Josette Dorius, Service Director

Autism Council of Utah

April 6, 2011

Objectives

History of the HOME ProgramStructure of our medical homeOur teamCollaboration of careMedical outcomesHow to enroll in HOMEH.O.M.E. acronym = Healthy Options

Medical Excellence

“To optimize the quality of life of the people we serve

by providing excellent, compassionate, and

integrated health services throughout the lifespan.”

Our Mission

Background

Started as a cooperative relationship in 2000 among the University of Utah, Robert Wood Johnson Foundation, and the Utah Department of Health.

Medicaid sought a population who were high utilizers of Medicaid services and who might benefit from coordinated health care.

Scott Stiefel, M.D., was already providing mental health services to people with disabilities.

Background (continued)HOME was created to provide medical and

mental health care in the same location (specialized medical home).

Original program required that enrollees also had Division of Services for People with Disabilities (DSPD) services in the central region.

In 2004, HOME was permitted to expand to any disabled eligible person with Medicaid, regardless of their DSPD status.

In 2005, HOME moved from ARUP to a new facility at 650 S. Komas Drive.

In 2009, opened HOME North clinic in OgdenIn 2011 current enrollment is 829

Eligibility

Utah MedicaidA developmental disabilityA mental health or behavioral concernWilling to receive primary care at the HOME

clinicSubstance, criminal, or perpetration issues

are not dominant

Funding Structure

Medicaid $$$$s

HMO Medical PremiumMedically Disabled Male Medically Disabled Female

Mental Health PremiumDisabled Male rate

Disabled Female rate

UNI HOME Program

What We DoProvide coordinated medical and mental health

care to people with developmental disabilities.Serve as a medical home and center of excellence

for each of our clients.Advocate for the best possible services for our

clients.Who We AreDoctors – Family Practice, Pediatrician, Child Psychiatrist (3) Triple Board Psychiatrist (2)

Advance Practice Nurses – 2; Licensed Clinical Social Workers – 5;

Medical Assistants – 3; Case Managers – 3 Nurse Case Manager – 1; Behavior

Specialist – 2; Billing Specialist – 1; Schedulers – 2; Information Specialist

– 1; Finance – 1;Manager – 1; Service Director - 1

Neurobehavior HOME Program

Comprehensive Care

Preventive

Care

•Medical•Mental Health•Therapy •Behavior Support• Individualized needs recognized•Inclusive treatment plan•Immunizations•Vaccines•Open Access appointments for Urgent visits

•Case Management•Interdisciplinary•Specialty Care•Extender Services

•Home Health•DME

•Pharmacology management•Interdisciplinary clinic•Coordination of referred care

Inpatient

Services

•Transition care• Follow up appt• Coordination of services• Case Manager involvement in team meetings•Discharge planning inclusive of follow up appointments

Chronic Disease

Management

•Evidence based• Education•Outreach•Specialty referrals•Outcome reporting

Social Suppo

rt

• Therapy Groups•Substance Abuse groups•Single Mingle Activities•Behavior Education Series – Parents, Providers• Home visits•Parent Provider Council•Advocate •Application assistance for SSI•DSPD•Partnering with Group Home staff

Long Term Care

•Coordinate with Utah Medicaid •Division of Services for People with Disabilities (DSPD)•End of life – palliative care

Serving Children and Adults with Developmental Disabilities

Outcome Reporting FY 2008 Medical Admits = 40.80% MH Admits = 59.20% Med readmits = 6.10% MH Readmits = 8.50%

 FY2009 Medical admits = 37% MH admits = 63% Med readmits = 7.7% MH Readmits = 10.6%

 

Emergency Room Visits FY 2008 Encounters = 232 ER rate/1000 =

3%/month  FY 2009 Encounters = 352 ER rate/1000 =

4%/month

Diabetic Management FY 2008 A1C

average = 6.3  FY 2009 A1C

average = 6.3

No Show Rate FY 2008 Appointments

= 6% FY 2009 Appointments

= 5.7%Customer Satisfaction

• FY 2008 = 88%

• FY 2009 = 90.5%

How to referCall Medicaid (Willow Greer) at (801)567-3835Medicaid screens for eligibilityIf eligible, Medicaid mails out an intake packet Upon receipt of the intake packet, HOME calls to

schedule a “Get Acquainted” visit and Psychiatric Evaluation.

Enrollment paperwork is completed at one of these visits.

HOME contacts:Dean Weedon, Manager (801) 587-3109Josette Dorius, Service Director (801) 587-3108HOME Program main number (801) 581-5515