Action Coalition to Ensure Stability(ACES Project, Indianapolis, IN) Using Medicaid* to End Homelessness *and whatever else you can find Brent Matthews Choices, Inc. July 17, 2006
AGENDA • What is ACES • Who ACES serves • How ACES works • Funding Approaches for Permanent Supported Housing Brent Matthews, Choices, Inc.
What is ACES BASICS (1999) • ACES serves homeless adults with co-occurring mental health and substance use disorders • ACES promotes a Housing First recovery model that supports members in increased periods of sobriety and mental stability • Focus is placed upon member strengths Brent Matthews, Choices, Inc.
What is ACES • 2002: ACES/Choices and Health and Hospital Corporation, receive $1.5 million federal grant to serve an additional 120 members • Lilly Endowment funds an additional 100 • 2003: ACES recognized with Exemplary Award from SAMHSA, CMHS, Homeless Programs Branch. • 2005 Eli Lilly & Co.1st Place Clinical Medicine Reintegration Award Brent Matthews, Choices, Inc.
Who ACES serves DEMOGRAPHICS • ACES has served nearly homeless adults • 57.5% Female • 58.1% African American; 37.4 Caucasian • 69.9% ages 35-54 (avg. 41) • Only 46% completed GED or High School Brent Matthews, Choices, Inc.
ACES Members Systems of Care MEDICAL RECOVERY FAMILY FUN! LEGAL SCHOOL TRANSPORTATION WORK HOUSING Brent Matthews, Choices, Inc.
HOUSING FIRST Brent Matthews, Choices, Inc.
THE MOST SIGNIFICANT PREDICTOR OF TREATMENT SUCCESS Treatment success derives from the implementation of an empathic, hopeful, continuous treatment relationship, which provides integrated treatment and coordination of care through the course of multiple treatment episodes in the process of dual recovery. Brent Matthews, Choices, Inc. SAMHSA consultant, Dr. Ken Minkoff, CCISOC
Serving the Dislabeled “The civil rights view of disability focuses on how society has failed people with disabilities. Like everyone else people with disabilities want to be seen like regular people, not labels. …” From Advocating Change Together, Tools for Change website 2004 Brent Matthews, Choices, Inc.
THE ACES SHIELD ACES MERGES MODELS! System of Care Wraparound & Strengths Motivational Enhancement Assertive Case Management- Resource Coordination Stages of Change
New and Innovative Service Delivery Processes Require New and Innovative Collaborations, Funding Streams and Accounting Processes. Brent Matthews, Choices, Inc.
PARTICIPATORY CARE MANAGEMENT • System of Care PrinciplesClinical • Member Directed • Wraparound Values & A.C.C.M. • Multi-system Coordinated Care • Care Management TechnologiesFiscal • Capitated/Case Rate • Outcome Based • Flexible Funding • Technology that blends the Clinical & Fiscal (TCM)
How ACES works Brent Matthews, Choices, Inc.
Midtown CMHC Leveraged Staff 1 Clinical Manager 2 Lead Resource Coordinators 22 Resource Coordinators Annualized: *25 FTE x $35,000 x 24% Fringe = $1, 085,000 We used grant and local dollars to pay for infrastructure support Brent Matthews, Choices, Inc.
FLEXFUNDS If you Need to Think Outside the Bucks $ You Must be Able to Spend Outside the Box. Brent Matthews, Choices, Inc.
Why ACES is different Brent Matthews, Choices, Inc.
Care Management Pre-authorization of Funds by the Worker Closest to the Consumer, that is the Result of a Team Process, is the Preferred Modality. Community Resourcing Brent Matthews, Choices, Inc.
FUNDING POOLS, STREAMS & GEYSERS United Way agencies, county contract providers, indigent care, University Hospitals, Faith Community, Animal Clubs: (Elks, Eagles, Moose, Lions), Masons, Exchange Club, PIC, Rotary, Optimist/Soroptimist, Urban League, Junior League... THE CLIENT, EXTENDED FAMILY, NON-BLOOD RELATIVES, AND ALL OF THEIR STRENGTHS and INTERNAL & EXTERNAL RESOURCES Brent Matthews, Choices, Inc.
How ACES works ACES has worked with Over 60 single housing providers for Scattered site housing. This a shift away from NIMBY to the normality of In Everyone’s Back Yard (IEBY). We use to call it Community! Brent Matthews, Choices, Inc.
COULD BE PUBLIC FUNDED ( CMHCS) PRIVATE PUBLIC FUNDED NOW - MRO Ending Homelessness with ACES TBRA GRANT PUBLIC FUNDING NOW Brent Matthews, Choices, Inc.
Member Funding Sources ENTITLEMENTS Medicaid* 32.9% Medicaid Pending* 38.6% Wishard Advantage* 14.6% Social Security 20.9% Medicare 0.6% Public Aid 38.6% Housing 3.8% Transportation 68.4% Pensions (empl/VA) 3.2% Other (incl. VA) 2.5% • 89% of members obtained access to at least one public entitlement through their involvement in ACES • Average income increased from $285.27/month at enrollment to $479.53 per month at twelve months Brent Matthews, Choices, Inc.
Case Rate • $344 per client per month ($11.30/day) • Serving 200 monthly x 12 = $825,600 • We will apply for CSAT $400k/5yr that begins October, 1, 2006 (If Awarded) • We will promote discussions for public funding • TBRA $250,000 Brent Matthews, Choices, Inc.
If you have come to help me, You’re wasting your time. But if you have come because your liberation is bound up with mine, Come, let us work together. ---Aboriginal Quote Brent Matthews, Choices, Inc.