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Dec 13, 2013 (3 years and 8 months ago)

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Department of Mental Health

624 N. Broadway


Baltimore, Maryland 21205


(410) 955
-
3910

Symposium Agenda

9:00
-
9:10

Bill Eaton

Welcome and opening comments

9:10
-
9:30

Phil Leaf

Introduction to the Public Health Approach

9:30
-
10:30

Panel

Chair: Josh Sharfstein

Secretary,
Maryland
Department of Health and
Mental Hygiene


Improving Behavioral Health: the Public Health Approach

Amanda Harris

Chief Operating Officer, Pathways to Housing

Dave Oslin

Associate Chief of Staff for Behavioral Health,
Philadelphia Veterans
Affairs Medical Center

Ron Manderscheid

Executive Director,
National Association of County
Behavioral & Developmental Disability Directors

Carl Bell

President, Community Mental Health Council, Chicago

Chacku Mathai

Associate

Executive
Director
,
N
ew
Y
ork

A
ssociation of
Psychiatric Rehabilitation Services

10:30
-
10:45

Audience Q & A


10:45
-
11:00

Break


11:00
-
12:00

7 Breakout Groups

E2133, E2527, W2303, W2205, W2207, two in Feinstone

12:00
-
12:30

Groups report back


12:30
-
1:15

Lunch


1:15
-
1:45

Richard Frank

Harvard Medical School
Department of Health Care
Policy

What do ACA and Parity Act mean for the future of
mental health care in the US? Mental Health Care reform
101

1:45
-
2:45

Panel

Chair: Charles Milligan

Deputy Secretary for Health
Care
Financing, State of
Maryland

Financing Mechanisms for Behavioral Health Care
Reform: Opportunities and Challenges

Carolyn Quattrocki

Executive Director
,

Governor’s Office of Health Care Reform

Howard Goldman

Editor,
Psychiatric Services

Barbara Leadholm

Office of Behavioral Health
,
MassHealth

Rita Vandivoort,
Senior Public Analyst,
HRSA

Anna Marsh,
Deputy Director,
CMHS

2:45
-
3:00

Audience Q & A


3:00
-
3:15

Break


3:15
-
4:15

8 Breakout Groups

E2133,W2017,E2527,W2300,W2205,W220
7
,
Feinstone(2)

4:15
-
4:45

Groups Report Back


4:45
-
5:00

Phil Leaf or Bill Eaton

Closing comments

5:00
-
6:30

Wine and cheese reception




Department of Mental Health

624 N. Broadway


Baltimore, Maryland 21205


(410) 955
-
3910

Morning
Breakout
Session
s: The Public Health Approach: Opportunities and
Challenges



Group 1

Group 2

Group 3

Group 4

Covering the whole
population

How to serve those with
dual diagnoses

How to organize services
for children and adolescents

Process and outcomes of
performance management

Room W2207

Room E2527

Room W2303

Room W2205

Lisa Colpe (Chair)

Chet Schmidt

Alan Levitt

Alexander
Cowell

Elspeth Ritchie

Carol Payne

Josh Sharfstein

Charles Milligan

Eric Strain (Chair)

Jackie Duval
-
Harvey

Frances R
andolph

Susan Cycyk

Jeffrey Buck

Tami Mark

Robert Findling

Carolyn Quattrocki

Amanda Harris

Larry Wissow (Chair)

David Dean, Jr

Anna Marsh

Sandra Spencer

Heather Ringeisen

Judith Teich

Dave Oslin

Howard Goldman

Mariana Salamoun

Al Zachik

Jane Plapinger (Chair)

Robert Heinssen

Sarah Duffy

Kirsten Beronio

Thomas Bornemann

William Narrow

Tom Croghan

Richard Frank

Pierre Alexandre

Note taker:

Anna
Flynn

Note taker: Lareina
LaFlair

Note taker: Lindsey Grimm

Note taker:

Ramin Mojtabai



Group 5

Group 6

Group 7

Deciding which programs are
successful

The place of primary care

Reducing disparities

Feinstone Hall

Feinstone Hall

Room E2133

Sharon
Larson (Chair)

Peggy Swarbrick

Chacku Mathai

Harold Perl

Colleen Barry

Ron Mandersheid

Barbara Leadholm

Rita Landgraf

Gerard Gallucci

Laysha Ostrow

Joyce West (Chair)

Jill Rogers

Joseph Gallo

Bernadette Cullen

Anita Everett

Charlotte Mullican

Kamala Allen

Carl Bell

Rita Vandivort
-
Warren


Bradley Karlin (Chair)

Kevin Keegan

Jim Lafferty

Marie Mann

Alexander Ross

John O'Brien

Lisa Townsend

Chacku Mathai


Note taker: Sarah Racz

Note taker:

William Eaton

Note taker: Emma McGinty






Department of Mental Health

624 N. Broadway


Baltimore, Maryland 21205


(410) 955
-
3910

Afternoon Breakout
Sessions: Financing Mechanisms for Behavioral Health Care
Reform: Opportunities and Challenges



Group 1

Group 2

Group 3

Group 4

Organizing finance
mechanisms for children
and adolescents

I
ntegrating funding
streams for dual
diagnoses

Financing
prevention and
identifying resulting cost
savings

Financing non
-
medical
services

Room W2207

Room E2527

Room W2303

Room W2205

Chet Schmidt (Chair)

Marie Mann

Heather Ringeisen

Judith Teich

David Dean, Jr

Sandra Spencer

Richard Frank


Chacku Mathai

(Chair)

Jeffrey Buck

Eric Strain

Larry Wissow

Charles Milligan

Bernadette Cullen (Chair)

Kevin Keegan

Joseph Gallo

Alan Levitt

Jane Plapinger

Susan Cycyk

Jim Lafferty

Carolyn Quattrocki

Anita Everett (Chair)

Joyce West

Bradley Karlin

Tami Mark

Kirsten Beronio

Car
ol Payne

Alexander Cowell

Rita Landgraf

Laysha Ostrow

Note taker: Lindsey
Grimm

Note taker: Lareina
LaFlair

Note taker:

Anna Flynn

Note taker: Sarah Racz



Group 5

Group 6

Group 7

Group 8

Financial implications of
electronic health
records

Financing
ancillary
services and providers
(e.g., case managers,
psychiatric nurses)

Pay for performance

Risk adjustment and
risk sharing
arrangements in
insurance market

Feinstone Hall

Feinstone Hall

Room E2133

Room W2017

William Narrow (Chair)

Sharon Larson

Anna Marsh

Lisa Townsend

Robert Findling

Lisa Colpe

Barbara Leadholm

Frances R
and
olph

(Chair)

Charlotte Mullican

Jackie Duval
-
Harvey

Jill Rogers

Dave Oslin

Rita Vandivort
-
Warren

Robert Heinssen


Thomas Bornemann

(Chair)

Tom Croghan


Kamala Allen

Peggy Swa
rbrick

Gerard Gallucci

Amanda Harris

John O'Brien

(Chair)

Sarah Duffy

Alexander Ross

Harold Perl

Carl Bell


Note taker: Michelle
Colder
-
Carras

Note taker:

William Eaton

Note taker: Christina Pate

Note taker:

Ramin
Mojtabai







Department of Mental Health

624 N. Broadway


Baltimore, Maryland 21205


(410) 955
-
3910

Charges for
Morning

B
reakout
Sessions



Morning Group 1
:
Covering the whole population


1.

What are the priority groups not
currently

covered and who would be left out after the
implementation of the healthcare reform
?


2.

What would be the impact of Supreme Court decision regarding

Medicaid expansion of
ACA

on coverage of near
-
poor population?


3.

What would be the impact

of implementation of ACA on mental health care disparities?


Morning Group 2
:
How to serve those with dual diagnoses


1.

What are the best models for mental health care
and substance use disorder
integration/coordination?


2.

What

will be

the impact of

the ACA

on the coordination of substance abuse and mental
health care services?


3.

How

can we

best define and measure outcomes

in dual diagnosis services?


Morning Group 3
:
How
to organize services for children and adolescents


1.

What is the

best

setting for administration of mental health services

to children and
adolescents
?


2.

What place

will the schools have

in provision

mental healthcare of children and
adolescents after impleme
ntation of the health care reform?


3.

What would be the impact of the ACA on coordination of mental health services in
primary care and specialty mental health services?


Morning Group 4
:
Process and outcomes of performance management


1.

What measures do we ne
ed to use for performance measurement?



Department of Mental Health

624 N. Broadway


Baltimore, Maryland 21205


(410) 955
-
3910


2.

The "when" and the

"how" of measuring performance management.


3.

What would be the impact of the ACA on measurement of process and outcome in
performance management?


Morning Group 5
:
Deciding which programs are
successful


1.

How

should

we define success?


2.

How

should

we

measure success?


3.

How

should

we incentivize successful programs under the ACA?


Morning Group 6
:
The place of primary care


1.

What would be the role of

medical homes in management of mental health
conditions?


2.

How do we get

primary care to take on new roles for mana
gement of substance abuse
and
mental disorders?


3.

What is the
best

model for coordinating mental health services with medical services?


Morning Group 7
:
Reducing disparities


1.

Would ACA re
duce the disparities in access to mental health care?


2.

Would ACA

reduce disparities in quality of mental health care?


3.

How can services be optimized to reduce disparities in access and quality?











Department of Mental Health

624 N. Broadway


Baltimore, Maryland 21205


(410) 955
-
3910

Charges for
Afternoon

B
reakout
Sessions


Afternoon
Group 1: Organizing finance mechanisms for children and adolescents


1.

How would financing mental health care for children and adolescents change under the
ACA?


2.

What are the financial implications of the alternative models of delivery of children
mental hea
lth services?


3.

How can mental health and substance abuse prevention programs be optimally
incorporated in child mental health services?


Afternoon Group 2:
Integrating funding streams for dual diagnoses


1.

What are the challenges in integrating funding
streams for dual diagnoses services after
health care reform?


2.

What

are the implications of changes in block grants after the health care reform?


3.

What would be the challenges in challenges staffing of integrated dual diagnosis
services?


Afternoon Group 3
: Financing prevention and identifying resulting cost savings


1.

How

should

we measure cost savings associated with prevention programs?


2.

How would prevention services be funded

under the ACA?


3.

Can prevention services be

included as part of the essential package of mental health
services?


Afternoon Group 4:

Financing non
-
medical services


1.

How would housing services be funded under the ACA?


2.

How would employment services be funder under the ACA?



Department of Mental Health

624 N. Broadway


Baltimore, Maryland 21205


(410) 955
-
3910


3.


What are the
essential non
-
medical services left out after the implementation of the
ACA?


Afternoon Group 5:

Financial implications of electronic health records (EHR)


1.

How
much would

EHR

save health care

costs?


2.

How can EHR be best designed to safeguard patients'
privacy?


3.


How can EHR be best designed to improve quality of mental health services?


Afternoon Group 6:

Financing ancillary services and providers (e.g., case
managers, psychiatric nurses)


1.

How would the financing of ancilliary services change un
der

ACA?


2.

What would be the s
t
affing needs for ancillary services and providers?


3.

What are the financial implications of new technologies in the delivery of mental health
services (e.g., tele
-
psychiatry)?


Afternoon Group 7:

Pay for performance


1.

Have we
learned any lessons from prior experience with pay for performance in delivery
of physical healthcare that is transferable to mental healthcare?


2.

What have we learned from prior experience with pay for performance in delivery of
mental healthcare in the US

and other countries?


3.

How

can we

make gains

in targeted outcomes of pay for performance generalizable to

a
broader set

of mental health outcomes?



Afternoon Group 8:

Risk adjustment and risk sharing arrangements in insurance
market


1.

Would risk adjustment

and risk sharing arrangements be successful in reducing adverse
selection for the mentally ill in insurance exchanges?



Department of Mental Health

624 N. Broadway


Baltimore, Maryland 21205


(410) 955
-
3910


2.

What are the information needs for risk adjustment?


3.

What are the implications of failure of risk adjustment and risk sharing arrangeme
nts in
insurance markets for financing of mental healthcare?


4.

Are risk adjustments and risk sharing arrangements different

among

psychiatric
patients

and patients with other chronic health conditions?

































Department of Mental Health

624 N. Broadway


Baltimore, Maryland 21205


(410) 955
-
3910

P
anelist and Presenter
Biographies


Carl Bell,
M.D., F.A.P.A.,
F.A.C.P.


Carl Bell is the CEO and President of the

of the Community
Mental Health Council, Inc
,

a large not
-
for
-
profit community
mental health centers in the U.S. He is also
Director of the
Institute for Juvenile
Research and a clinical professor of
psychiatry and public health at the University of Illinois School
of Medicine.

After graduating from the
University of Illi
nois

in
1967 with a Bachelor’s of Science Degree in Biology, he went
on to
Meharry Medical College

where he graduated with an
M.D. His postgraduate training i
n psychiatry was at the Illinois
State Psychiatric Institute in Chicago.

Richard Frank, PhD


Richard G. Frank, PhD, is the Margaret T. Morris Professor of
Health Economics in the Department of Health Care Policy at
Harvard Medical School. He is also a
research associate with
the National Bureau of Economic Research.

Dr. Frank received
a BA in economics from Bard College and a PhD in economics
from Boston University.

Howard Goldman, MD,
PhD


Howard H. Goldman is Professor of Psychiatry at the University

of Maryland School of Medicine. He is
a
mental health services
and policy researcher, who is the author of 300 publications in the
professional literature. Dr. Goldman is the editor of
Psychiatric
Services
. He served as the Senior Scientific Editor of the Surgeon
General's Report on Mental Health for which he was awarded the
Surgeon General’s Medallion.
Dr. Goldman received his M.D.
from Harvard University and Ph.D. in social policy research from
Brandeis U
niversity.

Barbara Leadholm,
MSN, MBA


Barbara Leadholm has served as Commissioner of the
Department of Mental Health since 2007. Under her leadership,
the agency has made significant strides in implementing the
Community First initiative as part of its
continuum of quality
services for people with serious mental illness.

She earned her
Master of Science in Psychiatric Nursing from Boston College
and her Master of Business Administration from Boston
University.

Philip Leaf, PhD


Dr. Leaf is a

professor i
n the Department of Mental Health at
the Johns Hopkins Bloomberg School of Public Health and
director of the Center for Prevention of Youth Violence. His


Department of Mental Health

624 N. Broadway


Baltimore, Maryland 21205


(410) 955
-
3910

work focuses on preventing youth violence and promoting
positive youth development.

Dr. Leaf is also s
enior associate
direct of the Johns Hopkins Urban Health Institute. He received
his PhD from the University of Wisconsin.

Ron Manders
c
heid, PhD


Ron Manderscheid,

serves as the Executive Director of the
National Association of County Behavioral Health and
Developmental Disability Directors. The Association represents
county and local authorities in Washington, D.C., and provides
a national program of technical assi
stance and support.
Concurrently, he is Adjunct Professor at the Department of
Mental Health, Bloomberg School of Public Health, Johns
Hopkins University, and President of ACMHA

The College for
Behavioral Health Leadership. Dr. Manderscheid serves on the
b
oards of the Employee Assistance Research Foundation, the
Danya Institute, the FrameWorks Institute, the Council on
Quality and Leadership, and the International Credentialing and
Reciprocity Consortium. He also serves as the Co
-
Chair of the
Coalition for
Whole Health
. Dr .
Mandersheid received his PhD
from University of Maryland.

Anna Marsh, PhD


Dr. Anna Marsh is

Deputy Director

of the Center for Mental
Health Services (CMHS) in the Substance Abuse and Mental
Health Services Administration (SAMHSA) of the

U.S.
Department of Health and Human Service (DHHS). She has
worked for SAMHSA and its predecessor agency, the Alcohol,
Drug Abuse, and Mental Health Administration, since 1985.


Dr.
Marsh received her Ph.D. in Psychology from Yale University,
where she w
as a Fellow at the Bush Center in Child
Development and Social Policy.

She received her B.A. in
Psychology from George Washington University.



Chacku Mathai, CPRP


Chacku

Mathai has over twenty
-
five years experience in mental
health and community based services in a wide variety of roles
including peer advocate, peer support meeting facilitator, self
-
help educator, community organizer and educator, community
residence mana
ger, psychiatric rehabilitation practitioner,
trainer and program administrator. He currently serves as the
Associate Executive Director for the New York Association of
Psychiatric Rehabilitation Services and is an implementation
partner for the New York S
tate Center of Excellence for the
Integration of Care (CEIC) and the SAMHSA Recovery to


Department of Mental Health

624 N. Broadway


Baltimore, Maryland 21205


(410) 955
-
3910

Practice Resource Center for Mental Health Professionals.

Charles Milligan, JD,
MPH


Charles Milligan was appointed deputy secretary for health care
financing at the
Maryland Department of Health and Mental
Hygiene in March 2011.

In this role, he is responsible for the
state’s Medicaid program. Previously Mr. Milligan was executive
director of The Hilltop Institute at the University of Maryland,
Baltimore County (UMBC
), which is a public sector consulting
and research organization that provides services to the
Maryland Medicaid program, other state and local agencies, the
federal government, and private foundations. Earlier in his
career he was Medicaid and SCHIP direc
tor for the state of
New Mexico.

Mr. Milligan holds a J.D. from Harvard Law
School, an M.P.H. from the University of California at Berkeley,
and a B.B.A. from the University of Notre Dame.


David

Oslin, MD


David Oslin

is an Associate Professor of Psychiatry at the
Philadelphia Veterans Affairs Medical Center and the University
of Pennsylvania Medical Center. Dr. Oslin is the Director of the
VISN 4 Mental Illness, Research, Education, and Clinical
Center (MIRECC) and th
e Associate Chief of Staff for
Behavioral Health at the Philadelphia VAMC. The MIRECC and
BHL support research on comorbidity and integrated care,
respectively, and facilitate a number of research projects for
post
-
doctoral fellows and faculty. He is the a
uthor of over 75
research publications and 30 chapters, books, or editorials.

Dr.
Oslin received is MD from
University Of Virginia School Of
Medicine.

Amanda Harris
,
MP
H
,
LGSW

Amanda Harris is the Chief Operating Officer at Pathways to
Housing in DC.

The
mission of Pathways to Housing DC is to
end homelessness for people living with psychiatric disabilities
by providing housing first and giving support and treatment for
their recovery and integration into the community.

Ms. Harris

received her Master

of Art, Philosophy, and Public Policy from
George Was
hington University

and Master of Social Work from
University of Michigan
.

Josh
ua
Sharfstein, MD


Josh
Sharfstein is the Secretary of the Maryland Department of
Health and Mental Hygiene.


Previously,

he served as the
Commissioner of Health in Baltimore, Maryland and as the
Principal Deputy Commissioner of the U.S. Food and Drug


Department of Mental Health

624 N. Broadway


Baltimore, Maryland 21205


(410) 955
-
3910

Administration.

In these positions, Dr. Sharfstein has pursued
creative solutions tlongstanding public health problems
--

inc
luding drug addiction, school failure, unsafe consumer
products, and most recently, cheap, candy
-
flavored cigars.

Dr.
Sharfstein received his MD from Harvard Medical School.

Carolyn Quattrocki, JD


Carolyn Quattrocki is the Executive Director of Maryland
Governor O’Malley’s Office of Health Care Reform. Prior to her
appointment, she served as a Deputy Legislative Officer and
health policy advisor in the Governor’s Legislative Office, with
primary responsibility for health care
, insurance, and labor
issues
.
Ms. Quattrocki has a law degree from Yale University
and a B.A. from Northwestern University.

Rita Vandivort
-
Warren,
MSW





Rita Vandivort
-
Warren is a Public Health Analyst on financing
services and government project officer in the Quality
Improveme
nt and Workforce Branch, Division of Services
Improvement, Center for Substance Abuse Treatment,
Substance Abuse, Mental Health Services Administration
.

She
currently manages, among other federal projects, the SAMHSA
Spending Estimates Project, which deter
mines the total national
expenditures on mental health and substance abuse services
from all public and private sources. She handles numerous
other assignments in financing and organization of services,
integrating state cross system databases, blending fu
nding for
children’s mental health and substance
abuse

services,
financing services expert to grantees and is the CSAT lead on
Medicaid issues.

Ms. Vandivort
-
Warren received her
Master’s

in
Social Work
from

University of Missouri
-
Columbia.