Mecklenburg’s
Promoting Recovery and Opportunity through Mentoring, Insight, Support and Education
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Mecklenburg's PROMISE Community Support Recovery Toolkit 2007.1
INDEX
I. Community Support Recovery Toolkit Toolkit Purpose Toolkit Development Mecklenburg’s PROMISE/ Recovery Collaborative Contact Information
II. The Recovery Model Origins of the Recovery Model Definition of Recovery Elements of the Recovery Model Medical Model VS. Recovery Model Recovery Model: Guiding National Mental Health Reform Recovery Model: Guiding Reform in North Carolina Recovery Model: Guiding Reform in Mecklenburg County Evidence-Based Best Practices Definition/Purpose SAMHSA Toolkits Illness Management and Recovery (IMR) Medication Management Assertive Community Treatment (ACT) Family Psychoeducation Supported Employment Integrated Dual Disorders Treatment (IDDT) Consumer-Driven and Recovery-Oriented Services Wellness Recovery Action Planning (WRAP) Peer Bridger Warm Line Psychosocial Rehabilitation Clubhouse (PSR) Compeer
III. General Overview of Community Support Services Service Definition of Community Support Provider Requirements Staffing Requirements Qualifications/ Job Description of Qualified Professionals (QP), Associate Professionals (AP), and Paraprofessionals (Para), Peer Support Specialists Service Type/Setting Program Requirements Entrance Criteria Continued Stay Criteria Discharge Criteria Expected Outcomes Service Exclusions/Limitations “Clinical Home” Global Assessment of Functioning (GAF) Target Population of SPMI/SMI Diagnostic Assessments/Clinical Evaluation Documentation MOA/IPRS Full/Conditional Endorsement Accreditation/Accrediting Organizations
IV. Person-Centered Thinking and Person-Centered Planning What Is Person-Centered Thinking? Definition/Purpose Recovery-Based Language Cultural Competence Empowerment vs. Enabling Developing a Partnership Boundaries and Ethics in Recovery-Oriented Environment Sensitivity and Empathy Strengths-Based Approach Giving Up Power and Control
The Destination Preparing for the Trip Assessments Motivational Interviewing Re-Ordering Step One: Orientation Step Two: Strengths Assessments Step Three: Needs Assessments Step Four: Assessing and Prioritizing Life Domains Step Five: Identifying an Individual’s Resources Step Six: Forms and Paperwork What is a Person-Centered Plan? The Map The Process Team Meetings Determining Outcome Statements and Long-Range Goals Identifying Symptoms and Observations Determining Short-Range Goals/Objectives Developing Supports/Interventions to Reach Goals Incorporating Strengths and Needs into Strategies Step One Step Two Step Three Step Four Dignity of Risk and Crisis Planning What is Dignity of Risk? What is a Crisis Plan? What is included in a Crisis Plan? Predict Prevent (Pro-Active Intervention) Plan (Reactive Intervention How do I develop a Crisis Plan? Advance Directives Living Will Healthcare Power of Attorney Advanced Instruction for Mental Health Treatment Rules to Establish Advance Directives in North Carolina
V. Participants Who Are New or Transferring New Participant Transferring Participant
VI. Person-Centered Planning with a New Participant with Medicaid General Overview Referral Process Screening, Triage and Referral (STR) Definition/Purpose STR Registration Form PCP Consumer Admission Form Utilization Management Diagnostic Assessments Provider Connect/ eCura Definition/Purpose Training/Technical Support Value Options Definition/Purpose Recovery-Oriented Intake Process Definition/ Purpose Activities of Intake Establishing a Rapport “The Common Sense Approach” Motivational Interviewing Seven Ethical Principles for Service Providers Strengths Assessments Needs Assessments Understanding Intake Forms Agency Admission Packets Definition/Purpose Value Options Re-Authorizations Definition/Purpose Inpatient Treatment Report (ITR) Outpatient Treatment Report (ORF 2) To Request an Increase in Authorized Units Contact Information Training/Technical Support Target Population Definition/Purpose Contact Information Training/Technical Support Due Dates Tips for Completing Target Population Target Population and Recovery NC TOPPS Definition/Purpose Contact Information Training/Technical Support Due Dates Tips for Completing the NC TOPPS NC TOPPS and Recovery Overview of Person-Centered Plans and Crisis Plans Intake Checklist
VII. Person-Centered Planning with a New Participant without Medicaid General Overview Referral Process Screening, Triage and Referral (STR) STR Registration Form PCP Consumer Admission Form Utilization Management Clinical Evaluations Provider Connect/ eCura Definition/Purpose Training/Technical Support Authorizations and Re-Authorizations Definition/Purpose Initial Authorization Request Form for Participants without Medicaid Re-Authorization for Participants without Medicaid Directions for Submitting Re-Authorizations To Request an Increase in Authorized Units Recovery-Oriented Intake Process Definition/ Purpose Activities of Intake Establishing a Rapport “The Common Sense Approach” Motivational Interviewing Seven Ethical Principles for Service Providers Strengths Assessments Needs Assessments Understanding Intake Forms Agency Admission Packets Definition/Purpose Target Population Definition/Purpose Contact Information Training/Technical Support Due Dates Tips for Completing the Target Population Form Target Population and Recovery NC TOPPS Definition/Purpose Contact Information Training/Technical Support Due Dates Tips for Completing the NC TOPPS NC TOPPS and Recovery Overview of Person-Centered Plans and Crisis Plans Intake Checklist
VIII. Person-Centered Planning with a Participant Transferring with Medicaid General Overview Referral Process Consumer Representative and Consumer Choice PCP Consumer Admission Form Utilization Management Diagnostic Assessments Provider Connect/ eCura Definition/Purpose Training/Technical Support Recovery-Oriented Guidelines for Participants Transferring Transfer from the Current Provider Agency Consumer Transfer Form Informational Meeting Final Consumer “Transfer Session” Discharging a Participant Transfer to the New Provider Agency Consumer Transfer Form Informational Meeting Final Consumer “Transfer Session” Value Options Definition/Purpose Recovery-Oriented Intake Process Definition/Purpose Activities of Intake Establishing a Rapport “The Common Sense Approach” Motivational Interviewing Seven Ethical Principles for Service Providers Strengths Assessments Needs Assessments Understanding Intake forms Agency Admission Packets Definition/Purpose Value Options Authorizations and Re-Authorizations Definition/Purpose Inpatient Treatment Report (ITR) Outpatient Treatment Report (ORF 2) To Request an Increase in Authorized Units Contact Information Training/Technical support Target Population Definition/Purpose Contact Information Training/Technical Support Due Dates Tips for Completing Target Population Target Population and Recovery NC TOPPS Definition/Purpose Contact Information Training/Technical Support Due Dates Tips for Completing the NC TOPPS NC TOPPS and Recovery Overview of Person-Centered Plans and Crisis Plans Intake Checklist
IX. Person-Centered Planning with a Participant Transferring without Medicaid General Overview Referral Process Consumer Representative and Consumer Choice Screening, Triage and Referral (STR) PCP Consumer Admission Form Utilization Management Clinical Evaluations Recovery-Oriented Guidelines for Participants Transferring Transfer from the Current Provider Agency Consumer Transfer Form Informational Meeting Final Consumer “Transfer Session” Discharging a Participant Transfer to the New Provider Agency Consumer Transfer Form Informational Meeting Final Consumer “Transfer Session” Provider Connect/ eCura Definition/Purpose Training/Technical Support Authorizations and Re-Authorizations Definition/Purpose Initial Authorization Request Form for Participants without Medicaid Re-Authorizations for Participants without Medicaid Directions for Submitting Re-Authorizations To Request an Increase in Authorized Units Recovery-Oriented Intake Process Definition/Purpose Activities of Intake Establishing a Rapport “The Common Sense Approach” Motivational Interviewing Seven Ethical Principles for Service Providers Strengths Assessments Needs Assessments Understanding Intake forms Agency Admission Packets Definition/Purpose Target Population Definition/Purpose Contact Information Training/Technical Support Due Dates Tips for Completing Target Population Target Population and Recovery NC TOPPS Definition/Purpose Contact Information Training/Technical Support Due Dates Tips for Completing the NC TOPPS NC TOPPS and Recovery Overview of Person-Centered Plans and Crisis Plans Intake Checklist
X. References XI. Appendices Glossary Diagnostic and Axis Codes Mecklenburg County Local Management Entity Forms Endorsement Forms Application Notification of Endorsement Action Notification of State Application Information MOA IPRS Contract with Mecklenburg County STR Registration Form PCP Consumer Admission Form Target Population Provider Connect/eCura Training Manual Value Options ITR ORF2 Strengths Assessment Needs Assessment Life Domains NC TOPPS Consumer Transfer Forms Mecklenburg County AMH/DD/SAS Mecklenburg County Provider’s Counsel Admissions/Intake Packets Introduction/Acclimation Letter Consumer Choice Policy Consumer’s Rights HIPPA Release of Information Consent for Treatment Grievance Forms Admission/Screening Information Consumer Tracking Form Emergency Fact Sheet Person-Centered Plan/Crisis Plan Directions (Rev. 6/07) Advance Directives Living Will Healthcare Power of Attorney Advance Instruction for Mental Health Treatment Psychiatric Advance Directives Toolkit Consumers Family Members Providers Accreditation CARF CQL COA JACHO
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