1. FAMILY PEER SUPPORT SERVICES OMH Children’s Division of Integrated Community Services May 19, 2015 Presentation to New York State Success Membership

2. 2 Internal and External Transformational Events The Evolution of Family Peer Support Services  A movement from “whatever it takes” to discipline with clearly defined roles and responsibilities. Environmental Pressures  The transition to Medicaid Managed Care (MMC) here it is proposed that Family Peer Support will become a State Plan Medicaid billable service.

3. 3 The Evolution of Family Peer Support Services Current Philosophy Family Peer Support Services (FPSS) focus on the family for the benefit of the child. The role of FPSSs is to:  support families in identifying their strengths and needs, and  work with families on targeted goals that will assist them in becoming stronger. FPSSs delivered by a Family Peer Advocate (FPA).

4. 4 Environmental Pressures Medicaid Managed Care Managed Care Organizations contract with providers:  that have staff that are well trained in their discipline,  that meet licensing/credentialing set forth by State and CMS,  whose services: o are clearly defined, o are of high quality, o that are highly correlated with consumer satisfaction, o produce positive outcomes for the consumers they serve.

5. 5 Current Initiatives to Address Internal and External Pressures

6. 6 Environmental Scan of Current Family Peer Support Providers (1650 Programs) 2012 Data

7. 7 Key Findings-Family Composition

8. 8 Key Findings-Ages of Youth

9. 9 Key Findings- Youth Systems’ Involvement

10. 10 Health Insurance-Key Findings H

11. 11 Environmental Scan Next Steps  Data submitted to workgroup developing Children’s Behavioral Health Model.  Annual survey to be sent to all 1650 programs o 6/1 target date for 2015 via Survey Monkey

12. 12 Family Support Definition

13. 13 Family Peer Support Definition In 2013, the creation of consistent definition across NYS for Family Peer Support Programs. Core Services Include: o outreach and Information, o engagement, bridging and transition support, o self-advocacy, self-efficacy and empowerment, o community connections and natural supports, o parent skill building, and o promoting effective family-driven practices Services do not include: o care coordination, and o respite

14. 14 Family Peer Support Definition Definition is/will be:  inserted into the Waiver Guidance Document,  utilized in all RFPs that reference FPSSs released by OMH Children’s Division,  submitted to the Center for Medicaid Services for Family Peer Support State Plan Services, and  reflected in the definition manual of the Consolidated Financial Report.

15. 15 Credentialing of Family Peer Advocates

16. 16 Credentialing of Family Peer Advocates  Through an RFP process in 2012, FTNYS was awarded a contract to administered credentialing of OMH Family Peer Advocates.  Currently over 200 Credentialed Family Peer Advocates in New York State.  Credentialing of Peers is a CMS requirement for Medicaid reimbursement.  It is anticipated that this process will be submitted to CMS by NYS for FPA credential.

17. 17 Tenets of Family Peer Advocate Credential Applicants must:  be at least 18 years old,  obtained a high-school diploma or GED,  have lived experience,  have successful completed the NYS Parent Empowerment Program (PEP) training,  have 1000 hours (six months full-time or one year half-time) documented service providing peer-to-peer family support and advocacy services to other parents/caregivers in either a paid or ‘formal’ volunteer, and  complete an application that includes: o supervisor’s letter of recommendation, o two additional letters of recommendation, o signed Family Peer Advocate Code of Ethics, o statement of lived experience, o resume, and o professional development plan.

18. 18 Outcomes Family Assessment of Needs and Strengths (FANS)

19. 19 FANS The FANS, developed by John Lyon and the OMH Western Region Family Support Directors, identifies a family’s strength and needs much the same as the CANS-NY for the identified youth. The CANS-NY, typically implemented by a care coordinator (case manager or ICC) has a family functioning domain with 4 dimensions that correspond with the FANS tool. The FANS has 17 questions which is administered by a FPA that: o assists families in recognizing their strengths, o directs the focus of the FPAs work with the family, o measures progress in meeting focused goals over time, and o assists in saying goodbye. The FANS has also proven to be an effective tool in: o communicating with providers on the specific goals of the family and o supervision of FPA

20. 20 FANS First cluster of four questions hones in the parents self care Second cluster of seven questions hones in on parents knowledge and areas of skill development Third cluster of two questions hones in on the parents internal awareness of external challenges Fourth cluster of questions hones in on assuring parents voice in service delivery Talents/Interests/Hobbies, Recreation, Optimism, & Social Resources Listening, & Communication skills, Involvement in Services, Knowledge of Family Needs, Knowledge of Rights & Responsibilities, Knowledge of Service Options Self-Efficacy, & Burden & Stress Satisfaction with Youth’s Living Arrangements, Satisfaction with Youth’s Educational Arrangements, Satisfaction with School Participation, Satisfaction with Current Services

21. 21 FANS Implementation The FANS is currently utilized by Family Peer Advocates to guide their work with families in:  the Waiver program,  community-based (non-Wavier) family peer support programs that are working 1:1 with a family, and  residential programs that specified the FANS as their outcome tool in the Residential Family Peer Support Partner RFP.

22. 22 Quality Assurance Consumer Satisfaction Family Access to Care Survey (FACS)

23. 23 Family Assessment of Care Survey (FACS)  For calendar year 2014: o 10 questions specific to Family Peer Support were developed and inserted into the FACS survey tool, and o a sample of Family Peer Support Programs were surveyed.

24. 24 I received Family Support Services directly from a Family Peer Support Partner. It was important to me that the family support services offered were delivered by a Family Peer Support Partner. I have a better sense of my family’s strengths. I have information I need to make decisions about my child’s treatment. I have the support I need to make decisions about my child’s treatment. I feel less alone and isolated. I connected more with friends and relatives. I increased my involvement in my community. I understand better how to take care of myself. I gained skills to better help my child. Family Support Services Questions

25. 25 Family Assessment of Care Survey (FACS)

26. 26 Discussion