Transcript PIHP Application for Participation (AFP) Overview

MDCH PIHP Application for Participation
(AFP)
Stakeholder Overview
ISSUED FEBRUARY 6, 2013
DUE APRIL 1, 2013
Formal Stakeholder Venues
AFP Overview
 LifeWays Citizens Advisory Committee – Weds,
March 20th
 LifeWays Provider Network Meeting- Tues, March
19th
 Coffee & Conversation with CEO
What is the AFP?
• Restructuring of system from 18 to 10 PIHPS
• New state contracts January 1, 2014
• Re-procurement of Medicaid specialty services
• Submission of policies, plans and/or assurances by
existing or new entities according to MDCH map with
identification of direct, delegated or contracted functions
• Maintaining/Improving public mental health system
Similar to 2002 AFP, targeted to CMHSPs in keeping with
Michigan’s waiver renewal
AFP Sections
• 1. Governance
• 2. Administrative Functions
Financial Management
Information Systems Management
Provider Network Management
Utilization Management
Customer Services
Quality Management
AFP Section (continued)
 3. Accreditation Status
 4. External Quality Review
 5. Public Policy Initiatives
Regional Crisis Response Capacity
Health & Welfare
Olmstead Compliance
Substance Use Disorder Prevention & Treatment
Recovery
What Does This Mean for LifeWays?
• Part of a new structure – Mid-State PIHP
• Maribeth Caldwell has been participating in 12 CEO
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discussions and planning since fall 2012
Working with new regional mental health public partners
to make submission and post-submission operations
plans, with support of TSG Solutions
Retain CMHSP status
New PIHP – Contractual oversight of 12 CMHSPs
Delegation of many responsibilities based on CEOs
planning to date
Maintain local communities strengths and priorities
Transition of substance abuse programs
Consumer AFP Involvement
“Because MDCH continues to value and promote
community involvement, there must be
documentation that individuals who receive services,
family members, and/or advocates representing each
service area of the region, if applicable, and all
populations served, including adults with serious
mental illness, children with serious emotional
disturbance, children and adults with developmental
disabilities, and children and adults with substance
use disorders were involved in the development of this
application.”
AFP Themes
• The PIHP must be a separate legal entity
• The PIHP must have common policies and
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procedures in key areas
The PIHP applicant must attest to assurances and
outline contractual CMHSP delegations
The PIHP is responsible for oversight and all
assurances
The PIHP must have certain leadership
positions/roles, but has flexibility in how arranged
New Accreditation expectations
AFP Consumer Specific Themes
• Customer Service
• Public Policies
Crisis response/at-risk consumers
Health and welfare
Community living
Employment
Community activities
• Recovery
Customer Services
 Information Services & Consumer Handbook
 Includes “facilitation of consumer empowerment and
participation in PIHP planning and monitoring”
 Customer Complaint, Grievances and Appeals
 Community Benefit
Crisis Response
 Tracking/Trending of Critical Incidents
 Employing Prevention Strategies
 Regional Crisis Response to Behavioral or Medical
Crises
 Evaluate factors/precursors/warnings
 Eliminate or lesson risk – including training
 Data - Crisis placements, 911 calls, inpatient
admissions, and related training
Employment
• Work as key component to recovery
• Competitive, integrated employment
• Customary wage and benefits optimal
• Increase agency and subcontractor employment of
persons with disabilities
• Linkages to benefits
• Data – workshop, supported employment,
integrated employment and volunteer
Health & Welfare
 Wellness
 Chronic Condition Management
 Access to and Coordination/Integration with
Primary Care
 Abuse & Neglect Prevention
 Trauma Informed Care & Services
 Data – Trauma training
Community Living
 Non-Institutional Care
 Community Housing Options & Choices
 Community Integration
 Culture of Gentleness
 Data - Licensed and independent living
Community Activities
• Data – involvement at least once per month
• Clubs, Social Events, Visiting Friends/Relatives
• Continuing Education Classes
• Athletic/Recreational Participation
• Attendance at Sporting/Art/Theater/Movies
• No extra-curricular activity
• Informed PCP Choice regarding work and activities
• Opportunities for integration and inclusion
SAMHSA New Recovery Dimensions
• Health – overcoming or managing one’s disease(s)
or symptoms-and making informed, healthy choices
that support and promote physical and emotional
wellbeing
• Home – a stable and safe place to live
• Purpose – meaningful daily activities, such as a job,
school, volunteerism, family caretaking, or creative
endeavors, and the independence, income and
resources to participate in society
• Community – relationships and social networks
that provide support, friendship, love and hope
In Conclusion
• Stay tuned for updates from LifeWays
• This AFP will not disrupt or change services and
should be transparent to consumers
• This AFP should help LifeWays to continue to
improve upon outcomes and supports for persons
with disabilities in Jackson & Michigan
Your Input for AFP
• Questions ?
• Comments ?
• Suggestions ?
• Updates from LifeWays ?