Strategic Planning 2013

1. Strategic Planning 2013 CMHSAS-SJC Board

2. Description of a Good and Modern Addictions and Mental Health Services System • Affordable Care Act • Patient and Protection and Affordable Care Act of 2010 • Health Care and Education Reconciliation Act of 2010 • Recognizing that Behavioral Health is integral part to improving and maintaining overall health

3. Who has Health Care Coverage? • Health Insurance - 25,989* • Medicaid – 15,236 • Medicare – 11,178 • ABW- 350 • County Health Plan -169 • Uninsured - 8,214** * 2010 Small Area Health Insurance Estimates uses 84.5% under age of 64 **2009-11 ACS estimates the percent of uninsured at 13.6% (+ 1.6) people.

4. SAMHSAs focus is on: • Continuum of services benefit package within available funding that are cost effective and evidence based and best practices services approach • Local system of care with primary care and behavioral health providers and practitioners are aligned with one another and with other systems

5. Least Restrictive Independent Living Contributing Citizen Most Restrictive Hospitalization Incarceration Continuum of Care

6. Previous Goals • Maintain CARF accreditation • Maintain Focus on Continuous Quality Improvement. • Fulfill Aspects of the Master Contract with the Affiliation PIHP • Continue to improve Services Under a Capitated Managed Care Arrangement. • Successful affiliation status with Kalamazoo, Allegan and Cass Counties. • Integration of Primary Care and Mental Health • Integration of Mental Health and Substance Abuse • Provide Evidence Based Practices

7. System of Care Individual

8. Recovery Supports • Peer Support • Recovery Support Coaching • Recovery Support Center Services • Supports for Self directed care • Continuing care for SUD

9. Acute Intensive Services • Mobile Crisis Services • Medically monitored intensive inpatient • Peer based crisis services • Urgent Care Services • 23 hour crisis stabilization services • Area identified for improvement: 23 hour crisis stabilization services • 24/7 Crisis hotline Services

10. Out of Home Residential Services • Crisis residential/stabilization • Area identified for improvement. • Clinically managed 24-hour care • Clinically managed medium intensive care • Adult Mental Health Residential • Children's Mental Health Residential • Area identified for improvement • Youth Substance Abuse Residential • Therapeutic Foster Care

11. Out of Home Residential Services (cont.) • Additional areas identified for improvement: • Olmstead citation • Children’s Respite • Funding • out-of-area • What are the licensure needs? • Possible joint venture? • Would it decrease hospitalization?

12. Intensive Support Services • Substance abuse intensive outpatient services • Partial hospital • Assertive Community Treatment (ACT) • Intensive home based treatment • Multi-Systemic therapy • Currently not recognized in Michigan but it is something to look in to. • Intensive case management

13. Other Supports (Habilitative) • Personal Care • Homemaker • Respite • Supported Education • Transportation • Assisted Living Services • Recreational Services • Interactive Communication Technology Devices • Trained Behavioral Health Interpreters • Area identified for improvement: Additional Training for Behavioral Health interpreters

14. Other Supports (Habilitative)(cont.) • Contracting with community services is something we do very well!

15. Community Support (Rehabilitation) • Patient/Caregiver support • Skill Building (social, daily living, cognitive) • Area identified for improvement: • Case Management • Behavioral management • Supported Employment • Area identified for improvement: Bring in-house • Permanent supported housing • Recovery housing • Area identified for improvement: none available in our county • Therapeutic mentoring • Traditional healing services

16. Medication Services • Medication Management • Pharmacotherapy (including MAT) • Laboratory Services • Additional areas identified for improvement: • Not enough Doctors • Substance Abuse Meds

17. Outpatient Services • Individual Evidenced Based Therapies • Group Therapy • Family Therapy • Multi-Family Therapy • Area identified for improvement: not enough interest • Consultation to Caregivers • Additional area identified for improvement: • DBT is currently low fidelity but there is a cost to make it high fidelity

18. Engagement Services • Assessment • Specialized Evaluations (psychological, neurological) • Area identified for improvement: need additional training • Service planning (including crisis planning) • Consumer/Family education • Outreach • Area identified for improvement: need more presence

19. Prevention (including promotion) • Screening, brief intervention and referral to treatment • Brief Motivational Interviews • Screening and brief intervention for tobacco cessation • Parent training • Facilitated Referrals • Relapse Prevention/Wellness Recovery Support • Warm line • Additional area identified for improvement: SA prevention programs are good but MH is week (lacks funding)

20. Healthcare Home/Physical Health(Room for Improvement/Work In Progress) • General and Special outpatient medical services • Acute primary care • General health screens, tests and immunizations • Comprehensive Care Management • Care coordination and health promotion • Comprehensive transitional care • Individual and Family support • Referral to community services

21. Integration of Primary Care and Mental Health General and Special outpatient medical services Acute primary care General health screens, tests and immunizations Comprehensive Care Management Care coordination and health promotion Comprehensive transitional care Individual and Family support Referral to community services 23 hour crisis stabilization services Crisis residential/stabilization Skill Building (social, daily living, cognitive) Supported Employment Recovery housing Continue to improve Services Under a Capitated Managed Care Arrangement. Identified Goals

22. Specialized Evaluations (psychological, neurological) DBT Low to High Fidelity Children’s Mental Health Residential Children’s Respite Funding, out-of-area, licensure needs?, Would it decrease hospitalization? Olmstead citation Not enough Doctors Substance Abuse Meds Multi-Systemic therapy Outreach Mental Health Prevention Trained Behavioral Health Interpreters Additional Goals: