Recovery Assistant Training Mental Health Waiver On-line training to be completed prior to attending in person class.

What is a Waiver? Allows CMS to set aside certain Medicaid regulations and by doing so permits the funding of community based care instead of institutional care ( nursing home) Better social policy; persons with mental illness will have the opportunity to recover at home, build a community and use natural supports.

Mental Health Waiver in CT DHMAS/DSS were approved for the Mental Health Waiver in April of 2009, reapproved 2012 and 2017 Is tied to MFP “Money Follows the Person” 615 people can be enrolled on Waiver through 2022 Cost neutrality must be met; no more than what’s being paid in nursing home for all Medicaid billing.

Cost Neurality ABC nursing home WISE Town, USA Sally has lived there 2 years It costs Medicaid $65,000 per year WISE Sally wants to live in Community MHW clinician determines eligibility and develops a Recovery Plan cost sheet Town, USA Sally now lives in apartment and receives Recovery Assistant, CSP and Nursing twice a week Plan costs $50,000 per year Sally has more independence and is on her way to Recovery

Mental Health Waiver Roles DMHAS (Department of Mental Health and Addiction Services) serves as “Operating Agency” DMHAS assesses eligibility for waiver DMHAS and ABH MHW clinicians develops Recovery Plan with the person being discharged/diverted Services delivered by ABH certified providers

DSS (Department of Social Services) maintains complete oversight of all Medicaid Waivers in CT DSS assesses Medicaid eligibility DSS must ensure compliance with Medicaid “assurances”

Doesn’t need inpatient now Waiver Eligibility >22 years old Medicaid eligible Mets NF LOC criteria SMI diagnosis (PASARR-II) 2 or more due to SMI A. Requires meds B. Unable to work full time C. Requires supervision & support D. Homeless or at risk E. Has had or is likely to have acute episode And Doesn’t need inpatient now Needs: A. 1:1 psych rehab, and B. Support Coordination Plus Plus In a nursing home or In the Community 1 2

DMHAS Mission “We endorse a broad vision of recovery that involves a process of restoring or developing a positive and meaningful sense of identity apart from one’s condition (Who am I?) and a meaningful sense of belonging while rebuilding a life despite or within the limitations imposed by that condition.” ( & Where do I fit in the world around me?)

DMHAS Definition of Recovery “Recovery" is a process of restoring or developing a positive and meaningful sense of identity apart from one's condition and then rebuilding one's life despite, or within the limitations imposed by that condition.  

Recovery Goal To develop new life purpose and meaning as a person moves beyond the catastrophic effects of psychiatric disability. William Anthony RA role is to assist clients using psychiatric rehabilitation interventions Developing skills Developing supports

Examples of Recovery Returning to a health state evidenced by improving one's mood and outlook on life following an episode of illness Managing one's illness such that the person can live independently and have meaningful employment and healthy social relationships Building on personal strengths to offset the adverse effects of a disability Feeling empowered to making personal choices about one's own life

Recovery Assistant Position Qualifications: Be at least 18 years old; Possess at least a high school diploma or GED; Possess a minimum of a state issued ID; Be registered with the Department of Mental Health and Addiction Services (DMHAS)/ABH as having completed an approved Recovery Assistant training program, have a Criminal Background check conducted within six months of application and meet any continuing education and/or training requirements set by DMHAS/ABH. RA needs to complete 6 hours of additional training each year. RA needs to complete additional boundaries training within 6 months of start date. DMHAS/ABH

Potential Boundary Violations Recovery Assistants should consider their relationship with clients to be a fiduciary one. The fiduciary responsibility: means that the client can expect to have trust and confidence in the worker puts the relationship in an ethical framework that bars the Recovery Assistant from situations in which his or her personal interest conflicts with the client.

World Health Organization What is Mental Health ? World Health Organization “A state of well being in which the individual realizes his own abilities, can cope with normal stressors, can work productively and is able to make a contribution to the community.”

What is Mental Illness? A psychological or behavioral pattern that occurs in an individual and is thought to cause distress or disability that is not expected as part of normal development or culture. Add story about women in china. New mother. 30 days, no shower, no going out side, no touching the baby.

People with mental illness are in touch with reality more often than not. Some live in silence with their symptoms. Stress does not cause mental illness, although it can make symptoms worse. Reality: Most people with even the most severe of mental illnesses are in touch with reality more often than they are not. Many people quietly bear the symptoms of mental illness without ever showing signs of their illness to others, and most people with mental illness live productive, active lives. Also, the stigma and discrimination associated with mental illness acts as a barrier to people seeking care.

Misconceptions People with severe mental illness: Are not more likely to be homeless Did not grow up with “bad” parenting Are not more dangerous than the general population Are more likely to be victimized

Expectations for in person class Arrive on time (Registration 8:30-8:50am) Bring a valid form of identification Be prepared to stay for entire training (9-4) Be respectful of others and their questions Please limit personal conversations during training Please bring lunch or be able to leave campus to purchase lunch Dress in layers; we do not control temperature of the room There will be a test at the end

Here is the link for the test: Online Test You are now ready to take the online test! A score of 80 or higher is needed to pass Once you have completed this exam your results will be sent to Advanced Behavioral Health Your Agency will be notified by an ABH representative confirming that you have completed/passed your online exam Please follow up with your agency regarding any registration details for the one day training Here is the link for the test: https://www.surveymonkey.com/r/M7HF2DD