Scope of Report

SCOPE OF REPORT

Our review focuses on 16 of the elements required in the Local Business Plan, a small subset of the total of elements. It is a selective, but representative review of key plan elements. These 16 elements represent major sections of the Local Business Plan but also to reflect the underlying principles of reform. The elements reviewed were in the areas of planning, qualified provider network development, service monitoring and oversight: quality management, and evaluation.

The General Information section for Local Business Plans in the State Plan (p.3) states: "The LBP should be approached as a strategic plan and process. A strategic plan acknowledges a fundamental understanding of the vision and known elements of pursuing the vision. Although the vision stays constant, the strategic process is dynamic and recognizes the need to adapt to the acquisition of new and better information". We strongly support this notion of constant improvement in the plans as more is understood and recognized. Thus, this review does not focus on critiquing individual plans but attempts to identify patterns and trends across plans where additional clarification or technical assistance may be necessary, and to identify exemplary elements of plan components that could be emulated. At points throughout the review specific plans are identified as examples of what we considered a very good response or approach to a particular business plan element. If a program is not identified it does not mean its plan or approach was not good. Our intent in highlighting programs was to identify those that had gone beyond the usual and perhaps encourage other programs to learn more about what their colleagues had done. Finally, we offer recommendations on how Local Business Plans can be strengthened and improved to support the implementation of the vision and principles of reform.

Limitations: There are several limitations to this study that must be acknowledged. First, we do not review all dimensions of every plan; such an undertaking is beyond the scope of our resources. In so doing, however, we may have missed important elements in and across plans. Second, this is a review of plans submitted to the Division. No attempt is made to review implementation or to check whether plans accurately reflect the community planning and implementation process. Finally, all plans reviewed were submitted before the April 1^st deadline to submit modifications to Local Business Plans. Some changes to individual plans may have been made, however, we feel that the overall patterns and themes in the Local Business Plans did not change in any significant manner.

Methodology

The state requirements for local business plans were reviewed by a group of local experts. (Appendix 1) Certain components of the plan were determined to be central to the success of reform efforts. These local business plan components chosen to be reviewed are:

PLANNING

1) The Local Business Plan demonstrate congruence with the Mission and Principles of the State Plan
2) The Local Business Plan planning process meets State Plan requirements

There is a strength/weakness analysis including a methodology for building on strengths and addressing and/or ameliorating weaknesses

There is a separate report submitted by the local CFAC

3) The Local Business Plan incorporates a 3-year strategic plan for initial implementation that:

contains goals, objectives and activities

addresses steps necessary to transition individuals now in services who do not meet target population criteria to other community resources as necessary

QUALIFIED PROVIDER NETWORK (QPN) DEVELOPMENT
1) The local business plan identifies the current qualified provider services lists and service array
    a) A current lists of all qualified service providers matched to service category and target populations
    c) A comprehensive assessment of service capacity need has been completed, and a summary of its conclusions and recommendations are attached
2) The local business plan complies with the State Plan requirements in establishing a qualified provider network
    d) A QPN development plan is attached addressing

A technical assistance protocol to support the QPN, including resources and methods of implementing the protocol

How network development will incorporate best practices, including such things as fostering recovery, preventing relapse and promoting freedom

4) The local business plan complies with State Plan requirements and establishes a system of services and supports for existing populations

Provides a plan for identification of individuals in transition

Identifies generic community resources, such as faith-based groups, to provide services and supports to members of the non-target populations

SERVICE MONITORING AND OVERSIGHT: QUALITY MANAGEMENT
1) The Local Business Plan describes a quality management process to meet the State Plan requirements, including how the LME will address the following:

Monitoring all risk management and health and safety issues in the LME and its qualified provider network to include formal review of incident and death reports and compiling and analyzing this information for meaningful use in quality improvement.

2) The Local Business Plan describes a policy that adopts state identified best practices for each target population and individual outcome-based goals.
3) The local business plan describes management information systems capabilities sufficient to meet State Plan requirements including the ability to effectively track service events, track outcome data related to public funding and generate performance indicators

a) Performance indicators (long, long list. How do we reflect it?)
b) A description of how data will be used for planning

EVALUATION

2) The Local Business Plan is consistent with State Plan requirements for managing a continuous quality improvement process
a) A description of how the LMEs earlier configuration of counties/area program participated in evaluation processes for the last two years and actions taken as a result of the evaluations
c) A plan for the development of quality improvement process is provided
3) The local business plan meets State Plan requirements for evaluation system performance

a) The plan for development of the quality improvement process adopts system performance indicators in internal evaluation reports that include:

access

quality of care

administrative process

consumer outcomes

COLLABORATION
1) The local business plan delineates a process that supports and encourages collaboration among community agencies and organizations.
3) The local business plan describes how the LME will identify, build on, develop and manage a network of informal services and resources necessary to provide the foundation for individualized support and community integration at the consumer, family and community level.

Five graduate students (Appendix 2) from the UNC School of Social Work reviewed key plan dimensions across the 16 Local Business Plans applying to be "phase one" programs (Appendix 3). These students provided a summary of each of the sixteen elements across the 16 programs. Following the review of individual plans, NAMI enlisted the review panel of local experts to compile this report (Appendix 2). The panel reviewed the data compiled by the students in order to identify patterns and themes. Recommendations were developed based on issues and themes identified.