1. LENAPE VALLEY FOUNDATION BUCKS COUNTY AREA AGENCY ON AGING BUCKS COUNTY MENTAL HEALTH/ DEVELOPMENTAL PROGRAMS Senior Empowerment for Life Fulfillment

2. What is SELF The goal of the SELF program is to provide therapeutic intervention that facilitates an individual’s acceptance of traditional mental health services and/or drug and alcohol treatment. The SELF program provides outreach, treatment, peer support, and case management to individuals 60 yrs and older; that are experiencing mental health and/or drug and alcohol problems; and are unable to access needed BHS services.

3. Why SELF The “silo”-style ports of entry in the current behavioral health system can limit access to services for older adults. Altering traditional ways of delivering behavioral health needs. Decrease stigma and increase acceptance among aging adults of mental health treatment. Attention to medical needs and physical capability to receive recommended services. An ever growing need to provide older adults with mental health supports in their homes. By 2030, there will be about 72.1 million older persons, over twice their number in 2000. Department of Health & Human Services, 2012

4. Collaborative Beginning AAA and MH/DP began collaborating to meet this need in 2004. Deputies from Aging, Mental Health, and early on, a representative from the County’s BHS contractor came together to develop a means to engage those 60+ older adults with unmet BHS needs and assisting them with developing connections to appropriate providers. Collaborative cross-training of Aging & MH workers including BSU staff, and later including D/A staff The AAA and MH/DP were pleased to bring Lenape Valley Foundation (LVF) into the collaboration in July, 2009 for the SELF program.

5. Staffing Clinical Executive Program Director Clinical Coordinator Psychiatry CRNP Case Manager Certified Peer Support AAA CM Supervisor AAA Deputy Director for Long-Term Care Bucks County MH/DP Deputy or representative

6. Program Services Referral & Intake Outreach Assessment and Goal Planning Psych Evaluation/Medication Management Nursing assessment Therapeutic Intervention Case Management Peer Support Discharge Planning

7. Clinical Charting Consent for Treatment Treatment Planning Clinical Documentation ( DAP Note) Release of Information Medication Management Documentation Case Management Activities Certified Peer Support Recovery Planning Certified Peer Support Activities

8. Collaboration LVF Weekly / Bi-Weekly Clinical Team Meetings LVF, AAA, MH/DP Bi-Monthly Administrative Meetings LVF, AAA, MD/DP Quarterly Case Conference Review LVF, AAA, MD/DP Yearly QA Audit

9. Monthly Reporting Tracking Forms Statistical Report/Quarterly/ YTD Case Notes Tracking List

10. Collaborative Funding Annual Budget of $150,000.00 from MH/DP (90%) and Aging ( 10%) LVF Billable Services /Collection of Co-Pays

11. Program Challenges C0-Pays Caseload size- The impact of Severe and Persistent Mental Illness (SPMI) Closure/ Discharge Planning Impact of Hoarding

12. Closing Program is continually evolving Benefits of cross-training Communication as a key element Collaborative attitude in providing the program and addressing challenges.