Virginia Geriatric

Planning

Partnership

 


A resource for mental health needs of the senior population in Virginia

Geriatric Mental Health Planning Partnership

Executive Summary

(adopted 4/17/2009)

MISSION 

 

To provide a continuum of collaborative care for older adults experiencing mental illness and substance abuse, which allows them to succeed in the community and receive support consistent with the values of self-determination, recovery, and empowerment. 

VISION

To enhance collaborative local networks of public-private-academic partners, committed to improving service delivery effectiveness by improving access, increasing capacity, ensuring quality, and providing accountability for the service outcomes.

OVERVIEW

Mental health issues pose a serious risk to the health and well-being of older adults, resulting in increased disability, reduced independence, intensified caregiver stress, escalated mortality, and magnified risk of suicide.  Given the rising demand for critically needed mental health services, coupled with a decline in available resources, older adults are having great difficulty accessing and utilizing the services they need.

The target population of older adults, for the purpose of this endeavor, is defined as individuals 60 years and older who are at risk for or are experiencing mental health issues.  However, the Partnership recognizes that the same issues exist for children and adults who suffer various medical and co-occurring illnesses.

BACKGROUND

 

The first meeting of the Geriatric Mental Health Planning Group occurred on May 4, 2007 and included representatives from the DMHMRSAS Central Office and facilities, long-term care (LTC) providers, CSBs, nursing homes, assisted living facilities, VHHA, and was hosted by the VHCA.  It came together as a group of committed professionals who serve older adults in various ways, and is chaired by David Rumford of Birmingham Green in Manassas. 

 

The group meets several times a year and has grown in membership since its inception. It now includes members from the Governor’s Office, Secretary’s Office, DMAS, Adult Protective Services, VDSS Licensing, Department of Aging, Department of Corrections, and private consultants.  Though the group has at least doubled in size since its beginning, it has remained true to the central core, Quality Care. This central premise has already been actualized in the collaborative efforts of its members, improving care and access in cost effective means throughout the Commonwealth.

 

It is important to note that this is not a mandated effort, rather the result of what happens when collaborative partners share a common vision.

 

GOALS, OBJECTIVES, EXPECTED RESULTS, and STRATEGIES

 

Goals:

Improving service delivery effectiveness by increasing capacity and providing accountability for service outcomes is the definitive goal of this group. Via collaborative evidence- based practices, communities are providing direct services and building the necessary infrastructure to support expanded services for meeting the diverse mental health needs of older individuals.  Such a foundation is critical for delivering and sustaining effective mental health outreach, treatment and prevention services, as well as resources to support the direct delivery of services.  Such efforts come from local networks of public-private-academic partners.

 

Several critical issues were identified early on in the Partnership’s process. From these, a strategic plan was developed identifying four key areas to address: Collaboration, Regulation, Resource Management, Professional Development. The strategies involved are both macro and micro. The macro emphasis develops an informed, networked, and competent public-private-academic collaborative resource and provider service base. The micro emphasis provides direct support services to older adults who are at risk for or are experiencing mental health issues.  Such direct support will also prevent mental health issues of caregivers, while allowing older adults to age in place longer, delaying the need for a more intensive level of care.  Both maximize current federally, state, and privately funded endeavors.

 

Objectives:

1.      Improve quality, accessibility and availability of mental health service delivery for older adults via an enhanced service network

2.      Enhance the quality of care via regulations, standards, and educational efforts that promote best practices

3.      Maximize funding levels via outcomes based measurement systems

 

Expected Results:

This endeavor will build a solid foundation for coordinating the delivery and continuation of effective outreach, treatment and prevention services.  It will capitalize on existing efforts improving service delivery effectiveness by increasing access, capacity and accountability for service outcomes. Via collaborative evidence- based practices, among private, public and academic entities, it will coordinate and provide direct services while building the necessary infrastructure to support existing service coordination for long-term continuation of expanded services.  It will maximize current federal, state, and private endeavors, to include Virginia’s Systems Transformation Initiative, PACE, Virginia’s No Wrong Door initiative, Virginia’s Money Follows the Person Demonstration, and Virginia’s community integration (Olmstead) initiative.  Such efforts will meet the diverse needs of older individuals and their caregivers with mental health issues in cost effective ways and ensuring long term viability. 

 

Potential Outcomes:

·         Increase the number of individuals served, ranging from information, referral, and  education through mental health interventions

·         Reduce the length of stay in acute care and state facilities

·         Reduce mental health admissions to acute care facilities /state facilities

·         Prevent admissions to state mental health and long term care facilities

·         Educate workforce participants to reduce falls, restraints, and reportable incidents

·         Improve caregiver stress and ability to manage the support of the older adult

·         Delay nursing home/residential placement, promoting aging in place

·         Educate students receiving specialized mental health gerontology experience

·         Enhance future planning and funding efforts by collecting data, creating evidence-based  practices, identifying service gaps, and addressing culturally sensitive needs to improve access and utilization                

 

 

Strategies:

STRATEGY 1:  PUBLIC-PRIVATE-ACADEMIC COMMUNITY-BASED COLLABORATIVE INFRASTRUCTURE

 

Components

·         Promote collaboration, communication and trust for enhanced resource development and utilization

·         Advance Centers of Excellence (COE’s) of both public and private entities

·         Develop an older adult support website for ongoing online professional consultation

·         Complement statewide mental health transformation initiatives

·         Encourage regional efforts to actualize best practices in communities

·         Hold an annual statewide conference with key speakers and workshops to explore evidence- based best practices, identifying gaps and trends in the field, while synthesizing these findings

STRATEGY 2: ADDRESS REGUALTORY REQUIREMENTS AND STANDARDS THAT ENSURE QUALITY CARE AND ACCESS TO SERVICES

 

Components

·         Review regulations and standards that need updating to match current best practices (i.e. reforming psychotropic medication use)

·         Educate the workforce in best practices

·         Post mental health best practice care examples and educational materials on the older adult support website 

 

STRATEGY 3: DEVELOP STRATEGIES TO MAXIMIZE CURRENT FUNDING EFFORTS AND PURSUE ADDITIONAL RESOURCES

 

Components

·         Develop outcomes-based measurement systems to ensure effective and efficient use of funds

·         Maximize funding levels via outcomes-based best practices

·         Pursue grants, foundation  and other funding sources to continue efforts

·         Identify service gaps and pursue funding

 

STRATEGY 4:  DEVELOP CLINICAL AND BUSINESS BEST PRACTICES

 

Components

·         Educate and train workforce in supporting older adults

·         Refine clinical and business best practices

·         Encourage regional efforts to actualize best practices in communities

·         Hold an annual statewide conference with key speakers and workshops to explore evidence- based best practice, identifying gaps and trends in the field, while synthesizing these findings

STRATEGY 5:   KEEP GOING!

 

·         Continue prior efforts, refining as needed

·         Identify service gaps

·         Key in on special populations (e.g., Corrections)

 Activities in 2008

 

The group met various times throughout 2008 to refine and formulate the strategic plan.  Through this process, the group continues to add to its membership a diverse cross section of professionals.  Efforts complemented the first strategic initiative by:

·         Promoting collaboration, communication and trust for enhanced resource development and utilization

·         Advancing Centers of Excellence (COE’s) of both public and private entities

·         Developing an older adult support website for ongoing online professional consultation: www.vaseniors.org

·         Educating the workforce in best practices

·         Encouraging regional efforts to actualize best practices in communities

On November 10, 2008, it hosted a statewide Geriatric Mental Health Summit.  This was a multi-agency consortium addressing the mental health care needs of the older adult and their families.

Cost to Commonwealth: $0

Contributions by CJW Medical Center (meeting space) and various healthcare product and service vendors (refreshments and lunch)

Results: Over 75 attendees from various agencies and organizations discussing innovative ways to develop continuity if care for the older adult with special needs. Follow up working session and broader consortium to follow in 2009

 

Expected Activities for 2009

 

The group will continue to meet various times throughout 2009, promoting efforts in keeping with the first strategic initiative:

·         Promoting collaboration, communication and trust for enhanced resource development and utilization

·         Advancing Centers of Excellence (COE’s) of both public and private entities

·         Enhancing the older adult support website for ongoing online professional consultation: www.vaseniors.org

·         Continuing to educate the workforce in best practices

·         Posting mental health best practice care examples and educational materials on older adult support website 

·         Encouraging regional efforts to actualize best practices in communities

It is planning two statewide efforts to promote further collaboration and the exploration of evidence- based practices among a larger participant base. One effort will include participants form the November summit to explore opportunities raised.  The next will be a larger statewide conference with key speakers and workshops to explore evidence- based best practice, identifying gaps and trends in the field, while synthesizing these findings.

Finally, a work group will be developed to begin to address regulatory requirements and standards that ensure quality care and access to services.