Delivering Recovery-Focused Treatment Services in a Managed Care Environment

4/29/2011Delivering Recovery-Focused Treatment Services in a Managed Care Environment

Sue Bergeson, VP Consumer AffairsOptumHealth Behavioral SolutionsUnited Community and State

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Consumer-Centered Recovery

OptumHealthSM Public Sector’s approach to Consumer-Centered Recovery stems from meaningful partnerships with:

Individuals and Families to Empower Recovery

Communities to Improve

Awareness and Support

Recovery

Consumer-Run Organizations and Provider Systems to

Promote Recovery

Systems of Care to Foster a

Whole-Health Approach to

Recovery


Individuals and Families to Empower Recovery

Recovery DVD and over 100 2- to 3-minute consumer/family videos on liveandworkwell.com to educate, encourage, and empower consumers and family members

Family-based developmental disability organization in New Jersey: support, engagement, crisis, appointments, transportation

Building Support Groups in New Mexico: 16 peers hired on staff, 68 new groups developed

Face-to-face, peer-led community-based training including CPS training, whole-health training, trauma-informed care, recovery-oriented practice, and many others

WRAP: In New Mexico, Tennessee, and Pierce County, WRAP and other training is available through our consumer portal


Communities to Improve Awareness and Support Recovery

Mental Health First Aid: Promotoras training (New Mexico, California, Texas,Satellite sites [Mississippi]), More remote locations (San Diego County, Appalachian area of Ohio)

Support Group Database: Everyone gets a support group (includes over 2,000 behavioral health, trauma, grief, cancer, and faith-based groups of all types and kinds)

Warm Lines In San Diego, OptumHealth promotes three consumer- and family-run warm lines: OptumHealth staff can warm transfer callers to these warm lines for support;In addition, these warm line staff can transfer calls to OptumHealth’s Access and Crisis Line; OptumHealth is also supporting the consumer-run warm lines in Hawaii

NYAPRS and BASIC Needs / Ghana Partnership Through this program, our partner NYAPRS is working with Basic Needs in Ghana to set up a series of exchanges so that consumers in Ghana can learn how consumers in US do peer support and consumers in the US can learn how consumers in Ghana approach peer support. The program also supports community training and outreach in Ghana


Mental Health First Aid/ Emotional CPR (eCPR)

Mental Health First AidA: Assess for RiskL: Listen Non JudgmentallyG: Give reassurance and informationE: Encourage Self Help and SupportE: Encourage Appropriate

Professional Help

Emotional CPR (eCPR) is an educational program designed to teach people to assist others through an emotional crisis by three simple steps:

C = ConnectingP = emPowering, and R = Revitalizing

http://emotional-cpr.org


Consumer-/Family-Run and Provider Organizations to Support Recovery

Peer Bridger: New York, Wisconsin, Tennessee, Texas, Arizona, Florida in process; Yale study: 49-77% reduction of rehospitalization (Yale study Poster/handout at the OptumHealth Booth)

Sustainability Institutes: SAMHSA Public/Private Partnership Training sessions teaching consumer and family run groups how to become a part of an MCO network – over 500 groups trained (Workbook available at the booth)

Family Navigator Program with the Federation of Families in Rhode Island Person-centered planning initiative with providers in Pierce County using

Dr. Neal Adams Living Room Crisis step-down service using peers reducing traumatizing

hospitalization and saving over 2 million per year in one county alone; New York Rose House support for development of manualized training program and consumer brochure to extend program

Peer Run Respite Tool And How To Guide With People Inc In NY


Mr. Bus

After I self-disclosed a history of substance abuse, Mr. Bus said that he learned a lot and gained a sense that if I could do it, then he could find purpose. He’s had many deaths in his family in the last two years. He felt alone and hopeless, but was relieved to hear of my ongoing goal for sobriety.

As a result of my openness, he disclosed his discomfort with himself and his sexuality. He responded to encouragement and support. Mr. Bus shared some of his past accomplishments and how he would like to use them to serve others in the future. He is an expert in Greek, Latin and the Arts. One of his several hobbies is to read and listen to Opera. Mr. Bus set goals to begin attending his Synagogue weekly, visit the neighborhood library where he hopes to offer tutoring. The Bridger program has assisted Mr. Bus to look beyond loss, to remember his strengths, and to aid in future planning and hope.


Systems of Care to Provide a Whole-Health Approach to Recovery

Whole-Health Peer coaching program in Texas, Arizona, New York — Texas showing 96% reduction in hospitalization

Mobile Medical Van Washington Primary-Care-on-Wheels located at behavioral health centers, using peers as wellness coaches

NAMI Hearts and Minds initiatives and spin-offs

Pillars of Peer Support III Joint initiative with Carter Center, SAMHSA, National Council, NASMHPD on the role of peers in integrating physical and mental health

System of Care Pilots. Partnership with Georgetown’s Technical Assistance Center for Children’s Mental Health: targeted system of care pilots in support of a community public health model addressing children with anxiety and ADHD disorders

Coping with Trauma Skills Training in Prisons. We are offering Seeking Safety classes run by peers to teach inmates living with mental illnesses who have experienced trauma how to cope with the effects of the trauma.


Mrs. Dawn

“When alone with Mrs. Dawn, she talked of her Diabetes and the complications she has at times – fatigue, light-headedness and foot numbness and dull pain. Her physical therapist had recommended a home program for exercise to relieve circulation problems in her feet. Together, we established a calendar for daily activities that included her doctor’s appointments, exercise and relaxation. I also taught her relaxation response techniques which she continues to do daily.

Mrs. Dawn experiences what she calls “panic attacks.” When they are particularly difficult, she will call me or ask that I schedule to come over. I come visit her and, with supportive listening or just sitting quietly with her, I become a part of her stability solution and have helped limit her hospital stays.”


Examples of Work We Are Doing in ASO-Only Markets

Prison Outreach Program: daily wellness peer-led recovery sessions

Warm lines: Promotion of existing peerfamily-led warm lines, coordination with our crisis line

Hearts and Minds Wellness Event: support groups and peers lead 10K walk training groups

MHFA English and Spanish language Mental Health First Aid in the Communityand doing nursing home/hospital staff training

TA: Currently making a case for peer bridger and offering technical assistance to implement

Restoring Dignity: Support for local cemetery restoration and National Consumer Memorial

4/29/2011Thank you!

“Our job is to inspire and create irresistible services: Interesting, inspired, irresistible services. Instead, we do three things to consumers that no longer fit: control, manage, and take care of.Current services are boring: bingo, day treatment, watching TV. Who ever reached recovery through bingo? We need interventions that empower, skills that instill resiliency, and connections that are human.”

—OptumHealth Consumer Advisory Board

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Documents

Delivering Recovery-Focused Treatment Services in a Managed Care Environment