As a result of the growing need for community-based crisis response, New York State is seeking to expand the services provided by crisis response teams. CCSI has developed a series of technical assistance offerings specifically designed to meet the needs of crisis providers, aimed at increasing the effectiveness of your crisis services.
The technical assistance offerings below will be tailored to your agency’s degree of experience in each area, ranging from introductory to advanced, as well as your agency's needs and goals. Using the scales within each offering will help your organization determine the scope of the assistance needed.
Click on each offering below to get more details, including learning objectives.
While there has recently been more of a focus on racism and its impact on traditionally marginalized identities, we know that inclusion, belonging, and equity can’t be viewed as only moment-in-time priorities. There must be an intentional commitment made within individuals, our communities, and in the work we do.
Some organizations have a limited understanding of how racism and harm are perpetuated by decisions, policies, and practices. This not only impedes their ability to help service recipients and employees navigate crisis, but often causes deeper trauma. Through expert consultation, our team supports you in the enhancement of existing, or the designing of new, practices and programs. By formally incorporating various aspects of DEI and antiracism as a business imperative throughout your organization, you will be engaged in various activities with our team that work to achieve improved and desired results. Our approach includes examining current practices; organizational assessment, strategic planning and implementation; specialized learning & development; poverty simulation; and coaching of your leadership, all to inform improvements and cultural transformation.
Learning Objectives
- Understand current state
- Strategically plan for sustainable DEI practices
- Gain staff engagement and buy-in
| 1 | 2 | 3 | 4 |
|---|---|---|---|
| No formal work in the area of Diversity, Equity, and Inclusion (DEI) | Some discussion and planning around DEI, but no organized work in this area | Planning and implementation has begun around DEI needs; DEI efforts in process | Agency-wide DEI efforts have been established and the effectiveness is being monitored |
Mobile crisis responders have a crucial role in our current healthcare environment due to the increased prevalence of behavioral health concerns and the need for effective outreach to individuals in crisis. As ‘conduits to stabilization’ for those experiencing crisis, these service providers perform essential clinical functions: assessing and triaging initial crisis calls, risk assessment, crisis de-escalation, facilitating Mental Hygiene transportation, linkage and referral, and follow-up to support stabilization. It will be helpful to provide responders with guidance so they can understand documentation requirements and write contact notes that are person-centered, clear, and concise. This supportive guidance will include references to the specific mobile crisis services, billing codes and modifiers, as well as the points of medical necessity that are required for reimbursement.
The goal of this technical assistance offering is to highlight the essential functions performed by mobile crisis responders and offer clear guidance that demonstrates how to document client contacts in a way that is person-centered, meets the standards of medical necessity, and concisely captures the delivery of quality mobile crisis services.
Learning Objectives
- Write documentation that records and identifies the scope of services delivered, individual participation in treatment decisions, and essential linkages to community supports
- Write documentation that establishes successful follow-up services
| 1 | 2 | 3 | 4 |
|---|---|---|---|
| No documentation of Mobile Crisis services | Inconsistent documentation of Mobile Crisis services; numerous issues with completion and billing denials | Mobile Crisis documentation is completed fairly consistently, but numerous billing and/or content issues are present | Mobile Crisis Documentation is completed consistently and there are few issues with billing and reimbursement |
In order to ensure effective delivery of crisis services, it is essential for providers to have a deep understanding of the impact of trauma and utilize trauma-responsive practices, given that most individuals accessing crisis services have a history of trauma. In this TA offering, we begin by identifying current strengths and areas for development, and then partner with you on your unique journey toward building a trauma-responsive culture. Trauma-responsive practices not only improve engagement, satisfaction, and outcomes for individuals served, but they also create cultures where staff can flourish. We help you to create a workplace that promotes the well-being of your staff so that they are best positioned to deliver high-quality, effective services and supports. These practices support staff retention and counter the exposure to both primary and secondary traumatic stress.
We customize our approach to help you grow. Your tailored solution may include assessment, training, coaching, and change management support to ensure you have the framework, knowledge, and tools to transform at the individual, organizational, or system levels.
Learning Objectives
- Understand the foundation and principles of Trauma-informed Care
- Learn about the benefits of trauma-informed care for the individual, direct care staff and the organization as a whole
| 1 | 2 | 3 | 4 |
|---|---|---|---|
| No formal training on the impact of trauma and toxic stress | Some training on trauma-informed care has been provided, but no formal agency efforts in this area | Trauma-informed training has been provided to staff, but there is no formal follow-up on the benefits of this work | Trauma-informed training has been provided and efforts are underway to measure the benefits of trauma-informed approaches |
Peers are an essential part of crisis outreach as they have a unique window on the experiences of individuals under stress and how to engage with them at times of crisis. Recruitment, supervision, and retention of all crisis staff is currently a challenge – peer crisis workers require specialized attention in these areas to maintain a dynamic workforce. Supervision of peers requires a sensitivity to their unique position within the workforce, including being sensitive to the impact of peers’ lived experiences, their positive influence in a crisis situation, and the effect of the vicarious trauma they encounter.
CCSI can work with your program and human resources to review best practices for recruitment and developing a working environment that is conducive to peers’ growth and development. Additionally, staff can offer advice on supervision and HR policies that support a culture where retention is improved.
Learning Objectives
- Understand recruitment and retention practices for a robust peer workforce
- Develop policies that support a diverse and essential peer workforce
| 1 | 2 | 3 | 4 |
|---|---|---|---|
| Little or no experience with peers and/or in the early stages of hiring peers | Some peers on staff, but are struggling with high turnover and effective integration into teams | Have peers on workforce and are working to fully integrate them in many programs | Have many peers on staff who are fully integrated in all programs |
When responding to an individual in crisis, it is important to have access to client information like risk factors, behavioral health diagnoses, health conditions, current supports, healthcare providers, and medications. For individuals on Medicaid and Medicaid Managed Care, this client-level information is available in the PSYCKES data set and can be accessed as part of the crisis assessment process. Other important tools in the crisis response toolbox include the Columbia Suicide Severity Rating Scale (CSSRS) and, when possible, access to the RHIO system.
The goal of this time limited and focused technical assistance offering would be to help your crisis response team develop a clear process to use PSYCKES in both assessment and in measuring client engagement. This would include the client consent and attestation process, as well as the HIPAA compliant documentation of other permissions received. This type of data-driven practice will improve the quality of the information received in the crisis assessment process, reduce the need for client self-report, and help clinicians make referrals that promote continuity of care.
Learning Objectives
- Utilize PSYCKES as a tool to assist in engaging and managing client health care needs
- Employ best practices around using PSYCKES in assessment, development of attainable goals, and measurement of client engagement and success in health care management
- Learn how to use data to inform decision making
- Identify practical applications for PSYCKES data in client care
| 1 | 2 | 3 | 4 |
|---|---|---|---|
| No access to PSYCKES for mobile crisis staff | Mobile crisis staff has access to PSYCKES, but PSYCKES is not frequently utilized | Mobile crisis staff have access to PSYCKES and it is utilized fairly consistently | Mobile crisis staff routinely utilize PSYCKES to reference client information |
Collecting, analyzing, and using data to support our decisions, drive efficiencies, and improve quality, is critical to supporting our mission to enhance the health and well-being of the communities we serve, particularly those in crisis. Many organizations struggle to implement a data-informed approach to management and quality improvement.
CCSI has a long history of supporting organizations in their goals to use data to improve their services. By helping to identify Key Performance Indicators (KPIs), our team can leverage your data, using the tools you already have, to join data from different sources to model your environment. The data models can then be used to create user friendly charts and graphs to monitor performance and improve quality. Data from different systems can also be combined to create dashboards and score cards that are easily updated to support ongoing monitoring and improvement of your services. Organizations have varying degrees of sophistication when it comes to incorporating data as a management and quality improvement tool. We will customize our approach for a tailored solution.
Learning Objectives
- Identify the key operations, financial, and quality indicators that will support efficient high-quality services
- Leverage the data you have from various systems to make them available in a user-friendly manner to support ongoing monitoring and improvement of your services
- Use your available analytic tools to connect to your data, isolate critical variables, and model your environment by joining data from different data sources to create charts and graphs
| 1 | 2 | 3 | 4 |
|---|---|---|---|
| Little or no experience or ability to collect and use data for mobile crisis services thus far | Data available to support mobile crisis program but not user friendly or updated regularly | Data available and used to support mobile crisis program, but needs to be utilized more consistently in practice | Mobile crisis data is available and utilized consistently to support the MC program and outcomes are monitored |
With so many programs available in our community, it is more important than ever to ensure that you know the value of your services and what sets you apart from others. Communicating your value proposition to the communities you serve will help individuals to be more aware of your offerings, as well as how to access your services for needed support in times of crisis.
CCSI can help you in defining your value proposition to better inform the ways in which you market your services. We begin with brainstorming exercises to understand your agency’s impact and goals, why individuals access your services, what you do well, how others might view your services, the available alternatives if your organization was not available, and so on. We also help you identify types of data to support or prove your responses to the exercise above. The next step is to develop a customer profile to help identify their motivations, the problems they may be trying to solve, and their unique goals and objectives.
Learning Objectives
- Define your value proposition
- Identify data to support your value proposition
- Develop a customer profile
| 1 | 2 | 3 | 4 |
|---|---|---|---|
| Little or no experience in creating a value proposition to market MC services | Some knowledge about the need to create a MC value proposition, but no plan or implementation | MC value proposition has been created but has not been shared with the community stakeholders | MC value proposition has been created and has been shared with the community stakeholders |
Crisis services act as a safety net for many at-risk populations, providing support to individuals and families when a crisis arises, and connecting them to ongoing programs in their communities. Not only can immediate, local support often prevent a larger scale crisis, but it is also financially responsible to invest in services preventing the need for more intensive treatment like hospitalization or interaction with law enforcement. As an entry point on the behavioral health care continuum, an effective crisis response may influence the success of the whole system.
New York Health Equity Reform Waiver (NYHER) is New York State’s proposed Medicaid Demonstration Amendment that aims to address health disparities and systemic health care delivery challenges that were highlighted and intensified during the COVID-19 pandemic. NYHER allows the New York State Department of Health (NYS DOH) some flexibility with using Medicaid dollars to pay providers to meet locally identified needs. It acknowledges that long-standing inequities and barriers must be eliminated to improve healthcare and offers the potential to build sustained, adequate payment for services provided by CBOs to individuals and families covered by Medicaid.
This two-hour session will provide participants with the following key takeaways:
Learning Objectives
- Examine the importance of the NYHER Waiver as it relates to crisis services
- Get ideas that support your organizations participation and planning
| 1 | 2 | 3 | 4 |
|---|---|---|---|
| Little or no knowledge of practice expectations associated with the NYHER Waiver | Some knowledge of practice expectations associated with the NYHER Waiver, but little experience in applying these to practice | Some knowledge of practice expectations associated with the NYHER Waiver and there are plans for implementation | Solid plan for implementing practice expectations associated with the NYHER Waiver |
When individuals with Intellectual and Developmental Disabilities (I/DD) and Traumatic Brain Injuries (TBI) experience a crisis, they face fear, prejudice, and lack of understanding from the teams trying to support them. Crisis team personnel may lack accurate and appropriate knowledge to apply standards of treatment in a manner that provides useful interventions to persons with IDD and TBI.
I/DD and TBI are different from other types of disabilities and often require a different approach to treatment. It can be quite challenging for crisis teams to spot these disabilities, which often have no outward or obvious signs. As a result, people with I/DD and TBI are often mistakenly perceived as suspicious when, in actuality, the behavior is related to their disability.
This two-hour session will provide an Introduction to Intellectual and Developmental disabilities with the following key takeaways:
Learning Objectives
- Get an introduction to the I/DD and TBI communities, including a discussion of historical trauma and discrimination
- Learn about commonly misunderstood behaviors that are associated with I/DD and TBI, and are also associated with perceived threats.
- Explore resources to support crisis team personnel when engaging with people with I/DD, TBI, and their families.
| 1 | 2 | 3 | 4 |
|---|---|---|---|
| Little or no knowledge of treatment approaches with I/DD and TBI individuals | Some knowledge about I/DD and TBI treatment approaches, but little experience in applying these to practice | Some knowledge about I/DD and TBI approaches is currently being applied to practice for some individuals | I/DD and TBI approaches are understood and routinely applied to practice for individuals that meet criteria |
We are interested in understanding more about your agency's needs, and we look forward to sharing how we can tailor these offerings to meet your goals around improving service effectiveness. Please note that pricing will vary based on the customization of the offerings. Connect with our team at mobilecrisisteam@ccsi.org to learn more.
**These TA offerings above are not part of the NYS OMH Mobile Crisis Response System Webinar Series.**