Opportunities to Serve People with
Co-Occurring Disorders through
Medicaid
Behavioral Health Serivces
Administration
Jane Beyer – DSHS Asst. Secretary
Melodie Pazolt - DBHR
Transforming lives
Washington State Department of Social &
Health Services
Legislative direction to improve
outcomes
5732-1519 Steering Committee
membership
• Six workgroups were created.
Two additional workgroups have produced
recommendations in the areas of:
• Workforce Development
• Evidence Based Practices
Transforming lives
Washington State Department of Social &
Health Services
5732-1519 Outcomes
• Workgroups are focused on combined areas of
performance measures:
– Quality of Life
– Health/Wellness, Utilization and Disparities
– Criminal Justice and Forensic Patients
– Employment, Education, Meaningful Activities,
and Housing
• Washington State Institute for Public Policy
(WSIPP)
– Inventory of Evidence-Based, Research-Based,
and Promisting Practices
Transforming lives
Washington State Department of Social &
Health Services
New Opportunities
• E2SSB 6312
– Adult Behavioral Health System Taskforce
• Regional Service Areas
• Key issues for purchasing BH Services
• Strategies to move toward full integration with
PHC
• Contract Standards
• Process to contract for BH services
– Option to include Peer support, supported
employment and supportive housing services for
mental health and chemical dependency treatment.
• Financial incentives for improved performance
Transforming lives
Washington State Department of Social &
Health Services
New Opportunities
• E2SHB 2572
– State Innovation Plan in preparation for
Centers for Medicaid and Medicare
Innovation Grant
– 2 Pilot projects for Communities of Health
– Health extension program to disseminite
tools, training and resources to providers
– Standard measures of health performance
– Restructure Medicaid procurement
Transforming lives
Washington State Department of Social &
Health Services
BHSIA/DBHR’s efforts to address
homelessness
• Permanent Options for Recovery Centered
Housing (PORCH)
• Projects for Assistance in Transition from
Homelessness – (PATH)
• Bringing Recovery into Diverse Groups
through Engagement and Support
(BRIDGES)
• Offender Re-Entry Community Support
Program (ORCSP)
• Access to Recovery (ATR)
• Oxford
Transforming lives
Washington State Department of Social &
Health Services
Mental Health Transformation Grant
(2nd Round)
• 5 year grant from SAMHSA
• Transformation through EvidenceBased Practice
• Government Performance
Accountability (GPRA)
• Infrastructure Development,
Prevention & Mental Health
Promotion
Transforming lives
Washington State Department of Social &
Health Services
Permanent Options for RecoveryCentered Housing (PORCH)
• 2 sites within WA state (Pierce County
& Chelan/Douglas Counties)
• Utilize Peer Support to provide
Evidence-Based Permanent Supportive
Housing
• Utilize Illness Management & Recovery
to measure recovery
• Partnerships with Housing System
(Dept. of Commerce provided $300,000
in TBRA in C/D Counties)
Transforming lives
Washington State Department of Social &
Health Services
Goals
• Serve 180 individuals over the course of 5
years
• Integrate consumer and family member
input into services and systems
• Integrate EBP Supp. Housing into Quality
Management Processes
• Develop stronger connections between
MH & Homeless Systems of Care
• Enhancement of Peer Certification to add
housing component
Transforming lives
Washington State Department of Social &
Health Services
Projects for Assistance in Transition
From Homelessness (PATH)
• The PATH program is administered by the
Center for Mental Health Services, a
component of the Substance Abuse and
Mental Health Services Administration
(SAMHSA), within the U.S. Department of
Health and Human Services.
• PATH programs provide outreach services
to people who are experiencing mental
illness and are experiencing homelessness
or risk of homelessness.
Transforming lives
ORCSP
• Offender Re-Entry Community Support Program
compensates RSN and other providers who
contract with DSHS to provide additional
support services to individuals transitioning
from prisons who have a history of serious
mental illness. The program funds up to
$10,000 per participant per year for a maximum
of five years.
• Pre-Release Planning is a component of the
program involving multiple systems.
• The funds are often used to support individuals
obtain/maintain housing and services to help
them transition to the community and connect
with services and supports.
Transforming lives
Access to Recovery
The Access to Recovery (ATR) program is funded by the federal Substance
Abuse and Mental Health Services Administration (SAMHSA). With support
from SAMHSA, Washington State’s Division of Behavioral Health and
Recovery is moving toward Recovery Oriented Systems of Care.
•Washington State ATR is administered with six county partners: Clark, King,
Snohomish, Pierce, Yakima, and Spokane. The purpose of this three-year
grant project is to provide recovery services to qualifying individuals and
their families to help them become productive members of their
community. This program is designed to help people reach recovery in body,
mind, and heart.
•ATR is based on the knowledge that there are many pathways to recovery
from substance use. The promise of this initiative - founded on a belief in
individual choice - is ensuring that a full range of treatment options are
available, including the transforming power of faith.
•Once a client is assessed and a recovery plan established, the client can
choose any authorized recovery provider for each service identified. Funds
for these services are reserved for this person/family member using a
voucher.
Transforming lives
Oxford
• An Oxford House is a live-in residence for
individuals in recovery from substance use
disorders. An Oxford House describes a
democratically self governed and self-supported
drug-free home.
• The number of residents in an Oxford House may
range from six to fifteen; there are houses for men,
for women, as well as for women with children.
• DBHR provides a revolving loan for the
development of new Oxford houses in WA State
• DBHR provides funds to support 6 FTE for outreach
services associated with Oxford houses
• Oxford House currently has 229 provider sites in 21
counties in Washington State. Rent is established
by each Oxford House.
Transforming lives
Bringing Recovery into Diverse Groups
through Engagement and Support
(BRIDGES)
Transforming lives
Cooperative Agreement to Benefit Homeless
Individuals (CABHI) Grant funded by the Substance
Abuse Mental Health Services Administration
(SAMHSA)
4 main objectives of the grant:
• A plan to address Chronic Homelessness –
Combine the Chronic Homeless Policy
Academy with CABHI – BRIDGES project
• Delivery of behavioral health housing
support services - Using modified PATH
and PORCH model for a substance abuse
treatment population targeting individuals
who are chronically homeless
Transforming lives
Housing 3000: Chronic Homeless
Policy Academy
2013 - present
Date
Transforming lives
Department of Social
and Health
Washington
StateServices
Department of Social &
Health Services
Policy Academy Overview
The policy academy sponsored by SAMHSA
provides assistance to four states with high
rates of chronic homelessness: California,
Washington, Louisiana and Georgia.
Each state receives support and coaching
from a faculty team, led by federal staff, with
access to technical assistance and planning
tools.
Transforming lives
Housing 3000 – High Impact Chronic Homeless Solutions
Intervention Subcommittee
Federal
Partners
Federal
Partners
Federal
Partners
Federal
Project
Team
Draft Strategic Plan
- based on May 1st
Workgroups will refine
In-State Meeting Strategies/Action steps
Based on SWOT,
Team
members
Team
Members
Team
Members
Key Informant
Interviews,
Research,
Team
Members
PA State
Team
Team
members
Team
members
Analysis
Team
members
Workgroups will
decide who else
needs to be part of
the action
steps/what
additional
Infrastructure
information is
needed and be
prepared to
present draft action
Needs Assessment, steps by August
Data/information
Service System Design
Workforce
Development
Active Work
Sufficient Housing
Data
Prevention
Service Design
Income & Employment
Sufficient
Groups =
Housing.
Transforming lives
Housing 3000 – High Impact Chronic Homeless
Solutions Intervention Subcommittee
August Meeting:
Additional
Information through
4 Panel
Presentations
• Counties
• State Agencies
• Federal Partners
Transforming lives
Refining of
Strategies/
Action Steps
and ‘Asks’ from
State PA Team
/Workgroups
October 16th
3nd In-State
Meeting
Finalize Draft
Strategic Plan,
Actions, Asks,
Input
Present Draft
Strategic plan at
October
Joint Interagency
Council on
Homelessness & Gov.
Advisory Council on
Homelessness
Final Draft Strategic
Plan – Logic Model
with Federal Partners
(December)
•Policy change
recommendations
•Pilot Project suggestions
•Short Term Targeted CH
solution recommendations
Housing 3000 – High Impact Chronic Homeless
Solutions Intervention Subcommittee
Activity Update:
•SAMHSA is sponsoring ‘white paper’ funding for
WLIHA & CSH
•Implementation of CABHI/BRIDGES grant
•Monthly conference calls re: putting strategies
into action
•Supplemental CABHI/BRIDGES grant from
SAMHSA
•3 Supportive Housing Pilots funded in DBHR
budget – Transitioning from institutional settings
Transforming lives
Photovoice Presentation
Transforming lives
Washington State Department of Social &
Health Services