Conference of Local Mental Hygiene Directors Pilot Project: Improving Coordination for Incarcerated Health Home Eligible Consumers Monroe County Office of Mental Health and CCSI April 28, 2014
Presenters Scott S. LaVigne, LCSW-R, MBA, Director of Community Services, Seneca County Mental Health Department Mandy Teeter, MBA, MSW Mental Hygiene Administrator, Monroe County of Mental Health John Crilly, PhD, MPH, MSW Director, Quality Improvement, CCSI
Agenda Introduction Brief History of Problem and Technical Assistance Project Request Review of Project Background, Design Considerations, Construction Discussion of Lessons Learned Live Demonstration of tool Next Steps
History of Problem, TAP Request On behalf of the Conference, CCSI was engaged to: Develop a protocol for LGUs to use with the jail, sheriff, and probation departments to support services coordination Identify high needs individuals who may be eligible for health home enrollment and work with the health homes to notify them of such individuals status Develop processes to obtain data to support successful re-entry
Project Background Collaboration-Building and Scope: Community-based stakeholders, LGUs Monroe and other surrounding counties Sheriff s office Jail Officials Mental Health Socio-Legal Services (MCOMH) Data holder representatives Health Homes of Upstate NY (HHUNY) Feedback from other LGUs via CLMHD DELINEATE INTO 2 PHASES:
Collaboration, Design Considerations Collaboration Factors Data availability Data Access Permissions, relationships, expectations, promises Successful Phase I Design Factors Data formatting Determining available common denominators Simplicity, yet functionality Useful output Solid base for moving to Phase II
Project Background Monroe County LGU How they intend to use the application How they work with local health homes Data sharing agreements needed Comments on application testing done to date
Monroe County Health Homes Two Health Homes in Monroe: Health Homes Upstate New York (HHUNY) Operates in 22 Counties Greater Rochester Health Home Network (GRHHN) Operates in Monroe County MCOMH entered into DEAAs with both Health Home Share DOH Member Files MCOMH provides clinical consultation on community referrals Agreements to share HH Enrollment Files
Monroe County HH Care Management Phase II County Sept/Oct 2014 CM Transition HH Activity- February 2014 PIT ~5,000 receiving care management services ~1,200 receive services from transitioned OMH TCM provider
Monroe County Jail Average monthly census = ~1,000 individuals Two Jail Facilities Downtown Facility individuals not yet sentenced Correctional Facility individuals transferred post sentencing MC Jail long-time data sharing relationship MCOMH Jail Database- maintain Microsoft Access database populated with data received directly from a MC jail
MCOMH/MC Jail Collaboration MCOMH Transition Managers referral and facilitates linkages to community based services acts as mental health court liaison-monitor disposition and compliance of current court cases. Consultation on high-need individuals Data Analysis
MC Jail & Care Management Strategy One: New linkages to CM Identify Jail population eligible for care management services Complete universal CM referral form- send to SPOA OR HH CM embedded at Correctional Facility Individual linked to CM services prior to or upon discharge from Jail
MC Jail & Care Management Strategy Two: Existing linkages to CM Identify Jail population connected to CM services Communicate client status to Jail & CM Individual engaged with CM services prior to or upon discharge from Jail
Demo of Tool http://ccsi.staging.innovativesol.com/jaildataexchange
Next Steps Validating success of pilot in Monroe County CLMHD to define roll-out plan within other counties (to start, those involved with HHUNY) Continue to Phase II
Q & A THANK YOU!! COMMENTS? QUESTIONS? CRITIQUES? SUGGESTIONS?