Division of Mental Health & Addiction Continuum of Care

1. Division of Mental Health & AddictionContinuum of Care Provider Spring Meeting 2012 Sirrilla D. Blackmon, MSW, LCSW, LCAC Deputy Director Provider & Community Relations, Certification/Licensure

2. Continuum of Care Committee The Continuum of Care Committee is comprised of the following Stakeholders: Community Mental Health Centers Managed Care Providers Addiction Providers DMHA Staff Indiana Council of Community Mental Health Centers

3. IC 12-7-2-40.6 Continuum of Care Sec. 40.6 (a) “Continuum of Care” means a range of services: • Defined by the division in rules adopted under IC 4-2-22 to provide a comprehensive continuum of care by a community mental health center or other provider; and • Based on recovery focused models of care and that are intended to meet the individual treatment needs of the behavioral health consumer. (b) the continuum of care may include the following services: (1) Wellness programs (2) Engagement Services. (3) Outpatient and Inpatient services. (4) Rehabilitative and habilitative services (5) Residential care and supported housing (6) Acute intensive services. All services must support prevention and treatment of mental health and addiction for all populations. As added by P.L. 40-1994, Sec. 10. Amended by P/L/ 143-2011, SEC.5.

4. Continuum of Care Comparison 440 IAC 9-1-6 IC 12-7-2-40.6 Individual Treatment Plan 24 Hour Crisis Intervention Case Management Acute Stabilization Day Treatment for Adults Services to prevent unnecessary and inappropriate treatment and hospitalization and deprivation of a person’s liberty Residential services for individuals with psychiatric disorders Residential services for individuals with psychiatric disorders Safety Net Engagement Outpatient Services Community, Recovery and Resilience Supports Acute Intensive Services

5. Continuum of Care Comparison440 IAC 9-1-6 Residential services for adults with addictions Residential services for SED or addicted children Case Management Outpatient Services Medication evaluation and monitoring Family support

6. Safety NetThe safety net consists of services available to all persons within Indiana regardless of payer source. Services include: Behavioral health crisis services Risk screening Clinical needs assessment Resolution and/or referral Services are available 24/7 and include: Screening Assessment Referral to SOF

7. Safety Net Community Mental Health Center Continuity of Care Risk Screening Gatekeeper Addiction Service Provider Continuity of Care

8. Engagement Services Are targeted to individuals who are at risk for behavioral health disorders. Include activities to reengage persons who are no longer participating in the treatment process but continue to be at risk for behavior health disorders.

9. Engagement Services Community Mental Health Center Holistic Assessments (assessments reflect all life domains including trauma and special needs) Service Planning (including crisis) Consumer/Family Education Screening for both mental health and addiction across lifespan

10. Engagement Services Addiction Service Providers Holistic Assessments (assessments reflect all life domains including trauma and special needs) Screening for both mental health and addiction across lifespan

11. Outpatient Services Outpatient treatment services may consist of a combination of: therapeutic interventions that utilize evidence based practice, where available, and promote the achievement of the individual's recovery goals.

12. Outpatient Services These services could occur in any community or a clinic-based setting. These may include service models that provide a comprehensive, coordinated, and a set of structured therapeutic interactions that may vary in composition and level of intensity according to the recovery goals of the consumer.

13. Outpatient Services Community Mental Health Center Individual Evidence Based Therapies Group Therapy/ Family therapy Addiction Counseling (Individual) Addiction Counseling (Group) Individual Therapy Multifamily Counseling

14. Outpatient Services Community Mental Health Center Psychotropic Medications Medication Training and Support Medication Training and Support (group) Medication Management Pharmacotherapy Pharmacological Management

15. Outpatient Services Community Mental Health Center Laboratory Services Substance Abuse Intensive Outpatient Services (must provide or make provision for) Community Based Services Ambulatory detoxification (must provide or make provision for) Behavioral Health Level of Need Redetermination

16. Outpatient Services Addiction Service Provider Counseling/Psychotherapy, Individual and Group Individual Evidence Based Therapies Group Therapy/ Family therapy Addiction Counseling (Individual) Addiction Counseling (Group) Individual Therapy Multifamily Counseling Laboratory Services Substance Abuse Intensive Outpatient Services (must provide or make provision for) Ambulatory detoxification (must provide or make provision for) Behavioral Health Level of Need Redetermination

17. Community, Recovery, and Resilience Supports Person-centered and self directed support activities that build upon the strengths and resilience of individuals, families and communities to obtain and sustain health, wellness and recovery. These services may compliment outpatient services or may stand alone to assist the individual in integration within the community. These may include emerging practices and may vary in composition and level of intensity according to the recovery goals of the consumer.

18. Community, Recovery and Resilience Supports Community Mental Health Center Housing support services Peer/Caregiver Support Peer Recovery Services Skills Training and Development Case Management Addiction Service Providers Housing Support Services Peer/Caregiver Support

19. Acute Intensive Services The provision of services that accomplish rapid assessment, intervention, stabilization and management of symptoms of psychiatric/addiction crisis. Community Mental Health Center & Addiction Service Providers Crisis Intervention Inpatient Services (must provide or make provision for) Detoxification Inpatient (must provide or make provision for)

20. Next Steps for DMHA Incorporate the new continuum into the affected rules Rule Promulgation Process

21. Thank You If you have any questions regarding certification or licensure please feel free to contact us at 317-232-7800. Sirrilla Blackmon, Deputy Director of Provider and Community Relations, Certification/Licensure Sirrilla.Blackmon@fssa.in.gov Tonja Thompson ,Assistant Deputy of Certification and Licensure Tonja.Thompson@fssa.in.gov