Transcript Mayview Regional Service Area Planning Process Allegheny

Mayview Regional Service Area Plan
Quality Improvement/Outcomes
(QIO) Committee
November 19, 2008
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Agenda for Today’s Meeting
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Update on the closure and resource
development
Discussion of County responses to
our feedback
Discussion of interviewing families
Wrap-up and recommendations
Mayview Update
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47 people in Mayview (as of 11/14/08)
197 people have been discharged since the
closure announcement
2 units remain open
Resource development
As Mayview has downsized, the counties have
invested funds in:
 Residential options
 Treatment services
 Supports and resources
New Residential Options
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Permanent Supportive Housing (PSH) and related
services
Comprehensive Mental Health/Enhanced Personal
Care Homes (CMHPCH and EPCH)
Long-term Structured Residences (LTSR)
Specialized Supportive Housing (aka long-term
residences)
Extended Acute Services (EAC), both hospital and
community-based
Residential Treatment Facility for Adults (RTF-A)
Other county-specific options
New Residential Options
Perm. SH
CMHPCH/
EPCH‡
LTSR†
Spec. SH/
long-term res.†
Ext. Acute
RTF-A
Other
Allegheny
Beaver
Washington
Lawrence
Greene
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* Regional resources are being developed by the suburban counties
† State operated services that all counties will have access to
‡ While not all counties are developing, counties will have access to resources
New/Expanded Community Services
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Community Treatment Teams (CTT), also known
as Assertive Community Treatment (ACT)
Enhanced Clinical Case Management (ECCM)
Expanded Case Management/Service
Coordination
Mobile Medication Teams/Mobile Mental Health
Expanded Outpatient
Expanded Psychiatric Rehabilitation
Crisis Services
New/Expanded Community Services
CTT/ACT
ECCM
Case mgmt./
Svc. Coord.
Mobile Meds,
Mobile MH
Outpatient
Allegheny
Beaver
Washington
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Greene
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Psych Rehab
Crisis Svcs
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Lawrence
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* Through a new Clubhouse program
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New/Expanded Peer Support
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Peer mentors
Warmline
Peer specialists
Recovery specialists (County staff)
New/Expanded Peer Support
Allegheny
Beaver Washington
Peer
Mentors
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Warmline
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Peer
Specialists
Recovery
Specialists
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Drop-in
Center
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Lawrence
Greene
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Process of Using Data for Evaluation
Collect data
Make changes
based on data
Analyze data:
What does it mean?
Distribute data,
talk about it
Recap: QIO Feedback for Counties
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In August, we reviewed survey data for 62
people discharged from Mayview who had
been living in the community for at least six
months
We talked about the positive comments and
experiences in the responses, and the areas
we thought people needed more assistance in
Our Priority Areas
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Social life, family connections, community
integration, activities
Work and education
Physical health, including coordination with
mental health
County Responses for Priority 1:
social life, activities, community integration
Allegheny
County staff facilitate discussion and monitor provider
activities through:
• Follow-up on individual surveys, update CART
• Completing a rating report with consumers monthly
• CSP meeting 1 month, 6 months, then annually
• Consulting with Community Care
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Beaver
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County Recovery Coordinators meet with consumers to:
Review community integration part of CSP
Discuss changes, needs
Discuss use/interest in peer mentors and peer specialists
Provide information to County staff for follow-up
Other County staff also review entire CSP for accuracy
County Responses for Priority 1 (cont.):
social life, activities, community integration
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Washington
Lawrence
Greene
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County staff will discuss with CTT and case management
the importance of community participation and the
development of natural supports
Each CTT/case manager will be responsible to revisit the
topic with the consumer and report back to county
representative monthly detailing progress and/or barriers
in this area
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The Drop-in Center is available to all people. The Drop-in
Center offers a wide variety of activities.
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The Drop in Center and AMI (social rehabilitation) are
available as social organizations
The Community Support Program, health fairs and senior
centers are also options and the County is developing a
Psychiatric Rehabilitation Program.
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Discussion of Priority Area 1
The Counties had different approaches to addressing
this area. Their strategies fall into two categories:
1. Individual monitoring of people’s CSPs, their
changing interests, and provider actions to support
people
2. Listing what is available to consumers to access
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Do these strategies meet your expectations for
addressing this priority area? What is missing?
(Discuss Committee’s responses to questions
sent prior to meeting)
County Responses for Priority 2:
Work and Education
Allegheny
County staff facilitate discussion and monitor provider
activities through:
• Follow-up on individual surveys, update CART
• Completing a rating report with consumers monthly
• CSP meeting 1 month, 6 months, then annually
• Consulting with Community Care
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Beaver
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County will make sure CTT/case management review
work and education interest/goals with individuals
CSPs will be updated as necessary
System-wide training on employment opportunities using a
Supported Employment grant
County Responses for Priority 2 (cont.):
work and education
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Washington
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Lawrence
County staff will discuss with CTT and case management
the need to provide intensified efforts to assist people in
exploring meaningful opportunities.
Immediate assistance will be offered to consumers. Each
CTT/case manager will report back to county
representative monthly detailing progress and/or barriers.
System-wide training on Supported Employment
Existing services to support interest in work and education:
• Drop-in-Center-(DIC)
• Lark Enterprises
• Lawrence County Social Services
• Career Link
• Community Mental Health Center-(CMHC)
County Responses for Priority 2 (cont.):
work and education
Greene
• Through our recovery trainings, workshops and
Community Support program we encourage individuals to
volunteer or become employed, if only on a part time
basis. We support our consumers through peer specialist
trainings and referrals to OVR.
Discussion of Priority Area 2
The Counties had different approaches to addressing
this area. Their strategies fall into three categories:
1. Individual monitoring of people’s CSPs, their
changing interests, and provider actions to support
people
2. System-wide training on Supported Employment,
other options
3. Listing what is available to consumers to access
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Do these strategies meet your expectations for
addressing this priority area? What is missing?
(Discuss Committee’s responses to questions
sent prior to meeting)
County Responses for Priority 3:
physical health, coordination with mental health
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County staff facilitate discussion and monitor provider
activities the same as with the first two priority areas
The County also will distribute “Being a Proactive Patient:
A Guide to Person-Centered Care” from the Consumer
Health Coalition
Allegheny
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Beaver
County will make sure CTT/case management are
addressing physical health/coordination with individuals
through:
• Verifying documentation on when each person last visited
their PCP, psychiatrist, dentist, eye doctor, gynecologist,
other specialists, etc.
• Verifying documentation that coordination between the
PCP and psychiatrist is occurring
• CSPs will be updated as necessary
County Responses for Priority 3 (cont.):
physical health, coordination with mental health
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Washington
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Lawrence
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County staff will discuss with CTT/case management
CTT/case management will intensify efforts to offer
assistance for the following: PCP visits, Specialist Care,
Dental and Vision Care, Nutrition Counseling and
opportunities for physician approved exercise.
CTT/case management will also provide direct linkage
between the various practitioners when necessary.
The Drop-in Center has a weight/exercise room, and also
offers free health screenings and some vaccinations.
Case management and mobile medications services
already assist in addressing this priority area.
All provider agencies are engaged in this.
Opportunities for consumer education occur during
recovery events, workshops, Community Support
Program meetings. Health Fairs and screenings are held
throughout the year.
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Greene
Discussion of Priority Area 3
The Counties had different approaches to addressing
this area. Their strategies fall into three categories:
1. Individual monitoring of people’s CSPs, their
changing interests, and provider actions to support
people
2. Listing what is available to consumers to access
3. Distributing information to consumers
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Do these strategies meet your expectations for
addressing this priority area? What is missing?
(Discuss Committee’s responses to questions
sent prior to meeting)
Quality Improvement Plan Basics
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How will we measure the impact of the
counties’ strategies?
What is a reasonable expectation for
improvement, and when?
QI Plan: Example
Activity
Improve the rate of satisfaction with employment and
education for people discharged from Mayview
Why is this
activity
important?
Employment and education can be very important in
individual’s recovery, and also help people become
more independent.
Measurements
Percent of people working, percent of people satisfied
with work opportunities, etc.
Data sources
CFST surveys
Current rate
27% working or volunteering (first round of surveys)
Goal
Increase the rate of people working from 27% to ? by
the end of 2009
Analysis of the
rates
Why are people not working?
Interventions
Based on the analysis, what interventions will counties
do to improve the rates?
Next steps for priority areas
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What recommendations do we have for the
counties on their plans?
Can we establish one most important priority
area?
Family Interviews
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According to our data, about 80% of people discharged
have some involvement with their family.
During the community support plan process (discharge
planning), people’s families are asked to complete
assessments and come to the meetings.
We don’t have a way to ask people’s family members
how things are going for them in the community.
The QIO Committee recommended that a process for
interviewing family members be developed.
Family Interviews Discussion
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How do we get in touch with family members
while respecting the privacy of people
discharged?
Who should do the interviews?
What questions should we ask family
members?