Getting Started: Youth Peer Support as a Medicaid Service 10/27/2015 Board Association Fall Conference 1
Welcome and Introductions Krissy Dristy, Statewide Youth Peer Support Coordinator, Association for Children s Mental Health Jane Shank, Director, Association for Children s Mental Health Kim Batsche-McKenzie, MDHHS Division of Mental Health Services to Children and Families, Manager of Programs to Children with Serious Emotional Disturbance 2
Goals of Presentation MDHHS is excited to roll out the new State Plan Medicaid Youth Peer Support (YPS) service to PIHP/CMHSPs and their contract providers Review role of peers in the public mental health system Share expectations for MDHHS initial and ongoing training Describe hiring expectations and recommendations Answer questions related to this new service 3
Common Terms and Acronym's PIHP: Prepaid Inpatient Health Plan CMHSP: Community Mental Health Service Provider YPS: Youth Peer Support YPSS: Youth Peer Support Specialist ACMH: Association for Children s Mental Health Peer Support -generally refers to adult peer support 4
Michigan s Development of Youth Peer Support History of Peer Support in Michigan-Adult (2005)and Parent Support (2010) Worked with a national consultant to gather the input from stakeholders (CMHSP administrators, supervisors and other staff in addition to parents, youth and family organizations in Michigan) MDHHS relationship with ACMH 5
Benefits of Youth Peer Support Youth Peer Support is designed to provide benefits to multiple stakeholders (youth, families, treatment teams, CMHSPs, systems, organizations, etc.) When building a local capacity for Youth Peer Support, leaders should consider their desired benefits and what types of organizational, system and personnel structures should be put in place to realize those benefits. It is important to remember that the success of Youth Peer Support will require more than simply hiring the right people but also building the right structures, supports and organizational capacities. 6
Benefits to Youth and Families Involved in the CMHSP/PIHP System Connection to others with shared experience Decreasing isolation Increasing hope and sense of future Increasing engagement and satisfaction with services Decreasing stigma Enhancing child and family mental health service array 7
Why is lived experience so valuable? Youth Peer Support Specialist helps youth: Heard and validated by someone who understands because they have been there Hope for the future A sense of connection and not alone Not judged Valued Creates a safe space through connection 8
Benefits for the CMHSP/PIHP System Early adopters will be leaders and help to shape this service statewide Seamless continuum of services to children and families Broader perspective/understanding for treatment team Positive outcomes of youth to support them to stay in their community Improved overall services due to Youth Peer Support Specialist input Community involvement utilizing youth in the community in leadership roles Free MDHHS training and technical assistance 9
What is Youth Engagement and Youth Involvement? Youth involvement is a systems level approach to provide youth voice at all levels within systems Youth engagement is outreach, education and training to equip youth with the skills to become advocates. Community activities may already include: Youth Leadership Council Advocacy and awareness activities Anti Stigma Support groups and Advisory boards 10
Youth Peer Support as a Medicaid Service Youth Peer Support is designed to support youth with a serious emotional disturbance through shared activities and interventions. The goals of Youth Peer Support include supporting youth empowerment, assisting youth in developing skills to improve their overall functioning and quality of life and working collaboratively with others involved in delivering the youth s care. Youth Peer Support services can be in the form of direct support, information sharing and skill building. 11
Youth Peer Support as a Medicaid Service (continued) The Youth Peer Support service is provided by trained youth peer support specialists, one-on-one or in a group, for youth with serious emotional disturbance who are resolving conflicts, enhancing skills to improve their overall functioning, integrating with community, school and family and/or transitioning into adulthood. This service provides support and assistance for youth in accordance with the goals in their plan of service to assist the youth with community integration, improving family relationships and resolving conflicts, and making a transition to adulthood, including achieving successful independent living options, obtaining employment, and navigating the public human services system. 12
Youth Peer Support Specialist Youth Peer Support Specialists must have lived experience navigating behavioral health systems and must participate in and complete the approved Michigan Department Health and Human Services training curriculum. Youth Peer Support activities are identified as part of the assessment and the person-centered/family-driven, youth- guided planning process. The goals of the Youth Peer Support service shall be included in the individualized plan of service where interventions are provided in the home and community. These goals will be mutually identified in active collaboration with the youth receiving services and must be delivered by a Youth Peer Support Specialist with lived experience. The Youth Peer Support Specialist shall receive regular supervision by a child mental health professional and shall participate as an active member of the treatment team. 13
Youth Peer Support Specialist (continued) Qualifications for the Youth Peer Support Specialist include: Young adult, ages 18 through age 26, with lived experience who received mental health services as a youth. Willing and able to self- identify as a person who has or is receiving public behavioral health services and is prepared to use that experience in helping others. Experience receiving services as a youth in complex, child serving systems preferred (behavioral health, child welfare, juvenile justice, special education, etc.) Employed by PIHP/CMHSP or its contract providers. Trained in the Michigan Department of Health and Human Services approved curriculum and ongoing training model. 14
PIHP/CMHSP ENCOUNTER REPORTING HCPCS and REVENUE CODES Peer Directed and Operated Support Services H0038-TJ Youth Peer Support Specialist TT modifier: use when peer service is provided in a group Use of TJ modifier Youth Peer Support Specialist with H0038 or H0038-TT. The Youth Peer can also report H0038-TJ or H0038-TJ-TT if they are face-to-face with youth while another provider is working separately with the family. This type of situation is only allowed in homebased (H0036-HS), or family psychotherapy (90846-HS or 90849-HS). 15
What Youth Peer Support is NOT Not a: Friend Therapist Babysitter Spy Advocate Convincer Compliance monitor 16
Organizational/Agency Readiness Organizational/Agency Readiness Checklist Youth Peer Support Readiness Plan 17
Direct Hire/Contract Considerations/Supervision Can choose to directly hire or contract for YPS service Monthly call with Youth Peer Statewide Coordinator group supervision with supervisor(s) and all YPSS for 6 months and then quarterly thereafter Supervision if contract provider Bi-weekly with CMHSP supervisor 18
Hiring Expectations- Requirments The YPSS be hired and employed by the CMH or contract agency before they attend the initial four day training. The initial training is intended only for YPSS who will be providing this Medicaid service. All pre-training paperwork be completed by the given deadlines (registration, supervisor contact information, media release and emergency contact). All MDHHS requirements for initial training and follow-up technical assistance and coaching for the YPSS and supervisors will be met (coaching calls, quarterly meetings, and joint supervision). The agency will assure that YPSS have equipment and all technology to perform their job. All supervisors will attend the designated portion of the YPSS training for each YPSS they send to training (which could include the CMHSP, contract and/or Youth Peer Supervisor). Supervisors will continue to participate in additional TA/training as required by the YPSS model or requested by the Statewide Coordinator. 19
Hiring Expectations (continued) Regular individual supervision will be provided by a qualified children s mental health professional (CQMHP) identified by the agency on a bi-weekly basis at a minimum. If the YPSS is employed through a family or contract organization, a supervisor from that organization will be identified and will participate in bi-weekly supervision with the CQMHP and the YPSS. The agency will ensure that the YPSS will be an active member of the treatment team and will participate in team and planning meetings. 20
Hiring Recommendations It is strongly recommended that: A minimum of two YPSS be hired per agency as they will offer additional support to one another, which contributes to improved retention rates for the YPSS and offers choice by broadening the range of strengths, skills, and experiences from which to draw in providing support for youth. Employers establish a consistent work schedule that includes a minimum number of hours of work per week (i.e. 20 hours per week). The workload will be individualized to assure that youth receive a high quality YPS service. 21
Pre Training Timeline First training cohort of the Youth Peer Support training offered for Youth Peer Support Specialists on Tuesday November 3- Friday November 6, 2015 in Lansing. Two Organizational/Agency readiness documents will be completed first The completed Organizational/Agency Readiness documents will be returned to Krissy Dristy and she will send the registration packet Next training will occur in the Spring 2016 Training is intended for YPSS only 22
Ongoing Training Requirements Following the initial four day training: Quarterly one day meetings (3 out of 4 a year) Monthly coaching contacts for one year (phone, on line or via text) 23
Possible Challenges As with any new service funded under the state Medicaid plan, we fully expect administrative bumps and programmatic challenges. Youth Peer Support is no different. We anticipate that installing this critical and necessary service will take commitment and flexibility. We expect that we will be challenged as we roll out Youth Peer Support. Encourage input during this development phase 24
Questions/Contact Information Kristina Dristy, Youth Peer Support Statewide Coordinator, kdristy@acmh-mi.org or 517-643-3314. Sara Reynolds, Youth Peer Support Lead Trainer, sreynolds@acmh-mi.org or 517-643-3544. Kim Batsche-McKenzie, MDHHS Manager of Programs for Children with Serious Emotional Disturbance, batschemckenziek@michigan.gov or 517-241-5765. Jane Shank, Director, Association of Children s Mental Health, acmhjane@sbcglobal.net or 231-383-1595. 25