ISSUED FEBRUARY 6, 2013DUE APRIL 1, 2013

MDCH PIHP Application for Participation (AFP)

Stakeholder Overview

Formal Stakeholder VenuesAFP Overview

LifeWays Citizens Advisory Committee – Weds, March 20th

LifeWays Provider Network Meeting- Tues, March 19th

Coffee & Conversation with CEO

What is the AFP?

• Restructuring of system from 18 to 10 PIHPS• New state contracts January 1, 2014• Re-procurement of Medicaid specialty services• Submission of policies, plans and/or assurances by

existing or new entities according to MDCH map with identification of direct, delegated or contracted functions

• Maintaining/Improving public mental health system

Similar to 2002 AFP, targeted to CMHSPs in keeping with Michigan’s waiver renewal

AFP Sections

• 1. Governance

• 2. Administrative FunctionsFinancial ManagementInformation Systems ManagementProvider Network ManagementUtilization ManagementCustomer ServicesQuality Management

AFP Section (continued)

3. Accreditation Status4. External Quality Review5. Public Policy Initiatives

Regional Crisis Response CapacityHealth & WelfareOlmstead ComplianceSubstance Use Disorder Prevention &

TreatmentRecovery

What Does This Mean for LifeWays?

• Part of a new structure – Mid-State PIHP• Maribeth Caldwell has been participating in 12

CEO discussions and planning since fall 2012• Working with new regional mental health public

partners to make submission and post-submission operations plans, with support of TSG Solutions

• Retain CMHSP status• New PIHP – Contractual oversight of 12 CMHSPs• Delegation of many responsibilities based on

CEOs planning to date• Maintain local communities strengths and

priorities• Transition of substance abuse programs

Consumer AFP Involvement

“Because MDCH continues to value and promote community involvement, there must

be documentation that individuals who receive services, family members, and/or advocates

representing each service area of the region, if applicable, and all populations served,

including adults with serious mental illness, children with serious emotional disturbance,

children and adults with developmental disabilities, and children and adults with

substance use disorders were involved in the development of this application.”

AFP Themes

• The PIHP must be a separate legal entity• The PIHP must have common policies and

procedures in key areas• The PIHP applicant must attest to assurances

and outline contractual CMHSP delegations• The PIHP is responsible for oversight and all

assurances• The PIHP must have certain leadership

positions/roles, but has flexibility in how arranged

• New Accreditation expectations

AFP Consumer Specific Themes

• Customer Service• Public PoliciesCrisis response/at-risk consumersHealth and welfareCommunity livingEmploymentCommunity activities• Recovery

Customer Services

Information Services & Consumer HandbookIncludes “facilitation of consumer

empowerment and participation in PIHP planning and monitoring”

Customer Complaint, Grievances and AppealsCommunity Benefit

Crisis Response

Tracking/Trending of Critical IncidentsEmploying Prevention Strategies Regional Crisis Response to Behavioral or

Medical CrisesEvaluate factors/precursors/warningsEliminate or lesson risk – including trainingData - Crisis placements, 911 calls, inpatient

admissions, and related training

Employment

• Work as key component to recovery• Competitive, integrated employment• Customary wage and benefits optimal• Increase agency and subcontractor

employment of persons with disabilities• Linkages to benefits• Data – workshop, supported employment,

integrated employment and volunteer

Health & Welfare

WellnessChronic Condition ManagementAccess to and Coordination/Integration with

Primary CareAbuse & Neglect PreventionTrauma Informed Care & ServicesData – Trauma training

Community Living

Non-Institutional CareCommunity Housing Options & ChoicesCommunity IntegrationCulture of GentlenessData - Licensed and independent living

Community Activities

• Data – involvement at least once per month• Clubs, Social Events, Visiting Friends/Relatives• Continuing Education Classes• Athletic/Recreational Participation• Attendance at Sporting/Art/Theater/Movies• No extra-curricular activity

• Informed PCP Choice regarding work and activities

• Opportunities for integration and inclusion

SAMHSA New Recovery Dimensions

• Health – overcoming or managing one’s disease(s) or symptoms-and making informed, healthy choices that support and promote physical and emotional wellbeing

• Home – a stable and safe place to live• Purpose – meaningful daily activities, such as

a job, school, volunteerism, family caretaking, or creative endeavors, and the independence, income and resources to participate in society

• Community – relationships and social networks that provide support, friendship, love and hope

In Conclusion

• Stay tuned for updates from LifeWays

• This AFP will not disrupt or change services and should be transparent to consumers

• This AFP should help LifeWays to continue to improve upon outcomes and supports for persons with disabilities in Jackson & Michigan

Your Input for AFP

• Questions ?

• Comments ?

• Suggestions ?

• Updates from LifeWays ?