Results by Design. Peer Support: Managed Care Financed Innovations. NYAPRS 9 th Annual Executive Seminar April 25, 2013

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1 Peer Support: Results by Design Managed Care Financed Innovations NYAPRS 9 th Annual Executive Seminar April 25, 2013 Presented by Tom Lane, CRPS National Director, Consumer and Recovery Services

2 About the Presenter: Tom Lane, CRPS is the national Director, Consumer and Recovery Services for Magellan s Public Sector Division provides leadership and guidance in promoting the concepts of recovery and resilience throughout Magellan Behavioral Health Services systems of care, in addition to providing technical assistance and training to Magellan staff. Currently, he is leading Magellan s Peer Support Whole Health and Wellness initiative. Prior to joining Magellan, he worked as Vice President of Recovery Supports and Forensic Services for New Horizons of the Treasure Coast, a community mental health center in Florida. He has 14 years experience developing and implementing peer-operated programs, services, and supports in the community and within publicly funded provider settings, including inpatient and state hospital settings. He contributed to Principled Leadership in Mental Health Systems and Programs, authored by Dr. Bill Anthony and Ms. Kevin Huckshorn, published in 2008 by the Boston University s Center for Psychiatric Rehabilitation. Tom has provided technical assistance and training around recovery, reducing seclusion and restraint, and social inclusion at the state and national levels.

3 In health there is freedom. Health is the first of all liberties Henri Frederic Amiel

4 A Snapshot Our mental, physical, emotional, and spiritual health are connected Shifting from illness-centered strategies to well-centered strategies People can and do recovery from psychiatric disabilities, but the average life expectancy for a man is only 53 years, and only 59 years for a woman because of co-morbid conditions! (NASMHPD Mortality Report, 2006) Increased coordination and integration between primary care, mental health, and adjunct health care providers, including advocacy organizations, is critical to improving health outcomes The roles of peers in supporting, promoting, and sustaining improved health is changing whole health and wellness through self-determined goals 4

5 Magellan Health Services Promoting Peer Support Connections to grassroots peer support mutual self-help groups Support for peer-provided services along a continuum grassroots community-based provider-based 5 restrictive settings, other health care systems/providers Training and technical assistance (internal and external) Various funding strategies (mini-grants, contracts, Medicaid) 5

6 Real World Experiences Peer Support Whole Health and Wellness Initiative Partnership with ACG/Larry Fricks to provide training and TA Peer Support Whole Health and Resiliency over 450 certified peer specialists trained between (Maricopa County, AZ; Iowa, Nebraska, Pennsylvania, Florida) Peer Support Whole Health and Wellness e-news Health literacy materials Peers trained in PSWH&R in Integrated Health Homes (Iowa and Maricopa) Peer Internship Program (Louisiana) Pennsylvania Self-Directed Care project incorporates certified peer specialists trained as Recovery Coaches to help participants develop recovery plans supported by Freedom Funds Support for warmlines Maricopa Visions of Hope (4000+ calls/month) Louisiana statewide warmline RFP Collaboration with MHA of NE 6 6

7 Peer Crisis Transition Navigators Peer Crisis Transition Navigator A 24/7 short-term program delivered by trained and highly skilled peers. The goal: to provide willing recipients with; natural supports, pre-crisis planning, and access to post-crisis services designed to successfully help peers navigate through their current crisis episode and reduce the 7 likelihood of experiencing future crisis events. 7

8 Peer Crisis Transition Navigators Peer Crisis Transition Navigator Outcomes 8

9 Peer Recovery Navigators Peer Recovery Navigator 3 6 month peer support program delivered by Magellan team members who are peer specialists. The goal: To provide a bridge between people who receive mental health inpatient services and wellness recovery action planning, connections to 9 community peer specialists, natural supports, pre crisis planning services and post crisis services 9

10 Recovery Navigators and WRAP Program 1 references claims data related to members who were enrolled in the Recovery Care Management program and who receive Peer Recovery Navigator support in Florida for the reporting period. In this program, 49 members who had 144 inpatient admissions and 712 inpatient days before Peer Recovery Navigator engagement saw a decrease of 91 admissions (there were 53 admissions total), and an increase of 494 days in the community (there were 218 inpatient days) after engagement. In Program 1, the 49 individuals who were served saved $374,000 in inpatient costs. Program 2 references claims data related to members with our Florida health plan partner (WellCare) who were enrolled in RCM and supported in developing Wellness Recovery Action Plans (WRAP). In this program, 64 members who had 153 inpatient admissions and 617 inpatient 10 days pre-wrap saw a decrease of 113 admissions (there were 40 admissions total), and an increase of 436 days in the community (there were 181 inpatient days) post-wrap. In Program 2, the 64 individuals who were served saved $262,000 in inpatient costs. Program 3 references claims data related to Florida Medicaid members who were enrolled in RCM and supported in developing Wellness Recovery Action Plans. In this program, 60 members who had 145 admissions and 708 inpatient days pre-wrap saw a decrease of 89 admissions (there were 56 admissions total), and 451 days in the community (there were 257 inpatient days) post-wrap. In Program 3, the 60 individuals who were served saved $330,000 in inpatient costs. 10

11 Peer Recovery Navigators 11 11

12 Web Resources New York Association for Psychosocial Rehabilitation The Institute for Wellness and Recovery Initiatives of Collaborative Support Programs of New Jersey - University of Medicine and Dentistry of New Jersey Wellness Coaching - UIC Center on Psychiatric Disability and Co-Occurring Medical Conditions - Stanford Univ. CDSM - WRAP The Copeland Center SAMHSA Wellness Initiative - Magellan Peer Support e-courses Magellan Peer Support Whole Health and Wellness e-newsletter Health Literacy educational tip sheets

13 Contact information Tom Lane, CRPS National Director, Consumer and Recovery Services Phone: