1. Slide 1 Health Planning Council Meeting 6 Advisory Committee Meeting 3A- Pre-Meeting Madeleine Biondolillo, MD Director, Bureau of Health Care Safety and Quality Associate Commissioner Department of Public Health December 19, 2013

2. Slide 2 Agenda Goal of meeting First health planning analysis: Behavioral Health –Priority Area –Timeline & Deliverables Methodology for selecting key questions & approach for analysis –Health Resource Planning definition “refresher” –Taxonomy

3. Slide 3 Agenda Goal of meeting First health planning analysis: Behavioral Health –Priority Area –Timeline & Deliverables Methodology for selecting key questions & approach for analysis –Health Resource Planning definition “refresher” –Taxonomy

4. Slide 4 Goal of Meeting Report out from October council meeting Discuss planned approach Preface for next meeting (immediately following this)

5. Slide 5 Agenda Goal of meeting First health planning analysis: Behavioral Health –Priority Area –Timeline & Deliverables Methodology for selecting key questions & approach for analysis –Health Resource Planning definition “refresher” –Taxonomy

6. Slide 6 2013 – 2014 Proposed Priority Area Focus existing resources on a Level III analysis of a single service line: Allows staff to identify methodological and process challenges and correct them in future iterations Pursues a rigorous, comprehensive approach to one issue area, rather than a more limited analysis of many issue areas (depth rather than breadth) May be able to add additional service lines, time and resources permitting Behavioral Health as Year 1 focus: Directly relevant to all agencies represented on the council Significant policy interest in understanding and addressing weaknesses of the current system; active area of focus through initiatives to integrate care, address parity, improve access Need for immediate, purposeful study of existing resources and need

7. Slide 7 2013 – 2014: Timeline Oct. 2013Nov. 2013Dec. 2013Jan. 2014Feb. 2014Mar. 2014 Q2 2014 Q3 2014 Q4 2014 Council Meetings Strategic Plan Presented Check point First deliverables reviewed Advisory Committee Meetings Strategic Plan Presented Check point First deliverables reviewed Deliverable 1: Analytic Outline, Service Line Maps Deliverable 1 Complete Deliverable 1 submitted Deliverable 2: Key Definitions Deliverable 2 Complete Deliverable 2 submitted Deliverable 3: Level III Analysis Public Hearings on Deliverable 3 Public Hearings Deliverable 3 Complete = delayed by one month due to missing the November meeting

8. Slide 8 2013 – 2014 : Deliverables Deliverable 1A: Analytic Outline Description of proposed methodology for Level III analysis Terms requiring definitions Proposed data sources and analyses Geographic regions for subservices

9. 2013 – 2014: Deliverables Deliverable 1B: Service Maps Maps of existing facilities/services by geographic location Based on current definitions, databases Broken down by services offered, number of beds (if possible) Subject to change based on new definitions, methodologies, etc. Propose to include the following services: Slide 9 Mental HealthSubstance Abuse Acute Inpatient Psychiatric Units/Facilities (child/adult/geriatric) Acute inpatient substance abuse beds (Adult/family/youth) Licensed Outpatient Mental Health Clinics Residential substance abuse beds (Adult/family/youth) Diversionary Services: Partial Hospitalization Programs Day Treatment Programs Emergency Service Programs Crisis stabilization services Methadone treatment service providers DMH Continuing Care Units/FacilitiesSubstance abuse day treatment Community Support Agencies Outpatient substance abuse counseling DMH Site Offices

10. 2013 – 2014: Deliverables Deliverable 2: Key Definitions Final definitions of all terms required for Level III analysis Emphasis on using existing definitions as much as possible Any new definitions developed to be vetted with expert stakeholders Example: Day Treatment: an outpatient service providing direct client services through group, individual, and family substance abuse counseling a minimum of 3.5 hours per day five days per week (105 CMR 164). –How does daily minimum hour requirement affect calculations of capacity? Most people who enroll in these programs do not attend 5 days per week. –How does single licensure category for group, individual and family substance abuse counseling affect classification within inventory? –Are “direct client services” defined on BSAS-issued license? How variable are services? Slide 10

11. 2013 – 2014: Deliverables Deliverable 3: Level III Analysis Slide 11 DeliverableDescriptionDate (2014) Identification of key questions Prioritize areas for further analysis Ascertain whether there are areas where additional targeted data collection is desirable/feasible January Estimation of NeedBy service/provider/bed type Including projections of future need January – March DefinitionsDrafted and vetted with stakeholder participation To include ideal occupancy rates and other standards February – March *Deliverable 2 InventoryStart with services included in Deliverable 1 Maps, with potential for additional refinement January - May Analysis of Capacity Based on accepted industry standards, where possible Standards vetted with experts and stakeholders, if needed April - June Issues BriefIdentification of laws, policies, etc. known to affect system Narrative description of expected effect May - July Public HearingsGoal to hold hearings in geographic areas of state identified as being over- or under-capacity in analysis August – October Final ReportCompleted and submitted to legislatureDecember *Deliverable 3

12. Slide 12 Agenda Goal of meeting First health planning analysis: Behavioral Health –Priority Area –Timeline & Deliverables Methodology for selecting key questions & approach for analysis –Health Resource Planning definition “refresher” –Taxonomy

13. Health Resource Planning in Brief Key elements of health planning: –Inventory/Supply: how many units of a service are currently operating in the Commonwealth? –Capacity: What volume of service is each supply unit able to provide? –Demand: How many units would have to exist to meet the needs of all residents of the Commonwealth? –Forecasting: How is supply and/or demand expected to change in the future? –Gap Analysis: Is current supply sufficient to meet current and future demand? Health Planning is not best suited to address: –Policy Questions –Payment Questions –Scope of work Questions Slide 13

14. Behavioral Health Slide 14 Behavioral Health Mental Health Substance Abuse Funding OperationLicensure Level of Care AcuteResidential Outpatient Community Population Served Adult Adolescent/ Transitional Age Child Developing a taxonomy of the care system

15. Slide 15 Wrap-up Questions/discussion Next steps