Strategic Planning 2013 CMHSAS-SJC Board

Description of a Good and Modern Addictions and Mental Health Services System Affordable Care Act  Patient and Protection and Affordable Care Act of 2010  Health Care and Education Reconciliation Act of 2010  Recognizing that Behavioral Health is integral part to improving and maintaining overall health

Who has Health Care Coverage? Health Insurance - 25,989* Medicaid – 15,236 Medicare – 11,178 ABW- 350 County Health Plan -169 Uninsured - 8,214** * 2010 Small Area Health Insurance Estimates uses 84.5% under age of 64 ** ACS estimates the percent of uninsured at 13.6% (+ 1.6) people.

SAMHSAs focus is on: Continuum of services benefit package within available funding that are cost effective and evidence based and best practices services approach Local system of care with primary care and behavioral health providers and practitioners are aligned with one another and with other systems

Continuum of Care Least Restrictive Independent Living Contributing Citizen Most Restrictive Hospitalization Incarceration

Previous Goals Maintain CARF accreditation Maintain Focus on Continuous Quality Improvement. Fulfill Aspects of the Master Contract with the Affiliation PIHP  Continue to improve Services Under a Capitated Managed Care Arrangement. Successful affiliation status with Kalamazoo, Allegan and Cass Counties.  Integration of Primary Care and Mental Health Integration of Mental Health and Substance Abuse Provide Evidence Based Practices

System of Care Mental Health and Substance Abuse Aging Legal Recreation (Parks, bowling, swimming) Faith Community (United Way, 4H) Physical Health (FQHC, RHC, Primary Care, Hospitals) Individual

Recovery Supports Peer Support Recovery Support Coaching Recovery Support Center Services Supports for Self directed care Continuing care for SUD

Acute Intensive Services Mobile Crisis Services Medically monitored intensive inpatient Peer based crisis services Urgent Care Services 23 hour crisis stabilization services  Area identified for improvement: 23 hour crisis stabilization services 24/7 Crisis hotline Services

Out of Home Residential Services Crisis residential/stabilization  Area identified for improvement. Clinically managed 24-hour care Clinically managed medium intensive care Adult Mental Health Residential Children's Mental Health Residential  Area identified for improvement Youth Substance Abuse Residential Therapeutic Foster Care

Out of Home Residential Services (cont.) Additional areas identified for improvement:  Olmstead citation  Children’s Respite Funding out-of-area What are the licensure needs? Possible joint venture? Would it decrease hospitalization?

Intensive Support Services Substance abuse intensive outpatient services Partial hospital Assertive Community Treatment (ACT) Intensive home based treatment Multi-Systemic therapy  Currently not recognized in Michigan but it is something to look in to. Intensive case management

Other Supports (Habilitative) Personal Care Homemaker Respite Supported Education Transportation Assisted Living Services Recreational Services Interactive Communication Technology Devices Trained Behavioral Health Interpreters  Area identified for improvement: Additional Training for Behavioral Health interpreters

Other Supports (Habilitative) (cont.) Contracting with community services is something we do very well!

Community Support (Rehabilitation) Patient/Caregiver support Skill Building (social, daily living, cognitive)  Area identified for improvement: Case Management Behavioral management Supported Employment  Area identified for improvement: Bring in-house Permanent supported housing Recovery housing  Area identified for improvement: none available in our county Therapeutic mentoring Traditional healing services

Medication Services Medication Management Pharmacotherapy (including MAT) Laboratory Services Additional areas identified for improvement:  Not enough Doctors  Substance Abuse Meds

Outpatient Services Individual Evidenced Based Therapies Group Therapy Family Therapy Multi-Family Therapy  Area identified for improvement: not enough interest Consultation to Caregivers Additional area identified for improvement:  DBT is currently low fidelity but there is a cost to make it high fidelity

Engagement Services Assessment Specialized Evaluations (psychological, neurological)  Area identified for improvement: need additional training Service planning (including crisis planning) Consumer/Family education Outreach  Area identified for improvement: need more presence

Prevention (including promotion) Screening, brief intervention and referral to treatment Brief Motivational Interviews Screening and brief intervention for tobacco cessation Parent training Facilitated Referrals Relapse Prevention/Wellness Recovery Support Warm line Additional area identified for improvement: SA prevention programs are good but MH is week (lacks funding)

Healthcare Home/Physical Health (Room for Improvement/Work In Progress) General and Special outpatient medical services Acute primary care General health screens, tests and immunizations Comprehensive Care Management Care coordination and health promotion Comprehensive transitional care Individual and Family support Referral to community services

Identified Goals  Integration of Primary Care and Mental Health  General and Special outpatient medical services  Acute primary care  General health screens, tests and immunizations  Comprehensive Care Management  Care coordination and health promotion  Comprehensive transitional care  Individual and Family support  Referral to community services  23 hour crisis stabilization services  Crisis residential/stabilization  Skill Building (social, daily living, cognitive)  Supported Employment  Recovery housing  Continue to improve Services Under a Capitated Managed Care Arrangement.

Additional Goals: Specialized Evaluations (psychological, neurological) DBT Low to High Fidelity Children’s Mental Health Residential Children’s Respite  Funding, out-of-area, licensure needs?, Would it decrease hospitalization? Olmstead citation Not enough Doctors Substance Abuse Meds Multi-Systemic therapy Outreach Mental Health Prevention Trained Behavioral Health Interpreters