Linda’s List of 2016 priorities includes legislation and diversification
January 19, 2016 by Julie Miller, Editor in Chief
This year, the U.S. Surgeon General will commission an inaugural report outlining the state of substance use, addiction and health. Such reports have a way of changing the national dialog around a heath concern, as evidenced by previous Surgeon General research related to smoking, nutrition, violence and HIV/AIDS. For example, the rates of tobacco use have been cut in half since the landmark Surgeon General’s report in 1964 cautioned for the first time that smoking is in fact bad for your health.
In cooperation with SAMHSA, researchers will review a broad range of current findings on addiction disorders and provide recommendations for future action. It’s intelligence that Linda Rosenberg, president and CEO of the National Council for Behavioral Health, is looking forward to.
“This may have great impact on the field, and it will help move along the idea that addiction is an illness just like any other chronic condition,” Rosenberg tells Behavioral Healthcare. “The timing is good, and I’m very pleased it’s going to include alcohol, which continues to be the biggest killer of all. We’ll be ready to weigh in on that research in any way that could be helpful.”
Have a look at what else is on “Linda’s List” for 2016:
* Behavioral Health Legislation: In his State of the Union speech, the president specifically challenged lawmakers to address behavioral health issues. Meanwhile, House Speaker Paul Ryan (R-Wisc.) has been optimistic about Rep. Tim Murphy’s (R-Pa.) bill passing this session because more Democrats have signed on in recent weeks. As of the middle of January, the bill had 178 co-sponsors (129 Republicans, 49 Democrats). Rosenberg says Murphy gets a lot of credit for making mental health such a visible issue, which has led to many others weighing in to propose solutions. But progress will be incremental, she says.
“It’s important because it signals ongoing interest in behavioral health that in years past we didn’t see,” Rosenberg says. “But we’re seeing it now.”
* Certified Community Behavioral Health Clinics (CCBHCs): The CCBHC pilot project aims to create an enhanced care-delivery and payment model. Once formal criteria and payment systems are established, treatment centers that qualify will have incentives to provide integrated, recovery-oriented care across the healthcare continuum.
A planning grant is already providing funds for 24 states to develop their models and prepare applications. Final applications for the two-year practical demonstration are due in October 2016, and eight of the applicants ultimately will be selected to test their programs in January 2017.
“I see it as a way to create the equivalent of what Federally Qualified Health Centers have been able to accomplish over the last 10 to 15 years: a way to have enough funding so you can provide state-of-the-science service,” Rosenberg says.
For example, the enhanced funding could allow for improved access to care on weekends or more technology supports or even broader clinical capabilities.
She says National Council and some congressional leaders are championing a possible expansion of the practical testing phase from eight states to every state. The organization’s annual conference in Las Vegas March 7 to 9 will offer several sessions on CCBHCs, from an introduction to the basics to a management deep dive for the back office.
* Mental Health First Aid: This year, National Council is driving a new campaign, “Be 1 in a Million,” which aims to train 1 million people in Mental Health First Aid. Rosenberg says Congress included $15 million for Mental Health First Aid in the 2016 budget to support the training, which teaches people in the community how to recognize when someone might be experiencing a mental health or substance use problem and how to encourage them to get help.
Currently more than 500,000 people, from law enforcement officers to educators to First Lady Michelle Obama, have participated, but National Council wants to double that number.
* Consolidation and Diversification: Increased insurance coverage and improved behavioral health benefits have made this segment attractive to investors who look to consolidate the fragmented industry and grow both vertically and horizontally. The evolution is foreboding for not-for-profits with slim margins and little in reserve.
“There’s worry among them about ‘are we big enough to survive?’” says Rosenberg. “We’ll see diversification as they go after opportunities to grow in the future.”
In addition, smaller organizations will be far more challenged to enter into value-based reimbursement arrangements. Rosenberg says providers will come to realize that “value-based” truly means “accepting financial risk” as the models demonstrate results in the healthcare system at large.
“Hopefully there will be some value in what’s purchased, but in the end, you have to take on some risk,” she says. “The Centers for Medicare and Medicaid Services is driving that, and they’re pretty clear about what it means.”
* Millennials: Rosenberg says millennials seek mental healthcare more often than any other group, and leaders in the older generations will need to rethink their approaches. For example, urgent care and walk-in clinics are more in demand by millennials, as are online supports and technology-based services. NatCon 2016 will include a technology track and a program for young leaders under the age of 35.
* Brain Health: There are new organizations entering the technology space with an eye on the research that indicates the plasticity of the human brain and its ability to transform. “From brain stimulation to games to home-monitoring technologies, which of those will be real solutions and which will survive? Those with technology and human touch are more likely to make it in the marketplace,” she says.
Those who operate treatment centers might not be comfortable with the technologies being developed right now to enhance brain health, but in time they could be a routine part of treatment. As evidence supports their use, brain technologies will also see opportunity for payer reimbursement as well.
* Social Determinants of Health: “While we might look at cultural competence, we don’t often look at racial bias,” she says.
According to Rosenberg, data shows black populations are more likely to be in more restrictive care settings, and those in poverty are more likely to have mental health diagnoses.
“These will be a series of uncomfortable conversations about race, class and privilege, which is very much tied to issues of incarceration and violence,” she says. “That’s an arena beyond what we traditionally think of as the behavioral health space.”