MDCH PIHP Application for Participation (AFP) Stakeholder Overview

1. MDCH PIHP Application for Participation (AFP)Stakeholder Overview Issued February 6, 2013 Due April 1, 2013

2. Formal Stakeholder VenuesAFP Overview • LifeWays Citizens Advisory Committee – Weds, March 20th • LifeWays Provider Network Meeting- Tues, March 19th • Coffee & Conversation with CEO

3. What is the AFP? • Restructuring of system from 18 to 10 PIHPS • New state contracts January 1, 2014 • Re-procurement of Medicaid specialty services • Submission of policies, plans and/or assurances by existing or new entities according to MDCH map with identification of direct, delegated or contracted functions • Maintaining/Improving public mental health system Similar to 2002 AFP, targeted to CMHSPs in keeping with Michigan’s waiver renewal

5. AFP Sections • 1. Governance • 2. Administrative Functions Financial Management Information Systems Management Provider Network Management Utilization Management Customer Services Quality Management

6. AFP Section (continued) • 3. Accreditation Status • 4. External Quality Review • 5. Public Policy Initiatives Regional Crisis Response Capacity Health & Welfare Olmstead Compliance Substance Use Disorder Prevention & Treatment Recovery

7. What Does This Mean for LifeWays? • Part of a new structure – Mid-State PIHP • Maribeth Caldwell has been participating in 12 CEO discussions and planning since fall 2012 • Working with new regional mental health public partners to make submission and post-submission operations plans, with support of TSG Solutions • Retain CMHSP status • New PIHP – Contractual oversight of 12 CMHSPs • Delegation of many responsibilities based on CEOs planning to date • Maintain local communities strengths and priorities • Transition of substance abuse programs

8. Consumer AFP Involvement “Because MDCH continues to value and promote community involvement, there must be documentation that individuals who receive services, family members, and/or advocates representing each service area of the region, if applicable, and all populations served, including adults with serious mental illness, children with serious emotional disturbance, children and adults with developmental disabilities, and children and adults with substance use disorders were involved in the development of this application.”

9. AFP Themes • The PIHP must be a separate legal entity • The PIHP must have common policies and procedures in key areas • The PIHP applicant must attest to assurances and outline contractual CMHSP delegations • The PIHP is responsible for oversight and all assurances • The PIHP must have certain leadership positions/roles, but has flexibility in how arranged • New Accreditation expectations

10. AFP Consumer Specific Themes • Customer Service • Public Policies Crisis response/at-risk consumers Health and welfare Community living Employment Community activities • Recovery

11. Customer Services • Information Services & Consumer Handbook • Includes “facilitation of consumer empowerment and participation in PIHP planning and monitoring” • Customer Complaint, Grievances and Appeals • Community Benefit

12. Crisis Response • Tracking/Trending of Critical Incidents • Employing Prevention Strategies • Regional Crisis Response to Behavioral or Medical Crises • Evaluate factors/precursors/warnings • Eliminate or lesson risk – including training • Data - Crisis placements, 911 calls, inpatient admissions, and related training

13. Employment • Work as key component to recovery • Competitive, integrated employment • Customary wage and benefits optimal • Increase agency and subcontractor employment of persons with disabilities • Linkages to benefits • Data – workshop, supported employment, integrated employment and volunteer

14. Health & Welfare • Wellness • Chronic Condition Management • Access to and Coordination/Integration with Primary Care • Abuse & Neglect Prevention • Trauma Informed Care & Services • Data – Trauma training

15. Community Living • Non-Institutional Care • Community Housing Options & Choices • Community Integration • Culture of Gentleness • Data - Licensed and independent living

16. Community Activities • Data – involvement at least once per month • Clubs, Social Events, Visiting Friends/Relatives • Continuing Education Classes • Athletic/Recreational Participation • Attendance at Sporting/Art/Theater/Movies • No extra-curricular activity • Informed PCP Choice regarding work and activities • Opportunities for integration and inclusion

17. SAMHSA New Recovery Dimensions • Health – overcoming or managing one’s disease(s) or symptoms-and making informed, healthy choices that support and promote physical and emotional wellbeing • Home – a stable and safe place to live • Purpose – meaningful daily activities, such as a job, school, volunteerism, family caretaking, or creative endeavors, and the independence, income and resources to participate in society • Community – relationships and social networks that provide support, friendship, love and hope

18. In Conclusion • Stay tuned for updates from LifeWays • This AFP will not disrupt or change services and should be transparent to consumers • This AFP should help LifeWays to continue to improve upon outcomes and supports for persons with disabilities in Jackson & Michigan

19. Your Input for AFP • Questions ? • Comments ? • Suggestions ? • Updates from LifeWays ?