Self-Directed Service Delivery Options for Mental Health Services

Self-directed service delivery options are an important component of a recovery-oriented system of care. While consumer-direction has been available in most other disability service and support programs, the state has been slow to embed consumer/self-direction in the delivery of mental health services. The long-standing “pilot” in the Dallas area has shown positive results validating the need for expansion. Current state initiatives to move behavioral health services into managed care offer prime opportunities for further development of self-directed service delivery options for mental health.

Recommendation:

Direct HHSC and DSHS to develop a pilot for self-directed mental health services in the integrated managed care system. The pilot program should be developed with the goal of maximizing consumer choice and encouraging personal responsibility for achieving recovery. Essential components include:

1. Eligible participants—adults with serious mental illness
2. Services and supports based on goals identified through person-centered planning
3. Individualized budget that relates to the goals identified in the person-centered plan
4. A pre-determined portion of the individual’s mental health budget allowed to be used for flexible goods and services including:
   1. Replace formal services with informal services
   2. Replace services with “normal” community activities
   3. Replace public services with private services
   4. Replace services with goods
5. Option for the services of a life coach to provide support , including but not limited to:
   1. Assistance with person-centered planning and budgeting
   2. Assistance identifying and navigating community services
   3. Assistance with recruiting, hiring and releasing service providers
   4. Assistance with crisis planning
   5. Assistance with the fiscal management agency and billing for goods and services
6. Qualifications for life coaches; must include opportunities for certified peer specialists
7. Fiscal intermediary provides financial management and billing support

Meaningful data collection and evaluation