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State of Connecticut Dept. of Mental Health and Addiction Services Linking PASRR to Transition

State of Connecticut Dept. of Mental Health and Addiction Services Linking PASRR to Transition. National Mental Health & Aging and PASRR Conference: March 24-25, 2014 Indianapolis, IN. Transitions result from…. Multi-pronged approaches to rebalancing Ongoing Collaboration.

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State of Connecticut Dept. of Mental Health and Addiction Services Linking PASRR to Transition

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  1. State of ConnecticutDept. of Mental Health and Addiction ServicesLinking PASRR to Transition National Mental Health & Aging and PASRR Conference: March 24-25, 2014 Indianapolis, IN

  2. Transitions result from….. • Multi-pronged approaches to rebalancing • Ongoing Collaboration

  3. Multi Pronged Approach to Rebalancing Goal to transition individuals to least restrictive environment • Mental Health Waiver/MFP • Nursing Diversion and Transition Program • Outreach and Engagement Project

  4. Mental Health Waiver/ W.I.S.E. Program • 1 of 2 MH waivers in U.S. • Operational since April 2009 • Assists clients to be diverted or discharged from NHs • Linked to MFP • Person-Centered, Recovery and Psych Rehab Model • Recovery Assistant: hybrid companion, homemaker, PCA, and respite • Cost Neutrality • www.ct.gov/dmhas/cwp/view.asp?a=290&q=425724

  5. Nursing Home Diversion & Transition Program • Nurse Clinicians and Case Managers assigned to geographic locations in state • Clarify/validate Level of Care (LOC) needs and services • Cross-trained with Mental Health Waiver program • Monthly meetings with NH staff and Money Follows the Person (MFP) staff • Piloting groups in NH settings: • Chronic disease self management • Double Trouble for co-occurring Mental Illness & Substance Abuse • Community skills-building

  6. Outreach and Engagement Project • Outreach to residents in nursing facilities • Education to nursing facilities, home care agencies, behavioral health providers, community resources • Ongoing engagement of residents Shifting Culture Institution vs. Home Based Care Providers and Residents experience change

  7. Collaboration through….. • Keeping the conversation going & shared responsibility. • Public/Private input to Core Standardized Assessment Tool. • Consultation between waiver programs. • Cross-agency/provider trainings and retreats. • PASRR process & follow-up on Level II recommendations. • MDS Section Q prompts NH to refer to MFP

  8. State of CT Overview Others Medicaid Authority MH Authority PASRR and Electronic Vendor Statewide Services Unit & PASRR • State DD Authority • ADRCs • State Dept. Public Health • State Dept. on Aging • Triple A’s • LTC Ombudsman’s Office • Nursing Homes • Hospitals • Independent Living Centers • Community providers NHDTP MH Waiver (W.I.S.E.) Key Offices • MFP • Alternate Care Unit • Other waiver units • EPS Outreach and Engagement Community Placements

  9. Give a HootDon’t Institute!! Jennifer Glick, RN, MSW, 860-262-5818 jennifer.glick@ct.gov Megan Goodfield, LCSW, 860-262-6953 megan.goodfield@ct.gov CT Department of Mental Health & Addiction Services www.ct.gov/dmhas

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