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HomeMy WebLinkAboutRES-2002-096 Approval of OPC Area Program Local Business Plan ~ ~" ,S _ .2od ~ -- c~ q ~ R£SOLUTION OF THE BOARD OF COMMISSIONERS OF ORANGE COUNTY, NORTH CAROLINA /~~ ~~~~2 S6 3 WHEREAS, N.C.G.S. ~122C-115(a) requires each county in North Carolina to provide mental health, developmental. disability and substance abuse services either through an area authority or a county program established pursuant to N.C.G.S. §122C-115.1; and WHEREAS, the Boards of Commissioners of Orange County, Person County and Chatham County intend to form a three county public entity to serve as the local management entity ("LME") for Orange, Person and Chatham counties; and WHEREAS, under the guidance and direction of a steering committee, comprised of commission, management, and consumer/family representatives, a local business plan has been developed and commended to the three counties which builds in as much flexibility as possible, allowing the elected leadership the maximum lead time on issues related to the best interests of the consumer and overall financial feasibility, NOW, THEREFORE, the Boards of Commissioners of Orange County by adopting this resolution approve and authorize transmittal by the OPC Area Program to the North Carolina Department of Health and Human Services a local business plan created as a joint effort for the provision of inental health, developmental disability and substance abuse services in Orange, Person and Chatham Counties. -3- 4 This resolution having been submitted to a vote, received the following vote and was duly adopted by Orange County this day of , 2002. Ayes Noes MHR05Resolution -4- 5 I. Planning I.1 The Local Business Plan demonstrates congruence with the Mission and Principles of the State Plan. Orange Person Chatham Area Program is a proven leader in the development of state of the art services and best practices to support citizens with disabilities. Our primary mission is to work in partnership with individuals with disabilities so that they may live full and productive lives within the community. It is the intention of the current administration and the Commissioners of Orange, Person and Chatham Counties to continue this important work under the Local Management Entity ME) Model. The OPC Board of Directors has been a primary partner ' our wo to fulfill this mission and an important liaison to the elected officials of nge so and Chatham counties and the citizens they represent. We have bee fo na o inc d in our Board Membership, individuals who are national y r cog iz ' the fi lds of public policy and disability rights. In May 2000, the ea B ard d ted d th L E hereby adopts the following Mission Statement• Our Missi is to o k~a tn r p't c nsumers and their families so th c ea atisfy' g ves d me integral, valued and o 'b 'ng m er the community. We will: • Suppor 1 I id a s t e meaningf'ul choices and to achieve their • Respec the gnity and diversity of those we serve. • Ensure man and civil rights. • Serve individuals most in need. • Make services readily available and as timely as possible. • Assist individuals to secure and keep a home and a job. • Recognize the importance and complex interaction offamilies. • Use natural supports such as family, friends, neighbors and community organizations. • Use appropriate resources wisely by using no more or no less than what is needed. The OPC 1Vlission Statement is both congruent with and reflective of the North Caxolina Department of Health and Human Services (DHHS) Mission, Vision and Guiding Principles. As an LME, we intend to be a responsible agent of the taxpayers by deploying public resources as efficiently as possible while supporting citizens with severe disabilities in their efforts to live as fully contributing members of the community. This Business Plan will describe an LME that will be both person centered and outcome focused. We will continue to work collaboratively with consumers, family members and community systems in order to maximize natural supports and minimize institutional dependence for both our existing clients and any future clients transitioned from state-run institutions to the communities served by the LME. Our abilitv to successfullv implement the chan~es described in this business plan is contin~ent unon two important factors First the best interest of our consumers will alwavs be our primarv ~uidin~principle as we consider implementing an~ystem refortns. If at anv noint we feel mandated chan~es are ne atively impacting t`peo le we serve then our nlan will be immediatelv modified to nrevent anv harm Secondlv the success of the LME svstem hin es completelv upon adequate funding All the ~oals and obiectives set forth in this nlan are subiect to amendment if funding is deemed insufficient. As we move from an Area Program to a Local Management Entity Model, the way we serve the community will change significantly. Feedback from unity Stakeholders indicates that there are many people in target populations i eed o additional services. Since OPC akeady spends very little on non-priority 'e and ince OPC has been a leader in developing best practice model communi su s o r opportunities to redeploy resources are not great. This ma s he ro ess of p'o ~tizing resources very important. Our LME proposal envisions a oca ly ag d pu li process for evaluating needs and outcomes, where fe ack 's r i ly tra sl into m dified action. Consumers, families, stakeh lder lo a f ci ls ill all cipate actively in this ongoing evaluation. ~ A continuous pl in o e s i a n c ss t'n order to implement our vision and we moved quickly e li i y to such a process. OPC created an active Steering Committ e t a m e s n thly basis. Steering Committee Members include a County Commis io fr O ange, Person and Chatham Counties, three County Managers, the OP Are irector, the OPC Board Chair and the chair of the Consumer and Family Advis ommittee. This group has provided important leadership in the planning process. hey have facilitated the review of stakeholder input and have worked to prepare the community and Area Program for the impending system transformations and improvements. Once the LME is initiated, three groups will assume the primary planning role. The OPC Local Management Entity Board, County Government and the Consumer and Family Advisory Committee will continuously monitor the system and recommend changes. These three groups will oversee OPC from the perspective of intemal monitoring and self improvement, elected official oversight and consumer-family "customer feedback", all working together to ensure that the goals described in both our mission statement and business plan are constantly being evaluated by the citizens we serve. We view the State Plan and its system reforms as an important opportunity to improve how we provide services to the people most in need. Although we anticipate challenges along the way, we look forward to promoting a fully person-centered, efficient and responsive system that the community will be proud to support. 2 I.2 LBP planning process meets state plan requirements I.2.a There is a strength/weakness analysis including methodology for building on strengths and addressing and/or ameliorating weaknesses. To accurately evaluate the relative strengths and weaknesses of the existing Area Program, management initiated an extensive evaluation. The first step in this analysis was to ensure that all stakeholders were given the opportunity to provide input into what they liked about OPC Area Program and where the system could be improved. Consumers, their families, local advocacy groups, staff, private service providers, public officials, local citizens, public agencies such as Department(s) of Social Services, public school systems, and Department(s) of Juvenile Justice, and hospitals have all been included in this process and their input make up findings of this evaluation. An independent consultant created a written survey and condu i terviews. Staff stratified active OPC clients by age and disabiliry group. e cons ant prepared survey instruments specific to each age and disability grou p x' ely 960 clients received the survey instruments. The consultant also condu ted son 1 i terviews with clients to allow for a more in depth exploration of r ev nt i su s. opi s f the surveys and the consultant's full report are attached ~ In addition to the work of thi c ult nt a e e t gather d~tata from other sources. Staff conducted nu rous 'n e ze s an e r se tations of the state plan to a variety o f groups. Wri tte s eys ere se to sta f f, co nity organizations and other stakeholders. Surv y in in ar att ed cal Consumer and Family Advisory Committee has m r gu ar si c Fe ry of 2002 and has provided extremely valuable feedback n h s e g s weaknesses of the existing Area Program. Each participating coun d i forums and County Commissioners are holding public hearings on this pr pose business plan. Findings identify strengths that we plan to integrate into the new system as well as weaknesses that will require significant program modifications. For example, stakeholders generally identified case management as a program strength, but described problems related to service access, including crisis services. Our response is to create a system that will dramatically simplify program access, facilitate crisis response and build upon our strong case management services. This seamless system will not only help people to easily access services, it will also provide the crucial ongoing support required to prevent hospitalization. System details can be found in the Strategic Plan as well as Chapter IV (Service Management) and Chapter V(Access to Care). Stakeholders also identified several services they would like to see more of in the community. Respite Services, ACT Teams, and Supported Living programs were all identified as areas requiring resource development. Through the use of outcome driven utilization management and performance based contracting, we intend to create a provider network system that will encourage and reward the development of high quality services. Again, details can be found in the Strategic Plan as well as Chapters III (Qualified Provider Network Development) and Chapter IV (Service Management). 8 I.2.b There is a policy establishing the local Consumer/Family Advisory Committee (CFAC) and assuring opportunity for meaningful involvement of consumers and families by requiring: • Recognition of the contribution of consumers lhrough their unique perspectives and abilities • Establishment of a non judgmental environment • Timely advance notification of actions proposed Establishment of Consumer and Family Advisory Committee Policy attached I.Z.c There is a statement attached attesting to consumer/stakeholder involvement consistent with the State Plan, which is representative of the broader population of the locality with the confirmation by the CFAC. A statement is attached /I I.2. d There is a resolution of the governing body ac ti /a p oving the LBP as submitted. A resolution is attached l1 I.2.e There is a separate repo ub 'tte t e 1 ca AC~ ( The CFAC Report is attache V I.3 The LBP in or or s a~ ~ ye r stra i plan for the inihal • Ide ti ie a, an year implementation strategy • Co ta n g a s, b ves and activities • Ide ti s m mes and responsible party (individual or entity) for eac goa and objective • Pr ' es evidence of ongoing planning effort • Attaches a policy requiring long-range planning methodology that meets State Plan requirements Tactical & Strategic Planning Policy is attached • Addresses steps necessary to transition individuals now in services who do not meet target population criteria to other community resources as necessary 4 9 STRATEGIC PLAN I. INTRODUCTION: THE STRUCTURE AND FUNCTIONS OF THE LOCAL MANAGEMENT ENTITY We propose a strong LME model that will act as a local governmental unit, organized under the statutory authority granted the counties, and covering Orange, Person, and Chatham counties. We envision a public process that includes both the local government and citizens in the allocation of care and in the evaluation of its results. We intend to minimize the portion of public dollars that is spent on administration to ensure that maximum resources are available for consumer services. We will use these resources to target services to the consumers who are most in need and then build upon our track record in providing best practices to ensure the best possible result. The LME Service Delivery System will directly provide Tria , s essment and Crisis Services, Case Management Services (for complex case y) an sychiatry (for the purpose of short term assessment and crisis interve 'on o 1 I has been suggested that LMEs could also act as a service provider for earl in enti n ervices. OPC is currently evaluating the feasibility and be efit of nc u` g t is ervice as a core service component. All remaining service ill b con ac ed ou to o etwork of private providers. These systems wi ork ry cl se it Colla o tion and Advocacy Unit whose primary fu ion wi~e t f st p si iv workin lationships with other community agenci and o g ni o s. The LME Admini tr iv S te wil e ed to maxirnize the efficient use of resources. It will o e e u i ed r ider Network Unit, Core Service Management, Service Authoriza io U i in nc nd Information Systems, Quality Improvement and Human Resources II. THE LME SER vICE DELIVERYSYSTEM The Tria~e. Assessment and Crisis Unit (TAC) All individuals, regardless of problem or disability group, will enter our service system the same way. Five Triage, Assessment and Crisis Units will be opened in convenient locations where citizens can receive assessment, refenal and crisis related services. These same services can be accessed through a toll free 24 hour phone service. Additionally, people can access LME services through hospitals, key public agencies and qualified providers who will receive training and information regarding how to help people access LME services. In addition to providing access and referral services, the TAC Unit will also provide crisis related services. Immediate crisis intervention counseling and brief crisis intervention follow-up will be available as well as the mobilization of emergent resources as appropriate. These may include: Psychiatric assessment and medication evaluation; Community-based crisis stabilization, which may include brief residential placement or in-home supports to preserve community living; 5 10 • Determination of need for hospitalization when the level of need is more intensive than community alternatives can appropriately offer; and facilitation of such hospitalization; • Diversion from state hospitalization for persons with mental retardation; • Mobile crisis response, providing crisis assessment, intervention and supportive services in-home or elsewhere in the community; • respite care (in and out of home); If services are needed on a long term basis the TAC Unit will refer consumers to appropriate service providers. The Case Mana~ement Unit The essence of LME operations will be to expend resources by mea s of the person- centered service plan and to evaluate the results of these expe ' r s. This makes case management a critical part of local LME operations, as i rms th asis of the relationship between the individual with a disabili d t bl c system for those people least able to negotiate, a complex syste w ho ssist n e. When a person is in need of complex and/or long term service , th pri ci a elat n hip between the individual and the system is negoti d t o~g th case an e. We believe this role is best played by the LME. A decision tool wi e de 1 p~r do t~'in r ei to determine who needs case management at th L le 1. nl ca es th t e d med long term and complex will receive LME Case M n ge nt~All t e ca ill be referred an array of qualified providers. I ~ , The LME case ma a~f w 11 ~as an advocate, negotiator of the service plan, service broker and service moni r. Outcomes and client satisfaction will to be monitored through a direct p rship with a consumer through the documented, written service plan. The Collaboration and Advocacv Unit This unit will continually work to improve, develop and enhance relationships between the LME and community organizations. Additionally, this unit will work to maximize consumer and family participation in collaborative efforts and will participate in needs assessment and program evaluation studies. Finally, the LME is involved in a number of special projects that are described in detail below. The Collaboration and Advocacy Unit will be charged with administering and overseeing these efforts. III. THE LME ADMINSTRATIVE SYSTEM We are designing an administrative infrastructure that will be efficient in both its use of resources and how it manages the service system. Finance, Information Systems, Quality Improvement and Human Resources will continue to provide the support and training necessary to keep the service system running. Additionally, a Core Service Manager will be responsible for overseeing the Triage, Assessment and Crisis, Case Management and Collaboration Units. The Qualified Provider Network Unit will be charged with 6 11 managing the Private Provider system for the LME. Finally, a Service Authorization Unit will be designed to monitor service provider outcomes and to manage the utilization review process. Iv THEROLE OFCONSUMER & FAMILYADVISORYCOMMITTEE (CFAC) As an Area Program, we have a twenty -year plus history of consumer involvement in an advisory and decision making capacity that goes far beyond state mandated requirements. Consumers have consistently played an active role in a variety of areas including membership on the Client Rights Committee and the Area Board. In keeping with this long standing practice, we look forward to a productive working relationship with our Consumer Family Advisory Committee. As directed bv state statute and rule, the Committee's duties and responsibilities shall be consistent with the principles of the State Plan. These include, but are not limited to: • advising and commenting on the LME's local business plan pl ing effort • reviewing and submitting a separate report to the Divis' on the ME's local business plan and planning effort • providing recommendations on areas of service ligi ' ty d ervice anay, including identifying gaps in services • assisting in the identification of der- rve po ulatio s • providing advice and cons tion g d~ig e e opme t additional services and new models of servi~ n ~ S • monitoring se ~ e dev o m~ d eli~dery ~ reviewing and o nt on s e d l0 1 ' e budgets • observing and ep rt' g im ntat' of state and local business plans • participating in all qu li 'm r ve activities, including tracking and reporting on outcome meas e d e o ce indicators • ensuring cons e an f' y participation in all quality improvement projects at both the provider an L levels In addition, CFAC will have representation on various LME committees. This will allow for the participation in policy development, consumer survey development and outcome system design and analysis. The CFAC will also have access to LME management and ~overninQ board for the purpose of advising the LME about needed service improvements. The CFAC has alreadv identified several ur~ent needs includin housing, transnortation, and the DD waitin~ list. CFAC will also help ~ather and provide ongoing needs assessment service evaluation data and will have access to all LME service outcome, and cost data that is not restricted bv confidentialitv. CFAC will also help gather and provide ongoing needs assessment service evaluation data. They will be responsible for assisting in the identification of training needs and for providing relevant training to LME staff. The CFAC has nroposed the establishment of a Self-Helv & Peer Sunnort Center. The LME will support the establishment of such a proiect and will work to mobilize resources sufficient to onerate a formal staff organization. Since the State of North Carolina has expressed stron~ supnort and endorsement of independent consumer empowerment outside LME control. we fullv expect direct State fundin~ of this effort. Once 7 12 operational, the LME will work with the center to make system consumers aware of the center and to assist in the romul ation of information about the center. The full text of the CFAC proposals made to the LME durin~ the plannin~ urocess is attached. V. PILOT PROGRAMS The Area Program has a long history of involvement in pilot projects that demonstrate the principles of best practice. These include projects in supported housing, supported employment, ACT Teams, the Transitional Employment Demonstration Project, Mental Illness/Substance Abuse Pilot Project, Self Determination Pilot Project, OPC Sexually Aggressive Youth Program, Child and Youth Demonstration Project, and our Supported Living Project. We feel this history prepares us to take a leadership position as we enter this new era of service provision. We are requesting permission p lot four changes to the State's plan for the LME system. ~, First, we propose a system that allows the LME to inde li'e tl manage at-risk capitated funds. This authority will give t E th ne ess exibility to meet the unique needs of our community. We are illi g t a u e th ri k associated with these decision making capabilities b use e ee~ a tr ng E is be t suited to serve its citizens. „ ~ ` Second, we propo e that th the region. The L E i 1 ~ will authorize all p n i E range of services a' a le c practically mount ' o t process for the sel ction f a ie respo s bi 'ty for utilization management for •o o provider contracts are managed and r sources. The LME will develop a competitive of the client. When services cannot be ~ contract, the LME assures a fair, competitive Thirdly, we propose that the Division of Mental Health Services supports our efforts to recruit a Multisystemic Therapy (MST) program for our area. This pilot requires the creation of a service definition for the intensive, in-home service for youth in the CMSED categories. Reimbursement for this intensive service would be a monthly or daily rate and be supported by Medicaid, IPRS and CTSP. A community group including DSS, DJJ, school staff and family members have determined that this type of service is a priority for youth in Orange, Person and Chatham counties who have serious emotional disturbances. Finally, our intention is to implement a system of performance based contracting that will tie financial rewards to favorable outcomes. This will be accomplished initially through the selection of critical indicators and the specification of financial incentives for the attainment of critical outcomes. This activity will not replace the use of any DMH developed outcome instruments nor the ongoing development of our local system of Utilization Management. This system will gather extensive data related to client outcome measures and resource costs. Profiles of individual and team providers will be developed in order to compare providers to their peers on a local, regional and (when available) 8 13 national level. This proactive, broad-based approach will allow the LME to create a learning environment within the network which will shape more effective service strategies. The LME will devote its time and energy toward examining trends with the larger client population while clinicians and providers are empowered to work with people on an individual level. A more comprehensive system of performance contracting using more sophisticated outcomes instruments and standards will be developed over time and will replace the initial few indicators used in performance contracting. i~I. SPECIAL PROJECTS ~ The Area Program is involved in a variety of special projects that we intend to continue as a Local Management Entity. It is our feeling that these ventures represent important collaborative efforts that will ultimately promote positive outcomes and best practices. These programs will be administered through the Collaboration and Advocacy Unit of the LME. Examples of some of these projects are described below:/~ Clinical Trials Network The Area Program has been a participant node of the National Institute on Drug Al Network was established by th ati al innovative approaches to tre in~ b ta Research and Traini~ e~ite fdr the e~ OPC is one of the North Carolina als Network. The to test and disseminate ty. The Regional 1 Research Institute. The LME is co itt d t' u ng is articipation, enabling clinical trials to be implemented with i s e i e s e d provider network, thereby enhancing the quality of its subs n e b s tr atment practices and furthering the development of treatment nationw de. . Proiect Odvssev The Developmental Disabilities Department of OPC Area Program is in the third year of participation in the NC Self-Determination Demonstration Project. OPC was selected to receive one of the four grants in North Carolina to implement the principles and practices of Self-Determination for persons with developmental disabilities. These principles require that individuals with developmental disabilities be given control over how public funds for DD services and supports are spent. The pilot projects have worked to change the service system to put people with disabilities and their families in charge of their own lives. Our goal has been to provide the person with a disability the responsibility of deciding what services are needed and direct their own service purchases using public monies. The project has made funds available to hire "support brokers" who are accountable to the participant with developmental disabilities. The support broker assists in planning and coordinating the needed services as identified in the person-centered plan and individual budget. 9 Svstem of Care Grant In 1999, OPC received a federal System of Care Grant to develop community-based services for children with serious emotional disturbance and their families. Child and Family Teams and interagency collaboration are core components of the system of care approach. The existing Orange and Chatham Community Collaborative and a Person Community Collaborative serve as the local management structure for the System of Care project. Involved with OPC in this Collaborative are parents of children with serious emotional disturbance, Family Advocates, Department of Social Service staff, Juvenile Justice, local schools, Guardian ad Litem, cflmmunity agencies (including Chatham Together and the Mental Health Association) and interested community members. The Collaborative has many responsibilities including budget oversight for the grant, identifying and coordinating services and resources across child serving agencies, identifying training needs and exploring resource development rtunities. In 2001, the System of Care project for OPC initiated a resource projec ' volv' community partners, families and private foundations to explore p ling f public funds and acquisition of private funds in order to expand the onti f ervices for children with serious emotional disturbance. ~1 Deaf Services In FY 2000 the OPC Area MH/DD/SAS, Adu en coordination and livery Central Region. T e a year hired two co di at r Services. ~ s p oa h d y the S te ivision of ct o i r uest to consider taking on the to he deaf d ard of hearing for part of the North e o h' equest and at the end of that fiscal ~ ul Services and one for Child and Youth These positions se e the P~ catchment area with direct therapy and case management services. They al o vide consultative services and limited direct service to Durham, Alamance, Caswel , Vance, Granville, Franklin, Warren, Rockingham and Randolph counties. In addition to individual client services, the Coordinators work collaboratively with the area programs and other service and community providers to access resource/service needs and develop therapeutic, vocational, recreational, and social services for the deaf and hard of hearing throughout the area. They also serve as advocates and educators in obtaining and enhancing access to services and improving the quality of a range of services. They do outreach case finding, coordinate specialized services, including interpreter services and provide linkage to the State Coordinator for Deaf Services. A consequence of the establishment of these coordinator positions has been a dramatic increase in the accessing of these specialized services, as consumers needing them have been identified. From an initial 5, the caseload has grown to nearly 50. Continuation of these functions will be assured by the Regional Coordinator positions, as employees of the LME. Due to the special access needs of deaf and hard of hearing consumers, the Regional Coordinators will work closely with the Triage, Assessment and 14 10 Crisis unit and Case Management unit of the LME. The coordinators will provide access, crisis, case management and special therapy functions where possible and will assist the unit staff when they are providing service directly to consumers. The LME will also establish contracts with other LME's in the region. This will ensure Medicaid reimbursement for services provided by the Regional Coordinators to consumers who reside in other catchment areas. i~II. DIVESTITURE AND TRANSITION ISSUES A transition plan and checklist will be developed to help LME staff to identify current consumers who do not meet the target population eligibility requirements. Appropriate community resources will be identified and LME staff will provide individuals with the necessary information and referrals. LME staff will work to ensure individuals are transitioned in a thoughtful and appropriate manner. ~ Community resource information will be compiled i a st tha will be available to all staff and will also be made available on the LME ebsi . 's 'st will be updated on a regular basis and will include contact info a ion or acc ssi : ealth services, financial support, self-help and advocacy services, aith bas d e ices h eless support services, Alcoholics Anonymous suppo , nd 11 o h~r a p p' res ur es. The LME intends o~w6rk toward divesting from its current role as service provider gradually over the course of the next three to five years. Programs that spin off from the OPC system will be supported as much as possible during this transition. We are currently examining specific ways of helping those agencies create the necessary infrastructure they will need to succeed, while ensuring the integrity of free access to a diverse qualified provider network. All plans and time tables for service divestiture are subiect to immediate amendment if at any point it is determined that these chan e~ s are not in the best interest of our consumers. We will be exQloring divestinQ ovtions that mav include contracting out current services, transferring current functions to existing a~encies or assistin~ in the creation of new entities. This is a com~licated~rocess and all divestiture decisions will require careful consideration to ensure consumers are not ne at~v impacted during this transition period. Like all comnonents of this business plan, successful divesture is contin e~nt upon sufficient fundin~. Our divestiture plan is subject to modification if the necessar ~~supnorts are deemed inadequate. A detailed divestiture plan is being written and will be completed during the first quarter of fiscal year 2004. 15 11 16 THREE YEAR IMPLEMENTA TION PLAN Goal One - The Service Delivery System: The LME will work to maximize client choice and accessibility while maintaining service integrity during the building and implementation of the Core Service System and the Qualified Provider Network. Objectives Activities Projected Responsible ~:> x~~~~ ~ ....i°_ i {r A.: ~ . x , ~ ,. , -R .. . . , . . , <: ~ . f . _ ~ ~. ~. _ ., o tion ~ple ~ ~ Date arties P Core Services: Analysis of the • Finalize core service structure First Quarter Management current service structure is and content FY 2004 Team complete and the design and • Continue to analyze service initial implementation of the delivery data new core service units is • Finalize Target Population underway. Eligibility system • Develop implem ation a with process an date Core Services: • E s C C e anagem t First Quarter Management The implementation of the f t a d ol a or ti a d Advoc c FY 2005 Team phase of core services ' O nit ar lly cti nal complete and all esse ial • eg n to gathe ele ant baseline functions are in place. a di new s stem as needed Qualifed Provider or : • Fi ' review of stakeholder and First Quarter Management The analysis of curren pr vi er WOT data FY 2004 Team network is complete. • Evaluate needs assessment data and make recommendations regarding any service gaps • Finalize decisions regarding which services to spin off and add to PN Qualified Provider Network: • Ongoing meetings with potential Third Quarter QPN Unit The initial Qualified Provider QPN members are underway FY 2004 Network is in place. • Publish RFPs for unmet service needs • Continue to build comprehensive service network Qualified Provider Network: . Outcome and other performance Third Quarter QPN Unit, QI QPN related data is being based contracting data is being FY 2004 Unit, UM Unit gathered, analyzed and shared gathered with providers in a meaningful . C1ienYs Rights, incident review ~'"aY• and other QI information is integrated into the new QPN system • Feedback loops between the LME and the QPN are developed and modified as needed 12 17 Goal Two - The Administrative System: Develop an accountable, flexible and efficient organization designed to provide all the necessary supports required by the service system. Ob~2Ct1VeS ACt1VltieS Projected Responsble Parties Completion Date The LME Governing • Compile necessary First Quarter County Board the LME qualifications and FY 2004 Commissioners, Advisory Board is in conduct member search Management Team place. if necessary Implementation of by- • Research various First Quart r Management Team laws and permanent options FY 2 , committee structure of • Create by-laws CFAC Chair CFAC is established. • Finalize committee - LME Staff Liaison structure Continue to identify • Consolida on pti ns irst u er Management Team contract options for are onsi ered d Y 2 0 cost sharing. nego 'ate ns rti ar d e d Merger or o ple e any First Quarter Management Team Consolidations nec s ti i ns FY 2005 decisions are final ze . ak n decisions Information In ta rofiler system First Quarter Management Team, technology Implement decision FY 2005 Information infrastructure has een support tools Systems Unit developed and • Continue report im lemented development process An LME Financial • Continue to monitor First Quarter Finance Unit, Management Plan is in and evaluate internal FY 2004 Management Team place. controls and audit trails • Ensure compliance ~ with all state and federal re uirements 13 18 Goal Three - Pilot and Special Projects: Use the LME model to build upon the Area Program's long history as a proven leader in the development and implementation of pilot programs that demonstrate principles of best practice. Objectives Activities Projected~. Responsible Completion Parties Date Pilot a Service • Gain authorization Third Quarter Utilization Authorization System from the Division to FY 2004 Management Unit that will measure implement pilot client outcomes and program reward providers who • Gather and finalize demonstrate positive baseline data results. • Determine outcome indicators to be measured • Work wi N U it, MIS, QI d ntr ct o 'ders to en ur syste m o ly ea a d di o s cess The Implementati n Ga a ori tio First Quarter Management Team, performance base om ivi ' to FY 2005 Utilization contracting pilot ill i ple e pilot Management Unit, begin Pr QPN Unit Negotiate and finalize performance criteria with QPN • Negotiate and finalize reward criteria and feedback loops with QPN • See service authorization activities above ' At-risk capitation • Gain authorization First Quarter Management Team management pilot from the Division to FY 2005 program is fully implement pilot implemented. program • Design reports or any additional requirements the Division deems necessaryto accurately monitor ilot ro ram ~ 14 19 Goal Four - Transition and Divestiture Issues: Ensure that all clients are supported in a thoughtful manner during this time of significant change and that important programs are transitioned in a manner that maximizes their chance for success in the private sector. Objectives Activities Projected. Responsible Completion Parties Date A detailed Divestitttre • Develop criteria that First Quarter Management Team Plan is completed. will deternune which FY 2004 programs to divest • Determine specific timetable for divestiture • Create support system to maximize ' opportunity for divested program ' success A detailed transition • Develop irst u rter Management Team plan is complete. reh s've Y 2 0 transi io c c ist m le 1 s o prp't o i res ure s rai s af in a pro 'a e id n ' cation and transition of individuals who do not meet target population criteria • Ensure a thoughtful transition process that will match all non- • target clients with community programs of their choice Internal to extemal • Continue First Quarter Management Team service provision tarset Implementation of FY 2005 ratio will be 40%: Divestiture Plan 60%. Internal to external • Continue First Quarter Management Team service provision tar~et implementation of FY 2006 ratio will be 20%: Divestiture Plan 80%. Tar~et for 100% • Complete First Quarter Management Team divestiture of services. implementation of FY 2007 Divestiture Plan 15