A new way to find and organize NIATx promising practices

Last month we sent out a survey asking for feedback on the NIATx website. One of our goals was to determine which resources people used. Of the twelve options, four were closely bunched together as the most popular. The Process Improvement 101 online tutorial and the Provider Toolkit, which features a step-by-step guide to conducting a successful change project, tied for third place. Our Forms and Templates page came in second, and our catalog of Promising Practices topped the list.

The NIATx Promising Practices are a rich resource. They teach and inspire by using the successes and failures of other agencies. In an effort to help you find the promising practice that best suits your needs, we've added some new features that allow you to refine your search.

Located under the NIATx Resource Center tab, the new Promising Practices page alphabetically lists all of the promising practices available to you. A new "Refine Promising Practices" feature on the right side of the page allows you to quickly sort the list by aim, ease of implementation, expected benefit, and financial impact. Just check the boxes that apply to your agency's goals.

If you prefer the original organization of promising practices, those pages are still available and links to them are located above the "Refine Promising Practices" search options on the right side of the page.

As you're using this new tool, please let us know what you think. Your feedback helps us determine which new services and tools to offer.

Send your comments or questions to webmaster@niatx.net

NIATx/SAAS Seeking Nominations for Leading Innovations in Behavioral Healthcare Services

Behavioral healthcare organizations who are leading the way with innovative approaches to management and process improvement have an opportunity to be recognized as leading innovators with the 2010 iAward.

Sponsored by Washington, D.C.-based State Associations of Addiction Services (SAAS) and NIATx, based at the University of Wisconsin, the 2010 Innovation in Behavioral Healthcare Services Awards highlights innovations in process improvement practices that position an organization to meet the challenges of future service delivery.

The iAwards aim to provide national recognition of agencies that are using innovative approaches and provides a venue for them to share how they have adapted to meet the changing needs of clients, staff and the addiction healthcare field.

To be eligible for the iAward, provider organizations, coalitions, or state, county or local government payors/agencies must have developed and implemented an innovative practice in either management or process improvement within the previous three years. Innovations may be evidence-based or a best/promising practice and should be a new practice or an adaptation of a current practice.

This award is limited to entities engaged in addiction treatment and recovery services. Other behavioral healthcare organizations are eligible if the innovations relate to services integrated directly with treatment and/or recovery, e.g., co-occurring disorders, criminal justice, child welfare, primary healthcare. This could also include organizations that have implemented recovery-oriented systems.

Up to ten awards recognizing innovations in management and process improvement will be presented. Examples of areas in which innovations have occurred include (but are not limited to): workforce development, client access to treatment, client engagement /retention in treatment, continuity of care, staff engagement and retention, creative funding models, performance management, and community engagement.

Awards will be presented at the NIATx Summit and SAAS Annual Conference in Boston, July 10-13, 2011.

All expenses for travel and registration will be covered for one representative of each award. Deadline for submissions is February 15, 2011. For more information or to nominate your organization, download the award nomination form at www.saasniatx.net.

Are you ready for health reform?

Are you ready for Health Reform?

Or other major trends impacting how behavioral health will be delivered in the future?

NIATx has developed a Health Reform Readiness Index that is easy to complete and free. The brief tool assesses your readiness based on the organizational processes you need to have in place to participate in accountable care organizations or Medicaid; achieved desired clinical outcomes; and participate in the general health care system. Complete the Health Reform Readiness Index today and begin making your plans for pending changes in how behavioral health services are delivered.

The "Health Reform Readiness Index" was developed and tested in the twenty-two organization national "Accelerating Reform Initiative" project. The Accelerating Reform Initiative gives behavioral health care organizations the tools and peer supports they need to respond to the sweeping changes that parity, health care integration, and decreased grant funding may bring. Click here to see a list of additional Accelerating Reform Initiative resources.

Reclaiming Futures Looking For New Executive Director

"Reclaiming Futures at Portland State University, in downtown Portland along the tree-lined Park Blocks, is an excellent place to work. As our full-time national executive director, you will provide the vision, leadership, and direction to spread Reclaiming Futures -- a proven model used by 29 communities to help teens overcome drugs, alcohol and crime -- to new sites across the country. For position description and application instructions, visit: www.hrc.pdx.edu, under "Faculty and Administrative Opening." To learn more about Reclaiming Futures, visit www.reclaimingfutures.org."
"Application review begins mid-November and position is open until filled. The successful applicant is expected to start work April 2011. PSU is an AA/EO institution and welcomes applications from diverse candidates and candidates who support diversity."

Victor Capoccia on health reform and the Accelerating Reform Collaborative

With the announcement of the NIATx Accelerating Reform Collaborative, we asked NIATx Senior Scientist Victor Capoccia to share his views on health reform and how NIATx will position itself within that new environment.

1. What is your view on the current state of affairs in behavioral health?

Without question, this is the most exciting period I have experienced in my 40-year career in social welfare and behavioral health. Here is why:

• There is greater knowledge about mental and substance based disorders and successful treatments. We have medications as well as counseling protocols that are tested and efficacious.
• Despite a slow economy, there are more resources to prevent and treat mental and addiction disorders than ever before; and there are more to come with the provisions of the Accountable and Affordable Care Act.
• There is greater understanding and awareness of addiction as a treatable health condition than at any previous period. Stigma still exists, but it exists in tandem with a better public understanding of mental health and alcohol and drug misuse.

Take these three forces, and they shout: OPPORTUNITY! Shame on us if we fail to make the changes needed to reach those who continue to suffer with untreated addiction and mental health conditions.

2.What kind of opportunities do you see health reform presenting to behavioral health organizations?

I feel that health care reform presents the following opportunities:

• Coverage of 32 million uninsured Americans that largely include a mental health and addiction benefit; this coverage includes dependents up to 26 years of age and low-income adults up to 100% of the federal poverty level.
• Insurance coverage if these conditions existed prior to coverage.
• Parity with general medical care for addiction and mental health treatments.
• Medical homes for chronic and acute patients.
• Prevention screening and intervention for Mental Health and Addiction disorders.
• Workforce development and training for behavioral health professionals.
• And many others...

3. What is the NIATx Accelerating Reform Collaborative?

The Accelerating Reform Collaborative comes from a simple premise: in a period of great opportunity where the "stars have aligned", we need to transform our treatment systems to reach more of the 20 million untreated people with addiction disorders and the 1/3 untreated of those with mental illness. Our current system is designed to reach 10% of 23 million people with addiction disorders, and 66% of people with mental illness. "Every system is perfectly designed to produce the results that it produces".

Only transformation of the system will reach beyond current performance.

The Accelerating Reform Collaborative is a collection of innovators from provider, academic, consumer and policy groups who are willing to share their ideas and experience to redesign the system to reach the untreated.

4. What's special about this collaborative? Why should organizations join?

It's the PEOPLE. The colleagues, the experience, the ideas. This is where the leading edge is being cut.

5. What is NIATx's future role with health care reform?

NIATx has and will continue to focus on the customer, understand the patient experience, and design systems that will help meet those patient needs.

That is our core, our soul.

CHESS to join NIDA Clinical Trials Network-Florida Node

Being involved in public health research for the past 40 some years, I feel fairly confident in saying that the group here at CHESS (which includes NIATx), well, we're pretty darn good at what we do.

We're really in a lucky situation. We can let our imaginations run wild, without limitations or barriers.

But in the real world we all face limitations and barriers. For many of our NIATx organizations just keeping the doors open or making payroll are a daily reminder of that.

One of the barriers that we struggle with at CHESS is how do we get the results of great research into the hands of the people who need it most. Effective dissemination has to be a priority for us.

And that is one of the many reasons that I'm excited to announce that beginning October 1, CHESS will join the Florida Node Alliance of the National Institute of Drug Abuse (NIDA) Clinical Trials Network (CTN).

The CTN works to bring researchers and treatment providers together with the aim of improving substance abuse treatment. What this means is that we'll be able to conduct large scale studies that can take into account the variations between treatment agencies and variations in payment schemes so that the research will be of more practical value.

The CTN will allow our research to expand beyond tightly controlled laboratory environments. Having access to agencies that represent a range of delivery sites and philosophies will help us to better understand the real-world implications of our research.

When we start moving into the community and trying things out we will have a much better idea of what works, when it works and for whom it works. That's one of the problems with Evidence Based Practices (EBPs). What worked in a very controlled environment doesn't necessarily translate in the real world.

This will allow us to extend work that NIATx has already begun through programs like Advancing Recovery. Advancing Recovery took EBPs, continuing care for example, and partnering with treatment agencies and State government learned what it takes to make these innovations work in the real world.

Technology will be the focus of the Center's work with the Clinical Trial Network, beginning with Addiction-CHESS (A-CHESS), with plans to test similar technology under development for families (FAM-CHESS), drug courts, and a number of other populations.

And through this new relationship with CTN and the continued work of all our NIATx member organizations, my hope is that the results of our research will be relevant to the full range of treatment agencies, and not just a limited subset.

David Gustafson
Director, NIATx

Preparing for Parity and Health Care Reform

As the landmark parity legislation takes effect this year and we look forward to the increased access to health care coverage that will take effect in 2014 due to the recently passed health reform legislation, NIATx is working to develop tools to help service providers use process improvement and systems design to improve their back office functions as well as their work with clients.

Parity and health reform will increase the number of people who seek treatment and have insurance to cover it. One part of the health reform bill that takes place this year is the requirement for health plans to allow adult children to stay on their parent's insurance until age 27. This expansion of coverage to young adults means that many people that need treatment now have coverage. That coverage requires the capacity to bill for service. The capacity to bill for services may mean a change in staff, both clinical and office staff; it may mean the need to develop a process for billing or for paying more attention to collections as insurance reimbursement may become a bigger portion of your revenues.

As the health care payment system becomes more responsible for paying for services, the health care delivery system will become more responsible for delivering services. Already we see widening use of SBIR and a large proportion of community health centers already have behavioral health specialists who are providing mental health counseling but will soon develop capacity for adding addiction treatment to their mix. What this means for specialty providers is the need to develop relationships with health care providers now.

It may be time to begin thinking about integrated electronic health record systems that can communicate with other local health systems and can offer both a clinical record and practice management services. An important aspect of health reform is to modernize the health care delivery system through these kinds of systems and a great deal of money is available to help providers purchase and integrate these systems into their practice. Right now you are mostly excluded from access to the funds, but there are several efforts underway that should change that in the near future.

All of these changes will have a huge impact on the behavioral health and particularly the addiction treatment business model. NIATx is developing a set of tools and training opportunities to help you make the transition from your current business model to the business practice of the future. The first two projects are already underway. We have the NIATx Billing Guide, published for those who have never had to bill for services and want a place to start. We also have a fifty site learning collaborative that will launch in October to help providers develop or improve upon their billing practices. In October, we will also launch a collaborative project with the National Association of Community Health Centers to better integrate behavioral and community health programs.

Keep reading our blog and checking the web site for more opportunities to participate in efforts to move business practices forward.

And always remember to keep your customer/client in mind. In the end, we hope that these changes will expand access to services to an extent that we couldn't achieve by just improving agency efficiency. Together, we will move forward to ensure that everyone that needs treatment can get it!

Kim Johnson
Co-Deputy Director, NIATx