How To Change A City

Transcription

1 Liz Noll, M.A. 1 Aileen Rothbard, ScD 1 Marsicilla Cole, M.S., C.P.R.P. 2 1 University of Pennsylvania, Center for Mental Health Policy & Services Research 2 Horizon House Wellness Alliance Eastern Evaluation Research Society Annual Conference April 30, 2012

2 Converting Partial Hospital Day Programs to Community Integrated Recovery Centers for Persons with Serious Mental Illness Study Team Cathy Bolton, PhD 1 Eugene Brusilovskiy, MUSA 4 Marsicilla Cole, MS, CPRP 3 Arthur Evans, PhD 1 Christina Kang, PhD 2 Joan Kenerson King, RN, MSN, CS 5 Trevor Hadley, PhD 2 Suet Lim, PhD 1 Liz Noll, MA 2 Aileen Rothbard, ScD 2 Mark Salzer, PhD 4 1 Philadelphia Department of Behavioral Health and Intellectual DisAbilities Services 2 University of Pennsylvania, Center for Mental Health Policy & Services Research 3 Horizon House Wellness Alliance 4 Temple University Collaborative on Community Inclusion of Individuals with Psychiatric Disabilities 5 Joan Kenerson King Consulting and Counseling LLC 2012 Eastern Evaluation Research Society Annual Conference April 30, 2012

3 Converting Partial Hospital Day Programs to Community Integrated Recovery Centers for Persons with Serious Mental Illness Panel I: Creating a Recovery Oriented System of Care Marsicilla Cole, M.S., C.P.R.P. Horizon House Wellness Alliance 2012 Eastern Evaluation Research Society Annual Conference April 30, 2012

4 ...merely making incremental improvements in current systems of care will not suffice. Institute of Medicine Crossing the Quality Chasm: A New Health System for the 21 st Century (2001)

5 Rationale and Background Dissatisfaction for years with the maintenance PHP model OMHSAS unsuccessfully ramping up PRS and standards Maintenance Partials: limited appeal (slots trending down; newer/younger not using) New direction of New Freedom Commission, OMHSAS s Call for Change and Dr. Evans s vision and approach 5

6 Process of Change Recovery Advisory Committee (RAC) developed to spearhead DBH system transformation Reviewed day programs including maintenance PHP and developed beginning charge: Belief in recovery into staff and participants Bold transformation Both treatment and rehabilitation needs Life domains broaden the approach Personal, individual goals that matter to the person being served Increased community integration/inclusion as central theme Change staffing to include persons in recovery to inspire hope, increase active engagement of those being served. 6

7 Process of Change Multiple internal presentations for guidance Emphasis on partnership across DBH, with providers and people served Conference to engage widest involvement of our professional, advocacy, and recovering person communities in envisioning a new direction Request for Information process What are your organizational interests What are the regulatory, funding, manpower, conceptual barriers we need to address especially what keeps you building based 7

8 Conceptual Framework Guiding the Philadelphia Recovery and Resilience Oriented Transformation Process Aligning Concepts: Changing how we think Aligning Practice: Changing how we use language and practices at all levels; implementing values based change Aligning Context: Changing regulatory environment, policies and procedures, and community support The Importance of connecting the dots.. Aligning Concepts Aligning Context Aligning Practice

9 Policy & Planning Summary Barriers to Pursuing Individualized Recovery Goals & Advancing Community Inclusion can come from: History of Site Based Interventions Licenses BHMCO Funding Practices Provider Skills No defined mechanism for tracking in community time or community based individual outcomes. 9

10 CIRC Programs Who are we? Community Integrated Recovery Center What we do? Psychiatric Rehabilitation, Skill Building, Psychosocial Education, Illness Management and Recovery, Psychotherapy, Psychiatry

11 CIRC Programs How do we partner? Linking, Advocating, Teaching, Coaching and Modeling Where does it happen? Using the site as an gateway to transition the individual into the community of this or her choice.

12 CIRC Goals The interdisciplinary team will meet persons where they are 1) Focusing on individual needs to improve quality of life 2) Providing opportunities to explore, engage and integrate into the community 3) Allowing individuals to experience hope while achieving his or her recovery goals

13 Recovery Planning Community Inclusion Family Inclusion Peer Culture and Leadership

14 Recovery Planning Living holistic document driven by the person that helps the person achieve his/her hopes and dreams. Each small step reached is celebrated and checked off by the individual so he/she can concretize the success. Living breathing document that changes with the person

15 Community Inclusion Primary Goal: Getting a life more than symptom reduction and/or management for the purpose of living an increasingly full and satisfying life. Community Inclusion means increased opportunities in all areas of one s life.

16 Family Inclusion Defined by person in recovery Partners in recovery process, program design, & policy development Experience of families is valued & respected Highly effective in supporting recovery & community integration

17 Peer Culture/Leadership/Support Based on: shared respect shared experience honesty commitment to helping

18 Peer Culture cont d Peer Council / Steering Committee Self help / 12 step groups Feeling Blue Suicide Anonymous NA/AA/Double Trouble Home group and Sponsorship Peer Leadership and Certified Peer Specialist Peer run groups Trainings WRAP Special Events Graduation

19 Cost Issues Decreasing CRC admissions Decreasing number of Inpatient Episodes Decrease Medicaid funded van services