omhsas advisory committee update may 3, 2007 omhsas updates reorganization highlights staff changes...
TRANSCRIPT
Commonwealth of Pennsylvania - Department of Public Welfare
Office of Mental Health & Substance Abuse Services (OMHSAS)ORGANIZATION CHART
Deputy Secretary
Office of the Medical Director
Bureau of Community &
Hospital Operations
Bureau of Children’s Behavioral Health
Bureau of Financial Management & Administration
Bureau of Planning & Program Development
Division of Behavioral Health
Policy
Division of Substance Abuse
Services
Division of Planning & Program
Development
Division of Medicaid Finance
Division of Budget & Administration
Division of Hospital Operations
Division of Children’s Policy & Program
Development
Division of Service Delivery
Division of Eastern Operations
Division of Western Operations
Division of Hospital Operations
Quality
Management
Utilization Management
Info Systems
Supporting our Journey: Aging Forums; Evidence of Progress
Two recent Aging and Behavioral Health Forums Held
Good representation at each Forum of Aging and MH
Profiled Aging and D&A issues Profiled successful collaborations Lessons Learned from Case Reviews
Highlighted
Continuing our Journey: School Based Behavioral Health: Setting the Stage
Secretary of Department of Welfare and Secretary of Pennsylvania Department of Education; regular meetings to address the education and the behavioral health needs of students using an integrated approach
Deputy Secretaries and key policy personnel from DPW and PDE attend
Identification of issues and priorities established
Core Principles
The best education for a child is in the “least restrictive environment: inclusive setting in her or his ”home school”
Students who must be placed out of their “home school” environments should experience such placements for as brief a time as possible
Operations and policy changes must address the set of incentives and disincentives that result in keep children out of their “home schools”
PDE and DPW must jointly support the program and fiscal design of school based behavioral health services
Priority Projects
Partial Hospitalization Education Law Center, PCPA, and advocacy
community raised issue regarding access to education for children and adolescents receiving mental health partial hospitalization services during the school day
DPW and PDE agreed to develop policies and practice standards regarding access to intensive behavioral health services including partial hospitalization
Priority Projects ( cont)
Partial Hospitalization DPW Bulletins; PDE School Code Change DPW Bulletins
Partial Hospitalization as short term stabilization Family Driven; Youth Guided; IEP and ISPT occurring
at same time when able Interagency team meeting/notice requirements to
“home school” Interagency team meeting/discharge planning/notice to
“home school”
Supporting our Journey: Housing
1. Summary Of a CRRS Conversion Process in Cumberland County. Total Dollar amount converted: $505,812
In an effort to provide maximum opportunity for persons with mental illness to choose their preferred housing and successfully maintain the residence of their choice, the provider agency New Visions will, in collaboration with the County MH Program, will reduce the number of CRRS beds from 16 to ten, provide case management support services to 18 additional persons in community apartments, and support 9 persons in two Fairweather Lodges. A Consumer-Run Drop-In Center will be developed in Shippensburg.
The changes in numbers of persons served: CRRS beds are reduced from 16 to10, Thirty-one persons will receive Supported Living services in community apartments – an increase
of 18 individuals. Two Lodges will provide for another 9 consumers. This represents a change from 29 to 50 total consumers supported – twenty-one additional
persons supported in housing. 15-20 persons will chose to participate in the Drop-In Center. In addition, the Cumberland County Housing Authority will offer Section 8 rental vouchers to all
persons leaving a CRRS , beginning in July 2007. The Redevelopment Authority has donated a building for use as the second Fairweather lodge.
Supporting our Journey: Housing
2. In the last three years of Fairweather Lodge operation in Erie County, 50 separate individuals served in Lodges have moved to successful employment.
3. In March 2007, 45 of 48 County MH Programs were represented at an all day Conference in Harrisburg devoted to Training on how to start and manage a Local Housing Options Team, a requirement for all MH Programs for the current County Plan. It is anticipated that the number of LHOTs that are fully operational will reach 35 by the end of the 2007 calendar year.
4. Huntingdon, Juniata and Mifflin County MH Program is currently converting a CRRS, to begin operation later in the 07/08 year. The total budget for the CRRS is $322,000, and the conversion will include conversion of that site to a Lodge and the development of a new community based supportive living counselor/program, which, will serve at least 20 new persons living independently in the community.
Continuing our Journey: Peer Supports
Fundamental element of Transformation; Consumer Directed; Consumer Operated Services & Supports; Choice in Peer Supports
Variety of Opportunities for Peer Work and Support
Mutual Support Groups Community Support Programs Recovery Specialists Consumer Satisfaction Teams Consumer- Run/Operated Services Warm-lines Drop-In Centers Clubhouses Patients’Rights Advocates Certified Peer Specialists
Certified Peer Specialists
Five States and Washington DC have successfully developed Medicaid funded peer supports (Georgia, South Carolina, Hawaii, Arizona, and Iowa)
Pennsylvania submitted a State Plan Amendment to Center for Medicaid /Medicare Services (CMS) which was approved on February 22, 2007
Will provide for certified peer specialists to bill for specific services to peers with mental illness
Finalizing: Service Description Review & Approval Process Licensing Process Enrollment &Billing Planning of Statewide Technical Assistance Days
Certified Peer Specialists
Certified Peer Specialist Bulletin will be issued May, 2007 Three Options
Existing MH Licensed Agency Subcontract to MH Licensed Agency Independent Peer Agency
Additional training and technical assistance ( Southeast Mental Health Association current approved trainer) may be available: Recovery Innovations Incl., formerly META Services
Initiated discussion with OVR regarding funding of peer specialist training and certification
Over 200 certified peers trained; billing will begin July 2007. An array of peer supports and other consumer operated and
directed services to be maintained!
OMHSAS: Guiding Principles
The Mental Health and Substance Abuse Service system will provide quality services that: Facilitate recovery for adults and resiliency for children; Are responsive to individuals’ unique strengths and needs
throughout their lives; Focus on prevention and early intervention; Recognize, respect, and accommodate differences as they relate to
culture/ethnicity/race, religion, gender identity and sexual orientation; Ensure individual human rights and eliminate discrimination and
stigma; Are provided in a comprehensive array by unifying programs and
funding building on natural and community supports unique to each individual and family;
Are developed, monitored and evaluated in partnership with consumers, families and advocates;
Represent true collaboration with other agencies & service systems
OMHSAS Objectives
Transform the children’s behavioral health system to a system that is family driven and youth guided.
Policy implementation of a “Call for Change” to support recovery and resiliency in the Adult Behavioral Health System
Assure that behavioral health services and supports recognize and accommodate the unique needs of older adults.
Children’s Objective
Transform the children’s behavioral health system to a system that is family driven
and youth guided.
Some Guiding Principles
Trauma informed culture should serve as the background for all services to children and adolescents
CASSP principles are assumed to be part of the children’s Objective and Supporting Projects
Youth and Family Teams will lead to a transformation of the children’s behavioral health system.
Children’s Supporting Projects and Actions
Establishment of Child-Family Teams to support Transformation Establish an Institute to provide training,
support and monitoring of Youth and Family Teams
Develop mechanism for Medicaid payment of Youth and Family Team process
Children’s Supporting Projects and Actions
Create Home and Community Based Alternatives to Residential Treatment Develop a “White Paper” addressing current
environment, needs and recommendations for creating alternatives to the current residential treatment system
Change existing rules to permit small group homes and therapeutic housing
Enroll Multi Dimensional Treatment Foster Care as a Medicaid funded service
Maintain data base on RTF utilization
Children’s Supporting Projects and Actions
Partner with Education to support the development of effective school based supports and interventions Have OMHSAS Children’s Advisory develop “White Paper” on
school based behavioral health services Engage youth to get their perspective on school based
behavioral health services Review and update the existing Memorandum of Understanding
with DOE, DOH, and DPW to detail responsibilities for SBBH Continue to build the relationship with DOE and collaborate on
projects such as SBBH Demonstration Grants, Positive Behavioral Interventions and Supports, etc.
Reduce admission to segregated programs Identify efforts underway with BHMCOs on collaborative efforts
with schools Enhance letters of agreement between Counties, BHMCOs and
Schools
Children’s Supporting Projects and Actions
Partner with Education to support the development of effective school based supports and interventions Have OMHSAS Children’s Advisory develop “White Paper” on
school based behavioral health services Engage youth to get their perspective on school based
behavioral health services Review and update the existing Memorandum of Understanding
with DOE, DOH, and DPW to detail responsibilities for SBBH Continue to build the relationship with DOE and collaborate on
projects such as SBBH Demonstration Grants, Positive Behavioral Interventions and Supports, etc.
Reduce admission to segregated programs Identify efforts underway with BHMCOs on collaborative efforts
with schools Enhance letters of agreement between Counties, BHMCOs and
Schools
Children’s Supporting Projects and Actions
Create Behavioral Health competency to honor the strengths and address the unique individualized needs of children and adolescents: In the child welfare system In, or at risk of entering, the Juvenile Justice system In the drug and alcohol system With Fetal Alcohol Syndrome Disorder That are Deaf or Hard of Hearing With Traumatic Brain Injury With Autism Spectrum disorder or other Pervasive
Developmental Disorder With Physical Disabilities And infants and young children
Children’s Supporting Projects and Actions
Develop a process for identifying and implementing evidence based practices; promising practices and culturally relevant practices Utilize the SAMHSA National Registry of Evidence Based
Practice, the NASMHPD Research Institute, the National Blue Print initiative and other sources to identify evidence based and promising practices
Document the expansion of Multi Systemic Therapy, Functional Family Therapy and other evidence based practices in current practice
Develop the Youth and Family Team process as the practice model for children’s behavioral health to support evidence based practice
Children’s Supporting Projects and Actions
Develop strategies to address the needs of Transitional Youth Support Youth involvement in the OMHSAS
Advisory Council Obtain Youth input in identifying needs,
developing plans, implementing and monitoring service development for Transition Youth
Summarize OMHSAS Transition Pilot projects Identify existing initiatives in other agencies Work with OMHSAS housing plan
Adult Objective
Policy implementation of services to support recovery
and resiliency in the Adult Behavioral Health System
Adult Supporting Projects and Actions
Define and expand the range of and financial commitment to consumer-run services, supports and trainers New Freedom Initiative Project Gain baseline understanding of existing consumer-
run services, supports and trainers statewide Develop Centers of Innovation around
Evidence-based and Promising Practices Review national models and define the
Pennsylvania model
Adult Supporting Projects and Actions
Support community re-integration of individuals who have been in state hospitals over 2 years Close at least 2 state hospitals by 2010
by Development and implementation of
individual community support plans Development of community infrastructure
Adult Supporting Projects and Actions
Implement an integrated system of services and support for co-occurring mental health/drug and alcohol recovery Identify how to increase co-occurring and
substance abuse awareness and activities within OMHSAS
Develop joint licensing standards Issue guidelines around D&A confidentiality Develop practice standards for co-occurring
screening and service provision
Adult Supporting Projects and Actions
Implement the recommendations of the Housing Workgroup Assure that every county/joinder have develop a
housing plan using the OMHSAS Housing Plan template
Implement and evaluate the Allegheny SSI Supplement Demonstration project and develop plan for statewide implementation
Develop strategies and convert at least $1 mil in CRR beds to supported housing
Policy development regarding use of public mental health funds in Personal Care Boarding Homes
Adult Supporting Projects and Actions
Implement, monitor and expand peer specialist services Enroll providers statewide, assuring availability of at least 2
programs offering peer specialists in each county/joinder Assure availability of peer specialist certification training Assure formalized peer support structures are available for
peer specialists Develop the capacity for certified peer specialists to serve
specific populations – older adults, individuals involved in criminal justice system
Work in collaboration with the Bureau of Drug & Alcohol Programs to develop use of certified peer specialists in the drug and alcohol system
Examine the use of consumer run peer specialist “employment agencies”
Identify specific outcome measures for Quality Improvement monitoring
Adult Supporting Projects and Actions
Implement recommendations of the Forensic Workgroup Partner with PMHCA to develop resources to
support Certified Peer Specialists in serving individuals in the Criminal Justice system
Work with the Governor’s Office on cross-systems task group
Inventory existing community diversion and re-entry services
Support Allegheny county national conference
Adult Supporting Projects and Actions
Develop plan for expanding Employment opportunities to support recovery
Collaborate on the delivery of trauma informed care Work with Hospital Association of PA to eliminate
seclusion and restraint in community hospitals Target resources to plan for the expansion of trauma-
informed care statewide for individuals, including: Transition age youth, returning veterans, individuals involved
with the criminal justice system
Adult Supporting Projects and Actions
Restructure the Medicaid State Plan to support recovery and resiliency Review current regulations and
revise/develop regulations supporting recovery/resiliency-oriented services
Older Adult Objective
Assure that behavioral health services and
supports recognize and accommodate the unique
needs of older adults.
Older Adult Supporting Projects and Actions
Expand access to services for older adults with the flexibility to provide services wherever they are Ensure that implementation of peer services
includes training of older adults as providers of the service to older adults as well as younger adults
Monitor access of peer specialist and mobile mental health services to older adults.
Older Adult Supporting Projects and Actions
Increase awareness of and planning for suicide prevention for older adults Adopt at least one recommendation of
the Suicide Prevention Plan for Older Adults.
Coordinate an annual Suicide Prevention Day in Harrisburg
Older Adult Supporting Projects and Actions
Review the impact of dual eligibility on service provision Compile Medicare and Medicaid inpatient and
outpatient date for older adults. Develop information and resources to help older
adults better understand services under Medicare and Medicaid (OMHSAS/AGING/APPRISE)
Use regional behavioral health Older Adult forums to share information on Medicare/Medicaid
Increase collaboration with Area Offices of Aging
Older Adult Supporting Projects and Actions
Expand access to the interagency planning project for older adults with complex needs Compile information for case reviews Encourage greater county participation
through access to training and continued collaboration with Aging
Older Adult Supporting Projects and Actions
Increase awareness of needs of older adults for substance abuse treatment and programs structured to accommodate those needs in a culturally competent manner Identify facilities appropriate to serve older
adults Define type of services older adults are
likely to use by getting their feedback
Older Adult Supporting Projects and Actions
Ensure community consumer involvement by providing support to individuals transitioning from South Mountain Restoration Center into communities where they live. Ensure consumer participation in discharge
planning teams. Ensure consumer resources are identified
and utilized in community where they return
Older Adult Supporting Projects and Actions
Continue to assure appropriate mental health services are available to older adults experiencing dementia who have behavioral health problems Continue to monitor complaints or
concerns regarding access to care. Engage in educational efforts with public
and managed care partners.
Older Adult Supporting Projects and Actions
Develop a collaboration with physical health partners (Home Health, Visiting Nurses Assn, etc.) to promote behavioral health screenings for older adults Assess willingness of MCOs/providers to
partner on provision of screenings
Older Adult Supporting Projects and Actions
Ensure an active role for the Older Adult Advisory Committee in the Money Follows the Person (MFP) project Older Adult Committee will identify
representatives to serve on the MFP Advisory Work Group anticipating receipt of grant award.
Older Adult Supporting Projects and Actions
Support efforts to promote a study of Older Adults through the Legislative Budget and Finance Committee (LBFC) When presented with a request for
legislative analysis, respond with positive support and background research on the bill soon to be introduced.
Advisory Committee members may advocate for support, either as individuals or members of their respective organizations
What Will It Take to Support Our Change?
Culture Change Consumer and family voice is central to design,
implementation and oversight of system change Opportunities must be made available for consumers,
families and advocates to challenge, question, confirm assumptions of what is meaningful to them.
A variety of options must be made available, to include education, supported employment, competitive employment
Stakeholder investment Common Vision Providers must be provided opportunity to change
practice Hard Work
Recovery
Recovery Recovery is remembering who you
are through the darkness and using your strengths to become all that you were meant to be
Support the Journey~