An Evolving Semi-Monthly Update on Community Behavioral Health in New York
September 19, 2012
The State has released draft agreements outlining the establishment of Special Needs Plans (SNPs) and Mainstream Plans/Behavioral Health Organizations (BHOs) in “Phase 2” of Behavioral Health Managed Care. The plan proposes three models: 1) full benefit SNPs as the preferred managed care vehicle for members with significant behavioral health conditions in New York City and other areas of the State where viable, 2) mainstream plans working with a State certified BHO for management of behavioral health benefits, or 3) mainstream plans managing behavioral health benefits with close monitoring from OMH, OASAS and DOH. For the latter option, mainstream plans would have to demonstrate capacity to meet “rigorous” requirements for the clinical management of behavioral health benefits. The State plans for Phase 2 to be fully operational in the Spring of 2014.
Special Needs Plans (SNPs)
According to the draft agreements, a limited number of SNPs will be selected in New York City to serve Medicaid patients with significant behavioral health needs. While the SNP model will be considered in other areas of the State, it is expected that mainstream plans/BHOs will be the predominant approach outside of New York City. SNPs will be required to function as integrated networks, share information electronically among network providers and deliver intense care coordination services. Health Homes must be included as vital parts of SNP networks. SNPs will be fully integrated plans that will manage the entire Medicaid benefits for patients, including physical health, behavioral health, acute care, long term care and pharmacy. SNPs will be appropriately licensed by the State as risk-bearing entities, and will be subject to “robust” performance metrics monitored by DOH, OASAS, OMH and the City of New York (for NYC SNPs). Both health and behavioral health service savings will be identified and made available for reinvestment (under a State approved reinvestment plan) into the Special Needs system to promote crisis response, recovery outcomes, employment support, housing and collaborative care in primary settings.
Mainstream plans (working with a BHO or managing behavioral health benefits under State oversight) will be responsible for managing all behavioral health services for their members. This will include both the behavioral health benefits already covered and mental health and substance use services that are currently “carved out” of mainstream managed care contracts. OMH, OASAS and DOH will develop and implement new behavioral health quality measures that will track the performance of BHOs and plans. The total behavioral health premium, including all existing behavioral health fee-for-service (FFS), service and administration dollars currently administered by the plan will be separately identified from the health premium and be separately tracked. Behavioral health services savings will be identified and available for reinvestment (under a State approved reinvestment plan) into the behavioral health system to promote crisis response, recovery outcomes, employment support and housing.
On September 6, 2012, The Coalition testified at the OASAS and OMH held a joint public hearing on their statewide plans. The hearing and subsequent plans are intended to address issues concerning the future direction of mental health and substance use disorder services and systems. In our testimony, we commented on the implementation of BHOs and Health Homes and the future direction of integrated care. We spoke to the value of strengthening existing services, most notably the kinds that address the social determinants of health, such as housing, peer and family supports, and employment services. In addition, we drew attention to the need for an adequate and well-trained workforce that is culturally and linguistically competent. You can view our testimony here.
On August 31, 2012, President Barack Obama signed an executive order to improve access to behavioral health services for veterans, service members and military families. The executive order directs the Secretaries of Defense, Health and Human Services (HHS), Education, Veterans Affairs (VA), and Homeland Security to expand suicide prevention strategies and improve access to mental health and substance abuse treatment services. It requires the VA and HHS to establish 15 new pilot programs to integrate consumers served by community-based providers into the VA’s healthcare system.
In addition, the VA will hire and train 800 peer to peer counselors to empower veterans to support other veterans and help meet behavioral health care needs, along with hiring and training 1,600 new mental health professionals. A National Research Action Plan will be developed to address traumatic brain injury (TBI) and posttraumatic stress disorder (PTSD). An Interagency Task Force on Military and Veterans Mental Health (Task Force) will also be established. More details are available in this summary fact sheet.
The NYC Department of Health and Mental Hygiene (DOHMH) seeks individuals to apply to be part of the Federation Mental Health Consumer Advisory Board. Membership is open to New York City residents who receive or have received mental health services in New York City. All applications must be received by Monday, October 15, 2012.
The Federation Mental Health Consumer Advisory Board began in October 2011. The Board is comprised of 20 members at a time, whose primary function is to advise DOHMH on matters related to mental health policy, planning and the provision of services. Consumer Advisory Board members are unpaid, volunteer positions. Members will be provided with Metrocards for transportation. Applicants must be able to attend meetings, which will take place the second Tuesday of each month from 5:00pm-7:00pm alternating locations between Manhattan and Queens. In addition, board members are required to participate in subcommittees that take place outside of regular meetings. For more information please contact Sharon Niederman (Office of Consumer Affairs) by e-mail email@example.com or phone 347-396-7194.
Aaron Vieira, Associate Director of The Coalition’s Center for Rehabilitation and Recovery will be leaving The Coalition after 7 years of dedicated service. Aaron has accepted a new position at the New York Presbyterian/Columbia University Medical Center. There, he will work on a new patient-centered care initiative in NYP/CUMC’s faculty practice organizations (FPOs). He will be responsible for guiding the development of NYP/CUMC’s Learning Academy, delivering training, and providing organizational development consultation to the FPOs. In a statement to Coalition membership and the behavioral health field, Aaron testified that he has “valued the many collaborations with government partners, mental health providers, consumer advocates and academic researchers.” We at The Coalition have benefited significantly from our work with him as well! We wish him great success and much satisfaction in his new position. Aaron will be missed by his colleagues and associates.
Laura Osinoff, who has served as the Deputy Director and Compliance Officer at the Service Program for Older People (SPOP) since 1997, after initially joining SPOP in 1993, is leaving the organization to become the Executive Director at the National Institute for Psychotherapies. We congratulate Laura, who has been an active member of The Coalition. We will miss her participation at Coalition meetings and her contributions to our work.
Pam Corbett, the Legislative Financial Analyst for Mental Hygiene in the NYC Council Finance Division, will be entering the advocacy world as the new Policy Associate for Health and Mental Health at the Citizen’s Committee for Children (CCC). We have appreciated working with Pam on the City’s mental health and substance use budgets and her diligence in grasping how community-based behavioral health programs operate. We are looking forward to continued work with her in her new role. We welcome her to this new corner of our world.
Stella V. Pappas, Chief Operating Officer at ICL, will share a perspective on the social work implications for agency work at the October 12th conference The DSM-5: Proposed Changes, Controversies, and Implications for the Future of Clinical Practice. The conference is sponsored jointly by The NYU Silver School of Social Work and NYC NASW.
To learn more or register for the DSM-5: Proposed Changes, Controversies, and Implications for the Future of Clinical Practice Conference, visit www.nyu.edu/socialwork/continuing.education/dsm5.html
FEGS Health and Human Services has announced the appointment of Nancy L. Klein as Chief Development & Marketing Officer. Ms. Klein has broad expertise in a number of arenas, having served in senior development, marketing and public affairs positions in not-for-profit healthcare, corporate marketing/communications firms, and in New York City and New York State government. She was most recently the Chief Marketing & Revenue Officer at The Leukemia & Lymphoma Society (LLS), the world’s largest voluntary health organization dedicated to blood cancer research and improving the quality of life for patients and their families.
PSCH and Netsmart have launched a unique partnership to furnish clinical and financial shared services to behavioral health providers. This innovative partnership is designed to strengthen business and clinical efficiency and effectiveness of community-based behavioral healthcare providers. It will help community-based behavioral healthcare providers meet an increased demand for services in a time of tight budgets and reduced resources.
Coalition Members advertise staff positions for free on The Coalition’s Job Board! Here's a sample: