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DHS News May 2011

pdf.gif May 2011 DHS Newsletter

Single Point of Accountability transforms OBH case management, earns national recognition

In Allegheny County, a case management transformation has taken place that changes how mental health services are coordinated. It’s a transformation that is receiving national recognition for its success.

The changes to the mental health service system were spurred by community-based research that studied the capacity, training and quality of case management service delivery in Family Services of Western Pennsylvania, a DHS contracted service provider. The research, conducted through a mental health services research partnership between Western Psychiatric Institute and Clinic (WPIC) and the University of Pittsburgh School of Social Work, identified that service delivery could be improved by making adjustments to case management.

According to the study, case management staff members needed improved training to work with consumers diagnosed with serious emotional disturbances or mental illness. The study also found that high staff turnover rates and low wages affected service delivery, and staff focused on crises and didn’t spend enough time assessing planning or strengths and needs.

Case Management Transformation
Armed with the information from the study, the case management transformation, called the Single Point of Accountability (SPA) Initiative, began in 2006 at Family Services.

“SPA transforms case management to a recovery-oriented service,” said Steve Christian-Michaels, chief operating officer at Family Services. “The initiative moves the system to a more collaborative approach. It focuses on strengths and works collaboratively with consumers, family members and other programs to build a service plan focused on strengths.”

SPA also creates a professional role for case managers, provides training and career ladders with improved salary, and improves employee retention. Also, under SPA, the title “case manager” was changed to “service coordinator.” From a funding perspective, however, case management and service coordination are the same service.

“We changed the name because consumers and family members said they were not cases and did not need to be to be managed,” said Christian-Michaels. “The title ‘service coordinator’ eliminated the negative stigma that was associated with the old title.”

Expanding the Transformation
OBH, having contracts with several agencies for service coordination, played a pivotal role in expanding SPA beyond Family Services and developing it into a county-wide system change.

“We wanted to build on the successful transformation that took place at Family Services and expand it to all of our service coordination units,” said Pat Valentine, DHS executive deputy director. “After seeing the results of the research applied to real-world interactions with the people we serve, we felt it was important to begin to engage the rest of the service coordination units in this transformation.”

The county-wide transformation started with a stakeholder group in 2007. Christian-Michaels assisted OBH with getting the transformation process started.

“We started with a 25-member stakeholder group who contributed to a 26-page recommendations report,” said Christian-Michaels. “Then, in 2008, four committees were created to guide the transformation initiative.”

OBH also hired several consultants to aid in the effort, created and printed manuals and funded several research projects to provide feedback and evaluation.

Today, all 11 contracted agencies that provide service coordination have transitioned to SPA, and OBH now includes SPA expectations in its contracts with those agencies and utilizes a quarterly mentoring tool to measure compliance and fidelity.

Additionally, there is also county-wide use of the Children and Adolescent Needs and Strengths (CANS) tool to help support the strengths-based and consumer-driven focus of SPA. Plans are also in place to start using the Adult Needs and Strengths Assessment (ANSA) in the near future.

Training is another important aspect of the OBH effort to transform case management. There are four days of training for all new hires followed by six months of additional mentor training. Furthermore, a certificate course is offered by the University of Pittsburgh. To date, OBH is one-third of the way through training all existing staff with the certificate course.

OBH plans to also provide CANS and ANSA training this fall and other advanced training opportunities in 2012 or 2013.

“There is much more training with SPA than with the former case management system,” said Christian-Michaels. “We’ve really turned the service coordinator position into a profession and staff members are much more prepared for the job.”

A National Success
The case management transformation in Allegheny County has been so successful that Family Services was recently recognized by the Annapolis Coalition on Behavioral Health Workforce in partnership with the Hitachi Foundation with the prestigious 2011 Behavioral Health Pacesetter Award.

Family Services was one of five organizations receiving the Pacesetter Award that recognizes behavioral healthcare treatment and support organizations in the United States that utilize best workforce practices.

“We were honored to receive the award,” said Christian-Michaels. “I think the sheer scope of what we accomplished with the Initiative is part of the reason we were recognized. OBH also played a big role in our success. Pat Valentine provided leadership, ideas and the extra push the Initiative needed when things got stuck, and the OBH staff provided a lot of help to critical projects.”

More information about the SPA Initiative


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