Mecklenburg County Area Mental Health, Developmental Disabilities and Substance Abuse Authority

1. Mecklenburg County Area Mental Health,Developmental Disabilities andSubstance Abuse Authority Local Business Plan Update Board of County Commissioners: Tom Cox Dan Ramirez H. Parks Helms Jim Puckett Norman A. Mitchell, Sr. Valerie C. Woodard Dumont Clark Ruth Samuelson Bill James County Manager: Harry L. Jones, Sr. Deputy County Manager: H. Russell Crider Presented by: Grayce Crockett, Area DirectorSeptember, 2003

2. Local Management Entities (LME) Development • Granted conditional approval of the Local Business Plan effective 7/1/03 through 6/30/06 with the following stipulations: • Must continue to work on full divestiture of non-county funded services • Further develop efforts to support and educate the broader community as to the terms and purpose of the State Plan and the related Local Business Plan • Created an LME organizational structure and a Provided Services organizational structure to develop a “firewall” between the LME and services

3. LME Organizational Structure Yellow Boxesindicate transitional structures that will serve both LME and Provided Services. Green Boxes indicate contracted positions that are not full time.

4. Provided ServicesOrganizational Structure

5. Why Change? • Many of the changes are aimed at improving: • Access • Quality of care • Administrative processes • Consumers outcomes • Key component will be the involvement of community stakeholders, consumers and families in the planning, implementation and ongoing operation of the enhanced service delivery system

6. The Consumer and Family Advisory Committee (CFAC) • Consumers and family members make up the CFAC representing all disability groups. • Members are appointed based on Bylaws developed by the CFAC and meet monthly • Reviewed the Local Business Plan before Mecklenburg submitted it in December 2002. • Reviews all policies affecting consumers and their families. • Participates in all quality improvement measures and performance indicators.

7. The Consumer and Family Advisory Committee (CFAC) • Advocates for consumers locally, regionally and with the State’s Office of Consumer Affairs. • Provides an annual written report to the State and the local BOCC about issues and concerns, successes and progress. • Will work with AMHA to develop communication materials that empower consumers and aid with choice of services and service providers. • Offers recommendations on areas of service eligibility and service array, including identifying gaps in services.

8. What Will Change? • Each consumer will have a Person Centered Plan authorized by the LME • Consumers will have identified benefit plans based on their target population • Provider contracts will be issued based on Best Practices as identified at the local and state level

9. What Will Change? • Requests for Proposals (RFP’s) will be issued over the next three years for the remaining directly operated services • RFP decisions to be made by a community panel of consumers, LME staff, providers, stakeholders and advocates • Some services may remain within the Area Program based on availability and quality of community providers

10. Local Management Entity(LME) - the entity authorized by the state to manage the public mental health system in a defined geographic region Local Business Plan (LBP) - plan developed by the LME submitted to the state every three years identifying the strategic goals and operation of the LME Firewall - separation of LME and services provided by the Area Authority Person Center Plan (PCP) - a life planning method/process of determining real life outcomes (ends) for individuals and developing strategies to achieve these life outcomes Utilization Management (UM) - a management function of the LME that includes eligibility determination, medical necessity determinations, person centered plan authorization and utilization review Glossary of Terms

11. Care Coordination - a Utilization Management function that includes individual-specific activities but does not usually require face-to-face interaction with consumers. This service is focused on consumers who have limited benefits or those who are not eligible for case management and need assistance with coordination of care Utilization Review (UR) - the clinical treatment review conducted by the LME to determine a consumers progress toward treatment goals described in the PCP. UR matches clinical information submitted by the treatment provider with the State Continuing Authorization Criteria. A determination is then made regarding the medical necessity and authorization of continued treatment Glossary of Terms

12. Target populations - groups of individuals identified by the State as having the most severe disabilities and thus the primary focus for services through the LME Consumer and Family Advisory Committee (CFAC) - a committee, required by the state composed of consumers and family members who advise the LME and send an annual report to the BOCC and the State Best Practice - a model of care identified by the State as the acceptable standard of practice for a certain disability group System of Care (SOC) - Thebest practice identified for treating children. Treatment is in the community in a home environment which reduces reliance on out of home placement Recovery Model - Best practice identified for adult mental health with a focus on empowerment, strengths and self-determination Glossary of Terms

13. Mecklenburg County Area Mental Health,Developmental Disabilities andSubstance Abuse Authority Local Business Plan Update Board of County Commissioners: Tom Cox Dan Ramirez H. Parks Helms Jim Puckett Norman A. Mitchell, Sr. Valerie C. Woodard Dumont Clark Ruth Samuelson Bill James County Manager: Harry L. Jones, Sr. Deputy County Manager: H. Russell Crider Presented by: Grayce Crockett, Area DirectorSeptember, 2003