Torrance Regional Service Area Planning Project Stakeholder’s Meeting August 23, 2007

Goals for this Meeting Introduce the project and people involved Answer your questions…at least try to Get input from you on some specific issues that will be important to counties, hospital, and AHCI in developing and implementing a regional service area plan

The Torrance Regional Service Area Planning process initiated by these counties: Allegheny Cambria Armstrong Fayette Bedford Indiana Blair Somerset Butler Westmoreland

Brief History The State (DPW) has required each state hospital service area to develop a regional service plan for that area Major focus of the plans has been on one of three goals – reducing the number of individuals in state hospitals over 2 years Goal driven to a large extent by Supreme Court decision – Olmstead decision

Brief History cont’d State began requiring assessments and community support (discharge) plans for all persons in hospital over 2 years Interests of hospital, counties and individuals came together recognizing the need to more assertively plan for individuals returning to their home communities – developed joint goal of closing one unit

Brief History cont’d Counties have been responsible for developing their own community resources with their base (county) funds Also, counties generally have approached bed reduction through Community-Hospital Integration Program Project (CHIPP) initiatives Now counties recognize need for more systemic and regional approach for developing needed community supports and services and more sustainable and equitable approach to funding – build more on what may be available as a result of HealthChoices

Counties’ Concerns Not enough funds to move and support people in the community and develop necessary diversion services Less influence/lack of success in negotiating different funding options with the State when done one county at a time Not able to do long-term, strategic planning due to current funding arrangement – such planning essential to moving toward more recovery based services

Where does AHCI fit in? AHCI was approached by the Counties to provide assistance in the CSP process, and service planning and development both on a county and multi-county/regional level, financial analysis and budgeting, and training Efforts based on experience in other areas

Primary Tasks Finalize Assessment and CSP (Discharge Planning) Process Implement that process Conduct Financial Analysis including hospital costs and costs of community services Identify Service and Support needs and begin developing them Provide regional training as common needs identified Review and implement discharge tracking process

Structure of Project Planning Committee Assessment and Discharge Committee Quality Improvement Committee (to be formed)

Planning Committee Provides overall direction and decision making for project Composition Advocates (4) Consumers/Family (8) Managed Care/Oversight (5) Counties – 2 or 3/county as guide OMHSAS (4) Providers (3) Torrance State Hospital (4)

Project Goals Facilitate the counties’ and hospital working together to discharge 30 individuals by September 30, 2008 Develop a financial approach that will better support people in the community Coordinate and monitor the discharge process Assist counties in service planning and development

Financing Options Existing state hospital resources Mental Health base funding Mental Retardation waiver funds Department of Aging funds HealthChoices capitation funds HealthChoices reinvestment funds Bridge funding was used in some counties COMCARE waiver funds individuals with traumatic brain injury

Assessment & Discharge Activities

What is the Goal? To implement a coordinated and recovery-driven assessment and discharge planning process for individuals being discharged from Torrance State Hospital To monitor the assessment and discharge process from beginning to end so that consumers and families get what they need to ensure successful community living

Committee’s Goals Review the assessment tools and the assessment process Monitor the discharge planning process Composition Consumers/Family (13) CFST Directors (5) Providers (6) OMHSAS (2) Torrance (2) County (1)

Assessment Tools Consumer Needs Assessment Family Assessment Clinical Team Assessment

Assessment Process Develop a coordinated, thorough, and inclusive assessment process Determine how consumers, families, and staff will be notified of the process Define the roles, competencies, and tasks of the assessment teams, specifically the assessors Pick and train the assessment teams Monitor the process through completion Report regularly to the Planning Committee

Discharge Process Develop and monitor a coordinated and recovery driven discharge process that ensures: The consumer leads the process to the best of his/her ability and with assistance, if needed Consumers invite who they want to be involved in their discharge process Discharge plans are focused on what the consumer (and family) wants and needs for successful community living

Discharge Process Discharge plans are focused on what the consumer (and family) wants and needs for successful community living Resources/supports are in place prior to discharge A facilitator and recorder are part of the planning process

Questions from Group?

We Need Your Input What are some examples of recovery-focused programs that exist in your community? With the goal of diverting from the hospital, what services do people in your community need? What services should be in the community to help people once they leave the state hospital? Identify top three training needs in your community.