Action Coalition to Ensure Stability (ACES Project, Indianapolis, IN)

Action Coalition to Ensure Action Coalition to Ensure StabilityStability

(ACES Project, Indianapolis, IN)(ACES Project, Indianapolis, IN)

Brent MatthewsBrent MatthewsChoices, Inc.Choices, Inc.

July 17, 2006July 17, 2006

Using Medicaid* to End Homelessness*and whatever else you can find

Brent Matthews, Choices, Inc.Brent Matthews, Choices, Inc.

AGENDAAGENDA

What is ACES Who ACES serves How ACES works Funding Approaches for

Permanent Supported Housing


What is ACESWhat is ACES

BASICS (1999) ACES serves homeless adults with co-

occurring mental health and substance use disorders

ACES promotes a Housing First recovery model that supports members in increased periods of sobriety and mental stability

Focus is placed upon member strengths


What is ACESWhat is ACES

2002: ACES/Choices and Health and Hospital Corporation, receive $1.5 million federal grant to serve an additional 120 members

Lilly Endowment funds an additional 100 2003: ACES recognized with Exemplary

Award from SAMHSA, CMHS, Homeless Programs Branch.

2005 Eli Lilly & Co.1st Place Clinical Medicine Reintegration Award


Who ACES servesWho ACES serves

DEMOGRAPHICSDEMOGRAPHICS ACES has served nearly homeless ACES has served nearly homeless

adultsadults– 57.5% Female57.5% Female– 58.1% African American; 37.4 58.1% African American; 37.4

CaucasianCaucasian– 69.9% ages 35-54 (avg. 41)69.9% ages 35-54 (avg. 41)– Only 46% completed GED or High Only 46% completed GED or High

SchoolSchool


LEGAL

MEDICAL

WORK

FAMILY

HOUSING

SCHOOL

TRANSPOR

TATION

FUN!

ACES MembersSystems of Care


HOUSINGFIRST


THE MOST SIGNIFICANT PREDICTOR OF THE MOST SIGNIFICANT PREDICTOR OF TREATMENT SUCCESSTREATMENT SUCCESS

Treatment success derives from the Treatment success derives from the implementation of an implementation of an empathic, empathic, hopeful, continuoushopeful, continuous treatment treatment

relationship, which provides relationship, which provides integrated treatment and integrated treatment and

coordination of care through the coordination of care through the course of multiple treatment episodes course of multiple treatment episodes

in the process of dual recovery.in the process of dual recovery.

SAMHSA consultant, Dr. Ken Minkoff, CCISOC


“The civil rights view of disability focuses on how society has failed people with disabilities. Like everyone else people with disabilities want to be seen like regular people, not labels. …”

From Advocating Change Together, Tools for Change website 2004

Serving the Dislabeled

System of Care

Wraparound&

Strengths

Assertive Case Management-

Resource Coordination

Stagesof Change

Motivational Enhancement

THE ACES SHIELDACES MERGES MODELS!


New and Innovative Service DeliveryProcesses Require New and InnovativeCollaborations, Funding Streams and Accounting Processes.

System of Care Principles ClinicalMember DirectedWraparound Values & A.C.C.M.Multi-system Coordinated Care

Care Management Technologies FiscalCapitated/Case RateOutcome Based Flexible Funding

Technology that blends the Clinical & Fiscal (TCM)

PARTICIPATORY CARE MANAGEMENT


How ACES worksHow ACES works


Midtown CMHC Leveraged Staff

1 Clinical Manager2 Lead Resource Coordinators22 Resource Coordinators

Annualized:

*25 FTE x $35,000 x 24% Fringe = $1, 085,000

We used grant and local dollars to pay for infrastructure support


If you Need to Think Outside the Bucks $

You Must be Able to Spend Outside the Box.

FLEX FUNDS


Why ACES is differentWhy ACES is different

Flex Fund Allocation Fiscal Year 2004

Transportation14.0%

Supplies/Groceries9.8%

Utilities8.4%

Incentive Money6.9%

Activities3.0% HF - Housing

23.5%

Legal1.4%

Housing21.6%

Medical5.6%

Clothing4.5%

Furnish/Appliance0.5%

Educational0.3%

Automobile0.5%


Pre-authorization of Funds by the WorkerClosest to the Consumer, that is the Result of a Team Process, is the Preferred Modality.

Care Management

Community Resourcing


FUNDING POOLS, STREAMS & GEYSERS

United Way agencies, county contract providers, indigent care, University Hospitals, Faith Community, Animal Clubs: (Elks, Eagles, Moose, Lions), Masons, Exchange Club, PIC, Rotary, Optimist/Soroptimist, Urban League, Junior League...

THE CLIENT, EXTENDED FAMILY,NON-BLOOD RELATIVES, AND ALL OF

THEIR STRENGTHS and INTERNAL &EXTERNAL RESOURCES


How ACES worksHow ACES works

ACES has worked with Over 60 single housing providers for

Scattered site housing. This a shift away from NIMBY to the

normality of In Everyone’s Back Yard (IEBY).

We use to call it Community!


Ending Homelessness Ending Homelessness with ACES with ACES

ACES Funding - 2006 Estimate

Office Support, $101,915 , 7%

MRO Funded Staff, $719,820 , 46%

Other, $10,492 , 1%

Choices Admin., $75,055 , 5%

IT & Communications, $85,186 , 6%

Personnel Costs, $204,952 , 13%

Flex Funds, $348,000 , 22%

PUBLIC FUNDINGNOW

PUBLIC FUNDED NOW -

MRO

COULD BE PUBLIC FUNDED ( CMHCS)

PRIVATETBRA GRANT


Member Funding Member Funding SourcesSources

ENTITLEMENTSENTITLEMENTS

Medicaid* 32.9%

Medicaid Pending* 38.6%

Wishard Advantage* 14.6%

Social Security 20.9%

Medicare 0.6%

Public Aid 38.6%

Housing 3.8%

Transportation 68.4%

Pensions (empl/VA) 3.2%

Other (incl. VA) 2.5% 89% of members obtained access to at least one public entitlement through their involvement in ACES Average income increased from $285.27/month at enrollment to $479.53 per month at twelve months


Case Case Rate Rate

$344 per client per month $344 per client per month ($11.30/day)($11.30/day)

Serving 200 monthly x 12 = Serving 200 monthly x 12 = $825,600$825,600

We will apply for CSAT $400k/5yr that We will apply for CSAT $400k/5yr that begins October, 1, 2006 (If Awarded)begins October, 1, 2006 (If Awarded)

We will promote discussions for public We will promote discussions for public fundingfunding

TBRA $250,000TBRA $250,000


If you have come to help me,You’re wasting your time.

But if you have comebecause your liberation is bound up with mine,Come, let us work together.

---Aboriginal Quote

Documents

Action Coalition to Ensure Stability (ACES Project, Indianapolis, IN)