Mackenzie Hawkins

New Haven children’s health center Clifford Beers is one of seven recipients of a competitive federal grant of up to $16 million. The grant, administered by the Centers for Medicare and Medicaid Services, also known as CMS, will support Clifford Beers’ implementation of an Integrated Care for Kids, or InCK, model — a new CMS framework specifically targeting children’s health.

Clifford Beers has been in New Haven for over a century and works in schools, homes and clinics to provide holistic care to children and families. According to a press release, the health center served over 6,300 children and caregivers last year. To ensure that it addresses the full scope of clients’ needs, Clifford Beers uses a care coordination model that synthesizes resources for families by including school administrators, social services and emergency crisis care. The center plans to use the InCK grant to improve quality of care and reduce costs for children’s medical treatment, with special attention to substance abuse and the opioid crisis.

“What we want for New Haven is for there to be no wrong door,” Clifford Beers CEO Alice M. Forrester said at a Friday press conference. “So when [a] mom comes, we can begin to address all of [her family’s challenges so that] she doesn’t have to run around on a bus trying to find a million different resources and navigate the system herself.”

Collaboration, she continued, is key to Clifford Beers’ operations and to the grant application process. A slew of state actors across several departments contributed their knowledge and expertise, consistent with the spirit of collaboration that Lt. Gov. Susan Bysiewicz called the “hallmark” of the Lamont administration. These departments — which include Children and Families, Mental Health and Addiction Services, Early Childhood and Education and Public Health — will continue to work with Clifford Beers over the next seven years to implement the InCK framework in New Haven.

InCK is a two-pronged model. First, CMS hopes that the InCK grants will streamline local delivery via case management. Given that services often operate separately — in different government departments and across public and private sectors — it can be difficult for families to identify available resources and work with providers to develop holistic care plans.

To address this, InCK requires that grant recipients develop interventions that bring together a variety of care providers to meet its goals: “improving child health outcomes” and “reducing avoidable inpatient stays and out-of-home placements.” Clifford Beers currently has 52 partners that have signed on or plan to sign on to the program.

Second, recipients have the first two years of the seven-year implementation period to develop a sustainable Alternative Payment Method, or APM, within Medicaid and the Children’s Health Insurance Program. APMs aim to distribute costs and accountability across state and local providers, according to the CMS website.

Forrester said that Clifford Beers’ proposed APM would bundle services to create a per-person per-month rate rather than relying on third-party providers for some payments but not others. She noted that this payment scheme is only a proposal and is subject to change.

As an InCK recipient, Clifford Beers has been designated the “lead organization” for Connecticut’s Department of Social Services — or DSS — which administers Medicaid and related programs. This means that Clifford Beers is responsible for delivering outcomes in its geographic area that will provide data for an in-state comparison. Ultimately, stakeholders hope that lessons learned from the seven grant recipients can inform healthcare provision in other settings.

DSS Commissioner Dr. Deidre S. Gifford said in a press release that the department is interested in improvements across many areas that connect to health provision, such as improved educational outcomes, fewer referrals to juvenile justice and reduction in substance use.

Clifford Beers is the only grant recipient focused specifically on behavioral and mental health — other recipients are large medical centers with public or university affiliation.