LifeWays Community Mental Health Pine Room 9:30am-11:00am Agenda - - PowerPoint PPT Presentation

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LifeWays Community Mental Health Pine Room 9:30am-11:00am Agenda - - PowerPoint PPT Presentation

LifeWays Community Mental Health Pine Room 9:30am-11:00am Agenda Introductions/Welcome Provider Kudos Director Updates of Contracts and Network Management LifeWays Procedure Changes & Announcements Integrated Care


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LifeWays Community Mental Health

Pine Room│9:30am-11:00am

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Agenda

 Introductions/Welcome  Provider Kudos  Director Updates of Contracts and Network Management  LifeWays Procedure Changes & Announcements  Integrated Care – Traci Fowler, Supervisor Medical Services  Alternative Choices- Dianna Nelson, COO  Community Inclusive Recreation - Stephen Edwardson,  30 Second PSA  Employment First - Julie Strenn, Subject Matter Expert

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Welcome │ Introductions

Michael Cupp, Director Contracts and Network Management

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“I would like to recognize David Lowe – he has helped collaborate on several Wraparound cases recently. His feedback has been extremely beneficial and helpful in getting the most appropriate services to help keep our consumers safe. I really value his partnership and teamwork approach.”

  • Terra Chall

Community Services Supervisor Highfields

Kudos!

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Kudos!

“I would like to recognize Recovery Technology, Hope Network and Segue for their hard work to immediately address a data integrity issue when it was discovered. A recent review from the Data Integrity Group (DIG) produced a result of over 400 inactive staff members who were still assigned to a consumer case. Although those staff did not have access to the record any longer, the incorrect information produced incorrect results connected to treatment team lists, caseloads, consumers not seen,

  • etc. These three providers, without hesitation, made the corrections immediately

(within an hour of sending the initial email) to the consumer chart. Thank you so VERY MUCH for your prompt attention to this matter as LifeWays (and its DIG committee) is committed to ensuring the integrity of the data within LEO.” Alexis Shapiro EMR System Administrator LifeWays Community Mental Health

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Director Updates Contracts and Network Management

Michael Cupp, Director Contracts and Network Management

 Contracts- in process: goal for fully executed is 10/19/18  MST update  Provider Review Process

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LifeWays Procedure Changes & Announcements

 14-03.02 Referral Process for ICSS  5-01.01 NARCAN฀ (naloxone HCI) Nasal Spray  Revised: 4-01.01 Authorization of Authorization of LifeWays Network

Services

 14_03_01_Components of Service Delivery  Special Process Alert: Integro, LLC is closed for referrals to Behavior

Psychology for Behavior Treatment

 Commencement of 30-Day Comment Period for Revised Procedure 2-

04.02 Incident Report

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Integrated Care

Traci Fowler, Supervisor Medical Services

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Integrated Care

Traci Fowler, Supervisor Medical Services

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Integrated Care

Traci Fowler, Supervisor Medical Services “Focusing on whole health and wellness requires a change in mindset. It means helping people live healthier lives by partnering with their physical health providers and assisting them in changing their health behavior to support

  • recovery. I believe this is possible even though it is hard and change takes time.”
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Alternative Choices Dianna Nelson, COO

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Alternative Choices Dianna Nelson, COO

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Alternative Choices Dianna Nelson, COO

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Community Inclusive Recreation

Stephen Edwardson - Art Program Coordinator

Community Inclusive Recreation 331 Jackson Street West, Battle Creek, MI 49037 Phone: 269-968-8249 Fax: 269-969-6218 www.cirFUN.com

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Julie Strenn, Subject Matter Expert Employment First Grant

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Michigan Employment First…

 State of Michigan established an Employment First Policy Priority.  In FY 2018 State of Michigan budget, funds for this project are

appropriated to support the objectives stated in Executive Order 2015- 15 titled Employment First in Michigan.

 In FY 2016 Oakland Community Health Network in collaboration with

Office of Disability Employment Policy (ODEP) rate initiative, was chosen to participate in rate restructuring.

 In FY 2018 an opportunity was created for four (4) CMH to receive

technical assistance for rate restructuring to support the Employment First philosophy.

 NEMCMH was CHOSEN to receive Rate Restructuring TA!

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Employment First Rate Restructuring Goals:

 Increase # of working-age members (16-64) working in integrated

employment at competitive wage with supports as needed.

 Support CMH and employment providers to use alternative payment

methodologies (to allow use of reimbursement models other than fee- for-service)

 Determine options for addressing negative consequences of being able

to bill only for face-to-face service delivery.

 Match outcomes desired with payment model to encourage maximum

level of independence.

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Competitive Integrated Employment…

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Integrated Employment…

Integrated Employment refers to individualized work paid directly by employers at competitive wage with commensurate benefits, occurring in a typical work setting where the employee with a disability interacts or has the

  • pportunity to interact continuously with co-workers without disabilities, has

an opportunity for advancement and mobility, and is preferably engaged full time. Individualized - individual employment situations, not small groups (even if pay is competitive and setting is integrated)

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Supported Employment

Supported employment is considered competitive, integrated employment when:

  • It takes place in a typical work setting where the employee with

a disability interacts or has the opportunity to interact continuously with co-workers without disabilities and has an

  • pportunity for advancement and mobility.
  • It is individualized (one person – one job)
  • The wages paid are competitive (at least minimum)
  • The employer is not the funder or provider of supported

employment services for the individual

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Federal Initiatives

 WIOA – Youth Transition  HCBS - March, 2014: (Implementation by 2019-2022)

 Heightened Scrutiny will be released soon on all non-residential settings  Implementation – compliance by March 2019 unless individualized plan for each person

 Home and Community-Based Settings are places that:

 Support access to the greater community  Provide opportunities to seek employment and work in competitive integrated settings  Provide opportunities to engage in community life  Provide opportunities to control personal resources  Give people receiving services the same access to the community as those who aren’t receiving

services

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 Key Themes:

 Re-adjust rates to match preferred outcomes/services  Create a ”financial incentive” to do Competitive Integrated Employment and a “cost” if not

transitioned to CIE.

 Need to create a financial path for providers to transform their system. – payment for Job

Development

 Maintain Cost Neutrality:

 Build expectation of job coach fading into reimbursement structure for supported

employment

 Fading possible due to blend of the following strategies:

 Customize positions to match skills  Use systematic training to teach job duties  Use of assistive/adaptive technology and aids  Engage natural supports (compensate if necessary)

Outcomes Based Payment Options:

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Supported Employment

  • Fading expected as key to cost-effectiveness and as integral part of service

model

  • Hours of participation are expected to differ from hours of service
  • Face to face service delivery not desirable in many aspects of service model
  • Everyone needs 1:1 paid support 100% of the time they are working in

individual integrated employment.

  • If rates are based on this assumption, Employment First will bankrupt the

waiver

  • Step #1 is accurately projecting support needs in relation to hours being

worked to determine outcome based rates

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Job Development Outcome Based Payment Example:

Outcome Rate Career Profile/Report $950.00 Job Development Placement/Hire $1500-$2100 depending on hours/wages/benefits Ongoing Support (usually 90 days) $800/month 90 or 120 days on Job (retention) $1200

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Job Coaching – Ongoing Outcome Based Payment Example

Acuity Tier 0-11 Months on Job 12-24 Months on Job 25+ Months on Job 1 95% $30.40 78% $24.96 60% $19.20 2 80% $25.60 60% $19.20 45% $14.40 3 60% $19.20 40% $12.80 30% $9.60 4 35% $11.20 30% $9.60 24% $7.68 **Based on $32/hour Job coaching base rate

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Lifeway’s Outcomes:

 Goal 1:

 Ensure Consultation from SME is streamlined into provider transformation

 Goal 2:

 Expand capacity building through provider training

 Goal 3:

 Develop a rate restructuring model that results in a new reimbursement model other

than fee-for-service and increase (35% growth) in members in Competitive Integrated Employment  Goal 4:

 Strengthen and expand partnerships in implementing Employment First principles

and practices in Jackson and Hillsdale Counties.  Goal 5:

 Inspire others through the sharing of success stories of persons moving from facility-

based services to competitive integrated employment with Employment Frist Initiative stakeholders.

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30 Second PSA

 Provider Updates, announcements, questions, comments?

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LifeWays Community Mental Health Thank You for Attending!

Pine Room│9:30am-11:00am