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OMHSAS

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Partial Hospitalization. DPW Bulletins; PDE School Code Change. DPW Bulletins. Partial Hospitalization as short term stabilization ... – PowerPoint PPT presentation

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Title: OMHSAS


1
OMHSAS
  • Advisory Committee Update
  • May 3, 2007

2
OMHSAS Updates
  • Reorganization Highlights
  • Staff Changes
  • Retirement Challenges

3
Commonwealth of Pennsylvania - Department of
Public Welfare Office of Mental Health
Substance Abuse Services (OMHSAS) ORGANIZATION
CHART
Deputy Secretary
Bureau of Financial Management Administration
Office of the Medical Director
Bureau of Planning Program Development
Bureau of Community Hospital Operations
Bureau of Childrens Behavioral Health
Division of Childrens Policy Program
Development
Quality Management
Division of Behavioral Health Policy
Division of Medicaid Finance
Division of Eastern Operations
Utilization Management
Division of Western Operations
Division of Substance Abuse Services
Division of Budget Administration
Division of Service Delivery
Division of Planning Program Development
Division of Hospital Operations
Division of Hospital Operations
Info Systems
4
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 DA issues
  • Profiled successful collaborations
  • Lessons Learned from Case Reviews Highlighted

5
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

6
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

7
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

8
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

9
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 v ouchers
    to all persons leaving a CRRS , beginning in July
    2007.
  • The Redevelopment Authority has donated a
    building for use as the second Fairweather lodge.

10
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.

11
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
  • PatientsRights Advocates
  • Certified Peer Specialists

12
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

13
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!

14
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

15
OMHSAS Objectives
  • Transform the childrens 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.

16
Childrens Objective
  • Transform the childrens behavioral health system
    to a system that is family driven and youth
    guided.

17
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
    childrens Objective and Supporting Projects
  • Youth and Family Teams will lead to a
    transformation of the childrens behavioral
    health system.

18
Childrens 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

19
Childrens 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

20
Childrens Supporting Projects and Actions
  • Partner with Education to support the development
    of effective school based supports and
    interventions
  • Have OMHSAS Childrens 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

21
Childrens Supporting Projects and Actions
  • Partner with Education to support the development
    of effective school based supports and
    interventions
  • Have OMHSAS Childrens 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

22
Childrens 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

23
Childrens 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 childrens behavioral health
    to support evidence based practice

24
Childrens 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

25
Adult Objective
  • Policy implementation of services to support
    recovery and resiliency in the Adult Behavioral
    Health System

26
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

27
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

28
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 DA confidentiality
  • Develop practice standards for co-occurring
    screening and service provision

29
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

30
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

31
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 Governors Office on cross-systems
    task group
  • Inventory existing community diversion and
    re-entry services
  • Support Allegheny county national conference

32
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

33
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-oriente
    d services

34
Older Adult Objective
  • Assure that behavioral health services and
    supports recognize and accommodate the unique
    needs of older adults.

35
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.

36
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

37
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

38
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

39
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

40
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

41
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.

42
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

43
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.

44
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

45
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

46
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

47
Transition from the past to the future.
Drawing by Brenda Wagner
There are two ways to look at your life. One is
as though nothing is a miracle the other is as
though everything is. Albert Einstein
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