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Iowa’s Walk-Through Experience

Iowa’s Walk-Through Experience. Cross Systems Financing Project Santa Fe, New Mexico March 21, 2007 DeAnn Decker – Iowa Department of Public Health Michele Tilotta – Magellan Health Services. What part of the service system did the walkthrough focus on?

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Iowa’s Walk-Through Experience

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  1. Iowa’s Walk-ThroughExperience Cross Systems Financing Project Santa Fe, New Mexico March 21, 2007 DeAnn Decker – Iowa Department of Public Health Michele Tilotta – Magellan Health Services

  2. What part of the service system did the walkthrough focus on? Co-occurring Clients (Mental Health & Substance Abuse) Where in the process did you begin and end? Initial Intake through the evaluation Who was involved and who played what role? DeAnn Decker – Client Michele Tilotta – Sister

  3. What were the three most important observations made through this walkthrough experience? • Walking integration is different than talking integration • Paperwork • Focus on funding

  4. What was it like to be in the role? Exhausting Rewarding Helpful Somewhat frustrating

  5. What will change as a result of your walkthrough? • Specific performance measures will be built into the RFP For example – 1. Require walkthroughs at all participating agencies 2. Use of NIATx. aims

  6. Co-Occurring Provider Intake Call • Very attentive to both Mental Health and Substance Abuse issues • Took time to discuss my issues and place me with the “right” person • Very friendly • Called on Friday - Appointment on Monday! (next day)

  7. Appointment • Asked to arrive at 9:30 for 10:00am appointment • Glass windows • Given intake packet – short and simple! (3 forms) • Lobby clean and organized, however bulletin board hidden in corner • Two small garbage cans overflowing with food and cans • Very helpful and friendly

  8. Meeting with Therapist • Asked for approval to have “sister” present • Warm and immediately engaging • Continuously checked on both MH and SA issues • Suggested appointment for meds (3 week wait) • Suggested ongoing therapy for both issues

  9. Opportunities for Improvement • No glass partitions • Larger, covered garbage cans • Reposition bulletin board for better visibility • No need to come 30 minutes early • Assess and review intake health symptoms questionnaire – too long, repetitive • 3 weeks is too long to wait for meds • May want to refer to SA groups (AA) or other related support groups

  10. Substance Abuse Program Intake Call • When I asked for appointment, I was sent to central assessment center • Program wouldn’t see me without assessment first • I was given phone number for assessment center and the Program call was ended.

  11. Arrive at Facility • Completed many forms standing in the lobby at glass partitions • Lobby was clean and organized • Receptionist was very friendly and helpful

  12. Meeting with Therapist • Asked MANY questions • Repetitive • Very focused on SA – some focus on MH • Recommended to have a MH evaluation at Mental Health Center • Said I would have a case manager • Very long and boring • Interrupted 3 times during course of session

  13. Opportunities for Improvement • Evaluate the process of evaluation • Review and assess paperwork • Review and assess repeating same questions • Review length of session • Review how questions are asked (read off form) • Explain the meaning of “case manager” • Review referral process – call Mental Health Center? • Review why so many interruptions

  14. Mental Health Center Intake Call • Receptionist friendly • Transferred to Intake Coordinator • Call transfer went to voicemail – no appointment! • Voicemail says will call back in 24-48 hours • Very focused on funding

  15. Arrive at Facility • Friendly, warm staff • Large waiting area • Spent 20 minutes filling out paperwork – all related to funding • More focused on mental health • Intake Coordinator sent me to lobby while she checked Medicaid status • Reported Medicaid status to me in the lobby

  16. Meeting with Therapist • Warm and friendly therapist • Checked with client regarding “sister” involvement • Very attentive to both MH and SA • Many questions • Can see Doctor within a week • Discussed ongoing appointments

  17. Opportunities for Improvement: • No voicemail at initial call • Less focus on funding – more on client • Review and assess required paperwork • Streamline paperwork • Relationship with Substance Abuse Program - case manager? • Refer and suggest more services for SA

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