Assessing the Impact of Self-directed Care, Within a Medicaid-funded Environment,on Participation and Community Living

Temple University Collaborative on Community Inclusion

Status: Completed

Conditions: Major Depression; Schizophrenia; Bipolar Disorder

Treatments: Behavioral: self-directed care

Study type: Interventional

Funder types: Other

Identifiers

NCT02520024

13304

Details and patient eligibility

About

This project proposed to demonstrate the effectiveness, costs, and benefits to participation and community living self-directed care programming within a financially sustainable Medicaid managed care environment. The study examined outcomes associated with the implementation of a novel self-directed care (SDC) approach being implemented in Delaware County, Pennsylvania in which consumers were able to access a set amount of renewable funds per year and direct how they were spent, both to purchase the types and amounts of rehabilitation and treatment services they desire (and from whom they choose) and to purchase a broad-range of individualized resources and services that are generally outside of Medicaid funding (e.g., health club memberships, yoga classes, support in taking care of bills).

Enrollment: 120 patients

Sex: All

Ages: 18 to 65 years old

Volunteers: Accepts Healthy Volunteers

Inclusion criteria

1. Adults between 18-65 who are currently receiving Medicaid-reimbursed services in Delaware County, Pennsylvania for either a schizophrenia-spectrum, major depression, or bipolar disorder;
2. Individuals with a cost profile within the 60-90% band of all Magellan-administered Medicaid recipients in the county (estimated service costs between $10,048 and $22,324); 3) No more than two inpatient hospitalizations of 10 days per stay, over a 2 year period prior to the study;

4. No hospitalization within 6 months of the study; 5) Ability to understand self-directed care requirement and express interest in working with a "recovery coach."

Exclusion criteria

1. do not speak English;
2. have a legal guardian;
3. are unable to give informed consent

Trial design

120 participants in 2 patient groups

Self-directed Care

Experimental group

Description:

Individuals in the experimental condition will work with a specially trained certified peer specialists (CPS) who will serve as "recovery coaches" to develop an individualized recovery plan that describes their goals and desires. They will then work with the team to select both the behavioral health treatment and rehabilitation services, and the non-behavioral health materials and resources they believe are necessary to achieve their goals.

Treatment:

Behavioral: self-directed care

Treatment as usual

No Intervention group

Description:

Participants in the control condition will receive services as usual.