Transcript Building an FSP in Rural California

Building an FSP Program
in Rural California
Alan Yamamoto, L.C.S.W
San Benito County Behavioral Health
Nancy Callahan, Ph.D.
IDEA Consulting
Kathy Montero, L.M.F.T
Glenn County Mental Health, Health Services Agency
Patricia Ayers, L.M.F.T
San Benito County Behavioral Health
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Overview of FSP Planning for a Small County
Alan Yamamoto, L.C.S.W
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Developing the CSS Plan
San Benito County
Glenn County
FY 05/06 FY 06/07 FY 07/08
Total
Total
Total
Children
0
5
10
TAY
0
5
10
Adults
0
5
10
Older Adults
0
0
0
•
FY 05/06 FY 06/07 FY 07/08
Total
Total
Total
Children
0
0
0
TAY
0
0
0
Adults
0
5
10
Older Adults
0
0
0
Planning process to develop FSP Services
• Additional Funds: Expanding the number of FSP clients
• FSP Eligibility Criteria (see Handout)
• Panel will present on:
• Referral Process
•24/7 Response
• Authorization
• Drop-in Centers as an Adjunct to FSP Services
• FSP Service Team
• Working with the CA Network of Clients
• Services and Support Planning
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Referral Process to Full Service Partnership Program
Nancy Callahan, Ph.D.
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Develop an Eligibility Checklist that includes Medical Necessity information
(e.g., Seriously Emotionally Disturbed; Seriously Mentally Ill; Serious
impairment in functioning; Routine services not successful) to collect
information on person referred for FSP
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Assess client’s level of interest and motivation to participate in Full Service
Partnership
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Staff completes a Referral Request for Authorization (brief summary of
client’s needs and history, why FSP level of care is needed if routine
services have not been successful)
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Staff and supervisor discuss client’s appropriateness for FSP and determine
if there is a vacancy for FSP services
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When there are no ‘vacancies’ for FSP, discuss other options for services?
– Staff provide the highest level of services necessary to meet the needs
of individuals until a vacancy is available
– Review persons currently receiving FSP services and determine if there
is someone who is ready to be discharged from FSP services
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Review budget and determine if there is capacity to serve more clients with 3
FSP services
FSP – Authorization Process
Partnership Authorization Team (PAT)
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Philosophy: Provide leadership and oversight to create a vision of wellness
and recovery.
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PAT Team consists of any combination of the following positions: Director/
Deputy Director, MHSA Coordinator, UR/QI Coordinator, Program Manager,
Consumer/Mentor, Budget Analyst
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PAT Activities:
– Provide leadership and oversight to FSP services
– Assess new referrals and authorize clients for FSP participation
(dependent upon availability of funds and eligibility)
– Review status of existing FSP clients, progress toward goals,
exceptional events (Crisis, Inpatient Admissions), and celebrate
successful completion of clients from programs
– Discuss system-level issues
– Authorize request of flex funds for items costing $50 or more
– Track expenditures: year-to-date dollars per client; year to date dollars
for all FSP; year-to-date dollars for MHSA
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Full Service Partnership Service Team
Kathy Montero, L.M.F.T.
Philosophy:
- Wellness and Recovery Philosophy
- Team approach
- Flexible services to meet the needs of individual clients and shared
program function
• Consists of direct service team members working with FSP clients (MHSA
Coordinator, clinician, consumer/peer mentor, family members, etc)
• Regularly Scheduled Meetings
- Daily Check In (15 minutes) to provide staff a briefing on night/ weekend calls
- Weekly Staff meetings for
• business announcements, training, discuss critical incidents
• Key Events Tracking (prompt staff to report changes in living situation,
encounters with the law, etc.) -- Staff complete Key Event Tracking Forms
during meeting
• Clinical support for staff development
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FSP Services and Supports Planning
Kathy Montero, L.M.F.T.
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Client Care Plan (CCP) – Medi-Cal component addresses medical
necessity and symptom reduction
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Individual Services and Supports Plan (ISSP) – Outlines individual’s
recovery and wellness goals (combine with CCP or create separate
document)
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Family/ Collateral/ Community Supports’ involvement in Planning Process
– Meet to set goals, discuss role of each family member/ collateral person
– What does it take for the individual and his/her family to thrive?
– Who is the client’s support system? This may be someone different
than ‘family,’ including a friend, neighbor, landlord, minister, coach, etc.
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Development of Culturally Relevant Treatment Planning Strategies
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24/7 Response for FSP Clients
Alan Yamamoto, L.C.S.W.
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Identify who will respond on a 24/7 basis to FSP clients
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Establish a number for clients to call
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Establish on-call rotation for staff (For example: one week on)
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Develop a protocol for persons on-call
– How they will be reimbursed for ‘stand-by’/working hours?
– (Example: $2.50 per hour stand-by weekdays; Time and a half for
hours worked in the evenings)
– Are staff required to work the next day if they were up all night?
(flexibility)
– Establish a back-up response plan when the person on-call needs
additional clinical support
– Policy for going into the field during the day; at night (safety issues)
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24/7 Response for FSP Clients (Continued…)
Alan Yamamoto, L.C.S.W.
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Deliver cross training to FSP Staff, police and first responders, crisis staff,
hospital staff to help coordinate care
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Share client’s Advance Directives with FSP team members to coordinate
care and follow client’s wishes during an emergency
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Develop a policy for responding to residential complaints including resolving
conflicts, noise problems, fighting, behavior problems, and potential
evictions. Train staff on how to support landlords and/or family members
with the client.
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Develop a policy on staff’s use of the county car(s) for after hours response.
For example, determine if staff can drive the car home at night; or come into
the office to pick up vehicle, when needed.
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Developing a Drop-In Center
with Small County Resources
Patricia Ayers, L.M.F.T.
DROP-IN CENTER (This is a Location of Services, Not a Type of Service)
Center can be used as an adjunct to FSP services – allows support without an
appointment
Services Which May be Available at the Drop-In Center or other Location
• New Requests for Services
• Groups
• Life Skills/ Classes
• Social/ Recreational Connections
• Telemedicine
• Other Agency Services
• Weekly Community Meeting (for clients)
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Summary
Alan Yamamoto, L.C.S.W
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FSP in a rural county
Services are multipurpose to maximize limited dollars
Work with CA Network of Mental Health Clients – Pilot Project
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Contact Information
Alan Yamamoto, L.C.S.W, Director
San Benito County Behavioral Health
1113 San Felipe Rd., Hollister, CA 95023
(831) 636 – 4020
[email protected]
Nancy M. Callahan, Ph.D.
IDEA Consulting
2108 Alameda Ave., Davis, CA 95616
(530) 758-8815
[email protected]
Kathy Montero, L.M.F.T., Program Manager, Children’s Mental Health & MHSA
Glenn County Mental Health Department, Health Services Agency
242 N. Villa
Willows, CA 95988
(530) 865-6459
[email protected]
Patricia Ayers, L.M.F.T, Assistant Director
San Benito County Behavioral Health
1113 San Felipe Rd., Hollister, CA 95023
(831) 636 – 4020
[email protected]
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