Implementation Guide No. 2
CMEs are a promising model for serving high-cost, high-need youth with serious behavioral health concerns. Designing and implementing a CME, however, can be a large undertaking. Some States may be well positioned to undertake the challenge. Others may need to build capacity for CME design by, for example, facilitating high-level support for CMEs, fostering interagency collaboration, engaging stakeholders, or developing internal data analysis capabilities. Before a State moves forward with CME design, it should carefully consider the resources required to build CME capacity, weighing the potential benefits of CMEs against other priorities in the State.
A State that decides to move forward has considerable flexibility in how it designs CMEs. As noted throughout this guide, many CME design features are linked, and decisions on one design component can influence the options available for other aspects of the CME. For example, the funding mechanisms identified for a CME may directly influence the CME management structure, target population, and available services. As another example, if a State requires CMEs to oversee and finance behavioral health or social services, it may be restricted to selecting large organizations with sophisticated administrative capabilities to provide those services.
Given the complexity and interrelatedness of design features, a State should review the full implications of each design decision before moving forward. Engaging stakeholders, consulting experts, and analyzing data can help a State determine which approach is most appropriate for its context..