Individual Placement Support IPS Evidencebased supported employment for
Individual Placement & Support (IPS) Evidence-based supported employment for people with serious mental illness & substance use disorders Tom Starling, MHA of Middle TN Chair: TN Coalition for Mental Health & Substance Use Services Naveh Eldar, Park Center, Nashville Sita Diehl, National Alliance on Mental Illness (NAMI) Presentation to the 3 -Star Task Force Tennessee General Assembly September 12, 2016
TN Coalition for Mental Health & Substance Abuse Services Members Organizations AIM Center Alliance Healthcare Services Centerstone Mental Health Centers Cumberland Heights Foundation Disability Rights Tennessee Frontier Health Lowenstein House Mental Health America of Middle TN Mental Health Association of East TN Mental Health Cooperative, Inc. NASW, Tennessee Chapter National Alliance on Mental Illness–TN Park Center Prevention Alliance of Tennessee Quinco Mental Health Center Ridgeview TAADAS TAMHO TCCY TN Assn of Drug Court Professionals TN Commission on Aging & Disability TN Conference on Social Welfare TN Hospital Association TN Licensed Professional Counselors Assn TN Mental Health Consumers’ Association TN Psychiatric Association TN Suicide Prevention Network TN Voices for Children, Federation of Families Volunteer Behavioral Health Care System
Applause for the 3 -Star Plan • Eligible Population: • • Uninsured childless adults with mental health & substance use disorders Income at/below 138% FPL. High needs population With potential for independence from public assistance. • State assistance: Finding employment, job training, earning a degree • Department of Labor and Tenn. Care coordinate. • HSA accounts: • Incentives for job training, education & employment • Health Homes: • Timely, integrated medical/BH care strengthens ability to work. • As income increases above 138% FPL: • Help with moving to private insurance
Most people with mental illness want to work 2/3 want to work, yet less than 15% of people with SMI are employed Without coverage, the choice is between work and treatment Unemployed Quit work or leave treatment Enter labor market Income exceeds SSI threshold Choice: Lose benefits or resign The 3 -Star Plan opens a path to work and independence from public support
What works? Supported employment for behavioral health population Individual Placement & Support (IPS) developed in 1996 • Rapid employment model ‘Place then train’ is more effective than traditional ‘train then place’ approach Research findings Train Place IPS 24. 3% 70. 4% 212 140 8. 1 months 24. 2 months 11% 49% % who gain competitive employment Days to first job Job tenure (longest held job) Working at least part-time > 5 years later Reduced MH/SU treatment costs over 10 years IPS is successful in urban and rural communities $16, 000/client
IPS Model Individual Placement and Support (IPS) is an evidence-based approach to supported employment for people with severe mental illness. IPS supports people in their efforts to achieve steady employment in mainstream competitive jobs, either part-time or fulltime. IPS Principles: 1. Competitive employment is the goal 2. Supported employment service integrated with treatment 3. Zero Exclusion: Eligibility is based on client choice 4. Attention to client preferences 5. Benefits counseling is important 6. Rapid job search: Begin job search within 30 days 7. Systematic job development: IPS specialists meet frequently with employers 8. Time-unlimited support
IPS Learning Community Feb 2016
Tennessee Outcomes Compared to other states in IPS Learning Collaborative
Tennessee Agencies with IPS Agency Location IPS Specialists Frontier Health Northeast TN 4 Helen Ross Mc. Nabb Knoxville 2 Ridgeview Oak Ridge 3 AIM Center Chattanooga 1 Volunteer Behavioral Health Chattanooga 1 Park Center Nashville/ Murfreesboro 6 Mental Health Coop Nashville 1 Pathways Behavioral Health Jackson 2 Carey Counseling Center Northwest TN 2 Lowenstein House Memphis 3 Alliance Healthcare Memphis 1 Total IPS Specialists 25 Note: At least 3 IPS specialists required per agency to meet fidelity standards
Need & TDMHSAS Goals Need in Tennessee • 145, 184 Working age adults (18 -64) with SMI served in community mental health • 8, 075 employed full or part time • 1, 014 (0. 7%) received IPS Source: TDMHSAS 2014 BH Block Grant Report (based on 2013 data) 2013: IPS initiative started • Collaboration between TDMHSAS, DHS/Voc. Rehab TDMHSAS/DHS 3 -year IPS initiative goals: 1. Improve & increase IPS training, TA, and fidelity monitoring 2. Build & maintain DHS/Voc. Rehab. and TDMHSAS integration and capacity 3. Build on existing funding sources, plan for financial sustainability
Budget Proposal $6, 400, 000 to bring IPS to scale* $6, 000 for personnel • 60 additional IPS specialists • 5 additional IPS trainers (2 for each grand region) • 2 additional TDMHSAS coordinator for IPS (1 for each grand region) Salary, benefits, operating costs Bring existing programs to fidelity staffing level (3 per agency) Integrate IPS into community mental health agencies $250, 000 Training $150, 000 Evaluation * Estimate for discussion purposes only. Actual budget to be provided by TDMHSAS.
Funding Mechanisms Current: • Vocational Rehabilitation: Short term only • TDMHSAS grants • Tenn. Care: Under-utilized; • Explore reimbursement rate & procedures Options: • Behavioral Health Safety Net • State budget appropriation • Explore Medicaid waiver • MCO reinvestment grants • PASS plan (homeless)
Discussion Tom Starling: tstarling@mhamt. org Naveh Eldar: Naveh. Eldar@parkcenternashville. org Sita Diehl: sdiehl@nami. org
- Slides: 13