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DHS News Newsletter April 2009  

OBH incorporates Single Point of Accountability for adult consumers

April 2009

DHS is moving ever closer to fulfilling its Vision of creating a human services system that “ensures individually tailored, seamless and holistic service.” 

This year, the best practice concept of Single Point of Accountability (SPA) is being applied to the services supported by the DHS Office of Behavioral Health (OBH). Within those services, SPA will allow adults to overcome problems related to mental illness and substance abuse and to get the full benefit of available resources. This is because SPA will change the way the provision of behavioral health services is coordinated.

The change process was initiated at meetings held in January and February 2007 that included consumers, family members of consumers, providers of behavioral health services, OBH staff and representatives from Community Care Behavioral Health, the behavioral health managed care organization for residents of Allegheny County who receive Medical Assistance.

These stakeholders recommended several steps to overhaul behavioral health case management services: 

  • Change the nomenclature to reflect the fundamental changes ahead.  Replace the detached, top-down term “case management” with the more integrated, person-centered term, “service coordination.”
  • Add, adjust and standardize billable codes and categorizations of services to acknowledge the underlying fiscal implications of the new prominence of service coordination.
  • Offer a certificate course through the University of Pittsburgh to Senior Service Coordinators so they may become mentors to newly hired Service Coordinators. 
  • Assign a mentor to each new Service Coordinator to give him/her formal instruction and guidance. Mentors will model effective service coordination skills including: how to conduct service planning, how to find appropriate resources, how to complete required documentation, and how to forward recovery principles in the process.
  • Reflect the high value placed on quality Service Coordinators by increasing the minimum base salary to improve retention and by offering Service Coordinators certificate training through the University of Pittsburgh. 
  • Develop and implement a behavioral health service coordination specialization in Bachelor of Social Work degree programs at the University of Pittsburgh, Carlow University and other institutions of higher learning.
  • Make the concept of trusting the consumer to drive his/her own planning process (with the support of the Service Coordinator as coach and interagency liaison) imperative, thereby promoting recovery principles among all partners in the SPA process. The concept has been deemed very important by former consumers.
  • Expect Service Coordinators to expand their responsibilities over time to include the eventual convening and facilitating of service planning meetings that bring the consumer, as the recognized driver of the service planning, together with other appropriate staff from provider agencies who are involved in the consumer’s service plan.
  • Create a new high-level recovery plan that centralizes goals, processes and outcomes for each participant in a consumer’s service plan thereby recognizing the importance of having all participants aware of each other’s activities. Work to develop the capability of having this individualized plan accessible through a secure web site.
  • Define the responsibilities of the “Single Point of Accountability” as:
    • Being the consumer’s “go-to” person;
    • Communicating clearly with the consumer about what she/he can expect;
    • Making sure the consumer’s immediate needs are met;
    • Assuring that all the consumer’s needs are identified; 
    • Assuring that services that cross multiple systems are well-planned and coordinated;
    • Planning, with consumer, to identify people in his/her life who can be of short-and long-term help, including peers and family members;
    • Linking the consumer with community-based resources;
    • Assisting the consumer in developing high-quality, long-lasting relationships;
    • Helping the consumer sustain a positive, hopeful outlook for his/her future; and
    • Providing feedback to administrators about system barriers and problems.

Child-serving systems, including behavioral health, child welfare, juvenile probation and education are also gearing up to enact similar changes in service coordination. Of no surprise, attention is also being given to coordination of services for individuals who are transitioning from the child-serving to the adult-serving system. Future issues of DHS News will highlight these efforts.

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