Torrance Regional Service Area Planning Project

1. Torrance Regional Service Area Planning Project Stakeholder’s Meeting August 23, 2007

2. Goals for this Meeting • Introduce the project and people involved • Answer your questions…at least try to • Get input from you on some specific issues that will be important to counties, hospital, and AHCI in developing and implementing a regional service area plan

3. The Torrance Regional Service Area Planning process initiated by these counties: Allegheny Cambria Armstrong Fayette Bedford Indiana Blair Somerset Butler Westmoreland

4. Brief History • The State (DPW) has required each state hospital service area to develop a regional service plan for that area • Major focus of the plans has been on one of three goals – reducing the number of individuals in state hospitals over 2 years • Goal driven to a large extent by Supreme Court decision – Olmstead decision

5. Brief History cont’d • State began requiring assessments and community support (discharge) plans for all persons in hospital over 2 years • Interests of hospital, counties and individuals came together recognizing the need to more assertively plan for individuals returning to their home communities – developed joint goal of closing one unit

6. Brief History cont’d • Counties have been responsible for developing their own community resources with their base (county) funds • Also, counties generally have approached bed reduction through Community-Hospital Integration Program Project (CHIPP) initiatives • Now counties recognize need for more systemic and regional approach for developing needed community supports and services and more sustainable and equitable approach to funding – build more on what may be available as a result of HealthChoices

7. Counties’ Concerns • Not enough funds to move and support people in the community and develop necessary diversion services • Less influence/lack of success in negotiating different funding options with the State when done one county at a time • Not able to do long-term, strategic planning due to current funding arrangement – such planning essential to moving toward more recovery based services

8. Where does AHCI fit in? • AHCI was approached by the Counties to provide assistance in the CSP process, and service planning and development both on a county and multi-county/regional level, financial analysis and budgeting, and training • Efforts based on experience in other areas

9. Primary Tasks • Finalize Assessment and CSP (Discharge Planning) Process • Implement that process • Conduct Financial Analysis including hospital costs and costs of community services • Identify Service and Support needs and begin developing them • Provide regional training as common needs identified • Review and implement discharge tracking process

10. Structure of Project • Planning Committee • Assessment and Discharge Committee • Quality Improvement Committee (to be formed)

11. Planning Committee • Provides overall direction and decision making for project • Composition • Advocates (4) • Consumers/Family (8) • Managed Care/Oversight (5) • Counties – 2 or 3/county as guide • OMHSAS (4) • Providers (3) • Torrance State Hospital (4)

12. Project Goals • Facilitate the counties’ and hospital working together to discharge 30 individuals by September 30, 2008 • Develop a financial approach that will better support people in the community • Coordinate and monitor the discharge process • Assist counties in service planning and development

13. Financing Options • Existing state hospital resources • Mental Health base funding • Mental Retardation waiver funds • Department of Aging funds • HealthChoices capitation funds • HealthChoices reinvestment funds • Bridge funding was used in some counties • COMCARE waiver funds individuals with traumatic brain injury

14. Assessment & Discharge Activities

15. What is the Goal? • To implement a coordinated and recovery-driven assessment and discharge planning process for individuals being discharged from Torrance State Hospital • To monitor the assessment and discharge process from beginning to end so that consumers and families get what they need to ensure successful community living

16. Committee’s Goals • Review the assessment tools and the assessment process • Monitor the discharge planning process • Composition • Consumers/Family (13) • CFST Directors (5) • Providers (6) • OMHSAS (2) • Torrance (2) • County (1)

17. Assessment Tools • Consumer Needs Assessment • Family Assessment • Clinical Team Assessment

18. Assessment Process • Develop a coordinated, thorough, and inclusive assessment process • Determine how consumers, families, and staff will be notified of the process • Define the roles, competencies, and tasks of the assessment teams, specifically the assessors • Pick and train the assessment teams • Monitor the process through completion • Report regularly to the Planning Committee

19. Discharge Process • The consumer leads the process to the best of his/her ability and with assistance, if needed • Consumers invite who they want to be involved in their discharge process • Discharge plans are focused on what the consumer (and family) wants and needs for successful community living Develop and monitor a coordinated and recovery driven discharge process that ensures:

20. Discharge Process • Discharge plans are focused on what the consumer (and family) wants and needs for successful community living • Resources/supports are in place prior to discharge • A facilitator and recorder are part of the planning process

21. Questions from Group?

22. We Need Your Input • What are some examples of recovery-focused programs that exist in your community? • With the goal of diverting from the hospital, what services do people in your community need? • What services should be in the community to help people once they leave the state hospital? • Identify top three training needs in your community.