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1STARTOverviewandImplementation2Overview•CenterforSTARTServices-InstituteonDisability/UCEDofNewHampshire•START-Systematic,Therapeutic,Assessment,ResourcesandTreatment•Evidence-informedmodelforcrisispreventionandinterventionservices•CenterforSTARTservices-2009•ImplementedinVirginia,NorthCarolina,Ohio,NewHampshire•PilotedinNYRegion1and33start•Linkagemodelthatpromotesasystemofcareintheprovisionofcommunityservices,naturalsupportsandmentalhealthtreatmenttoindividualswithI/DDandmentalhealthneeds•Mission-enhancelocalcapacityandprovidecollaborativecost-effectivesupporttoindividualsandtheirfamiliesthroughexemplaryclinicalservices,educationandtraining,withcloseattentiontoserviceoutcomes4Mission•Promotethedevelopmentofleast-restrictive,lifeenhancingservicesandsupportstopeoplereferred•Provide24houraday,7daysaweektimelyresponsetothesystemofcareinsupportofpeoplewithI/DDandbehavioralhealthneeds.Incrisisimmediatetelephoneaccessandinpersonassessmentwithin2hourswheneverpossible•Provideclinicaltreatment,assessment,andstabilizationaswellasshorttermtherapeuticrespite•Facilitatethedevelopmentandimplementationofindividual,Cross-SystemsCrisisPreventionandInterventionPlans5Mission-•Providesupportandtechnicalassistancetopartnersinthecommunitysuchasfamilies,mentalhealthcrisisteams,residentialanddayproviders•ProvidestateoftheartassistancethroughCertifiedSTARTcoordinatorsalongwithahighlytrainedworkforce•Createaffiliationsandlinkageagreementswithcommunitypartnerstoenhancethecapacityofthesystemasawhole•Providesystematicconsultationtoworkwithteamstoimprovethecomprehensiveunderstandingofthepeopleweserve6Mission•Assesstheneedsofthepopulationlocally,statewide,nationally,andintentionally,andworkwithstakeholderstoinsurethateffectiveservicedeliverytakesplace•Collectdata,measureoutcomes,andmodifystrategiestomeetaforementionedgoals7ImplementationinRegion4•Process-GapAnalysisinNewYorkCity1.December-February:OnLineSurvey(313)2.November-February2015:FocusGroups(9)3.January-March2015:FamilyInterviews(20)4.March-April:AnalysisofData5.April24,2015:DraftReportSubmitted6.June2015PresentationandFinalReport8QuestionsAddressed•HoweffectiveisthecurrentcommunitysystemofcareinNewYorkCityinaddressingtheneedsofindividualswithintellectual/developmentaldisabilitiesandmentalhealthneeds/challengingbehavior?•HowcantheNYSTARTprogramhelptoenhanceNYC’sexistingservicedeliverysystemtoimproveservicesandsupportstothoseinneed?•WhatshouldtheprogramdesignofNYSTARTlooklike?9SurveyandFocusGroupFinding•SignificantdifferencesinthewayMHproviders,IDDprovidersandserviceusersviewthesystem•Familiesbelievethatthereisnoconsistentunderstandingofwhattodoandwhoshoulddoit•Families,IDDproviderandmanyMHproviderswantmoreeducationandtraining•Crisissupportsareaproblemoverall;overuseofpoliceandERasaresult•Familieswantbetteraccesstocarethathelps10NYSTARTSERVICES-REGION4•NYSTARTservicesconsistoflinkage/clinicalteamsandtherapeuticresourcecentersa)Ateamapproachb)Linkages,outreach,followupc)Systemicandclinicalconsultationandtrainingd)Culturalcompetencydevelopmente)Crisisassessmentandinterventionf)Mobilecrisisresponseandservicesg)Emergencyandplannedtherapeuticresourcecentersh)Facilitationofinterdisciplinarymeetingsi)Ongoingassessmentofserviceoutcomes(data)j)AdvisoryCouncil11WhoCanBeServed•Individualmustliveinregion4•IndividualmusthaveadevelopmentaldisabilityasdefinedinNewYorkStateMentalHygieneLawsection(exception,confirmedOPWDDeligibilityisnotrequiredforaccesstoSTARTlinkageservicesduringanemergentsituation,onlysuspicionofDDwillbesufficient)•Individualmusthaveasignificantbehavioralormentalhealthneedsthathavenotbeenadequatelyaddressedwithtypicallyavailablesupports;and•Individualmustbeatleastsixyearsofageforallservicesotherthantherapeuticrespite,andatleast21yearsofageforadmissiontotherapeuticresourcecenters12Region4START-2Teams•STARTwillhave2clinicaltreatmentteamsinregion41.Team1:Brooklyn/StatenIsland(3subteams)2.Team2:Bronx/Manhattan/Queens(Manhas2subteams,Queens2subteams)Bothteamswillhavethefollowingstaff3.Director4.Assistantdirector5.Administrativeassistant6.ClinicalDirector7.MedicalDirector8.ResourceCenterDirector9.InHomesupportsDirector13ResourceCenters•PlannedResourceCenter1.Halfthebedsareforplannedrespiteandareforthosewhohavenotbeenabletouserespiteinmoretraditionalsettingsduetobehavioralormentalhealthissues.2.Shorttermandshouldnotexceed5days14ResourceCenters•EmergencyResourceCenters1.Halfthebedareforemergencyrespitepurposes2.Emergencyrespiteisdesignedtoprovideout-of-homehousingandservicesforpeoplewho,forashortperiodoftime,cannotbemanagedathomeorintheirresidentialprogramA.ClinicalassessmentB.HospitaldiversionC.stabilization,D.StepdownfrommentalhealthinpatientservicesE.BehavioralsupportandrefinementoftreatmentapproachesF.Familysupportandeducation15ResourceCenterServices•Locatedwithineachteamsareaofoperation•Provideaproactiveclinicalserviceapproach•Providesassessmentandsupportsinahighlystructuredsetting.•Providescommunity-based,shorttermrespiteexclusivelyforpotentialguestseligibleandenrolledintheSTARTprogramexperiencingacute,chaoticand/orotherneedsthatmayalsobeidentifiedasa:”crisis”TheintentofthisrespitewithheSTARTprogramiscrisisprevention,stabilization,assessment,treatment,andtrackingviaprovidingachangeinenvironmentandastructured,therapeuticcommunity-basedhomelikesetting16ResourceCenterPersonnel•ResourceCenterDirector•Nurse/AssistantDirector•DirectSupportProfessionalsandResourceCenterCounselors•Teamofprofessionalclinicalstaff17ProvidersofSTARTServices•RFAapplicationduedateSeptember28,2015•Interviews/oralpresentationsNovember9-13•ContractstartdateJanuary12016•Additionalresources:•http://www.opwdd.ny.gov/node/6089•http://www.opwdd.ny.gov/node/6088•http://www.opwdd.ny.gov/ny-start/FAQs
STARTOverviewandImplementation
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