July-August 2018

Summer Activities:

Even with vacations (2 weeks in Brazil in July, 2 weeks on Cape Cod in August) it has been a busy summer.

Interdepartmental Serious Mental Illness Coordinating Committee:

Dr. Minkoff worked with the non-federal members of ISMICC to help organize several activities to support the implementation of the ISMICC recommendations:

  • Developing a plan for assigning non-federal ISMICC members to each of the five ISMICC workgroups, as well as to maximize non-federal member and other stakeholder engagement in the process within the limits of the Federal Advisory Committee Act (FACA).
  • Beginning to outline a process for the non-federal members to produce an annual report of progress in December 2018
  • Creating a process for organizing the non-federal members into a regular working team
  • Contributing input to the Data and Quality Workgroup on quality standards, and contributing to the non-federal ISMICC member input into a draft set of standards proposed by the National Quality Forum (NQF).

Meadows Mental Health Policy Institute:   Dr. Cline and Dr. Minkoff continued active involvement in multiple projects and activities conducted by MMHPI, as follows:

  • Finalizing the Houston Endowment Substance Use Disorder System report following submission of the first draft to the funder.
  • Coordinating with the Local Systems team regarding how to best support progress in a variety of local system consultations
  • Working with Dr. Seema Shah to discuss statewide efforts to improve primary health/behavioral health integration for children, and to develop statewide academic partnerships regarding research and services.
  • Participating with Sam Shore on the HHSC-MMHPI workgroup on SUD services, focusing on data accuracy and policy recommendations for sober living and expansion of Opioid Use Disorder services.
  • Supporting implementation of a Texas TA team to work with the American Academy of Addiction Psychiatry on statewide TA for MAT, as part of the national STR-TA initiative.
  • Coordinating with Dr. Meher Karam on STR-TA and the state of treatment for nicotine addiction in Texas
  • Working with Coby Chase and Michelle Harper to organize the events related to children, youth, and early intervention services during the MMHPI visit to London for the Global MH Summit in early October
  • Planning attendance representing MMHPI at the One Mind Conference in St. Helena, CA in September
  • Working with Susan Fordice and Sam Shore to develop the SUD track for the third annual MMHPI Engage and Excel Conference (Houston, Oct 23-25) (engageandexcel.org). Dr. Minkoff and Dr. Cline will be presenting on developing universal co-occurring capability.
  • Working with LDWW on the development of materials for the next phase of Okay to Say: (Okay to Share; Okay to Care).
  • Contributing to an MMHPI Report on Criminal Justice-Behavioral Health Services in Texas
  • Contributing to MMHPI’s public input on HHSC’s redrafted Medicaid policy on SUD treatment.

Follow MMHPI at www.texastateofmind.org

CALM:   Engaged in continuing activities to accomplish the following objectives:

  • Developed a draft supervision plan for CALM
  • Developed a tool for prioritization of the various CALM programs (in accordance with mission alignment, level of success, uniqueness, and financial performance) which will be used by CALM leadership in September
  • Consulted to the intake team on a process for improving welcoming access through the intake process.
  • Discussed the process of conceptualization of CALM programs as a continuum of services based on individual, family, and community need, rather than as distinct service components driven by funding requirements.

Tennessee Co-occurring Strategic Initiative: Begun planning for a series of webinars in the fall to engage new participants in the statewide co-occurring capability development process, particularly Substance Use Disorder programs working with criminal justice. Strategic Initiative

Vermont Co-operative for Practice Improvement and Innovation (VCPI): Dr. Minkoff has been working with the VCPI leadership team to develop a working leadership and operations structure for VCPI.

Follow the Vermont Co-perative at vtcpi.org

Recovery to Practice: On August 6, Dr. Minkoff participated in the final teleconference for the RTP Advisory Committee (Task 4) hosted by Advocates for Human Potential, to discuss project successes and recommendations for continuation of the work following project conclusion in September.

Mid-Hudson (NY) Region Co-occurring Initiative: Dr. Minkoff has been working on organizing the November events, which so far includes a conference on November 13 for co-occurring capability implementation teams from all seven counties in the region, and individual county meetings with Westchester and Putnam on November 14. Other counties may schedule individual meetings as well.

Common Ground: Continued consultation to assist in the development of improved capacity for Common Ground to deliver the highest possible quality comprehensive crisis service array in Oakland County, Michigan. In July the focus of activity was to work with Common Ground on completion of a response to an RFP to develop a comprehensive continuum of crisis services in Detroit-Wayne County, and in August to prepare for a proposal interview.

Iowa East Central Region: ZiaPartners initiated a consultation activity with the MHDS East Central Region (including 9 counties with three regional hubs in Cedar Rapids, Iowa City, and Dubuque). This evolved into a project helping all the MHDS regions in Iowa respond to new proposed rules for required intensive core services based on recent legislation. Dr. Minkoff attended the MHDS Commission hearing regarding those regulations on July 19, and then worked with all the regions and a few other stakeholders to write suggested revisions of the proposed rules and regulations on behalf of the regions. These were submitted to the regions on August 30 and are due to MHDS on September 4. The suggested revisions address in detail the relationship between the state, the MCOs, the regions and the providers, moving toward a collaborative design and away from the implication of an unfunded mandate. There is also detailed language regarding the design of the crisis continuum, including Access Centers, crisis residential programs, continuing crisis intervention services, and so on. Language addressing multi-occurring conditions (MH, SUD, IDD, BI) was modified and improved.

Solano County, CA: ZiaPartners began a conversation with Solano County (in central CA, based in Fairfield) behavioral health services in July about how to help with their movement to developing a systemwide integration of MH and SUD services.   The next step in this process will be a presentation given by Dr. Minkoff on September 20 at the Solano County Recovery Day event.

Silver Hill Hospital – ZiaPartners has contracted with Silver Hill (located in New Canaan, CT) to provide assistance with continuing implementation of the transformational recommendations from our April visit, to implement a collaborative culture to facilitate admissions, transitions, and staff engagement. The first on-site visit in this phase of the work will be September 26-27,

College for Behavioral Health Leadership – As a Board member, Dr. Minkoff has been contributing to launching a new set of CBHL activities that will allow the organization to operate on a much bigger scale and will attract resources for the development of materials to “make leaders better” across multiple sectors and boundaries within the universe of BH service delivery. This initiative will be formally launched at the CBHL Summit in Richmond in September (link to website)

SAMHSA – Dr. Minkoff was asked by SAMHSA to coordinate a day-long panel meeting on Co-occurring Serious Mental Illness and Opioid Use Disorders on August 23. The forum incorporated input from NASMHPD, NACBHDDD, National Council, CCBHCs, CMHCs, and various Behavioral Health provider disciplines, including peers. The objective was to identify what is known about how to help individuals with SMI/OUD and how to implement what we know more systematically across the nation.   There will be a report prepared on the results of the panel, and the content of this report will be referred to the relevant ISMICC workgroup (which is co-chaired by Justine Larson, MD, Medical Director for the Center of Mental Health Services, who was one of the SAMHSA conveners of the panel, along with Tison Thomas, who is one of SAMHSA’s experts on co-occurring disorders and oversees the MH Block Grant.).

 

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“September is Recovery Month”

This was taken from Hon. Peggy Hora of the Justice Speakers Institute

September is Recovery Month

A Time of Celebration and Hope

www.recoverymonth.gov

In Memorium: Christopher Kennedy Lawford, 33 years sober.

While recovery should be celebrated every day, September is the 29thAnnual National Recovery Month to remind us of the importance of this issue in our communities.  We ask local policy makers to sign proclamations to demonstrate a commitment to improving access to treatment programs for mental and/or substance use disorders. According to the Substance Abuse and Mental Health Services Administration (SAMHSA), the “[m]onth celebrates individuals throughout the country who have achieved long-term recovery from mental and substance use disorders and recognizes the contributions of the dedicated men and women who provide treatment and recovery services.”

Approximately 21 million Americans ages 12 and up dealt with a substance use disorder in 2014.

SAMHSAreports that approximately 21 million Americans ages 12 and up dealt with a substance use disorder in 2014, and that was before the opioid epidemic.  SAMSHA also reports “about 44.7 million Americans aged 18 and older experienced a mental disorder. In addition, an estimated 2.6 million adults aged 18 or older had co-occurring serious mental illness and substance use disorder.”

The triple message for Recovery Month is:

    • Prevention works.
    • Treatment is effective.
    • People can and do recover.

     

People in long-term recovery tell their story best.  Greg Williams stopped using alcohol and other drugs when he was only 17-years-old.  You can see his story here.

The Betty Ford Center defines recovery as “[a] voluntarily maintained lifestyle characterized by sobriety, personal health and citizenship.”  Recovery is clearly more than the absence of alcohol or other drugs in one’s life.  Watching people work to complete a drug treatment court or a behavioral health court program reveals how difficult a struggle it is. The road to recovery is seldom a straight path but, rather, one filled with twists and turns, potholes and distractions.

Click on the box to tweet the important message!

Relapse prevention is often part of treatment’s curriculum and for good reason. While using is part of relapse, it is not uncommon for use episodes to occur.  If that happens, it is imperative that corrective action be taken immediately and that the person return to treatment and follow their recovery plan.

Actress Kristen Bell publicly celebrated her husband’s 14 years of recovery on Instagram recently.  She said, “…I know how much you loved using. I know how much it got in your way. And I know, because I saw, how hard you worked to live without it.”    And it is difficult to find a family that is not touched by substance use disorders or mental health issues. When family members are supportive of their loved one’s recovery, outcomes are usually better.   SAMHAS has a free booklet for family members of people with substance use disorders.  Hazelden, a well-known recovery corporation, has developed “Nine Strategies for Families Helping a Loved One in Recovery.”

They are:

    1. Help your loved one follow all treatment recommendations.
    2. Encourage total abstinence from alcohol and other drugs
    3. Help your loved one build good coping skills
    4. Reduce family friction and provide social support
    5. Encourage participation in peer support groups
    6. Help your loved one create a sober peer network
    7. Know the signs of relapse
    8. Support your loved one’s involvement in meaningful, structured activities
    9. Keep hope alive

 

While we celebrate the 23 million+ Americans living in recovery, we must not lose sight of those still struggling with these disorders who are losing their lives every day.  Last year more than 72,000 people died from opiate overdoses.  When you add in deaths caused by alcohol and impaired driving crash statistics, there is much to mourn.  How will you recognize and celebrate Recovery Month?

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Paradigm

Dr. Minkoff had an article published in Illinois Institute for Addiction Recovery’s journal Paradigm.  His article “Twelve Steps to Co-Occurring Competency: Building Competency in the Entire System” can be found on page 14 of the journal.

Here is a copy of this issue of Paradigm.

If you would like to subscribe to Paradigm you can do so for free here.

 

 

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June 2018

Activities in June

Interdepartmental Serious Mental Illness Coordinating Committee:

Dr. Minkoff attended the first official ISMICC meeting of 2018, held in Washington, DC on June 8. (Opening Remarks of the ISMICC meeting) The ISMICC report released in December 2017 is a foundation for much of SAMHSA’s ongoing efforts and has been very successful in engaging not only cooperation but enthusiasm from other federal departments. This meeting included a very supportive introduction from newly appointed Health and Human Services Secretary Alex Azar, and then focused entirely on practical discussions of implementation efforts.   ISMICC members heard reports from each of the five interdepartmental implementation workgroups and were able to provide feedback and input.   In addition, there was a highly engaged discussion about the importance of collecting up to date epidemiologic data about the population of people with serious mental illness/serious emotional disturbance, using updated and consistent definitions, and attending to co-morbidity. Going forward, the non-federal ISMICC members will have the opportunity to participate in continuing activities of the workgroups, as well as in periodic topic meetings, and will also be able to work collaboratively to engage partners in the implementation process at the state/tribe and local level nationwide. These are important steps of progress in a multi-year process that has the potential to transform the national delivery system for adults and children with severe mental health and substance use issues.

Meadows Mental Health Policy Institute:   Dr. Cline and Dr. Minkoff continue active involvement in multiple projects and activities conducted by MMHPI, as follows:

  • Finalizing the Houston Endowment substance use disorders System report that is due in July.
  • Coordinating with the Local Systems team regarding how to best support progress in a variety of local system consultations
  • Working with Dr. Seema Shah to discuss statewide efforts to improve primary health/behavioral health integration for children, and to develop statewide academic partnerships regarding research and services.
  • Participating with Sam Shore on the HHSC-MMHPI workgroup on substance use disorders services, focusing on data accuracy and policy recommendations.
  • Supporting implementation of a Texas TA team to work with the American Academy of Addiction Psychiatry on statewide TA for MAT, as part of the national STR-TA initiative.
  • Participating in Policy Workgroup and Financing Workgroup for the Mental Health Association of Greater Houston Integrated Health Care Initiative
  • Working with Susan Fordice and Sam Shore to develop the substance use disorders track for the third annual MMHPI Engage and Excel Conference (Houston, Oct 23-25) (engageandexcel.org). Dr. Minkoff and Dr. Cline will be presenting on developing universal co-occurring capability.
  • Working with LDWW on the development of materials for the next phase of Okay to Say: (Okay to Share; Okay to Care).

Follow MMHPI at www.texastateofmind.org

CALM:   ZiaPartners (Drs. Cline and Minkoff) provided continuing teleconference support to CALM to help with organizing next steps, with a focus on developing guidance materials to help CALM leadership conceptualize the implementation of a QI Action Team with front line staff partners.

Tennessee Co-occurring Strategic Initiative: On June 6-7, Dr. Minkoff provided the second of three regional 2-day TA sessions, and on June 20-21, the third of those sessions, to support the work of individual provider organizations to make progress toward co-occurring capability in Tennessee. These regional events were held in Memphis and Knoxville, to engage both mental health centers and addiction provider organizations in west and east Tennessee. The agencies that attended each had individual meetings with Dr. Minkoff to focus on the results of their COMPASS-EZ self-assessments and how to utilize those to develop achievable and meaningful action plans to improve co-occurring capability within their current services and resources. (Tennessee Co-Occurring Strategic Initiative). There was a follow-up conversation with leadership of the Substance Abuse Division at the Tennesse Department of Mental Health and Substance Abuse Services to discuss how the division could best engage new providers from the criminal justice system in making progress toward C0-Occurring Disorder Capability, as well as how to support the few remaining community Substance Use Disorder providers who had not yet started to make progress.

Vermont Co-operative for Practice Improvement and Innovation (VCPI): Dr. Minkoff participated with the VCPI Leadership Team in finalizing the transition plan for VCPI to move out from under Southern New Hampshire University to its new “parent” at Northern Vermont University. This change will be effective as of July 1 and is an exciting opportunity for VCPI to have more support for growth and innovation going forward. (For more information vtcpi.org)

Common Ground: Continued consultation to assist in the development of improved capacity for Common Ground to deliver the highest possible quality comprehensive crisis service array in Oakland County, Michigan. In June the focus of activity was to work with Common Ground on the preparation of a response to an RFP to develop a comprehensive continuum of crisis services in Detroit-Wayne County.

Mid-Hudson (NY) Region Co-occurring Initiative: Dr. Minkoff provided a COMPASS-EZ training teleconference on June 19 with representatives of the project teams from the seven counties (Dutchess, Orange, Putnam, Rockland, Sullivan, Ulster, Westchester) participating in this regional project. This project was described in more detail in the May notes. The next on-site activity for this project will be in November 2018.

Michigan Co-occurring College: Dr. Minkoff did a full day plenary event at the Michigan Co-occurring College in Lansing, on June 25. The presentation was a participatory event for the approximately 100 attendees from all over the state, and focused on practicing welcoming, recovery-oriented, integrated, stage-matched treatment planning, and on implementing the 12 steps of co-occurring competency, utilizing the ZiaPartners ILSA Supervision Workbook (2017). This event was met with excitement by both local participants and state level leadership. (For more information about the Michigan co-occurring college)

Iowa East Central Region: ZiaPartners initiated a consultation activity with the MHDS East Central Region (including 9 counties with three regional hubs in Cedar Rapids, Iowa City, and Dubuque). The focus of the consultation, which builds on the relationships developed during ZiaPartners five-year consultation statewide on universal development of multi-occurring capable services within emerging regional systems of care, is to help the region with the implementation of various core services for individuals with complex needs. The earliest challenges involve responding to new regulations about Access Centers and working with the various local hubs about implementation strategies.

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May 2018

Interdepartmental Serious Mental Illness Coordinating Committee:

Dr. Minkoff worked with the non-federal members of ISMICC to contribute input to the agenda and content of the first ISMICC meeting of 2018, to be held on June 8.   This included preparation of a one-page document outlining how the non-federal members could best support the ongoing implementation of the recommendations in the ISMICC report.

Meadows Mental Health Policy Institute:  

Dr. Cline and Dr. Minkoff participated in the MMHPI semiannual staff meeting held at the Horseshoe Bay Resort outside of Austin on May 16-17. This exciting event provided an opportunity for MMHPI staff working on many different projects to come together and share energy and information, and to better coordinate efforts.  Dr. Minkoff and Sam Shore made a presentation to the group on the findings and recommendations from the Houston Endowment funded project to assess the substance use disorder delivery system for Harris County (Houston), and how those recommendations are contributing to MMHPI input to the currently ongoing work of the Texas House Select Committee on substance use disorder.

Follow MMHPI at www.texastateofmind.org

CALM:   ZiaPartners (Drs. Cline and Minkoff) and TriWest had the second two day on-site visit with CALM in Santa Barbara County, CA on May 9-10. This highly successful event provided an opportunity for ZiaPartners to contribute to the implementation of an internal reorganization of the agency that provided the beginning steps to the creation of a structure that reinforces the importance of the provision of clinical supervision and allows for a focus on clinical performance and staff engagement across the agency.   The meeting opened a dialogue between senior administration (Executive Team) and program managers and set the stage for the development of a quality improvement Action Team for the agency that would provide a mechanism for formal staff engagement in problem-solving and improvement activities. Work was done on launching a pilot to eliminate barriers in the intake and engagement process, taking next steps in clarifying the elements of the agency’s supervision plan, and redoing the employee handbook. Next on-site meeting will be held in October.

Texas Association of Addiction Professionals – Houston Chapter: Dr. Minkoff presented on May 4 on Welcoming, Integrated Services for Individuals with Co-occurring Disorders at the TAAP Annual Conference. The presentation was well received and provided a framework for front-line counselors to be able to proceed through the “12 Steps of Co-occurring Competency” (link on our website) to be able to improve their ability to deliver integrated services to their current clients who have a high prevalence of co-occurring mental health issues.

New Jersey Co-occurring Disorders Psychopharmacology Conference: On May 21, Dr. Minkoff presented to over 100 attendees on psychopharmacologic interventions for co-occurring disorders, at Rutgers University in Piscataway, NJ. The conference attendees were very excited about the opportunity to immediately implement some of the information provided in their current efforts to work with individuals with opioid use disorders as well as individuals with serious mental illness and a variety of co-occurring conditions.   The New Jersey state co-occurring technical assistance and training team that sponsored the event indicated an interest in a follow-up consultation to support the implementation of co-occurring services statewide.

Tennessee Co-occurring Strategic Initiative: On May 22-23, Dr. Minkoff provided the first of three regional 2-day TA sessions to support the work of individual provider organizations to make progress toward co-occurring capability in Tennessee. This regional event was held in Nashville, to engage both mental health centers and addiction provider organizations in central Tennessee. The agencies that attended each had individual meetings with Dr. Minkoff to focus on the results of their COMPASS-EZ self-assessments and how to utilize those to develop achievable and meaningful action plans to improve co-occurring capability within their current services and resources.

For more information visit Tennessee Co-occurring Disorders Collaborative

Vermont Co-operative for Practice Improvement and Innovation (VCPI): Dr. Minkoff participated with the VCPI Leadership Team in helping to develop the transition plan for VCPI to move out from under Southern New Hampshire University to its new “parent” at Northern Vermont University. This provides an exciting opportunity for VCPI to have more support for growth and innovation going forward.

For more information visit vtcpi.org

Recovery to Practice: On May 31, Dr. Minkoff participated in a teleconference for the RTP Advisory Committee (Task 4) hosted by Advocates for Human Potential, to discuss accomplishments to date on the preparation of webinars on rrecovery-oriented psychopharmacologic practice and next steps in the project.

Mid-Hudson (NY) Region Co-occurring Initiative: Dr. Minkoff participated in a planning call on May 31 with representatives of the seven counties (Dutchess, Orange, Putnam, Rockland, Sullivan, Ulster, Westchester) participating in this regional project, which was launched in November of 2016.   The counties are at the stage of readiness to implement COMPASS-EZ self-assessments across their mental health and substance use disorders programs in each county and work collaboratively under the guidance of the region (Marcie Colon – regional coordinator; Stephanie Marquesano of the Harris Project providing technical support and overall encouragement), county specific project managers, and county steering committees in each county to prepare to make formal progress. This conference call was a first step to helping each county match its next steps to its level of preparation, and to plan for a conference call to do COMPASS-EZ training in June. The next on-site activity for this project will be in November 2018.

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Current Work

We are always working to spread our ideas for hopeful, strength-based, integrated mental health practice to the many communities that need support.

January 2018

February 2018

March 2018

April 2018

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April 2018

Activities in April

Meadows Mental Health Policy Institute:   Continued work on finalizing the Houston Endowment substance use disorder System Report and helping to develop MAT TA capacity for Texas. Dr. Minkoff gathering information for the report on the new naltrexone pilot implemented in the Harris County jail, which is an excellent innovation. Dr. Minkoff and Dr. Cline continue to participate in the HHSC-MMHPI workgroup on substance use disorder policy.

On April 11, Dr. Minkoff and Dr. Cline joined Coby Chase and LDWW to meet with Bring Change to Mind leadership in San Francisco, as part of MMHPI’s efforts to seek collaborators for the next phase of its highly successful Okay to Say anti-stigma campaign. Dr. Minkoff and Dr. Cline are contributing content to help develop tools for families and loved ones to provide more effective help and support.

Follow MMHPI at www.texastateofmind.org

NATCON 2018 (April 22-25): Dr. Minkoff and Dr. Cline made four major presentations (averaging 100 attendees each). The topics included:   Implementing an Ideal Crisis System (this is connected to one of the important ISMICC recommendations and the GAP project -see below); Practical Strategies for Implementation of Medication Assisted Treatment; Implementation of Integrated Systems and Services for Individuals with Co-occurring Disorders in the Criminal Justice System, a general overview of principles and practices, and then a hands-on practicum session co-delivered with Judge Steven Leifman. The latter presentations incorporated material from the GAP Report which Dr. Minkoff co-chaired: People with Mental Illness in the Criminal Justice System: Answering a Cry for Help (2106). Dr. Minkoff attended his first meeting as a member of the national Council Medical Director’s Institute and reported to the group on the ISMICC Recommendations and how they could be helpful partners in supporting implementation efforts.

NATCON 2018.

People with Mental Illness in the Criminal Justice System: Answering a Cry for Help

CALM:   Continued telephone consultation to assist with the major implementation areas within the consultation, including improving revenue, addressing documentation challenges, improving the overall organization’s ability to provide a clinical management, training, quality improvement, and supervision structure that reinforces clinical care and values, and addressing the need for better program budgeting to align staff capacity and service expectations.

Vermont Co-operative for Practice Improvement and Innovation (VCPI): VCPI has made a decision to go forward with Northern Vermont University as a new parent partner. The process of transition is proceeding smoothly.   There is planning underway for a new federal grant to support improvement in health and behavioral health integration and trauma-informed care.

Common Ground: Continued consultation to assist in the development of improved capacity for Common Ground to deliver the highest possible quality comprehensive crisis service array in Oakland County, Michigan

Tennessee Co-occurring Strategic Initiative: Planning for 6 days of on-site training, consultation, and technical assistance during May and June.

Group for the Advancement of Psychiatry: On April 12-14, Dr. Minkoff attended the GAP meeting, and co-chaired, with Dr. Jackie Feldman, the Committee on Psychiatry and the Community, continuing work on the project of identifying the specific criteria that define a model crisis system for any community. This work in progress was presented at NATCON, and elicited great interest and energy from many in the audience who are directly attempting to address this issue in their home communities.

Silver Hill Psychiatric Hospital: On April 26, Dr. Minkoff and Dr. Cline conducted an on-site consultation at Silver Hill to assist the whole organization addressing the improvement of its admission processes and internal collaborations to align with organizational mission and values of customer service and staff well-being. This exciting project resulted from an invitation from our colleague Dr. John Santopietro (from AACP, GAP, and NATCON Medical Director’s Institute), who is the relatively new CEO at Silver Hill, and is bringing a wealth of positive energy to the organization with his leadership.

 

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March 2018

Activities in March

Interdepartmental Serious Mental Illness Coordinating Committee: Numerous telephone conferences to discuss how best to implement the ISMICC recommendations.   This culminated in an interdepartmental meeting coordinated by SAMHSA on March 28, where over 50 representatives of multiple federal departments came to organize implementation efforts, along with 4 of the 14 non-federal ISMICC members, including Dr. Minkoff (along with David Covington, Elena Kravitz, and Conni Wells). SAMHSA’s leadership (Assistant Secretary McKance-Katz) made it clear that the ISMICC report is a foundation for much of SAMHSA’s ongoing efforts and has been very successful in engaging not only cooperation but enthusiasm from other federal departments. The attendees gathered into five workgroups, based on the major areas in which the ISMICC recommendations were organized, and developed initial work plans for those recommendations, with input from the non-federal members. This is the first important step in a multi-year process that has the potential to transform the national delivery system for adults and children with severe mental health and substance use issues.

Meadows Mental Health Policy Institute:   Dr. Minkoff was on site on March 1 to meet with community representatives to discuss an initial outline of recommendations for the Houston substance use disorders system.   The work on the Houston Endowment report is proving invaluable in providing important data on the current system that can result in state and local models for significant improvement in substance use disorder services of all types, with a particular focus on the opioid epidemic. Dr. Minkoff and Dr. Cline continue to participate in the HHSC-MMHPI workgroup on substance use disorder policy.

Follow MMHPI at www.texastateofmind.org

Ballad: A final round of on-site visits on March 6-7, along with meetings with the Ballad Behavioral Health Steering Committee to discuss and refine the 11 major themes identified by the TriWest-Zia team to recommend for Ballad’s investment in behavioral health services per its cooperative agreements with Virginia and Tennessee to support the approval of the merger.   Based on the successful response to the initial themes, the consultation team worked throughout March to provide an initial 121-page report to guide Ballad’s initial 3 years of implementation, which was accepted by Ballad as the final deliverable for the project.

CALM:   Continued telephone consultation to support initial efforts of various quality improvement teams, as well as to help the executive team transition to developing more solid administrative, financial, and HR processes to strengthen the organization and provide a foundation for developing a more solid “trauma-informed” organizational culture as well as improve service delivery capacity.

Vermont Co-operative for Practice Improvement and Innovation (VCPI): Dr. Minkoff has worked with the VCPI leadership to assist in planning for the transition of VCPI from SNHU to a new “parent organization” as well as in helping the maturation of the organization’s leadership and decision making structures and processes.   VCPI continues to grow and has recently acquired resources to support several new statewide projects.

SAMHSA: As a non-federal ISMICC member, and a psychiatrist, Dr. Minkoff was invited to a meeting convened by SAMHSA on March 12 to develop a partnership between SAMHSA and the leadership of the Association of Psychiatric Department Chairs. One of the key topics of this meeting was how departments of psychiatry can be implementation collaborators in the areas of both training and service delivery, at both the national and state levels, to make progress on the ISMICC recommendations.

Common Ground: Continued consultation to assist in the development of improved capacity for Common Ground to deliver the highest possible quality comprehensive crisis service array in Oakland County, Michigan

Tennessee Co-occurring Strategic Initiative: Dr. Minkoff provided a webinar on co-occurring supervision and competency development to the Middle Tennessee regional Co-occurring disorders learning community on March 21.

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February 2018

Interdepartmental Serious Mental Illness Coordinating Committee: Beginning efforts to organize the federal interdepartmental implementation process for the ISMICC Recommendations.

Meadows Mental Health Policy Institute:   Dr. Minkoff and Dr. Cline contributed to the policy recommendations submitted by MMHPI to the state legislature. Continued work on finalizing recommendations for developing a model for an ideal substance use disorder system for Harris County. In addition, Dr. Minkoff, as a member of the American Academy of Addiction Psychiatry (AAAP) has begun a process to link AAAP leadership to MMHPI and Texas addiction psychiatry leaders, in order to create capacity for bringing AAAPs newly funded 12.5 million dollar federal STR-TA grant for medication-assisted treatment expansion to Texas.

Follow MMHPI at www.texastateofmind.org

CALM:   Continued telephone consultation to initiate change processes at all levels of the organization, including initiation of quality improvement teams to improve access, supervision, and overall capacity for service delivery.

Ballad: On-site visits on February 5 (for official project launch), and February 12-13, during which ZiaPartners and TriWest conducted interviews with Ballad services throughout the North East Tennesee and South West Virginia regions, as well as meeting with important community providers (particularly Frontier Health, the major Mental Health center in Tennesee and part of Virginia), state leaders in Virginia and Tennesee, and other community stakeholders.

Vermont Co-operative for Practice Improvement and Innovation (VCPI): On February 23, Dr. Minkoff consulted to a half-day meeting of all the co-occurring project teams, to engage the participants in both the final evaluation of the project’s success, as well as in helping to design a continuing co-occurring competency learning community to be supported by state mental health and substance abuse leadership as well as by VCPI.

American Association of Community Psychiatrists: Dr. Minkoff attended the AACP Winter Board meeting in Nashville, TN Feb 9-11. As Chair of the Products and Services Plank, Dr. Minkoff helped to produce a formal position statement developed by the AACP recommending a comprehensive review of the current administrative treatment planning requirements for community mental health service delivery.

SAMHSA: As a result of the above, Dr. Minkoff was invited, along with other AACP members and other stakeholders, to a meeting convened by SAMHSA on February 28 to gather information about the current challenges of treatment planning requirements to determine how SAMHSA could implement such a review that would improve both service quality and customer and staff experience in public behavioral health services.

Common Ground: Continued consultation to assist in the development of improved capacity for Common Ground to deliver the highest possible quality comprehensive crisis service array in Oakland County, Michigan

For more information about common ground click here.

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January 2018

Interdepartmental Serious Mental Illness Coordinating Committee:

Meadows Mental Health Policy Institute:   Dr. Cline and Dr. Minkoff, along with Sam Shore, began participation in a Texas Health and Human Services Committee joint workgroup with the Meadows Mental Health Policy Institute (MMHPI) on substance use disorders, with an initial focus on aligning data and policy recommendations to the House Select Committee. The recommendations to the state legislature continue to be aligned with findings and recommendations from the Houston Endowment funded project to assess the substance use disorders delivery system for Harris County (Houston). Dr. Minkoff has worked to create a summary of evidence-based practices for substance use disorder systems and services, including universal co-occurring capability, which aligns with MMHPI recommendations for the design of an ideal substance use disorder system using a population health framework.

Follow MMHPI at www.texastateofmind.org

CALM:   ZiaPartners and TriWest had the first two-day on-site visit with CALM (Child Abuse Listening Mediation, INC) on January 24-25 and were able to get a broad overview of the strengths and improvement opportunities for the whole organization, within each region (South County, North County, Lompoc) and program.   This will be formulated into a change plan that will involve significant telephone support at various levels of the organization leading up to the next on site visit, which is scheduled for May 9-10.

Follow CALM at http://calm4kids.org/  

PROJECT LAUNCH- Ballad Health System Initial on-site and telephone meetings are scheduled for February.

For more information about Ballad Health click here.

Community Mental Health of Central Michigan: On January, 8-9, Dr. Minkoff provided a successful on-site training and consultation on integrated services for individuals and families with co-occurring mental health and substance use disorders for this regional multi-county system.

For more information about CMHCM click here.

Vermont Co-operative for Practice Improvement and Innovation (VCPI): Dr. Minkoff provided the final round of TA Conference calls to the six project teams in the statewide project to implement co-occurring competency.

For more information about VCPI click here.

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