The Center

Resources

As part of its mission, the Center for Rehabilitation and Recovery provides resources and information that can be helpful to community mental health providers.

Index to Resources

• Measurement of Clinical Outcomes
• Job Aids
• Medicaid Buy-in
• Ticket to Work
• Psychiatric Rehabilitation

Measurement of Clinical Outcomes

Providers attending a PROS Learning Collaborative asked for a way to measure the small functional changes in consumer status every three months.   Courtenay Harding suggested that agencies consider the Life Skills Profile (LSP) developed in Australia many years ago by Rosen et al, in 1989.  This brief instrument is scored on 1 page, is easy to use, and has undergone substantial psychometric testing repeatedly across many populations.  

It was designed to assess people who have severe and episodic disorders and are found primarily in the public mental health system of care.  It comes in three forms with 16, 20 or 39 questions which produce 5 subscales: communication, social contact, non-turbulence, self-care, and responsibility.  These scales are framed with recovery values but can be scored with either strengths or impairments or in mind.   The longest form (LSP-39) is used primarily in research while the LSP-20 appears to be the best one to use clinically, capturing the subtle changes occurring across every three months (see Rosen et al, 2001).  No special training is required to administer it and it is free of psychiatric jargon.

The use of such a short instrument routinely will inform clinicians and the people with whom they are working about whether or not progress is being made and in which areas.  In addition, aggregated data will allow the agency to proclaim success with its interventions if shown in the outcome findings.

Permission has been given by the authors, who are from the Departments of Psychiatry at the Universities of Sidney, New South Wales, Melbourne, Wollongong, and Monash in Australia . 

 A congregated link is available at: www.blackdoginstitute.org.au/research/tools/index.cfm .

 The senior author, Prof. Alan Rosen may be also reached at:  alanrosen@med.usyd.edu.au

Life Skills Profile

Overview of the Life Skills Profile 

Job Aids

We have packaged some information in the form of Job Aids. They are designed to better equip agency staff to deliver recovery-focused services.

All of the Job Aids listed in this section can be easily downloaded and reproduced. To print a specific Job Aid, simply click on the title that interests you. If you do not have Adobe Reader, download it free at: http://get.adobe.com/reader/.

Defining Recovery
Person Centered Approaches
Enhancing Motivation thru Change Talk
Defining Natural Supports
Assessing Group Behavior
Supported Education:  Four Student Perspectives
Supported Education:  Demonstrated Positive Outcomes
Supported Employment: Core Principles
Powerful Staff Meetings: Creating a Culture of Recovery
Recovery Internet Resources

Medicaid Buy-in

Since September, 2007, The Center has facilitated a work group focused on ways to increase enrollment in the Medicaid Buy-in Program for Working People with Disabilities (MBI-WPD) among people with psychiatric disabilities. This initiative is being undertaken in collaboration with NYSOMH, NYSDOH, NYCDOHMH, consumers, and providers. 

• On November 26, 2008 The Center released an easy to understand fact sheet designed to give consumers and providers the most current and important information on the Buy-In Program.  We encourage you to download, post and distribute this new flyer.

The flyer is available in full color or printer friendly black and white.

Ticket to Work

Ticket to Work is a voluntary employment program for people with disabilities administered by the Social Security Administration (SSA). The Ticket program offers people receiving Social Security disability benefits age 18 through 64 expanded opportunities to obtain the services and supports that they need to work and to achieve their employment goals. SSA does this by paying approved service providers, referred to as “Employment Networks” or “ENs”, for assisting beneficiaries to reach designated Milestones and Outcomes associated with achieving self-supporting employment. An EN can be any agency or organization that provides or is equipped to provide employment- related services and supports to individuals who have disabilities.

The Ticket program may be of particular interest to providers of Personalized Recovery Oriented Services (PROS) programs. PROS programs may apply to become an EN and use ticket revenue to finance employment services, such as the Individual Placement and Support (IPS) model of Supported Employment. It is also worth noting that SSA revised the Ticket program in 2008 to facilitate payments to ENs.  Now ENs can be paid sooner, more frequently and at higher amounts for the services they provide.

To learn more about the Ticket program and how to become an Employment Network, please utilize the information and Internet resources below:

All information has been gathered from SSA and its contract agencies (CESSI, a private company focused on Ticket program recruitment and outreach, and MAXIMUS, a private company that provides oversight and management for the Ticket program).

Ticket to Work: Basic Information & Breaking News

Visit www.yourtickettowork.com for a variety of payment-related resources

Ticket to Work: Frequently Asked Questions

Visit www.cessi.net/ttw/faqs/ for answers to frequently asked questions.

Website for Ticket Holders (People with Disabilities)

Visit Choose Work web site (www.choosework.net) to see testimonials of people with disabilities who have benefited from the Ticket program.

Ticket to Work & Mental Health Organizations

Program Mental Health Web site at www.cessi.net/ttw/EN/mental_health/index.asp.

Employment Network Application--Request for Proposal (EN RFP)

If your organization would like to become an Employment Network (EN), please follow the link to download the RFP: www.ssa.gov/work/enrfp.html.

To learn how to complete the EN application visit www.cessi.net/ttw/walkthru-app.html  

Don’t hesitate to get in touch with the CESSI Account Manager specializing in Mental Health: David Jones, at 703 448 6155 x 201 if you or others at your organization still have questions about becoming an EN.

Ticket Quick Start

This link provides information on the Individual Work Plan (IWP), EN payment amounts, and other tools that can be downloaded by your organization for reference and training. www.yourtickettowork.com/training_2

Payment Process Resources

This link provides information about the items needed to submit a payment request.
www.yourtickettowork.com/payment_options

EN Capitalization Resource Directory

This link provides information on tapping into government and private funding for upfront capital to implement employment and support services for beneficiaries under the Ticket to Work Program. www.yourtickettowork.com/en_cap_resource

SSA’s 2009 Ticket to Work Mental Health Summit: Recovery Through Work

In mid-November 2009, the Social Security Administration’s (SSA) Office of Employment Support Programs (OESP), Centers for Medicare & Medicaid Services, and the Substance Abuse and Mental Health Services Administration (SAMHSA) hosted a summit with a first-ever focus on its Ticket to Work Program and mental health employment services.

Presentations and related Summit materials are now available for download at the following address: www.cessi.net/ticketmentalhealthsummit/program.html. Just click on any presenter’s name that is a live link and you will be able to open or save the associated documents.

CMS Issues Policy Clarification: Medicaid Providers Participating In Ticket Program as ENs are NOT “Double-Dipping”

Many providers have been concerned that receiving payments for Ticket related services and Medicaid reimbursement constitutes “double dipping” and would be disallowed. In response to these concerns, the Center for Medicare and Medicaid Services (CMS) issued a policy clarification in a letter sent to State Medicaid Directors on January 28, 2010. The letter states that “Ticket Outcome and Milestone payments do not conflict with regulatory requirements and do not constitute an overpayment of Federal dollars for services provided since EN payments are payment for an outcome, rather than for a Medicaid service rendered. Furthermore, State agencies and/or providers interested in participating in the Ticket to Work program as ENs are encouraged to do so.” This policy clarification paves the way for Medicaid providers to fully benefit from Ticket revenue.

CMS Policy Clarification Ltr—2010-01-28

Archived Webinars

SSA and CESSI, the Ticket to Work Program Manager for Recruitment and Outreach (PMRO), hold regular Webinars on a variety of important topics for both prospective and current Employment Networks. These are available for continued access via the Web at www.ilr.cornell.edu/edi/m-cessi-webinars.cfm; Webinars with a specific mental health focus are archived at www.cessi.net/ttw/en_menthealth-UCP/en_info4.html.

Additional Resources

Visit www.cessi.net/ttw/resources/  for more Ticket program resources.

Documents to Download

Basics 
Beneficiary Ticket Holder 
Overview of New Ticket Program 
Social Security—Your Ticket to Work Brochure 
Contact Info—Program Manager for Recruitment and Outreach 
Ticket to Work Resources of Interest

EN Handbook for Service Providers 
EN Resources 
EN—RFP Application

Psychiatric Rehabilitation

The Psychiatric Rehabilitation Approach includes a philosophy and an evidence-based process for involving recipients in rehabilitative activities underscoring particular psychiatric rehabilitative values that will be reflected in the trainings. The focus is on recovery and the approach is a well defined service that is complimentary to treatment, case management, and other types of mental health services. This approach can be applied in a range of programs and settings.

• Articles on the Five Strategies
• PowerPoint Modules
• Technical Assistance Forms