Transcript Insert PtP Families Don’t Fail…

An Introduction
to Choices, Inc.
Afternoon Agenda
• Introduction to Choices
– Provider networks
– Family involvement
– Outcomes and success stories
• Impetus, vision, and goals of the Pilot
• Breakout sessions / facilitated discussions
Choices, Inc.
• Non profit care management organization
created in 1997
• Developed around a community need: “high
cost youth out of state”
• Blended system of care principles with
wraparound values and managed care
technology.
Choices Care Management
•More than 200 employees
• $50 million annual budget
• More than 1350 youth served in
child and family teams daily
• Working across ALL child serving
systems – 60% child welfare
Indiana Choices – Since 1997
Ohio Choices – 2002 - 2011
Maryland Choices – Since 2005
DC Choices – Since 2008
Louisiana Choices - 2012
Choices OS
• Systems of Care Principles (clinical)
– Family Centered Involvement
– Wraparound Process
– Multi-system Coordinated Care
• Care Management technologies (fiscal)
– Capitated or Case Rates
– Outcome Based
– Flexible Funding
• Technology blending clinical & fiscal
– Real Time Data
– Data driven decision making
Care Coordination
Case Manager
Provider Network
School
Child Welfare
Family
Juv Probation
Care
Coordinator
PLAN
Mental Health/
Substance Abuse
Case Rate
Community Provider Networks
• Build upon the existing service system in a
community
• Add organizations who aren’t typically
involved as service providers (churches,
African American organizations – after school,
respite, mentoring)
• Individuals, solo practitioners, small groups
from across the community have an
opportunity to grow with the network
Community Provider Network
Behavioral Health
Psychiatric
Behavior management
Crisis intervention
Day treatment
Evaluation
Family assessment
Family preservation
Family therapy
Group therapy
Individual therapy
Parenting/family skills training
Substance abuse therapy, individual and
group
Special therapy
Assessment
Medication follow-up/psychiatric review
Nursing services
Mentor
Community case management/case aide
Clinical mentor
Educational mentor
Life coach/independent living skills mentor
Parent and family mentor
Recreational/social mentor
Supported work environment
Tutor
Community supervision
Community Provider Network
Placement
Care Coordination
Acute hospitalization
Foster care
Therapeutic foster care
Group home care
Relative placement
Residential treatment
Shelter care
Crisis residential
Supported independent
living
Case management
Activities
Service coordination
Automobile repair
Intensive case management Childcare/supervision
Clothing
Educational expenses
Other
Furnishings/appliances
Camp
Housing (rent, security
Team meeting
deposits)
Consultation with other
Medical
professionals
Monitoring equipment
Guardian ad litem
Paid roommate
Transportation
Supplies/groceries
Interpretive services
Utilities
Incentive money
Respite
Crisis respite
Planned respite
Residential respite
Discretionary
Enhancing Your
System of Care
New Challenges
and Opportunities
Are You a System of
Care Enhancer
In a Strengths Based
Culture?
Strength Based Culture
•
•
•
•
Wraparound Values
Phrases That Pay
Strength Based Care
Strength Based Supervision
Phrases That Pay and Make a
Difference
• LISTEN, LISTEN, and then LISTEN! Enhancers as well as other team
members are expected to listen to the messages that are delivered by
families, as well as one another. When the messages are heard,
enhancers have a better understanding of how to get to Know
Parents.
• Change Agents Change First – Enhancers are challenged from a
strength based approach that in order to help families transition to
change, everyone must be willing to adapt.
Phrases That Pay and Make a
Difference
• Needs Aren’t Services – Enhancers are educated by child and family
teams to focus on the needs of families and not force another service
in their lives.
• Incremental not Instantaneous – Enhancers are challenged to
support the belief that change comes over time and from hard work
and commitment.
What is a SOC Enhancer?
• What is a SOC Enhancer
• Qualities of an Enhancer
• What to Expect
SOC Enhancers….
•Empower youth and families
•Understand the System of Care Values and Phrases That Pay
•Know how to work themselves out of a person’s life
•Understand the strength of a Child and Family Team
•View themselves as Pioneers for Change
•Know how to challenge youth and families to use their strengths
SOC Enhancers…
•Know how to help families learn how to be self-sufficient
•Know how to establish boundaries for themselves
•Know when to share information with the Care Coordinator and
Child and Family Team
•Understand the treatment team goals and the expectation from
the Child and Family Team.
SOC Enhancers Believe…
• That they are the System of Care.
• That the System of Care is exclusive to their locality.
• That they are the true pioneers for change.
• That the value they bring is essential to the success of the System
of Care.
Reciprocity…
How do SOC Enhancers give back?
• SOC Enhancers believe that assisting families is “Just the right
thing to do.”
• SOC Enhancers allow families to contact them for “life.” Many
providers have been called upon by families who were in need
of a “booster shot.”
Reciprocity…
How do Faith-based Enhancers give back?
• Faith-based Enhancers have been known to remain in the lives of
families far after the funding is gone. They offer lifetime support.
• Faith-based Enhancers have been known to practice Servant
Leadership. They assist families selflessly.
Qualities of SOC Enhancers…
• People who show strong compassion for mankind.
• People who do not perceive themselves as heroes.
•
People who do not mind getting in the “trenches” with families.
• People who truly believe that it takes a village.
What to Expect?
Shared Ownership
Togetherness
Shared Accountability
Shared Values
Shared Practice Model
Family Involvement
Continuous Learning
Reciprocity
You represent the SOC in your community
SOC
ENHANCER
STRENGTH
BASED
PRACTICE
WRAPAROUND
STRENGTH
BASED
SUPERVISION
Definition of Family Driven Care
Families have a primary decision making role in the
care of their own children, as well as the policies
and procedures governing care for all children in
their community, state, tribe, territory and nation.
Federation of Families for
Children’s Mental Health
Indiana
Families Reaching for Rainbows est. in
1999 as part of the Marion County, IN
SAMHSA grant.
Advocates for families of children with
behavioral and mental health needs
Marion County Chapter of the
Federation of Families for Children’s
Mental Health
Provider of services:
Peer to peer support
Community supervision
Parenting Classes
Louisiana
•
Partner with a statewide organization
called Ekhaya
•
Provides a Parent Support and
Training Specialist to work directly
with the caregiver in a variety of ways
including household budgeting,
helping to schedule and follow
through with appointments, teaching
parenting skills. They also provide a
Peer Support Specialist who works as
a mentor for the youth.
Maryland
•
Partner with Maryland Coalition of
Families for Children’s Mental
Health & Montgomery County
Federation of Families for
Children’s Mental Health
•
Both provide family navigation:
one-to-one support to families. A
Family Navigator is a parent who
has cared for a child with special
needs and has been trained to
help other families. Navigators
know about the services in
Maryland and in their community,
and how to apply for them. A
Family Navigator can listen to
concerns, attend meetings, when
possible, assist with completing
forms, explain rights, make
connections to appropriate
services. All families in Maryland
can access this service.
Outcomes & Successes
• Hypotheses
– Serve more youth in the community
– Reduce expenses for out-of-home placements
– Improve outcomes for youth
– Save money
Methodology
• Time period: November 2008 through January 2010
• Data obtained:
– Indiana Department of Child Services (DCS) monthly indicator
reports from Region 10
– The Clinical Manager (TCM)
– Child and Adolescent Needs and Strengths Assessment (CANS)
Methodology
• Compared outcomes between youth that received services from
Choices and those that did not
• Note that DCS data includes Choices youth
• Average monthly census
– Choices 122 youth
– DCS 3022 youth enrolled as CHINS
Results
Monthly Living Arrangement Snapshot
60%
DCS
50%
Choices
40%
30%
20%
10%
0%
In Home
Relative Home
Foster Home
Residential
Other
Results
Average Number of Out of Home Placements
3
2.5
2
1.5
1
0.5
0
DCS
Choices
Results
Days in Out of Home Placement
700
DCS
600
Choices
500
400
300
200
100
0
Average
Median
Clinical Outcomes
# of CANS Strengths at Intake & Discharge
10.0
Not in RTC
In RTC
9.0
8.0
# of Strengths
7.0
6.0
5.0
4.0
3.0
2.0
1.0
0.0
Intake
Discharge
Clinical Outcomes
# of CANS Needs at Intake & Discharge
14.0
Not in RTC
12.0
# of Needs
10.0
8.0
6.0
4.0
2.0
0.0
Intake
Discharge
In RTC
Fiscal Outcome
Service
Residential
Choices Tier 3
Cost per day for
Total Cost Per
DCS
LOS (Days)
Youth Episode
$
293.24
270 $
79,174.80
$
126.94
341 $
43,286.54
In 2009, there were 102 youth referred by DCS that were not in RTC at
enrollment. Of those 85 youth remained out of residential treatment.
Savings per Youth= $79,174.80 (cost of residential treatment episode) $43,286.54 (cost of a Choices episode) = $35,888.26
Savings to DCS = $35,888.26 * 85 youth = $3,050,502.10
Choices saves DCS approximately 3 million dollars for every
100 youth they divert from residential treatment.
Results
• Intensive care coordination models can be used to:
• Serve more youth in the community
• Reduce expenses for out-of-home placements
• Improve outcomes for youth
• Save money
Questions?
www.ChoicesTeam.org
Choices, Inc.
4701 N. Keystone Ave.
Suite 150
Indianapolis, IN 46205
(317) 726-2121