Building Stronger Behavioral Health Services in ND

1. Building Stronger Behavioral Health Services in ND Framing Key Issues and Answers March 25, 2014

2. Welcome • Thank you for participating • www.NDBehavioralHealth.com • Under Updates – Comprehensive Strategic Plan • Under Presentations – UND Medical School PowerPoint • Future Plans for this website • Plan for the Morning • For those on the phone, going until about 9:30. Please call again at 11:00 am. • For those present, we plan to break into small groups at 9:30 until 11:00 am to work on action plans. • At 11:00 we will have reports from the small groups, have an update from the State’s consultant, and discuss what is next.

3. History • Past legislative testimony and studies. • Rapid growth within ND (Oil Boom). • Strong economy brings new BH challenges. • Concerns expressed by BH consumers, advocates, providers, law enforcement, the courts, and others. • Numerous media stories.

4. History • Section 1 of 2013 SB 2243 • Calls for Study of Behavioral Health Needs • Interim Human Services Committee • RFP submitted for a consultant • Schulte Consulting, LLC was recommended/selected • Independent Committee Previously Formed • Initial Steering Committee members • Sen. Judy Lee • Sen. Tim Mathern • Rep. Kathy Hogan • Rep. Pete Silbernagle • John Vastag, BCBS of ND, formerly with Sanford Health • Gary Wolsky/Joy Ryan, Village Family Services • Rod St. Aubyn

5. History • Secured funding for a BH retreat/website. • Identified stakeholders that should be included in the initial retreat. • Consumers and Advocates • Direct Care Providers • Key System Partners (Law Enforcement, Schools, Courts, Public Health, etc.) • Public Sector (Governor’s Office, Legislators, and Human Service Representatives, Native American Representatives) • Meant to be a resource for the consultant (time/financial constraint).

6. History • Held a very successful retreat on February 6th-7th with the representative stakeholders. • Today is a continuation of our February 6-7 Retreat and to expand stakeholder participation. • We have made great progress to date, but we have a lot more to accomplish. • To date we have: • Identified Behavioral Health Challenges • Identified BH successful programs and services • Identified possible solutions • Compiled all of this information into a proposed Strategic Plan with Initiatives and Goals.

7. Purposes/Goals • Identify the BH challenges faced in ND • Identify the priority/urgency of each of these challenges. • Get a consensus of the solutions and action plans. • Advocate these solutions to the Consultant, Legislative Interim Human Services Committee, other policy makers, to other stakeholders, and to the public. • Monitor actions to develop and implement the identified solutions. • Participate in follow-up meetings to update/revise the new BH Plan in the future.

8. Purposes/Goals • You represent your area of expertise. We ask that you update and educate your fellow professionals. • Establish a BH Model that can be duplicated and modified by other states. • But most importantly, create a BH system that serves ND citizens in a timely and cost efficient manner.

9. Adult Mental Health • Strategic Initiative 1: Increase accessibility to behavioral health services through a more consistent, coordinated and transparent system of care • Goal 1.1 Identify core services available in all regions of the state including public and private providers. Have a consistent public sector delivery system that is routinely monitored based on public data. • Goal 1.2 Identify and inform consumers/partners of available services • Goal 1.3 Strengthen relationships between providers • Goal 1.4 Expand and train workforce and key partners • Goal 1.5 Develop crisis response system with accountability standards • Goal 1.6 Improve Discharge Planning and Coordination • Goal 1.7 Expand Case Management

10. Adult Mental Health • Strategic Initiative 2 Identify and address changes in Rules/NDCC/Licensing issues • Goal 2.1 Review and Revise commitment procedures/processes • Goal 2.2 Review Licensing requirement for various mental health/LAC professionals • Goal 2.3 Revise the NDCC to permit Law Enforcement to access behavioral health information to assure public safety

11. CHILDREN AND ADOLESCENT MENTAL HEALTH • Strategic Initiative 1: Increase accessibility to specialized behavioral health services through a more consistent, coordinated and transparent system of care • Goal 1.1 Identify core services available in all regions of the state including public and private providers. Have a consistent public sector delivery system that is routinely monitored based on public data. • Goal 1.2 Expand residential treatment services • Goal 1.3 Expand home and community based services for children/adolescents • Goal 1.4 Expand Case Management • Goal 1.5 Expand and train workforce and key partners

12. CHILDREN AND ADOLESCENT MENTAL HEALTH • Strategic Initiative 2: Expand availability of behavioral health services within the schools • Goal 2.1 Expand onsite behavioral health services within the schools

13. CHILDREN AND ADOLESCENT MENTAL HEALTH • Strategic Initiative 3: Establish early childhood behavioral health screening and assessment • Goal 3.1 Establish consistent early childhood behavioral health screening, assessment and treatment to be available for all pre-school children.

14. ADULT AND ADOLESCENT SUBSTANCE ABUSE • Strategic Initiative 1: Increase accessibility to specialized behavioral health services through a more consistent, coordinated and transparent system of care • Goal 1.1 Identify core services available in all regions of the state including public and private providers. To have a consistent public sector delivery system that is routinely monitored based on public data. • Goal 1.2 Expand Medical and Social detoxification resources • Goal 1.3 Identify funding structures both public and private that support a comprehensive system of care. • Goal 1.4 Expand and train workforce and key partners

15. ADULT AND ADOLESCENT SUBSTANCE ABUSE • Strategic Initiative 2: Inform the public of the risks of substance abuse through education and media efforts to reduce abuse • Goal 2.1 Develop a major public information campaign and primary prevention initiative.

16. QuestionsCommentsorSuggestions

17. Recess the Callers • We will soon begin the small group sessions. • Please call back at 11:00 to hear the reports from each group and to also hear about our future plans.

18. “Ground Rules” • Use allotted time judiciously • Participate • Be Specific – Use examples, explain your reasons • Be Respectful and Courteous • Everyone is an expert and expected to contribute • Disagree if you do, but appropriately and respectfully • Listen, Listen, Listen • Be Open-Minded • Agree to donate time and efforts to pursue our goals.

19. Breakout Sessions • We want the stakeholders to start the process of developing action plans. • Each Small Group will identify action plans for their group and the facilitator will report on their work beginning at 11:00 am. • The stakeholders will breakout into small groups for: • Adult Mental Health Services • Children’s Mental Health Services • Substance Abuse Services

20. Breakout Session • Breakout Groups should consider 3 core questions. • Are there issues or suggestions/recommendations under the goals that should be added? (10 minutes) • Brainstorm action plans in each area (60 minutes) • Prioritize action steps for each goal area (20 minutes) • Facilitators be prepared to present your groups ideas. • We will come back at 11:00 am for those reports.

21. Breakout Groups

22. Breakout Group Reports

23. Comments by Renee SchulteSchulte Consulting, LLC

24. What’s Next? • The Action Plans will be compiled and posted on our website. • The Steering Committee has a meeting with the Governor this afternoon. • We will be reporting our progress to the Human Services Committee at their next meeting, tentatively scheduled for April 9th. • Renee Schulte and Elle will be completing their stakeholder visits around the state and completing their report early this summer. Hopefully, our recommendations will become a part of their report.

25. Momentum • We have made significant progress. • Like the cliché, this is a marathon and not a sprint. • Solutions will not happen all at once. • Some make take state funding, others may only take collaboration. • Success takes everyone’s commitment and help. • This requires continuous review and refinement. • Like a large locomotive, we have the momentum and nothing is going to stop us now.

26. Thank you for your participation and your involvement!!! Let’s Get Our Locomotive Moving!!!!