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Winning Strategies

Winning Strategies. Best Practices and Innovations As Demonstrated in States Across the Country. A Recent View of State Practices. NAMI releases Grading the States in March 2006 National report card: we eek out a “D”

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Winning Strategies

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  1. Winning Strategies Best Practices and Innovations As Demonstrated in States Across the Country

  2. A Recent View of State Practices • NAMI releases Grading the States in March 2006 • National report card: we eek out a “D” • Five states get a “B”; eight states flunk; two states choose not to respond • Report focused on 39 criteria reflecting NAMI values • Other values/priorities/opinions relevant

  3. The Best Practice Realizes… • Poor mental health does not occur in a vacuum • Debate on criminal justice, education, general healthcare, and workforce development must include acknowledgement of mental health • Maintenance is not a positive outcome

  4. Financing • Prop 63 (CA) • The New Mexico Behavioral Health Purchasing Collaborative • Special tax districts that promote local-based financing of MH services (CO & AZ) • Privatized healthcare has yet to demonstrate comparable capacity for treating mental illness as experienced in public sector

  5. Housing Development • Real estate transaction fees in IL to fund housing development • Dedicated housing initiatives through legislative process in states such as NJ (10,000 units) and NY (36,0000 units)

  6. Jail Diversion Strategies • Telephonic triage and screening program that support treatment and linkage to services (KY) • Prison staff education initiatives (IN) • Mandated county diversion strategies (TX) • Post-booking jail diversion strategies through arraignment courts (CT)

  7. State Initiated Parity • Best laws exist in Connecticut, Maryland, Minnesota and Vermont; to be joined by Oregon in 2007 • Inclusion of both substance abuse and mental health is critical • Data from analysis of federal employee benefits plan supports low-fiscal impact of parity • Healthcare transformation and the tailoring plans?

  8. Approaches to Medication Access • Formalized prescriber feedback approach to address poly-pharmacy and other outliers (MO) • Strict script limits problematic – “exempting mental health drugs from count” • Research demonstrates uniqueness of mental health medications; best approachesprovide prescriber discretion

  9. Strategies to Broaden Cultural Competency • Expectations of monitoring efforts at the provider level (CA) • Staff expectations for diversity in communication skills (AZ) • Subcommittee strategy to develop approaches to unique populations based upon cultural background, living situation (WA)

  10. Proven Practices As Cornerstone of System of Care • Assertive community treatment • Supported employment • Family and consumer education • Peer run/peer operated programs • An emphasis on recovery • Seven state transformation: CT, MD, OH, OK, TX, NM, & WA

  11. Other Areas to Concentrate • Increased use of A/V technologies to aid rural constituents • Invest in system access supports – web infrastructure and front-end customer service • Full health promotion beyond just treating mental illness • Investment in peer run/peer supported services • Efforts in reducing use of restraints and seclusion

  12. Disaster Response Related to Mental Health Services • Mississippi, Louisiana, Alabama, Texas mental health systems responded quickly and to differing degrees • Mutual aid agreements appeared to activate quickly and effectively • Medicaid provided reasonable guidance and assistance

  13. Consumer/Family Involvement Is Essential • Statewide planning (WV’s task force) • Medicaid advisory bodies • Mental Health Agency planning participation • Expectations for consumer/family surveys • Data collection is critical

  14. Future Practices Related to DRA/Reform Initiatives • Cost sharing – state option • Benefits design for expansion programs – importance of including a mental health benefit • Documentation standards • “Deliberate and deliberative” (NE)

  15. NAMI • The Nation’s Voice on Mental Illness • Steven Buck, Director of State Policy, 405/749-1366 or sbuck@nami.org

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