriate documentation of medications, meeting documentation timelines, and demonstration of the “golden thread”. The CSA has successfully completed several tasks associated with this goal
including providing more training on documentation and the “golden thread”, better monitoring and tracking of diagnostic information and medications, and increased psychiatric training and consultation. Work continues on ensuring timely completion of documentation, such as assessments, and we continue to monitor this through monthly internal audits. Another goal on our development plan has focused on enhancing staff understanding and practice of wraparound based transition planning. Completed tasks for this goal include increased training on the transition planning process, developing a plan for incorporating discharge criteria in the youths’ records, and introducing a Transition Readiness Scale for staff to complete with families. Tasks we continue to focus on include ensuring the transition scales are being utilized and included in the youths’ records, incorporating and tracking family led team meetings as a measure of transitions readiness, and implementing the plan for incorporating discharge criteria into the records. The final goal on our development plan is focused on capturing youth voice in the care planning process-established in the fall of 2017. To date the Brien Center CSA has provided training on engagement of youth in the process, have introduced a new form that allows the team to obtain information directly from the youth to share with the teams if the youth is not able to attend his/her meeting, and have been having ongoing conversations about the importance of youth age 11 and older attending their meetings. The CSA has been measuring youth attendance since July 2017, seeing a 21% increase in attendance since that time.
Goals over the course of the DSRIP program
The Brien Center’s Infrastructure and Capacity Building Funding supports enhanced care coordination, care planning, and care management services for ICC-Engaged Members. The Brien Center CSA conducts ICC Team meetings, when appropriate, in pediatrician’s offices, to engage and support youth, families, and providers. CSA funding supports expert training in the Wraparound Model and Systems of Care philosophy to enhance fidelity to the model and increases coordination, planning, and care management for ICC-Engaged Members.
The Brien Center measures structures, processes, and outcomes of care on an ongoing basis. For the CSA, we develop specific metrics to evaluate: fidelity to the Wraparound Model; improvements in ICC-Engaged Member satisfaction; and, to create other Population Health measures that allow staff to assess and improve performance. In addition, we will continue to meet Development Plan Goals and align our goals with efforts described in the Full Participation Plan. The Brien Center’s practice- based ICC model maximizes coordination with pediatricians through on-site care management
meetings in the pediatrician’s office, regular communication with secure email via eHana, and telephone communication. Such meetings and contacts include other providers, State agencies, family, and Community Based Organizations (CBOs).
DSRIP investments assist in meeting the goals in the Development Plan by:
- Upgrading software. Our new EHR (“eHana”), which specializes in care management software, allows the care team to efficiently capture data related to a member’s comprehensive assessment, care plan and treatment interventions. The new EHR offers a secure HIPAA compliant means to communicate information on the progress of youth and families served. This new system enhances our CSA’s ability to involve primary care in community meetings and the overall care planning process. eHana provides Mass Highway integration and assist ICC staff in completing CANS.
- Funding for enhanced training in Wraparound, specifically sending supervisors to the National Wraparound Implementation Academy, improves fidelity to the model. Supervisors are becoming enrolled in the UMASS Integrated Care Management Training. Goals listed above in the Development Plan are Wraparound specific measures.