The Neighborhood Integrated Care for Kids (NInCK) is an innovative model of care that will create a Socially and Clinically Integrated Network of core child service providers including social services, behavioral and physical health providers, crisis services, schools, and many others. NInCK will serve approximately 43,000 youth in two contiguous zip codes of Chicago (60639 and 60651) which represent two ethnically diverse communities of Belmont-Cragin and Austin neighborhoods. NInCK aligns core child service providers in a culturally-competent, trauma-informed, family- and youth-centered model of care that is grounded in the strengths of the community and creates a framework for collective problem-solving from the community level up through all aspects of the healthcare and social services delivery systems.
A fundamental strategy of the NInCK model is to enhance the capacity and competency of community-based primary care and school-based services so that more services can be delivered in the community, in a more timely, coordinated, and convenient manner. Collaborative care models integrating behavioral health, as well as medical specialty care, into primary care and school-based settings will be expanded. Families will be strengthened through enhanced family support and parenting education. All core child service providers in the Socially and Clinically Integrated Network will be connected through robust data-sharing systems with appropriate privacy and security controls. The Network will employ a universal screening process and youth will be stratified based on both assessment and a claims-based algorithm so that rising-risk (Service Integration Level 2) and high-risk (Service Integration Level 3) youth receive care coordination and care management services through interdisciplinary care teams and families are connected to needed services.
NInCK will be supported by an innovative Alternative Payment Model (APM) that creates three incentives pools of funding for NInCK providers including 1) primary care providers (PCPs), 2) community-based core child service providers such as schools and social services, and 3) mobile crisis and care coordination teams. The APM incentivizes community-based services through gainsharing to provide prevention, early detection, community-based treatment, and enhanced care coordination, and thereby reduce expensive upstream utilization. The ultimate goals of the NInCK are to reduce health care costs, reduce out-of-home placement (including long-term care, prolonged hospitalizations, and foster care), and improve health outcomes on standard measures.
Integrated Care for Kids Model funding will be used to: 1) support the leadership for the development and implementation of NInCK infrastructure of the Socially and Clinically Integrated Network and supporting APM 2) expand community-based models of care 3) support staffing for Service Integration Coordinators (SICs) to ensure that youth and families receive coordinated services 4) support staffing for Network Liaisons to ensure that providers are informed, aligned, and able to use the data-sharing tools 5) support the development of an RFP to design the data-sharing infrastructure 6) implement the selected data-sharing systems and 7) perform outcomes measurement for continuous quality improvement and model assessment.