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July 19, 2011

July 19, 2011. DRIVERS OF CHANGE. 2. CONTEXT OF CHANGE. 3. Integrated care requires new thinking About recovery, wellness, role of peers Responding to whole health needs; not just one disease Evolving role and new opportunities for behavioral health in health care Parity/Health Reform

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July 19, 2011

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  1. July 19, 2011

  2. DRIVERS OF CHANGE 2

  3. CONTEXT OF CHANGE 3 • Integrated care requires new thinking • About recovery, wellness, role of peers • Responding to whole health needs; not just one disease • Evolving role and new opportunities for behavioral health in health care • Parity/Health Reform • Tribal Law and Order Act • HHS Behavioral Health Coordinating Committee • National Prevention Strategy

  4. BUDGET: STATE BUDGET DECLINES 4 • Maintenance of Effort (MOE) Waivers • FY10/SY09 – 13 SA waivers; $26,279,454 • FY10/SY09 – 16 MH waivers; $849,740,799.50 • FY11/SY10 – 18 SA waivers; $179,410,946* • FY11/SY10 – 19 MH waivers; $517,894,884* *FY11/SY10 waiver information reflects information available as of June 7, 2011 • State Funds • MH – $ 2.2 billion reduced • SA – Being Determined

  5. BUDGET: SAMHSA 5 • ACA • PHS • BA

  6. Substance Abuse and Mental Health Services Administration 6 *Note: This chart includes Budget Authority, ACA Prevention Funds, and PHS Evaluation Funds ($131.5M – already included within corresponding program totals).

  7. Substance Abuse and Mental Health Services Administration FY 2011 Enacted Major SAMHSA Non-Block Grant Programs 7 *Note: This chart does not include Block Grants or ACA Prevention Funds. The PHS Funds ($31.3M) are included in the above corresponding program totals.

  8. PARTNERING – WHERE CAN WE START? 8

  9. SAMHSA’S THEORY OF CHANGE 9

  10. SAMHSA GRANTS TO COUNTIES AND COMMUNITIES (2011) • Adult Treatment Court Collaboratives • TCE-Health IT • Enhancing Adult Drug Court Services, Coordination, and Treatment (Joint program with DOJ/BJA) • System of Care Expansion Planning Grants • Minority AIDS Initiative TCE • Cooperative Agreements to Benefit Homeless Individuals (Short Title: CABHI) • http://www.samhsa.gov/grants/

  11. SAMHSA Grants for Counties and Communities (2010) • Child Mental Health Initiative (CMHI) • Mental Health Transformation Grants • Community Resilience and Recovery Initiative (CRRI) • Drug Free Communities Support Program • Drug Free Communities Mentoring Program • Juvenile Drug Courts • Treatment for Homeless • SAMHSA Grants For Programmatic Directives • Assertive Adolescent and Family Treatment • SAMHSA Juvenile Treatment Drug Courts • Grants to Expand Substance Abuse Treatment Capacity in Targeted Areas of Need - Local Recovery Oriented Systems of Care • Children Affected by Methamphetamine

  12. SAMHSA’S BUDGET: FY 2012 17 • Substance Abuse – State Prevention Grants (SA-SPG) • Creates a sustainable and predictable source of substance abuse prevention funding for the 50 States, the District of Columbia (DC), and eight Territories that will require focus on high-risk communities and youth • Moves the Strategic Prevention Framework State Incentive Grant (SPF-SIG) approach to scale across the Nation

  13. SAMHSA’S BUDGET: FY 2012 18 • Requires States and Territories to: • Use a comprehensive, data-driven planning process to identify and address problems in communities, and hold States and the Territories accountable for achieving measurable outcomes for their residents. • Allocate at least 80 percent of the funds to local high-risk, high-need communities to organize coalitions or other approaches to carry out activities in keeping with the plan while addressing the particular needs of the community. 3. Establish a comprehensive community plan that utilizes evidence-based and/or proven successful programs, policies or practices

  14. SAMHSA’S BUDGET : FY 2012 19 • Mental Health – State Prevention Grants (MH-SPG) - Provide support to States and Territories in their efforts to implement State-wide comprehensive prevention strategies and coordinated mental health promotion, mental illness prevention, and suicide prevention services for children, youth, and young adults from birth through age 25 by: • Using evidence-based practices to promote known protective factors for mental health in children and youth and to reduce risk factors for mental illness and substance abuse; • Preventing or delaying the onset of mental illnesses and prevent suicide; and, • Building mental health promotion and mental illness prevention capacity and infrastructure at the State, local, and community levels.

  15. DATA AND RESOURCES • NSDUH: • Substance Use Disorders in Substate Regions - http://www.oas.samhsa.gov/2k10/190/SubstateRegionsHTML.pdf • Data on small geographic areas provide insight into the nature and scope of substance use problems and help State and local public health authorities to better understand and effectively address the needs in their communities

  16. DATA AND RESOURCES • Behavioral Risk Factor Surveillance System (BRFSS) • SAMHSA proposes the use of mental illness and stigma modules, including the K6 questions in FY 2012 • 16 States administered the mental illness and stigma module in 2009 • Exploring link with ACE module • C-EMS • In FY 2012, SAMHSA proposes the development of a community-level, early warning system to detect the emergence of new drug threats and to assist in the identification of public health and safety consequences of drug abuse

  17. NATIONAL BEHAVIORAL HEALTH QUALITY FRAMEWORK 17 • Building on the National Quality Strategy for Improving Health Care • 6 goals • Effective prevention, treatment and recovery practices • Person- and family-centered • Coordinated • Best practices • Safe • Affordable, high quality • 3 levels of measures • SAMHSA funded programs • Practitioner/system-based • Population-based

  18. NATIONAL BEHAVIORAL HEALTH QUALITY FRAMEWORK 18 • June 15 Webcast/Listening Session – 500+ people • Draft document on web http://www.samhsa.gov/healthreform/framework.aspx?from=carousel&position=1&date=07052011 • Use of SAMHSA tools to improve practices • Models (SPF, coalitions, SBIRT, SOCs, suicide prevention) • Emerging science (e.g., oral fluids testing) • Technical Assistance (TA) capacity (trauma) • Partnerships (meaningful use; Medicaid & Medicare quality measures) • Services research as appropriate

  19. WHAT AMERICANS BELIEVE 19

  20. HOW DO WE CREATE . . . 49 • A national dialogue on the role of behavioral health in public life • Behavioral health = healthy community • Common message & public health approach that engages everyone • General public, elected officials, schools, families, churches, health professionals; persons affected by MI and addiction and their families • A desire for a personal public health commitment to saving and improving lives

  21. SAMHSA PRINCIPLES 21 www.samhsa.gov

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