Connecticut PASRR Linkages Highlights: Relationships and Communication Best Practices: Nursing Home Diversion & Transition Program (NHDTP) Mental Health Waiver/ W.I.S.E. Program Contact: Jennifer Glick, RN, MSW CT Dept of Mental Health & Addiction Services www.ct.gov/dmhas 860-262-5818 or jennifer.glick@ct.gov
State Overview Medicaid Authority MH Authority Others PASRR and Electronic Vendor Key Offices MFP State Unit on Aging LTC- Ombudsman Older Adult Services PASRR And NHDTP MH Waiver (W.I.S.E.) Community Placements State DD Authority ADRCs State Dept. Public Health Elderly Protective Services Triple A s Nursing Homes Hospitals Independent Living Centers
Nursing Home Diversion & Transition Program Divert clients from NH admission Originate in hospitals or community settings PASRR Trigger: Does not meet NH LOC criteria Medicaid Authority, PASRR vendor, and referral source communicate directly with Program Manager and staff Transition NH clients back to community Originate in NHs PASRR Trigger: Approved for short term placement or no longer meets NH LOC Medicaid Authority, PASRR vendor, and NH communicate directly with Program Manager and staff Program staff see clients wherever they are located Program staff collaborate with clients and NH staff, and MFP on Discharge Planning to community setting 7/2008-7/2011: 264 diversions 7/2008-7/2011: 270 transitions
Nursing Home Diversion & Transition Program 7 Nurse Clinicians and 2 Case Managers assigned to geographic locations in state Clarify/validate Level of Care (LOC) needs and services Cross-trained with Mental Health Waiver program Monthly meetings with NH staff and Money Follows the Person (MFP) staff Piloting groups in NH settings: Chronic disease self management Double Trouble for co-occurring Mental Illness & Substance Abuse Community skills-building
Mental Health Waiver/ W.I.S.E. Program 1 of 2 MH waivers in U.S. Operational since April 2009 Assists clients to be diverted or discharged from NHs Person-Centered, Recovery and Psych Rehab Model Recovery Assistant: hybrid companion, homemaker, PCA, and respite Cost Neutrality
Secure Online Website for the Utah Mental Health PASRR Program Robert H. Snarr, MPA, LPC, NCC State Adult Programs Manager Utah Department of Human Services Division of Substance Abuse and Mental Health
Innovation and Efficiency To directly impact the quality of life for individuals who are pending admission or admitted to Nursing Facilities statewide Reduce State costs and improved time frames in completing all determinations Utah State PASRR Program Division of Substance and Mental Health
Experience Recommendation to Leadership in 2007 Two Year Process Automate all Level II Evaluations and Determinations Electronic Billing Process Vision-Have a clear idea of a strong system Educate everyone and provide cross training Recognize and appreciate the concerns, constraints and expertise of others Involve those with decision-making power Collaboration Utah State PASRR Program Division of Substance and Mental Health
Experience Keep expectations and timelines realistic Promote sustainability Develop a strategic financial plan How the system works in your local jurisdiction or State and what that means for your planning process Identify local expertise that can help with planning efforts The capabilities and limitations of the users network in your area Olmstead compliance Utah State PASRR Program Division of Substance and Mental Health
Cost Effectiveness Decreased staff time Reduced Work load System cost Maintenance cost Total Cost Savings Utah State PASRR Program Division of Substance and Mental Health
Key Features & Outcomes Improved Individual Care Improved communication Improved Time frames Better long-term relationships with stakeholders Decreased unnecessary institutional placements Utah State PASRR Program Division of Substance and Mental Health
Contact Information Robert H. Snarr, MPA, LPC, NCC State Adult Programs Manager Utah Department of Human Services Division of Substance Abuse & Mental Health 195 North 1950 West Salt Lake City, UT 84116 phone: 801-538-4080 fax: 801-538-9892 e: rsnarr@utah.gov
Nevada PASRR Program and Promising Practices Dave Caloiaro, MSW, LISW PASRR Level II Program Manager Nevada Division of Mental Health and Developmental Services (MHDS)
PASRR II-B Resident and Specialized Services Coordination The Nevada Division of Mental Health and Developmental Services assigns a regional PASRR Coordinator to NF residents screened as PASRR II-B, to ensure the client receives the provision of Specialized Services they require. There are six statewide MHDS PASRR Coordinators in three locations of the state north, south and rural this represents one MH coordinator and one DS coordinator in each region.
PASRR II-B Resident and Specialized Services Coordination (cont) The MHDS Regional PASRR Coordinator: Performs quarterly onsite reviews of the PASRR II-B client at the nursing facility (out-of-state performs medical record reviews), to assure PASRR clients are receiving the provision of Specialized services they require. Whenever possible, serves as a member on the client s multidiscipline Treatment/Care Plan team. Assists acute care hospital discharge planners with finding alternatives to nursing facility placement, if requested.
Nevada PASRR II-B Specialized Services For Clients with Mental Illness (most common) Psychotropic Medications Psychiatrist Follow-up Services Transitioning Services, to assist in moving to a less restrictive environment Monitoring and Advocacy Psychotherapy
Nevada PASRR II-B Specialized Services For Clients with Developmental/Intellectual Disabilities (most common) Day Services School Referral and Services Transitioning Services, to assist in moving to a less restrictive environment Monitoring and Advocacy
MHDS Bi-Annual PASRR Program Compliance Reviews MHDS conducts a comprehensive PASRR Program Compliance Review on a bi-annual basis, in three parts: 1) a desk review of the PASRR QIO-like contractor/vendor, shared jointly by Medicaid and MHDS, of randomly selected PASRR case determinations (and accompanying medical records), 2) onsite review of PASRR II-B residents who require Specialized Services, in a number of statewide Nevada and out-of-state nursing facilities; and 3) a performance review of each of MHDS six regional PASRR coordinators.
MHDS Continuing Commitments with the Nevada PASRR Program Continuing the close working relationship and partnership with Nevada Medicaid, which deserves recognition and praise for the success of the Nevada PASRR Program. Maintaining the Nevada Statewide Nevada PASRR Committee, which meets quarterly, and includes members from Medicaid, the PASRR Vendor, and the MHDS six statewide regional PASRR Coordinators. When funding resources permit it, continuing to provide education and training to nursing facility staff with respect to Nevada PASRR requirements, including documentation requirements.
Contact Information: Dave Caloiaro, MSW, LISW, PASRR Program Manager Nevada Division of Mental Health and Developmental Services (775) 684-5970 Email: dcaloiaro@mhds.nv.gov