January-June 2020 Work


In the context of the COVID pandemic, there has been continuing (virtual, of course) activity on both old and new projects and a very busy summer!

Interdepartmental Serious Mental Illness Coordinating Committee:

Dr. Minkoff and the other non-federal members of ISMICC attended the in-person meeting of ISMICC at SAMHSA in December, 2019.   There are continued efforts by the non-federal members of ISMICC to develop mechanisms for outlining what has been achieved and to outline suggested next steps for the federal ISMICC agencies to make further progress on implementation of the ISMICC recommendations.  The ISMICC report provides an important road map for addressing many issues of significant concern to the nation regarding people of all ages with serious behavioral health needs, such as providing appropriate crisis response to help prevent suicide and violence, as well as the development of an integrated recovery-oriented continuum of care.

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.  During the November, 2019 GAP meeting (in person) and the April 2020 Committee meeting (virtual), the Committee has outlined a plan for completing revisions to the 155-page Draft Report, entitled: Getting to the Ideal Behavioral Health Crisis System: Essential Elements, Measurable Standards, and Best Practices.  The National Council has committed to publishing the document (fall 2020) once the draft is completed.

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. Dr. Minkoff and Dr. Cline’s presentations on Ideal Crisis Systems and Implementation of Welcoming, Integrated Systems of Care for Individuals with Co-occurring mental health and substance use disorders for the NATCON conference in Austin in April 2020, were canceled due to the cancellation of the conference.  Dr. Minkoff has been invited by Dr. Joe Parks (National Council Medical Director) and the Center for Integrated Health Solutions to be one of four editors for a National Council publication defining a new framework for measuring, implementing, and financing progress in dissemination of Primary Health/Behavioral Health integration in all types of settings and systems.   Dr. Minkoff has been participating in MDI discussions and webinars on COVID response.

American Association of Community Psychiatry (AACP): Dr. Minkoff is an emeritus Board Member, and Dr. Cline a past Board member of AACP.  Dr. Minkoff is a member of the leadership team, as coordinator of the Products and Services “plank” of the Board.  Dr. Minkoff has been helping AACP leadership (Michael Flaum, MD President and Wesley Sowers, MD, LOCUS lead) work with National Council leadership (Joe Parks, MD, Medical Director) to develop a combined strategy to advance the use of LOCUS (Level of Care Utilization System) and CALOCUS as a national standard for measurement of level of care determination.   This has been enhanced by the recent federal court decision in Wit vs United Behavioral Health, in which the federal court indicated that LOCUS indeed represented such a standard of care (in contrast to the proprietary instruments used by the managed care organization).  A LOCUS advisory committee has been formed (second meeting, June 29) under the auspice of the National Council, for the purpose of continuous improvement of the clinical quality of LOCUS and CALOCUS, developing further research on the effectiveness of LOCUS, and implementing plans for further dissemination. The most recent (virtual) AACP Board meeting was held in May 2020, supporting this process.

American Academy of Addiction Psychiatry (SAMHSA’s Serious Mental Illness TA Center):  Dr. Minkoff has been contracted by the AAAP to assist with its subcontract to the American Psychiatric Association’s Serious Mental Illness TA Center to provide materials that focus on improving services nationwide for individuals with co-occurring Serious Mental Illness and Substance Use Disorers.  Dr. Minkoff has created implementation guides for use by front line staff and managers.  He also services on the Serious mental illness TA Center’s Advisory Committee.

American Psychiatric Association: President’s Task Force on Psychiatric Beds:  Dr. Minkoff has been appointed to this taskforce by the APA President, effective May 2020. The goal of this taskforce is to delineate a methodology for recommending how many psychiatric “beds” are needed in any community.

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.     CBHL has used its summer Board retreat and a late 2019 membership convening to identify specific strategies for moving in the direction of this new vision, and for attracting funding partners to support this direction.  Dr. Minkoff will be participating on the Collective Impact subcommittee of the Board to help this direction.

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) entitled: Integrated Systems and Services for individuals with co-occurring Mental Health and Substance Use Disorders: What’s Known, What’s New, What Now  Dr. Minkoff has co-authored this paper with Nancy Covell, PhD of the Center for Practice Improvement at Columbia. The paper was released in August 2019, and includes specific recommendations for system leaders, policy makers, and funders.  Dr. Minkoff and Dr. Covell are preparing a shorter version to be submitted for publication to Psychiatric Services.

Northwest Mental Health Technology Transfer Center:  Dr. Minkoff presented a webinar on Ideal Crisis Systems to over 400 registrants on March 30 2020.

Meadows Mental Health Policy Institute:    ZiaPartners has concluded its contracted relationship with MMHPI, effective December 31, 2019, but remains in support of the Institute and its accomplishments.

Follow MMHPI at www.texastateofmind.org

Model Mental Health Commitment Law Working Group:  Dr. Minkoff was invited by Judge Steven Leifman (Miami-Dade, Circuit Court Judge, and national leader of criminal justice/Mental Health collaboration) to join a working group of judicial and psychiatric leaders to draft a model civil commitment law for the 21st Century, balancing current scientific knowledge, the need to have more access to civil commitment to help prevent unnecessary arrest and incarceration, and the importance of protecting civil liberties for people with all types of behavioral health challenges. The development of this product is also aligned with one of the recommendations in the ISMICC report. This project is coordinated by the Equitas Project and has had a series of teleconferences through the summer. There were full-day in-person meetings of this group in Denver on November 21 and in Miami on March 3.  The group is developing recommended procedural language for state and local jurisdictions to use to guide emergency intervention, non-emergency civil commitment (to any level of care), and diversion from the criminal system at any point in the sequential intercept

Missouri Foundation for HealthZiaPartners organized a team (including TriWest, Lynfro Consulting, and Joe Parks, MD from The National Council) to respond to an RFP released by MFFH (based in St. Louis and covering the eastern two thirds of Missouri), in partnership with Health Forward, a similar health access foundation based in Kansas City, for a statewide analysis of the Missouri Behavioral Health System for the purpose of helping the foundations develop an effective “investment strategy” for behavioral health to achieve greatest impact over time.   The team was awarded the project, which began in August, with the first on-site meeting in St. Louis on September 4, and further visits to Missouri in October and December to meet with a developing Advisory Committee for the project, as well as to interview a wide range of key informants, and to plan and organize consumer listening sessions. The team has completed an initial draft of a statewide report and is now conducting deeper analysis of 12 communities within six major regions within the state. 

Kent County Crisis System Project:  ZiaPartners, TriWest Group, and Common Ground have partnered to assist Kent County (Grand Rapids, MI) for assistance with developing an excellent behavioral health crisis system. This project involves intensive engagement with community leaders and included on-site visits in November and February to develop specific recommendations and implementation strategies. The County Consensus Workgroup has made considerable progress to developing consensus on a plan.

Mid-Hudson (NY) Region Co-occurring Initiative:  ZiaPartners is participating in grant funded project organized by Stephanie Marquesano of The Harris Project, as well as the 7 County Behavioral Health leaders, to implement co-occurring capable services in the Mid-Hudson region.  Dr. Minkoff, Dr. Cline, Ms. Marquesano, Michael Orth of Westchester County, and Marcie Colon of the Mid-Hudson Region provided presentations at the Institute of Psychiatric Services in NYC on October 6.  The current project involves 14 days of virtual consultation, training, and technical assistance over the next year. Columbia University’s Center for Practice Improvement is also partnering on this project, which is launching in June 2020.

Illinois Department of Human Services:  ZiaPartners has continued its 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. ZiaPartners provided a successful specialized training on integrated services for the most seriously disabled individuals with co-occurring Substance Use Disorders, in Chicago on December 12-13.  Based on this conference, ZiaPartners provided a set of next step recommendations to the Mental Health Division and SUPR that will inform continuing efforts in FY 2020.  This contract concluded on June 30, 2020 but may be renewed once the COVID pandemic permits.

All Health NetworkOn October 7-8, ZiaPartners engaged in continuation of a division wide improvement project for co-occurring capability development, as well as specific consultation and technical assistance to the agency’s Substance Use Disorder IOP and MAT services. The organization formed a change agent team, to support the improvement of welcoming, integrated services in partnership with leadership.  ZiaPartners continues to be available for teleconsultation.

Tennessee Co-occurring Strategic Initiative: Dr. Minkoff provided a videotaped webinar training on March 31 to provide guidance for working with people with co-occurring conditions during the pandemic. ZiaPartners will be continuing to work with TAMHO in the coming year to provide further support to this statewide initiative. 

Common Ground: Continued consultation to assist in the development of comprehensive redesign of the community crisis services system to result in improved capacity for Common Ground to deliver the highest possible quality comprehensive crisis service array in Oakland County, Michigan.  Dr. Minkoff provided a two-day on-site consultation visit on September 30-October 1 and continues to provide teleconference consultation as indicated.

Alameda County Healthcare Services Agency and Alameda County Behavioral Health:  Based on successful work performed by ZiaPartners with ACBH (2007-11) on improving co-occurring capability in the county behavioral health system, ZiaPartners has been asked to provide some ideas for how Alameda can advance its more recent efforts to improve integrated health, behavioral health and human services for individuals with complex needs, particularly those who are experiencing homelessness.   This project is termed Care Connect and is a key component of the Alameda County Whole Person Care effort.   The timeline of this project is currently on hold due to the pandemic.

Pillars Community Health:  ZiaPartners provided consultation to Pillars Community Health an integrated health and behavioral health provider organization in the Chicago suburbs, on how to maximize the capacity of services for individuals with substance use disorders throughout their continuum of care.  The project began in May 2020, and the consultation recommendations were submitted in June.

Berryhill Community Mental Health Center:  ZiaPartners is being contracted to provide training and consultation to this organization in Ft. Dodge, IA to assist with their meeting the expectations of their Certified Community Behavioral Health Center grant. This project will begin this summer and extend until Spring 2021.

Victoria, Australia: ZiaPartners had been contracted to come to Victoria in May 2020 to provide training and consultation in integrated Mental Health and Substance Use Disorders service and system change, in alignment with the Royal Victoria Commission’s recommendations for Behavioral Health system restructuring in Victoria. The visit was canceled due to COVID, but ZiaPartners is in the process of negotiating to provide similar services virtually.

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