For too many people with mental illness, crisis medical
care has become the norm—a trend that has a great personal and financial toll. In
2013, hospitalizations for Nassau County residents who received Medicaid mental
health services cost the agency more than $35 million. The fact that many
patients are rehospitalized within 30 days of discharge calls into question the
effectiveness of this crisis approach to mental healthcare.
To address
this issue, New York State is now working with physicians and health clinics to
provide health homes for Medicaid recipients who suffer from chronic mental and
physical illness. The health home concept is to offer an integrated system of
care in which a patient’s needs—from scheduling medical appointments to
providing transportation to those appointments to setting up social
services—are coordinated by a small interdisciplinary team or an individual
care manager.
Central
Nassau Guidance & Counseling Services, Inc., based in Hicksville, New York,
is one agency that offers health home services. Last year, with funds from a
New York State Innovation Fund grant, the agency established its Stability at
Home pilot program to help Medicaid recipients with serious mental health
conditions transition from hospitalization or haphazard community care into a
more stable health home system of care.
Chrisann
Newransky, Ph.D., an assistant professor at Adelphi’s School of Social Work,
explained that a primary goal of this new approach is to facilitate the many healthcare
responsibilities and tasks that seem routine to the rest of us. “If people stay
connected to the system—they don’t drop out of the system—then they’re less
likely in general to use emergency care, which we know is completely expensive
and not all [that] effective,” she said.
After
consulting with Adelphi’s Center for Nonprofit Leadership and its faculty
director, Peter Chernack, Ph.D., Central Nassau Guidance & Counseling
tapped Dr. Newransky, whose primary research interests are disease prevention
and health disparities, to be the external evaluator of Stability at Home.
Dr.
Newransky is advising on the best sources of data and approaches to data
collection for evaluating the program’s effectiveness for the nearly 150
participants and their families. She is also conducting independent follow-up
research with the participants and families.
“What’s unique
about the [program] design is that different organizations are coming
together,” she said, noting that the Long Island Crisis Center and Options for
Community Living, Inc. are also involved in the project. This coming summer,
Dr. Newransky plans to interview the leaders of the three organizations in
order to document this model of interagency collaboration and understand what
worked well and what improvements can be made.
This article appeared in the Spring 2015 edition of Erudition.
