Mayview Regional Service Area Plan Quality Improvement/Outcomes (QIO) Committee

1. Mayview Regional Service Area PlanQuality Improvement/Outcomes (QIO) Committee November 19, 2008

2. Agenda for Today’s Meeting • Update on the closure and resource development • Discussion of County responses to our feedback • Discussion of interviewing families • Wrap-up and recommendations

3. Mayview Update • 47 people in Mayview (as of 11/14/08) • 197 people have been discharged since the closure announcement • 2 units remain open

4. Resource development As Mayview has downsized, the counties have invested funds in: • Residential options • Treatment services • Supports and resources

5. New Residential Options • Permanent Supportive Housing (PSH) and related services • Comprehensive Mental Health/Enhanced Personal Care Homes (CMHPCH and EPCH) • Long-term Structured Residences (LTSR) • Specialized Supportive Housing (aka long-term residences) • Extended Acute Services (EAC), both hospital and community-based • Residential Treatment Facility for Adults (RTF-A) • Other county-specific options

6. New Residential Options * Regional resources are being developed by the suburban counties † State operated services that all counties will have access to ‡ While not all counties are developing, counties will have access to resources

7. New/Expanded Community Services • Community Treatment Teams (CTT), also known as Assertive Community Treatment (ACT) • Enhanced Clinical Case Management (ECCM) • Expanded Case Management/Service Coordination • Mobile Medication Teams/Mobile Mental Health • Expanded Outpatient • Expanded Psychiatric Rehabilitation • Crisis Services

8. New/Expanded Community Services * Through a new Clubhouse program

9. New/Expanded Peer Support • Peer mentors • Warmline • Peer specialists • Recovery specialists (County staff)

10. New/Expanded Peer Support

11. Process of Using Data for Evaluation

12. Recap: QIO Feedback for Counties • In August, we reviewed survey data for 62 people discharged from Mayview who had been living in the community for at least six months • We talked about the positive comments and experiences in the responses, and the areas we thought people needed more assistance in

13. Our Priority Areas • Social life, family connections, community integration, activities • Work and education • Physical health, including coordination with mental health

14. County Responses for Priority 1:social life, activities, community integration

15. County Responses for Priority 1 (cont.):social life, activities, community integration

16. Discussion of Priority Area 1 The Counties had different approaches to addressing this area. Their strategies fall into two categories: 1. Individual monitoring of people’s CSPs, their changing interests, and provider actions to support people 2. Listing what is available to consumers to access • Do these strategies meet your expectations for addressing this priority area? What is missing? (Discuss Committee’s responses to questions sent prior to meeting)

17. County Responses for Priority 2:Work and Education

18. County Responses for Priority 2 (cont.):work and education

19. County Responses for Priority 2 (cont.):work and education

20. Discussion of Priority Area 2 The Counties had different approaches to addressing this area. Their strategies fall into three categories: • Individual monitoring of people’s CSPs, their changing interests, and provider actions to support people • System-wide training on Supported Employment, other options • Listing what is available to consumers to access • Do these strategies meet your expectations for addressing this priority area? What is missing? (Discuss Committee’s responses to questions sent prior to meeting)

21. County Responses for Priority 3:physical health, coordination with mental health

22. County Responses for Priority 3 (cont.):physical health, coordination with mental health

23. Discussion of Priority Area 3 The Counties had different approaches to addressing this area. Their strategies fall into three categories: • Individual monitoring of people’s CSPs, their changing interests, and provider actions to support people • Listing what is available to consumers to access • Distributing information to consumers • Do these strategies meet your expectations for addressing this priority area? What is missing? (Discuss Committee’s responses to questions sent prior to meeting)

24. Quality Improvement Plan Basics • How will we measure the impact of the counties’ strategies? • What is a reasonable expectation for improvement, and when?

25. QI Plan: Example

26. Next steps for priority areas • What recommendations do we have for the counties on their plans? • Can we establish one most important priority area?

27. Family Interviews • According to our data, about 80% of people discharged have some involvement with their family. • During the community support plan process (discharge planning), people’s families are asked to complete assessments and come to the meetings. • We don’t have a way to ask people’s family members how things are going for them in the community. • The QIO Committee recommended that a process for interviewing family members be developed.

28. Family Interviews Discussion • How do we get in touch with family members while respecting the privacy of people discharged? • Who should do the interviews? • What questions should we ask family members?