MEDICAID FUNDED PEER SUPPORT SERVICES AND THE TRAINING AND by ay5aByO

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									MEDICAID-FUNDED PEER
  SUPPORT SERVICES
 AND THE TRAINING AND
CERTIFICATION OF PEER
     SPECIALISTS

Building a Recovery House
   Hawaii                  Recovery                  South
                             and                    Carolina

                         Transforming
                       Mental Health Care

   External Review
    and Recovery
        Plans                                 Training and
                                              Certification
                                                of Peers
        Under
    Construction:
   Evolving Roles of
         CPSs

                                             Mental Health
                                             and Medicaid
                                             Partnerships




                            FOUNDATION
                                                Barriers to
 Evaluation As                                 Recovery and
Tool for Change                                  Seeking
                                                 Solutions
                           Consumer Values
                            and Leadership
                 Overview
President’s New Freedom Report

“Consumers who work as providers help expand
      the range and availability of service and
     supports that professionals offer. Studies
       show that consumer-run services and
   consumer- providers can broaden access to
     peer support, engage more individuals in
   traditional mental health services, and serve
  as a resource in the recovery of people with a
       psychiatric diagnosis. Because of their
      experiences, consumer-providers bring
   different attitudes, motivations, insights and
        behavioral qualities to the treatment
                 Overview
President’s New Freedom Report

     “Consequently, consumers should be
  involved in a variety of appropriate service
      and support settings. In particular,
   consumer-operated services for which an
     evidence base is emerging should be
                  promoted.”
      Consumer Values and
          Leadership
                                    Foundation of
                                   Consumer Values
                                    and Leadership

                               •   Advocacy
                               •   Training in governance
                               •   Setting Priorities
                               •   Establishing
Foundation
                Section 1:         Relationships with Key
             Consumer Values
               & Leadership        Leaders
  Mental Health and Medicaid
         Relationships
                                                  Medicaid Overview

                                              • created as a medical
                                                assistance program in 1965
                                                with Title XIX of the Social
                             Section 2:
                          Mental Health and
                                                Security Act
                             Medicaid
                           Relationships

                                              • Medicaid is the single largest
                                                fund source (almost 20%) of
Foundation
     FIRST FLOOR                                all mental health services
                                                delivered in the United States
    SECTION 2: Mental Health and
       Medicaid Relationship



                                                (GAO, 2000)
  Mental Health Block Grant as
           Stimulus
• Federal funding designed to stimulate mental
  health service system development and
  innovation
• Consumer directed activities meet block grant
  requirements
   Peer Supports and other consumer provided
    services are major components of a comprehensive
    service system as required in Criterion 1 of the State
    Plan
   Peer specialist training and certification address
    workforce development and training requirements
    included in Criterion 5 of the State Plan
   Training & Certification of
             Peers
    Candidates for certification training will:

– Identify themselves as former or current consumer of
  mental health or dual diagnosis services and are well-
  grounded in their own recovery
– Hold a High School diploma or GED (including diploma
  earned in Special Education)
– Demonstrate basic reading comprehension and written
  communication
– Have demonstrated experience with leadership, including
  advocacy and or creation/implementation of peer-to-peer
  services
Training & Certification of
          Peers
               The Recovery Process
Onset of        Life is   Change is      Change      Actions for
 Illness       Limited    Possible                    Change




           The Role of Services in the Recovery Process

     The Role of Peer Support in the Recovery Process

    The Role of Documentation in the Recovery Process
   Training & Certification of Peers
                      The Role of Services in the Recovery Process
  Treatment                                      Rehabilitation Services
   Services

                      Developing            Setting an           Functional                Direct
                     Rehabilitation            Overall           Assessment           Skills Teaching
                        Readiness            Rehab Goal
Person is disabled    Person is not       Person begins to     Person is willing to   Person is willing to
        by the            ready to             believe that        explore what it              take
    symptoms of            make a             their life can      will take to make        responsibility
     the illness.       commitment            be different.        some changes.       for their actions.
                         to change.
Task- to decrease                        Task – to empower     Task – to help the     Task – to help the
   the emotional      Task- to instill        the person to       person identify         person use his
     distress by          hope and            participate in       strengths and              or her
    reducing the          rebuild a              his/her         needs in terms of        strengths and
     symptoms.          positive self-          recovery.         skills, resources      to get the skills,
                            image                                  and supports.          resources and
                                                                                             supports
                       “despair”            “hope and          “the will to do”              needed.
  “shock and                                  courage”
     denial”                                                                            “responsible
                                                                                            action”
Training & Certification of Peers
          Other Key Components
                       •Code of Ethics
                            •Continuing Education
                                   •Technology Support



•Mediation for Recovery Training
   •Recovery Support Specialists

           The Peer Support Institute
        • •The Peer Support Institute
    Overcoming Barriers

Changing Hearts




           Changing Heads
   Peer Support and Hospitalization
Data
• New enrollments in FY03 to Peer Supports (not in that service in FY02)
• FY02 hospital admissions, and FY04 hospital admissions
Definitions
• Consumer assigned to Peer Supports group if received service during FY03
Analysis
New Peer Supports Consumers
Of consumers receiving Peer Support services, 15% were admitted to hospital
at least once during FY02, while only 10% were admitted to hospital at least
once during FY04
Of those hospitalized in FY02, 84% showed a reduction in the number of
hospitalizations from FY02 to FY04. Of those 84% who showed a reduction, the
average number o f hospitalizations went from 1.81 to 0.25.
      Peer Supports Employment & Functioning
                      (DLA)
Data
• Assessment data on consumers enrolled in Peer Supports in FY04
Definitions
• A Peer Supports matched pair is an initial assessment matched to the
  last available follow-up available during an FY04 enrollment in Peer
  Supports
• Analysis based on those consumers with available matched pairs
Analysis
Of consumers receiving Peer Supports services, 8% were employed at the
   time of initial assessment, and 9% were employed at the time of the last
   follow-up.
Of consumers receiving Peer Supports services, 49% showed at least
   some statistically significant improvement in functioning on the DLA
   between their initial and last available follow-up assessment (compared
   to 45% of all adult mental health consumers).
29% of Peer Supports consumers showed at least some statistically
   significant improvement in functioning (compared to 18% of all adult
         Cost Comparison

Peer Supports Billing rate = $6.12/ Hour

Psychosocial Rehabilitation Billing rate =
$11.13/ Hour
 State MHA / University Collaboration
Medical College of GA Research Institute
This contract is the first of a planned three- year
  project to evaluate Georgia’s peer support and
  consumer directed services and replication. This
  will strengthen the state’s position as a national
  leader in consumer directed recovery services
  and provide valuable information to us as we
  plan for our own service system transformation.
  It will also give the Division an opportunity to
  impact the training and preparation of future
  mental health professionals with the possibility of
  increasing the availability of psychiatrists and
  psychologists who can work within our public
  mental health system.
 State MHA / University Collaboration
Medical College of GA Research Institute

• Contract developed based on proposal from MCG/Dr.
  Peter Buckley
• Contractor will conduct evaluation of Georgia’s Peer
  Specialist Certification and Training
• Contractor will identify “key ingredients” for successful
  development/ implementation of Peer Centers
• Contract includes development and testing of
  curriculum module to train psychiatry and psychology
  residents in the value of strength based recovery and
  partnering with peers to assist individuals to achieve
  recovery in the mental health practice area
 State MHA / University Collaboration
Medical College of GA Research Institute
• Contractor will develop and implement a practicum
  opportunity to expose psychiatry and psychology
  residents in clinical practice to consumer co-
  management with an emphasis on recovery, through
  partnership with a Certified Peer Specialist
• Contractor will develop recommendations and a plan
  for potential Medicaid and third party insurance billing
  for peer support services provided by peer specialists
  working within psychiatric practices
• Contractor will develop publication strategy to
  disseminate information and service data on Georgia
  recovery based best practice services
            Contact Information
                              Larry Fricks
                             State of Georgia
                    Department of Human Resources
Division of Mental Health, Developmental Disabilities & Addictive Disease
                   2 Peachtree Street, NW, 22nd Floor
                         Atlanta, Georgia 30303
                          Phone: 404-657-2100

                               Cherry Finn
                             State of Georgia
                    Department of Human Resources
Division of Mental Health, Developmental Disabilities & Addictive Disease
                    2 Peachtree Street, NW, 23rd Floor
                         Atlanta, Georgia 30303
                          Phone: 404-657-6087

                            Chris Marshall
                   Center for Mental Health Services
       Substance Abuse and Mental Health Services Administration
                  1 Choke Cherry Road, Room 6-1071
                          Rockville, MD 20857
                          Phone: 240-276-1947
                 Email: chris.marshall@samhsa.hhs.gov
www.gacps.org

								
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