1. Chapter title Explanation of chapter here 1 Presented by: Richard Sheola, ValueOptions’ Senior Vice President, Public Sector Division April 28, 2011 New York Association of Psychiatric Rehabilitation Services A ValueOptions Presentation to:

2. ValueOptions Corporate Overview Public Sector Experience and Related Systems Integration Successes Partnering with Peers to Transform Systems The Emerging Landscape: ACO Partnerships Provider Positioning for the Road Ahead Housing First Preserving the Integrity of our Public Behavioral Health System 2 Agenda

3. ValueOptions Corporate Overview 3 Singular focus on behavioral health and wellness More than 24 million members nationwide Medicaid represents 80% of our annual revenue Medicaid programs in 14 states, covering 5.3 million Members 15 years of Public Sector Experience

4. Public Sector Landscape 4 States with a ValueOptions Medicaid Contract Service Center locations Support office locations

5. Medicaid Program Successes Reducing costs while improving outcomes Facilitating long-term systems change through re-alignment of financial incentives Reducing children’s institutionalization (Hospital and PRTF level of care) Reducing adult psychiatric inpatient, state hospital admissions, and nursing facility usage Expanding holistic treatment for high-cost/high-risk members through Complex Chronic Care Management 5

6. Provided seed-funding and developmental support for peer- operated organizations and service models. (800) 495-0086 100 High St, 3 rd Floor Boston, MA 02110 A ValueOptions Organization 6 2002 - Peer Support in Aftercare clubhouse peers bridging to inpatient units and providing aftercare support and integration into peer and recovery activities Consumer Advisory Council proposed peer specialists in emergency services, contributing to MBHP policy, procedures and member materials since 1996. Family Advisory Council proposed family training infrastructure, contributing to MBHP policy, procedures and member materials since 1996. Trained providers in rehabilitation, recovery and the integration of peer services. 1999 - Launched self-help peer support groups, including Recovery Workbook meetings, DoubleTrouble addictions meeting and W.E.L.L. meetings for women experiencing trauma, addictions, and psychiatric conditions 2003 - MBHP coordinated peer planning process and developed the first proposal for Recovery Learning Communities In Massachusetts, a peer-operated wellness and recovery infrastructure, a national model 1999 - Launched the first Massachusetts Leadership Academy to develop peer-trained peer leadership, now a national model in outreach and training of diverse language and cultural groups, including Deaf and Hard of Hearing 1999- Supported development of peer infrastructures for training and support, including peer mentoring, peer-to-peer education, cross-training, and the development of peer facilitator and peer educator training, which led to the development of the peer-operated Massachusetts Certified Peer Specialist training program, a national model 1999 - Consumer Quality Initiatives Launched consumer satisfaction evaluation of provider services, a national model, now an independent peer-run, nationally-recognized organization 1999 - The Transformation Center Peer-operated hub of statewide Recovery Learning Communities, Certified Peer Specialist training, and MBHP-funded peer and provider training 1999 - Launched statewide support of Dual Recovery Anonymous peer facilitated meetings in clubhouses, now a national and international ICCD model program 2008 - Pat Deegan PhD & Associates and MBHP launched CommonGround in Massachusetts, a consumer/prescriber shared medication decision-making program with peer-support, a national model 2005 - Enhanced Day Treatment created peer specialist positions in day treatment programs 2009 - Certified Peer Specialists hired to work in redesigned community-based Emergency Service Programs statewide, a national model 1999-2008 - Partnering for Recovery, large statewide conference creating dialogue among peers, providers, families, and state agencies, a national model 2009-present - Three regional forums per year focused on recovery, wellness, and peer specialist integration, produced by The Transformation Center 2010 - MBHP and The Transformation Center began collaborating on training for Emergency Service Provider teams statewide, a national model ValueOptions, through its Massachusetts Behavioral Health Partnership, has worked with peers since1998 to build individual and organizational KNOWLEDGE and LEADERSHIP for wellness and recovery. Ahead of the Curve: Partnering with Peers to Transform Systems of Care Created, expanded, and supported peer workforce capacity. Created, expanded, and supported peer workforce capacity. Rehabilitation & Recovery, a dedicated MBHP business unit since 1996 Rehabilitation & Recovery, a dedicated MBHP business unit since 1996 Expanded peer support services and peer leadership training.

7. Health Care Reform: Colorado’s Accountable Care Initiative 7 Program Objectives: –Expand access to comprehensive primary care –Build patient-centered Medical Home capacity –Ensure a positive member and provider experience –Effectively apply an unprecedented level of statewide data and analytics functionality Performance Goals: –Achieve cost neutrality –Reduce unnecessary ER utilization –Reduce preventable hospitalizations –Reduce unnecessary imaging

8. Health Care Reform: Colorado’s Accountable Care Initiative 8 Colorado ACO/ASO Services –Member enrollment and referral services –Network development and integration –Practice supports (patient-centered Medical Homes) –Medical management and care coordination –Performance improvement –Reporting –Financial management

9. 9 Health Care Reform: Colorado’s Accountable Care Initiative New LLC—Integrated Community Health Partners –3 Federally Qualified Health Centers –Colorado Community Managed Care Network –4 Community Mental Health Centers –ValueOptions – Management Services Partner Region 4: Southeastern Colorado –70+ k Members –>$6.5M total contract revenue

10. Provider Positioning for the Road Ahead 10 Promote collaboration Learn about new health care landscape and educate about recovery Form/join coalitions regarding parity/Health Care Reform Involve/promote/advance individuals in recovery and promote consumer-directed care Identify gaps in coverage and services Promote high-quality and integrated care Promote prevention and wellness Understand economic environment and provide guidance—tough choices for States Stay focused on people we serve -- Pamela S. Hyde, J.D., Administrator, Substance Abuse and Mental Health Services Administration (SAMHSA)

11. Housing First 11 Community Support Program for People Experiencing Chronic Homelessness (CSPECH) – CSPECH is a behavioral health model that supports members who are chronically homeless – Pioneer Award-winning “housing first” program – Partnership between Massachusetts Behavioral Health Partnership (MBHP), Massachusetts Housing and Shelter Alliance (MHSA) and the Department of Transitional Assistance. – Estimated savings of $3M annually Pre-CSPECHCSPECH-Year 2Savings BH Costs$12,388$10,702$1,686 ED Utilization$2,795$1,144$1,651 Medical Costs (MHSA)$28,436$6,056$22,380 Total$43,619$17,902$25,717

12. Preserving the Integrity of our Public Behavioral Health System 12 Containing costs while strengthening our Systems of Care Expectations of our BHO partners/Raising the bar Performance contracting: “Doing Well by Doing Good” The Importance of Visionary Leadership The Road Ahead

13. Thank You 13 If you have any questions, please feel free to contact: Richard Sheola, Senior Vice President, Public Sector Division (617) 790-4081(office) Richard.sheola@valueoptions.com