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Complex Behavior Collaborative

The Complex Behavior Collaborative (CBC) program helps providers meet the needs of Medicaid and Non-Medicaid clients with complex needs who are often aggressive, assaultive, and difficult to support. The CBC program offers consultation and training to providers and clients’ natural supports, including family members.

The goal is to help clients live as independently as possible, and avoid Alaska Psychiatric Institute, jail, emergency rooms or out-of-state care. Benefits include:

  • Better quality of life for Alaskans with complex needs
  • Cost savings for the state
  • Development of a robust, competent workforce in Alaska
  • Development of infrastructure for collaborative interventions and continuity of care

Population Served

  • Children, Adolescent, & Adult
  • Complex behavior management issues
  • Cognitive Impairment, such as:
    • Serious Mental illness
    • Intellectual and Developmental Disability
    • Alzheimer’s Disease or related Dementia
    • Traumatic Brain Injury, or
    • Chronic Substance Use Disorder w/one of the above

Application Process

Referrals are made through an agency. Families or Schools cannot refer directly to the CBC program, even though CBC consultants do collaborate with school teams and natural supports (family members).

Agencies who have a potentially eligible client should contact the program. The CBC will evaluate the client. If the client is eligible, the CBC will contract with a consultant, who will support the agency through consultation and training.

Eligibility

Target clients for the program may be in Pioneer Homes, Alaska Psychiatric Institute, or live in the community. Eligibility requirements include clients who:

  • currently receive services from Senior & Disabilities Services or Behavioral Health
  • have stable housing where they can be assessed and receive services
  • must have an Alaskan Service Provider willing to work with the client
  • Be medically stable
  • have behaviors that are so complex that they,
    • Utilize of multiple systems & are high-end users of community resources
    • Are outside the range of expertise of local caregivers and providers, or
    • Have exhausted all other treatment options without success
  • at risk of
    • losing placement (housing)
    • out of state placement
    • psychiatric hospitalization
    • police involvement
    • higher level of care or institutional level of care

CBC Consultants

CBC consultants are experts in the areas of Behavioral Health Alzheimer’s Disease and Related Dementia, Intellectual and Developmental Disabilities, Traumatic Brain Injury, Chronic Mental Illness and/or Substance Use Disorder and have successfully worked with clients who exhibit maladaptive behavior, often dangerous, possibly life-threatening, and may be complicated by medical or mental health factors.

Consultants provide CBC services statewide and will work with a client in every community setting the client receives services. Because the CBC services are not a Medicaid billable service, our consultants can provide CBC services to a client receiving Medicaid services and this is not considered a duplication of services.

Current list of approved CBC consulting agencies:

  1. UAA/CHD
  2. Method Works, LLC
  3. Lubitsh Counseling, LLC
  4. Behavior independence, LLC
  5. Aspire Behaviors Solutions, LLC
  6. Step-In Autism Services

Key Points to know about the program

  1. The CBC program does not provide placement (housing)
  2. The CBC program does not provide Care Coordination or Case Management
  3. CBC consultants do not provide any hands-on staffing

CBC’s Origin

The project started in 2009, when the State and the Alaska Mental Health Trust Authority contracted with WICHE (Western Interstate Commission for Higher Education) to examine how Alaska served Medicaid clients with complex needs and challenging behaviors.
WICHE in 2010 identified gaps in Alaska's continuum of care, and suggested a model consisting of three components (pdfexecutive summary):

  1. specialized training support for service providers
  2. short-term stabilization of clients
  3. medium-term intensive intervention

The first step, the 2012 pilot project, was launched with one-time funding from the legislature.

Known at the time as The Hub, the project included adults and youth from the start. Project goals were to build in-state capacity and expertise to serve individuals with complex behavior management needs, and to keep participants in the community and out of hospitals or institutional care.

In state fiscal year 2015, 50 participants were served (31 adults, 8 adolescents, 11 children) in 17 communities. The participants experienced development disabilities, mental illness, TBI, or Alzheimer’s Disease and Related Dementias. Most participants – 30– were discharged from CBC services, and 22, or 82 percent, successfully stayed in the community.

In many cases, prior to CBC services, families had not had training available to them. Trainings provided by the CBC helped families and direct care staff to better understand behaviors and successful ways of affecting change.

The program continues to get positive reviews from agencies, families and clients, while remaining within budget.

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