January-February 2019

ZIA NEWS – January-February 2019


There has been continuing activity on both old and new projects as 2019 starts off with a lot going on!

Interdepartmental Serious Mental Illness Coordinating Committee:

Dr. Minkoff and the non-federal members of ISMICC were successful in putting together a draft report outlining progress and suggested next steps for the federal ISMICC agencies to make further progress on implementation of the ISMICC recommendations. The next step is to work with Dr. McKance-Katz and SAMHSA staff to identify the best way for the non-federal members to work collaboratively with the federal members to help everyone be successful. One of the items under consideration is how the report should be utilized, if at all. Currently, the report is in draft form, and further dissemination is on hold, pending discussions in March.

Group for the Advancement of Psychiatry (GAP) – Committee on Psychiatry and the Community: 

Dr. Minkoff is co-chair of the committee, with Dr. Jackie Feldman, working on developing a report outlining the measurable criteria for an “Ideal Crisis System” for any community. Dr. Feldman, Dr. Balfour, and Dr. Minkoff met in Tucson at the end of February to coordinate the contributions from the entire Committee into a first draft. This meeting was highly productive, and it is anticipated that the review draft will be available in March 2019.

National Council for Community Behavioral Healthcare: ZiaPartners is an Affiliate Member of National Council, and Dr. Minkoff is a member of the Medical Director’s Institute. ZiaPartners has committed to two presentations at the NATCON conference in Nashville in March: A pre-conference institute on co-occurring disorder service implementation on March 24, and a presentation on the criteria for designing and implementing an Ideal Crisis System (with Dr. Margaret Balfour from Connections AZ) on March 25.

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 Behavioral health service delivery. Dr. Minkoff has developed an updated vision and mission draft for the organization that outlines this new direction, which is pending approval at the March Board meeting.   Once this material is disseminated, Dr. Minkoff will be working on helping to seek funding to support the “big new vision” for the organization.

National Association of State Mental Health Program Directors (NASMHPD) – Dr. Minkoff was contracted by NASMHPD to prepare one of its 2019 concept papers (funded by SAMHSA) on developing integrated systems and services for individuals with co-occurring Mental health and substance use disorders. Dr. Minkoff will be working on this project with Nancy Covell of the Center for Practice Improvement at Columbia. The paper’s first draft is nearly completed, and will be due for finalization by June.

American Association of Community Psychiatrists – Drs. Minkoff and Cline worked during December to plan the Winter Board meeting of AACP in Vieques, Puerto Rico. The meeting was held from January 31-February 2 and involved AACP working with the entire community on how to improve mental health services on this tiny island (Population 10,000) that has experienced considerable trauma.   Drs. Minkoff and Cline participated in a community event on mental health, that involved a wide representation of community representatives and a consulting psychiatrist group called Crear Con Salud, one of whose members is an AACP Board Member. AACP is planning continued involvement with this small community, including planning for holding a follow up Board meeting in Vieques next winter.

Meadows Mental Health Policy Institute:   ZiaPartners came to Texas in January to be part of a proposal presentation for system consultation to John Peter Smith, the Tarrant County Hospital District. ZiaPartners has continued active involvement in multiple projects and activities conducted by MMHPI, as follows:

  • Finalizing the Houston Endowment Substance Use Disorders 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 substance use disorder 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.
  • Working 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

Iowa East Central Region: ZiaPartners held a very successful two-day crisis training conference in Dubuque, attended by representatives from crisis center development in all three major communities in the region (Dubuque, Iowa City, Cedar Rapids).   The conference covered a range of topics including: characteristics of an ideal crisis system, team-based staffing models, clinical practice development, integrated crisis assessment, integrated level of care assessment, developing data driven quality improvement metrics, and a deep dive conversation on funding and billing within the Iowa Medicaid system, involving representation from two MCOs and from DHS. There was a follow up conversation on implementation steps with Dubuque, and a follow up conference call on developing specific recommendations for how to define various types of service provision and associated reimbursement.

Greater Oregon Behavioral Health, Inc. (GOBHI): ZiaPartners engaged in an onsite planning visit with GOBHI leadership and board members in West Linn, OR on February 13. This involved a presentation on the CCISC model and how it could be applied within the GOBHI system (and the state of Oregon generally) to advance Mental Health/Substance Use Disorders and Psychological Health/Behavioral Health integration, especially within the context of CCO 2.0 re-procurement. The presentation was well-received, and the decision was to go forward with a formal launch at the spring conference in May.

Illinois Department of Human Services: ZiaPartners began a consultation project with the Mental health Division and the Substance Use, Prevention, and Recovery (SUPR) Division to assist the Mental health Division with addressing the needs of individuals with co-occurring Mental Health and Substance Use Disorders who are in institutions (IMDs and Nursing Homes) who are covered by two federal consent decrees requiring progress in deinstitutionalization. The project will involve consultation to the state, engagement with providers, and provision of recommendations, as well as technical assistance, consultation, and training on implementation of recommendations that will help the state meet its targets under the consent decrees.

Massachusetts:   On January 16, Dr. Minkoff participated on a panel for a state leadership conference on integration of Mental Health and Substance Use Disorders in Massachusetts, coordinated by Danna Mauch, Executive Director of Massachusetts Association of Mental Health, in collaboration with National Council (BHECON project). The result of Dr. Minkoff’s presentation was a verbal consensus from participants that Massachusetts should take organized steps to implement an integrated system of care where all programs become co-occurring capable.

St. Clare’s Behavioral Health: On January 18, Dr. Minkoff did a full day training on developing integrated services and systems for individuals with co-occurring mental health/substance use disorders for St. Clare’s Hospital Behavioral Health Services in Denville, NJ. The presentation was very well received and generated some significant energy and excitement for change.

All Health Network: In February, Dr. Minkoff conducted a 2 day on-site assessment of the full array of co-occurring disorder services at this large mental health center serving Arapahoe and Douglas Counties in Colorado (outside of Denver). The assessment generated substantial excitement for organizational change, and to improve the existing co-occurring IOP services as well as to develop co-occurring capability in the current array of serious mental illness recovery services. This will result in an ongoing implementation project that will begin in March, with a formal launch event in April.

All Health Network

Tennessee Co-occurring Strategic Initiative: Dr. Minkoff and Dr. Cline had a teleconference with Patrick Slay and representatives of 7 agencies participating in the Tennessee Co-occurring disorders project, regarding how these agencies can participate as peer mentors to registrants at the Pre-Conference Institute at NATCON in Nashville in March. The participants were delighted to share their positive experiences and learning and indicated that it would be fun for them to be involved in this way.

Vermont Co-operative for Practice Improvement and Innovation (VCPI): Dr. Minkoff continues working with the VCPI leadership team to develop a working leadership and operations structure for VCPI. ZiaPartners is also a subcontractor along with VCPI on a proposal submitted by Vermont Care Partners to Vermont Department of Mental Health to expand co-occurring Mental Health/Substance Use Disorders services, with a focus on adults with Serious Mental Illness and Opioid Use Disorder.

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, as well as assistance with application for a SAMHSA Grant to develop “air traffic control” capability.

Genesee County, MI: Dr. Minkoff contracted to provide six days of co-occurring disorder implementation training to Genesee County Behavioral Health: 2 days each in April, June, and September.

Network 180, Grand Rapids, MI: Dr. Minkoff contracted to provide one day of training in June on integrated strength-based case formulation and treatment planning for individuals with co-occurring disorders and other complex needs.

CALM:   ZiaPartners met by phone with the individuals who funded our consultation project to report on successful progress to date. CALM has made dramatic progress in the course of our consultation, and the results of their organization’s commitment to healthier organization culture, involving both clinical and business practice, are really taking hold at all levels.

Silver Hill Hospital – ZiaPartners had a teleconference with the new CEO, Andrew Gerber, MD to discuss our observations and recommendations.   ZiaPartners had contracted with Silver Hill (located in New Canaan, CT) to assist with continuing implementation of the transformational recommendations from our April visit, to implement a collaborative culture to facilitate admissions, transitions, and staff engagement. Dr. Gerber will be in touch regarding any requests for continuing help.

Mid-Hudson (NY) Region Co-occurring Initiative: Following the November conference, there has been continuing progress in counties across the region.   ZiaPartners is very appreciative of the amazing work on this project by Marcie Colon of the Mid-Hudson Region (link) and Stephanie Marquesano of The Harris Project, as well as the 7 County BH leaders.

Equine Assisted Therapies and Activities:   ZiaPartners was awarded a competitive bid to help multiple organizations involved with equine assisted therapies and activities to come together to develop a common language for the entire field. This three-day meeting is scheduled for July 2019.

Missouri Foundation for Health: ZiaPartners organized a team (including TriWest, Lynfro Consulting, and Joe Parks, MD from The National Council) to respond to an RFP released by Missouri Foundation For Health for a statewide analysis of the Missouri Behavioral Health System.   This proposal is under review and is one of three finalists. If accepted, the project will begin in summer 2019.

Monterey County, California: ZiaPartners was contacted by Michael Lisman, Director of Adult Services, for possible engagement with implementing an integrated service continuum in Monterey County. ZiaPartners submitted a proposal with multiple levels of possible effort, which is currently under review.


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