Transcript Mayview Regional Service Area Planning Process Allegheny

Mayview Regional Service Area Plan
Quality Improvement/Outcomes
(QIO) Committee
August 26, 2009
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Allegheny HealthChoices, Inc.
Agenda for Today’s Meeting
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MRSAP Steering Committee updates
Review of survey results
Overview of the Southwest Regional SOS
Update on family interviews
Summary of findings from quality
assurance activities
Wrap-up
Allegheny HealthChoices, Inc.
MRSAP Steering Committee Updates
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Lessons Learned
Land Reuse Task Force
Inpatient Utilization
Pitt Evaluation Study
Service Development
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Community EAC
Suburban RTFA
ACSP
Allegheny HealthChoices, Inc.
August 2009 Report
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Data sources
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Compares services and supports used in January 2009 - right after the
hospital closed , and June 2009 – six months after the closure
Covers the following areas
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Monthly tracking reports
Early warning and critical incident system
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Use of Community Treatment Team (CTT) and case management/service
coordination
Use of behavioral health treatment services
Housing
Benefits, income sources, and guardianship
Rehabilitation and employment activities
Social supports
Transportation
Physical health care visits
Early warnings and critical incidents
Allegheny HealthChoices, Inc.
People Discharged by County
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Allegheny HealthChoices, Inc.
Use of CTT, Case Management, and
Service Coordination
June 2009
 Allegheny
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Beaver
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100% (7 of 7) received
CM (CTT not available)
Washington
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63% (17 of 27)
received CTT
Lawrence
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81% (181 or 223)
received CTT
59% (13 of 22)
received CTT
Allegheny HealthChoices, Inc.
Frequency of Contact: CTT
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Allegheny HealthChoices, Inc.
Frequency of Contact:
Case Management, Service Coordination
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Allegheny HealthChoices, Inc.
Behavioral Health Treatment Services
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76% used CTT services
19% had mental health services through their LTSR
12% had outpatient mental health services.
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A small number had mobile medication teams or
mobile mental health services
Substance abuse treatment:
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A larger percentage of people in Washington County (27%, 6
individuals) accessed outpatient in comparison to Allegheny
County (11%, 25 people) or Beaver County (15%, 4 people).
Only one person used drug and alcohol detoxification services.
Substance abuse treatment is included in CTT services.
AA/NA are included in “Social Supports”.
Allegheny HealthChoices, Inc.
Housing
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Allegheny HealthChoices, Inc.
Housing by County – June 2009
Allegheny
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Beaver
Lawrence
Washington
Long-term structured residence (LTSR)
17%
39 people
26%
7 people
43%
3 people
18%
4 people
Personal care home
(PCH, EPCH, CMHPCH)
22%
50 people
18%
5 people
0%
23%
5 people
Community Residential Rehabilitation
(CRR)
12%
26 people
11%
3 people
29%
2 people
5%
1 person
Specialized supported housing
12%
27 people
0%
0%
0%
Living independently
5%
12 people
11%
3 people
0%
9%
2 people
Living with family
2%
4 people
4%
1 person
14%
1 person
14%
3 people
Supported housing
5%
12 people
22%
6 people
0%
14%
3 people
All other housing categories
(inpatient, MR housing, Nursing Homes,
TSH)
25%
53 people
7%
2 people
14%
1 person
9%
4 people
Allegheny HealthChoices, Inc.
Benefits
47 Dually eligible individuals – Medicaid/Medicare: AC – 30, BC – 7, WC - 10
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Allegheny HealthChoices, Inc.
Sources of Income
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Allegheny HealthChoices, Inc.
Guardianship, Rep Payee, and Power of Attorney
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Allegheny HealthChoices, Inc.
Rehabilitation and Employment
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Allegheny HealthChoices, Inc.
Social Supports
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Allegheny HealthChoices, Inc.
Transportation Supports
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Allegheny HealthChoices, Inc.
Physical Health Care
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Allegheny HealthChoices, Inc.
Early Warning Indicators
Jan09
0
Feb09
1
Mar09
1
Apr09
2
May09
2
Jun09
2
Atypical Behavior - Change From Baseline
25
18
13
18
18
8
Complaints - Property Destruction/Eviction
4
2
4
2
0
0
Consumer Not Responding to Contact
2
0
0
0
0
0
E/R Visit - Behavioral/Physical Health
18
12
17
18
15
15
Inability to Locate Consumer
0
2
6
5
3
0
Indications For Increased Service/Supports
3
5
14
9
4
8
Police Involvement
5
11
6
6
6
4
30
17
29
19
16
15
Sleep Pattern Change From Baseline
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0
1
0
0
0
Unexcused Missed Appts
4
3
2
0
0
0
Total Number of Early Warning Signs
91
71
93
79
64
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Unduplicated Number of Consumers
48
42
49
47
37
35
288
282
286
283
278
279
Attempts At Elopement
Refusal to Take Medications Posing Risk
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Number of people being followed postdischarge
Allegheny HealthChoices, Inc.
Critical Incidents
Physical/Sexual Abuse
Arrest
Attempted Suicide
Client Injury - Accident/Intentional
Community Hosp - Involuntary
Community Hosp - Voluntary
Death
Fire
Housing Change
Medical Hospitalization
Medical Treatment Error
Missing Person
Other Incident - Serious Nature
Total Number of Critical Incidents
Unduplicated Number of Consumers
Number of people being followed
post-discharge
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Jan-09
Feb-09
Mar-09
Apr-09
May-09
Jun-09
0
1
0
1
13
8
1
1
2
15
1
1
11
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39
288
0
2
1
1
4
4
1
0
7
14
1
1
4
40
36
282
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0
2
7
4
1
0
13
14
2
1
6
50
35
286
1
0
0
0
5
4
1
0
1
10
1
1
3
27
24
283
1
2
0
1
8
3
0
0
3
8
3
2
8
39
30
278
0
2
0
0
9
5
0
0
2
9
0
0
13
40
31
279
Allegheny HealthChoices, Inc.
Quality Management and Clinical Consultation
(QMCC) Team
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Works collaboratively with counties and providers
Monitors service quality, effectiveness, and
coordination
Assists community providers in
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Implementing supports through monitoring benchmarks of
recovery
Providing indirect support and education to community
providers, and
Providing direct support when necessary/appropriate and in
coordination with the counties.
Monthly consumer visits have increased from 19 in
January to 179 in July 2009
QMCC team includes: RN, Clinical Nurse Specialist,
SW, D&A Specialist, Pharmacist and Peer Specialist.
Allegheny HealthChoices, Inc.
Community Support Team (CST)
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Resource for counties in offering additional supports to individuals
as they transition from Mayview State Hospital to the community.
Provides direct services to consumers and works to assist the
community providers in implementing optimal supports for the
consumers.
Requests have increased from 2 in January to over 50 in July
2009
Highest areas of support requested thus far have been:
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Spiritual Support
Life Style Improvement
Purposeful Recreation
CST Team includes: RN, SW, D&A Specialist, Vocational,
Recreation, Spiritual, and Peer Specialists.
Allegheny HealthChoices, Inc.
Monarch Springs Long Term Structured
Residence (LTSR)
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15 bed – LTSR providing residential and treatment
services in a structured setting for individuals who
have demonstrated severe and persistent psychiatric
disorders and can reasonably be expected to respond
to therapeutic intervention.
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The facility is licensed and secure.
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Managed in partnership with the SOS transitional
provider, Mercy Behavioral Health, who is the licensed
provider for this facility.
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The location of the LTSR moved from MSH grounds to
Glen Hazel – 3000 Naomi Drive, Pittsburgh on June
30, 2009.
Allegheny HealthChoices, Inc.
Two Specialized Support Homes
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Small specialized support homes providing 24
hours/day, 7 days/week supervision.
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Each home serves 3 residents
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Activities take place in the community with the
expectation that residents will become fully
integrated into the community system of care
and supports over time.
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Homes are managed in partnership with the
SOS transitional provider, Mercy Behavioral
Health.
Allegheny HealthChoices, Inc.
Update on Family Interviews
Response rates from June/July pilot
 Next steps
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Allegheny HealthChoices, Inc.
Summary of Findings from Quality
Assurance Activities
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Objective of these activities is to ensure that
system issues are readily identified and
communicated to relevant stakeholders
Common concerns and similar issues among
treatment systems
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System fragmentation
Engagement / re-engagement
Family involvement / education
Other issues
MRSAP steering committee approach to QA
issues
Allegheny HealthChoices, Inc.