Winning Strategies Best Practices and Innovations As Demonstrated in States Across the Country

A Recent View of State Practices NAMI releases Grading the States in March 2006 National report card: we eek out a “D” Five states get a “B”; eight states flunk; two states choose not to respond Report focused on 39 criteria reflecting NAMI values Other values/priorities/opinions relevant

The Best Practice Realizes… Poor mental health does not occur in a vacuum Debate on criminal justice, education, general healthcare, and workforce development must include acknowledgement of mental health Maintenance is not a positive outcome

Financing Prop 63 (CA) The New Mexico Behavioral Health Purchasing Collaborative Special tax districts that promote local- based financing of MH services (CO & AZ) Privatized healthcare has yet to demonstrate comparable capacity for treating mental illness as experienced in public sector

Housing Development Real estate transaction fees in IL to fund housing development Dedicated housing initiatives through legislative process in states such as NJ (10,000 units) and NY (36,0000 units)

Jail Diversion Strategies Telephonic triage and screening program that support treatment and linkage to services (KY) Prison staff education initiatives (IN) Mandated county diversion strategies (TX) Post-booking jail diversion strategies through arraignment courts (CT)

State Initiated Parity Best laws exist in Connecticut, Maryland, Minnesota and Vermont; to be joined by Oregon in 2007 Inclusion of both substance abuse and mental health is critical Data from analysis of federal employee benefits plan supports low-fiscal impact of parity Healthcare transformation and the tailoring plans?

Approaches to Medication Access Formalized prescriber feedback approach to address poly-pharmacy and other outliers (MO) Strict script limits problematic – “exempting mental health drugs from count” Research demonstrates uniqueness of mental health medications; best approaches provide prescriber discretion

Strategies to Broaden Cultural Competency Expectations of monitoring efforts at the provider level (CA) Staff expectations for diversity in communication skills (AZ) Subcommittee strategy to develop approaches to unique populations based upon cultural background, living situation (WA)

Proven Practices As Cornerstone of System of Care Assertive community treatment Supported employment Family and consumer education Peer run/peer operated programs An emphasis on recovery Seven state transformation: CT, MD, OH, OK, TX, NM, & WA

Other Areas to Concentrate Increased use of A/V technologies to aid rural constituents Invest in system access supports – web infrastructure and front-end customer service Full health promotion beyond just treating mental illness Investment in peer run/peer supported services Efforts in reducing use of restraints and seclusion

Disaster Response Related to Mental Health Services Mississippi, Louisiana, Alabama, Texas mental health systems responded quickly and to differing degrees Mutual aid agreements appeared to activate quickly and effectively Medicaid provided reasonable guidance and assistance

Consumer/Family Involvement Is Essential Statewide planning (WV’s task force) Medicaid advisory bodies Mental Health Agency planning participation Expectations for consumer/family surveys Data collection is critical

Future Practices Related to DRA/Reform Initiatives Cost sharing – state option Benefits design for expansion programs – importance of including a mental health benefit Documentation standards “Deliberate and deliberative” (NE)

NAMI The Nation’s Voice on Mental Illness Steven Buck, Director of State Policy, 405/ or