Mental Health Services Act Steering Committee

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Mental Health Services ActSteering Committee

• May 5, 2008
• 100 pm 400 pm

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Mark Refowitz

• Local/State Updates

3
Kathleen Murray

• MHSA Technological Needs

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Technology Goals and Interoperability

• DMH goal is to develop an Integrated Information
  Systems Infrastructure where all counties can
  securely access and exchange information
• To realize this goal we must achieve
  interoperability

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Interoperability Defined

• HIMSS defines interoperability as the ability of
  health information systems to work together
  within and across organizational boundaries in
  order to advance the effective delivery of
  healthcare for individuals and communities.

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Challenges to Interoperability

• No definitive agreement on standards
• Medical Care delivered by multiple providers
• No single format for medical records
• Multitude of software applications used to assist
  in the delivery of care
• Realities of the marketplace
• Consumers are mobile
• Security and Privacy Concerns
• Government Regulations

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Interoperability Can Be Achieved

• The banking an finance industry may
• offer a model
• Worldwide Network of International Banking
• ATM Networks
• Debit Cards
• Credit Cards
• Portability of credit and finance in all areas of
  commerce

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Contrast Internet Banking and
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Universal ATM Access, With
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This
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Paper Kills (and wastes)

• Inevitable human errors are not prevented people
  die.
• 20 of labs and tests ordered b/c previous
  results cant be found.
• Filing, retrieving, faxing, moving paper costs
  billions.
• Difficult to get data for research and reporting.

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IT Has The Power To Transform Health Care

• Enables comprehensive patient information at the
  point of care.
• Enables clinical decision-support to improve
  care.
• Enables efficiencies in administration.
• Enables empowerment of patients.
• Enables tremendous new research capabilities.
• Enables robust public health surveillance.
• Enables robust and streamlined quality reporting.

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Wiring Healthcare for Success
Current system fragments patient information and
creates redundant, inefficient efforts
Future system will consolidate information and
provide a foundation for unifying efforts
Public health
Hospitals
Hospitals
Public health
Health Information Exchange
Laboratory
Laboratory
Primary care physician
Primary care physician
Outpatient Pharmacy
Data repository
Network applications
Outpatient Pharmacy
Payors
Specialty physician
Ambulatory center (e.g. imaging centers)
Payors
Specialty physician
Ambulatory centers
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Improved Clinical Data Management
Data management
Data access and use

• Results delivery
• Secure document transfer
• Shared EMR
• Credentialing
• Eligibility checking

Hospitals
Payers
Hospital

• Results delivery
• Secure document transfer
• Shared EMR
• CPOE
• Credentialing
• Eligibility checking

Health Information Exchange
Physicians
Labs

• Results delivery

Labs
Data repository
Network applications
Outpatient RX

• Surveillance
• Reportable conditions
• Results delivery

Public health

• Secure document transfer

Payers
Physician office
Ambulatory centers
Public health

• De-identified, longitudinal clinical data

Researchers
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Roadmap to Integrated Information System
Practice EHR Lite
Ordering Full EHR
Management
Electronic registration, scheduling and billing
with contract providers and State
Document Imaging, or Clinical Notes Module, or
EHR lite
CPOE (Lab, RX) ordering, reporting
interface
Full EHR
Interface from external Providers and PHR EHR
Infrastructure
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Goal-EHR Lite

• The next step on our Road Map to a fully
  functioning Electronic Health Record is the EHR
  Lite

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EHR Lite

• Allows Electronic Clinical Data Management
• Aids decision-making by providing access to
  health record information where and when it is
  needed
• Incorporates evidence-based decision support and
  treatment planning.
• Streamlines the service providers workflow,
  closing loops in communication and response that
  result in delays or gaps in care

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We Need ConsumersAnd Providers Involved
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Behavioral Health Services EHR Lite
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Assessment and Treatment History
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Diagnostic and Decision Support
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Treatment Planning
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Progress Notes
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Reminders and Reports
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Questions?

• We would like follow up meetings with interested
  parties to provide progress reports and get
  feedback
• Thank you for your time and attention

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Bonnie Birnbaum

• Community Services and Supports2007
  Implementation
• Progress Report

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Program/Services Implementation

• Implementation of Work Plans Original Three Year
  Plan
• Have CSS Programs and Services been Implemented
  as originally described in the Plan?
• For the most part, the answer is Yes.
• Of the sixteen programs in the original Plan, all
  but two have been implemented.
• One exception is Adult Crisis Residential, due to
  challenges with finding/developing a program
  site.
• Transitional Age Youth has been delayed due to
  licensing and construction issues however,
  operation will begin this quarter.

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Program/Services Implementation

• FY 2007/08 CSS Growth Funding Plan
• New Programs
• Mentoring for Children
• Mentoring for Transitional Age Youth (TAY)
• Program for Assertive Community Treatment (PACT)
• Wellness/Peer Support Center
• All implemented except Wellness Center
• Site has been identified
• RFP will be issued in May.

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Program/Services Implementation (Contd)

• FY 2007/08 CSS Growth Funding Plan
• Expanded Programs
• All implemented
• Childrens Full Service Wraparound Program
• TAY Full Service Wraparound Program
• OA Recovery Services
• OA Full Service Partnership Program (OASIS)

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Program/Services Implementation

• Other Differences in Implementation from the
  Original CSS Plan
• Some programs started later than planned due to
  delays in RFP and contracting process
• Higher costs than planned
• Less Medi-Cal revenue than planned

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Successful Strategies

• Community Collaboration
• Wellness/Peer Support Center Planning
• Cultural Competence
• Vietnamese Collaborative
• Client/Family-Driven M H System
• Consumer/Family Member Training to Work in the
  Mental Health System

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Successful Strategies (contd)

• Wellness/Recovery/Resiliency Focus
• OA Recovery Program
• Integrated Services
• TAY Full Service/Wraparound Program

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Full Service Partnership Programs

• No FSP funding spent on shortterm acute
  inpatient services.

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General Systems Development

• Strengthening the Public MH System
• Childrens In-Home Crisis Program
• In 2007, of 115 admissions, 113 diverted from
  hospitalization

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Efforts to Address Disparities

• Successful Strategy API Collaborative
• Challenge Providing Needed Training on Cultural
  Competency
• System Improvements to Reduce Disparities Casa
  de la Familia Program

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Stakeholder Involvement

• CSS Planning Process
• Open, participatory, inclusive
• Community Outreach
• Steering Committee
• Documentary Film
• Consumer Action Advisory Committee
• Consumer-Driven Committee for Wellness/Peer
  Support Center Planning

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Public Review and Hearing

• Actions Taken
• Thirty-Day Public Comment Period
• Notice on MHSA Website and Network of Care
• Press Release Sent to Media
• Notice Sent to Steering Committee, CAAC, Mental
  Health Board
• Copies of Report available at clinics, libraries,
  and by request

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Alan Albright

• Prevention and Early Intervention update

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Casey Dorman

• Workforce Education and Training Update

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Workforce Education and Training Three-Year
Program and Expenditure Plan

• Mental Health Board Public Hearing
• May 8, 2008
• 900 a.m. 1130 a.m.
• Board Hearing Room
• Hall of Administration
• 10 Civic Center Drive
• (333 W. Santa Ana Blvd.)
• Santa Ana, CA 92701

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Rochelle Pierre

• MHSA Housing

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Kate Pavich

• MHSA Capital Facilities

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Department of Mental Health

• DMH Information Notice No. 08-09 included
  guidelines for submitting our Capital Facilities
  and Technological Needs Plan
• Our plan must provide an overview of how the
  County expects to utilize the funding and how it
  supports the goals of the Mental Health Services
  Act (MHSA)

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MHSA Goals

• Our three-year Community Services and Supports
  plan identified the need for more crisis
  residential, wellness/peer support and vocational
  training services
• Constructing buildings to house these programs
  will produce long-term impacts with lasting
  benefits and would provide opportunities for
  accessible community-based services for clients
  and their families.

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Stakeholder Process

• Orange Countys Stakeholder Process was open,
  participatory, and inclusive of a wide variety of
  stakeholders, including consumers and family
  members.

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Stakeholder Meetings

• Community Services and Supports stakeholder
  meetings
• Wellness Center Planning Committee
• Community Action Advisory Committee meetings and
  tour of the site
• Steering Committee Meetings
• Workforce Education and Training and Capital
  Facilities stakeholder meetings

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Capital Facilities Needs

• Types of facilities needed
• Crisis residential program to serve as an
  alternative to hospitalization for acute and
  chronic mentally ill persons
• Wellness/Peer Support Center to offer clients
  assistance with benefits, socialization,
  self-reliance, and recovery
• Vocational Training to provide education and
  employment support to consumers and their families

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401 S. Tustin Avenue, Orange
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Proposed Buildings

• 7,500 square foot building providing structured
  mental health services 24 hours a day, 7 days a
  week
• 7,500 square foot building providing consumers
  with social activities, education, and peer
  support
• 7,500 square foot building providing a Recovery
  Education Institute and space for the MHSA
  Training program

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Current Allocation

• Expected allocation for Capital Facilities is
  28,308,300
• Estimated project cost is 16,500,00
• Not all of the funds need to be used for a project

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Balance of Funds

• Comprehensive planning process will occur for
  future Capital Facilities projects
• Priorities and discussions documented in the
  previous MHSA planning process will be reviewed
• Look at unmet needs what kinds of programs are
  missing, where do services need to be provided,
  what types of buildings must be built to support
  MHSA

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Alexander Hibbs, AIA

• INC. Architects for 401 S. Tustin

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Next Steering Committee Meeting

• Monday, June 2, 2008