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DMHA System Transformation Update

Meeting for Mental Health and Addiction System Transformation

October 18-19, 2006

On October 18 and 19 of 2005, the Division of Mental Health and Addiction held the kick off meeting for Mental Health and Addiction System Transformation. The attached document is an update on the progress of the Mental Health and Addiction System Transformation Process. We encourage all of you to please share this document with your staff, colleagues and others you feel may have an interest. Please feel free to include this document as a part of your in-house newsletters or other communication tools you may use.

DIVISION OF MENTAL HEALTH AND ADDICTION
MENTAL HEALTH AND ADDICTION TRANSFORMATION UPDATE

DENNY JONES, CHAIR
2006

Transforming Mental Health and Addiction is a priority in the State of Indiana. On October 18 and 19 of 2005, the Division of Mental Health and Addiction (DMHA) held a Transformation Kick-Off Conference Event at the Indiana State Library. Since the Kick-Off Conference Event, many positive strides have taken place. Below is an update on the progress of transforming Mental Health and Addiction in Indiana. Information on the Kick-Off Conference Event is available via DVD or by visiting the DMHA web site.

Formation of the Transformation Work Group:

  • A statewide Transformation Work Group (TWG) has been developed to guide the transformation process
  • The TWG consists of about 45 members representing State Agencies, Consumers, State Legislatures, Mental Health Providers and Advocates. For a complete roster of the TWG, please visit the DMHA web site at: http://www.in.gov/fssa/dmha/
  • The TWG meets monthly for the purposes of information sharing which includes national speakers, planning, decision making, and progress reports from the TWG Subgroups
  • Key themes of the TWG meetings were as follows: A shared vision, recovery, resiliency, updates on the DMHA Localization Project and the Larue Carter Rebuild Project

Formation of the Transformation Work Group Subgroups:

  • Group Each member of the Transformation Work Group subgroup has been assigned to a subgroup
  • There are a total of five subgroups and they are: priority responsible
    • Consumer/Family Involvement
    • Knowledge Dissemination and Use
    • Results Management
    • Relationship Management
    • Cross-Systems Initiatives

The subgroups have been assigned various initiatives and are required to reportreporting to the Transformation Work Group on a regular basis as to their progress. The following information summarizes the purpose and progress of each subgroup:

  • Consumer/Family Involvement - Chair, Kim Williams, Director of Families Reaching for Rainbows, Inc. PURPOSE: The purpose of this subgroup is to have an enhanced focus on specific statewide/local methods to ensure consumers/families are full partners in planning for, delivering and evaluating culturally, competent care.
    • The subgroup members have reviewed the roles and purposes of the group and began to work collectively on defining a working definition of full partnership
    • This action is in concert with the role of developing an initiative that will ensure or create the process of ensuring that families and/or consumers are equal partners in the development, delivery and evaluation of culturally sensitive and competent services
    • Next Steps: Create a uniform policy that will allow consumers/families to become actively involved in systems as full partners; Ensure consumers/families understand the purpose and mission of their participation and clearly define expectations of participation for consumers/families
  • Knowledge Dissemination and Use – Chair, Bob Postlethwait of Eli Lilly (Retired). PURPOSE: Develop specific strategies to address the gap between scientific/best practice knowledge and actual practice.
    • The subgroup members have accessed literature on the topic of evidenced-based practices and the science to service cycle dynamics and implementation research
    • Subgroup members represented Indiana at a Regional Science to Service Meeting in Oklahoma City on April 17 and 18th, 2006
    • Next Steps: Conduct work sessions to develop the recommended processes for knowledge dissemination as well as the test on the practicality and feasibility of those processes. Consider partnering with the Results Management Subgroup
  • Results Management – Chair, Bernice Pescosolido of Indiana University. PURPOSE: Three-part process for measuring the outcomes of our individual and collective efforts. Measurement of the Transformation Process; Develop system-level outcome measures and; Assist in monitoring of service level performance.
    • Consumer Service Review (CSR) has been the primary initiative thus far. During the first quarter of 2006, a contract was initiated with Human Systems and Outcomes, Inc. Most of the activity centered around protocol development for the Consumer Service Reviews and training of reviewers.
    • First Consumer Service Reviews occurred in May, 2006 in the Central Indiana Region. The remainder of the Community Mental Health Centers will be reviewed by the end of this calendar year.
    • Division of Technology Services Project Managers and an Indiana University Intern have been assigned to the TWG to measure and monitor the TWG process
    • Next Steps: Review the results of the CSR and determine how to disseminate and utilize the information to move the system forward to meeting the goals of Transformation.
  • Relationship Management – Chair, Bob Williams, CEO of Quinco Community Mental Health Center. PURPOSE: A formal business process with well defined accountability to ensure that Purchaser and Supplier are operating to one valid plan communicated through both organizations.
    • This subgroup has contracted with the Phoenix Images Company to identify and assess needs, goals/objectives and to develop an implementation plan
    • Reviewed provider and other service contracts in order to recommend a plan for the development of a contract framework for providers and service contracts
    • This subgroup is in the process of developing a Market/Spend/Business Analysis. The Internal Analysis was completed June, 2006
    • Next Steps: Continue Market/Spend/Business Analysis process adding external provider interface/input. Combine findings from internal and external sources to develop strategy and implementation plan for future contracting
  • Cross-Systems Initiatives – Chair, Steve McCaffrey, President and CEO of the Mental Health Association in Indiana. PURPOSE: Identify other entities working on priority areas, the work that has been done, and serve as a point of interface. Identify best practices or models for system change.
    • Established four Priority Areas in order to identify best practices and models for systems change in these areas. They are: Forensic, Early Identification/Intervention, Public Health and Prevention Task Forces
    • Several experts from each Priority Area have conducted presentations for this subgroup in order to discuss current initiatives, identify specific priority areas, work that has been done in these areas and initiatives that require further development
    • Next Steps: In collaboration with the TWG, identify priority initiatives. Develop and implement strategies for each priority initiative which may include policy, rule or code changes

As illustrated above, the Transformation Work Group and Subgroups have been very busy. Initial recommendations for Mental Health and Addiction transformation from each subgroup will be presented to the Transformation Work Group in September of 2006. These recommendations and the final outcome will be posted on the DMHA web site for review.

The end goal of transformation includes:

  • A consumer centric system of planning, delivering and evaluating effective care
  • The alignment of systems, services, funding and technology
  • A different State Role that focuses on leadership, not direct service delivery
  • Statewide Implementation of pilot projects proven to be effective models of care
  • Measuring Results to inform ongoing quality improvement efforts
  • Knowledge Dissemination that moves science to service as efficiently as possible

For more information on the Division of Mental Health and Addiction transformation activities, presenters and progress, please visit the DMHA web site at: http://www.in.gov/fssa/dmha/4720.htm.