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Partnership for Developing a Partnership for Developing a Spectrum of Family Spectrum of Family

Services, Resources & Services, Resources & Supports for Personalized Supports for Personalized

Recovery Oriented Services Recovery Oriented Services (PROS) Teams(PROS) Teams

Family Institute Family Institute for for

Education, Practice & ResearchEducation, Practice & Research

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Welcome & Introductions Welcome & Introductions Background on the Family InstituteBackground on the Family Institute Family Institute Personnel Family Institute Personnel

Anne SmithAnne Smith Thomas JewellThomas JewellBeth HohBeth Hoh Sherri LaddSherri LaddDoris Joy (FI/OMH)Doris Joy (FI/OMH) John Johnson (FI/OMH) John Johnson (FI/OMH)

Office of Mental Health Personnel Office of Mental Health Personnel David Bucciferro, Director, Rehabilitation Services Unit David Bucciferro, Director, Rehabilitation Services Unit

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OverviewOverview

I.I. PROS Information PROS Information

II.II. The Vision: Involving Families in a The Vision: Involving Families in a Recovery Oriented SystemRecovery Oriented System

III.III. Spectrum of Family ServicesSpectrum of Family Services

IV.IV. Details of the Practice Improvement Details of the Practice Improvement Network (PIN)Network (PIN)

V.V. Next StepsNext Steps

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PROS Information PROS Information

The Office of Mental Health has worked The Office of Mental Health has worked collaboratively with counties, mental health collaboratively with counties, mental health service providers, and consumer groups to service providers, and consumer groups to design the Personalized Recovery Oriented design the Personalized Recovery Oriented Services (PROS) program. The PROS license Services (PROS) program. The PROS license gives counties and providers the ability to gives counties and providers the ability to integrate multiple programs into a integrate multiple programs into a comprehensive rehabilitation service. comprehensive rehabilitation service.

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PROS InformationPROS Information

There are four Components in the PROS There are four Components in the PROS program: program:

Community Rehabilitation and Support (CRS)Community Rehabilitation and Support (CRS) Ongoing Rehabilitation and Support (ORS)Ongoing Rehabilitation and Support (ORS) Clinical TreatmentClinical Treatment Intensive Rehabilitation (IR)Intensive Rehabilitation (IR)

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PROS InformationPROS Information

The IR Component is composed of four The IR Component is composed of four different services. Through Intensive different services. Through Intensive Rehabilitation Goal Acquisition, services are Rehabilitation Goal Acquisition, services are designed to assist an individual to attain a designed to assist an individual to attain a specific goal within a certain area, such as specific goal within a certain area, such as education, housing or employment. education, housing or employment.

In addition, IR includes two evidence-based In addition, IR includes two evidence-based practices: practices: Family PsychoeducationFamily Psychoeducation and and Integrated Dual Disorder Treatment. Integrated Dual Disorder Treatment.

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Training the PROS Teams on the Training the PROS Teams on the Spectrum of Family ServicesSpectrum of Family Services

The New York State Office of Mental Health The New York State Office of Mental Health and the University of Rochester Medical and the University of Rochester Medical Center's Family Institute are offering PROS Center's Family Institute are offering PROS providers an opportunity to participate in a providers an opportunity to participate in a Practice Improvement Network (PIN) focused Practice Improvement Network (PIN) focused on promoting family oriented services. on promoting family oriented services.

In this initiative, the core foundational In this initiative, the core foundational approach is Consumer Centered Family approach is Consumer Centered Family Consultation (CCFC).Consultation (CCFC).

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The Vision: The Vision: Involving Families in a Involving Families in a

Recovery Oriented Recovery Oriented SystemSystem

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Creating a recovery oriented system insures that mental Creating a recovery oriented system insures that mental health programs routinely offer (or link families to those in health programs routinely offer (or link families to those in the community who offer) comprehensive education and the community who offer) comprehensive education and support services to family members and others in the support services to family members and others in the consumers' social networks.consumers' social networks.

Consumers choose to involve others in their treatment and Consumers choose to involve others in their treatment and recovery through collaborative decision-making. recovery through collaborative decision-making.

Involving Families in a Involving Families in a Recovery Oriented SystemRecovery Oriented System

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Role of ProvidersRole of Providers

Create an infrastructure (policies, procedures, Create an infrastructure (policies, procedures, staff competencies, supervision, measured staff competencies, supervision, measured performance indicators)performance indicators)

Integrate into the assessment, planning and Integrate into the assessment, planning and evaluation process integral to treatment evaluation process integral to treatment servicesservices

Partner with other stakeholdersPartner with other stakeholders

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Vision of a Family Involving Vision of a Family Involving Recovery Oriented SystemRecovery Oriented System

AssessmentAssessment Service Planning & InterventionsService Planning & Interventions Evaluation & Performance ImprovementEvaluation & Performance Improvement

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AssessmentAssessment Intake and ongoing assessments are Intake and ongoing assessments are

designed to identify:designed to identify: The nature and quality of the consumers The nature and quality of the consumers

relationship with members of their familyrelationship with members of their family The needs and wants of familiesThe needs and wants of families The family resources and strengths related to The family resources and strengths related to

supporting the consumers treatment and supporting the consumers treatment and recoveryrecovery

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Service Planning & InterventionService Planning & Intervention

Easily accessible system (e.g., designated role of Easily accessible system (e.g., designated role of family services coordinator)family services coordinator)

Full range of services integrated into the Full range of services integrated into the consumers service planconsumers service plan EducationEducation CommunicationCommunication Problem solvingProblem solving Using the mental health systemUsing the mental health system Emotional support and stigma reductionEmotional support and stigma reduction

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Service Planning & InterventionsService Planning & Interventions

Knowledge of and linkages to NAMI and other Knowledge of and linkages to NAMI and other community supportscommunity supports

Strategies to identify, reach out to and involve Strategies to identify, reach out to and involve families families

Reaching out to civic, religious, cultural and other Reaching out to civic, religious, cultural and other community resourcescommunity resources

Families are involved in helping organizations to Families are involved in helping organizations to create a family oriented systemcreate a family oriented system

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Evaluation and Performance Evaluation and Performance ImprovementImprovement

Progress notes in medical recordProgress notes in medical record Agency collects, analyzes and acts upon Agency collects, analyzes and acts upon

data that measures the performance of a data that measures the performance of a program with respect to family oriented program with respect to family oriented services.services.

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Spectrum of Family Oriented Spectrum of Family Oriented Services, Resources & SupportsServices, Resources & Supports

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Spectrum of Services and Spectrum of Services and SupportsSupports

The goal is to promote a system that provides a The goal is to promote a system that provides a wide range of service and support optionswide range of service and support options

A system in which access to services is supported A system in which access to services is supported by treatment providers, advocacy organizations, by treatment providers, advocacy organizations, local and state government and support local and state government and support associationsassociations

The spectrum of services matches the specific The spectrum of services matches the specific needs, preferences and life circumstances of needs, preferences and life circumstances of families and consumersfamilies and consumers

Flexibility and adaptations based on cultural Flexibility and adaptations based on cultural values and preferences promote widespread accessvalues and preferences promote widespread access

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Spectrum of Family ServicesSpectrum of Family Services“2 Categories”“2 Categories”

Services, supports and resources provided by:Services, supports and resources provided by: A mental health services agency/programA mental health services agency/program An advocacy and support organization (e.g. An advocacy and support organization (e.g.

NAMI)NAMI)

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Spectrum of Family Oriented Spectrum of Family Oriented Services, Supports & ResourcesServices, Supports & Resources

Agency Led ServicesAgency Led Services Integrate family into the intake, assessment and ongoing Integrate family into the intake, assessment and ongoing

care as agreed upon by consumercare as agreed upon by consumer Consumer Centered Family ConsultationConsumer Centered Family Consultation Family Support GroupsFamily Support Groups Multifamily GroupsMultifamily Groups Resource LibraryResource Library Family Information NightsFamily Information Nights Family Education CurriculumFamily Education Curriculum Family Therapy/Behavioral Family Therapy Family Therapy/Behavioral Family Therapy

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Consumer Centered Family Consumer Centered Family Consultation: Consultation:

Delivered by cliniciansDelivered by clinicians Location and duration are flexibleLocation and duration are flexible Client may or may not be present Client may or may not be present Needs, wants and goal assessment are core parts of a Needs, wants and goal assessment are core parts of a

consultationconsultation Helps families with illness related concerns, education, Helps families with illness related concerns, education,

emotional support, and involving families in their emotional support, and involving families in their loved one’s treatment planloved one’s treatment plan

May include a referral to adjunct services and May include a referral to adjunct services and community supportscommunity supports

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CCFC is characterized by:CCFC is characterized by: Consumer Centeredness -The consumer is at the Consumer Centeredness -The consumer is at the

center of all decisions. center of all decisions. Collaboration-CCFC promotes an equal partnership Collaboration-CCFC promotes an equal partnership

between consumers, families and providers. between consumers, families and providers. Education Orientation- CCFC provides basic Education Orientation- CCFC provides basic

information about: mental health diagnoses, causes, information about: mental health diagnoses, causes, treatments and services; family guidelines on how to treatments and services; family guidelines on how to support the consumer and family; and community and support the consumer and family; and community and agency resources.agency resources.

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Family Support GroupFamily Support Group Led by cliniciansLed by clinicians Fixed schedule (e.g., once per month)Fixed schedule (e.g., once per month) Fixed time frame (e.g., 90-min meetings)Fixed time frame (e.g., 90-min meetings) Brings family members together without Brings family members together without

consumerconsumer Emotional support and information are key Emotional support and information are key

componentscomponents

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Formal Family PsychoeducationFormal Family Psychoeducation Led by a professionals and linked to a clinical Led by a professionals and linked to a clinical

programprogram Lasts 9 months – several yearsLasts 9 months – several years Involves single or multiple familiesInvolves single or multiple families Usually diagnosis-specificUsually diagnosis-specific Focused primarily on recipient outcomesFocused primarily on recipient outcomes Eligible for Medicaid reimbursementEligible for Medicaid reimbursement Truly evidence-based (approximately 3 decades Truly evidence-based (approximately 3 decades

of research evidence)of research evidence)

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Resource LibraryResource Library Delivered by family members, clients, and/or Delivered by family members, clients, and/or

cliniciansclinicians Informational materials available free of Informational materials available free of

charge for familiescharge for families Resource library may be maintained at Resource library may be maintained at

community agency or local NAMI affiliatecommunity agency or local NAMI affiliate Family member can request specific materials Family member can request specific materials

via a menu of available resourcesvia a menu of available resources

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Family Informational NightsFamily Informational Nights Delivered by family members, clients, and/or Delivered by family members, clients, and/or

cliniciansclinicians One or more sessionsOne or more sessions Held monthly, quarterly or semi-annuallyHeld monthly, quarterly or semi-annually Typically an “overview” of mental illness or an Typically an “overview” of mental illness or an

overview and introduction to a specific agency overview and introduction to a specific agency and its servicesand its services

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Family Education CurriculumFamily Education Curriculum Delivered by family members, clients, and/or Delivered by family members, clients, and/or

cliniciansclinicians Typically 60-90 minute sessionsTypically 60-90 minute sessions Typically lasts from 1-12 classesTypically lasts from 1-12 classes Usually topic oriented (e.g., relapse Usually topic oriented (e.g., relapse

prevention; signs and symptoms of mental prevention; signs and symptoms of mental illness)illness)

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Behavioral Family TherapyBehavioral Family Therapy

Combined with appropriate psychotropic medications Combined with appropriate psychotropic medications consumers and relatives can expect:consumers and relatives can expect: To gain mastery over the illnessesTo gain mastery over the illnesses Experience fewer relapses and rehospitalizationsExperience fewer relapses and rehospitalizations Attain higher levels of social & occupational Attain higher levels of social & occupational

functioningfunctioning Enjoy a better quality of life Enjoy a better quality of life

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Spectrum of Family Oriented Spectrum of Family Oriented Services, Supports & ResourcesServices, Supports & Resources

Community Led ServicesCommunity Led Services National Alliance on Mental Illness National Alliance on Mental Illness

BasicsBasics ConnectionConnection Family to FamilyFamily to Family In our own Voice In our own Voice Peer to PeerPeer to Peer Monthly support groups Monthly support groups

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Details about the Upcoming Details about the Upcoming Practice & Improvement Network Practice & Improvement Network

Spectrum of Spectrum of Family Services Family Services

“Roll Out”“Roll Out”

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Practice Improvement NetworkPractice Improvement Network The Family Services Practice Improvement The Family Services Practice Improvement

Network (PIN) is a voluntary group of PROS Network (PIN) is a voluntary group of PROS providers in NYS formed together to focus on providers in NYS formed together to focus on a common improvement effort. a common improvement effort.

The common improvement effort is integrating The common improvement effort is integrating effective family involving services into the effective family involving services into the PROS Programs. PROS Programs.

The family service is Consumer Centered The family service is Consumer Centered Family Consultation. Family Consultation.

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Practice Improvement Network Practice Improvement Network Method (PIN)Method (PIN)

A PIN consists of a network of PROS providers and A PIN consists of a network of PROS providers and a resource panel who work in partnership to plan, a resource panel who work in partnership to plan, implement and evaluate approaches to involve family implement and evaluate approaches to involve family members in a way that supports the consumer’s members in a way that supports the consumer’s service plan and recovery. service plan and recovery.

The resource panel includes faculty of the Family The resource panel includes faculty of the Family Institute for Education, Practice & Research; experts Institute for Education, Practice & Research; experts in staff and supervisory training on a full range of in staff and supervisory training on a full range of family oriented services, organizational family oriented services, organizational implementation, PROS regulations, data analysis and implementation, PROS regulations, data analysis and outcome evaluation. outcome evaluation.

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Practice Improvement Network Practice Improvement Network Method (PIN)Method (PIN)

The first step for a PROS program joining the The first step for a PROS program joining the PIN is to identify 2-3 key individuals in the PIN is to identify 2-3 key individuals in the PROS program who will take primary PROS program who will take primary responsibility to work with the resource panel responsibility to work with the resource panel and to oversee the implementation of family and to oversee the implementation of family services in the PROS program. services in the PROS program.

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Practice Improvement Network Practice Improvement Network Method (PIN)Method (PIN)

Key individuals from each agency comprise Key individuals from each agency comprise the the Quality Improvement Team (QIT).Quality Improvement Team (QIT).

The QIT includes:The QIT includes: Executive level leadership/designee Executive level leadership/designee PROS Program leader/supervisorPROS Program leader/supervisor Data Person-someone who can collect and submit Data Person-someone who can collect and submit

data-this person could be a peer specialist data-this person could be a peer specialist interested in family services or anyone who may interested in family services or anyone who may champion the goals of the PIN.champion the goals of the PIN.

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Phase One Key Performance Phase One Key Performance Indicators: Initial and Ongoing Indicators: Initial and Ongoing Engagement and InvolvementEngagement and Involvement

# and % of face to face proactive family # and % of face to face proactive family consultations provided on a monthly basisconsultations provided on a monthly basis

# and % of face to face meetings with # and % of face to face meetings with consumer to discuss the involvement of consumer to discuss the involvement of family members or others in their treatment family members or others in their treatment and recoveryand recovery

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Phase One Key Performance Indicators Phase One Key Performance Indicators cont. cont.

Family members perception of the quality Family members perception of the quality of the consultation service (Zagat style)of the consultation service (Zagat style) SatisfactionSatisfaction HelpfulnessHelpfulness Culturally respectedCulturally respected

Categorizing the disposition of each Categorizing the disposition of each consultationconsultation

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NEXT STEPS NEXT STEPS

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Selection CriteriaSelection Criteria

In the event the demand exceeds supply of In the event the demand exceeds supply of resources, the following resources, the following selection criteriaselection criteria will will be employed:be employed: Completeness, timeliness of applicationCompleteness, timeliness of application Type, size and location of the applicantsType, size and location of the applicants Cultural, racial, ethnic characteristics of the Cultural, racial, ethnic characteristics of the

population servedpopulation served

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Application ProcessApplication Process

““Application to Join a Family Services Application to Join a Family Services Practice Improvement Network of PROS Practice Improvement Network of PROS Providers”Providers”

Application coversheetApplication coversheet Organizational Characteristics Data SheetOrganizational Characteristics Data Sheet Identification of Quality Improvement Identification of Quality Improvement

Team SheetTeam Sheet

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Submit all material in triplicate to:Submit all material in triplicate to: Anne M. Smith, LMSWAnne M. Smith, LMSW

Executive Director Executive Director Family Institute for Education, Practice & ResearchFamily Institute for Education, Practice & Research315 Science Parkway Suite 400315 Science Parkway Suite 400Rochester, NY 14620Rochester, NY 14620

Deadline: ____________________Deadline: ____________________ Questions may be submitted via email to Anne Smith at: Questions may be submitted via email to Anne Smith at: Email: Email: Annem_smith@urmc.rochester.eduTelephone: 585-279-7903. Telephone: 585-279-7903.