CCBC NEWS


October 2009
The Elder Mobile Outreach Team a Model for Success

In a recent evaluation of Community Counseling of Bristol County's Elder Mobile Outreach Team (EMOT), results reveal a program that continues to achieve its stated goal of keeping elders with mental health problems in their own homes through early detection and home-based interventions. EMOT is one of several pilot projects in Massachusetts funded by the Executive Office of Elder Affairs (EOEA) that aim to improve community-dwelling elders' mental health by addressing the barriers to mental health treatment access and affordability.

The EMOT program began operations in April 2007, offering comprehensive services on an outreach basis for persons 60 years and over, who are referred by their local Councils on Aging or Bristol Elder Services, the designated elder services agency for the region. Staffed by experienced clinicians, the EMOT Team has worked hard to address the needs of over 200 Bristol elders in the past two years. In order to make decisions on continuing, replicating or expanding the program, EOEA asked the University of Massachusetts Medical School (UMMS) Office of Long-Term Support Studies to conduct an evaluation of the program to address the strengths, weaknesses and areas of improvement needed.

The model

The EMOT uses an in-home, flexible intervention model that is tailored to meet the needs of each individual client. The goal of the intervention is to effect positive change in the client's mental health so that the client can function more effectively in his or her own home setting as long as possible. The intervention model includes elements of psychotherapy, case management, client education and community referrals. The centerpiece of the EMOT clinical structure is the home visit to clients. The schedule for home visits is flexible and depends on the priority of the need and the client's willingness to engage treatment.

According to the UMass report, there are several key aspects to the success of the EMOT clinical structure that differentiate it from other available mental health services for elders in Bristol County. The most important aspect is providing flexible services in the home; without this, these elders would not seek out or receive mental health services. The intervention itself is multifaceted, and can include psychotherapy, case management and linkage with community resources. This community service includes other services offered by CCBC and its affiliates, including outpatient services, partial hospital and inpatient services at Morton Hospital.

Areas for improvement and recommendations As the two-year period of the EMOT pilot concludes, the UMMS evaluation indicates that the EMOT has succeeded in its goals. In fact, client assessments using the Duke Health Profile, both at start-up and at 3-month intervals showed significant improvement in mental health, social health and general health scores of those enrolled in the program. On other measures analyzed (including anxiety and depression scores), results indicated a tendency towards improved scores over time. If the EMOT gets re-funded going forward, respondents interviewed by UMMS recommends referrals expanded beyond Bristol Elder Services or local Councils on Aging, to include other community sources (e.g. primary care physicians). Another area of improvement cited by respondents was the need for EMOT to provide regular updates on all clients referred to EMOT. Overall, client tracking and record keeping needs to be streamlined and more efficient. Results of the evaluation also indicate that more hours for clinical staff and a psychiatrist are needed.

Summary

The EMOT program has filled a need for community-based elder mental health services in Bristol County. There is no other program in Bristol County that does what EMOT does: provide individualized, flexible clinical mental health services as wall as comprehensive linkages to community resources – all from within the client's home. With these components in place, the EMOT model would be a valuable resource for elders with mental health conditions in other areas of the Commonwealth.


July 2009
CCBC Awarded CSA Designation

As part of MassHealth's Children's Behavioral Health Initiative (CBHI), Community Counseling of Bristol County, Inc. (CCBC) was recently selected as the Community Service Agency (CSA) for greater Attleboro/Taunton. As a CSA designee, CCBC has an unprecedented opportunity to be a change agent at a critical time of transformation of the system of care for children with emotional problems.

The CBHI is an interagency initiative of the Commonwealth's Executive Office of Health and Human Services designed to strengthen, expand, and integrate Massachusetts state services into a comprehensive, community-based system of care to ensure that families and their children with significant behavioral, emotional, and mental health needs obtain the services necessary for success in home, school, and community.

In order to ensure that Massachusetts has the infrastructure to successfully support and implement the CBHI, the Massachusetts Behavioral Health Partnership (MBHP), in collaboration with the four MassHealth-contracted managed care organizations (MCOs) - Boston Medical Center HealthNet Plan, Fallon Community Health Plan, Neighborhood Health Plan, and Network Health - has procured a network of Community Services Agencies (CSAs).

As CSA for the greater Attleboro/Taunton area, CCBC will provide Intensive Care Coordination (ICC) services that utilize the Wraparound process to help youth with serious emotional disturbance. Wraparound puts the family at the center of the planning process and builds a team around the family's vision for their child's future. In addition, the Family Support and Training (FST) component of these services will offer education and supports to the parent/caregiver of these special needs children themselves.

To learn more about this important CBHI initiative, please log on to MBHP at www.masspartnership.com.

CCBC's "Bridges to Recovery" program provides CBFS services to adults

In an effort to align the public mental health service delivery system with the needs and preferences of clients and families, the Department of Mental Health (DMH) has undergone transformative changes, which are now being provided through DMH's "Community Based Flexible Supports" (CBFS). CBFS services provide rehabilitation interventions and supports in partnership with clients and their families to promote and facilitate recovery.

In June of 2009 Community Counseling of Bristol County was awarded the contract for Attleboro, Taunton and surrounding communities to provide CBFS services through our "Bridges to Recovery" program. This program serves as a stable, reliable structure, "a bridge" to support individuals with a serious mental illness as they safely move beyond the disabling power of their illness. Services include, but are not limited to, interventions and supports that manage psychiatric symptoms in the community, restore or maintain independent living in the community, restore or maintain daily living skills, promote wellness and the management of medical conditions, and assist clients to restore or maintain and utilize the skills necessary to undertake employment.