Resiliency and Disease Management

Mission

Resiliency and Disease Management (RDM) is an effort to redesign the way public Mental Health services are delivered to adults with severe and persistent mental illness and children with severe emotional disturbance. One primary aim is to ensure the provision of interventions with empirical support to eliminate or manage symptoms and promote recovery from psychiatric disorders. Other aims of this project include:

• establishing who is eligible to receive services,
• establishing ways to manage the use of services,
• measuring clinical outcomes or the impact of services, and
• determining how much these services should cost.

The RDM initiative is intended to better match services to Mental Health consumers’ needs, and to use limited resources most effectively. The intention is to provide the right service to the right person in the right amount to have the best outcomes.

Some of the concrete goals that DSHS hopes to achieve through RDM include:

• Individuals will be regularly assessed using objective, valid assessment instruments;
• Individuals will participate in evidence-based services that are appropriate to address their unique individual needs;
• Individuals will participate in services of adequate intensity to aid in recovery from mental illness and the development of resiliency;
• Services will have fidelity to the key elements of the evidence-based practices; and
• Individual outcomes related to important indicators of quality of life will improve, providing progress toward the goal of recovery.

Key Components

Because RDM represents a major transformation of the Mental Health system, almost all aspects of the system have been changed to support the goals of RDM.

• Uniform Assessment. A uniform assessment was created to assess the needs of consumers, recommend appropriate services based on identified needs, and monitor individual outcomes. The result of the assessment is an authorized Level of Care (LOC) that corresponds to a service package.

• Service Packages. Service packages for both children and adults were developed to ensure the provision of evidence-based services to those individuals who would most benefit from those services. The Service Packages are described in the Clinical Guidelines. The Clinical Guidelines identify the services available and the intensity of service provision for each package, as well as guide decisions on eligibility and appropriate discharge from a service package.

• Utilization Management (UM). Utilization management processes are an important component of RDM, allowing Local Mental Health Authorities (LMHAs) to manage limited resources and ensure reasonable access to effective services.

• Contracts with the LMHAs. Performance contracts between DSHS and the LMHAs include important general provisions denoting the terms of the contract. Attachments to the contracts stipulate the services targets, performance measures, outcomes, and remedies, sanctions, and penalties that may result from failing to fulfill contract expectations.

• Quality Management. One aspect of quality management activities created to support RDM is the development of a fidelity assessment process. This includes a Fidelity Toolkit and processes for assessing fidelity at the provider, authority, and state levels.

• Data Management. Numerous changes were made to provide data support for the RDM initiative, including the creation of WebCARE and enhancement of the Consumer Analysis Data Warehouse, which allows for extensive monitoring of data for decision-making. Analysis of cost information is provided through the Cost Accounting Methodology (CAM).

• Funding Strategies. To better align funding resources with the goals of RDM, DSHS revised portions of the Medicaid State Plan, Medicaid program rules, and Medicaid Administrative Claiming (MAC).

• For more information, see the RDM Program Manual (PDF, 659 KB)

Email us to provide feedback and comments or to ask questions.
OR mail comments or questions to:
DSHS
MH Program Services – Mail Code 2018
P.O. Box 13247
Austin, TX 78711

This page was last modified November 07, 2007