InvisALERT Solutions – ObservSMART

Care Management Responses to COVID-19: Lessons from CBC Health Home’s ADAPT Series

Coordinated Behavioral Care (CBC) Health Home (HH), in recognition of the diligent work continuously done by CBC’s citywide Care Management Agencies (CMAs) and in response to the COVID-19 pandemic launched the ADAPT Series, allowing CMAs to document their best practices in Applying Dynamic Approaches and Practices Telephonically.

Melissa Martinez, MS

Melissa Martinez, MS

Amanda Semidey, LCSW

Amanda Semidey, LCSW

COVID-19 has posed serious challenges to the healthcare sector, with CMAs grappling with issues related to workforce and client safety, transitioning to telephonic care and remote supervision of Care Managers, all the while making both medical and behavioral health supports available to vulnerable members while under a NYS stay-at-home order. CMAs needed to nimbly adapt their models of community-based Care Management and Care Coordination services for CBC’s nearly 18,000 Adult Health Home members and over 3,000 Health Home Servicing Children to be more dynamic, flexible, person-centered and primarily telephonic.

CBC’s CMAs also had to quickly transition primary and meaningful engagement interventions away from face-to-face contact to telephonic, electronic, and video services, as well as contend with connecting to HH members with no phone service. It became clear early on in the pandemic that HH members were reporting limited cell phone data and minutes with the need to make tough choices about wanting to preserve those minutes for their natural supports versus using them for their care coordination and other social service needs/supports. CMAs were uncovering and addressing growing food insecurity, gaps in care, and the need for connections to recovery and rehabilitation services; all those added to the pressing need for COVID-19 psychoeducation and support.

In light of all the transition and challenges being posed and met by the CMAs, CBC HH launched the ADAPT Series in March 2020 to create an opportunity to share and highlight interventions and innovations applied and utilized during these unprecedented and challenging times by the CMAs and spread lessons learned. The CBC CMA Network embraced the value(s) of the ADAPT Series, as it created a forum for CMAs to contribute to the Network’s collective learning during this public health crisis, identify and highlighting best practices with our network’s Care Management leadership and staff on the frontlines. The ADAPT Series showcases the nimbleness of our CMAs to identify and swiftly address technological barriers and the rapid shift to managing a remote workforce, inclusive of creating new workflows, new norms for Care Management team communication, all while ensuring that member safety and immediate needs for medication, food and shelter were addressed.

CBC Network CMAs, such as Federations of Organizations, understood that it was imperative to arrange weekly group supervision and Care Management staff text messaging for additional support. NADAP, has been addressing Care Management morale by acknowledging staff birthdays and anniversaries via Zoom and recently implemented virtual meditation to support the well-being of their workforce.

CMAs have also been seeking opportunities to re-engage potential Health Home members. For example, Samaritan Daytop Village (SDV), initiated an outreach campaign to individuals they were unable to engage in February 2020 who were now accessible and receptive to services, obtaining verbal consent to enroll and beginning the assessment and care planning process.

Servicing high risk members in the community often calls for persistent and highly coordinated efforts to maintain safety and wellness. WellLife Network CMA demonstrated how they worked with transitioning an Adult Home Plus Member from an Adult Home Residence to an independent community setting thanks to the tenacious efforts of the Care Manager to ensure that the member receive all necessary supports to remain safe and stable in the community

Oftentimes, we forget to take stock of the incredible work that our frontline care managers do on a daily basis to fortify social supports, convene service providers, elicit the strengths of those they serve, and mitigate the barriers that all too often exist for marginalized and vulnerable communities. The ADAPT Series has allowed CBC HH to draw a spotlight on these successes and not only share them across our Network but disseminate lessons learned and emerging best practices. At a time when we are all coping with personal as well as professional anxiety and uncertainty, CBC HH has developed a process whereby we could showcase our CMA Network’s responses and expertise in adapting, connecting and intervening during this unprecedented crisis.

For more information about CBC HH and HHSC program, please visit our website at

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