Integrating behavioral health & physical health care

This is the third in a series of seven CEO minutes where I will be focusing on the need for all of  the behavioral health community to come together to roll out a grassroots advocacy plan focused on ensuring a strong alcohol, drug addiction and mental health service system.

Ohio’s behavioral health system is at a precipice. The future of Ohio’s Community behavioral health system is heavily reliant on many factors and the SFY 2012-2013 budget process is certainly going to be one of the most difficult processes Ohio has ever faced. Now, more than ever, the community behavioral health system must come together to prepare for a future that is likely to be full of change.

While it is clear that the upcoming biennial budget will impact the community behavioral health system, it is still unclear how, when and to what extent.  Policy decisions at many levels will be made as to how to implement changes in how local services are funded, and what these services will look like. What we also know is that in a time of shrinking budgets the most important question to be answered is how will Ohio’s leaders ensure that individuals in need of mental health and alcohol and drug addiction treatment and support services get the care that they need in order to achieve recovery. One area that we know needs to be addressed is the need to look at how behavioral health services will be integrated with physical health services both in regards to funding and in regards to individuals with a mental illness and/or addiction getting all of their health needs met.

Advocacy for the integration of physical and behavioral health care needs to occur at the local, state and federal levels. Advocates in Ohio need to support policy decisions that encourage the bi-directional integration of care by integrating primary care into community behavioral health settings and behavioral health care into primary care settings.  This approach will allow for the adoption of models suited to treat individuals with mild to moderate behavioral health concerns in primary care settings as well as provide primary care services to individuals with more serious conditions in behavioral health settings. The integration of physical and behavioral health services also supports the concept of integrating match for behavioral health services with the ODJFS 525 line and the funding of physical health Medicaid match funding.

So what can you do? Educate your local legislators on why funding and supporting behavioral health care is as important as physical health care, and how the two are so interrelated.

I hope you all have a very HAPPY NEW YEAR

Cheri L. Walter
Chief Executive Officer

As I stated last week, for the next several weeks I will be highlighting a grassroots advocacy plan that all of us who are advocates of strong alcohol, drug addiction and mental health services can engage in.  We know that in the next several months Ohio’s community behavioral health system will face a number of challenges and changes, in order to turn these challenges into opportunities we all need to educate policy makers and the public about why behavioral health care services and supports are so important and why they must be adequately funded.

This week I will lay out the Community Behavioral Health Financing Plan that is supported not only by OACBHA, but by all of Ohio’s behavioral health statewide provider, consumer, and family advocacy organizations. The plan has three specific recommendations, they are as follows:

Behavioral Health Medicaid match shall be funded out of the ODJFS 525 line.

• It’s a parity issue: BEHAVIORAL HEALTH CARE IS HEALTH CARE, and there should be no distinction in how Medicaid match is funded for physical and behavioral health care services.
• Without change and with the loss of enhanced FMAP, neither ODMH nor ODADAS will have enough community-focused GRF to meet Medicaid match in SFY 2012 and 2013.
• Behavioral health Medicaid match would represent less than two percent of the total Medicaid match, and could be funded with no increase in the ODJFS 525 line item.

Boards shall not be required to utilize local levy funds to match Medicaid.

• Voters pass levies to support locally identified needs, not a state entitlement.
• In the foreseeable future, there will continue to be individuals in need of treatment and recovery supports who have no insurance or means to pay.
• There will always be a need for non-Medicaid eligible recovery support services that allow individuals to live independently in the community.

ODMH line items 408 and 505, as well as ODADAS line item 401 shall remain fully funded, with the dollars being allocated to communities.

• The 408, 505 and 401 line items are necessary to fund services for non-Medicaid eligible individuals and non-Medicaid eligible recovery support services.
• Mental health and addiction services must be available for all Ohioans, whether they are Medicaid eligible or not.
• Without access to alcohol, drug addiction and mental health services, more Ohioans will die as a result of their disease, suicide or overdoses.

Have a Merry Christmas & a Happy New Year!

Cheri L. Walter
Chief Executive Officer

In the next several months and years, Ohio’s community behavioral health system will face a number of challenges and changes. Some are ongoing, some will be new. All carry with them, if addressed correctly, potential opportunities to help strengthen Ohio’s ability to provide community-based alcohol, drug addiction and mental health services and supports. In order to turn these challenges into opportunities a strong grassroots advocacy presence will be necessary to continue to educate policy makers and the public about why behavioral health care services and supports are so important and why they must be adequately funded.

Over the next 6 weeks (beginning 12-20-2010) I will be highlighting one of the 6 areas that we believe will be important a play a significant role in shaping the future of the community behavioral health system. The six advocacy areas that I will be addressing are as follows:

1. Community Behavioral Health Financing Plan;
2. Integration of Physical and Behavioral Health Care;
3. Addressing Stigma: Behavioral Health Care Is Health Care;
4. Economic Viability: Treatment Works–People Recover, Recovering People Work, Working People Pay Taxes;
5. Impact of and Potential Changes in Health Care Reform, and
6. Education—Ensuring that Decision Makers Understand Ohio’s Community AoD/MH Systems

Have a great week!

Cheri L. Walter
Chief Executive Officer

Sunday December 5, 2010 there was an article in the Columbus Dispatch titled Budget Tactic: Offer Savings. The most striking thing in the article is that going into a biennial budget where the state may face as much as an eight billion dollar hole; groups are going to have to show how what they are proposing in their budget plan will in the end save the state dollars. Additionally, we are learning that the best way to sell the behavioral health finance plan is to show that providing the appropriate alcohol, drug addiction and mental health treatment is in fact the wise fiscal choice for Ohio, and that through treatment we are helping Ohio economically. So for everyone who is promoting the behavioral health finance plan we would suggest that you first know and understand the behavioral health finance plan (please access the plan by clicking here) also to read the article that was in the Columbus Dispatch, click here.

If you have any questions concerning the behavioral health finance plan please feel free to contact Suzanne, Fonda, Liz or me at the Ohio Association of County Behavioral Health Authorities.

Have a great week!

Cheri L. Walter
Chief Executive Officer