1. health and fitness

COUNTY RURAL OFFICES OF SOCIAL SERVICES
MENTAL HEALTH AND DIABILITIES
MANAGEMENT PLAN
ANNUAL SERVICE AND BUDGET PLAN
FISCAL YEAR 2015
JULY 1, 2014-JUNE 30, 2015
SERVING THE COUNTIES OF: CLARKE, DECATUR, LUCAS, MONROE, RINGGOLD,
AND WAYNE
Duffy Kester-,
CROSS Governing Board of Directors
TABLE OF CONTENTS
INTRODUCTIONACCESS POINTS-
-4
TARGETED CASE MANAGEMENT-
-4
CRISIS PLANNING-
-5
SCOPE OF SERVICES and BUDGET-
--6
FINANCIAL FORECASTING-
-10
PROVIDER REIMBURSEMENT-
-11
CONTRACTED PROVIDER LISTING-
-11
Introduction
County Rural Offices of Social Services was formed under Iowa Code Chapter 28E to create a
Mental Health and Disability Service Region in compliance with Iowa Code 331.390.
In compliance with IAC 441-25 the CROSS Management Plan includes three parts: Annual
Service and Budget Plan, Annual Report and Policies and Procedures Manual. The Annual
Service and Budget Plan includes the services to be provided and the cost of those services,
local access points, Targeted Case Management agencies, a plan for ensuring effective crisis
prevention and a description of the scope of services, projection of need and cost to meet the
need, and provider reimbursement provisions.
The Annual Service and Budget Plan has been approved by the CROSS governing board and is
subject to approval by the Director of Human Services.
CROSS management plans are available in each local CROSS office and on the Region and DHS
Websites.
Access Points
An access point is a part of the service system or community that shall be trained to complete
the MH/DD funding applications for persons with a disability and forward them to the local
CROSS Office.
Access Points
Clarke County Courthouse, CROSS Coordinator Office
Crossroads Mental Health
Clarke County Hospital
Clarke County Public Health
Decatur/Ringgold County Case Management
Decatur County Community Services
Community Health Centers of Southern Iowa
Leon
Lamoni
Decatur County Hospital
Decatur County Public Health
Decatur/Ringgold County Case Management
Lucas County Community Services, CROSS Coordinator Office
Southeast Iowa Case Management
Lucas County Health Center
Monroe County Community Services, Cross Coordinator Office
Community Health Centers of Southern Iowa
Southeast Iowa Case Management
Ringgold County Public Health
Decatur/Ringgold County Case Management
Wayne County Community Services
Southeast Iowa Case Management
Community Health Centers of Southern Iowa
Decatur /Ringgold County Case Management
Address
Phone
Number
Clarke County Courthouse
100 S. Main, Osceola, IA 50213
820 N Main, Osceola, IA 50213
800 S Fillmore St. Osceola, IA 50213
134 W. Jefferson, Osceola, IA 50213
201 NE Idaho St, Leon, Iowa 50144
201 NE Idaho St., Leon, Iowa 50144
641-414-2968
302 NE 14th St., Leon, Iowa 50144
802 E Ackerley, Lamoni, Iowa 50140
1405 NW Church, Leon, Iowa 50144
207 NE Idaho St., Leon, Iowa 501044
201 NE Idaho St, Leon, Iowa 50144
125 South Grand Chariton, IA 50049
103 South Clinton, Albia, IA 52531
1400 N. 7th, Corydon, IA 50049
1801 South B Street, Albia, Iowa 52531
12 Washington Ave West, Albia, Iowa 52531
103 South Clinton, Albia, IA 52531
119 South Fillmore, Mount Ayr, Iowa 50854
201 NE Idaho St, Leon, Iowa 50144
101 North Lafayette, Corydon, IA 50060
103 South Clinton, Albia, IA 52531
215 West State Street, Corydon, IA 50060
201 NE Idaho Street, Leon, IA 50144
641-446-2383
641-784-7911
641-446-4871
641-446-6518
641-446-7178
641-774-0423
641-932-5697
641-774-3370
641-932-2427
641-932-2065
641-932-5697
641-464-0691
641-446-7178
641-872-1301
641-932-5697
641-872-1750
641-446-7178
641-342-4888
641-342-2184
641-342-3724
641-446-7178
641-446-7178
Targeted Case Management
CROSS shall offer a choice and access to cost effective, evidenced based, conflict free Targeted
Case Management as described in IAC 441-25.21{l)g. The CROSS Technical Assistance
Committee reviewed interested agencies, made recommendations to the Governing Board,
who designated Targeted Case Management agencies to offer services to individuals enrolled in
the Medicaid program.
Designated Case Management agencies serving the CROSS are accredited by the Department of
Human Services. Targeted Case Managers meet the qualifications as defined in IAC 441.
The designated Targeted Case Management and Service Coordination Services meet the
following expectations:
•
•
•
Performance and outcome measures relating to the safety, work performance and
community residency of the individuals receivingthe service
Standards including but not limited to social history, assessment, service planning,
incident reporting, crisis planning, coordination, and monitoring for individuals receiving
the services.
Methodologies for complying with the requirements of sub rule 441-25.21 g which may
include the use of electronic recording keeping and remote or internet based training.
CROSS has identified and designated the following providers for case management in the
CROSS region:
•
•
Decatur County Community Services - Case Management
Southeast Iowa Case Management
Crisis Planning
Emergency Services
Current basic crisis response provisions including 24 hour access to crisis response and
evaluation are provided through Community Mental Health Centers and providers listed below.
Area
Clarke County
Decatur County
Lucas County
Monroe County
Ringgold County
Wayne County
Page County
Story County
Henry County
Provider
Address
Cross Roads Mental Health
820 N. Main St. #1, Osceola, Iowa 50213
Clarke County Hospital
800 S. Fillmore St., Osceola, Iowa 50213
Clarinda Mental Health Institute
1800 N. 16th St. , Clarinda, Iowa 51632
Community Health Centers of Southern Iowa
302 NE 14th St, Leon, Iowa 50144
Decatur County Hospital
1405 NW Church, Leon , Iowa 50144
Lucas County Health Center
1200 N. 7th St., Chariton, Iowa 50049
Lucas County Hospital
1200 N. 7th St., Chariton, Iowa 50049
Community Health Centers of Southern Iowa
302 NE 14th1 St, Leon, Iowa 50144
Monroe County Community Hospital
6580 165tfl St., Albia, Iowa 52531
Ringgold County Community Hospital
504 Cleveland St., Mount Ayr, Iowa 50854
Community Health Centers of Southern Iowa
302 NE 14th St, Leon, Iowa 50144
Wayne County Hospital
417 S. East St., Corydon, Iowa 50060
Mental Health Institutes / Hospitals
Clarinda Mental Health Institute
1800 N. 16lh St. #1, Clarinda, Iowa 51632
Mary Greely Medical Center
1111 Duff Ave. , Ames, IA 50010
Mount Pleasant Mental Health Institute
1200 E Washington St., Mount Pleasant, IA
52641
Phone
(641) 342-4888
(641) 342-2184
(712) 542-2161
(641) 446-2383
(641) 446-4871
(641) 774-3000
(641) 774-3000
(641) 932-2065
(641) 932-2134
(641) 464-3226
(641)446-2383
(641) 872-2260
(712) 542-2161
(515) 239-2155
(319) 385-7231
***CROSS will honor other region(s) memorandums of understanding or contracts with mental
health hospitals for emergency placement.
Scope of Services and Budget for FY 15
CROSS is in the development stage of standardization and regionalization. The FY 15 budget
was developed at the local level with input and collaboration with stakeholders to assess need
Additional funds were budgeted for development and decentralization of core and core plus
services. As the funder of non-Medicaid services, CROSS is the funding entity of last resort.
CROSS recognizes the importance of individualized planning for services and supports to
empower all individuals to reach their fullest potential.
CROSS shall be responsible for funding only those services and supports that are authorized in
accordance with the process described in the MH/DS Plan, within the constraints of budgeted
dollars. CROSS shall be the funder of last resort and regional funds shall not replace other
funding that is available. An individual who is eligible for other privately or publicly funded
services and support must apply for and accept such funding and support and comply with
requirements to remain eligible for such funding and support.
Service Description
Assessment and
evaluation
Basic Needs
Case management
(Targeted Case
Management and
Service
Coordination)
Chore
The clinical review by a mental health professional of
the current functioning of the individual using the
service in regard to the individual's situation, needs,
strengths, abilities, desires and goals to determine the
appropriate level of care.
Includes meals on wheels, payment for room and
board homes, personal needs allowances.
Service provided by a case manager who assists
individuals in gaining access to needed medical, social,
educational, and other services through assessment,
development of a care plan, referral, monitoring and
follow-up using a strengths-based service approach
that helps individuals achieve specific desired
outcomes leading to a healthy self-reliance and
interdependence with their community.
Service for outside maintenance of home such as:
window and door maintenance including hanging
screens, replacing windowpanes and washing
windows; minor repairs to walls, floors, stairs, railings
and handles; heavy cleaning which includes attics or
basements to remove fire hazards, moving heavy
furniture, extensive wall washing, floor care or painting
and trash removal; yard work such as mowing lawns,
raking leaves and shoveling walks.
Amount
Other Possible
Funding
$9,750
$500
General
Assistance, faith
based social
programs
$47,609
Medicaid
$5,200
Volunteer
programs in the
community,
SCICAP programs,
Medicaid
Commitment Related
(Evaluations, Sheriff
Transport, Legal
Representation,
Mental Health
Advocates
Crisis evaluation
Crisis Response
Twenty-four hour
Day habitation
Family peer support
Health homes
Court ordered services related to mental health
commitments
$73,474
The process used with an individual to collect
information related to the individual's history and
needs, strengths, and abilities in order to determine
appropriate services or referral during an acute crisis
episode.
Telephone crisis service-program that operates a crisis
hotline either directly or through a contract. The
service shall be available 24 hours a day and seven
days a week including, but not limited to, relief of
distress in pre-crisis situations, reduction of the risk of
escalation, arrangements for emergency on-site
responses when necessary, and referral of callers to
appropriate services.
Services that assist or support the individual in
developing or maintaining life skills and community
integration. Services shall enable or enhance the
individual's functioning, physical and emotional health
and development, language and communication
development, cognitive functioning, socialization and
community integration, functional skill development,
behavior management, responsibility and selfdirection, daily living activities, self-advocacy skills, or
mobility.
Services provided by a family support peer specialist
that assists the family of an individual to live
successfully in the family or community including, but
not limited to, education and information, individual
advocacy, family support groups, and crisis response.
A service model that facilitates access to an
interdisciplinary array of medical care, behavioral
health care, and community-based social services and
supports for both children and adults with chronic
conditions. Services may include comprehensive care
management; care coordination and health promotion;
comprehensive transitional care from inpatient to
other settings, including appropriate follow-up;
individual and family support, which includes
authorized representatives; referral to community and
social support services, if relevant; and the use of
health information technology to link services, as
feasible and appropriate.
$24,650
$10,500
$61,300
Medicaid
$15,700
Medicaid
$24,209
Medicaid
Home and vehicle
modification
Home health aide
services
Information and
Referral
Job development
Medication
prescribing
Mental health
inpatient treatment
commitment
Mental health
outpatient therapy
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a service that provides physical modifications to the
home or vehicle that directly address the medical
health or remedial needs of the individual that are
necessary to provide for the health, welfare, and safety
of the member and to increase or maintain
independence.
Unskilled medical services which provide direct
personal care. This service may include assistance with
activities of daily living, such as helping the recipient to
bathe, get in and out of bed, care for hair and teeth,
exercise, and take medications specifically ordered by
the physician.
Activities designed to provide facts about resources
that are available and help to access those resources.
Services that assist individuals in preparing for,
securing and maintaining gainful, competitive
employment. Employment shall be integrated into
normalized work settings, shall provide pay of at least
minimum wage, and shall be based on the individual's
skills, preferences, abilities, and talents. Services assist
individuals seeking employment to develop or reestablish skills, attitudes, personal characteristics,
interpersonal skills, work behaviors, and functional
capacities to achieve positive employment outcomes.
Services with the individual present provided by an
appropriately licensed professional as authorized by
Iowa law including, but not limited to, determining
how the medication is affecting the individual;
determining any drug interactions or adverse drug
effects on the individual; determining the proper
dosage level; and prescribing medication for the
individual for the period of time before the individual is
seen again.
Acute inpatient mental health services are 24-hour
settings that provide services to individuals With Acute
psychiatric conditions. Primary goal is to provide a
comprehensive evaluation, rapidly stabilize acute
symptoms; address health and safety needs and
develop a comprehensive discharge plan to
appropriate level of care.
Services shall consist of evaluation and treatment
services provided on an ambulatory basis for the target
population including psychiatric evaluation, medication
management and individual, family, and group
therapy.
$33,930
Medicaid
$9,850
Medicaid, PHN
grants,
Homemaker
grants from AAA.
$3,474
$18,000
Medicaid
$55,650
Medicaid
Insurance
$789,466
Medicaid and
Insurance
$115,050
Medicaid and
Insurance
Peer support services
Personal emergency
response system
Prescription
Medicine
Prevocational
services
Residential Care
Facility
Respite Services
Service Coordination
Supported
Community Living
Services
Supported
Employment
A program provided by a peer support specialist
including but not limited to education and information,
individual advocacy, family support groups, crisis
response, and respite to assist individuals in achieving
stability in the community.
An electronic device connected to a 24-hour staffed
system which allows the individual to access assistance
in the event of an emergency.
$13,700
Medicaid
$8,820
Medicaid
$3,050
Medicaid, Insurance,
Drug company patient
assistance programs,
340b pharmacies, and
community assistance
program.
$47,268
Medicaid
$418,490
Medicaid
$50,500
Medicaid
Prescription psychiatric medications for persons having
a mental health diagnosis
Services that focus on developing generalized skills
that prepares an individual for employment.
Prevocational training topics include but are not
limited to attendance, safety skills, following
directions, and staying on task.
Licensed/Certified living arrangements approved by
DIAorDHS.
A temporary period of relief and support for individuals
and their families provided in a variety of settings. The
intent is to provide a safe environment with staff
assistance for individuals who lack an adequate
support system to address current issues related to a
disability. Respite may be provided for a defined period
of time; respite is either planned or provided in
response to a crisis.
Activities designed to help individuals and families
identify service needs and coordinate service delivery
but which do not constitute case management as
defined by the MH and ID Commission.
Services provided in a non-institutional setting to adult
persons with mental illness, mental retardation, or
developmental disabilities to meet the persons' daily
living needs.
Helping individuals participate as much as possible in
competitive work in integrated work settings that are
consistent with the strengths, resources, priorities,
concerns, abilities, capabilities, interests, and informed
choice of the individuals. Services are targeted for
individuals with significant disabilities for whom
competitive employment has not traditionally
occurred; or for whom competitive employment has
been interrupted or intermittent as a result of a
significant disability including either individual or group
supported employment, or both, consistent with
evidence-based practice standards published by the
Substance Abuse and Mental Health Services
Administration.
$66,712
$115,246
Medicaid
$26,600
Medicaid
Transportation to day habilitation and vocational
programs
Transportation
Work
Activity/Sheltered
Workshop
Is for services provided by a facility carrying out a
recognized program of rehabilitation, habilitation, or
education for persons with disabilities. Designed to
lead to competitive employment or provision of longterm, remunerative employment
$47,655
Medicaid
$159,076
Total Budget for Services
$2,255,429
Total Administration (Includes Direct Admin & Risk pool contribution)
$389,895
Direct Administration
$66,712
County Disbursement to MHDS Regional Risk Pool Funds
$55,389
Total Regional Budget
$2,627,985
Financial Forecasting
Historical service utilization is the starting point for all financial projections. However, recent
changes in the system including transition to residency and Iowa Health and Wellness Plan have
provided challenges to using historic data.
Throughout the year CROSS staff, the regional advisory board and local stakeholders will
identify unmet needs and areas for service development, and accounting for legislative action
which will be incorporated into subsequent budgets.
Provider Reimbursement Provisions
Each service provider shall provide monthly billing invoices within 60 days of service provision,
and other information requested of the provider for utilization review. The monthly billings
shall include the following information:
•
•
•
•
•
•
Name and unique identifier of each individual served during the reporting period.
Dates of service.
Number of units of service delivered to each individual served.
When requested, attendance records.
Unit rate and total cost of the units provided to each individual. Copayments or other
charges billed to other sources shown as deductions on the billing.
Actual amount to be charged to the Region for each individual for the period.
CROSS staff shall review the billings and additional utilization information in comparison with
service funding authorizations in place. Non-emergency services delivered without service
funding authorization shall be deducted from the billing.
All eligible bills shall be paid within 60 days of receipt of required documentation unless
unforeseen circumstances exist.
10
No billings received more than 60 days after the close of the fiscal year in which the service was
provided shall be considered for payment by CROSS unless there is a statutory obligation. Fiscal
year for CROSS is July 1 -June 30.
It is the intent of CROSS that only CROSS staff shall authorize services for residents of the CROSS
region. Due to that, it is the policy of CROSS that if another county, region, or the State
determines residency in error or approves services for persons who do not have residency in
their region, CROSS may not assume retroactive payment. When written notification is
received by CROSS of the error, CROSS staff shall authorize services according to the policies
and procedures set forth in this manual.
CROSS has identified the following providers currently contracting with the region. Additional
providers may be added throughout the year as services are developed to meet the continuum
of service needs of individuals. The CROSS region is in phase 3 of the establishment of
Integrated Health Homes. At this time no Integrated Health Homes have been authorized in
our region but two organizations have applied.
Outpatient Mental Health Services
Community Health Centers of Southern Iowa
302 NE 14 St, Leon, Iowa 50144
Cross Roads
820 N. Main St. #1, Osceola, Iowa 50213
Lucas County Health Center
1200 N. 7th St., Chariton, Iowa 50049
Mental Health Institutes and Hospitals
Clarinda Mental Health Institute
1800 N. 16th ST., Clarinda, Iowa 51632
Mary Greeley Medical Center
1111 Duff Av e., Ames Iowa 50010
Mount Pleasant Mental Health Institute
1200 E Washington St., Mount Pleasant, IA 52641
Home Community Based Services
MOSAIC -ID only
405 East Me Lane St., Osceola, Iowa 50213
Southern Iowa Resources for Families - Hab,
1605 W 1st St., Leon, Iowa 50144, 103 S. Lafayette St., Corydon,
Bl, and ID populations
Iowa 50060
Crest Services
1221 Brookdale, Chariton, Iowa 50049
11
Residential Care Facilities
Brees Rest Home
210 Washington Ave. E., Albia, Iowa 52531
New Venture
401 S. Washington, Corydon, Iowa 52531
Employment Services
MOSAIC
405 East Me Lane St., Osceola, Iowa 50213
Southern Iowa Resources for Families
1605 W 1st St., Leon, Iowa 50144
103 S. Lafayette St., Corydon, Iowa 50060
Crest Services
1221 Brookdale, Chariton, Iowa 50049
Ringgold County Supportive Services
507 S. Henderson Dr., Mount Ayr, Iowa 50854
Ragtime
116 North 2nd Street, Albia, Iowa 52531
12