Just last week, we took a look at how states are planning to transition their Medicaid home- and community-based services (HCBS) to meet the new federal Centers for Medicare and Medicaid Services (CMS) requirements (see Medicaid HCBS Is Driving A New I/DD Service Delivery Paradigm). And earlier in the year, we covered the growing state trend of moving all long-term services and supports (LTSS) – including HCBS – to managed care (see The LTSS Shift – Finding The Opportunities and Where Are We With Managed Long-Term Services & Supports?). Both of these trends are driving a need for innovative approaches for serving complex consumers that utilize more community-based settings, a more intensive focus on performance and outcomes, and greater care coordination.
So what are innovative provider organizations in the I/DD market space doing to be prepared for this evolution in both financing and service delivery? We got an up-close look at two very interesting programs – one from Indiana-based Meridian Health Services and one from Resources for Human Development (RHD) – in the session, Emerging Models, Complex Consumers: Innovative Approaches To Serving The I/DD Population, at The 2016 OPEN MINDS Strategy & Innovation Institute.
Deceil Moore, LCSW, NADD-CC, Director of Connxxions at Meridian Health Services started the day with a look at the Connxxions Program, which serves 1,400 consumers in 43 Indiana counties, and focuses on helping consumers with a dual mental health and developmental diagnosis build the necessary skills to understand themselves and cope. The program coordinates the complex care system for individuals with both developmental and mental health challenges – including a 24/7 approach to services that include individual therapy, group settings, caregiver training, and crisis assistance, while providing consumers with the necessary link to psychiatric services, behavioral health hospitalizations, and primary health care. While long-term outcomes are not available, a four-month snapshot of results from this “one-stop-shop” approach to providing (or coordinating) all the necessary services included:
- 32 hospitalization preventions
- 31 preventions of run-ins with police
- 32 prevention of emergency department runs
- 41 harm preventions
- 28 placement disruption preventions
Grace Dempster, Executive Vice President, Pennsylvania IDD Division, RHD wrapped up the session with a look at her work at RHD, a $260 million, national human services non-profit that has what Ms. Dempster called “the broadest possible service mission” – one that supports “people of all abilities in more than 160 programs in 15 states.” RHD delivers essential day and residential services to 30,000 consumers a year, and the organization’s community health centers serve 20,000 consumers per year. RHD delivers essential day and residential services to people with intellectual disabilities in 59 programs across 14 states – services that include: community living arrangements (CLA); supported living; lifesharing/family living; companion living; mainstay services for special offenders with problematic sexual behaviors; and services to families with children or parents with I/DD.
Ms. Dempster noted that RHD takes an innovative, person-centered approach to serving consumers by starting with the needs of the community first and then creating whatever services are needed to fill that void in a particular location. RHD accomplishes this by reviewing existing services that have a successful, intact infrastructure; then considering the needs of the geographically adjacent community and talking with [payers] and families in development and implementation” of the new services.
While outcomes are not yet available, for the I/DD consumer population, RHD is developing a data collection system with measurable outcomes that will track: reduced recidivism for special offenders; reduced psychiatric hospitalizations for individuals dually diagnosed with I/DD and Mental health Issues; increased employment; increases in integrated health care; and increases in staff retention.
For a more in-depth look at these two programs, check out the upcoming June edition of the OPEN MINDS Management Newsletter. In the meantime, check out Medicaid Services For Consumers With I/DD – You Need A State Roadmap, Big Shifts Ahead In The California IDD Landscape and Self-Determination & Community-Based Service Shaping The IDD Landscape In California. And for even more, join me on August 24 at The 2016 OPEN MINDS California Management Best Practices Institute, where my colleague and OPEN MINDS advisory board member Richard Louis will discuss how the California market is managing LTSS for the I/DD population in “Navigating The Challenges Of Serving Individuals With Intellectual & Developmental Disabilities: A Discussion Of The Transitioning California Market.”