Iowa Mental Health and Disability Services System Redesign Interim ...

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ID-DD system and the mental health system, Supported Employment 68 was identified as a key component of reformed systems of services. For Children, the most important priority, which fits integrally with crisis services, is to expand comprehensive systems of care. Throughout this transition, the system should strive to ensure a continuum of accessible, cost effective, high quality service modalities that help people achieve their fullest potential and live in the most integrated settings possible. This sense of priorities for transition could form the basis for new funding strategies for both the Medicaid and non-Medicaid programs that can further advance the redesign objectives. If there are to be any service expansion efforts in the next few years, in addition to current efforts to reinvest savings in the system, the funding could be directed towards these implementation priorities. 68 A SAMHSA-recognized evidence based practice. 128
XI. CONCLUSION This report presents a substantial number of recommendations to redesign and reform the system of services for adults and children with mental health disabilities, intellectual and developmental disabilities, and brain injury in Iowa. All of the issue analyses and formation of consensus recommendations were carried out in the context of SF 525. While the report may not address every issue in SF 525, it does provide a clear and concrete set of recommendations and implementation guideposts that can be used by the Iowa Legislature to meet its own goal of reforming these systems of services for people with disabilities. It also provides a set of principles and consumer-focused outcomes that can guide the Legislature in its decision making. The report represents the contribution and collaborations of many different stakeholders who came together over a brief period of time and engage in intensive discussions of very difficult and complex issues. The degree of consensus reached is a testament to both the hard work of these stakeholders and their willingness to put special interests aside in order to develop recommended reforms for the common good. The quality of this work, and the degree of consensus reached, should give the Legislature a high degree of confidence that, if the recommendations are accepted, there will be considerable support for implementation. All participants in the process recognized that resources are limited. Participants also realized that “the perfect can be the enemy of the good”. Thus, the consensus recommendations included in this report are considered by the Workgroup participants to be feasible to implement in a multi-year sequential process in the context of Iowa priorities, resources, and traditions. 129
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Iowa Mental Health and Disability S
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E. Process and Timeframes for the F
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The second source of principles is
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order to standardize approaches, re
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Children’s Disability Services Wo
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The Workgroup strived to attain a r
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Psychiatric Medical Institutions fo
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performance measures developed by t
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II. METHODOLOGY Senate File 525 cal
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III. VISION AND PRINCIPLES FOR THE
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Individual Outcomes • People make
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IV. REPORT OF THE INTELLECTUAL AND
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• Financial - Medicaid eligible
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1. Service Coordination Service Coo
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5. Health and Primary Care People w
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- in these difficult budget times -
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D. Outcome Assessment and Performan
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By using the Quality Framework, sta
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The table below illustrates how typ
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• Increased requirements by the C
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of performance data, it is importan
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9. Given the current inclusion of a
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allows supervisors to track a DSP
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Furthermore, this redesign process
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C. Eligibility - Adults The Workgro
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service should be considered for co
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Any current or future state or regi
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1. Peer Run Self-help Centers: The
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areas. ACT teams in rural areas can
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F. Olmstead and System Rebalancing
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continuum, how it should be funded,
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The Workgroup also recommends that
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H. Provider Qualifications and Moni
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VI. REPORT OF THE CHILDREN’S SERV
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• PMIC bed/Residential Services -
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• Learning Supports for Students
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order to provide a strong system of
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D. Initial Recommendations Recommen
Page 77 and 78: Recommendation Two: Rollout of init
Page 79 and 80: under the Iowa Plan 50 . Services w
Page 81 and 82: • Planning for implementation can
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Page 85 and 86: o I am part of a community; I belon
Page 87 and 88: We get lots of kids from southern I
Page 89 and 90: Table One: Summary of the Potential
Page 91 and 92: families from among the different d
Page 93 and 94: to begin operations and transition
Page 95 and 96: Table Two: Timeframe for Regional F
Page 97 and 98: Function Yes No Comments Data colle
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Page 101 and 102: • Designation of access points o
Page 103 and 104: o o Process to be used and resource
Page 105 and 106: Performance Domain Examples from ot
Page 107 and 108: • Maintenance of the strength of
Page 109 and 110: Service Integration and Coordinatio
Page 111 and 112: B. Regions designate a transportati
Page 113 and 114: • Inclusion of Physician Assistan
Page 115 and 116: and were resolved by the team in th
Page 117 and 118: 9. Mental Health Courts and Identif
Page 119 and 120: See Appendix F for details of each
Page 121 and 122: New Core Services Prioritized new c
Page 123 and 124: IX. REPORT OF THE PSYCHIATRIC MEDIC
Page 125 and 126: X. INTEGRATION AND TRANSITION PLANN
Page 127: eligible for Medicaid after 2014, t
Page 131 and 132: Services Currently Provided to Adul
Page 133 and 134: CMS State Balancing Incentive Payme
Page 135 and 136: Appendix C Children’s Disability
Page 137 and 138: o Roles o Data o Communication o Co
Page 139 and 140: o Crisis teams o Immediate access t
Page 141 and 142: • State plan for college/universi
Page 143 and 144: Appendix D Recommended Definition o
Page 145 and 146: Appendix E Brain Injury Definitions
Page 147 and 148: Appendix F Brain Injury Workgroup R
Page 149 and 150: Corresponding # to narrative recomm
Page 161 and 162: Adult Intellectual and Developmenta
Page 163 and 164: Brain Injury Workgroup Name Agency
Page 165 and 166: Judicial-DHS Workgroup Name Agency
Page 167 and 168: PMIC Transition Workgroup Name Agen
Page 169: Regionalization Workgroup Name Agen
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