Community Development Unit

1
Community Development Unit

• Cissie Bollinger, Manager
• 503-947-5543
• Cissie.M.Bollinger_at_state.or.us

2
Facilitating Discharges from OSH

• Olmstead
• Miranda
• Exceptional Barriers Review Committee
• Harmon vs. Fickle

3
The Continuum of Care

• Secure Residential Facilities
• Residential Treatment Facilities
• Residential Treatment Homes
• Adult Foster Homes
• Intensive Case Management or
  Assertive Community Treatment
• Supportive Housing

4
Applicable OARs

• RESIDENTIAL CARE FACILITIES FOR MENTALLY OR
  EMOTIONALLY DISTURBED PERSONS http//arcweb.sos.st
  ate.or.us/rules/OARs_300/OAR_309/309_035.html
• ADULT FOSTER HOMES
• http//arcweb.sos.state.or.us/rules/OARs_300/OAR_
  309/309_040.html

5
The Development Process

• Licensing
• Staff Hiring/ Training
• Opening of Program
• Enrollment in CPMS
• Community Success and Step-Down
• Survey of Process and Feedback

• Legislative funding
• Marketing
• Request for Proposal
• Timelines Established
• Siting
• Client Identification
• Budgets
• Program Development
• Construction
• Financing
• Trust Deed

6
Psychiatric Security Review BoardMary Claire
Buckley- Executive Director

• Mission
• To protect the public through on-going review
  of the progress of persons found guilty except
  for insanity and a determination of their
  appropriate placement.

7
Functions of the PSRB

• To accept jurisdiction
• To protect the public
• To balance the publics concern for safety with
  the rights of the client
• To conduct hearings
• To make findings
• To monitor progress
• To revoke CR if client violates plan
• To issue orders
• To maintain current history of all clients

8
Types of Hearings

• Upon Application
• Hospital Request
• Patient Request
• Out Patient Request
• Out Patient Supervisors Request
• Status Review

• Mandatory
• Initial
• Revocation
• Two Year
• Five Year

9
Hospital Treatment

• Engagement
• Treating Symptoms
• Goal Setting
• Motivational Strategies- Goal Setting
• Skills Acquisition
• Skills Training or Compensatory Support
• Transition
• Assertive Community Outreach
• Community Transition

10
Conditional Release PlanningAn Exercise in
Collaboration

• Key Players are
• Client Community Program
• Hospital PSRB
• DHS/ AMH (Funding Services)
• Collaboration works by sharing expertise
• Clients knowledge of their support needs and
  commitment to returning to the community in a
  supervised setting.
• Hospitals knowledge of the Clients behavior,
  mental illness, and process of recovery
• Communitys knowledge of resources, experience
  with similar clients, and knowledge of the post
  hospital adjustment process.

11
Extended Care Management Unit

• Manage the flow of consumers between acute and
  extended care services using high clinical
  standards of care.
• Maximize the efficacy and efficiency of state and
  federal resources devoted to treatment and
  placement of consumers in alternatives to state
  hospital.

12
ECMU Admission Criteria

• Consumer must be between 18-64
• Medically stable and not in need of ongoing
  nursing care
• Primary Diagnosis of Schizophrenia,
  Schizoaffective Disorder or Major Affective
  Disorders
• Persistent symptoms other than those caused
  solely by substance abuse or medical conditions
• Currently in a State Hospital Bed or on the State
  Hospital Transfer List.
• History of multiple psychiatric hospitalizations
  or frequent need for crisis intervention.
• Demonstrate Evidence of Participation in
  Treatment

13
Enhanced Care Services Overview

• Eligible for Senior and Disabled Services
  Division
• Do not require hospitalization (medically and
  psychiatrically stable)
• Has been an inpatient in an acute psychiatric
  unit for over 14 days.
• Currently exhibits two or more of the following
• Self endangering behaviors
• Aggressive behaviors
• Intrusive behaviors
• Problematic medication needs
• Sexually inappropriate behaviors
• Elopement behaviors

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Post-Acute Intermediate Treatment Services (PAITS)

• Axis I Diagnosis of a Severe and Persistent
  Mental Illness
• County of Responsibility and/or MHO agrees to be
  responsible for Discharge planning.
• Individual is SSD/I and OHP Eligible or benefits
  have been applied for
• Priority One, Two, and Three

15
Evidence Based Practices Definition

• Addictions and Mental Health Division defines
  evidence-based practices as programs or practices
  that effectively integrate the best research
  evidence with clinical expertise, cultural
  competence and the values of the persons
  receiving the services. These programs or
  practices will have consistent scientific
  evidence showing improved outcomes for clients,
  participants, or communities. Evidence based
  practices may include individual clinical
  interventions, population-based interventions, or
  administrative and system-level practices or
  programs.
• More information found at http//www.oregon.gov/D
  HS/mentalhealth/ebp/main.shtml

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Evidence Based Practices Definitions Continued

• Standardization
• Fidelity
• Replication

• Description that clearly defines the essential
  elements of the practice, as evidenced in a
  manual or toolkit.
• A Scale used to verify that an intervention is
  being implemented in a manner that is consistent
  with what the research shows to be effective
  practice.
• More than one study and more than one group of
  researchers have found similar positive effects.

17
Evidence Based Practice Facts

• Number of Practices currently under review
• Areas we are lacking applications
• Number of levels in Addictions and Mental Health
  Definition

• Six
• Children (0-6) and Suicide Prevention
• Six

18
Evidence Based Practices Quiz

• Number of approved mental health practices?
  
• A) 38
• B) 100
• C) 56
• D) 75
• Number of approved
• substance abuse
• practices?
• A) 33
• B) 59
• C) 45
• D) 82

• Number of approved
• co-occurring practices?
• A) 7
• B) 10
• C) 15
• D) 22
• Number of approved
• prevention practices?
• A) 106
• B) 26
• C) 48
• D) 64

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Development Needs

• Co-Management Plan- for Individuals under civil
  commitment in Oregon State Hospital
• Forensic Population Demographics- for individuals
  under the jurisdiction of the Psychiatric
  Security Review Board.

20
CPMS Enrollment

• Provides Accountability for funds spent by
• Monitoring Utilization Rates ( clients actually
  served compared with contracted minimum number to
  be served)
• Calculating measures for performance reports
• Generates more funds for treatment and prevention
  by
• Documenting Services provided to clients
• Documenting the need for federal and state
  funding
• Providing information to Legislators for planning
• Documenting Expenditures to Funding agencies
• Importance of Accurate Data
• Affect performance reports, utilization, and
  other reports
• Are used as part of a site review
• Are used for outcome studies
• Basis for future funding requests.

21
Residential Enrollment Forms

• Should accurately identify client information so
  payments may be sent to the provider in a timely
  manner.
• This form must be completed when individuals
  enter or leave services in the identified
  facility.

22
Vacancy Exception Forms

• Vacancy Exception Requests (VERs) are awarded to
  RTHs/RTFs if the following conditions are met
• the vacancy resulted from an action that was in
  the clients best interest and at the request of
  ECMU or
• the vacancy resulted from a resident moving and
  the RTH/RTF made every effort to fill the vacancy
  in a timely manner or
• the vacancy resulted from circumstances beyond
  the control of the RTH/RTF and the RTH/RTF made
  every effort to fill the vacancy in a timely
  manner AND
• the vacancy cannot be absorbed within the agreed
  upon occupancy rate for the RTH/RTF.

23
Vacancy Exception Forms

• Completed VERs must have a recommendation and
  signature from a CMHP residential services
  representative prior to being sent to the
  Addictions and Mental Health Division.
• The VER form was last updated in January 2007. To
  obtain an updated VER form, please request one by
  sending an email to michael.hlebechuk_at_state.or.us
  
• Using the most up-to-date VER form will aid in
  quick processing of your request.

24
Service Element 30 201Reporting Requirements

• Service Element 30
• Provides payment to the PSRB Supervisor who is
  providing Monitoring and Supervision to the PSRB
  Individual who is on Conditional Release in the
  community.
• Special reporting requirements include the
  county submitting a copy of the conditional
  release plan and monthly reporting.
• Service Element 201
• Provides payment for Adult Mental Health Services
  designated to a PSRB Individual.
• Special reporting requirements include yearly
  summary report of services delivered.