Connecticut PASRR Linkages
Highlights:
Relationships and Communication
Best Practices:
Nursing Home Diversion & Transition Program
(NHDTP)
Mental Health Waiver/ W.I.S.E. Program
Contact: Jennifer Glick, RN, MSW CT Dept of Mental Health & Addiction Services www.ct.gov/dmhas 860-262-5818 or [email protected]
State Overview
Older Adult Services
Key Offices •MFP
•State Unit on Aging •LTC- Ombudsman
PASRR and Electronic Vendor
Medicaid Authority
MH Authority
•State DD Authority •ADRCs
•State Dept. Public Health •Elderly Protective Services •Triple A’s
•Nursing Homes •Hospitals
•Independent Living Centers
Others
Community Placements PASRR And NHDTP MH Waiver (W.I.S.E.)Nursing Home Diversion & Transition Program
Divert clients from NH admission Transition NH clients back to community
Originate in hospitals or community
settings Originate in NHs PASRR Trigger: Does not meet NH LOC
criteria PASRR Trigger: Approved for short term placement or no longer meets NH LOC Medicaid Authority, PASRR vendor, and
referral source communicate directly with Program Manager and staff
Medicaid Authority, PASRR vendor, and NH communicate directly with
Program Manager and staff Program staff see clients wherever they
are located Program staff collaborate with clients and NH staff, and MFP on Discharge Planning to community setting
Nursing Home Diversion & Transition Program
7 Nurse Clinicians and 2 Case Managers assigned to
geographic locations in state
Clarify/validate Level of Care (LOC) needs and services
Cross-trained with Mental Health Waiver program
Monthly meetings with NH staff and Money Follows the
Person (MFP) staff
Piloting groups in NH settings:
Chronic disease self management
Double Trouble for co-occurring Mental Illness & Substance
Abuse
Mental Health Waiver/ W.I.S.E. Program
1 of 2 MH waivers in U.S.
Operational since April 2009
Assists clients to be diverted or discharged from NHs
Person-Centered, Recovery and Psych Rehab Model
Recovery Assistant: hybrid companion, homemaker,
PCA, and respite
Secure Online Website for the
Utah Mental Health
PASRR Program
Robert H. Snarr, MPA, LPC, NCC
State Adult Programs Manager
Utah Department of Human Services
Innovation and Efficiency
To directly impact the quality of life for
individuals who are pending admission or
admitted to Nursing Facilities statewide
Reduce State costs and improved time
frames in completing all determinations
Experience
Recommendation to Leadership in 2007
Two Year Process
Automate all Level II Evaluations and
Determinations
Electronic Billing Process
Vision-Have a clear idea of a strong system
Educate everyone and provide cross training
Recognize and appreciate the concerns, constraints
and expertise of others
Involve those with decision-making power
Collaboration
Experience
Keep expectations and timelines realistic
Promote sustainability
Develop a strategic financial plan
How the system works in your local jurisdiction or State
and what that means for your planning process
Identify local expertise that can help with planning efforts
The capabilities and limitations of the users network in
your area
Olmstead compliance
Cost Effectiveness
Decreased staff time
Reduced Work load
System cost
Maintenance cost
Total Cost Savings
Key Features & Outcomes
Improved Individual Care
Improved communication
Improved Time frames
Better long-term relationships with
stakeholders
Decreased unnecessary institutional
placements
Contact Information
Robert H. Snarr, MPA, LPC, NCC
State Adult Programs Manager
Utah Department of Human Services
Division of Substance Abuse & Mental Health
195 North 1950 West
Salt Lake City, UT 84116
phone: 801-538-4080
fax: 801-538-9892
e:
[email protected]
Nevada PASRR Program and
Promising Practices
Dave Caloiaro, MSW, LISW
PASRR Level II Program Manager
Nevada Division of Mental Health and
PASRR II-B Resident and
Specialized Services Coordination
The Nevada Division of Mental Health and
Developmental Services assigns a regional PASRR
Coordinator to NF residents screened as PASRR II-B, to
ensure the client receives the provision of Specialized
Services they require.
There are six statewide MHDS PASRR Coordinators in
three locations of the state – north, south and rural – this
represents one MH coordinator and one DS coordinator
in each region.
PASRR II-B Resident and Specialized
Services Coordination (cont)
The MHDS Regional PASRR Coordinator:
Performs quarterly onsite reviews of the PASRR II-B client at the nursing facility (out-of-state performs medical record reviews), to assure PASRR clients are receiving the provision of Specialized services they require.
Whenever possible, serves as a member on the client’s multi-discipline Treatment/Care Plan team.
Assists acute care hospital discharge planners with finding alternatives to nursing facility placement, if requested.
Nevada PASRR II-B
Specialized Services
For Clients with Mental Illness (most common)
Psychotropic Medications
Psychiatrist Follow-up Services
Transitioning Services, to assist in moving to a less
restrictive environment
Monitoring and Advocacy
Nevada PASRR II-B
Specialized Services
For Clients with Developmental/Intellectual
Disabilities (most common)
Day Services
School Referral and Services
Transitioning Services, to assist in moving to a less
restrictive environment
MHDS Bi-Annual PASRR Program
Compliance Reviews
MHDS conducts a comprehensive PASRR Program
Compliance Review on a bi-annual basis, in three parts:
1) a desk review of the PASRR QIO-like contractor/vendor,
shared jointly by Medicaid and MHDS, of randomly selected
PASRR case determinations (and accompanying medical
records),
2) onsite review of PASRR II-B residents who require
Specialized Services, in a number of statewide Nevada and
out-of-state nursing facilities; and
3) a performance review of each of MHDS’ six regional
PASRR coordinators.
MHDS’ Continuing Commitments
with the Nevada PASRR Program
Continuing the close working relationship and partnership with Nevada Medicaid, which deserves recognition and praise for the success of the Nevada PASRR
Program.
Maintaining the Nevada Statewide Nevada PASRR Committee, which meets quarterly, and includes members from Medicaid, the PASRR Vendor, and the MHDS’ six
statewide regional PASRR Coordinators.
When funding resources permit it, continuing to provide education and training to nursing facility staff with respect to Nevada PASRR requirements, including documentation
