Macomb County Community Mental Health

1. Macomb CountyCommunity Mental Health Provider Forum Clinton Macomb Public Library November 14, 2013

2. Recovery How MCCMH is supporting and encouraging recovery…and how you can help

3. Macomb County Community Mental Health, guided by the values, strengths, and informed choices of the people we serve, provides quality services, which promote recovery, community participation, self-sufficiency, and independence Macomb County Community Mental Health Mission Statement

4. There is a new working definition of Recovery from Mental Disorders and Substance Use Disorders as follows: A process of change through which individuals improve their health and wellness, live a self-directed life, and strive to reach their full potential. There is no set time requirement for recovery, as it is recognized that this is an individualized process whereby each person’s journey of recovery is unique and whereby each person in recovery chooses supports, ranging from clinical treatment to peer services that facilitate recovery.

5. Through the Recovery Support Strategic Initiative, SAMHSA has also delineated four major dimensions that support a life in recovery:  • Health : overcoming or managing one’s disease(s) as well as living in a physically and emotionally healthy way; • Home:  a stable and safe place to live; • Purpose:  meaningful daily activities, such as a job, school, volunteerism, family caretaking, or creative endeavors, and the independence, income and resources to participate in society; and • Community : relationships and social networks that provide support, friendship, love, and hope

6. As staff, providers, loved ones, we can have a major impact on how a person in service feels about their own recovery, their individual ability to recover and the confidence to make it happen! • Recovery is strength based…meaning we need to identify and focus on strengthsand abilities, not negatives or limitations. • Identify, support, encourage strengths!

7. Health: overcoming or managing one’s disease(s) as well as living in a physically and emotionally healthy way • MCCMH is working to raise awareness of the importance of Integrated Health Care. • Participation in State Learning Community • Case to Care Training made available to staff to focus attention on role as Care Manager, to include primary healthcare • Building co-location and other integrated care opportunities: • McLaren Mobile Outreach Clinic • Bruce Johnson, M.D. • MyCare • Focus on Integrated Care at Drop-in Centers…Healthy Eating, Yoga, Information for persons in service and staff • Person-Centered Plans are to be Recovery-Focused and address all aspects of a person’s care.

8. Home:  a stable and safe place to live • Recently issued Residential Placement Protocol to ensure people are served in the least restrictive level of care possible • Development of Person-Centered Plans to prepare for Semi-Independent and Independent Living • Approval of a contract with Community Housing Network to bring a “Getting My Own Address” support and informational group to Macomb County • Assignment of a Certified Peer Support Specialist to the MCCMH HUD-supported PATH program to assist staff and consumers in identifying resources and building strengths toward independent living

9. Purpose:  meaningful daily activities, such as a job, school, volunteerism, family caretaking, or creative endeavors, and the independence, income and resources to participate in society • Implementation of the Supported Employment evidence-based practice • What other activities are occurring with persons served to provide meaningful activities? • Needs to be a focus throughout, from case management, to group home providers, to natural supports on development of meaningful activities for persons served

10. Community: relationships and social networks that provide support, friendship, love, and hope • Development of the role of Commonwealth Administrator • Development/enhancement of social networks connectedness and further attention to development of meaningful activities for persons served • More later…

11. Where do we go from here…? • How do we assist the person served to become less dependent on services, and be able to more easily re-access services when needed? • Increase roles of Certified Peer Support Specialists • WRAP – Wellness Recovery Action Plans • ???

12. People can, do…and deserve the opportunity…for recoveryRECOVERY HAPPENS!

13. Business Management

14. Contracts Where is my contract???

15. Contracts Where is my contract??? All providers received notification of current contract extension until December 31, 2013

16. Contracts Where is my contract??? All providers received notification of current contract extension until December 31, 2013 New contract cycle to start January 1, 2014

17. Contracts Where is my contract??? All providers received notification of current contract extension until December 31, 2013 New contract cycle to start January 1, 2014 The new contracts will run for thirty-three (33) months

18. Contracts Where is my contract??? All providers received notification of current contract extension until December 31, 2013 New contract cycle to start January 1, 2014 The new contracts will run for thirty-three (33) months Contracts will run until September 30, 2016

19. THINGS TO LOOK FOR IN THE CONTRACT

20. Continuing Emphasis on Recovery “Mental health recovery is a journey of healing and transformation enabling a person with a mental health problem to live a meaningful life in a community of his or her choice while striving to achieve his or her potential.”

21. Continuing Emphasis on Recovery “Mental health recovery is a journey of healing and transformation enabling a person with a mental health problem to live a meaningful life in a community of his or her choice while striving to achieve his or her potential.” Section K - Recovery

22. Employment Opportunities for Individuals With Disabilities For example: Employ a sufficient workforce of persons with life experiences across all levels who are paid fair and competitive wages commensurate with their position and with other employees of the same pay grade, and provide multiple opportunities for full and/or part-time positions, and a viable career ladder; Make affirmative efforts to employ individuals with disabilities - recruit, place, with competitive pay scales, fringe benefits, and training included.

23. Employment Opportunities For Individuals With Disabilities For example: Include language of recovery in all job descriptions (paid and volunteer) and ensure that job descriptions outline recovery-based, person-centered, culturally competent practices and specify that applicants with 'lived experiences' with behavioral health issues are desired.”

24. Continuing Emphasis on Peer Support Specialists

25. Continuing Emphasis on Peer Support Specialists Continuation of Integration of Care

26. Contract Requirements and Audits

27. Contract Requirements and Audits MCCMH will continue to monitor the provider panel to ensure that all providers are meeting the contract requirements. MDCH is putting greater emphasis on the PIHP’s to guarantee that quality services are being provided. MCCMH will be increasing the number and type of audits with our provider panel.

28. Contract Requirements and Audits This means that MCCMH will continue to do the Technical review audits on the “front door” providers and the ancillary audit on all other providers. These will continue to be carried out by the Business Management Division of MCCMH. In addition, new audits are being developed and will be rolled out in the months to come.

29. Contract Requirements and Audits The Quality Improvement Division and Business Management Division are developing new audit tools. New audits will focus on: • Evidence based practices • Integration of Care • Treatment Plans

30. Contract Requirements and Audits Why are we doing this? We are all working together as an integrated team for the benefit of the people we serve. We are striving to improve the quality of life for the people we serve.

31. Contract Requirements and Audits Why are we doing this? The goal of these audits and reviews is to: • provide technical assistance/guidance on documentation requirements and service delivery; • To facilitate lines of communication between MCCMH and the provider panel.

32. Corporate Compliance Trends and Analysis During last fiscal year, the Corporate Compliance Division investigated 60 cases. Friendly reminder of the day! All staff are responsible for reporting all potential corporate compliance issues!!

33. Corporate Compliance Trends and Analysis

34. Corporate Compliance Trends and Analysis

35. Corporate Compliance Trends and Analysis

36. Corporate Compliance Trends and Analysis

37. Future Plans

38. Future Plans MCCMH will be going for NCQA accreditation Focus will be on quality

39. Macomb County Community Mental Health

40. Integration of Health Care and Quality Improvement

41. Why Integration Mental health problems and alcohol and drug use, are among the most common and disabling health conditions. They often co-occur with acute and chronic medical problems and can substantially worsen associated health outcomes. When mental health problems are not effectively treated, they can impair self-care and adherence to medical and mental health treatments, and are associated with increased morbidity and mortality, increased health care costs, and decreased productivity.

42. Goals Effective integration includes: Workforce development and capacity building Utilization of validated and effective tools to track clinical outcomes Development of supports to consumers and families Development of policies supportive of integrated practices Development of routine and effective outcomes, monitoring and evaluation

43. We Know: That the population we serve experience: High morbidity and mortality due to multiple conditions High incidence and prevalence of obesity, diabetes, hypertension, etc. Elevated risk factors for coronary heart disease Among this population there are issues such as: inadequate physical activity, poor nutrition, smoking , side effects of psychotropic medications, etc. These health conditions are preventable through routine health promotion activities, primary care screening, monitoring, treatment and care management /coordination strategies and/or other outreach programs at home or community sites.

44. System Integration and Transformation Needed Team Usual Care Fragmented (silo) Not coordinated PC Physicians Delivery System Transformation and Practice Redesign BH Specialists Specialists Behavioral health care - mental health - substance abuse Other licensed health care providers Specialist care Primary care - Prevention - Acute Care - Chronic Care Other care Coordination Collaboration Communication Integrated Team-based Adapted from : Behavioral health and the patient center medical home, 2012

45. What are we working on: Policy changes Wellness section of website for community Educational opportunities for providers and consumers Case consultation to better manage complex cases

46. Integration of Health Care and Quality Accountabilities/ value added services Proactively work to keep individuals healthy and manage existing illness or conditions Outcomes Coordinate individuals care among an organized team of health care professionals Outcomes Performance Standards Utilize systems at the practice level to achieve higher quality of care and better outcomes Outcomes Focus on whole person care for individuals (including behavioral health)

47. Next Steps: Continue training and coaching providers to support successful integration Develop a tool to monitor quality Create a Comprehensive, Continuous, and Coordinated System of Care

48. Impact: Increased quality of life for people we serve Increased communication and ownership of transformation by providers

49. Provider Forum:MCCMH Autism ServicesNovember 14, 2013 Nicole Dwyer, MALPC Autism Administrator

50. MCCMH Autism Services Agenda • Early Intervention Service Overview • Program Statistics • Program Successes and Improvements • Autism Council • Resources / Questions