1. 1 Partnership for Developing a Spectrum of Family Services, Resources & Supports for Personalized Recovery Oriented Services (PROS) Teams Family Institute for Education, Practice & Research

2. 2 Welcome & Introductions Background on the Family Institute Background on the Family Institute Family Institute Personnel Family Institute Personnel Anne SmithThomas Jewell Beth HohSherri Ladd Doris Joy (FI/OMH)John Johnson (FI/OMH) Office of Mental Health Personnel Office of Mental Health Personnel David Bucciferro, Director, Rehabilitation Services Unit

3. 3 Overview I. PROS Information II. The Vision: Involving Families in a Recovery Oriented System III. Spectrum of Family Services IV. Details of the Practice Improvement Network (PIN) V. Next Steps

4. 4 PROS Information The Office of Mental Health has worked collaboratively with counties, mental health service providers, and consumer groups to design the Personalized Recovery Oriented Services (PROS) program. The PROS license gives counties and providers the ability to integrate multiple programs into a comprehensive rehabilitation service. The Office of Mental Health has worked collaboratively with counties, mental health service providers, and consumer groups to design the Personalized Recovery Oriented Services (PROS) program. The PROS license gives counties and providers the ability to integrate multiple programs into a comprehensive rehabilitation service.

5. 5 PROS Information There are four Components in the PROS program: There are four Components in the PROS program: Community Rehabilitation and Support (CRS) Community Rehabilitation and Support (CRS) Ongoing Rehabilitation and Support (ORS) Ongoing Rehabilitation and Support (ORS) Clinical Treatment Clinical Treatment Intensive Rehabilitation (IR) Intensive Rehabilitation (IR)

6. 6 PROS Information The IR Component is composed of four different services. Through Intensive Rehabilitation Goal Acquisition, services are designed to assist an individual to attain a specific goal within a certain area, such as education, housing or employment. The IR Component is composed of four different services. Through Intensive Rehabilitation Goal Acquisition, services are designed to assist an individual to attain a specific goal within a certain area, such as education, housing or employment. In addition, IR includes two evidence-based practices: Family Psychoeducation and Integrated Dual Disorder Treatment. In addition, IR includes two evidence-based practices: Family Psychoeducation and Integrated Dual Disorder Treatment.

7. 7 Training the PROS Teams on the Spectrum of Family Services Training the PROS Teams on the Spectrum of Family Services The New York State Office of Mental Health and the University of Rochester Medical Center's Family Institute are offering PROS providers an opportunity to participate in a Practice Improvement Network (PIN) focused on promoting family oriented services. The New York State Office of Mental Health and the University of Rochester Medical Center's Family Institute are offering PROS providers an opportunity to participate in a Practice Improvement Network (PIN) focused on promoting family oriented services. In this initiative, the core foundational approach is Consumer Centered Family Consultation (CCFC). In this initiative, the core foundational approach is Consumer Centered Family Consultation (CCFC).

8. 8 The Vision: Involving Families in a Recovery Oriented System

9. 9 Creating a recovery oriented system insures that mental health programs routinely offer (or link families to those in the community who offer) comprehensive education and support services to family members and others in the consumers' social networks. Creating a recovery oriented system insures that mental health programs routinely offer (or link families to those in the community who offer) comprehensive education and support services to family members and others in the consumers' social networks. Consumers choose to involve others in their treatment and recovery through collaborative decision-making. Consumers choose to involve others in their treatment and recovery through collaborative decision-making. Involving Families in a Recovery Oriented System

10. 10 Role of Providers Create an infrastructure (policies, procedures, staff competencies, supervision, measured performance indicators) Create an infrastructure (policies, procedures, staff competencies, supervision, measured performance indicators) Integrate into the assessment, planning and evaluation process integral to treatment services Integrate into the assessment, planning and evaluation process integral to treatment services Partner with other stakeholders Partner with other stakeholders

11. 11 Vision of a Family Involving Recovery Oriented System Assessment Assessment Service Planning & Interventions Service Planning & Interventions Evaluation & Performance Improvement Evaluation & Performance Improvement

12. 12Assessment Intake and ongoing assessments are designed to identify: Intake and ongoing assessments are designed to identify: The nature and quality of the consumers relationship with members of their family The nature and quality of the consumers relationship with members of their family The needs and wants of families The needs and wants of families The family resources and strengths related to supporting the consumers treatment and recovery The family resources and strengths related to supporting the consumers treatment and recovery

13. 13 Service Planning & Intervention Easily accessible system (e.g., designated role of family services coordinator) Easily accessible system (e.g., designated role of family services coordinator) Full range of services integrated into the consumers service plan Full range of services integrated into the consumers service plan Education Education Communication Communication Problem solving Problem solving Using the mental health system Using the mental health system Emotional support and stigma reduction Emotional support and stigma reduction

14. 14 Service Planning & Interventions Knowledge of and linkages to NAMI and other community supports Knowledge of and linkages to NAMI and other community supports Strategies to identify, reach out to and involve families Strategies to identify, reach out to and involve families Reaching out to civic, religious, cultural and other community resources Reaching out to civic, religious, cultural and other community resources Families are involved in helping organizations to create a family oriented system Families are involved in helping organizations to create a family oriented system

15. 15 Evaluation and Performance Improvement Progress notes in medical record Progress notes in medical record Agency collects, analyzes and acts upon data that measures the performance of a program with respect to family oriented services. Agency collects, analyzes and acts upon data that measures the performance of a program with respect to family oriented services.

16. 16 Spectrum of Family Oriented Services, Resources & Supports Spectrum of Family Oriented Services, Resources & Supports

17. 17 Spectrum of Services and Supports The goal is to promote a system that provides a wide range of service and support options The goal is to promote a system that provides a wide range of service and support options A system in which access to services is supported by treatment providers, advocacy organizations, local and state government and support associations A system in which access to services is supported by treatment providers, advocacy organizations, local and state government and support associations The spectrum of services matches the specific needs, preferences and life circumstances of families and consumers The spectrum of services matches the specific needs, preferences and life circumstances of families and consumers Flexibility and adaptations based on cultural values and preferences promote widespread access Flexibility and adaptations based on cultural values and preferences promote widespread access

18. 18 Spectrum of Family Services “2 Categories” Services, supports and resources provided by: A mental health services agency/program A mental health services agency/program An advocacy and support organization (e.g. NAMI) An advocacy and support organization (e.g. NAMI)

19. 19 Spectrum of Family Oriented Services, Supports & Resources Agency Led Services Agency Led Services Integrate family into the intake, assessment and ongoing care as agreed upon by consumer Integrate family into the intake, assessment and ongoing care as agreed upon by consumer Consumer Centered Family Consultation Consumer Centered Family Consultation Family Support Groups Family Support Groups Multifamily Groups Multifamily Groups Resource Library Resource Library Family Information Nights Family Information Nights Family Education Curriculum Family Education Curriculum Family Therapy/Behavioral Family Therapy Family Therapy/Behavioral Family Therapy

20. 20 Consumer Centered Family Consultation: Delivered by clinicians Delivered by clinicians Location and duration are flexible Location and duration are flexible Client may or may not be present Client may or may not be present Needs, wants and goal assessment are core parts of a consultation Needs, wants and goal assessment are core parts of a consultation Helps families with illness related concerns, education, emotional support, and involving families in their loved one’s treatment plan Helps families with illness related concerns, education, emotional support, and involving families in their loved one’s treatment plan May include a referral to adjunct services and community supports May include a referral to adjunct services and community supports

21. 21 CCFC is characterized by: Consumer Centeredness -The consumer is at the center of all decisions. Consumer Centeredness -The consumer is at the center of all decisions. Collaboration-CCFC promotes an equal partnership between consumers, families and providers. Collaboration-CCFC promotes an equal partnership between consumers, families and providers. Education Orientation- CCFC provides basic information about: mental health diagnoses, causes, treatments and services; family guidelines on how to support the consumer and family; and community and agency resources. Education Orientation- CCFC provides basic information about: mental health diagnoses, causes, treatments and services; family guidelines on how to support the consumer and family; and community and agency resources.

22. 22 Family Support Group Led by clinicians Led by clinicians Fixed schedule (e.g., once per month) Fixed schedule (e.g., once per month) Fixed time frame (e.g., 90-min meetings) Fixed time frame (e.g., 90-min meetings) Brings family members together without consumer Brings family members together without consumer Emotional support and information are key components Emotional support and information are key components

23. 23 Formal Family Psychoeducation Led by a professionals and linked to a clinical program Led by a professionals and linked to a clinical program Lasts 9 months – several years Lasts 9 months – several years Involves single or multiple families Involves single or multiple families Usually diagnosis-specific Usually diagnosis-specific Focused primarily on recipient outcomes Focused primarily on recipient outcomes Eligible for Medicaid reimbursement Eligible for Medicaid reimbursement Truly evidence-based (approximately 3 decades of research evidence) Truly evidence-based (approximately 3 decades of research evidence)

24. 24 Resource Library Delivered by family members, clients, and/or clinicians Delivered by family members, clients, and/or clinicians Informational materials available free of charge for families Informational materials available free of charge for families Resource library may be maintained at community agency or local NAMI affiliate Resource library may be maintained at community agency or local NAMI affiliate Family member can request specific materials via a menu of available resources Family member can request specific materials via a menu of available resources

25. 25 Family Informational Nights Delivered by family members, clients, and/or clinicians Delivered by family members, clients, and/or clinicians One or more sessions One or more sessions Held monthly, quarterly or semi-annually Held monthly, quarterly or semi-annually Typically an “overview” of mental illness or an overview and introduction to a specific agency and its services Typically an “overview” of mental illness or an overview and introduction to a specific agency and its services

26. 26 Family Education Curriculum Delivered by family members, clients, and/or clinicians Delivered by family members, clients, and/or clinicians Typically 60-90 minute sessions Typically 60-90 minute sessions Typically lasts from 1-12 classes Typically lasts from 1-12 classes Usually topic oriented (e.g., relapse prevention; signs and symptoms of mental illness) Usually topic oriented (e.g., relapse prevention; signs and symptoms of mental illness)

27. 27 Behavioral Family Therapy Combined with appropriate psychotropic medications consumers and relatives can expect: Combined with appropriate psychotropic medications consumers and relatives can expect: To gain mastery over the illnesses To gain mastery over the illnesses Experience fewer relapses and rehospitalizations Experience fewer relapses and rehospitalizations Attain higher levels of social & occupational functioning Attain higher levels of social & occupational functioning Enjoy a better quality of life Enjoy a better quality of life

28. 28 Spectrum of Family Oriented Services, Supports & Resources Community Led Services Community Led Services National Alliance on Mental Illness National Alliance on Mental Illness Basics Basics Connection Connection Family to Family Family to Family In our own Voice In our own Voice Peer to Peer Peer to Peer Monthly support groups Monthly support groups

29. 29 Details about the Upcoming Practice & Improvement Network Spectrum of Family Services “Roll Out”

30. 30 Practice Improvement Network The Family Services Practice Improvement Network (PIN) is a voluntary group of PROS providers in NYS formed together to focus on a common improvement effort. The Family Services Practice Improvement Network (PIN) is a voluntary group of PROS providers in NYS formed together to focus on a common improvement effort. The common improvement effort is integrating effective family involving services into the PROS Programs. The common improvement effort is integrating effective family involving services into the PROS Programs. The family service is Consumer Centered The family service is Consumer Centered Family Consultation.

31. 31 Practice Improvement Network Method (PIN) A PIN consists of a network of PROS providers and a resource panel who work in partnership to plan, implement and evaluate approaches to involve family members in a way that supports the consumer’s service plan and recovery. A PIN consists of a network of PROS providers and a resource panel who work in partnership to plan, implement and evaluate approaches to involve family members in a way that supports the consumer’s service plan and recovery. The resource panel includes faculty of the Family Institute for Education, Practice & Research; experts in staff and supervisory training on a full range of family oriented services, organizational implementation, PROS regulations, data analysis and outcome evaluation. The resource panel includes faculty of the Family Institute for Education, Practice & Research; experts in staff and supervisory training on a full range of family oriented services, organizational implementation, PROS regulations, data analysis and outcome evaluation.

32. 32 Practice Improvement Network Method (PIN) The first step for a PROS program joining the PIN is to identify 2-3 key individuals in the PROS program who will take primary responsibility to work with the resource panel and to oversee the implementation of family services in the PROS program. The first step for a PROS program joining the PIN is to identify 2-3 key individuals in the PROS program who will take primary responsibility to work with the resource panel and to oversee the implementation of family services in the PROS program.

33. 33 Practice Improvement Network Method (PIN) Key individuals from each agency comprise the Quality Improvement Team (QIT). Key individuals from each agency comprise the Quality Improvement Team (QIT). The QIT includes: The QIT includes: Executive level leadership/designee Executive level leadership/designee PROS Program leader/supervisor PROS Program leader/supervisor Data Person-someone who can collect and submit data-this person could be a peer specialist interested in family services or anyone who may champion the goals of the PIN. Data Person-someone who can collect and submit data-this person could be a peer specialist interested in family services or anyone who may champion the goals of the PIN.

34. 34 Phase One Key Performance Indicators: Initial and Ongoing Engagement and Involvement # and % of face to face proactive family consultations provided on a monthly basis # and % of face to face proactive family consultations provided on a monthly basis # and % of face to face meetings with consumer to discuss the involvement of family members or others in their treatment and recovery # and % of face to face meetings with consumer to discuss the involvement of family members or others in their treatment and recovery

35. 35 Phase One Key Performance Indicators cont. Family members perception of the quality of the consultation service (Zagat style) Family members perception of the quality of the consultation service (Zagat style) Satisfaction Satisfaction Helpfulness Helpfulness Culturally respected Culturally respected Categorizing the disposition of each consultation Categorizing the disposition of each consultation

36. 36 NEXT STEPS

37. 37 Selection Criteria In the event the demand exceeds supply of resources, the following selection criteria will be employed: In the event the demand exceeds supply of resources, the following selection criteria will be employed: Completeness, timeliness of application Completeness, timeliness of application Type, size and location of the applicants Type, size and location of the applicants Cultural, racial, ethnic characteristics of the population served Cultural, racial, ethnic characteristics of the population served

38. 38 Application Process “Application to Join a Family Services Practice Improvement Network of PROS Providers” “Application to Join a Family Services Practice Improvement Network of PROS Providers” Application coversheet Application coversheet Organizational Characteristics Data Sheet Organizational Characteristics Data Sheet Identification of Quality Improvement Team Sheet Identification of Quality Improvement Team Sheet

39. 39 Submit all material in triplicate to: Anne M. Smith, LMSW Anne M. Smith, LMSW Executive Director Family Institute for Education, Practice & Research 315 Science Parkway Suite 400 Rochester, NY 14620 Deadline: ____________________ Deadline: ____________________ Questions may be submitted via email to Anne Smith at: Email: Annem_smith@urmc.rochester.edu Annem_smith@urmc.rochester.edu Telephone: 585-279-7903.