IMPLEMENTATION WORKBOOK

Transcription

1 Texas Institute for Excellence in Mental Health August 1st 2014 YES WAIVER PLANNING: IMPLEMENTATION WORKBOOK Supported by Texas Department of State Health Services Background: The Texas Institute for Excellence in Mental Health (TIEMH) at the University of Texas at Austin has entered into an agreement with the Texas Department of State Health Services (DSHS) Youth Empowerment Services (YES) Waiver program to provide implementation support for YES waiver expansion. The YES program has adopted wraparound planning as the case management model. Support for implementation of the YES Waiver includes wraparound training utilizing the National Wraparound Initiative (NWI) model and targeted coaching for supervisors and facilitators to achieve high quality/ fidelity practice. Support will also include technical assistance to program staff to ensure effective drivers of implementation.

2 Purpose of the Meeting We will use a combination of face-to-face and telephone meetings to assist in the development of an implementation plan, tailored toward each community. The goals of this first planning meeting are: 1) To review the role of wraparound in the YES waiver service delivery model. 2) To develop specific implementation strategies and plans for each community. Each community will break into groups and develop preliminary implementation strategies for initiating the YES waiver in their community. Strategies will address the core infrastructure that will support implementation during this initial planning and launch phase. 3) To prioritize next steps for YES waiver implementation. Each community participating in YES waiver will need to develop a site-specific plan, prioritizing the key strategies to achieve successful implementation. We recognize there will be a need for some refinements to the initial thoughts and action steps identified during this meeting upon the team's return to their respective communities. As a result, each site will be given the opportunity to customize and/or adjust the workbook upon their return to the community. During this initial kick-off meeting, next steps and key leadership strategies will be identified with follow-up provided by the TIEMH team within one month of the meeting. 4) To identify key data indicators to monitor implementation. The implementation team should identify key indicators that can be monitored to quickly identify barriers to successful implementation and begin a Plan, Do, Study, Act (PDSA) cycle. TIEMH will assist communities to regularly track program indicators. This workbook will serve as a guide to help each community to identify the key implementation strategies and critical next steps for YES waiver implementation, as well as provide each individual site with the opportunity to refine the plan to make it specific to their community. In addition, the workbook will help guide the discussion and thinking around the identification of quality indicators, data sources and data collection strategies. While it is recognized that further work will be necessary to finalize this work plan to prepare for implementation, each site will submit their initial implementation work plan to the TIEMH prior to the Strategic Planning Meeting.

3 Implementation Strategies Community: Leadership 1. a) An implementation team meets regularly to monitor progress with implementation, identify barriers, problem solve, and review data. Who are the critical persons within your organization who should participate as a part of your implementation team? b) How will your implementation team communicate and make decisions? 2. Buy-in and support from leadership in various roles in the organization is critical for successful implementation. Who within your organization should be engaged in implementation efforts and what strategies will you utilize to ensure support?

4 3. a) Awareness and support from community leaders will also be important. What organizations should you engage in your outreach? Please list key community leaders to engage. b) What strategies will you use to engage community leaders? Community Engagement 4. a) Where do you expect referrals to the YES waiver to come from? b) How do you plan on getting information to your referral network (e.g. brochures, presentations, etc.)?

5 5. How do you plan to engage referral organizations and other community partners (e.g., juvenile probation, child welfare, schools) in wraparound teams? 6. How will you ensure youth and family members have the opportunity to provide meaningful input on the YES program development? Wraparound Teams 7. a) How many wraparound facilitators does your organization have? (Please name the identified facilitators.) b) Do you have an adequate number of facilitators trained for the estimated population? c) What qualities are most critical in selecting wraparound facilitators for this population?

6 8. Is there an identified supervisor for the wraparound facilitators? (Please name your supervisor(s)). 9. a) Have you identified any barriers to wraparound that need to be addressed? b) What are your facilitators biggest barriers at present? YES Provider Network 10. a) What gaps are present in the provider network currently? b) How do you plan to identify or recruit appropriate service providers?

7 1. a) What information or training do likely providers need regarding wraparound and the YES program? b) What strategies will you utilize to educate providers and who are priority targets for training? 2. How do you plan on ensuring ongoing communication and collaboration between your organization and the service provider network (Are changes to record systems necessary)? 13. How will you ensure youth and parents have choice in service providers and have access to information to guide their selection of appropriate providers? 14. How will you ensure providers demonstrate cultural and linguistic competency for the diversity of the population enrolled?

8 Plan for Targets What is the target? (9% of their overall children's target) What are your thoughts on how to reach target numbers as assigned? What staffing needs are required to ensure the target numbers can be supported? Refer to contract for timeframe. Generally required to be at 40% of target by 6 months, 60% by 12, 80 by 18, and 100% by 2 years. They required to maintain at 95% of their target. This could vary some depending on when the site comes on board, due to contract periods.

9 Quality Indicators (Example indicators: Calls to inquiry list, referral sources, length of time to assessment, eligibility rates, days to first team meeting, days to first service, number of team members, number of informal supports on team, treatment retention rates, hospitalization, out-of-home placement, changes in identified needs, changes in strengths) 14. What quality indicators will you track and monitor at the initiation of the waiver? 15. Who will be responsible for gathering and reporting data to the implementation team and/or leadership? 16. Are data systems ready to collect the necessary data? 17. What agency partners exist in your community that can assist with measuring the outcomes for YES families (e.g. Juvenile Justice, Schools)?

10 Next Steps What are the six practical next steps that your team will take? For each step, please specify who will be responsible and when the step will occur. Step 1. Step 2. Step 3. Step 4.

11 Step 5. Step 6.

12 TIMELINES 90 DAYS PRIOR TO ENROLLMENT Week Month START ENROLLMENT YEAR ONE Month

13 Cost/Benefit Worksheet Model based on ICM billable items YES service billable items are not included in the table. *Based on figures when wraparound is done to fidelity. County Cost of Wraparound Facilitator Care Coordinator 1 FTE) Supervision 1/7th FTE) Total Salaries Total Fringe (25%) Other Costs Rent (144 Square $15 per square foot per month) Communications (internet & phone) Mileage (10,500 miles per $0.555/mile) Indirect Cost (40% of salaries) Total Cost 1 FTE care coordinator Costs Wraparound/Intensive Case Management Billing Estimated cost of 1 FT Wraparound Facilitator* Estimated number of ICM billable hours/month (full caseload) Estimated revenue/month based on full caseload (ICM rate of $126.76/hr) Estimated revenue/year ($8, x 12) Net revenue per facilitator ($106, $94,233.71) 70 *Includes percentage of supervisor s salary, fringe, & overhead