LifeWays Community Mental Health Pine Room │ 9:30am-11:00am
Agenda Introductions/Welcome Provider Kudos Director Updates of Contracts and Network Management LifeWays Procedure Changes & Announcements Integrated Care – Traci Fowler, Supervisor Medical Services Alternative Choices- Dianna Nelson, COO Community Inclusive Recreation - Stephen Edwardson, 30 Second PSA Employment First - Julie Strenn, Subject Matter Expert
Welcome │ Introductions Michael Cupp, Director Contracts and Network Management
Kudos! “I would like to recognize David Lowe – he has helped collaborate on several Wraparound cases recently. His feedback has been extremely beneficial and helpful in getting the most appropriate services to help keep our consumers safe. I really value his partnership and teamwork approach.” - Terra Chall Community Services Supervisor Highfields
Kudos! “I would like to recognize Recovery Technology, Hope Network and Segue for their hard work to immediately address a data integrity issue when it was discovered. A recent review from the Data Integrity Group (DIG) produced a result of over 400 inactive staff members who were still assigned to a consumer case. Although those staff did not have access to the record any longer, the incorrect information produced incorrect results connected to treatment team lists, caseloads, consumers not seen, etc. These three providers, without hesitation, made the corrections immediately (within an hour of sending the initial email) to the consumer chart. Thank you so VERY MUCH for your prompt attention to this matter as LifeWays (and its DIG committee) is committed to ensuring the integrity of the data within LEO.” Alexis Shapiro EMR System Administrator LifeWays Community Mental Health
Director Updates Contracts and Network Management Michael Cupp, Director Contracts and Network Management Contracts- in process: goal for fully executed is 10/19/18 MST update Provider Review Process
LifeWays Procedure Changes & Announcements 14-03.02 Referral Process for ICSS 5-01.01 NARCAN (naloxone HCI) Nasal Spray Revised: 4-01.01 Authorization of Authorization of LifeWays Network Services 14_03_01_Components of Service Delivery Special Process Alert: Integro, LLC is closed for referrals to Behavior Psychology for Behavior Treatment Commencement of 30-Day Comment Period for Revised Procedure 2- 04.02 Incident Report
Integrated Care Traci Fowler, Supervisor Medical Services
Integrated Care Traci Fowler, Supervisor Medical Services
Integrated Care Traci Fowler, Supervisor Medical Services “Focusing on whole health and wellness requires a change in mindset. It means helping people live healthier lives by partnering with their physical health providers and assisting them in changing their health behavior to support recovery. I believe this is possible even though it is hard and change takes time.”
Alternative Choices Dianna Nelson, COO
Alternative Choices Dianna Nelson, COO
Alternative Choices Dianna Nelson, COO
Community Inclusive Recreation Stephen Edwardson - Art Program Coordinator Community Inclusive Recreation 331 Jackson Street West, Battle Creek, MI 49037 Phone: 269-968-8249 Fax: 269-969-6218 www.cirFUN.com
Julie Strenn, Subject Matter Expert Employment First Grant
Michigan Employment First… State of Michigan established an Employment First Policy Priority. In FY 2018 State of Michigan budget, funds for this project are appropriated to support the objectives stated in Executive Order 2015- 15 titled Employment First in Michigan. In FY 2016 Oakland Community Health Network in collaboration with Office of Disability Employment Policy (ODEP) rate initiative, was chosen to participate in rate restructuring. In FY 2018 an opportunity was created for four (4) CMH to receive technical assistance for rate restructuring to support the Employment First philosophy. NEMCMH was CHOSEN to receive Rate Restructuring TA!
Employment First Rate Restructuring Goals: Increase # of working-age members (16-64) working in integrated employment at competitive wage with supports as needed. Support CMH and employment providers to use alternative payment methodologies (to allow use of reimbursement models other than fee- for-service) Determine options for addressing negative consequences of being able to bill only for face-to-face service delivery. Match outcomes desired with payment model to encourage maximum level of independence.
Competitive Integrated Employment…
Integrated Employment… Integrated Employment refers to individualized work paid directly by employers at competitive wage with commensurate benefits, occurring in a typical work setting where the employee with a disability interacts or has the opportunity to interact continuously with co-workers without disabilities, has an opportunity for advancement and mobility, and is preferably engaged full time. Individualized - individual employment situations, not small groups (even if pay is competitive and setting is integrated)
Supported Employment Supported employment is considered competitive, integrated employment when: • It takes place in a typical work setting where the employee with a disability interacts or has the opportunity to interact continuously with co-workers without disabilities and has an opportunity for advancement and mobility. • It is individualized (one person – one job) • The wages paid are competitive (at least minimum) • The employer is not the funder or provider of supported employment services for the individual
Federal Initiatives WIOA – Youth Transition HCBS - March, 2014: (Implementation by 2019-2022) Heightened Scrutiny will be released soon on all non-residential settings Implementation – compliance by March 2019 unless individualized plan for each person Home and Community-Based Settings are places that: Support access to the greater community Provide opportunities to seek employment and work in competitive integrated settings Provide opportunities to engage in community life Provide opportunities to control personal resources Give people receiving services the same access to the community as those who aren’t receiving services
Outcomes Based Payment Options: Key Themes: Re-adjust rates to match preferred outcomes/services Create a ”financial incentive” to do Competitive Integrated Employment and a “cost” if not transitioned to CIE. Need to create a financial path for providers to transform their system. – payment for Job Development Maintain Cost Neutrality: Build expectation of job coach fading into reimbursement structure for supported employment Fading possible due to blend of the following strategies: Customize positions to match skills Use systematic training to teach job duties Use of assistive/adaptive technology and aids Engage natural supports (compensate if necessary)
Supported Employment • Fading expected as key to cost-effectiveness and as integral part of service model • Hours of participation are expected to differ from hours of service • Face to face service delivery not desirable in many aspects of service model • Everyone needs 1:1 paid support 100% of the time they are working in individual integrated employment. • If rates are based on this assumption, Employment First will bankrupt the waiver • Step #1 is accurately projecting support needs in relation to hours being worked to determine outcome based rates
Job Development Outcome Based Payment Example: Outcome Rate Career Profile/Report $950.00 Job Development Placement/Hire $1500-$2100 depending on hours/wages/benefits Ongoing Support (usually 90 days) $800/month 90 or 120 days on Job (retention) $1200
Job Coaching – Ongoing Outcome Based Payment Example Acuity Tier 0-11 Months on Job 12-24 Months on Job 25+ Months on Job 1 95% 78% 60% $30.40 $24.96 $19.20 2 80% 60% 45% $25.60 $19.20 $14.40 3 60% 40% 30% $19.20 $12.80 $9.60 4 35% 30% 24% $11.20 $9.60 $7.68 **Based on $32/hour Job coaching base rate
Lifeway’s Outcomes: Goal 1: Ensure Consultation from SME is streamlined into provider transformation Goal 2: Expand capacity building through provider training Goal 3: Develop a rate restructuring model that results in a new reimbursement model other than fee-for-service and increase (35% growth) in members in Competitive Integrated Employment Goal 4: Strengthen and expand partnerships in implementing Employment First principles and practices in Jackson and Hillsdale Counties. Goal 5: Inspire others through the sharing of success stories of persons moving from facility- based services to competitive integrated employment with Employment Frist Initiative stakeholders.
30 Second PSA Provider Updates, announcements, questions, comments?
LifeWays Community Mental Health Thank You for Attending! Pine Room │ 9:30am-11:00am
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