BEHAVIORAL HEALTH PLANNING COUNCIL Adult/Substance Abuse/Medicaid Subcommittee Marcello Maviglia, MD, MPH Loretta Cordova, LMSW,CCM Donald Hume, Peer Support Specialist Supervisor
Improved Quality of Life Journey of healing, transformation enabling person to live meaningful life in a community & strive to achieve his or her fullest potential 2
3 Detox – Hospital Inpatient
4 Medication-Assisted Treatment
5 Intensive Outpatient (IOP)
Care Coordination Member Centered – “Meeting the Member Where • They Are” Recovery Project – Using the ROSC Model • 6
Continued efforts with Non-Medicaid Providers Engaging clients; Completion of assessments • Molina is currently in the following agencies: • Alb. Healthcare for the Homeless, Inc. • St. Martin’s Hospitality Center • Bernalillo County – Public Inebriate Intervention Program (PIIP) • Bernalillo County – Community Addiction Program (CAP) • Gordon Bernal Charter School (HS diploma or GED for people • coming out of jail) (providing face to face HRA and CNA’s and linking to care coordination) 7
Working with the Jails Molina is currently in the following agencies: Bernalillo County – Community Custody Program (CCP) • – electronic monitoring (pending County approval) State of New Mexico Men’s Recovery Academy • State of New Mexico Women’s Recovery Academy • (providing face to face HRA and CNA’s and linking to care coordination) 8
Bridging the Gap between Medicaid and Non- Medicaid Services Strategy – network Non – Medicaid wrap around services and services not covered by Medicaid, train care coordinators on ROSC Model for better quality and outcomes for members. These agencies are currently in initial stages of engagement to provide HRA. • VAS – Detox • Network detoxes statewide • Recovery Homes such as Oxford Houses etc… • Crossroads for Women • Barrett House • State of NM DOH funded SUD Programs 9
Peer Support Continuously looking at assisting our Members in • developing a Recovery Oriented life through: Support of the Wellness Centers • Utilization of Inpatient hospitalization • Assistance of Care Coordination • 10
Wellness Centers Letters of Agreement with the following: • Albuquerque Center for Hope & recovery – Albuquerque • A.R.T New Mexico – Albuquerque • Catron County Grassroots Behavioral Health Group – • Reserve Hozho Drop In Center - Gallup • Inside Out – Espanola, Los Alamos, and Taos • 11
Housing employment opportunities Strategy – network Non – Medicaid wrap around services and services not covered by Medicaid, train care coordinators on ROSC Model for better quality and outcomes for members. NM Housing Coalition • Albuquerque Homeless Alliance • State of NM Supportive Housing • LifeLink (Albuquerque locations) • Oxford Recovery Homes • 12
Vignette 36y old male, diagnosed with bipolar disorder and schizoaffective disorder. On 3/1/14, member became aggressive, agitated, and out of control. Police were called and member was brought to local psychiatric ER. Reportedly, he had stopped taking his medication approx. (6) months ago. He had been followed by the ACT team. MSE: Unkempt, agitated, tangential, disorganized, voicing vague HI with no identified target, denies SI/HI as well as A/V hallucinations. After a few days of treatment with Risperdal and Valproic Acid he showed the following MS: He was wearing the same sweater he has been wearing for days, behavior is calm, speech is slow and soft, and mood is slightly depressed. Affect is reduced in range and reactivity and somewhat somber. Thought process is organized. Thought content: No delusions, paranoia or grandiosity. No signs of internal stimuli. Insight poor and judgment fair and improving. 13
Vignette 19 y old male who was suicidal upon admission and had put a loaded gun to his mouth. He recently lost his job and he is having relationship problems. Family called the police and member was transported to a local hospital main ER, and then transferred to a local psychiatric hospital. He is unable to see his children at this time. He was incarcerated one month ago for violating restraining order. MS: Disheveled, uncooperative, thought process I tangential, thought content: presence of suicidal ideations and plans. No HI or AVH, mood is depressed; insight and judgment are fair/poor. 14
Conclusion Members improve their quality of life • Reduce utilization of high cost services • We see our communities thrive • 15
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