12/19/01
Draft - for Discussion Only
Community Mental Health Affiliation of
Mid-Michigan
Application for Participation
1.1.1.1.provide
a plan for ongoing involvement of primary consumers, family members, and
advocates in the implementation of the resulting contract
Approach of Affiliation:
The Affiliation employs a number of methods to insure the involvement of primary
consumers, family members, advocates, contractual providers, and other
community stakeholders in the development and approval of the Affiliation’s AFP and in the on-going
implementation of the work carried out under the contract with DCH. This plan consists of the following
components, each implemented in ways locally tailored to the needs and
traditions of each Affiliate community:
a. Consumer
and family member representatives on the Affiliation’s Core Group – the
group, made up of representatives from each of the Affiliates, which meets
regularly to develop the Affiliation and the AFP and to plan the day-to-day operations of the
Affiliation. This group, by its very nature, will continue to meet, after the
AFP submission, to oversee the on-going work of the Affiliation in fulfilling
the contract with DCH.
b. Stakeholder
AFP Review Groups, in each of the four Affiliate communities
will meet, on a regular basis, to
review, discuss, and modify, the
Affiliation’s AFP, its development and implementation. These groups will have a
number of members who are also the consumer and family member representatives
on the Affiliation’s Core Group.
c. All
four Affiliates have Boards of Directors, of which 1/3 are primary consumers
or their family members. These 16
people, 8 of whom are primary consumers, are a powerful force on
these Boards, which make the
final decisions relative to the formation of the Affiliation, its direction
relative to the development and
implementation of the AFP.
d. The
review of the AFP, its development and implementation, by longstanding advisory councils in each affiliate
community. These councils are made up of consumers, family members, advocates,
and other community stakeholders
d. The mailing
of the draft AFP, to a broad range of stakeholders, and the solicitation of
their comments by mail or e-mail.
f. The
placement of the initial draft of the
AFP and all subsequent drafts on the Affiliation’s web site with an
e-mail address dedicated to receiving stakeholder responses to each draft.
Evidence:
Stakeholder involvement grid, list of consumers and other stakeholders involved
in this effort, dates of AFP Review Group meetings, copies of written and
listserve discussions and comments.
Approach
by Affiliate:
Gratiot: Gratiot Co. CMHSP has had two primary
consumers participating g in the series of telephone conferences with HCFA
relative to the AFP development; has had consumer involvement at Core Group
meetings; and on a continuous basis has had information sharing and
feedback/input fro the Client Advisory Panel, Board, and Community groups
relative to the AFP process.
Ionia:
|
Four Primary consumers have attended one
meeting and two others have
volunteered to participate in
reviewing and advising on the AFP.
Two other consumers, one of whom is a Board Member, have attended
several Core group meetings. Per
Diems are being paid. |
List of names, meeting dates and minutes. Comments will be documented and discussed. |
|
Through QI Director an initiative to recruit
consumers to serve on numerous committees is underway. Advocacy community is sparse in Ionia Co. An ARC was attempted by CMH but did not
maintain a core group. |
Letters to consumers, bulletins to staff,
public postings in building, “will also develop recruitment as part of ongoing
marketing plan”. |
Newaygo: Newaygo
Mental Health will draw input and provide summary reports to consumers and
family members, and advocates through existing committees, and groups, such as
The Respite Advisory Committee, The Empowerment Group, the Board of Directors
(of which there are at least 6 primary or secondary consumers), as well as the
newly developed Consumer Advisory Group.
This latter group will be comprised of consumers and family members
representing severely mentally ill persons, persons living in independent and
dependent living arrangements.
Consumers will be asked to participate in review of the draft AFP
response.
The above mentioned
groups of consumers, family members, and advocates will given updates to the
AFP process. There will be
opportunities for consumers to give input, as well as receive progress reports
on agency performance such as satisfaction data, MBPIS indicators, etc. Additionally, per QISMC guidelines, consumer
input will be sought regarding projects to be improved in the delivery of
services, and other areas where improvement is needed.
CEI: CEI used a number of methods to ensure that
primary consumers, family members, advocates, and other community stakeholders,
were involved in the development and approval of the AFP and the on-going
implementation of the PHP and affiliation’s contract. These methods include:
1. A set
of community stakeholder meetings to discuss the AFP and the Affiliation
2. Development
of an Stakeholder AFP Review process:
a. a series of regular face-to-face discussion
sessions, by a Stakeholder AFP Review Group, focusing specifically on the AFP,
its development and implementation, This Stakeholder Review Group discussed the
AFP, several times prior to and during the AFP development. This group will
continue to meet, after the submission of the AFP, to provide guidance to CEI
and the affiliation in its fulfillment of the contract.
b. the
regular review of the AFP, its development and implementation by CEI’s
longstanding four Advisory Councils. These Councils are made up of consumers,
family members, advocates, and other community stakeholders
c. a
mailing group which receives AFP-related documents via the mail and responds
via written comments
d. an
internet-based listserve group which receives AFP-related documents via the
listserve and responds via the listserve.
These
consumer and stakeholder involvement initiatives are but one component of CEI’s
broader stakeholder involvement system.
Evidence:
Stakeholder involvement grid, list of consumers and other stakeholders involved
in this effort, dates of AFP Review Group meetings, copies of written and
listserve discussions and comments.
1.1.2.
be legally established and operating as a
Community Mental Health Services Program (CMHSP), in one of the forms described
in statute (Act 258 of the Public Acts of 1974 as amended)
Approach
of Affiliation: Each member of the Affiliation is duly established and operated
as a CMHSP consistent with P.A. 258.
Evidence:
Compliance with Mental Health Code
Approach
by Affiliate:
a. Gratiot: Gratiot Co.
CMHSP became a Community Mental Health Authority on September 23, 1997,
consistent with the provisions of Section 330.1205 of Michigan’s Mental Health
Code.
b. Ionia:
|
Ionia was the first CMHSP Authority in Michigan. Established in 1996 |
Documentation on Authority Status per Mental
Health Code requirements 204 & 205 |
c. Newaygo: Newaygo County
CMH operates as a community mental health authority as noted in Act 258,
Section 330.1205.
d.CEI: CEI is an
organization CMHSP as described in Act 258.
Evidence includes:
Tri-county agreement, DCH certification.
1.1.3 comply with the Mental Health Code, Section 222(1)
requirements on Board membership composition and a broad and diverse
representation of the community
Approach
of Affiliation: Each
member of the Affiliation meets the requirements of Section 222(1) of the
Mental Health Code, with their Boards of Directors consisting of primary
consumers, family members, and community members who represent the broad cross
section of the persons who make up the communities served by these CMHs.
Evidence: Chart outlining
affiliation/identity of each Board member. Affidavits, signed by each Board
member, indicating which constituency group each represents.
1.1.4. be certified per the Mental Health Code requirements
Approach
of Affiliation: All members of the Affiliation are certified, as per Section
330.1232a of the Mental Health Code.
Evidence :
DCH certification letter and records of certification on file at DCH.
Approach
of affiliation:
All of the members of the Affiliation
have certified rights systems.
Approach
by Affiliate:
Status
for CMH-CEI:
A.
CMH-CEI has a certified recipient rights system
B.
Evidence includes DCH-ORR review of December
10-13, 2001. CMH-CEI was found to be in
substantial compliance.
Status
for Gratiot CMH
A. Gratiot CMH has a certified recipient
rights system.
B Evidence
includes DCH-ORR review dated October 24-26, 2000. Gratiot CMH
was found to be in substantial compliance.
Status
for Ionia CMH
A. Ionia CMH has a certified recipient
rights system.
B. Evidence
includes DCH-ORR review dated April 27-29, 2001. Ionia CMH
was found to be in substantial compliance.
Status
for Newaygo CMH
A. Newaygo CMH has a certified
recipient rights program.
B.
Evidence includes DCH-ORR review dated September 26-28, 2000. Newaygo CMH
was found to be in substantial compliance
1.1.6 meet
the minimum covered lives criterion:
1.1.6.1: Standalone applicants must have a
minimum of 20,000 covered lives
1.1.6.2: Consolidated applicants must have
a minimum of 20,000 covered lives within their combined geographic service area
Approach of Affiliation:
The Affiliation has over 50,000 covered Medicaid lives in the counties served
by its members.
Evidence :
Most recent average monthly Medicaid eligible count (MSA/DCH) and DCH
confirmation of review of survey of interest (DCH response as of 12/7/01)
1.1.6 Affiliate
members must meet applicable contiguity standards in Public Act No. 60 or
Public Acts 2001 unless otherwise stipulated by other acts of law.
Approach
of Affiliation:
The counties served by Affiliation’s members are within 45 miles of another
Affiliate’s county, as per the definition of contiguity contained in PA 60 of
2001.
Evidence: DCH confirmation of review of survey of interest
(DCH response 12/7/012)
1.1.7. Define
the vision and values of the participating organizations that:
Approach
of Affiliation: The Affiliation’s
vision and values are central to its formation and day-to-day operation. The
Affiliation’s formation, in fact, was driven by the similarity of values, among
the Affiliation members. The Affiliation exists to ensure and promote:
Consumer choice and empowerment
Sound service and support provision
Best value in the services and supports that it provides,
to consumers, as well as administrative and PHP services. Best value is defined
as the highest quality services and supports at competitive costs.
Local community-driven,
local control and responsiveness
Outcome and data based decision making
Fiscal soundness
Proven capacity to manage risk
Sound care management capabilities
Regulatory compliance
The public good, public equity, social justice
The
Affiliation carries out this vision and adheres to these values through a
number of means:
The use of the Affiliation Agreement and
the Medicaid subcontract to guide the work of the Affiliation and the
relationship between each spoke and the hub and among the spokes. The
Affiliation agreement reflects the
Affiliation model developed by the
Affiliation members. It makes the vision real through the promotion of the existing strengths of the Affiliates
and through the identification and strengthening of weaknesses. In summary, the
strengths of the affiliates which are bolstered through the agreement and the
affiliation are:
Promoted by the use of federation-style
affiliation: strong local presence, strong local
participation and decision making,
strong consumer and community stakeholder involvement, ability to rapidly respond to local
community need and variations, alignment of interests of provider and care
manager via its integration in each Affiliate
Promoted through the strategic use of
centralization, standardization, and autonomy in the carrying out of PHP and
provider functions: The Affiliation, through the operation of
cross-Affiliate work groups, draws on the best of what each Affiliate has to
offer and the development of one of three approaches: centralization of function and responsibility; application of
affiliation-wide best practices and standards to functions carried out locally,
by each Affiliate ; or autonomous
functions, carried out locally, by each Affiliate. The decision, as to
which approach to pursue is made on the
basis of effectiveness, cost (via economies of scale or economies of autonomous
parties/small scale) , capacity for
synergy, nimbleness of action, value of uniform approach, existence of
unique local characteristics.
The Core Group, made up of representatives
of all of the Affiliate members, to guide the Affiliation.
These representatives consist of staff,
consumers, advocates, and other stakeholders. This group is advisory to the
PHP’s/hub’s Board of Directors, but, is charged with the day-to-day operations
of the Affiliation.
Evidence
: Guiding principles, Affiliation Agreement and Medicaid subcontract
(attachment to Agreement), Core Group
minutes, mission of each Affiliate
Functional
integration, among the Affiliates, is carried out via the use of
function-specific work groups. These work groups:
Identify areas of potential integration,
efficiency, or upgrading
Analyze the current practices of each
affiliate
Determine the goal of integration. The
goals can be any one or a combination of: reduced total cost/efficiency,
increased effectiveness or sophistication to meet industry or contractual
standards, improved ability of hub/PHP to ensure compliance with contractual
requirements, improved or retained local responsiveness and/or uniqueness.
Determine the best course of action to
achieve integration
Functional
integration has occurred in a number of administrative areas:
Recipient
rights:
The Recipient Rights services for three of the Affiliates (Gratiot, Ionia, and
CEI) have been integrated, at considerable savings and increased effectiveness
from the previous methods of providing these services
Consumer,
service, and encounter data: An integrated consumer and service data
aggregation, integrity-assurance, and reporting system has been developed that
will serve the needs of all four affiliates – at a savings over what such
services would cost if provided or purchased, on the market, by each Affiliate
Information
services:
An integrated IS system is being developed for all four Affiliates. The system
will initially, 2002 and 2003, integrate the IS systems of three of the
affiliates (Gratiot, Ionia, CEI) and
will bring Newaygo into the system in 2003 and 2004. This integrated system
achieves substantial efficiencies and substantial increases in quality and
sophistication in the IS systems of each Affiliate
Contract/Network management: Development of a uniform provider application for use by all four
affiliates. Development of increased standardization in contract/network
management by all four affiliates
Quality Improvement: Integration of QI systems across all four affiliates, via: quarterly
integration DCH mandated performance indicators, for all four affiliates, into
a single set of graphs; formation of a QI Core Group, made up of representatives
of all four affiliates, to review performance indicators; formation of
cross-affiliate work groups around QI categories.
Financial Management: Development of a uniform administrative costing method for
application across all four affiliates; joint review of proposed DCH contract.
Corporate Compliance/HIPAA: Development of a common corporate compliance/HIPAA approach, across
all four affiliates.
Evidence: Purchase of service
agreements between Affiliates, Core Group minutes, work plans of each work group,
analysis of pre-affiliation and post-affiliation functions relative to
integration goals cited above.
1.1.9. Member
boards must maintain local representation, stakeholder participation,
accessibility, participation, accountability, collaboration, and fulfillment of
public policy and public interest responsibilities
Approach of the Affiliation: These qualities are
maintained and promoted through a number of methods:
A. The
structure of the CMHAMM, in itself, works to ensure local representation and
participation, accessibility, accountability, and collaboration in that it is
an affiliation of locally-responsive CMHs tied together by functional
integration and a number of legal documents (Affiliation Agreement, Medicaid
subcontract, purchase of service agreements between Affiliates). This structure, in contrast to a merger of
the CMHs or a more centralized regional model, ensures that centralization and
standardization, across the Affiliation, are balanced with the autonomy of each
Affiliate. This autonomy is crucial for each Affiliate, within its own
community, in carrying out its locally-responsive mission. The presence of the
Affiliation is virtually transparent to consumers, families, advocates, elected
officials, community organizations, and other community stakeholders in the
local community of each CMH affiliate, in that the local CMH will still be
locally-based and locally-driven. The Affiliation provides for integration,
cost effectiveness (through the sharing or resources, economies of scale, and expertise),
and increased effectiveness and sophistication, without losing local
representation and stakeholder participation.
B. The
Core Group consists of consumers and
stakeholders from each local community.
C. Each CMH
continually communicates, and seeks guidance, about the work of itself and the
Affiliation via a number of locally-based venues: its local Board of Directors
(consisting of 1/3 consumers), local consumer advisory councils, and the
on-going, day-to-day dialogue with local consumers, collaborative partners, and stakeholders.
Gratiot: Gratiot’s
venues for local representation and stakeholder participation include: the
Gratiot CMH Board of Directors, its Client Advisory Panel, the Gratiot County
multi-purpose collaborative body, a wide range of community education
activities.
Newaygo: The Newaygo
Mental Health Board is comprised of at least 6 primary or secondary
consumers. The Program Committee is
held on the same day as Board meetings, resulting in extremely good attendance
over the 3 ½ to 4 hour monthly meeting.
This presents an opportunity to present to the Board information on
current developments regarding DCH, education on new federal compliance
legislation, QISMC guidelines and project nominations, QAPI, etc. Consumer involvement, and consumer
participation is addressed and integrated in frequent discussions. The Program Committee features one or more
programs, and frequently discussion generates suggestions, improvements, and
recommendations regarding access to services, penetration of services, reaching
to minorities, collaboration with schools, courts, etc.
Additionally, Board members are encouraged
to participate in the State Board’s Association sponsored conference and
trainings three times each year.
Routinely, at least half of the board members attend, and Board members
are challenged to tell about what they have learned at the sessions they have
attended.
Ionia:
|
All 12 Board Members are Ionia County
Residents. Board has committee
structure to assure maximum participation. Increasing Consumer
participation. Partner in a very
strong local MPCB initiative. |
Rosters and
minutes from Board Mtgs., and
Consumer Advisory meetings. |
CEI: CEI’s board is
representative of the community served by CEI and meets the requirements of the
Mental Health Code. CEI ensures local
representation and participation via involvement in dozens of community
collaboratives and dialogues in the tri-county area, including: multi-purpose
collaborative bodies, homeless resolution networks, hospital advisory boards,
neighborhood center boards, disaster response collaboratives, juvenile justice
committees, and supported employment bodies.
Evidence
includes:
List of members of each of the local governance and guidance-providing bodies,
meeting minutes, reports of accrediting bodies, list of community
collaboratives of which each CMH is an active member.
1.1.10. Affiliations
formed under the Intergovernmental Contracts Between Municipal Corporations Act
or Intergovernmental Transfer of Functions and Responsibilities Act that submit
a consolidated application must identify or designate a single CMHSP within the
affiliation to act as the applicant
CEI will act as the applicant for the
Affiliation, under the ICA or ITFRA.
1.1.11. Describe
how it will execute administrative obligations of a specialty PHP
While CEI is the specialty PHP in the
Affiliation, contracting, on behalf of the Affiliation’s members, directly with
the Michigan Department of Community Health (DCH) for the provision and
management of Medicaid specialty
services, each member of the Affiliation will carry out the administrative
functions of the PHP, via contract with and under the supervision of CEI, the
PHP. These functions are described in both the Affiliation Agreement and the
Medicaid Subcontract (an attachment to the Affiliation Agreement) as is the
method by which CEI will monitor the fulfillment of these functions.
1.1.12. Describe
other roles (e.g. service provider) that it intends to fulfill in the managed
care program and how any apparent conflict of interest would be resolved
All of the members of the Affiliation will
fulfill both care manager and service provider roles in the fulfillment of the
contract with DCH. The care management model being used by this Affiliation is
akin to a provider sponsored plans/organizations, in that the four CMH
affiliates will:
·
Be responsible for managing a population-based
rate (the population being the Medicaid eligibles within the community served
by each Affiliate)
·
Employ a range of risk management methods in
managing the benefit to the Medicaid recipients in their community
·
Make decisions as to whether to directly provide
or purchase services, for the Medicaid eligibles within its community, based
upon consumer choice, quality, and cost considerations.
·
Be able to capture and reinvest savings created
by sound clinical, fiscal and risk management approaches
This model is a hybrid
of the best of provider-sponsored plans, staff model HMOs/PHPs, and network
model HMOs/PHPs and applies a growing body of research, by the Robert Wood
Johnson Foundation and others, regarding the use of tight-knit provider systems
to ensure the highest total quality care at the lowest total cost for persons
suffering from chronic health conditions, such as serious mental illness and
developmental disabilities. [1]
This model avoids the principal
(payer/caremanager) – agent (provider) conflict found in traditional
fee-for-service (FFS) or case rate managed care arrangements. This conflict is
avoided in aligning the incentives of the provider with those of the care
manager. Far fewer resources and
dollars are lost in this integrated approach than in the traditional FFS or
case-rate system in which administrative and transaction costs skyrocket as a
result of: fragmented, missing, duplicative, or conflicting care risk shifting
between providers; authorization dispute and adjudication costs; and claim
dispute and resolution efforts.
While this model does avoid the traditional
conflict between the principal (payer/care manager) and the agent (provider),
it has the same potential conflict between the interests of these two parties
and the interests of the consumer. This conflict is addressed, in the
Affiliation’s model through the use of the following mechanisms:
1. Concurrent and retrospective utilization
review and quality assurance in the initial access stage: The on-going review
of initial triage and access contacts with each Affiliate’s Access Center to
ensure against the denial of access to assessment appointments.
2. Broad provider panel: The assurance that a
provider panel of sufficient size is maintained to ensure adequate choice, by
consumers, of their providers.
3. Safeguards against bias during the
person-centered planning process: The on-going review of the person-centered
planning process, via document review and direct observation, to ensure against
“steering” of the consumer toward select providers in the Affiliation’s
provider network. The availability of outside facilitators (those who are not
on the staff of the Affiliate CMH) to facilitate the person-centered planning
process works to ensure against bias in the planning and provider selection
steps of the process.
4. Concurrent utilization review of care
provision: The continual review of the
type of care provided to a consumer and its convergence with the consumer’s
person-centered plan and the community’s standard of care.
5. Strong and user-friendly grievance and appeal
processes: The widespread dissemination of information, to consumers and their
families, relative to the grievance and appeal rights of consumers; and the
process used to access those rights.
1. Sections 1.1.13 thru 1.1.16 CMHSPs planning to subcontract or outsource
any P.H.P. administrative responsibilities (e.g., authorizations, claims payment)
must have a description of:
This section is not applicable to the CMHAMM
members. All CMHSPs in the affiliation
will continue to perform their own administrative functions.
CMHSPs planning to be a provider of direct services must
have:
1.1.17. an organizational configuration or structural
arrangement that:
1.1.17.1. preserves
the integrity of beneficiary interests and public policy objectives in the
event these conflict with provider interests of the agency
The integrity of beneficiary interests and public
policy objectives (consumer choice, etc.) is ensured through a number of
methods, including:
1. Concurrent and retrospective utilization
review and quality assurance in the initial access stage: The on-going review
of initial triage and access contacts with each Affiliate’s Access Center to
ensure against the denial of access to assessment appointments.
2. Broad provider panel: The assurance that a
provider panel of sufficient size is maintained to ensure adequate choice, by
consumers, of their providers.
3. Safeguards against bias during the
person-centered planning process: The on-going review of the person-centered
planning process, via document review and direct observation, to ensure against
“steering” of the consumer toward select providers in the Affiliation’s
provider network. The availability of outside facilitators (those who are not
on the staff of the Affiliate CMH) to facilitate the person-centered planning
process works to ensure against bias in the planning and provider selection steps
of the process.
4. Concurrent utilization review of care
provision: The continual review of the
type of care provided to a consumer and its convergence with the consumer’s
person-centered plan and the community’s standard of care.
5. Strong and user-friendly grievance and appeal
processes: The widespread dissemination of information, to consumers and their
families, relative to the grievance and appeal rights of consumers; and the
process used to access those rights.
1.1.17.2. requires
separate reporting responsibilities and lines of authority for PHP functions
and provider activities
The lines of authority for the PHP functions, of
each Affiliate, are segregated from those of the provider activities of each
Affiliate in the following ways:
|
|
Line of authority for PHP functions flow
through |
Line of authority for provider functions flow
through |
|
Gratiot |
|
|
|
Ionia |
|
|
|
Newaygo |
|
|
|
CEI |
The
PHP functions (utilization
management, access center, inpatient pre-admission screening unit, customer
services, grievance/appeal system, recipient rights, quality improvement, ISF
management) report through the Deputy Executive Director or Access Supervisor
or Customer Quality Improvement/ Recipient Rights Director , whom report to
the executive director. |
Each
of four program directors; coordinated by the Program and Clinical Services
Committee (PCS), which is chaired by the Medical Director and made up of two
clinical leaders from each Program (one of whom is the program’s director,
and the Nursing Administrator. This group reports to the executive director. |
1.1.17.3. requires
special independent oversight structures (consumer, family, advocate
organizations representation).
The Affiliation has a number of independent
oversight structures, to further assure that payer/caremanager, provider, and
consumer interests are integrated into an organized system of care that
promotes consumer choice, independence, and inclusion; fiscal, clinical, and
community system stability; and strong clinical practice. These structures include:
a.
All four Affiliates have Boards of Directors, of which 1/3 are primary
consumers or their family members.
These 16 people, 8 of whom are primary consumers, are a powerful force on
these Boards, which make the
final decisions relative to the formation of the Affiliation, its direction
relative to the development and
implementation of the AFP.
b.
All four Affiliates have strong consumer and advocate participation on
their Recipient Rights Committees and Appeals Committees.
c. Consumer and family member representatives on
the Affiliation’s Core Group – the group, made up of representatives
from each of the Affiliates, which meets regularly to plan the day-to-day
operations of the Affiliation. This group, by its very nature, will continue to
meet, after the AFP submission, to oversee the on-going work of the Affiliation
in fulfilling the contract with DCH.
d. All
four Affiliates have a number of longstanding advisory councils in each affiliate community. These councils
are made up of consumers, family members, advocates, and other community
stakeholders. (Gratiot CMH is supporting the re-establishment of an Arc Chapter
in Gratiot County)
A number of advisory boards exist throughout the
Affiliation. Examples of such
boards/councils are provided below:
Gratiot: A Gratiot County CMH Client Advisory Panel
currently meets on a monthly basis.
Responsibilities of the panel include consumer satisfaction survey
review, review of performance indicator data, consumer orientation to services,
consumer recognition, suggestions for program development, affiliation updates,
and other issues related to agency service delivery and policy development.
Secondary and primary consumers serve as
members of the Recipient Rights Advisory Committee and Human Rights
Committee. Consumers have the
opportunity to provide input into policy development related to service
delivery.
Evidence of Compliance: Meeting minutes are available for the Client
Advisory Panel, the Recipient Rights Advisory Committee and the Human Rights
Committee.
Ionia:
|
Ionia has a Customer Relations Committee and
has a new consumer committee to provide input on the AFP. |
CRC Roster and minutes, AFP Roster, minutes and
input |
Newaygo: Existing
advisory committee - Respite Advisory Committee
CEI: CEI
has four advisory councils, made up of
consumers, family members, and advocacy organizations. These advisory councils
are associated with the four major
populations served by CMH and its four major service\support programs:
Community Support Service Advisory Council (services to adults with mental
illness), Community Services to the Developmentally Disabled Advisory Council
(services to persons with developmental disabilities), Children’s Services
Advisory Council (services to children and adolescents with emotional disturbances), Substance
Abuse Advisory Council (services to persons with substance abuse disorders).
Evidence: Roster and minutes of
Advisory Councils.
Gratiot: Gratiot County CMH has not held a
community meeting to date for fiscal year 2001/2002. A community meeting is planned to educate and inform stakeholders
and the community about the AFP bid process and ongoing affiliation activities
and benefits. This meeting will be scheduled as agreed upon by the CMHAMM core
group.
Ionia: Not yet done.
d. Newaygo:
Newaygo CMHSP participates on many community committees and community benefit
activities at which input is elicited from participants including stakeholders
and community members.
e. CEI
holds several community meetings on a regular basis to obtain community input on
the work of CMH. These include an annual stakeholder briefing (usually
held in the summer of each year) on the
upcoming year’s budget and other large-scale developments; an annual
report to the community, in which the past year’s events and accomplishments
are reviewed with community stakeholders (in February of each year).
Gratiot: The local newspaper is contacted
when an event is determined to be of benefit and/or interest to stakeholders
and community members. In addition, the
agency submits a “Mental Health Corner” article bi-monthly. These articles have been authored by
consumers, staff, advocacy organizations and community members.
Gratiot County
CMH utilizes the public access television to advertise and announce upcoming
events and other information. The
public access station has also aired, on occasion, our agency video.
Evidence of Compliance: Copies of news articles, agency video,
agency scrapbook.
Ionia:
|
Just beginning to use local press and
radio. Limited opportunity. Other organization newsletters regularly
utilized. |
Catalogue of newspaper articles and
newsletters. |
Newaygo:
NCMHSP submits articles to the local press
at least on a monthly basis. To date
all articles are printed as written.
CEI: CEI works closely with the print and
electronic media in the greater Lansing
area. This has resulted in
well-informed coverage of a wide range of CMH-related issues and events.
Gratiot
Ionia:
|
One consumer on CMHSP Board has publicly
disclosed. We have 5 Board Members
who claim to be or have been a primary consumer. |
Survey of CMHSP Board Members. |
Newaygo
CEI: Signed affidavits, collected as part
of CMH’s certification process, indicate, by self-disclosure the consumer
status of board members.
a. Gratiot:
Consumers have the opportunity to provide input and are involved in policy
formulation and implementation through participation on the MDCH Consumer and
Advocate Group, Client Advisory Panel, Affiliation Core Group meetings, local
ARC, Board of Directors meetings, quality improvement projects, and the
Recipient Rights Advisory Committee.
Consumers
participated in a joint informational meeting of the affiliation board and core
group to discuss affiliation activities and progress.
Internal
and external service providers, and consumers have a role in the quality
improvement process (e.g., focus groups to determine QISMC project). Results of quality improvement activities
are shared with appropriate staff, contract providers, and other stakeholders
as warranted.
Any individual is
welcome to address the Gratiot County CMH Board of Directors at their regular
monthly meeting during the public comment portion of the agenda.
Evidence of Compliance: Community Needs Survey, Client Advisory
Panel, AFP review, meeting minutes. Minutes from Affiliation, Board of
Directors focus group meetings and TQM activities
b.Ionia
c.Newaygo:
Other opportunities to secure feedback have
come in the development of a local group, Empowerment Inc. This group consists of persons with mental
illnesses and developmental disabilities living independently or in AFC. They have met with management to give feedback,
asked to participate in the AFP process and have offered to assist in the
future.
The Board of Directors appointed board
members to begin the process of developing a consumer advocacy sub committee to
the board. Several of those board
members have disclosed in open session of the board their use of services as
primary or secondary users. The group will begin recruiting consumer
representatives (equal to or more than the number of board members) to work
with and on this committee as it develops its mission, vision and scope. This
committee will be ethnically and ability/disability diverse representing the
community they will serve.
Annually NCMHSP has published an annual
report and numerous news articles regarding consumers of services including names,
services, and pictures.
CEI: CEI publishes an
annual report, outlining the past year’s accomplishments and challenges.
CMH actively participates in a number
of community education efforts, including the installation and staffing of
educational booths at health and community fairs and events, providing speakers
at community events.
The participants in all of the stakeholder and
community input venues and methods, described above, represent the scope and
diversity of the communities served by the Affiliation, by gender, income, racial and ethnic group,
age, disability, family status, sexual orientation, and geography.
Evidence: Breakdown, by these
characteristics, of the participants in these venues.
1.2.3.1. and
any arrangements for ongoing dialogue, meetings, consultation with these
individuals and entities
Status for each Affiliation member:
Gratiot: Letters of agreement with local schools,
local law enforcement agencies and the judicial system, human service agencies
and QHPs.
As part of our continued commitment to the
community staff representatives actively participate in a variety of human
service organizations and initiatives.
A designated
agency representative meets regularly with local law enforcement agencies to
educate and inform these entities about mental health issues and to discuss
coordination of services for shared consumers.
Several agency employees participate
monthly on the Gratiot County Multi-Collaborative Council. The Gratiot County CMH Prevention
Coordinator is responsible for the organization of this committee.
Evidence of Compliance: A list of community partnerships and
commitments our staff are involved in is available.
B. Ionia:
Alzheimer’s Association has a presence.
C. Newaygo:
Key
individuals and advocates in Newaygo County to whom the mental health authority
has active dialogue and meetings are:
·
Maria Kiss, president, Newaygo County Autism
Society
·
Arc/Newaygo County
·
Homeless advisory forum
·
Agency consumer advisory group
·
School transition advisory group
·
Drug-free schools committee
·
Newaygo Health Care Council
·
Senior Council of Newaygo
These organization
have agency liaisons who report on board recommendations/concerns/comments
regarding agency services, which are then incorporated into the overall agency
QI system.
A.
ARC of Newaygo County remains the sole advocacy
organization in Newaygo County.
B.
The NCMHSP Board of Directors appointed a
consumer advocacy committee in the December 2001 meeting. Three board members have been assigned with
one staff person to begin the process of consumer and family recruitment in
January 2002. The full committee’s
first task will be the development of mission, vision and scope.
C.
This committee is expected to make reports and
suggestions to the board and the agency ( QI, management team, service units,
etc.).
D.
CEI: CEI has on-going relationships with the
following advocates and advocacy groups:
Alliance for the
Mentally Ill (AMI)-Lansing: Member of
CMH’s CSS Advisory Council
Tri-County Community
Advocates (local Arc affiliate): Member of CMH’s CSDD Advisory Council and
Stakeholders AFP Review Group
Justice in Mental
Health Organization (JIMHO): Member of CMH’s CSS Advisory Council,
Stakeholders AFP Review Group; contract provider of a wide range of consumer
operated services.
Association for
Children’s Mental Health: Member of CMH’s Children’s Services Advisory Council
and Stakeholders AFP Review Group.
Project VOX : Member of
CMH’s Substance Abuse Advisory Council
United Cerebral Palsy,
Michigan Protection and Advocacy, Michigan Association of Emotionally Impaired
Children: Invitees to annual stakeholder briefing and annual report to the
community, recipients of monthly CMH Executive Directors Report and Board
packet,
|
Citation
#: 1.2.4. 1.2.4.1. 1.2.4.2. |
Assess
how the CMHSP, and each affiliate member have: Integrated
person-centered planning into all organizational practices. Supported
its implementation. |
|
Affiliation Agreement Status: |
Ionia
CMH Status: |
|
There
currently is no formal agreement between the affiliation partners related to
integrated PCP practices. It
is recommended that an agreement be established between the affiliation
partners that integrates PCP into all organizational practices and ensures
its implementation. |
Ionia has multiple clinical policies and
procedures that are reflective of principles of PCP Ionia has a full time Person Centered Planning
Coordinator who monitors PCP compliance based on DCH and JCAHO standards. The Person Centered Planning Conference is well
attended by both staff and consumers Support Coordination caseloads have been
reduced Paraprofessionals have been added to the
Support Coordination Team to increase their ability to meet the needs of the
consumers Agency values incorporate PCP principles: Community Inclusion, Best Practice, Family
and Children, Quality, Accountability, and Partnerships Evidence
of Compliance: documentation, individual case records,
agency values, policies, procedures, organizational structure, training
records, PCP reviews |
|
|
Gratiot
CMH Status:
|
|
|
The agency’s
Person-Centered Planning Policy drives service delivery. Person-centered planning training is
mandatory for all staff at the time of orientation. Annually the agency provides additional training in PCP to
enhance skill development of the staff.
Information from PCP training attended outside of the agency is shared
by clinical and administrative staff.
The required elements of person-centered planning are monitored
through a chart review process and reported on through the TQM system. Informational brochures are distributed to
consumers at the time of intake.
Training is slated for consumers in what person-centered planning
means to them. Implementation. Clinical supervisors are responsible for reviewing all
PCPs. Staff receive ongoing training
in PCP principles and facilitation.
Monthly monitoring of consumer charts is conducted to assure
compliance with PCP requirements. PCP
is also targeted as a goal in the strategic plan. The seven questions cited
as an example in this standard are addressed by the Supports Coordinator and
others involved in the individual’s PCP meeting Evidence
of Compliance:
PCP documents, chart monitoring, training records, Strategic Plan
goal, policy document, brochures, data through the TQM system, MDCH site
review |
|
|
Newaygo
CMH Status: |
|
|
Newaygo has adopted into policy the DCH PCP
Guidelines. The following policies are in place at Newaygo
regarding PCP and its implementation: All person-centered planning documents are
reviewed by the team leaders of the clinical units for completion and
compliance with PCP standards. Evidence
of Compliance: Person-Centered Planning Guidelines
09.06.00.00 Person-Centered Planning Guidelines Implementation
Review 09.06.00.01 Person-Centered Planning Meeting Summary
0906.01.00 |
|
|
CEI
CMH |Status: |
|
|
CEI has modeled its PCP policies after the DCH
policy guideline and fully implemented this policy. All staff are trained in the basics of PCP at
time of hire. Other trainings are
offered to staff throughout the year.
PCP brown-bag lunches are held quarterly. The PCP training committee plans and evaluates
the needs of the organization for education and skill training. The process is monitored through a UM process
by PCP committees. Supervisors review
plans and discuss plans are part of employee performance reviews. Agency principles include person-centered
statements. Evidence of compliance: PCP policies and
documents, chart monitoring, training curriculum and records, Strategic Plan,
data through the UM system, MDCH site review and JCAHO review. |
1.2.5
There must be a policy basis that insures consistency across the
applicant’s area in the provision of supports coordination and case management
options for consumers.
Approach of Affiliation:
Gratiot:
Ionia - staff are willing to
meet with other affiliate partners to develop a policy that is reflective of
consistency in the provision of supports coordination and case management options
for consumers across the affiliation.
The concept of
"provider of choice options" are reflective in various Ionia
policies, including but not limited to the policy related to person-centered
planning.
The Board of Directors
program committee reviewed and recommended the adoption of the draft
"provider of choice" policy to the full Board of Directors on
December 10, 2001.
Newaygo
CEI
- insures consistency in the provision of supports coordination and case
management options for consumers with mental illness and developmental
disabilities through the use of the following:
1) use of program descriptions and
assessment of consumer’s needs at CEI Access Point,
2) use of program decriptions and
assessment of consumer’s needs and
desires at initial assessment and person centered planning process, as these
needs or desires change, and at least annually thereafter,
3) education of consumers and their
advocates regarding available supports and case management options during
Person Centered Planning.
4)
review of supports coordination and case management needs for consumers with
mental illness through the Service Review Committee and for consumers with
developmental disabilities through the Person Centered Planning Committee
Evidence includes:
1) CEI -Access Level of Care Assessment
Instrument, CSS Level of Care Assessment Instrument, CSS Program Descriptions,
CSDD Program Descriptions, CSDD PCP Committee and CSS Service Review Committee
descriptions
2) Ionia - Draft policy, "Provider of
Choice" Program committee meeting minutes from December 10, 2001.
|
Citation
#: 1.2.6.1 |
Prepare an analysis of changes in
service delivery system patterns over the past three years (October
1998-September 2001) across populations (MI, DD, SA, co-occurring, ages,
cultural backgrounds): Increased use
of flexible options |
|
Affiliation Agreement Status: |
Ionia CMH Status: |
|
The affiliation has
no formal agreements relative to the increased use of flexible service
delivery options. |
Ionia CMH prides itself in being able to be responsive and
flexible with our consumers. Supports
and services are determined through a person-centered planning process, which
often lends itself to the use of increased creative options. Since September
1998, Ionia CMH has terminated all contracts with traditional day treatment
providers, offering instead a more personalized support-oriented,
community-based option for those in need of additional supports in the
community. Ionia CMH has
assisted several people with developmental disabilities in moving from an
institutional based setting (Mount Pleasant Center) into the community. These individuals now live in homes they
rent with one or two other individuals, with staffing support. Currently, Ionia CMH
supports twenty individuals with developmental disabilities living in their
own home, with varying levels of supports. Ionia CMH employs
paraprofessionals to provide additional support to individuals diagnosed with
a severe and persistent mental illness, as well as those individuals with
developmental disabilities, who have a case manager or support coordinator,
to promote greater community involvement and achievements. This flexibility has also allowed us to be
more responsive to consumers in a timely manner. In an attempt to
promote people staying in their community verses being psychiatrically
hospitalized, Ionia CMH has utilized a significant number of safe
alternatives, such as staffing support, motels, car repair, etc. Ionia CMH was
awarded funding to support an Elderly Outreach worker to promote greater
penetration in this population. This
position is designed to not only promote services, but to provide flexible
mental health related services to the elderly in the community. This funding was applied for and granted
during the timeframe noted; however implementation began after October 1,
2001. Evidence:
Board Meeting
minutes, Community Support Services Team statistics; Individual case records;
Listening Ear Contract(s); Pre-admission screening documentation; Elderly
Outreach contract |
|
|
Gratiot CMH Status: |
|
|
A significant increase in the
number of individuals with Developmental Disabilities residing in
semi-independent and independent settings has occurred during the cited
period. Individuals that previously
received day activity services in a segregated day program now access their
community through the support of community living staff. Environmental modifications have been made
to several homes of children residing with their families. Housing assistance dollars are available
for consumers meeting eligibility for this benefit. The agency has provided consumer and community education as
well as family skills development training.
Departmental reorganization in DD Services has resulted in expansion
and growth in family support and respite care services. Evidence of Compliance: List of Consumer and
Community Education activities, MDCH Performance Indicators, Consumer
Records, and Financial Records. |
|
|
Newaygo CMH Status: |
|
|
Newaygo CMHSP has diverted clinical staff to
the development of new and flexible services to meet the changing needs of
the populations served. Evidence of Compliance: Supported Employment
09.14.10.00 including coordination with MRS, ISD and other community work
organizations. Momentum 09.46.00.00 a
community integration and linkage program.
Integrated Health Care 09.47.00.00 providing services directly through
the primary physicians office. |
|
|
CEI CMH Status: |
|
|
CEI has continued to provide a range of living
options for its consumers including a homeless outreach program, supported
independence, group homes, home purchasing and residential treatment program
in substance abuse. Children’s services provide a range
of options for families including home based services, wrap-around and early
intervention and consultation services. Day programs continue to reduce the
use of segregated facilities and increase community options using the club
house model and community drop-in centers.
DD programs make use of over 120 sites for community inclusion
activities. All of these are supported by the
use of person-centered planning, consumer focus groups and consumer
satisfaction surveys. Evidence of Compliance: Review
of program descriptions, consumer
surveys and focus group reports.
Community inclusion site lists.
DCH reviews. |
|
Citation
#: 1.2.6.2 |
Prepare an analysis of changes in
service delivery system patterns over the last three years (October
1998-September 2001) across populations (MI, DD, SA, Co-occurring, ages,
cultural backgrounds): more
consumer-operated services |
|
Affiliation Agreement Status: |
Ionia CMH Status: |
|
Currently,
the affiliation has no formalized agreements relative to the provision of
more consumer-operated services. |
Prior
to October 1998, Ionia CMH did not have any formalized consumer-operated
services. In the Fall of 2000, Ionia
CMH began the process of establishing a consumer run drop-in center. The River’s Edge Drop-In Center officially
opened in February of 2001. The
River’s Edge Drop-in Center embraces all populations. The
Board of Directors of the River’s Edge continues to receive ongoing training
from various sources (Ionia CMH, JIMHO, etc.) and continues to grow and
develop. The River’s Edge is
incorporated, but still seeking their non-profit status. The Board of the
River’s Edge vacillates between feeling they are ready, trained and organized
enough to be given the responsibilities of a contractual relationship with
CMH and needing continued CMH support.
Ionia CMH has committed .5 FTEs of CMH staffing support to assist the
River’s Edge further growth and development.
Ionia
CMH committed a portion of their reinvestment monies for FY 00/01 to the
support of the River’s Edge Drop-in Center. Evidence: Organizational
Chart; Building lease contract; Independent provider contracts; Board Meeting
minutes, Contract with MDCH, Reinvestment Funding approval for FY 00/01. |
|
|
Gratiot CMH Status: |
|
|
One consumer with developmental
disabilities owns and operates a beverage service micro-enterprise. Several other consumers with developmental
disabilities are in the preliminary stages of developing their
micro-enterprises. A Jobs Club for DD
consumers has been organized to assist consumers in the development of a micro-enterprise. Evidence of Compliance: Service descriptions,
Jobs Club minutes |
|
|
Newaygo CMH Status: |
|
|
|
|
|
CEI CMH Status: |
|
|
The Justice in Mental Health Organization
(JIMHO) operates a number of support and training services in the 3 counties. JIMHO has also expanded into other areas
of the state. Several parent groups
have developed housing options for their children; including Rainbow homes,
House of Ruth and Chosen Vision. The
directors of these groups are parents and interested others. Evidence of Compliance: DCH and JCAHO site
visits to JIMHO. Board minutes
supporting these organizations. |
|
Citation
#: 1.2.6.3 |
Prepare
an analysis of changes in service delivery system patterns over the last
three years (October 1998-September 2001) across populations (MI, DD, SA,
co-occurring, ages, cultural backgrounds):
greater choice |
|
Affiliation Agreement Status: |
Ionia CMH Status: |
|
The
affiliation has no current formalized agreements relative to the promotion of
greater choice in service delivery |
From the point of
initial contact with Ionia CMH, consumers are asked about their preferences
related to when an appointment is scheduled; place of contact, clinician,
etc. and the principles of self-direction are promoted though out the tenure
of services received. Since September of
1998, the variety of supports and services provided by Ionia County CMH has
increased, including the River’s Edge Drop-in Center, Supported Employment,
Community Supports Staffing assistance, and Assertive Community
Treatment. All of these supports and
services, in addition to the greater flexibility provided in Medicaid Chapter
III have broadened options for consumers to choose what would best meet their
needs during the person centered planning process. Evidence:
Organizational
chart; RFS and PCP documentation; individual case files; Clinical policies,
including but not limited to Person centered planning and draft Provider of
Choice. |
|
|
Gratiot CMH Status: |
|
|
The agency provides a comprehensive
array of services to allow consumers greater choice in the services they
receive. Through the PCP process
service delivery is tailored to meet the individual’s desires and needs. Evidence of Compliance: Individual PCPs,
Service Eligibility Protocols, Informational Flyers, Agency Brochure, and
Member Handbook. |
|
|
Newaygo CMH Status: |
|
|
To meet the needs the children’s services have
been increased and diversified to access funding streams from community
organizations. The agency has designated
staff to become certified in Dialectical Behavioral Therapy to meet the
treatment needs of those persons with Borderline Personality Disorder. Finally, to reach the large geriatric
population a grant was applied for and received from DCH for a geriatric
outreach staff person to work 50% of the time out of the Commission on Aging.
Evidence of Compliance: |
|
|
CEI CMH Status: |
|
|
At Access consumers are given chose about times for initial
appointments. In Childrens’ services
families are given choice of service providers for respite care and in-home
care. Consumers can also chose to
change supports coordinators or case managers. Ranges of living and work opportunities allow people to have a
choice about where they live and work.
Choice is the basis of the PCP process. Evidence of Compliance: Consumer satisfaction
surveys, Board Minutes, DCH indicators – timeliness, agency brochures, PCP
plans. |
|
Citation
#: 1.2.6.4 |
Prepare
an analysis of changes in service delivery system patterns over the last
three years (October 1998-September 2001) across populations (MI, DD, SA,
co-occurring, ages, cultural backgrounds):
Self-determination |
|
Affiliation Agreement Status: |
Ionia CMH Status: |
|
Currently,
the affiliation has no formal agreements related to utilizing the principles
and practice of self-determination in the provision of services to consumers. It
is recommended that all affiliation partners adopt the principles of
self-determination as a means of service delivery for individuals served by the
CMHs. CEI
and Ionia have both completed the self-determination training process offered
by MDCH. |
Ionia currently has two individuals who are fully involved
in the self-determination process.
There are several others that are in various stages of the
process. It is expected that a
minimum of 10 individuals will be fully involved in the process by
9-30-01. It is difficult to discern the changes to the service
system as a result of self-determination, in isolation. The advances and progress of person
centered planning and the movement to less traditional service models are
entwined in changes made related to self-determination. It has certainly promoted a greater awareness of individual
budgets by staff and those consumers and their support system involved in
self-determination. Those involved in Self-determination currently have elected
to move away from more traditional providers of services. It appears to have promoted a greater collaboration of
efforts between programmatic and fiscal staff. Evidence of Compliance: Policy;
Self-determination team meeting minutes; organizational chart; newsletters;
training calendars; training registrations; individual case files; etc. |
|
|
Gratiot CMH Status: |
|
|
Staff has received training in
self-determination with additional training slated in the upcoming months. Evidence of Compliance: Training records |
|
|
Newaygo CMH Status: |
|
|
The agency has a commitment to
self-determination and has developed a strategic plan and concept paper. This information has been shared with the
community at large. Evidence of Compliance: Strategic plan and
concept paper. |
|
|
CEI CMH Status: |
|
|
CEI staff participated in the
self-determination replication training offered by MDCH and the Michigan
Association of CMH Boards. The team
has continued to plan for self-determination implementation. Training and orientation has been done for
staff, administrators and Board members.
Staff serving MI adults are now participating in the local team and in
state level discussions on how to implement self-determination for the people
they serve. A plan has been developed for implementation. Two consumers are actively in
self-determination planning. CEI has
also taken a position that self-determination policy guidelines and
person-centered guidelines should be merged into a single policy
position. It is too early to show the
impact on the system, but it is anticipated that more consumer choice and
control will be the end result of the full implementation of
self-determination. Evidence of Compliance: Training presentation,
Board minutes, self-determination team minutes. |
|
Citation
#: 1.2.6.5 |
Prepare an analysis of changes in
service delivery system patterns over the last three years (October 1998-September
2001) across populations (MI, DD, SA, co-occurring, ages, and cultural
backgrounds): Increase in independent
living situations |
|
Affiliation Agreement Status: |
Ionia CMH Status: |
|
Currently,
the affiliation has no formalized agreement relative to increasing
independent living situations in the provision of services. It
is recommended that the affiliation as a whole adopt philosophies and
practices that are supportive of individuals living independently, with
supports as needed. |
Ionia CMH currently supports 20 individuals with
Developmental Disabilities living in their own homes, with various levels of
supports. These numbers have remained relatively steady since October
1998. Most of the people diagnosed
with a severe and persistent mental illness are supported by casemanagement
staff to live in their own home. Ionia CMH has a
clinical policy on housing that supports each consumer living where and with
whom they chose. Ionia CMH was the
primary sponsor of a community-wide housing resource fair in August 2001. Ionia CMH has had a
“housing committee” to look at issues related to housing, in response to
interest from the 2000 PCP conference.
This committee is currently reorganizing and reprioritizing issues
related to housing. Evidence:
Statistics related
to # of individuals living in their own home; policy; housing committee
meeting minutes; newspaper articles, etc.
|
|
|
Gratiot CMH Status: |
|
|
As cited above in 1.2.6.1 a
significant increase in individuals residing independently has occurred over
the past three years. Individual community living support services are
provided to maintain consumers in the least restrictive living situation
possible. Evidence of Compliance: MDCH Performance
Indicators, Individual PCPs, Housing Minutes, Provider Contracts |
|
|
Newaygo CMH Status: |
|
|
Evidence of Compliance: Supported
Independent Living 09.48.00.00 and Supported Independent Living Discretionary
Fund 09.48.01.00. |
|
|
CEI CMH Status: |
|
|
There are 135 people with developmental
disabilities and people with
mental illness living independently.
Through the efforts of teams like the Homeless Outreach Program,
Supported Independence Team and Assertive Community Treatment people are
supported in living arrangements of their choice. CEI makes use of subsidies and low interest loan programs to
assist people to find affordable housing.
One staff person has been designated as a housing broker to assist
consumers in locating suitable housing. Evidence of Compliance: Individual plans, minutes from staff meetings of teams,
indicator reports, residential placement minutes. |
|
Citation
#: 1.2.6.6 |
Prepare
an analysis of changes in service delivery system patterns over the last
three years (October 1998-September 2001) across populations (MI, DD, SA,
co-occurring, ages, cultural backgrounds):
increase in employment opportunities |
|
Affiliation Agreement Status: |
Ionia CMH Status: |
|
Currently,
the affiliation has no formalized agreement related to increasing employment
opportunities for consumers in the service delivery system. It
is recommended that all affiliate partners review the practices in place
affiliate-wide to exam areas to promote best practices and possible
efficiencies. |
EmployAbilities was
implemented in the Fall of 1998.
EmployAbilities refers to the supported employment activities at Ionia
CMH. EmployAbilities is open to all
consumers that are in need of assistance finding employment, particularly
those people who also have casemanagement or support coordination services,
that are not able to utilize other community resources to obtain employment. Since
EmployAbilities inception, 145 people have been open to this service, with 73
of these individuals having successfully obtained at least one job. Ionia CMH does not
support the use of deviated wages, thus all employment found through
EmployAbilities is at minimum wage or higher. Evidence:
EmployAbilities data
and information, EmployAbilities brochure. |
|
|
Gratiot CMH Status: |
|
|
Gratiot
CMH contracts with a vocational service provider for job development and job
placement services. The agency has a tri-party W agreement funded by MRS, CMH
and the RESD. This agreement allows for job development, job placement, job
coaching, and job readiness training. Also, in the past 6 months the agency
has developed a job placement service to increase the number of individuals
that are competitively employed at minimum wage or higher. This service is
available to adults with mental illness and/or developmental disability, and
RESD students and has resulted in 21 individual job placements. The agency is
also a member of the RESD School-to-Work Transition Council. Evidence of Compliance: Employment Services Contract, Tri-Party
W-Agreement between MDCD-RS, GI-RESD and CMH, MDCH Performance Indicators,
Job Placement Data |
|
|
Newaygo CMH Status: |
|
|
Evidence of Compliance: |
|
|
CEI CMH Status: |
|
|
In 1998 there were XXX people with mental
illness in supported employment compared to XXX in 2001. During the same period there were XXX and XXX people with developmental
disabilities in supported employment.
It is mot practical to compare the change from 1998 to present because
consumers do not stay involved in supported employment – they move on to
simply being employed. CEI is
committed to job placement. We have a
Supported Employment Team made up of staff from MRS, CMH and Peckham
Industries. In addition, we work with
local schools to assure placements as students transition from schools. Evidence of Compliance: Indicator reports, employment data, MRS
cash match agreements, Supported employment team minutes. |
|
Citation: 1.2.7. Analyze the numbers and demographics of persons from the CMHSP
(and the affiliate members) currently in state institutions: 1.2.7.1. Compare
institutional usage over the last three years 1.2.7.2. Develop
plans for providing community-based alternatives for the populations no
longer needing institutional care |
||||||||||||||||||||||||||||||||||||||
|
Affiliation: No current formal agreements. |
||||||||||||||||||||||||||||||||||||||
Approach
|
|
|||||||||||||||||||||||||||||||||||||
|
Ionia CMH 1.2.7. Have 2 males and 1 female at Mt. Pleasant
Center. We have 3 males under
Forensic Order, 2 in the Forensic Center and 1 in Kalamazoo Regional
Hospital. 1.2.7.1. See attached grid. 1.2.7.2. Reestablished ACT in July 2001; opened a consumer-run
drop-in center in February 2001. In
1999 formed the Community Support Team staff by para-professionals to offer
an alternative to a structured traditional model day treatment. Ionia began the institutional reduction
process prior to 1998. Gratiot CMH 1.2.7. One Caucasian male consumer with developmental
disabilities has resided at the Mt. Pleasant Center during the time period
cited. At this time his prognosis for
community placement remains guarded.
(1.2.7.1.) Over the past three
years two Caucasian female consumers with mental illness have been admitted
to a state psychiatric hospital. 1.2.7.2. Newaygo CMH 1.2.7. Has no persons placed in any state
institutions. 1.2.7.1 Over the past three years there have been
sporadic short-term placements only when community alternatives have been
exhausted and consumer safety can be assured in no other way. 1.2.7.2 CEI CMH 1.2.7. There is currently one adolescent female (age
15) placed in the Hawthorne Psychiatric Center as of December 1,2001. Over
the past three years there have been a total of 5 placements into the state
institution ranging in age from 10-17.
Four of the admissions were male, one was female. Four of the admissions were from Ingham
County, and one was from Eaton County. As of December 1, 2001, there are 14 people
with developmental disabilities in Mt. Pleasant Center. Thirteen are male. Ages range between 23 and 67. All are Caucasian. Eight are from Ingham County, 4 from Eaton
County, and 2 from Clinton County. There are currently (December 11, 2001) five
mentally ill adults in state facilities. They are all male, all from Ingham
County and 4 are African American and 1 is Caucasian. They range in age from 28-58. The
type of admission and demographics for each is listed below:
1.2.7.1 Hawthorne Psychiatric Center is the state
institution that is utilized by this Board.
The placement of children into Hawthorne over the last three years has
been very infrequent. The Center
specializes in longer term care of children who present with severe
emotional/behavioral instability that is both persistent and of high risk to
themselves and/or others. Our
admissions have also been characterized by children who have severe cognitive
limitations. Over the past three
years there have been 5 placements into the Hawthorne Center. There were two
admissions in FY99, two admissions in FY 2000, and one admission in FY
2001. The discharges of these
children have been primarily to residential settings that offer 24 hour
staffing, structured milieu, and specializing in children with intellectual
limitations and behavioral disorders.
The utilization of the state institution has been consistently low for
a number of years as a result of an array of available supportive community
alternatives. The admission of people with developmental
disabilities to the Mt. Pleasant Center occurred 19 times in FY1999, 20 times
in FY2000 and 14 times in FY 2001. The three types of admissions for mentally ill
adults to state facilities include Probated admissions, Not Guilty for Reason
of Insanity (NGRI) admissions, and Incompetent to Stand Trial (IST)
admissions. CEI has no authority over
IST admissions and shares authority with the Center for Forensic Psychiatry
and state hospitals over NGRI admissions. Figures for each type
of admission to state facilities for the past three years are listed in the
table, below. 1.2.7.2 The community has in place alternatives to institutional
care that have allowed for the treatment of children and their families to
take place on a regular basis in the community. The strong home based
programming through C.H. that includes an array of respite options including
mentors, foster care, crisis residential care and prescribed social
recreational opportunities supported by well developed psychiatric
interventions allows for most children and their families to be supported in
their own community. The efforts of
our agency also is supported by community collaborative efforts to share
resources via the Single Door (multi agency community team committed to
solutions for exceptionally high needs children), use of non-traditional
creative alternatives via Wraparound and a strong community mental health
belief in family centered processes has created an environment where the need
for long term institutional care placements are infrequent and the exception. Community Mental Health continues to work with
the Mt. Pleasant Center to identify and develop plans to prepare consumers
with developmental disabilities for placement. Specialized housing has been developed in some cases and for
others placements in specialized housing in other areas of the state is being
considered. CEI is in the process of building tow
specialized care group homes for adults with mental illness. These homes are designed to serve
individuals requiring intensive services, including currently hospitalized in
state faculties. Staffing levels will
be consistent with the needs of these residents. Staff will also receive specialized training. Both homes will offer an enriched
environment with special activities and individualized treatment. The target date for opening thee homes is
April 30, 2002. |
|
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|
CMHB-
CEI STATE FACILITY ADMISSIONS FOR ADULTS WITH MENTAL ILLNESS |
|||
|
TYPE OF ADMISSION |
TOTAL
ADMISSIONS |
TOTAL
DAYS |
AVERAGE
DAYS PER PERSON |
|
FY
2001 |
|||
|
Kalamazoo: Probated NGRI IST Totals |
30 3 9 42 |
2,731 513 1,104 4,348 |
91 171 123 104 |
|
Mt. Pleasant: IST |
1 |
365 |
|
|
Caro: Probated |
1 |
8 |
|
|
FY
2000 |
|||
|
Kalamazoo: Probated NGRI IST Totals |
32 5 10 47 |
2,400 718 587 3,705 |
75 144 59 79 |
|
Mt. Pleasant: IST |
1 |
95 |
|
|
Northville: NGRI |
1 |
223 |
|
|
FY
1999 |
|||
|
Kalamazoo: Probated NGRI IST Totals: | |||