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TWG White Space Group Recommendations

Friday, September 26, 2008

Housing

Youth in Transition

Employment

Integration of Care

Older Adults

Use of Peers

Criminal Justice

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HousingI. Engage Peers to Help Consumers Obtain & Maintain Housing

A. Develop a Housing Assistance Model and train Clubhouses on its use in order to improve their ability to provide advice and assistance in accessing appropriate and affordable housing:

1. Partners: WIMHRT building on work being done for the Mental Health Division and Clubhouse Certification

2. Time Frame: Curriculum and Training completed by September 30, 20093. Cost: $25,000 for training location, consultation time and stipends for

clubhouse participantsB. Pilot Integrating consumer peers into existing Ready-to-Rent Programs

via an Application identifying an interested partner:1. Use licensed housing authorities as Ready-to-Rent partners2. Time Frame: December 31, 20103. Cost: $20,000-Wages for peer specialists

C. Design and Incorporate a mental health consumer presentation into Landlord Liaison Programs to reduce reluctance to rent to consumers:

1. Partners: Landlord association, WIMHRT, housing providers and advocated, homeless Coalition

2. Time Frame: December 31, 20093. Cost: $10,000-Component development, training presenters-stipends

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Housing (Continued)II. Sponsor a Housing Conference to Make Better Use of

Housing ProgramsA. Invite national experts to review existing resources that would help

people with mental health issues.B. Invite Housing Authorities to discuss competing demands on

resources.C. Partners: national, state and local housing and advocacy experts,

housing authorities, CTED, other housing organizations, local funders that connect local county homeless plans, Clubhouses

D. Time Frame: one-day conference to be held within one yearE. Cost: $50,000-$60,000

III. Have MHTP Support Sustainability of the Supported Housing Institutes (MHD STI on Housing)A. Partners: MHD, CTED, WA Families Fund, Counties and RSNsB. Time Frame: September 30, 2009C. Cost: $5,000-$10,000

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Youth in TransitionI. Create Parent Partner Pilot Programs between Family

Networks, JRA and DASA A. Programs would facilitate family engagement while in

custody and during transition out of JRA and DASA residential treatment facilities, utilizing trained parent partners and youth peers

B. Must be implemented in a way that allows assessment of effectiveness

C. Will create partnerships between SAFE WA, Youth N’ Action, PAVE and other parent affiliates with JRA and DASA

D. Two pilot sites for both programs were discussed1. Echo Glen or Maple Lane – JRA2. Identify appropriate residential inpatient program - DASA 3. Dan (JRA) and Tina (DASA) are the point persons for further

discussions

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Youth in Transition (Continued)II. Create and maintain a library of best practices for life

skills training. Identified as a major need for youth in transition. Currently materials and resources exist but there is no single repository and accessing what is available is haphazard

III. Youth Centered Crisis Intervention Training (CIT)A. Add youth focus to current curriculum from the Criminal

Justice Training CommissionB. Use Youth Speakers Bureau and Youth as trainersC. Use same model for Trauma-informed process in schools

IV. Use current MHTG Social Marketing contract to address employer and stigma issues identified above.

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EmploymentI. Increase Benefits (SSI, SSDI, etc.) Planning Capacity

A. Increase awareness of the rules, eligibility, requirementsB. How work affects benefitsC. Embed within the current service delivery system.D. Can include other benefits planning (housing, health, etc.)E. Peer support should have a role

II. Expand use of WRAP in employment services for people with mental illnessesA. Staff positions in systemB. Use of peers to expand capacity for WRAPC. More WRAP training is needed in the DVR environment

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Employment (Continued)III. Create Mechanism to Fund Longer-term Employment

for People with Mental Illness A. Take advantage of existing resources such as clubhouses.B. Encourage workforce development councils, clubhouses and

others to become Employment Networks.C. Examine Australia’s work-life balance program.D. Connect to WorkSource: demonstrate data on persons with

disability being served, and highlight potential revenue streams that could be tapped, through work in progress

IV. Marketing / Anti-stigma Targeting Employers A. Work with WorkSource staff, Washington Business Network

and groups addressing disabilities in the workplace

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Older AdultsI. PEARLS (Program to Encourage Active Rewarding Lives for

Seniors) A. Targets minor depression: provides an intervention that otherwise

wouldn’t exist.B. Communities and agencies serving older adults could be encouraged

to develop and implement PEARLS-like programs. C. Technical assistance, training, and other assistance could facilitate

PEARLS adoption statewideII. IMPACT: Targets major and minor depression by putting

depression care managers in doctors’ officesIII. Older Adult Advocacy Coalition

A. Work to reestablish Washington State Coalition on Mental Health, Aging and Substance Abuse

IV. Older Adult Volunteer Counseling ProgramsA. RSVP (Retired Senior Volunteer Program), a volunteer peer-to-peer

program.B. Older adult volunteer counseling programs in Pierce County and

Snohomish County.

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Older Adults (Continued)IV. Gatekeeper Program: Originally developed in Spokane

A. Proactive community training programB. Trains persons coming into contact with older adults to be vigilant

regarding their care, safety, and mental health, and to make appropriate referrals where indicated.

C. Find ways to promote the Gatekeeper Program through the Area Agencies on Aging.

V. Hope Options: Affiliated with the Everett Housing Authority.A. Collaborative project between:

1. Area Agency on Aging (AAA)2. Mental Health3. Housing Authority

B. Provides innovative supports to older adults at risk for losing housing would include:1. Housing vouchers2. Ongoing intervention services and 3. One-time assistance

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Integration of Primary & Mental Health CareI. Identify best practices and model programs for

engagement, and coordination of care for persons with mental health conditions. A. Report should address:

1. What approaches work with what populations with what results at what cost2. Common barriers and how they are overcome, 3. Use of peers and case aides, 4. Models for team approaches (similar to PACT) 5. Explore other options 6. Library should address: Unique challenges presented by specific populations

including: homeless, difficult to engage and treat, those with co-occurring disorders, chronic complex health conditions

II. Develop resources on availability of primary care physicians accepting Medicaid Coupons in different regions of the State. A. Create a standardized report

1. Routinely Update the report and 2. Distribute the report to mental health providers and RSNs throughout the

State so they are aware of local options in their communities.

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Integration of Care (Continued)III. Use the integrated database funded through the

Transformation Grant to produce a series of reports.A. Reports would show what primary care and other medical

services CMHC clients are receiving, and B. Report would examine regional/ethnic/age and other

demographic differences.

IV. Provide assistance to CMHCs to help them assist clients in accessing Primary Care and having a Medical Home. A. Have a consultant review existing best practices and models

(SAMHSA Wellness EBP, Georgia and Dartmouth models are starting points) and

B. Create a training/TA plan for WA state mental health providers to promote accessing primary care/medical homes.

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Integration of Care (Continued)V. Convene a Care Coordination/ Integration Summit (or series

of structured discussions) that brings the results of the above reports together.

A. Audience/participants would include key participants in existing integration efforts like the GAU Pilots, the King County Care Network, the Rethinking Care and chronic care pilots in HRSA, innovative programs in WA state, Providers, RSNs, State Agencies, and other interested parties.

B. Primary Goals would be: 1. Share state of the art practices from other states, 2. Understand what is already working in Washington State, and 3. Create a learning community to promote integration of care.

C. Additional goals would be to create momentum, visibility, and focus on the need for and effectiveness of coordination of care. May occur in conjunction with the Washington State Behavioral Health Care Conference.

Other areas identified for further consideration by this group are:A. Telepsychiatry/Telemedicine—how to use existing equipment and resources more

effectively/broadly.B. Psychiatric phone consultation for rural and underserved areasC. Better understanding and tools for clinics on both sides to use for coding and billing

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Use of PeersI. Develop/Consolidate Administrative and Clinical Guidelines

for Peer services throughout the state A. Create statewide definitions for peer positions B. Guidelines for billable Mental Health services C. Identify best practices

II. Survey those individuals that have completed peer counselor certification training at WIMHRT. The goals would be to determine : A. If they ultimately were certified and became registered

counselors, B. If they are being employed and utilized, successes, barriers to

employment, needed follow-up training, etc . C. The next step would be to put together a survey team to develop

content. Transformation Grant staff will develop plan to contract with WIMHRT and/or a consumer organization to conduct and analyze the survey.

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Use of PeersIV. Review the Mental Health Division’s about-to-be released

Consumer-Run Services (HB2654) Report to see if there are areas where this TWG Work Group could make further suggestions or recommendations.

V. Consolidate information on peers trained in WRAP facilitation in Washington State.

VI. Encourage providers, RSNs and agencies to hire peer specialists, identifying benefits and barriers related to the employment of peers.A. WCMHC to discuss with their members regarding interest, needs,

and methods likely to be successful.B. Some entities (NAVOS, Columbia River MH, others) have made

progress. Identify leaders and consider utilizing these peer agencies in providing guidance and TA for other agencies in the State.

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Criminal JusticeI. The Mental Health Council:

A. Was established by legislative budget proviso in 2006 “to investigate and promote cost-effective approaches to meeting the long-term needs of adults and juveniles with mental disorders who are likely to become offenders or who have a history of offending.”

B. Members include: 1. DOC2. MHTP3. MHD4. DSHS-PPA and 5. Judiciary

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Criminal Justice (Continued)II. Bureau of Justice Grant:

A. In May 2008, several MHC members (DOC, MHD and DASA) submitted an application for a grant through the federal Bureau of Justice Assistance.

B. This is a 12-month planning grant, with a maximum grant award of $50,000. The grant will provide the opportunity to plan cross-strategies addressing offenders with co-occurring disorders transitioning back into the community.

III. DSHS Offender Re-entry Initiative IV. Children and Families of Incarcerated Parents Bill