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PEER SERVICES

This project focuses on implementing peer services for adults inpatients being discharged from specific facilities in NYC to improve recovery outcomes and decrease re-admission rates. Challenges include hospital approval, referral changes, and staff interaction with peers. Data shows promising engagement rates. Future steps include integrating peer services in mainstream Medicaid and studying engagement success metrics.

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PEER SERVICES

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  1. PEER SERVICES Ian A. Shaffer MD, MMM September 11, 2014

  2. Peer Services Peer mentoring or coaching Recovery resource connecting Facilitating and leading recovery groups Building community

  3. Peer Bridger Improve engagement in recovery plan Support re-engagement in community Decrease re-admission rate

  4. Implementation Peer service group set up services in region Determine population to be served • All adult inpatients being discharged • Specific facilities Meet with hospital staff to introduce program and peers MCO clinical staff and peers meeting together to develop work flows

  5. Start Up Challenges Time needed for hospitals to approve peer access Staff doing post hospital clinical follow up need to determine how to interact with peers Slow rampup Change referral requirements • Move from only re-admitted members to first admit members

  6. Referral Data

  7. Referred Population Member data • 33% Bronx • 33% Brooklyn • 22% Queens • 12% Manhattan 318 referred had 2 or more hospitalizations 49 had 4 or more hospitalizations all with SUD diagnosis

  8. Referred Population • 60% male – 40% female • Age of member • <20 9% • 21-30 26% • 31-40 19% • 41-50 16% • 51-60 30% • >60 <1%

  9. Peer Service Contacts per person ranged from 1 – 78 (Ave. 18) Time 1 hour – 72 hours (Ave. 15) Most engagement still done in community (98%) • Dependent on our ability to get hospital clearance for peers. Slow going but improving Outreach and engagement 0.25 – 10 hours Average number of engagement attempts - 2

  10. New York and Peer Support Included in Home and Community Based Services (1915(i)) in our new Health and Recovery Plan (HARP) for those with significant mental illness and/or substance use disorders Can be delivered to main Medicaid population as an in lieu of service

  11. Next Steps Implement plan for peer services with HARP go live Develop plan for use of peer in main stream Medicaid Continue to reach out to inpatient facilities to increase peer access to members pre-discharge Study engagement success to improve • Pre-discharge meetings • How to increase post discharge engagement Develop outcome metrics • Recovery metrics • ROI

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