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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.

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action coalition to ensure stability aces project indianapolis in

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
AGENDA
  • What is ACES
  • Who ACES serves
  • How ACES works
  • Funding Approaches for Permanent Supported Housing

Brent Matthews, Choices, Inc.

what is aces
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 aces1
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
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.

slide6

ACES Members

Systems of Care

MEDICAL

RECOVERY

FAMILY

FUN!

LEGAL

SCHOOL

TRANSPORTATION

WORK

HOUSING

Brent Matthews, Choices, Inc.

slide7

HOUSING

FIRST

Brent Matthews, Choices, Inc.

the most significant predictor of treatment success
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

slide9

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.

slide10

THE ACES SHIELD

ACES MERGES MODELS!

System

of Care

Wraparound

&

Strengths

Motivational Enhancement

Assertive Case Management-

Resource Coordination

Stages

of Change

slide11

New and Innovative Service Delivery

Processes Require New and Innovative

Collaborations, Funding Streams and

Accounting Processes.

Brent Matthews, Choices, Inc.

slide12

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
How ACES works

Brent Matthews, Choices, Inc.

slide14

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.

slide15

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
Why ACES is different

Brent Matthews, Choices, Inc.

slide17

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.

slide18

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 works1
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.

ending homelessness with aces

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
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
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.

slide23

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.