OMHSAS Older Adult Committee

1

• OMHSAS Older Adult Committee
• Cynthia Zubritsky, PhD
• University of Pennsylvania
• November 6, 2008

2
Share the Care

• Phase II June July 2008
• Partners
• Pennsylvania Department on Aging PDA and Office
  on Long-term Living (OLTL)
• Office of Mental Health and Substance Abuse
  Services (OMHSAS)
• Older Adult Advisory Committee

3
Goal

• To train Pennsylvanias County Behavioral Health
  and Aging professionals
• Cross systems collaboration
• Development of Memo of Understanding
• Collaborative case review strategies

4
Planning Committee

• Planning committee comprised PDA/OLTL, OMHSAS,
  Older Adult Advisory Committee Members, and the
  Center for Mental Health Policy and Services
  Research (CMHPSR).
• Planning committee provided guidance on the
  development of the agenda, the meeting logistics,
  meeting feedback and evaluation review.

5
Training Objectives

• Participants will understand the need for
  cross-systems collaboration.
• Participants will be familiar with the MOU
  critical components.
• Participants will develop an MOU section
  reflecting
• standards issued in the MOU Directive and
  Bulletin Attachment and
• specific needs of their county.
• Participants will jointly review a case and
  develop an intervention plan based on their MOU.

6
Training Participants

• PDA/OLTL OMHSAS provided presentations about
  Share the Care and answered questions about
  programs, MOUs and funding issues.
• Counties currently implementing collaborations
  gave brief presentations.
• CMHPSR provided presentations and facilitated
  group activities.

7
Training Agenda

• Pennsylvania Aging/Behavioral Health Data
• Core Elements of Systems Collaboration
• MH and Aging Cross-Systems Elements (mission,
  legislation, funding, mandates)
• MOU Development and Application
• Successful Collaborations
• Shared Case Review Development

8
MOU Development

• MOU components developed collaboratively on-site
  by the participants
• General provisions
• Purpose
• Scope
• Assignment of staff
• Conflict resolution

9
Training Summary

• Three regionally located, 1 day trainings
• Harrisburg
• Scranton
• State College
• 60 Participants
• 29 Counties

10
June 11th Training

• MENTAL HEALTH Berks, Chester, Lebanon,
  Franklin/Fulton, and Bedford/Somerset
• AREA AGENCY on AGING Berks, Chester, Lebanon,
  Franklin , Huntingdon/Bedford/Fulton, and
  Somerset
• LOCATION Holiday Inn East, Harrisburg
• 17 attendees

11
June 11th County Presentation

• Successful Collaborators Presentations
• Project HELP (Helping Elders Live Productively)
• A four-county venture between CMSU Behavioral
  Health Services, Columbia/Montour Aging Office,
  Inc. and Union/Snyder Agency on Aging, Inc.

12
June 27th Training

• MENTAL HEALTH Lehigh, Bradford/Sullivan,
  Lackawanna/Susquehanna, Tioga, Northampton,
  Wayne, and Luzerne/Wyoming
• AREA AGENCY on AGING Lehigh, Bradford/Sullivan/Su
  squehanna/Tioga, Lackawanna, Northampton, Wayne,
  and Luzerne/Wyoming
• LOCATION Clarion Hotel, Scranton
• 22 attendees

13
June 27th County Presentation

• Ernie Laskosky, Tri-County Human Services, Mary
  Gaffy and Teresa Osborne, Lackawanna County Area
  Agency on Aging, Jim Martin, Lackawanna/Susquehann
  a Mental Health, and Doug Patella, Scranton
  Counseling Center perform joint visits through
  their mobile crisis team.

14
July 9th Training

• MENTAL HEALTH Cambria, Centre, Lycoming/Clinton,
  Huntingdon/Mifflin/Juniata, Northumberland,
  Blair, and Potter
• AREA AGENCY on AGING Cambria, Centre,
  Lycoming/Clinton, Huntingdon/Bedford/Fulton,
  Mifflin/Juniata, Northumberland, Blair, and
  Potter
• LOCATION Penn Stater Conference Center, State
  College, PA
• 21 attendees

15
July 9th County Presentation

• Jefferson County Joint Older Adult Assessment
  (JOAA)
• This group represented a collaboration between
  Clearfield and Jefferson Counties.
• Presented the JOAA assessment form, a rating
  scale that is used to determine risk factors.

16
Key Meeting Feedback Results

• 98 Related to practice needs
• 96 Acquired new skills or knowledge
• 94 Can use to write/improve County MOU
• 100 Good Very good overall quality

17
Recommendations

•    All levels of staff in both systems need to be
  trained
• Aging staff on psychiatric terminology and
  commitment procedures, psychiatric services
• MH staff on behavioral health issues of older
  adults and
• Crisis staff and delegates specifically on mental
  health issues of older adults, the individual
  interpretation MH Act and the need for provision
  of services for all individuals no matter what
  their age.
•       

18
Recommendations

• The trainings should be offered in counties that
  have not received the training
• One-day cross-systems trainings should be offered
  for a variety of topics such as
• court system/aging/mental health
• mental health/substance abuse/aging
• mental health commitment procedures
• risk management
• developmental disabilities and
• funding and confidentiality issues

19
Recommendations

• Schedule trainings specifically for case
  managers.
• Plan a half-day session with PDA and OMHSAS
  state-level staff.
• Identify system change outcomes that should occur
  as a result of the training and collaboration.
• Complete a six month follow-up interview to
  measure system changes.
• Provide on-going MOU TA

20
Recommendations

• Need training on the scope of each System
  (including limitations) specifically the MH Act
  and Aging protective service acts, and how the
  systems can support  each other within the
  community.
• Need to address the limitations of Community
  Hospitals how to address bed availability for
  older adults and under what conditions inpatient
  units are willing to accept geriatric clients
• Need to address the limitations of psychiatric
  services in the arena of long term care. Many
  seniors residing in LTC have behavioral health
  issues, yet nursing homes, assisted living, PCH
  do not have ready access to psychiatric care.

21
2007 Follow-up survey

• Telephone follow-up survey completed 6 months
  after the 2007 training
• N18 participants representing 9 Counties

22
2007 Follow-up survey

• 67 reported that they had implemented changes
  and/or held other activities related to
  behavioral health issues in older adults
• 39 reported that they had developed a new joint
  case review process to review difficult cases of
  older adults with behavioral health issues

23
2007 Follow-up survey

• 94 rated the training as Extremely Helpful to
  Helpful.
• 66 had suggestions for future training and
  collaborative activities.
• 66 are interested in advanced case review
  training and technical assistance.
• 83 are interested in advanced MH/Aging training
  and technical assistance.

24
Next Steps

• Deliver training to remaining counties
• Develop training in areas recommended by
  participants
• Develop technical assistance to counties in MOU
  application and case review collaboration
• Develop methods to continue to assess, develop
  and evaluate collaboration initiatives