New York City Ryan White Part A Mental Health Service Category Presentation

Survey Summary - Provider Responses February 5 th , 2014 Mary Kay Diakite, LMSW Care, Treatment, and Housing Program NYC Department of Health and Mental Hygiene

Purpose

• • To provide the HIV Planning Council Integration of Care (IOC) Committee with an overview of the Mental Health service category.

Additionally, the Providers can also give examples of their unique successes and challenges under the current program model.

Response Rate

• 17 out of 21 completed survey responses (81%): ▫ 10* Mental Health Services (MSV) providers ▫ 5 Mental Health Therapy Counseling (MHTAI) providers ▫ 1 Mental Health Services for Populations with Multiple Special Needs (MHS) provider * There were 2 responses from the same provider, which was counted as 1.

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Survey

10 Questions 1. Describe how the program fills a gap in care, justifying Ryan White Part A as the “payer of last resort.” 2. Cite gaps in any Ryan White Part A HIV services most often mentioned by MSV clients. 3. Describe the impact that the Medicaid certification requirement (Article 28, 31, or 32) has had on service delivery. 4. Describe the impact that reduced or eliminated funding has had on MSV clients. 5. Cite the MOST popular service elements based on client feedback and anecdotal evidence. 6. Cite the LEAST popular service elements based on client feedback and anecdotal evidence.

7. Are there specific components of this mental health program that should be enhanced or reduced? (Please give an example) 8. What would be the challenges associated with adding or removing those services from the program 9. How do you measure success? 10. Describe other notable program successes and challenges not mentioned above. • Provider responses collected via Survey Monkey

Summary and Analysis of Responses

Survey: Summary and Analysis of Responses

I.

Meeting Existing Needs II.

Program Elements III.

Medicaid Certification Requirement IV.

Gaps/Challenges V.

Successes

I. Meeting Existing Needs

• • • • • Addresses client’s eligibility issues Increases client’s access to mental health Broadens target population Provides services not covered by Medicaid but essential for the client’s care and treatment, especially client engagement, care coordination and counseling Provides services that address the specialized needs of the clients

II. Services Provided

• • Most popular services include: ▫ Treatment adherence ▫ Care coordination ▫ Individual/Family counseling ▫ Integration of therapy with Primary Health Care* But other providers cited treatment adherence and counseling as their least popular service, along with AOD services assessments .

and intake * Although technically not a service element, the fact that integrated services were being offered was also popular among the clients

III. Medicaid Certification Requirement

• • 1/3 of the providers stated that this requirement has no impact on their service delivery.

Other providers’ feedback: • •

PROs

Improved capacity to comprehensively meet clients’ needs Facilitated access to psychiatric evaluation and psychotropic medications • • •

CONs

Potentially reduce number of MH individual visits* Administratively, more monitoring involved Continuity of care and staffing challenges * Due to the restriction on “same day visits”

IV. Gaps/Challenges

• • • • • Eligibility verification ▫ Document requirements especially for foreign-born and hard-to-engage clients Incentives ▫ Clients do not receive the same incentives across different agencies  Non-RW incentives Staff ▫ Agencies have insufficient number of staff or the current staff is not trained to handle the specialized needs of the clients Billing and documentation ▫ Time-consuming and prevents staff from allotting more time for service provision Lack of Services ▫ Such as: videoconferencing as an option for maintaining appointments, affordable housing, psychological assessments and urgent care

V. Agency Reported Successes

• • • Client satisfaction ▫ Improved self-reported over-all well-being and quality of life ▫ Satisfaction with quality and service provided Improved health outcomes ▫ Self-reported reduction/improvement of symptoms ▫ Suppressed viral load ▫ Adherence to medications ▫ Reduced ER/hospital visits and crisis interventions Achievement of intermediate program outcomes ▫ Client retention ▫ Increased demand for services, client engagement, and linkage to care ▫ Integration and communication among providers

Mary Kay Diakite, LMSW Care, Treatment and Housing Program New York City Department of Health and Mental Hygiene [email protected]

347-396-7585