Daniel Essek, APSS from Barbourville, KY

Vicki Rahenkamp Choptank Community Health Denton M

Amy Paul, Crisis Preparation and Recovery, Arizona

Stephanie Siordia, CCAP l , VOALA, Los Angeles, CA

Brandy Harrell, Kinston Community Behavioral Health, NC

Kelli Sax-Pahl, Crisis Preparation and Recovery

Heather Helberg, HOPE Community Services, OKC, OK

Rosemarie Spencer, LMSW, MS The Mental Health Association of Westchester, NY

Hi everyone, thanks for joining! Just a reminder, here is the link to the Team-based Care John was referring to, which is what the curriculum for this ECHO was based from: https://www.thenationalcouncil.org/wp-content/uploads/2020/11/102820_MDI_High_Functioning_Team_Based_Care_Toolkit.pdf?daf=375ateTbd56 Looking forward to our discussion today.

Spencer Crihfield, CPNP-PC.Tri-Cities Community Health Care

Hi all! It would be great if you could please update (if you have not already) your name in Zoom to include your full name and organization so we can accurately count you as attending today's session. To change your name, please click the three dotted icon on your camera screen and scroll down to "Rename." Thanks and please let me know if you have questions!

Good Day.

Lisa Williams, Seraaj Family Homes, Mobile Alabama

We have Consumer Support Associates as well

Myself, a shared RN between 4 providers, and 1.5 MAs, 2 across the house care coordinators

sorry I didn't see other, we also have PCP's

We're also looking at adding a data/Admin person to each team

We also have a Client Advocate and Grant Coordinator

Roles are assigned as per skill and consumer needs

Family Support Worker-FSW

We would like to add Care Manager and Project Manager.

Family Partner peer

Myself, shared RN,1.5MA with care coordinators on staff but not on site.

I have each of my clients with their own team that I interact with frequently

We also have a financial advocate and diabetic educator that work on the teams

What is the role of the Consumer Support Associate?

Skill Building

Thank you.

Yes! we have 2 pharmacists

Excellent!

125

currently our teams serve 15-30

We are still in the implementation stage, so I'm not really sure

125

Two teams: 50 on one team and 110 on the second team.

I have currently 12 clients on my caseload. I have had as many as 32, and as few as 2. 10-15 seems to be a good size

100-150

our big teams are 150ish

2400 individual clients

our staff carry about 22 cases each with productivity goal of 82 hours/month

75-100

A full team would be 400. Up to 50 per clinician caseload

100 for our ICM team

I have 46 Homes with 50 children-Medically Complex

18-25

End goal - 1000 Current 250

That 2400 is over 21 clinicians

3 PACT Teams - 100 each

Trying to get down to 60 for each staff at 100 now

Direct Time goals are about 80 hours a month Full Time

We carry about 800 but touch up to 2000

the core team would be 800

It's hard to get all the team players together to be truly effective

We have 4 Social Worker, 3 Clinical Supervisor-Therapist, 7 Case Managers, and 4 Family Support Worker and myself as Clinical Regional Manager

is the employment serviceberries car

For each home there is a Clinical Team which Consist of

It appears that the larger/more specialized the team appears to have a smaller client caseload. I'm not sure if that's accurate perception or not.

The caseloads for our clinicians has been a recommendation for CARF for many years-they would like to see caseloads nearer 50

having a pharmacist would be nice as they call our nurses often with more regs in place. prior authorization and safety

Clinical Regional Manager, Clinical Supervisor-Therapist, Case Manager and FSW

Another question may be what is the ratio of staff/team members to caseload. So for a team of 9.5 staff (inc. .5 rx'er, 3 CSM, 1CC, 1 nurse, 2peers, 2 BH prof.)staff how many clts are assigned to them?

try aga9 emp. services percent loew because you use Vic.Rehab?

How well a team works is a direct relationship on how well the Leadership of the Group identifies drift and other issues

Clinical Supervision also varies by dependent vs. ind licensure

Supervision frequency is individual based - how long the staff has been with the organization, what is happening, etc

Good point Tracey! Also can be higher for new staff or staff who have performance reviews going on

How do you address a “huddle” for case consultation vs supervision? A company with with which I have worked didn’t support traditional therapy supervision.

The way my teams are organized I am meeting continually regarding problems, but monthly with each team on a monthly basis

Daniel when you say "continually" do you mean 1 on 1 or that you are present in the workflows supporting staff?

How do we keep huddles/staffing from becoming verification that "forms" are completed verses patient care.

The hardest thing is to introduce the team to working as a team. Its hard to get used to and requires patience

Hi Judy, we've seen teams keep "forms completed" as a metric that is tracked. So it is tracked more than discussed. If the number low/red showing a client or group of clients has a bunch of late notes or unsigned consents then the person/people responsible can get on it. The Huddle agenda has to aggressively managed to make it efficient so if a staff starts to dive into oh this client's record is a mess then that is a f/u task not a discussion in the huddle.

if there are large number of teams such as with an outpatient clinic with caseloads of 150+. how are people getting the teams together for meetings. Using FTF, Zoom (type), email threads other?

Please! If teams can send in your "role definitions" for different staff that would be helpful!

Our care coordinators play a key role to linking our clients to care via centralized scheduling, participating in huddles, etc

Our system as labeled RN's as care coordinators

so the functions you are describing I have to call care managers

or care coaches

Thank you for the course

Thank you guys so much.

Thank you!!

Thank you

THANK YOU

Thank you!

Thank you.

thank you!!!!!