Using Coaching and Displaying to Enhance Administrations to Youth Through a Medicaid Waiver.

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Using Coaching and Displaying to Enhance Administrations to Youth Through a Medicaid Waiver Building FASD State Frameworks May 13-14, 2009 Moderators L. Diane Casto, MPA Barbara Knapp The Frozen North DHSS, Behavioral Health Alaska DHSS, Behavioral Wellbeing Dan Dubovsky, MSW Cheri Scott
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Using Mentoring & Modeling to Improve Services to Youth Through a Medicaid Waiver Building FASD State Systems May 13-14, 2009 Presenters L. Diane Casto, MPA Barbara Knapp Alaska DHSS, Behavioral Health Alaska DHSS, Behavioral Health Dan Dubovsky, MSW Cheri Scott FASD Center for Excellence Stone Soup Group

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Alaska’s FASD History Alaska Native Medical Center with IHS financing started early liquor utilization screening for every single pregnant wome utilizing Alaska Native Health Services as a part of mid-1980’s. Built up statewide promotion and administrations for Alaska Native ladies and youngsters to decrease and counteractive action FASD—program dispensed with in mid-1990’s. 1997 Alaska Department of Health & Social Services holds first Alaska FAS Summit. 1998 Alaska Office of Fetal Alcohol Syndrome set up with $300,000 seed-cash from AK Mental Health Trust.

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Alaska’s FASD History Alaska’s FASD Project—4 essential results: Prevention of liquor uncovered births; Statewide arrangement of group based FASD Diagnostic Teams—improved indicative administrations; Quality arrangement of administrations for people with a fetal liquor range issue and their families; Statewide FASD Surveillance System. October 2000 - $29 million government reserve to build up a statewide FASD arrangement of administrations and system [$5.8 million every year for 5 years]

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Laying Foundation for FASD Waiver Project FASD analytic information gave clear ‘picture’ of youth with co-happening SED and FASD analyze. Ready to record requirement for Medicaid Waiver for youth ages 14-21 at high hazard for out-of-state position in RPTC with SED and FASD. Connected for SED Medicaid Waiver Demonstration Project in 2007 – recompensed 1 of 10 Waiver gifts. 5-year grant to consume $10 million in existing Medicaid stores on waivered administrations.

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An Alaskan Alternative to Residential Psychiatric Treatment Select the task: Locate a government award Request For Proposal (RFP) Pick a venture nobody else has attempted Call a meeting: Policy producers Program planners Computer programming originators Regulations essayists National specialists on the subject Stakeholders

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An Alaskan Alternative to Residential Psychiatric Treatment Pick a populace to serve: Youth age 14-20 years of age Meet level of tend to Residential Psychiatric Treatment Center, and With known pre-birth introduction to liquor or a Fetal Alcohol Spectrum Disorder Diagnosis

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An Alaskan Alternative to Residential Psychiatric Treatment Make up new acronyms: TIMS – Treatment Intervention Mentors 3M – Modeling, Mentoring, Monitoring RPTC – Residential Psychiatric Treatment Center Define new administrations: Mentor Training & Consultative Services Community Transition Supported Employment

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An Alaskan Alternative to Residential Psychiatric Treatment Define Service Providers: Collaborative endeavors between two beforehand irrelevant administration providers— Home and Community Based Agencies Community Mental Health Centers

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An Alaskan Alternative to Residential Psychiatric Treatment Home and Community Based Service (HCB) Agencies Traditional Medicaid Waiver Service Providers Habilitation group home encourage home day habilitation Supported business benefits Hourly & every day rest Community Transition administrations

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An Alaskan Alternative to Residential Psychiatric Treatment Community Mental Health Centers (CMHC) All HCB Agency administrations + CMHC administrations Individual & Group Skill Development Case Management Training & Consultative Services

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An Alaskan Alternative to Residential Psychiatric Treatment The Result—A Program Like No Other: Alaska’s 3M Project: Modeling, Mentoring, Monitoring Unique individual focused arrangement for every young who still gets Mental Health administrations and Medicaid medicinal services administrations - All this and Wraparound Services, as well

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An Alaskan Alternative to Residential Psychiatric Treatment Pivotal part: Mentor A man picked by the family who lives up to expectations under the heading of the Mental Health Agency giving the standard psychological wellness administrations. The tutor models positive practices and spends quality, coordinated time with the adolescent. Additionally, audits the administrations\' adequacy and family backings, can unite family & suppliers to concentrated mentors & advisors to help family, school & suppliers of different administrations.

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An Alaskan Alternative to Residential Psychiatric Treatment Stumbling squares Agencies Mental Health Agencies are regularly new to how Medicaid functions – charge for administration versus earlier approval for administrations HCB Agencies - not getting a sufficiently substantial offer of the administration $$$ to make it worth while Youth in RPTCs – frequently out of State – must be discharged before they quit meeting Level Of Care (LOC) for RPTC. Less demanding to discover customers near age 18 Harder to discover more youthful 14-18 year olds, who could stay with the project longer.

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An Alaskan Alternative to Residential Psychiatric Treatment Trouble focuses - Agencies Finding tutors – beginning with movement specialists with Mental Health Agency Finding out-of-home arrangements – FASD gathering homes Community positions – might never have been in RPTC – Getting mental assessments done and reports in an auspicious way Using psychiatric doctor\'s facility staff Pioneering telemedicine for Mental Health clinical administrations

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An Alaskan Alternative to Residential Psychiatric Treatment More hindrances – Unable to distinguish coach Family needs youth in out-of-home situation – however organization has no void beds Workforce advancement issues

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An Alaskan Alternative to Residential Psychiatric Treatment 3M Training Original preparing in 3M Model Started with 2x year vast, week long training Agencies can’t discharge staff that long New preparing model Moved to on-line preparing for FASD 101 and Core preparing “Webinar” subsequent preparing (4 times/year) Bring preparing to the group providers– train staff, do Level of Care & approve plans on same day

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Why the “3-M” Model? People with a FASD regularly learn most by displaying the conduct of everyone around them Individuals with a FASD improve having a balanced individual with them A coaching sort methodology has been appeared to be exceptionally successful in the avoidance of FASD Mentoring for persons with a FASD is starting to be tried Relationships are critical to constructive results Monitoring and assessment are a key part to guarantee continuation

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What is Mentoring? A type of showing that incorporates strolling close by the individual and welcoming him or her to gain from your illustration Participating in exercises with the individual instead of uniting the individual with exercises and afterward giving the individual the obligation to finish (as is run of the mill with case administration) Pointing out misinterpretations of words, activities, and body developments when they happen

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What is Mentoring? Giving exhortation, direction, direction, and coordinated support Helping the individual get to be mindful of, and take part in, circumstances Identifying qualities in the individual and family and expanding on those qualities

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What is Mentoring? Helping enhance a person’s feeling about him or herself (self-regard) Increasing a person’s capability in different regions Forming a constructive association with the individual Respect Caring No discharge A remedial approach however not a clinical administration

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Mentoring Is Not… Typical case administration Therapy Respite Guardianship Guarding A guide is not a superintendent

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What is Modeling? The movement of reproducing the progressions of an action so the individual can copy them Demonstrating so as to shape or trim the most ideal approach to do something in a mixed bag of circumstances An action A feeling A system for communicating a feeling

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Modeling Is Not… Telling somebody what to do “Once and done” “Do as I say” “Just do it”

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What is Monitoring? Survey and assessment of particular parts of an action or project to incorporate Measuring execution Assessing adherence to regulations, structure, and terms of the system Assessing advancement Of the individual and group Of the project Of the methodology Providing specialized help as required

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What is Monitoring? A key to the capacity to inspect whether a project or methodology produces constructive results A continuous procedure Begins with social affair benchmark information Continues with get-together information on a progressing premise Data assembled is examined for change and patterns

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Monitoring Is Not… Checking in with a man once in temporarily Vague reports of work being refined A summed up outline of what has happened Documenting occasions long after their event

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Treatment and Intervention Mentor (TIM) Role Is: Mentor Role model Coach Cheerleader For youth and family Is not: Sitter Disciplinarian “Spy” for the family Reward for good conduct

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Caregiver Perspective – Past encounters with behavioral wellbeing framework Few or no bolster administrations accessible until youth in out and out emergency Services not accessible in home group Caregivers had restricted comprehension of screening, position choice making procedure Limited compelling treatment alternatives for youth with FASD once set in treatment setting Difficulty getting fitting analysis

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Caregiver Perspective – Past encounters with behavioral wellbeing framework Few treatment staff comprehended FASD Limited contact with youth after situation Limited preparing

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