1. 1 American College of Mental Health Administration Santa Fe Summit March 31, 2005 Santa Fe, NM A. Kathryn Power, M.Ed., Director Center for Mental Health Services Tracking the Transformation: A Celebration of Our Progress

2. 2 “…connotes some process and intent surrounding a profound, deep, intense, and penetrating alteration in the status quo. It implies a formation of and an effort to realize a vision that is palpably different from what existed before—a conscious decision to substantively alter and make a difference in a given reality.” —from “Concepts of Transformation” Noel A. Mazade, Ph.D. Transformation…

3. 3 Continuous Small Steps A focus on core missions, improving what the system is already doing. A Series of Many Exploratory Medium Jumps Pushing the boundaries of core competencies, trying to create something new within the existing paradigm. A Few Big Jumps New rule sets that leverage new ideas. Transformation as a Strategy for Innovation

4. 4 Transformation Begins… SAMHSA/ CMHS Federal Partners States & Communities Other Stakeholders in Mental Health

5. 5 SAMHSA/CMHS: First Steps ►Advanced the work of an internal matrix workgroup. ►Developed the first Federal Action Agenda. ►Increasing Federal support to States for their formal transformation efforts. ►Defining the constructs and values that are essential to the process.

6. 6 "Family driven" means that families have a decisionmaking role in the care of their own children as well as the policies and procedures governing care for all children in the community, State, and Nation. “Youth guided" means that youth have a role in guiding their own care. For older youth, it may mean directing their own care. Defining Constructs and Values

7. 7 Transformation Action Initiative (TAI) Vision The TAI will provide a cohesive, coordinated, and strategic structure for the provision of technical assistance within the Mental Health Transformation SIG program and for CMHS programs focused on assisting individuals in achieving recovery and promoting resilience. Technical assistance for the TAI will be realigned with mental health transformation priorities, including— ►Leadership/Consumer Leadership ►Comprehensive Mental Health Plans ►Individualized Plans of Care (person-directed planning approaches) ►Disparities Reduction/Elimination ►National Registry of Evidence-Based Programs and Practices ►Workforce Development (including consumers as staff).

8. 8 FY 2005 Proposed Activities Effective behavioral health care leadership will be developed at the State and local levels. CMHS will build and sustain this leadership by developing a support model that moves away from the “train and hope” approach. ►Educate individuals and groups in leadership theory and techniques ►Maintain the network of leaders to ensure continuity of support for sustaining systems change ►Provide access to a wide range of current leadership curricula from programs such as Harvard, the Center for Creative Leadership, and the Office of Personnel Management ►Develop consumer leadership at all levels Vision Strategic Transformational Leadership

9. 9 Transformation Leadership

10. 10 Providers will become more effective in working with communities of color so that they will no longer be underserved. ►National Strategic Plan on the elimination of disparities ►Workforce training curricula evaluation ►Workforce development task force ►Cultural competence standards and guidelines ►Behavioral health care training program assessment ►Public education program description ►Evidence-based practice adaptation and implementation Vision FY 2005 Proposed Activities Disparities Reduction/Elimination

11. 11 An ethnically and racially diverse workforce, including consumers as staff, will be trained and supported in evidence-based practices. This workforce will respond to and help shape a mental health policy and practice environment that supports recovery. ►Develop a draft national strategic plan with consumers and key constituents ►Provide technical assistance to the field ►Develop toolkits for field use and to monitor progress and evaluate success Workforce Development Vision FY 2005 Proposed Activities

12. 12 Evidence-based treatments will be widely applied to support recovery. Consumers will have meaningful involvement in the development of these treatments. ►Develop four new toolkits related to— 1. Supportive housing 2. Aging 3. Consumer-operated services 4. Children ►Publish an implementation guide on supported education ►Offer technical assistance for implementation of evidence-based practices and individual care plans Vision FY 2005 Proposed Activities Science to Service

13. 13 Every adult with a serious mental illness and every child with a serious emotional disturbance will have a consumer- and family-directed IPC that promotes resilience and recovery. ►Development of prototypes of IPCs for adults and children ►Contractor review of existing models and best practices ►Strategy and consensus meetings with stakeholders ►Dissemination and technical support for prototype care plans Individualized Plan of Care (IPC) Vision FY 2005 Proposed Activities

14. 14 State plans will create an extensive and coordinated system of services and supports that enable each person to attain an optimal level of self-care, interpersonal relationships, employment, and community participation. ►Develop a model plan template through collaboration with NASMHPD, consumers, and other stakeholders ►Make model plan available for States when the Mental Health Transformation SIG awards are made Model Comprehensive State Mental Health Plans Vision FY 2005 Proposed Activities

15. 15 ►Developing an employer initiative ►Exploring customized employment strategies ►Examining community-based workforce opportunities for ex-offenders ►Connecting employers to employment service providers through EARN, the Employer Assistance Referral Network. ►Promoting successful transitions for young adults from school to secondary school or employment. Spotlight on U.S. Department of Labor Federal Partners: First Steps

16. 16 States: First Steps ►California ─ Mental Health Services Act ►Nevada ─ Mental Health Plan Implementation Commission ►South Carolina ─ Proviso Committee to incorporate the six Commission goals into its State Mental Health Plan ►New Mexico ─ Interagency Behavioral Health Purchasing Collaborative ►Texas ─ Transformation Task Force 16

17. 17 Stakeholders: First Steps Spotlight on IBM’s Care Advocacy Model The Step Toward Transformation: IBM’s Mental Health Care Program promotes identification and intervention for persons who may have co-occurring behavioral health problems. The Goal: to use claims information, surveys, and other tools to proactively identify members who have or who are risk for behavioral health issues. The Result: IBM’s behavioral health vendor reports a 95% satisfaction rate; that overall rates of treatment increased from 2.2% to 8.8%; and that outpatient costs went down by $500,000 in 2003.

18. 18 T = (V + B + A)  (CQI) 2 Transformation  (Vision  Belief  Action)  (Continuous Quality Improvement) 2 The Transformation Equation

19. 19 ►Never give up. ►Claim your successes. ►Celebrate the victories along the way. Put your power to work to help us achieve the promise! 19