Maryland Quality Incentive Program (QuIP) JUNE 25, 2013 Presented by: ValueOptions Maryland.
1 ValueOptions Care Coordination Program. Program Scope and Objectives Single point of contact for...
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Transcript of 1 ValueOptions Care Coordination Program. Program Scope and Objectives Single point of contact for...
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ValueOptions Care Coordination Program
Program Scope and Objectives
• Single point of contact for an individual child and family whose needs are complex and severe
•Supports family in coordination of services and focuses on the family
•Family driven, youth guided and child centered
•Assures that adequate and appropriate assessments are conducted and that systems come together to tailor services based on needs of the beneficiary
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Program Scope and Objectives
•Promote effective and efficient use of natural resources and promote positive outcomes for individuals and families
•Care Coordinators are assigned specific regions within the State and are resource experts within their geographical region
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Program Goals
• Increase time living in the community and unification with family/significant others
• Decreased admissions to acute inpatient psychiatric settings and to residential programs
• Timely discharge planning and linkages into the community
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Program Goals
• Shorter length of stay in residential programs
• Increased utilization of outpatient services and community supports
• Reduction in duplication of services by accessing existing System of Care initiatives
• Improved treatment planning and coordination among care givers
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Care Coordination Map
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2 Types of Care Coordination
• Consultation• Intervention at the request of the provider,
family member, state agency, etc.
• Intensive Case Management• Beneficiaries meet at least one of the
ValueOptions criteria
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Criteria for Intensive Case Management
• Beneficiaries under age 6 who are admitted to acute or residential inpatient services;
• Beneficiaries who are admitted to acute inpatient services 2 or more times within a 3 month period of time;
• Beneficiaries whose length of stay for their first acute hospitalization is more than 28 calendar days;
• Beneficiaries who are admitted to residential treatment programs and have a length of stay of greater than 12 months;
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Criteria for Intensive Case Management
• Beneficiaries in out of state residential facilities (excludes the border facilities);
• Beneficiaries who have 2 or more residential admissions in one calendar year;
• Beneficiaries in residential treatment with a stay longer than 24 months who have a sexual abuse diagnosis secondary to their mental illness;
• Beneficiaries who are admitted to acute or residential inpatient services that have a chronic comorbid medical diagnosis.
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Consultations
• An intervention that is made at the request of the family, provider, state agency, etc.
• Please contact the coordinator in your area to make this referral.
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Services provided by Care Coordination
• Monthly follow up and collaboration via telephone to the guardian and the provider
• Education• Advocacy• Referrals• Identification and linkages to natural supports
in their community• Discharge planning
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Discharge Criteria
• Stable• Relocation out of state• Refusal to participate in outpatient therapy • Unable to locate despite multiple documented
attempts to contact• Jail or DYS (Division of Youth Services)• DDS placement (such as ICF/MR program)
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Questions for Providers
• How is the client doing?
• What are his/her recent symptoms and behavior?
• How is the client progressing towards their treatment goals?
• Is the family participating in treatment and if so, how often?
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Questions for Providers
• Have there been any medication changes?
• Have recent referrals to wraparound or other services been helpful?
• What are the plans for discharge?
• Can you think of anything this child or family might need at this time? Any additional supports or resources?
• How can I help you with this client?
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Discharge Planning
• Care coordinators advocate for early and timely discharge planning from acute and/or residential facilities
• Care Coordinators will ask the following: • What are the recommendations from the treatment team upon
discharge?• Where will the beneficiary follow up for outpatient mental health
services?• What is the discharge location for the beneficiary? • What are the education recommendations?• What resources or supports does the beneficiary/family need in order
to successfully discharge? (Wraparound, Medicaid Transportation, Parent Training, etc.)
• Is there a safety plan and has it been reviewed with the parent/guardian?
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ValueOptions Health Alert• ValueOptions offers a unique and very helpful resource
for the State of Arkansas’ beneficiaries called Health Alert.
• Outpatient providers can set up OP appointment reminders and/or medication reminders by logging on to ProviderConnect.
• Inpatient providers can set up OP appointment reminders when completing IP discharges via ProviderConnect.
• Members can also manage their appointments and/or medication reminders by logging onto Member Connect. The member can be reached via telephone or email.
• http://arkansas.valueoptions.com/providers.htm
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ValueOptions Health Alert
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ValueOptions Health Alert
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Achieve Solutions• Achieve Solutions is a website available to both Providers
and Beneficiaries providing statewide resources and information.
• To Access Achieve Solutions visit the ValueOptions Arkansas website and click on “For Members”
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Achieve Solutions
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The Arkansas System of Care
• Care Coordination refers often to the Arkansas System of Care initiatives including • CASSP (Child and Adolescent Service System
Program)• Wraparound• MAPS (Multi Agency Planning Services)• Youth MOVE • Parenting Seminars • Family Fun Nights/Activities• Family Support Partners
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Links for the Arkansas System of Care
• Link for CASSP Providers: http://humanservices.arkansas.gov/dbhs/Documents/CASSP%20Providers.pdf
• Link for Wraparound Providers: https://ardhs.sharepointsite.net/ARSOC/Lists/Announcements/DispForm.aspx?ID=74&Source=https%3A%2F%2Fardhs%2Esharepointsite%2Enet%2FARSOC%2Fdefault%2Easpx
• Brochure for the Arkansas System of Care: http://humanservices.arkansas.gov/dbhs/Documents/System%20of%20Care%20Brochure.pdf
• Brochure for Wraparound: http://humanservices.arkansas.gov/dbhs/Documents/Children's%20Wraparound%20Brochure.pdf
• Brochure for the Care Coordination Council: http://humanservices.arkansas.gov/dbhs/Documents/Care%20Coordinating%20Council%20Brochure.pdf
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Meet the Care Coordinators
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From left to right: Kirsten Bird, RN; Corinne Sappington, LCSW; Melanie Hilt, LPC; Jamie Ables, LCSW; Ginger Cheek, LPC; Jill Sorrow, LCSW; and Tosha Brown, LCSW
Contact a Care CoordinatorJamie Ables, LCSW
Clinical Services Manager-Care Coordination
501-707-0961
Central East Region
Ginger Giddens, LPC
Care Coordinator
501-707-0954
Central West Region
Corinne Sappington, LCSW
Care Coordinator
501-707-0974
Northwest Region
Kirsten Bird, RN
Care Coordinator
501-707-0971
Comorbid Coordinator
Tosha Brown, LCSW
Care Coordinator
501-707-0969
Northeast Region
Jill Sorrows, LCSW
Care Coordinator
501-707-0952
Southern Region
Melanie Hilt, LPC
Care Coordinator
501-707-0921
North Central Region
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