(Formerly known as STAR-SI)
Key DFMCH Personnel
Mary F. Henningfield, PhD – Principal Investigator
Deanne Boss, MS – STAR-QI Program Director
Wisconsin Department of Health Services
Teresa Steinmetz, Director, Bureau of Prevention Treatment and Recovery
Wisconsin Department of Health Services (DHS)
The Wisconsin STAR-QI Program began in October 2006 as a three-year grant from the U.S. Substance Abuse and Mental Health Services Administration (SAMHSA). The purpose of the grant was to use the Network for the Improvement of Addiction Treatment (NIATx) Quality Improvement Model to improve organizational processes at the state and treatment agency level to impact client access to and retention in outpatient substance abuse treatment services.
The STAR-QI quality improvement projects aim to:
- Reduce the wait time between a client’s first request for service and the first treatment session
- Reduce client no-shows
- Increase addiction treatment centers’ admissions
- Increase the treatment continuation rate between the first and fourth treatment sessions
Collecting and reporting data is central to the NIATx model. Provider agencies collect baseline data before beginning a change. During the rapid-cycle quality improvement cycle, the agency continues to collect data, which they study to determine how the change impacted services. Change Teams at the provider agencies use their data to decide whether to adopt, adapt, or abandon their change project and to decide which quality improvement projects to pursue next.
Spread and sustainability are important concepts in the NIATx model. Initially ten Provider Organizations were participants in the first grant year; currently 33 agencies are participating and outreach efforts are continuing.
Spotlight on STAR-QI Agencies Meeting Child and Youth Clients Where They Are—In the Schools
Brian Boomgarden, MS, LCSW, SAC, is the Clinic Manager for Holy Family Memorial Behavioral Health (HFMBH) in Manitowoc, Wisconsin. John Sowders, PhD, LMFT, is the Behavioral Health Operations Manager for Mayo Clinic Health System-Franciscan Healthcare (MCHS-FH) in La Crosse, Wisconsin. John and Brian are also the Change Project Leaders at their organizations for the Wisconsin Strengthening Treatment Access and Retention-Quality Improvement (STAR-QI) Program. STAR-QI is a 13 year-strong Behavioral Health (BH) focused program with the mission of increasing access to and retention in BH treatment. The program accomplishes this by helping agencies implement the NIATx Process Improvement Model, in service areas that are important to the agencies and community members they serve. From October 2018 through September 2019, both Brian and John chose to collaborate with their school districts to remove an important BH treatment barrier—transportation—particularly prevalent for children and youth needing to access BH services. Through partnerships with their community school districts, these process improvement leaders have a story to tell that may help the 106 Wisconsin school districts that received notification in June 2019 of their Wisconsin Department of Instruction School-Based Mental Health Service Grants totaling $6.5 million. These grants, ranging from $13,122 to $75,000 began July 1, 2019 and will end June 30, 2020. John and Brian, along with their change team members and school districts, have already been blazing the trail for other BH delivery systems interested in meeting children and youth where they are—in the schools, and following are their stories.
Brian and the HFMBH change project team are partnering with the Manitowoc County Public School to provide 15 BH visits each week during the school year, to youth in two middle schools. Their baseline in September 2018 was four BH visits per week. Some of the rapid cycle improvements they have made to increase their weekly visits from four to 14, a 250% increase, include the following. First, they conducted a Walk-through (a NIATx Tool) of the current referral and intake process to identify areas for improvement. Based on that walk-through they implemented simple, yet effective patient-focused changes such as developing a Parent Feedback Survey, and contacting the principals, teachers, and school guidance counselors, for their feedback about the process, which was helpful in making subsequent improvements. Some of these changes included a letter/flyer to pediatricians advising them of the school-based MH services, and the school superintendent writing a letter to the public as a news release about the new services.
John has led the MCHS-FH change team in working with a year-around elementary school in La Crosse to implement outpatient school-based services utilizing two on-site clinical therapists. Some of the changes made include utilizing two licensed therapists to provide services at the schools and meeting with the identified elementary school to discuss needs and what type of outpatient services to provide. Then involving the MCHS-FH Operations Analyst to discuss insurance and contract related issues, followed by discussions with the legal and compliance team to write a Memorandum of Understanding (MOU). The MOU has been submitted to the Lacrosse school district for review.
Deanne Boss, MS, Program Manager for the STAR-QI Program, interviewed John and Brian about their experiences implementing school-based mental health services. Both change project leaders have found the monthly accountability and coaching, respectively, of the STAR-QI program helpful in advancing them toward implementing these BH services. In addition, agencies and school districts interested in implementing BH services, may find the following information helpful.
“When I think about new BH programming for our health system and the community we serve, I think of the barriers patients experience when attempting to access BH services–often times that is transportation. In addition, most schools are in need of BH services within their schools. By us providing school-based BH services, we contribute to the removal of the transportation barrier for children and youth accessing services, and we support our school community by offering evidence based treatment in their facilities.” John said.
Brian said, “In the 11 years I have been working with schools to implement school based mental health services, some of the barriers that have been present in the past—including state certification and reimbursement processes—have recently been modified or removed. This is an opportune time to provide this type of programming.”
If you are a school district or BH care provider interested in implementing school-based mental health services in your community, with the support of the STAR-QI Program, please contact Deanne Boss.
Archive: Spotlight On…
Our current participants include:
- 4th Dimension Recovery Center
- AMRI Counseling
- Arbor Place, Inc
- ARC Community Services-Madison
- Behavioral Health Services of Racine County
- Brown County Human Services Department
- Connections Counseling
- Family Health Center of Marshfield
- Family Services of Northeast Wisconsin Inc.
- Foundations Health & Wholeness
- Four Winds Counseling
- IRIS Healthcare
- Jackie Nitschke Center
- Jefferson County Human Services
- Jefferson County Human Services: CCS Program
- Kinnic Falls ADA Services
- La Causa Inc
- Lad Lake
- Libertas Treatment Center
- Mayo Clinic Health System La Crosse
- Meta House
- Mindstar Counseling
- NorthLakes Community Center
- Oakwood Clinical Associates
- Rock Valley Community Programs
- Shorehaven Behavioral Health, Inc.
- United Community Center
- UW Health Behavioral Health Services
- Waukesha County Health and Human Services
- West Central Wisconsin Behavioral Health Clinic
- WisHope Recovery
- Wood County Human Services Department
To promote sustainability, the staff members at participating Treatment Agencies are trained in the principles of the NIATx Improvement Process through an annual face-to-face learning session. They also participate in monthly group provider videoconference calls to support and promote continued rapid cycling quality improvement projects and network with other providers. 1:1 coaching calls are an additional option in an effort to support the quality improvement practices providers are implementing.
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