An Act To Cut the Cost of Behavioral Health Care in Hospital Emergency Rooms and To Enhance Access to Peer Support and Community-based Services

CONCEPT DRAFT SUMMARY

This bill is a concept draft pursuant to Joint Rule 208. This bill proposes to provide community-based mental health and substance abuse providers in emergency rooms to triage both mental health and substance abuse patients, in order to refer such patients to more appropriate and less expensive community based treatment, and use the savings to increase access to peer support services.

Amendment to change from a concept draft to a Resolve directing the Department to:

1. Review Emergency Department usage information to determine the number/percentage of people who present in the ED with behavioral health or substance issues using MaineCare Data and any other health information studies available.

2. Determine the percentage of people who present with only behavioral health or substance abuse issue (without a co-occurring physical health issue that must be dealt with in the ER)

3. Work with stakeholders (including behavioral health providers, consumers, families, law enforcement, emt personnel, hospital staff) to determine the reasons for people with solely behavioral health and substance abuse issues being taken to the Emergency Rooms and the barriers to taking them to a more appropriate community based emergency service

4. Research best practice models around the country that triage this population away from Emergency Rooms BEFORE they incur the cost of emergency room admittance and evaluation, and ways to train/educate emergency personnel in knowing more accurately where to take people. Special attention shall be given to:

5. Estimate the cost savings that would be associated with this diversion

6. Recommend augmented peer and community supports that could be funded with these savings that would lessen the need for emergency services.

7. Report back to the HHS Committee of the Legislature in March, 2012 with at least three different models that might accomplish the goal of Diverting behavioral health and substance abuse clients to more appropriate and cost-effective services for the Committee’s review and action.

To Reflect New Opportunities Provided By Parity, Health Reform, Emerging Science

The Substance Abuse and Mental Health Services Administration (SAMHSA) announced a new approach for the Substance Abuse Prevention and Treatment Block Grant (SABG) and the Community Mental Health Services Block Grant (MHBG) in the Federal Register today.

“Changes in healthcare delivery structures, rapid adoption of health information technology, scientific advances in prevention and treatment services, growing understanding of recovery, and implementation of the Mental Health Parity and Addiction Equity Act and the Affordable Care Act will greatly enhance access to prevention, treatment and recovery support services nationwide,” said SAMHSA Administrator Pamela S. Hyde,. J. D. “These changes also present opportunities to establish the role of the block grants as critical underpinnings of the public substance abuse and mental health service systems, drivers of quality and innovation, and essential resources for transforming health care in America, especially in difficult economic times.”

Under this new approach states and territories will have the opportunity to use block grant dollars for prevention, treatment, recovery supports and other services that supplement services covered by Medicaid, Medicare and private insurance. The Block Grant funds will be directed to four purposes:

Fund priority treatment and support services for individuals without insurance or for whom coverage is terminated for short periods of time.

• Fund those priority treatment and support services not covered by Medicaid, Medicare or private insurance for low income individuals and that demonstrate success in improving outcomes and/or supporting recovery.
• Fund primary prevention - universal, selective and indicated prevention activities and services for persons not yet identified as needing treatment.
• Collect performance and outcome data to determine the ongoing effectiveness of behavioral health promotion, treatment and recovery support services and plan the implementation of new services on a nationwide basis.

SAMHSA will be working with states and territories to consider new factors in their redesigned plans such as:

• Taking a broader approach in reaching beyond the populations they have historically served through block grants.
• Conducting a needs assessment and developing a plan that will identify and analyze the strengths, needs and priorities of the state/territory’s behavioral health system – painting a more complete picture of their behavioral system.
• Designing and developing collaborative plans for health information systems - grants and other funding.
• Forming strategic partnerships to provide individuals better access to good and modern behavioral health services.
• Increasing focus on recovery for person experiencing mental health problems and substance use problems.
• Redesigning systems and services to be more accountable for improving the caliber and performance of services funded.
• Describing tribal consultation activities.

Currently the two SAMHSA block grant programs have been administered somewhat differently by separate SAMHSA centers, and states have had idiosyncratic structures and timing for accepting, planning and accounting for these grants. In an effort to streamline application and funding procedures, SAMHSA is now issuing guidance promoting consistent application, assurance and reporting dates across both block grants and offering states and territories the option to submit one coordinated plan for both grants. 

For detailed information about proposed changes to the block grant programs, including their application policies, one can go to http://samhsa.gov/grants/blockgrant/ or to the Federal register notice at: http://www.gpo.gov/fdsys/pkg/FR-2011-04-11/pdf/2011-8520.pdf                      

Mental Health America Launches Online Support Community

Connects Families, Friends, and Caregivers in Safe, Secure Environment

 Contact: Steve Vetzner, (703) 797-2588 or This email address is being protected from spambots. You need JavaScript enabled to view it.

ALEXANDRIA, Va. (July 26, 2010)—Mental Health America today announced it has launched the Mental Health America Support Community—a new online community that connects families, friends, and caregivers for support and inspiration.  

The community has been created in partnership with Inspire, which works with nonprofits to provide safe, online health and wellness communities to help members live mentally healthier lives.

Located at http://www.mentalhealthamerica.net/community, the community will allow registered members to take part in moderated discussion groups and post personal journals, enabling them to support one another through their individual journeys and experiences.

Those joining the community will find coping strategies and answers to their questions, as well as vital support, compassion, encouragement, and inspiration from others sharing experiences similar to theirs. Registration is free; upon joining, members will have complete control of their privacy options and can communicate with others in a safe, secure environment.

“We know how important social support and connecting with others are to protecting our mental health and improving well-being,” said David Shern, Ph.D., president and CEO of Mental Health America. “This new community will allow more people to connect with each other, find valuable resources, and learn and gain inspiration from others.”

Brian Loew, CEO of Inspire said: "We are pleased to partner with Mental Health America. Through their partnership with Inspire, we hope that Mental Health America will be able to reach even more people and provide a place to support living mentally healthier lives. Helping people find others who are also dealing with these issues fills an overwhelming need. Mental Health America is a trusted organization and champion of those trying to lead mentally healthy lives. We are pleased to welcome them to the Inspire family." 

The Mental Health America Support Community features 20 discussion topics. Once they have registered, members can:

• Read and participate in discussions
• Post personal profiles – share as much or as little as they’d like about themselves
• Post personal photos or videos
• Invite other members to be friends
• Create a personal journal (or “blog”) where they can express their feelings and allow others to comment
• Read others’ journals to learn about their experiences

"Strategies for Change" Free Online Training on Implementing Plans and Practices to End Homelessness

The Substance Abuse and Mental Health Services Administration (SAMHSA) is launching “Strategies for Change,” five new self-guided, stand-alone training modules, free of charge.

The modules are designed for service providers and community stakeholders working to end homelessness for people with serious mental illnesses and/or co-occurring substance use disorders. They include practical advice for planning, organizing, and sustaining an integrated system of care. Courses include: Homelessness 101, Strategic Practices, Partnering and Planning, Financing, and Evaluation.

Upon completion of each module, continuing education units are available through NASW, NAADAC, and CRCC. 

For more information visit: SAMHSA’s Homelessness Resource Center