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

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• Respite – Respite is the short-term, temporary relief to those who are caring for family members. It is the service most often requested by family caregivers. Respite can be provided in the family home or in another location. • Family to Family mentoring – Matches knowledgeable and more experienced families with those in need of assistance to offer guidance and support. • Crisis prevention and support – Includes evaluation of possible risks and puts in place deterrents to prevent and ameliorate potential crisis situations. Should a crisis occur, onsite evaluation, intervention and training would be available in the community on 24-hour basis. • Counseling services – Includes individual therapy, family therapy, support groups, coaching, and other therapeutic interventions to assist a family with understanding, coping and working though difficult situations and times. 3. Community Living Community living for people with developmental disabilities is not only best practice, but a decade after the Olmstead decision, it is expected practice. Community living should be outcome driven, focused on ensuring the services provided result in progress and achievement of the goals for the person served. Community living services support the integration of people with developmental disabilities in their local communities. People with intellectual and developmental disabilities should be able to live, work and play in their local neighborhoods and communities. These services should emphasize the unique characteristics of each individual and include options for self-direction. 4. Employment Services The vision for employment services should be well articulated and focused on a Work First policy that expects that people with developmental disabilities will earn wages at or above minimum wage and will include benefits commensurate with employees without disabilities. Employment services focused on this goal should include the following services: • Job Development that identifies steps to assist the person to achieve integrated employment. • Prevocational services that are time-limited and not an end point in themselves. The service is focused on activities that lead to competitive employment and include volunteer and other unpaid activities. • Supported Employment to assist the person with a developmental disability once they have a job. The service can be provided in both an individual and group setting. 28
5. Health and Primary Care People with developmental disabilities experience more difficulty accessing basic health and primary care services than the general population. This occurs even with coverage through the Medicaid program available to most adults with intellectual and developmental disabilities. In 2011, a University of New Hampshire report found that 40% of people with disabilities report their health as fair or poor compared to 23% general population. Best practice health and primary care services should be available in local communities and provide the following basic services: • Effective diagnostic and clinical evaluation services • Access to general health screenings and primary care • Care Coordination • Behavior Support services • Psychiatric and Counseling services • Therapies – Occupational Therapy, Physical Therapy, Speech-Language Pathology • Medication management and self-administration training programs • Dental services Access to health and primary care services is especially important considering that the highest proportion of sedentary people is those with disabilities (37%). Inactivity is strongly linked to obesity and 38% of people with disabilities are obese. 4 National data collected through the National Core Indicators (NCI) project further shows a link between level of ID and obesity. NCI national data also shows high use of psychotropic medication. Fifty-one point three percent of people take medications for mood disorders, anxiety, behavior problems, or psychotic disorders. The use of psychotropic medications is strongly linked to obesity and health problems when used long term. Access to health and primary care practitioners can help address these challenges for people with intellectual and developmental disabilities. 6. Crisis Intervention and Prevention Effective crisis intervention and prevention services ensure that people with intellectual and developmental disabilities are fully supported in their communities. This is especially important for people with ID and mental health or substance abuse issues. Best practice dictates that crisis intervention and prevention services be provided in the community, where the person lives. They must be responsive and available for family and community agencies on a 24-hour basis. With the number of adults with ID-DD who live with their families increasing, it is important that 4 Health Disparities Chart Book on Disability and Racial and Ethnic Status in the United States. Institute on Disability, University of New Hampshire. August 2011. 29
Page 1 and 2: Iowa Mental Health and Disability S
Page 3 and 4: E. Process and Timeframes for the F
Page 5 and 6: The second source of principles is
Page 7 and 8: order to standardize approaches, re
Page 9 and 10: Children’s Disability Services Wo
Page 11 and 12: The Workgroup strived to attain a r
Page 13 and 14: Psychiatric Medical Institutions fo
Page 15 and 16: performance measures developed by t
Page 17 and 18: II. METHODOLOGY Senate File 525 cal
Page 19 and 20: III. VISION AND PRINCIPLES FOR THE
Page 21 and 22: Individual Outcomes • People make
Page 23 and 24: IV. REPORT OF THE INTELLECTUAL AND
Page 25 and 26: • Financial - Medicaid eligible
Page 27: 1. Service Coordination Service Coo
Page 31 and 32: - in these difficult budget times -
Page 33 and 34: D. Outcome Assessment and Performan
Page 35 and 36: By using the Quality Framework, sta
Page 37 and 38: The table below illustrates how typ
Page 39 and 40: • Increased requirements by the C
Page 41 and 42: of performance data, it is importan
Page 43 and 44: 9. Given the current inclusion of a
Page 45 and 46: allows supervisors to track a DSP
Page 47 and 48: Furthermore, this redesign process
Page 49 and 50: C. Eligibility - Adults The Workgro
Page 51 and 52: service should be considered for co
Page 53 and 54: Any current or future state or regi
Page 55 and 56: 1. Peer Run Self-help Centers: The
Page 57 and 58: areas. ACT teams in rural areas can
Page 59 and 60: F. Olmstead and System Rebalancing
Page 61 and 62: continuum, how it should be funded,
Page 63 and 64: The Workgroup also recommends that
Page 65 and 66: H. Provider Qualifications and Moni
Page 67 and 68: VI. REPORT OF THE CHILDREN’S SERV
Page 69 and 70: • PMIC bed/Residential Services -
Page 71 and 72: • Learning Supports for Students
Page 73 and 74: order to provide a strong system of
Page 75 and 76: D. Initial Recommendations Recommen
Page 77 and 78: Recommendation Two: Rollout of init
Page 79 and 80:
under the Iowa Plan 50 . Services w
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• Planning for implementation can
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• The RFP will seek proposals fro
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o I am part of a community; I belon
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We get lots of kids from southern I
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Table One: Summary of the Potential
Page 91 and 92:
families from among the different d
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to begin operations and transition
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Table Two: Timeframe for Regional F
Page 97 and 98:
Function Yes No Comments Data colle
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Function Regional discretion within
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• Designation of access points o
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o o Process to be used and resource
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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
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and were resolved by the team in th
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9. Mental Health Courts and Identif
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See Appendix F for details of each
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New Core Services Prioritized new c
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IX. REPORT OF THE PSYCHIATRIC MEDIC
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X. INTEGRATION AND TRANSITION PLANN
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eligible for Medicaid after 2014, t
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XI. CONCLUSION This report presents
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Services Currently Provided to Adul
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CMS State Balancing Incentive Payme
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Appendix C Children’s Disability
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o Roles o Data o Communication o Co
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o Crisis teams o Immediate access t
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• State plan for college/universi
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Appendix D Recommended Definition o
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Appendix E Brain Injury Definitions
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Appendix F Brain Injury Workgroup R
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Corresponding # to narrative recomm
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Page 153 and 154:
Page 155 and 156:
Page 157 and 158:
Page 159 and 160:
Page 161 and 162:
Adult Intellectual and Developmenta
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Brain Injury Workgroup Name Agency
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Judicial-DHS Workgroup Name Agency
Page 167 and 168:
PMIC Transition Workgroup Name Agen
Page 169:
Regionalization Workgroup Name Agen
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Iowa Mental Health and Disability Services System Redesign Interim ...

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