Partners in CARE
Community Access to Recovery and Empowerment

The Village Integrated Service Agency, a program of the Mental Health Association of Los Angeles, provides a coordinated, comprehensive range of services to people with schizophrenia and other serious and persistent mental illnesses. This visionary model was established through a statewide competition to design and implement an integrated service delivery system that uses capitated, or fixed level, funding.

Mission

The goal of the Village is to "empower adults with psychiatric disabilities to live, learn, socialize and work in the community." To accomplish this goal, the Village integrates services, support, opportunity and encouragement.

Population Served

The Village provides services to 276 individuals with schizophrenia and other serious and persistent mental illness. Services target those individuals who have used mental health services at a moderate or high rate.

Philosophy

The psychosocial rehabilitative services at the Village build upon strengths and abilities while de-emphasizing illnesses and disabilities. Program staff believe that members learn and grow best through experiences in the real world, not through skills training workshops that isolate members from the rest of society. These experiences help individuals become productive members of their communities.

The Village philosophy is evident in the staff's work. Instead of dictating treatment methods to members, three treatment teams -- each consisting of one psychiatrist, one nurse, one social worker, and several para-professional personal service coordinators -- collaborate with individuals to create a supportive environment that promotes individual growth, hope and the recovery process. Resource specialists in employment, recreation, money management and substance abuse are crucial to members' successes. Members also help each other reach their recovery goals.

None of this would be possible without the innovative model of capitated funding used by the Village. Rather than rely on fiscal administration to make financial decisions, each treatment team receives a budget and works with its members to decide which services to provide or purchase. With an emphasis on coordination and intensive case management, the Village has decreased the amount of funds spent on costly care, including hospitalization. Instead, the Village has shifted more resources into improving members' quality of life through services focusing on employment, housing support, social opportunities, etc.

TREATMENT PRINCIPLES/PROGRAM DESCRIPTION

The Village Integrated Service Agency adheres to the following principles:

• The program establishes collaborative, adult-to-adult interactions between members and staff.
  
• The clinician to patient role is de-emphasized; members are equal partners in determining the services they receive. Staff are coaches rather than therapists.
  
• The Village provides supportive services in whatever settings the members choose.
  
• The Village empowers members by encouraging them to try new things and not be afraid to fail.
  
• Employment is a cornerstone of the Village. All members are encouraged to work and are supported on the job by their personal service coordinator and other Village staff. The Village also provides members with opportunities for paid employment in a variety of settings.
  
• The Village uses a menu approach to help members develop customized service plans. Members select from a list of psychiatric, employment, housing, health, financial and recreation options.
  
• Each service plan incorporates self-help, peer support, family support and community involvement.
  

Program Success

By emphasizing services that support individuals in the community, the Village has reduced expenditures on more costly kinds of care. During the initial three-year period of the Village program, less than 20 percent of the Village members required hospital treatment. The number of hospitalizations was reduced and the length of stay in hospital settings was shortened. The Village spent only 10 percent of its funds on the most expensive services: hospital services, acute residential services and other 24-hour care programs. In contrast, California's public system spends an average of 55 percent of its funds on such care.

Just as significant were the improvements in the members' living, working and social lives. Approximately 60 percent of Village members lived independently, either alone or with a roommate or spouse. About 30 percent of all Village members worked or attended school. Rather than leaving these individuals with serious and persistent mental illnesses in long-term, costly service treatment centers, the Village has fulfilled its mission and allowed many individuals to lead full and productive lives in their communities.

Contact Person:
Martha Long, Director
The Village Integrated Service Agency
456 Elm Avenue
Long Beach, CA 90802
PH: (562) 437-6717
E-MAIL: village1@pacbell.net
WEB: www.mhala.org