Center for Quality & Health Integration Projects
Benchmarks is committed to quality in all areas of our practice and that includes selecting projects that work towards enhancing the standards of service delivery system for our members to ensure the highest level of care for the people needing services, through research, data collection and analysis, pilot projects and proven standards of care. Our Center for Quality and Health Integration (CQHI) houses our latest quality enhancing initiatives outlined below:
Benchmarks’ Partnering for Excellence (PFE)
Nationally there is a trend of more children entering state custody, thus, providing appropriate child well-being interventions, including accurate behavioral health services, demands multi-systemic attention. Nearly all children in the child welfare system have experienced traumatic events in their lives – abuse, neglect, abandonment by a parent, domestic or community violence – and many have undergone several traumas over a prolonged period, resulting in complex trauma. Some impacts of trauma are easy to see because they are externalized behaviors (hitting, swearing); other times, the impacts of trauma are harder to identify because they are internalized (self-injury, isolation, disassociation). Trauma also has an impact on the brain, increasing stress hormones in the body, resulting in smaller brain mass and delays in development. These impacts of trauma continue until they are identified, effective mental health treatment is utilized and healing can begin.
However, disconnect between governmental programs for people and families in crisis can be a major challenge in addressing underlying causes of poor health. In response, Benchmarks created Partnering for Excellence (PFE), a groundbreaking initiative that changed the way DSSs, LME-MCOs, local providers, and the wider community understand and provide accessible, appropriate health services for children and families who experience traumatic events. The Benchmarks’ Partnering for Excellence (PFE) model creates a more trauma-informed community, through the development of agency partnerships, to improve the well-being of children and families. With this program, children entering the child welfare system are screened for trauma and referred for a Trauma-Intensive Comprehensive Clinical Assessment (TiCCA), an in-depth evaluation completed by a trained, certified TF-CBT mental health clinician, when appropriate. In this way, PFE aligns multi-systemic processes around a common clinical assessment and shared responsibility for treatment and outcomes.
The Duke Center for Child and Family Policy found that PFE significantly reduced high-cost out-of-home treatment options and increased more accurate assessment and diagnosis among children who have been impacted by trauma. Through correct diagnoses and appropriate treatment, PFE is able to reduce health expenditures exhibited by less emergency department, crisis service and hospital usage for children in the PFE program.
Standardized Assessment Pilot
Goal: Every youth, four years and older, entering foster care receives a standardized, trauma and evidence-informed assessment to ensure an appropriate diagnosis leading to proper service provisions with the goal of improving child and family outcomes.
Pilot Area: Up to three Managed Care Organizations will work with their DSS partners in up to four counties within their catchment area.
Background: Through Benchmarks’ Partnering for Excellence (PFE) pilot project, data has shown that early intervention through proper screening and assessment decreases the utilization of the emergency room, crisis management, and residential placement while cutting the Medicaid costs by up to 44% per child 12 months after he/she enters DSS custody. Through the selection of critical components from PFE applied to this pilot for a standardized screening and assessment, more children will receive the appropriate services at the appropriate time while decreasing the utilization of high level services, lowering the overcall cost to the Medicaid system, and minimizing the traumatic impact to the child resulting from multiple, failed or inappropriate placements.
Partnering for Community Prosperity (PFCP)
Health begins where we live, learn, work and play.
Health is something that starts in our families, in our schools and workplaces, in our playgrounds and parks, and in the air we breathe and the water we drink. Research has shown that the conditions in which we live and work are responsible for up to 40% of an individual’s health outcomes. However, this country has approached health from a disease model that introduces services and intervention after a problem has arisen and siloes an individual’s physical/behavioral health needs, extraneous from her/his environment. It’s time we expand the way we think about health to include our community and how to create health and keep it, not just how to get it back.
Poverty is the single biggest factor contributing to adverse health and life outcomes, and outcomes worsen as poverty becomes more severe. Scarce resources and scattered programming do not address whole person in the context of his/her family and community. The many barriers to well-being (e.g., trauma, hunger, isolation, stress, inability to work and earn a living or to succeed in school, and more) put immense pressure on families, especially those with limited incomes, assets and/or social supports, especially for people of color. The result is real health, educational and long-term life outcome disparities.
Benchmarks provided leadership to steering committees in several NC communities that reach across public systems to address complex, intergenerational challenges. We researched and spoke with community leaders, foundations, and local officials about place-based work being developed across NC and nationally. This gave us knowledge about the key features of upstream, collaborative approaches to addressing social determinants of health, under education, housing, and health and wellness frameworks. As local stakeholders identified their key priorities, Benchmarks was able to make connections to and help bring in resources from other similar initiatives around the state that aligned with the strengths, needs and will of the community.
 Excerpted from A New Way to Talk about the Social Determinants of Health , Robert Wood Johnson Foundation, 2010. Available online at: http://www.rwjf.org/content/dam/farm/reports/reports/2010/rwjf63023
Benchmarks’ North Carolina Chapter for Direct Support Professionals (NCADSP)
NCADSP envisions a world where all children, adults and families in need of support services have the opportunity to live community-based lives of their choosing and are supported by Direct Support Professionals who have the knowledge, skills, and values needed to assist them in achieving their life goals.
NCADSP’s mission is to enhance the quality of support provided to all children, adults and families through the provision of products, services, and certifications which elevate the status of Direct Support Professionals, improve practice standards, promote systems reform and, most importantly, advance the knowledge, skills, and values of Direct Support Professionals.
NCADSP values the full participation of all children, adults and families in all aspects of community life through the provision of person-centered supports. We believe that high quality support requires all Direct Support Professionals follow the individual path suggested by the unique gifts, preferences and needs of each person they support, to walk in partnership with that person and those who love them, toward a life of opportunity, well-being, freedom, and contribution.
NCADSP’s Operating Principles–NCADSP is guided by a belief that: All Direct Support Professionals benefit from access to well-constructed educational experiences (e.g., in-service training, continuing and higher education) and lifelong learning; Certifying highly qualified Direct Support Professionals incentivizes continuing education, and access to career pathways while providers may adopt using certifications as a means to justify increased compensation, thereby improving retention. Values and ethical decision making can be learned and infused into daily practice; and Strengthening relationships and partnerships between Direct Support Professionals, and the children, adults and families in need of services, improves the quality of support.