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Department of Health and Mental Hygiene Behavioral Health Services 2013 and Beyond

Department of Health and Mental Hygiene Behavioral Health Services 2013 and Beyond . Integrating Mental Health and Addiction Treatment in Maryland Tuerk Conference April 9, 2013. Behavioral Health Services. Mental Hygiene Administration Developmental Disabilities Administration

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Department of Health and Mental Hygiene Behavioral Health Services 2013 and Beyond

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  1. Department of Health and Mental HygieneBehavioral Health Services 2013 and Beyond Integrating Mental Health and Addiction Treatment in Maryland Tuerk Conference April 9, 2013

  2. Behavioral Health Services • Mental Hygiene Administration • Developmental Disabilities Administration • Alcohol and Drug Abuse Administration • Forensic Services • Residents Grievance System

  3. Mental Hygiene Administration today • 5 regional facilities (one with an adolescent unit) • 2 child and adolescent residential facilities • 130,000 + served; Budget: over $1 billion • Funds the Specialty Mental Health Service System for Medicaid and the uninsured • Fee for service reimbursement • Authorization for services based on medical necessity • Funds the Specialty Mental Health Service System for Medicaid and the uninsured • Core Service Agencies function as the local mental health authority

  4. Mental Hygiene Administration • Program-specific regulations include: appeals process, due process, provider requirements • Various levels of oversight-MHA, OHCQ, MHA, Medicaid • Coordination of care through case managers, ASO, CSAs • Value Options Maryland-Administrative Service Organization (ASO) • manages utilization, authorization, auditing, data collection and reporting • coordinates with providers and manage care organizations • facilitates collaboration with other state serving agencies • MHA audits appropriateness of clinical decision making and compliance with contract

  5. Alcohol and Drug Abuse Administration • 49,762 persons served in FY2012 • Budget of approximately $150,000,000 • Grant funds for ambulatory (uninsured only), residential and recovery services. • Grant funds awarded to jurisdictions for allocations based on service needs. • MCOs receive funding for ambulatory substance abuse services • Levels of care determinations based on ASAM II criteria • Public health initiative • Maryland Center of Excellence on Problem Gambling • Overdose Prevention Initiative • Smoking Reduction Initiative

  6. Alcohol and Drug Abuse Administration Today • ADAA funds specialized programs • Buprenorphine Initiative • Methadone clinics • Regulations • OHCQ • Medicaid • ADAA • Federal government • MCO-specific Administrative and clinical management • Each MCO determines authorization for services • SMART program – collects data, has EHR

  7. DHMH-Behavioral Health Services Beyond 2013 Mission: • To develop and manage an outcome guided behavioral health service delivery system: • Integrating prevention, health disparities, recovery principles evidence based practices and cost effectiveness

  8. Integration-Why now? • Leading causes of death • Co-morbidity of somatic and behavioral health conditions • Expansion of health care access • Need for consumer specific outcome measures and population specific outcome measure • Performance measures to effectiveness of treatment services

  9. Integration-Why now? • Improve communication between providers and consumers and health care managers • Engage consumers in managing illness and recovery • Continuity of care • Reduce fragmentation in the service delivery system • Outcome driven process for administrative and clinical decision making • Reduce disparities in health care • Reduce morbidity and overall cost of care • Expand role to include public health initiatives

  10. Status of Integration-Financing Model FINANCIAL MODEL • Recommendation – Behavioral Health Administrative Service Organization that manages carved out funding for substance abuse and mental health treatment integrating evidence based practices and performance risk • Next steps: • Collaboration between DHMH agencies • Draft next ASO request for proposal • Obtain stakeholder input

  11. Status of the Integration of the Regulations • Objective: Maintain quality of care • Maintain access to clinically appropriate services • Remain consumer sensitive and welcoming • Address both mental health and substance abuse service delivery systems • Strategy: Accreditation • Consistent with current medical practice • Sets minimum standards • Reduces redundancy • Simplification of the regulations with some degree of flexibility • Integrates evidence based practice • Regulations to address services not covered by accreditation

  12. Merger of the Administrations GOALS: • Maintain the strengths of both agencies – MHA & ADAA • Align the Behavior Health Administration more closely with a public health oriented agency. • Engage administrative representatives and stakeholders • Establish new guidelines that reflect the changing role of the local authorities • Provide for ongoing cross-training and agency collaboration

  13. Status of the Integration of the ADAA and MHA • Update organizational chart to reflect expansion of the public health mission and restructured oversight • Overdose Initiative, Suicide Commission, Drug Monitoring, Smoking Reduction, Primary care consultation, Problem Gambling, Early Intervention • Monitor attrition, gaps in staffing, changes in the administration, liaisons with other departments, • Propose statutory/regulatory language for the consolidation of the agencies • Continue with cross-training of DHMH, MHA and ADAA staff

  14. Proposed Organizational Chart

  15. Next Steps • Jurisdictional needs assessment • Jurisdictional diversity: • Integrated administrative systems • Access to services within the jurisdictions • Population specific needs • Data collection and reporting • Continue with merger process, cross training, agency collaborations • Identify programming needs, operational needs • Develop a provider “toolkit” • Engage stakeholders in the process to identify provider and consumer transitional needs and outcome measures • Establish communication process and formal timeline

  16. Acknowledgements • Consumers, Providers, Elected Officials, Local Health Departments and staff • Brian Hepburn, M.D. Execute Director of the Mental Hygiene Administration • Charles Milligan, Deputy Secretary for Health Care Financing • Kathleen Rebbert-Franklin, LCSW-C, Acting Director of ADAA

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