The National Council for Community Behavioral Healthcare

1. Representing 1667 community organizations that provide safety-net mental health and substance use treatment services to nearly six million adults, children and families The National Council for Community Behavioral Healthcare

2. Commitment to Action - Practice and Policy “The most effective way to cope with change is to help create it” L.W. Lynett

3. Clinical Design and Payment Mechanism driven by: Medicare (and the Public Health Insurance Option) as incubator for design changes, followed by… State or National Exchanges, that become huge buyers of insurance over time and… State Medicaid Programs that are challenged to manage current enrollees & large number of high cost, indigent, previously uninsured, and… Integration of Medicare and Medicaid funding to manage high cost Dual Eligible population Healthcare Reform: Managing Total Health Expenditures

4. Practice Improvement Agenda: access; healthcare homes; and outcomes • Access and Retention (SPQM) Initiatives; Six Sigma; National Benchmarking • Transition Age Youth Project • Criminal Justice Leadership Forum • Psychiatric Leadership Project; CEO University; and Middle Management Academy • Health Promotion - Healthcare Collaborative Project; Learning Communities; and Mental Health First Aid

5. Primary Care/Behavioral Health Learning Communities Current Learning Communities National Council Integrated Health Learning Community (27 sites) Mental Health Corporations of America (30 sites) Michigan IH Learning Community (18 sites) Pending Learning Communities Hogg Foundation Learning Community (10 sites) HRSA (5 sites)

6. Healthcare Homes - Primary Care/Behavioral Health Project Safety net population in every community has seamless access to both mental health/addiction and physical healthcare services. Stepped care - mental health/addiction and physical healthcare providers, with roles defined, referral protocols and cross-placement of clinical staff. Phases I and II : 12 sites in 10 states Phase III and IV– 9 additional sites • 45% pts. treated for depression - PHQ-9 • 85% pts. treated for depression assessed for hypo-mania or mania • 90% pts. treated for depression got suicide assessment • 100% pts. receiving atypical anti-psychotics assessed for hyperlipidemia.

7. A Collaborative Partnership • National Council • Maryland State Department of Mental Hygiene • Missouri Department of Mental Health • 350 instructors certified,3,000 community members trained

9. Public Policy Health care reform design work focused on needs of Americans with serious mental health/substance use disorders and challenges for Community Behavioral Healthcare Organizations.

10. 2009 Policy Agenda • Regulatory Guidance for Parity Legislation • HIT Incentives • Behavioral Health/Primary Care Grant Program • Medicaid Healthcare Homes • Federal status for Community Behavioral Health — FQBHC • Safety Net Protection - Increase to Mental Health Block Grant

11. Policy progress… • Wellstone Domenici parity law applies to all qualified health plans  • Individuals with serious mental illness eligible for Medicaid health care homes option & behavioral health organizations included as designated providers • Establishes criteria for certifying Federally Qualified Behavioral Health Centers. • Expands Medicaid 340B drug discount program to public addiction and mental health providers. • Authorization and increased funding for Behavioral Health/Primary Care Grant Program

12. Together We Will! 6th Annual HILL DAY June 29&30, 2010