HomeMy WebLinkAboutAgenda - 12-10-2002-5bORANGE COUNTY
BOARD OF COMMISSIONERS
ACTION AGENDA ITEM ABSTRACT
Meeting Date: December 10, 2002
Action Age~ndab
Item No. ..~
SUBJECT• Approval of OPC Area Program Local Business Plan
DEPARTMENT: OPC Mental Health PUBLIC HEARING: (Y/N) No
ATTACHMENT(S):
Resolution
Revised Chapter I, "Planning",
In response to State Plan 2002:
Blueprint for Change
(Under Separate Cover)
INFORMATION CONTACT:
Gwen Harvey, 245-2300
Tom Maynard, 913-4000
TELEPHONE NUMBERS:
Hillsborough 732-8181
Chapel Hill 968-4501
Durham 688-7331
Mebane 336-227-2031
PURPOSE: To consider approval of the final version on the OPC Local Business Plan
addressing statewide mental health system reform which is due to the State on January 1,
2003, and adopt a resolution authorizing transmittal to the State.
BACKGROUND: At its meeting on November 19, the BOCC received the last update from
Orange-Person-Chatham (OPC) Mental Health staff along with a copy of the draft plan. The
OPC Steering Committee met again on November 21 to review the draft plan and make any
needed changes requested by the counties before referring the finished document back to each
of the three governing boards -Orange, Chatham and Person -for formal approval before the
end of the calendar year.
Changes made on the basis of BOCC, Steering Committee and staff discussions are reflected
in the revised Chapter I, "Planning", which is attached. No other sections of the draft plan
were changed, although other appendices required by the State and referenced only in the
earlier draft will be included in the formal submittal. A complete copy of the OPC Local
Business Plan will be available in the Clerk's office by January 2, 2003. In the interim, please
refer to the draft copy provided in the November 19 agenda materials for additional review.
In general, the changes were made to emphasize the following points:
The counties' ability to successfully implement the Local Business Plan required by the
State is contingent upon the best interest of consumers and the availability of
adequate funding.
• The LME (Local Management Entity) will support the establishment at State expense
of a Self Help & Peer Support Center as envisioned by the Consumer and Family
Advisory Committee.
• All plans and timetables for service divestiture are subject to immediate amendment if
at any point it is determined to not be in the best interest of consumers or if the
necessary supports are deemed inadequate.
• Target Ratios for internal/external service delivery objectives are provided in the
description of transition and divestiture issues.
The OPC Steering Committee will meet next on January 22, 2003 to continue developing the
legal and administrative framework for the transition from an area program to the LME structure
under the strong governance model as previously authorized by the BOCC.
FINANCIAL IMPACT: There is no immediate financial implication with the approval of the local
plan. The three counties continue to assert, and it is embedded throughout the Local Business
Plan, that the success of the LME system hinges completely upon adequate funding from the
State. The Plan was drafted to allow as much flexibility as possible to the local elected officials
and to allow the maximum time to carefully address issues of consumer interest and financing.
RECOMMENDATION(S): The Manager recommends that the Board approve the OPC Area
Program Local Business Plan and adopt the resolution authorizing its transmittal to the State by
January 1, 2003.
3
RESOLUTION OF THE BOARD OF COMMISSIONERS OF
ORANGE COUNTY, NORTH CAROLINA
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 mental 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 and d ted a d th L E hereby adopts the
following Mission Statement•
Our Missi is to o k ~a to rs~h'ip it~i consumers and their families
so the c ea atisfy' g 'ves d me integral, valued and
o 'b 'ng m er the community.
We will:
• Suppor i i id a s t e meaningful choices and to achieve their
• Respec the gnity and diversity of those we serve.
• Ensure uman 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 of families.
• 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 Mission Statement is both congruent with and reflective of the North Carolina
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
6
dependence for both our existing clients and any future clients transitioned from state-run
institutions to the communities served by the LME.
Our ability to successfully implement the changes described in this business plan is
contingent upon two important factors. First, the best interest of our consumers will
always be our primar~guiding_princi~le as we consider implementing_any system
reforms. If at an~noint we feel mandated changes are ne~ativel~pacting the people we
serve then our plan will be immediately modified to prevent any harm. Secondly
success of the LME system hin e~ s completely upon adequate funding. All the goals and
objectives set forth in this plan are subject 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 already spends very little on non-priority 'e and ince OPC has been a
leader in developing best practice model communi y su s o r opportunities to
redeploy resources are not great. This ma she ro ess of p 'o itizing resources very
important. Our LME proposal envisions a oca ly a ag d pu li process for evaluating
needs and outcomes, where fe ack 's r pi ly tra sl into m dified action.
Consumers, families, stakeh lder n to a f ci is ill all a cipate actively in this
ongoing evaluation-~
A continuous pla in o e s i a n c ss to Y order to implement our vision and
we moved quickly ea li t i y a 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 Area 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 internal 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 i
stratified active OPC clients by age and disability group.
instruments specific to each age and disability grou p
the survey instruments. The consultant also condu ted
allow for a more in depth exploration of r ev nt i su s~~
consultant's full report are attached
In addition to the work
Staff conducted nu r
of groups. Writte su
stakeholders. Surv y i
Committee has m r g
valuable feedback n t]
participating coun
hearings on this pr pos
lu~te~t i terviews. Staff
cons ant prepared survey
{' ely 960 clients received
i 1 i terviews with clients to
i s f the surveys and the
~diata from other sources.
of the state plan to a variety
~nity organizations and other
al Consumer and Family Advisory
c Fe ry of 2002 and has provided extremely
is weaknesses of the existing Area Program. Each
forums and County Commissioners are holding public
ss 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).
3
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 through 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.2.d There is a resolution of the governing body ac ti /a p oving the LBP as
submitted.
A resolution is attached
I.2.e There is a separate repo ub 'tte b t e l ca A
The CFAC Report is attache
O
I.3 The LBP in or or s a 3 ye r stra i plan for the initial
implementatio t a
• Ide ti ie a an year implementation strategy
• Co tan gas, b~ fives and activities
• Ide ti s m ames 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 'ono 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
providers. These systems
Unit whose primary fup
community agenciesand
The LME Admini
resources. It will
Service Authoriza
Human Resources
to o r etwork of private
olla o tion and Advocacy
-kin lationshins with other
to maximize the efficient use of
hider Network Unit, Core Service Management,
Information Systems, Quality Improvement and
II. THE LME SERVICE DELIVERYSYSTEM
The Triage, 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, referral 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;
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 Management Unit
The essence of LME operations will be to expend resources by
centered service plan and to evaluate the results of these expe
management a critical part of local LME operations, as i rm;
relationship between the individual with a disabili d t
people least able to negotiate a complex syste w' ho ssist
need of complex and/or long term service , th pri ci ~elat c
individual and the system is
best played by the LME.
A decision tool
management at
receive LME C
providers.
The LME case i
broker and servi
through a direct
plan.
case
~ s of the person-
r s. This makes case
asis of the
system for those
When a person is in
ip between the
We believe this role is
~to determine who needs case
med long term and complex will
be referred an array of qualified
11 ~as an advocate, negotiator of the service plan, service
. Outcomes and client satisfaction will to be monitored
~ with a consumer through the documented, written service
The Collaboration and Advocacy 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 THE ROLE OF CONSUMER & FAMILYADVISORY COMMITTEE (CFAC)
As an Area Program, we have atwenty -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 by 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 a pl nning effort
• reviewing and submitting a separate report to the Divisi on the ME's local business
plan and planning effort
• providing recommendations on areas of service ligi ' ity a d ervice array, including
identifying gaps in services
• assisting in the identification of der- rve po ulatio s
• providing advice and cons tion ga d' g he de opme t additional services and
new models of servi
• monitoring se e dev o m~ a d el ery
• reviewing and o nt n on s e d l0 1 e budgets
• observing and ep rti g t im ntat' n 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 fo ace indicators
• ensuring cons a an fa ' 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
governing board for the purpose of advising the LME about needed service
improvements. The CFAC has already identified several urgent needs including housing,
transportation, and the DD waiting_list. CFAC will also help father and provide on~oin~
needs assessment service evaluation data and will have access to all LME service,
outcome, and cost data that is not restricted by confidentiality. 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 proposed the establishment of a Self-Help & Peer Support Center. The
LME will support the establishment of such a project and will work to mobilize resources
sufficient to operate a formal staff organization. Since the State of North Carolina has
expressed strong support and endorsement of independent consumer empowerment
outside LME control, we fully expect direct State funding of this effort. Once
7
12
oyerational, the LME will work with the center to make system consumers aware of the
center, and to assist in the promulgation of information about the center.
The full text of the CFAC proposals made to the LME during the planning_process 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 plot four changes to
the State's plan for the LME system.
First, we propose a system that allows the LME to
capitated funds. This authority will give t E
unique needs of our community. We are illi g tc
decision making capabilities b use a eel a trc
citizens. ' I
Second, we propo e that th M'~ a~
the region. The L E i l ~nt 'n c
will authorize all p n it o ul
range of services a~ a le o th c e
practically mount o t n xc L
process for the sel ction f a vendor.
e tl manage at-risk
s exibility to meet the
;h ri k associated with these
is be t suited to serve its
b~ty for utilization management for
provider contracts are managed and
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)
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.
VI. 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 s' c the Fa 10 200 i the North Carolina
node of the National Institute on Drug Ab se I A 1' ica T ials Network. The
Network was established by th ati al n tit to n g A us to test and disseminate
innovative approaches to tre in b to e bu e 'n he com a ity. The Regional
Research and Train' Ce to f r e e w i t e uke Clinical Research Institute.
OPC is one of fo Area Pr ra s rti ipating.
The LME is com itt d ti u'ng is articipation, enabling clinical trials to be
implemented with i s e i e s s e nd provider network, thereby enhancing the
quality of its subst 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
14
System 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, community 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 volvi 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. ~
Deaf Services
In FY 2000 the OPC Area
MH/DD/SAS, Adu en
coordination and
Central Region.
year hired two cc
Services.
the St~teJDivision of
~ct or~,~vit r uest to consider taking on the
to he deaf d and of hearing for part of the North
r 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
10
15
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.
VII. 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 Bless support services,
Alcoholics Anonymous suppo ,nnd 11 o h r a p pr' res ur es.
As the transition to na~re^~c sefl hri 't' s oc a s. some resources will be freed uv that
identified in our
iressin~ unmet r
and
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
subject to immediate amendment if at anypoint it is determined that these Chan eg s are
not in the best interest of our consumers. We will be exploring divesting options that
may include contracting out current services, transferring current functions to existing
agencies or assisting in the creation of new entities. This is a complicated process and all
divestiture decisions will require careful consideration to ensure consumers are not
ne at~~pacted during this transition period. Like all components of this business
plan successful divesture is contingent upon sufficient funding. Our divestiture plan is
subject to modification if the necessary supports are deemed inadequate. A detailed
divestiture plan is being written and will be completed during the first quarter of fiscal
year 2004.
11
16
THREE YEAR IMPLEMENTATION 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.
nb~CCt1VeS f~Ct1v1t1eS Projected Responsible
Completion Parties
Date
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 su C C e anagem t First Quarter Management
The implementation of the f t a d of a or ti a d Advoc c FY 2005 Team
phase of core services ' D nit ar lly cti nal
complete and all esse ial • eg n to gathe ele ant baseline
functions are in place. at
• dif news stem as needed
Qualified Provider or • Fi review of stakeholder and First Quarter Management
The analysis of cunen 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 • Client's Rights, incident review
way 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.
ObjectlveS Activities Projectcti Responsible Parties
Completion
Datc
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 first u rter Management Team
contract options for are consi ered nd Y 2 0
cost sharing. nego 'ate
ns rti s ar
d e d
Merger or o ple e any First Quarter Management Team
Consolidations nec s tia i ns FY 2005
decisions are final ze ak na decisions
Information In to 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 wit N U it,
MIS, QI d ntr ct
o 'ders to en ur
syste n mot ly
ea a d di
o s s cess
The Implementati n Ga a hori do First Quarter Management Team,
performance base om t e ivis~ to FY 2005 Utilization
contracting pilot ill i ple e pilot Management Unit,
begin Pr m 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 Divestiture Develop criteria that First Quarter Management Team
Plan is completed. will determine 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 first a rter Management Team
plan is complete. reh s've Y 2 0
transi io c c fist
m let 1 s o
pr prat o nit
res urc s
rai s of m
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 external • Continue First Quarter Management Team
service provision target Implementation of FY 2005
ratio will be 40%: Divestiture Plan
60%.
Internal to external • Continue First Quarter Management Team
service provision target implementation of FY 2006
ratio will be 20%: Divestiture Plan
80%.
Target for 100% Complete First Quarter Management Team
divestiture of services. implementation of FY 2007
Divestiture Plan
15