1. Sustainable Self-Directed Care in Pennsylvania’s Mental Health System Presenter: Kristin Ahrens, Policy Director

2. Person Driven Services Project “All people with disabilities shall have the option to design, control and direct their own services and funding.” Why? ●Civil rights, integration ●Cost effectiveness ●Better outcomes ●Response to demographic changes ●Impossible complexity of system(s) Collaborators: Values into Action-PA, Mental Health Association of SE Pennsylvania, Philadelphia Coordinated Health Care, Disability Rights Network, PA Health Law Project, PA Mental Health Consumers Association

3. Self-Directed Care in Medicaid Employer Authority: participants are afforded the decision-making authority to recruit, hire, train and supervise the individuals who furnish their services. Budget Authority: participants may also have decision- making authority over how the Medicaid funds in a budget are spent.

4. Key Features of Medicaid SDC 1.Person-Centered Planning Process 2.Service Plan 3.Individualized Budget 4.Information and Assistance

5. Background on SDC Participant-Directed Services (PDS), also known as “self-directed services” or “self-directed care,” an option in Medicaid since the 1990s Self-Directed Care programs are available in every state and the District of Columbia 800,000+ people self-direct at least 1 service - option used for most Medicaid HCBS populations In PA approximately 19,000 people self-direct at least 1 home and community based waiver service

6. Natural Alignment of Principles Recovery Hope Relational Person-Driven Culture Many Pathways Addresses Trauma Holistic Strengths/Responsibility Peer Support Respect Self-Directed Care Freedom Support Authority Responsibility Self-Advocacy

7. What Does Research Tell Us? SDC generally - fewer unmet needs, can be cost effective, higher satisfaction, better outcomes SDC for people with SMI - preliminary results –SDC can address unmet needs –In FL saw reduction of expensive interventions like use of in-patient treatment and forensic involvement

8. SDC in PA’s MH System Consumer Recover Investment Fund (CRIF) Allegheny County North Central

9. Activities Promoting SDC in PA’s MH System Demonstration Environmental scan Policy analysis Stakeholder Meetings Meetings with Department - OMHSAS and OMAP Draft stakeholder recommendations

10. Institute on Disabilities at Temple University 1755 N 13 th Street Student Center, Room 411S Philadelphia, PA 19122 Fax: 215-204-6336 Web: www.disabilities.temple.edu/programs/pds/ www.disabilities.temple.edu/programs/pds/ Kristin’s contact information: Tel: 215-204-9543 Email: kahrens@temple.edu