Mississippi RCSC Summary

<A NAME=\"MSRC\"></A> <P ALIGN=\"RIGHT\"><EM>Real Choice Systems Change</EM></P> <H2 ALIGN=\"CENTER\">MISSISSIPPI</H2> <H3>Identified Problems with the State's Long-Term Care System</H3> <P> <UL> <LI>Need for a more person-centered and hands-on approach by case managers and therapists as part of the community support system.</LI> <LI>Need for improvements in the quality of supports, to be based on individual preferences.</LI> <LI>Inadequate transition support for individuals discharged from state psychiatric hospitals and crisis centers.</LI> <LI>Gaps in services for individuals with serious mental illness and dual diagnosis.</LI> <LI>Lack of collaboration with family members.</LI> <LI>Inadequate advocacy on behalf of individual mental health clients.</LI> <LI>Concerns about losing SSI, SSBI and other financial assistance for mental health clients who undertake work.</LI> <LI>Lack of support in accessing safe, affordable housing.</LI> <LI>Lack of flexible funding for support services that otherwise can not be accessed.<EM> </EM></LI> </UL> </P> <H3>Perceived Strengths</H3> <P> <UL> <LI>Strong long-term administrative leadership as well as legislative and gubernatorial support of community-based continuity of care.</LI> <LI>Strong interagency collaboration with the Division of Medicaid.</LI> <LI>The Department of Mental Health (DMH) is actively involved in the Mississippi Access to Care Plan (House Bill 929), a comprehensive ten year plan to address the needs and expand service options for persons with disabilities. These include persons with mental illness, mental retardation/developmental disabilities, and physical disabilities, as well as elderly persons with disabilities.</LI> <LI>DMH is committed to establishing and maintaining partnerships with consumers and families as reflected through participation by consumer and family members as chair persons and members of several task forces and coalitions throughout the state, and as participants in the peer review process of the Mental Health Association's regular monitoring program.</LI> </UL> </P> <H3>Primary Focus of Grant Activities</H3> <P> <UL> <LI>Improve quality of life for adolescents and adults with severe mental illness or dual diagnosis.</LI> <LI>Train stakeholders in the Person Centered Planning (PCP) process in three selected mental health regions.</LI> <LI>Collaborate with current support systems to demonstrate the PCP process.</LI> <LI>Document the individual-level cost effectiveness of the PCP process.</LI> <LI>Document improvements in the quality of supports based on the PCP model.</LI> </UL> </P> <H3>Goals, Objectives, and Activities</H3> <P><STRONG>Overall Goal.</STRONG> Introduce the PCP process to Mental Illness Management and Intensive Case Management (MIMS) services to reduce the need for unnecessary hospitalization and improve quality of life for adolescents and adults with serious mental illness or dual diagnosis.</P> <P><STRONG>Goal.</STRONG> Review MIMS and Intensive Case Management services and introduce the PCP process.</P> <P><STRONG><EM>Objectives/Activities</EM></STRONG> <UL> <LI>Identify current supports and key stakeholders in three Community Mental Health Regions.</LI> <LI>Select co-facilitators for the PCP process from each pilot region (the MIMS provider, the Intensive Case Manager, a Regional Support Coordinator, and a peer specialist).</LI> <LI>Make initial modifications to the existing developmental disabilities PCP process for use with adolescents and adults with mental illness or dual diagnosis, based on evaluation by the Real Choice project evaluator, Advisory Committee recommendations and input from peer specialists.</LI> <LI>Conduct introductory workshops for Community Mental Health professionals on how to use the PCP process in a regional mental health center.</LI> <LI>Conduct multiple demonstrations of the PCP process and two annual follow-up trainings for the staff of the three pilot centers, as well as members of the Advisory Committee.</LI> <LI>Provide the selected peer specialists with training, support and technical assistance.</LI> </UL> </P> <P><STRONG>Goal.</STRONG> Implement the PCP model in participating Community Mental Health Regions and conduct ongoing evaluation of model effectiveness.</P> <P><STRONG><EM>Objectives/Activities</EM></STRONG> <UL> <LI>Conduct PCP meetings with four individuals with mental illness and staff in each of the three pilot centers in order for staff to thoroughly understand the PCP process.</LI> <LI>Document staff activities and individual outcomes to make recommendations for systems change. An activity log will be used by every staff person involved with each of the four individuals at each of the three centers.</LI> <LI>Implement evaluation methods and the PCP survey instrument, to be used annually with all participants to collect anecdotal information on the use of PCP.</LI> <LI>Conduct process evaluation of the impact on PCP participants, including consumers and service providers, and incorporate evaluation findings into the model.</LI> <LI>Document the individual-level cost effectiveness of the PCP process.</LI> <LI>Analyze community support systems in the three pilot Mental Health Regions regarding the availability of services and gaps in services identified by the PCP process.</LI> <LI>Develop recommendations directed to the Department of Mental Health and the Division of Medicaid for using the PCP process as an alternative to the current Comprehensive Treatment Plan.</LI> <LI>Develop a final product that would include instructions for use and anecdotal information designed to help other professionals implement the PCP model.</LI> </UL> </P> <P><STRONG>Goal.</STRONG> Publish and disseminate findings on the implementation of the model.</P> <P><STRONG><EM>Objectives/Activities</EM></STRONG> <UL> <LI>Prepare PCP co-facilitators at the pilot project sites to train others in the process.</LI> <LI>Publish and present PCP process and project findings, including quality of services and cost effectiveness data, at state and national conferences.</LI> </UL> </P> <H3>Key Activities and Products</H3> <P> <UL> <LI>Review the MIMS and Intensive Case Management systems and introduce the PCP process to meet the needs of adolescents and adults with mental illness or dual diagnosis.</LI> <LI>Train professionals and peer specialists from each of the three participating Community Mental Health Regions to use the PCP model.</LI> <LI>Implement the PCP model in the three participating Community Mental Health Regions and conduct ongoing evaluation of the effectiveness of the model.</LI> <LI>Incorporate evaluation findings into the model and revise as necessary.</LI> <LI>Publish and disseminate findings of the implementation of the model at state and national conferences.</LI> </UL> </P> <H3>Consumer Partners</H3> <P> <UL> <LI>Peer specialists and consumers from the three pilot projects.</LI> <LI>Mental Health Association of Mississippi (MHAM) is an advocacy organization that is consumer driven and operated.</LI> <LI>National Association of Mental Illness (NAMI) is an advocacy organization that includes consumers and their families.</LI> <LI>The Advisory Committee for the Real Choices Grant will include consumers.</LI> </UL> </P> <H3>Consumer Partners and Consumer Involvement in Planning Activities</H3> <P>MHAM and NAMI reviewed the grant application and were involved in meetings to discuss the project activities and proposed outcomes.</P> <H3>Consumer Partners and Consumer Involvement in Implementation Activities</H3> <P> <UL> <LI>Peer specialists at each of the regional mental health centers will be involved in implementing the PCP process, monitoring the progress of individuals, and evaluating the model for potential systems change.</LI> <LI>Consumer partners will be involved in initial training during Year One of the project. During Year Two, consumer involvement will increase with the evaluation and planning processes for reviewing project goals and developing recommendations for systems change.</LI> </UL> </P> <H3>Public Partners</H3> <P> <UL> <LI>Mississippi Council on Developmental Disabilities (MS-CDD).</LI> <LI>Department of Rehabilitation Services.</LI> <LI>The University of Southern Mississippi&#151;The Institute for Disabilities Studies, Home of Your Own Program.</LI> <LI>The University of Southern Mississippi&#151;Department of Curriculum, Instruction and Special Education.</LI> <LI>The University of Mississippi&#151;Department of Psychology.</LI> <LI>Office of Medicaid.</LI> </UL> </P> <H3>Private Partners and Subcontractors</H3> <P> <UL> <LI>Mental Health Association of Capital Area (MHAC).</LI> <LI>The Mental Health Association of Mississippi (MHAM).</LI> <LI>National Association for the Mentally Ill (NAMI).</LI> <LI>Mississippi ARC (Association for the Rights of Citizens with Disabilities).</LI> <LI>Employment for All.</LI> </UL> </P> <H3>Public and Private Partnership Development/Involvement in the Planning Phase</H3> <P><STRONG>Public</STRONG> <UL> <LI>The University of Mississippi and the University of Southern Mississippi co-authored the Grant application and provided the structure for implementation activities, training content, and project evaluation procedures.</LI> <LI>Council on Developmental Disabilities, Office of Medicaid, and USM-Home of Your Own advised and recommended procedures for Grant implementation strategies.</LI> </UL> </P> <P><STRONG>Private</STRONG> <UL> <LI>MHAM and NAMI reviewed the grant application and were involved in meetings to discuss the project activities and proposed outcomes.</LI> <LI>ARC, Employment for All and NAMI also provided technical assistance in the form of recommendations for project implementation strategies.</LI> </UL> </P> <H3>Public and Private Partnership Development/Involvement in Implementation</H3> <P><STRONG>Public</STRONG> <UL> <LI>The Department of Rehabilitation Services will provide the necessary contact with Ticket to Work staff and attend the PCP meetings at the three pilot centers to advise individuals on next steps towards employment.</LI> <LI>The Home of Your Own program staff at the University of Southern Mississippi will supply linkages to housing options as requested by individuals involved in the PCP process.</LI> <LI>The Council on Developmental Disabilities' Executive Director will assist with training and demonstrations of the PCP process, and will be involved in an advisory capacity in studying evaluation results and making systems change recommendations.</LI> <LI>The University of Southern Mississippi&#151;Department of Curriculum, Instruction and Special Education and The University of Mississippi&#151;Department of Psychology will provide staff to implement the project, evaluate the project and assist in making systems change recommendations.</LI> <LI>The Office of Medicaid will be involved in the evaluation of unique activities in implementing the PCP process as used by staff of the three pilot centers.</LI> </UL> </P> <P><STRONG>Private</STRONG> <UL> <LI>The MHAM will provide input regarding the PCP process and outcomes, both for the individual and the system, through MHAM advisory committees and MHAM-sponsored conferences.</LI> <LI>Employment for All, a private nonprofit, and MS ARC will provide training and technical assistance to the three centers.</LI> <LI>NAMI will conduct family training events, incorporating PCP awareness training into the schedule, and will provide peer specialist training. Trained peer specialists will work collaboratively with the pilot centers staff.</LI> <LI>Mental Health Association of Capital Area (MHACA) will conduct provider training and will be involved in monitoring and evaluation.</LI> <LI>There will be collaboration on training and awareness efforts throughout the project among MHACA, MHSM, and NAMI.</LI> </UL> </P> <H3>Oversight/Advisory Committee</H3> <P>The Advisory Committee comprises approximately 30 members, including representatives from the three pilot centers (staff, administration and consumers), peer specialists, representatives from the public partners (MS-CDD, USM, UM, Medicaid) and the private partners (MS-ARC, Employment for All, NAMI). <UL> <LI>Reports will be provided to the Advisory Committee documenting the impact of the pilot project on the quality of services, which will include feedback from both the providers and consumers.</LI> <LI>The Advisory Committee will meet biannually to review and evaluate project activities and make recommendations for next steps and changes in the use of the PCP process.</LI> <LI>The Advisory Committee will develop recommendations targeted to the Department of Mental Health and the Division of Medicaid concerning systems change needs that may be indicated as a result of the PCP pilots.</LI> </UL> </P> <H3>Formative Learning and Evaluation Activities</H3> <P> <UL> <LI>Evaluation of the project will occur at every PCP meeting, both the initial meetings and the follow-up meetings, to determine if targeted outcomes for the individuals are being reached.</LI> <LI>The Advisory Committee will receive reports, review and evaluate project activities, and make recommendations for any necessary changes in project strategies.</LI> </UL> </P> <H3>Evidence of Enduring Change/Sustainability</H3> <P> <UL> <LI>Lower costs of care will benefit the community and the mental health system. Most importantly, it will serve as a demonstration for statewide, long term reform in community mental health services.</LI> <LI>The new Medicaid funding stream, Mental Illness Management Services and intensive case management, is expected to provide permanent funding of case management positions at community mental health centers that can maintain the use of the PCP process and implement a new reimbursement mechanism for the unique activities suggested by the PCP process.</LI> <LI>Throughout the piloting process of PCP, the mindset of everyone involved is shifting towards viewing individuals with mental illness as capable individuals, willing and able to contribute to their home communities.</LI> </UL> </P> <H3>Geographic Focus</H3> <P>Three Community Mental Health Regions: Regions 6 (Greenwood), 13 (Gulfport), and 15 (Vicksburg).</P>