Mayview Regional Service Area Planning Process

1. Mayview Regional Service Area Planning Process Stakeholder’s Meeting February 15, 2008

2. Today’s Agenda • Welcome • Update from the Office Mental Health and Substance Abuse Services, Department of Public Welfare • Progress Report on the Mayview Closure • Overview of the State Operated Services Initiative • County Highlight: • Washington County Peer Mentor Services • Questions and Answers with Audience

3. Welcome • Goals • Share updates on the progress of the CSP process • Show how we are keeping track of everybody, and how we use this information to: • Develop new services: Community based and State Operated • Strengthen interventions • Hear your questions and opinions

4. Mayview State Hospital Update • 4 Units Closed • 6 Units Remaining • 180 individuals are currently in the hospital • 118 Total Discharges • 102 discharges as of December 31, 2007 • 16 discharges have occurred in January and February, 2008

5. Mayview Closure Progress Report • Demographics • Services • Inpatient Utilization • Profile of Residential Placements • Profile of Consumer Community Supports • Rehabilitation; Employment; Educational, Leisure, and Spiritual Activities; Benefits, Income, and Guardianship

6. Demographics: Discharged Individuals By Age Group Discharged Individuals Age

7. Demographics: Discharged Individuals By Race and Gender Race and Gender Data Across State Mental Hospitals (SMH), MRSAP Discharges, and HealthChoices (HC)

8. Services Received After Discharge: All Counties - HealthChoices Service Coordination includes all case management services except Community Treatment Teams and Administrative Case Management.

9. Services Received After Discharge: Allegheny County - Base Service Coordination includes all case management services except Community Treatment Teams and Administrative Case Management.

10. Community Inpatient Utilization: Length of Stay (LOS) MRSAP Discharges: 17 members, 36 IP Admits, Max LOS = 124 days (Inflates AVG)

11. Community Inpatient Utilization: Readmissions

12. Residential Placement Type

13. Supports: Use of Natural Supports By People Discharged

14. Supports:Individuals in Rehabilitation, Employment-Related, or Educational Activities

15. Supports: Individuals with Leisure or Spiritual Activities

16. Supports: Individuals with Guardianship, Income, or Benefits Guardianship Income Benefits

17. Update on the CSP Process • 102 discharges as of 12/31/2007 • 118 Total (16 in Jan & Feb) • Currently, 90 of the 180 total patients are involved in the CSP process Days Between Earliest CSP Meeting And Discharge Date Note: Because the dates of CSP meetings weren’t tracked in a database until the start of phase 2, only those individuals discharged during Phase 2 or Phase 3 are included in Table 4.

18. Community CSP Initiative • Community CSP Initiative • Proactive use of CSP process in community inpatient settings and extended acute care • Currently being piloted at WPIC

19. Overview of Tracking Process What we do with the information • On going monitoring • Service development • Strengthen interventions • Quality Improvement and Outcomes Committee • University of Pittsburgh Evaluation of Closure Allegheny AHCI Secure Database OMHSAS Beaver 250 Pieces of Information For each person discharged Every month MRSAP Counties Greene MRSAP Steering Comm Lawrence Washington Stakeholders

20. Other Tracking Allegheny Early Warning Indicators Implementation of Recommendations Beaver Investigation, Determination of Required Action Greene Lawrence Incidents Washington DPW

21. Quality Assurance • The Failure Mode & Effects Analysis (FMEA) process proactively evaluates activities associated with the closure and works to develop contingencies to minimize risk to consumers, staff, and the community at large. • The Root Cause Analysis (RCA) process objectively and systematically reviews the contributing factors associated with certain critical incidents deemed “sentinel events” involving individuals within the Mayview Service Area.

22. State Operated Services: What Is It? • State will provide services for 40 – 60 individuals in a variety of settings, including: • LTSR • 2 Small Residences of 3 – 4 beds • CTT • Mobile In-Home Crisis • Quality Management and Clinical Consultation

23. State Operated Services: Who Is Eligible? • The State and Counties are working together to identify the target population • High intensity of services / supervision • Individuals with significant criminal background • High risk medical co-morbidity

24. State Operated Services: Staffing Locations • LTSR site not determined at present • Offices for Mobile Services will be in Washington County • Total staff of 92 for all areas combined • Staff will be highly mobile and be available as needed throughout the 5 County area

25. State Operated Services: Integration of Services • All services will be collaborative with the Counties and provider network • As consumers transition out of residential programs, the State anticipates admissions and discharges from all services • Services are intended initially to help transitions out of MSH, but will be available as needed to non-CSP consumers as well

26. County Highlight: Washington County Peer Mentor Service • Developed and delivered by AMI, Inc. • AMI, Inc. contracted with the Peer Support & Advocacy Network (PSAN) • Develop ongoing relationships with Peer Mentors • This service offers numerous benefits: • Comfort • Consistency • Stability • Video • Enhanced Personal Care Home • Clubhouse • Consumer Interviews

27. Discussion