Early Intervention Financing and Resources: Final Report. Site Visit Approach and the Discussion Guides

10/01/2012

In all cases, the data collected and analyzed were intended to provide informed perspectives on the implementation and financing of the interventions and illuminate important barriers and barrier-resolution strategies. The project used a case study approach to obtain information on how sites are using different federal and local sources of funding to finance these services.

One-day site visits included interviews with identified key staff or a designee who was viewed as more appropriate:

  • The RAISE NAVIGATE program Director; and
  • The Director of the agency sponsoring the NAVIGATE Clinical Team.

The site visit protocols were customized for each key informant category. Each interviewee was asked to discuss issues in seven topical areas during the interviews:

  1. A site-specific description of defining characteristics of the treatment site, including an assessment of supports or barriers to implementation encountered in the site's community or catchment area.

  2. A description of the site-specific outreach, referral, recruitment and retention processes utilized with first-episode clients, including the training and implementation costs associated with adding -- and maintaining -- first-episode client interventions.

  3. A description of policy barriers encountered by the site and how such barriers are addressed and resolved.

  4. A description of the existing insurance coverage for new, first-episode clients (e.g., remain on parents' insurance, indigent, Medicaid), including any realized or anticipated impacts to clients' coverage associated with the ACA.

  5. A description of the non-insurance funding sources (e.g., General Relief Fund, county or state monies, the RAISE contract) specific to the site that are used to provide services that are not typically funded by insurance, such as supported education or supported employment services and family psychosocial education.

  6. A description of how or whether the treatment site develops or maintains partnerships in support of early intervention services, and if so, how partners were identified and cultivated.

  7. A description of key structural and procedural components related to the scalability of first-episode services and whether successful (versus struggling) treatment sites can articulate specific factors that are associated with this success (e.g., client mix, staffing, financial mechanisms, size of catchment area, outreach, education, training, fidelity monitoring, and referral requirements).

Table 2.1 presents an overview Site Plan for a one-day visit to the RAISE NAVIGATE programs and the interview protocols developed for key informants are in Appendix 2.

TABLE 2.1. RAISE NAVIGATE Site Visit Overview Plan
  Agency Administrator or Designee
-- -- -- -- --
  Key Informants with Knowledge  
of Funding and Implementation
RAISE NAVIGATE Project Director
or Designee
-- -- -- -- --
  Key Staff with Knowledge  
of Funding and Implementation
Purpose and content of interviews To provide informed perspective and information about RAISE NAVIGATE implementation processes, activities and delivery of services.
  • How first-episode outreach, referral, treatment, and retention services are funded, coordinated and delivered
  • Nature of relationships with providers and other stakeholders partners
  • Professional development processes (how training needs are determined and funded)
  • Existing and anticipated funding resources for first-episode services
  • Identification of program components necessary to provide effective interventions
  • Identification of structural and procedural components that facilitate effective first-episode services (e.g., size of catchment area, financial mechanisms, etc.)
To provide informed perspective and information about RAISE NAVIGATE implementation processes, activities and delivery of services.
  • Comprehensive description of program components, from intake to follow-along or program exit
  • How each component is funded and coordinated
  • Information about professional development training, including note of training gaps or continuing issues (e.g., accommodations for staff turnover and staff training on staggered schedules)
  • Perspectives on policy barriers to achieving implementation
  • Perspectives on other structural (e.g., size of catchment area, client mix) or procedural barriers (e.g., staffing patterns, referral requirements) to successful implementation of first-episode services
  • Thoughts on first-episode program sustainability (e.g., necessary components, anticipated funding sources)
Duration   1.0-2.0 hours 1.0-2.0 hours
Type of interview In-person, semi-structured format In-person, semi-structured format

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