BEST PRACTICE MODEL

As part of its transformation process, New Passages is redesigning each of its services using a Best Practice Model.  Best Practice Models are research-based and have proven track records to produce the best outcome.  Obviously, as we move towards a recovery model it is our hope to produce the best possible outcomes.  For example, we recently conducted an analysis on our crisis residential program in Genesee County.  Using a project management approach, we have developed a comprehensive project plan, which addresses all the major elements consistent with a dynamic crisis residential program.  These include staff qualifications, staff training, therapeutic approaches, and the physical plant.  Over the next three months, we will completely overhaul this program.  One of the most important elements of our new approach is to add a program evaluation piece to every design.  New Passages' Compliance and Quality Department will be responsible for evaluating this program.  Because these elements will be built into the design it will be clear, whether or not, the program is faithful to the Fidelity Scales.  All of the staff will be trained to use a motivational interviewing approach.  This is especially useful for people with substance use issues.  Mental Health Technicians will be trained to run therapeutic groups and to use a solution-focused model of therapy.  There will be a much greater emphasis on transition planning, led by the program's Social Worker.

Helping people through a psychiatric crisis is an extremely important element in the recovery process.  It is not something to be done in isolation.  The program needs to be fully integrated with other New Passages' mental-health programs, and the larger community.  Many of the people who come to us have multiple issues that need to be addressed.  Many have substance use issues and housing needs.  New Passages is committed to using the best approach to produce the best outcome. 

I look forward to more discussion around Best Practice Models.  As always, I look forward to your comments. 

As I continue to write about the changes that are in store for New Passages in the coming years it is important to understand the difference between New Passages and a county community mental health system. Unlike a Community Mental Health Board, New Passages is a private 501(c)3 non-profit behavioral health organization, governed by a Board of Directors.  As a non-profit organization, New Passages, not only contracts with Mental Health Boards across Michigan, but it also raises additional dollars through grants, corporate donations, fundraising events, and private citizens.  These additional dollars go directly to support the mission of New Passages.  Fund development also raises the visibility of the organization in the community.

New Passages is also different in another significant way from Community Mental Health Boards.  New Passages specializes in providing community-based services to adults and children with mental illness and some adults with Development Disabilities, while CMHs are charged with both providing mental health services to a broad array of people and managing their care.  Some CMHs in Michigan serve exclusively as the managed care entity for a particular county or a network of counties.  Some continue to provide services directly, while others contract for all community-based services.  Some CMHs make use of a mixed model, contracting for some services and providing others.

Michigan is fairly unique in its mixed model approach. In many states, community mental health services are managed through large behavioral health managed-care companies or directly by the county or state.  Some states contract services directly from community-based providers.  Most do not provide services themselves, because it is perceived as a conflict of interest.

My gut feeling is that Michigan will move towards a system that is more uniform.  My guess is that this will take the form of having the current managed care entities manage the care of mental health consumers and contract for all services from community-based providers.  In many ways, this makes sense, especially when  contracting with organizations like New Passages, which bring tremendous resources and expertise to the table.  Because New Passages specializes in only providing community-based care to adults and children with serious mental illness, it can focus exclusively on providing exemplary services to this very vulnerable population.

I think this is a debate worth engaging in.  I look forward to your comments.

In the next six months, New Passages will be rolling out new HR, financial, and electronic medical record programs.  These three systems will interface, creating one integrated management information system.  It is our goal to use this technology to become much more efficient.  There are instances now, where we have to enter data multiple times.  This new system will streamline this process so that most information will only be entered once. This new system will also reduce billing errors and increase the quality of client charts.

Obviously a major issue for New Passages is how to get our system to exchange information with the other organizations we do business with.  One of the problems in the current mental health system is that there is a mishmash of management information systems across the state.  New Passages is taking the lead in an effort to pilot a project that will share information across systems.  Given the degree to which the community mental health system is fractured this will be a very ambitious project.  If we are ever to get to a place were information is readily available and easily accessible we will need a statewide plan that mandates this kind of integration.  The more consistent the information we have about consumer's mental health and primary health care needs the more effective we can be at providing quality treatment that leads to increased recovery.

I welcome your comments regarding this issue.