1. Josette Dorius, Service Director Autism Council of Utah April 6, 2011

2. Objectives History of the HOME Program Structure of our medical home Our team Collaboration of care Medical outcomes How to enroll in HOME H.O.M.E. acronym = Healthy Options Medical Excellence

3. “To optimize the quality of life of the people we serve by providing excellent, compassionate, and integrated health services throughout the lifespan.” Our Mission

4. Background Started as a cooperative relationship in 2000 among the University of Utah, Robert Wood Johnson Foundation, and the Utah Department of Health. Medicaid sought a population who were high utilizers of Medicaid services and who might benefit from coordinated health care. Scott Stiefel, M.D., was already providing mental health services to people with disabilities.

5. Background (continued) HOME was created to provide medical and mental health care in the same location (specialized medical home). Original program required that enrollees also had Division of Services for People with Disabilities (DSPD) services in the central region. In 2004, HOME was permitted to expand to any disabled eligible person with Medicaid, regardless of their DSPD status. In 2005, HOME moved from ARUP to a new facility at 650 S. Komas Drive. In 2009, opened HOME North clinic in Ogden In 2011 current enrollment is 829

6. Eligibility Utah Medicaid A developmental disability A mental health or behavioral concern Willing to receive primary care at the HOME clinic Substance, criminal, or perpetration issues are not dominant

7. Funding Structure

8. What We Do Provide coordinated medical and mental health care to people with developmental disabilities. Serve as a medical home and center of excellence for each of our clients. Advocate for the best possible services for our clients. Who We Are Doctors – Family Practice, Pediatrician, Child Psychiatrist (3) Triple Board Psychiatrist (2) Advance Practice Nurses – 2; Licensed Clinical Social Workers – 5; Medical Assistants – 3; Case Managers – 3 Nurse Case Manager – 1; Behavior Specialist – 2; Billing Specialist – 1; Schedulers – 2; Information Specialist – 1; Finance – 1; Manager – 1; Service Director - 1

9. Neurobehavior HOME Program Comprehensive Care Preventive Care Medical Mental Health Therapy Behavior Support Individualized needs recognized Inclusive treatment plan Immunizations Vaccines Open Access appointments for Urgent visits Case Management Interdisciplinary Specialty Care Extender Services Home Health DME Pharmacology management Interdisciplinary clinic Coordination of referred care Inpatient Services Transition care Follow up appt Coordination of services Case Manager involvement in team meetings Discharge planning inclusive of follow up appointments Chronic Disease Management Evidence based Education Outreach Specialty referrals Outcome reporting Social Support Therapy Groups Substance Abuse groups Single Mingle Activities Behavior Education Series – Parents, Providers Home visits Parent Provider Council Advocate Application assistance for SSI DSPD Partnering with Group Home staff Long Term Care Coordinate with Utah Medicaid Division of Services for People with Disabilities (DSPD) End of life – palliative care Serving Children and Adults with Developmental Disabilities

10. Outcome Reporting FY 2008 Medical Admits = 40.80% MH Admits = 59.20% Med readmits = 6.10% MH Readmits = 8.50% FY2009 Medical admits = 37% MH admits = 63% Med readmits = 7.7% MH Readmits = 10.6% Emergency Room Visits FY 2008 Encounters = 232 ER rate/1000 = 3%/month FY 2009 Encounters = 352 ER rate/1000 = 4%/month Diabetic Management FY 2008 A1C average = 6.3 FY 2009 A1C average = 6.3 No Show Rate FY 2008 Appointments = 6% FY 2009 Appointments = 5.7% Customer Satisfaction FY 2008 = 88% FY 2009 = 90.5%

11. How to refer Call Medicaid (Willow Greer) at (801)567-3835 Medicaid screens for eligibility If eligible, Medicaid mails out an intake packet Upon receipt of the intake packet, HOME calls to schedule a “Get Acquainted” visit and Psychiatric Evaluation. Enrollment paperwork is completed at one of these visits. HOME contacts: Dean Weedon, Manager (801) 587-3109 Josette Dorius, Service Director (801) 587-3108 HOME Program main number (801) 581-5515