Implementation Guide No. 2
Deciding whether and how to adopt, expand, or improve a CME structure to serve youth with complex behavioral needs is, like any change to the health care delivery system, a major undertaking for a State. We analyzed interview data from the CHIPRA quality demonstration States and identified the following four factors that contributed to their readiness to undertake CME design:
- A high-level CME champion.
- Support for interagency cooperation.
- A group of engaged and supportive stakeholders.
- Data for decision support.
Use Table 1 to assess State readiness to undertake CME design and identify next steps that can help address any weaknesses. After assessing readiness, States can use the subsequent sections of this guide to (1) help further prepare for CME design activities, (2) start the CME design process, or (3) improve existing CMEs.
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Additional Resources The Wraparound Implementation Guide: A Handbook for Administrators and Managers (includes self-assessment tool for planners of efforts to implement wraparound) |
Table 1: Assessing State Readiness for CME Design and Implementation
| Key Questions | What do States need? | Why is it important? | How can States prepare? |
|---|---|---|---|
| Does the State have a high-level CME champion(s)? | One or more leaders in the State, such as the governor or director of a child-serving agency (for example, a Medicaid Medical Director), who strongly supports the CME concept and champions its implementation. | One child-serving agency often initiates the CME design process. High-level buy-in for the CME model at that agency can facilitate:
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Consider having State leaders meet with national CME experts to develop their understanding and support of CMEs before initiating the CME design process (see “Consult CME Experts” in Part 3). |
| Does the State support interagency cooperation? | Interest in and support for interagency collaboration. For example, a State could have:
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Support for interagency cooperation:
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Consider establishing an interagency workgroup or assign new duties to a workgroup formed for some other purpose (see “Work with Stakeholders” in Part 3). Consider applying for grants to support interagency work (for example, SAMHSA System of Care grants). |
| Can the State assemble a group of engaged and supportive stakeholders? | Child-serving agencies, youth, families, and the provider community in the State meaningfully engage in and support CME design. | Engaged stakeholders can facilitate:
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Establish a stakeholder engagement process (see “Work with Stakeholders” in Part 3). |
| Does the State have data for decision support? | Capacity to obtain and analyze demographic, cost, and service utilization data from multiple child-serving agencies. | Analyzing data from multiple child-serving agencies facilitates:
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Develop internal data capacity or consider hiring consultants (see “Use Data to Drive Decisions” in Part 3). |
