Minnesota Mental Health Action Group Reform for Results & Recovery DN:

2 President’s New Freedom Commission on Mental Health “The mental health services delivery system needs dramatic reform. The system is fragmented and in disarray – not from lack of commitment and skill of those who deliver care, but from underlying structural, financial, and organizational problems.”

3 What is MMHAG?

4 “MMHAG” Inclusive, broad-based coalition Providers, hospitals, health plans, consumer advocacy organizations, MDH and DHS Funded by hospitals and health plans, plus in- kind support Linkages with existing mental health projects Brings groups together to achieve a shared vision Includes both public and private funding and services

5 MMHAG’s Mission Minnesota embraces a vision of a comprehensive mental health system that is accessible and responsive to consumers, guided by clear goals and outcomes, and grounded in public/private partnerships.

6 Who is MMHAG? Health Professionals MH Centers Medical Clinics Health Plans Hospitals Schools County Agencies State Agencies Academics & Researchers Consumers & Advocates

7 Who is MMHAG? Consumer Forum: Children’s Mental Health Partnership Mental Health Association of Minnesota Mental Health Consumer/Survivor Network of Minnesota Minnesota Association for Children’s Mental Health Minnesota Disability Law Center National Alliance for the Mentally Ill Office of Ombudsman for Mental Health/Mental Retardation PACER Center State Mental Health Advisory Council State Mental Health Advisory Council – Children’s Subcommittee Suicide Awareness Voices of Education Volunteers of America And Others

8 Consumer Perspectives on Steering Committee Sue Abderholden, National Alliance for the Mentally III- Minnesota Kris Flaten, State Advisory Council on Mental Health and Subcommittee on Children’s Mental Health Sandra Meicher, Mental Health Association of Minnesota Maureen Marrin, Mental Health Consumer/Survivor Network of Minnesota Patricia Seibert, Disability Law Center Roberta Opheim, Ombudsman for MH and Mental Retardation

9 MMHAG = ACTION MMHAG was created to take action to transform the mental health system Action steps built upon the work and recommendations of many prior task forces, commissions and studies To the extent possible, MMHAG is implementing changes without seeking legislation Some legislative changes will be pursued in 2005

10 Guiding Principles Is flexible to meet the needs of different populations, ages and cultures Provides the right care and service at the right time Delivers care and services in the least intensive site possible Uses a sustainable and affordable financial framework with rational incentives

11 Guiding Principles (continued) Is easily navigated by consumers and providers because it operates in efficient, understandable pathways Uses evidence-based interventions and treatment to produce the desired outcomes Employs effective health promotion and prevention strategies Has appropriate providers and service capacity Clearly defines accountability among all parties

12 ACCOMPLISHMENTS Researched existing system: mental health programs, funding, services, providers and laws Analyzed past reports of commissions, task forces and studies Convened a consumer forum to engage broader group of consumers, families and advocates Formed a coalition and created a web site for communication and information Set priorities and formed Action Teams and Work Groups Hundreds participating in work groups to develop specific action plans Now working on the road map and securing public and private commitments to make needed changes

13 MMHAG Action Teams Fiscal Framework –public and private funding –rational incentives –the right care, in the right setting, at the right time Coordination of Care and Services –easy to navigate –achieves the desired health and social outcomes Quality of Care –standardized assessment of performance and outcomes. Earlier Intervention –consumers are willing to seek, and able to access, help when needed Workforce Solutions –adequate supply of qualified mental health professionals Public/private Partnerships

14 PROBLEM PRIORITIES DRAFT OUTCOMES STRATEGIES ANTICIPATED DELIVERABLES PROVIDER SHORTAGES Find solutions workforce shortages Consumers and families get the services they need, when they need them, from appropriately trained health care professionals. Promote shared care models between psychiatrists and primary care providers Address licensing and credentialing barriers University and college recruitment and admissions process and training programs. Identify strategies to assure a culturally competent workforce. A statewide workforce plan. Legislation Practice models between primary care and mental health. Strategies for improving cultural competence.

15 PROBLEM PRIORITIES DRAFT OUTCOMES STRATEGIES ANTICIPATED DELIVERABLES STIGMA DISCOURAGES ACCESSING CARE Increase public awareness to encourage screening and earlier interventions Persons with MH problems are identified and receive services earlier and have a better chance for recovery and quality of life. Statewide public education and provide training and support to caregivers and providers. Enhance preschool mental health screening. Screen persons with physical illnesses with a high incidence of co-morbidity with mental illness. Broaden mental health screening for the aged. Professional education and cross-training on mental health screening, consultation and referral. Coordination of public and private resources to implement statewide plan. Written information and training Targeted strategies across the lifespan. Screening training and roles for healthcare professionals.

16 PROBLEM PRIORITIES DRAFT OUTCOMES STRATEGIES ANTICIPATED DELIVERABLES LACK OF EQUITABLE ACCESS TO SERVICES STATEWIDE Access to a full continuum of publicly funded mental health services. Consumers and families in every part of the state have equitable access to needed services. Change public funding system from program to person focus. Redirect institutional funds to more flexible, community-based services. Develop regional partnerships with private funders and providers. Redefine the State’s roles as funder, regulator and provider. Public funding follows individual consumers’ needs. Public and private funders participate in regional partner- ships to assure that a full continuum of services are available in every geographic region.

17 PROBLEM PRIORITIES DRAFT OUTCOMES STRATEGIES ANTICIPATED DELIVERABLES FINANCING DYSFUNCTIONS Make corrections to current financing dysfunctions in the short term. Consumers and families can access the services they need, when they need them, from appropriately trained, culturally competent health care professionals. Change the most significant dysfunctions in the financing system. Provide technical assistance to providers who bill for public services. Changes in payment and reimbursement, both public and private.

18 PROBLEM PRIORITIES OUTCOMES STRATEGIES DELIVERABLES PAYMENTS EMPHASIZE PROGRAMS, NOT PEOPLE Develop a new statewide funding and payment model for the long term. The consumer or family plays a central role in choosing services and providers; payment systems are consumer- centered and promote high quality, efficient care provided at the right time in the right setting. Develop funding and payment model. A new funding model for publicly funded services. A model for realignment and coordination of public and private funding. An under- standable “consumer guide” to mental health services, coverage and eligibility.

19 PROBLEM PRIORITIES DRAFT OUTCOMES STRATEGIES ANTICIPATED DELIVERABLES COST SHIFTINGDevelop a model mental health benefit set. Consumers and families have access to a full continuum of effective services with no gaps. Develop model benefit set and promote its adoption by public and private payers.  The financial responsibility clearly identified among health plans, government programs, and consumers. A coordination of benefits is implemented to resolve payment issues among multiple payers and funders.

20 PROBLEM PRIORITIES DRAFT OUTCOMES STRATEGIES ANTICIPATED DELIVERABLES LIMITED ACCOUNT- ABILITY Establish outcomes for care. Consumers and families have access to quality information to guide them in choosing a provider and evaluating care and services. Standardized measurement tools. Independent authority to compile, integrate and report on mental health data. Adoption of standardized measurement tools and methods by health plans, government agencies and grantors. An independent data reporting authority is designated.

21 PROBLEM PRIORITIES DRAFT OUTCOMES STRATEGIES ANTICIPATED DELIVERABLES SYSTEM TOO COMPLEX Coordinate care and services in the public and private mental health systems. Consumers and families understand the mental health system and find it easy to navigate. Models and interagency agreements combine and coordinate essential service components into a comprehensive care plan. Service coordination is built into practice protocols and expected of providers. Model working agreements. Coordination is an element of accountability when assessing quality.

22 PROBLEM PRIORITIES DRAFT OUTCOMES STRATEGIES ANTICIPATED DELIVERABLES COMPROMISED STUDENT LEARNING WITHOUT MENTAL HEALTH CARE Expand opportunities for partnerships between education systems and mental health providers. Increased academic achievement and well being of students. Enhance school mental health screening. Develop a policy framework that creates pathways to integrate mental health services and education systems. Best practices identified and disseminated. Working models of enhanced relationships between schools and mental health providers. Children and families are given understandable information to explain services and payment sources in the schools and community.

23 PROBLEM PRIORITIES DRAFT OUTCOMES STRATEGIES ANTICIPATED DELIVERABLES LACK OF COORDINATION BETWEEN PUBLIC AND PRIVATE MH SYSTEMS Establish a statewide public-private partnership. Consumers and families are satisfied with Minnesota’s mental health system. Maintain action-oriented forum. Set goals for the private and public mental health system changes. Recommend proposed legislative changes. Integration plan that builds all of the above into the way of doing business on an ongoing basis.

24 Next Steps: 2005 Legislation Non-legislative changes in 2005 Regional partnerships More hard work

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