Mental health self-direction programs enable participants with serious mental illness to self-direct their Medicaid outpatient mental health budget with the assistance of an adviser, who can be a trained peer or professional. The adviser helps the participant develop an individual recovery plan and budget which determines expenditures and might also assist in identifying and purchasing goods and services. Goods and services can be traditional (for example, counseling) or non-traditional (for example, computer classes to train for re-entry into the workforce).
HHSC is testing mental health self-direction as a performance improvement project in partnership with two Medicaid-managed care organizations in the Travis Service Delivery Area. The project, also known as My Voice, My Choice, assesses the impact of mental health Self-Directed are specifically in the Medicaid-managed care system for adults with disabilities and, if successful, could inform statewide implementation of mental health self-direction for adults with serious mental illness. Texas is also participating in a multi-state learning community regarding mental health self-direction, so the Texas Self-Directed Care project could also help inform change in other states.
The association of serious mental illness with poor health and social outcomes makes innovative service models of critical interest to state and national policymakers. Robust analysis of self-directed outcomes for adults with serious mental illness will help Texas develop more effective, person-centered systems of care.
To learn more, contact Jessie Aric, Self-Directed Care Pilot program manager.
Sponsor Acknowledgment: This pilot was developed under grant CFDA 93.791 (PDF) from the U.S. Department of Health and Human Services, Centers for Medicare & Medicaid Services. However, these contents don't necessarily represent the policy of the U.S. Department of Health and Human Services, and you should not assume endorsement by the federal government.
The Human Services Research Institute and Applied Self-Direction, the home for the National Resource Center for Participant-Directed Services, sponsor a national website with information and research findings on self-direction for people with serious mental health conditions at https://www.mentalhealthselfdirection.org.
National Association of Medicaid Directors Conference: How Integration Supports Adopting Evidence-based Practices (2017) [PDF]
Self-Directed Care Pilot - Overview (2017) [PDF]
Behavioral Health Advisory Committee's Self-Directed Care Stakeholder Advisory Subcommittee
The Self-Directed Care Stakeholder Advisory Subcommittee, which meets quarterly, provides input on the operation and evaluation of the Self-Directed Care Pilot. Members include Behavioral Health Advisory Committee representatives, professionals with experience in mental health, people with experience and other community members. The work of the group is focused in four areas.
- Program design and operation
- Evaluation design and operation
- Outreach materials
- Dissemination of evaluation results to stakeholders
- University of Texas Health San Antonio provides adviser functions to the intervention group and serves as the centralized Institutional Review Board.
- The University of Texas at Austin's Addiction Research Institute provides all qualitative and quantitative evaluation of the project, including the creation of a centralized database for use by University of Texas Health San Antonio and University of Texas Austin personnel.
- Texas A&M's Public Policy Research Institute provides recruitment and data collection services.
Managed Care Organizations
Managed Care Organizations provide funding for participant self-directed budgets and other physical, behavioral health and long-term services and supports to participants.