Josette Dorius, Service Director Autism Council of Utah April 6, 2011

1. Josette Dorius, Service Director Autism Council of Utah April 6, 2011

2. Objectives • History of the HOME Program • Structure of our medical home • Our team • Collaboration of care • Medical outcomes • How to enroll in HOME • H.O.M.E. acronym = Healthy Options Medical Excellence

3. Our Mission “To optimize the quality of life of the people we serve by providing excellent, compassionate, and integrated health services throughout the lifespan.”

4. Background • Started as a cooperative relationship in 2000 among the University of Utah, Robert Wood Johnson Foundation, and the Utah Department of Health. • Medicaid sought a population who were high utilizers of Medicaid services and who might benefit from coordinated health care. • Scott Stiefel, M.D., was already providing mental health services to people with disabilities.

5. Background (continued) • HOME was created to provide medical and mental health care in the same location (specialized medical home). • Original program required that enrollees also had Division of Services for People with Disabilities (DSPD) services in the central region. • In 2004, HOME was permitted to expand to any disabled eligible person with Medicaid, regardless of their DSPD status. • In 2005, HOME moved from ARUP to a new facility at 650 S. Komas Drive. • In 2009, opened HOME North clinic in Ogden • In 2011 current enrollment is 829

6. Eligibility • Utah Medicaid • A developmental disability • A mental health or behavioral concern • Willing to receive primary care at the HOME clinic • Substance, criminal, or perpetration issues are not dominant

7. Funding Structure

8. What We Do • Provide coordinated medical and mental health care to people with developmental disabilities. • Serve as a medical home and center of excellence for each of our clients. • Advocate for the best possible services for our clients. Who We Are Doctors – Family Practice, Pediatrician, Child Psychiatrist (3) Triple Board Psychiatrist (2) Advance Practice Nurses – 2; Licensed Clinical Social Workers – 5; Medical Assistants – 3; Case Managers – 3 Nurse Case Manager – 1; Behavior Specialist – 2; Billing Specialist – 1; Schedulers – 2; Information Specialist – 1; Finance – 1; Manager – 1; Service Director - 1

9. Neurobehavior HOME Program Serving Children and Adults with Developmental Disabilities Comprehensive Care Chronic Disease Management Preventive Care Inpatient Services Social Support Long Term Care • Therapy Groups • Substance Abuse groups • Single Mingle Activities • Behavior Education Series – Parents, Providers • Home visits • Parent Provider Council • Advocate • Application assistance for SSI • DSPD • Partnering with Group Home staff • Coordinate with Utah Medicaid • Division of Services for People with Disabilities (DSPD) • End of life – palliative care • Medical • Mental Health • Therapy • Behavior Support • Individualized needs recognized • Inclusive treatment plan • Immunizations • Vaccines • Open Access appointments for Urgent visits • Case Management • Interdisciplinary • Specialty Care • Extender Services • Home Health • DME • Pharmacology management • Interdisciplinary clinic • Coordination of referred care • Transition care • Follow up appt • Coordination of services • Case Manager involvement in team meetings • Discharge planning inclusive of follow up appointments • Evidence based • Education • Outreach • Specialty referrals • Outcome reporting

10. Outcome Reporting • FY 2008 • Medical Admits = 40.80% • MH Admits = 59.20% • Med readmits = 6.10% • MH Readmits = 8.50% •  FY2009 • Medical admits = 37% • MH admits = 63% • Med readmits = 7.7% • MH Readmits = 10.6% • Emergency Room Visits • FY 2008 • Encounters = 232 • ER rate/1000 = 3%/month •  FY 2009 • Encounters = 352 • ER rate/1000 = 4%/month • Diabetic Management • FY 2008A1C average = 6.3 •  FY 2009 A1C average = 6.3 • No Show Rate • FY 2008Appointments = 6% • FY 2009 Appointments = 5.7% • Customer Satisfaction • FY 2008 = 88% • FY 2009 = 90.5%

11. How to refer • Call Medicaid (Willow Greer) at (801)567-3835 • Medicaid screens for eligibility • If eligible, Medicaid mails out an intake packet • Upon receipt of the intake packet, HOME calls to schedule a “Get Acquainted” visit and Psychiatric Evaluation. • Enrollment paperwork is completed at one of these visits. • HOME contacts: • Dean Weedon, Manager (801) 587-3109 • Josette Dorius, Service Director (801) 587-3108 • HOME Program main number (801) 581-5515