June 11, 2009
Dear Stakeholders:
Over the past two years, the Office of Mental Health (OMH) has continued to “update” key components of the public mental health system. As you likely know, the planning phase associated with the clinic restructuring initiative is close to completion, and we are currently working with stakeholder groups to design and implement relevant training approaches for clinic providers to ensure a successful and smooth transition to the new model in January 2010. Additionally, we are working on improved access, efficiency and relevance of inpatient and community services provided by OMH Psychiatric Centers (PCs). The past year saw a 15% increase in admissions in 5% fewer beds in the adult PCs; this work will continue.
To better emphasize a recovery agenda, OMH has launched a project to research peer operated “recovery centers.” This project is funded through a grant from the Substance Abuse and Mental Health Services Administration (SAMHSA), and will explore best practices related to these programs. Experience in New York and elsewhere shows that excellent peer-run programs supplement the work of more traditional treatment and rehabilitation programs, provide an alternative for people seeking care, and are an integral component of a redesigned system of care. A final report associated with this project is scheduled for release this fall.
The next phase of outpatient redesign – commonly referred to as ambulatory restructuring – involves programming and financing models for other programs. We are addressing the redesign process separately for Children and Adults so that we can respond to the complexity and diverse needs of each ambulatory system. The Children's Ambulatory Workgroup, composed of providers, other state agencies, advocates, family and youth has been working for nearly a year. A draft report of their initial findings and recommendations is being finalized.
The first step in ambulatory restructuring for the Adult service system was to detail the current array of mental health programs from both a programmatic and fiscal perspective. This assessment was conducted by Richard Dougherty PhD, of DMA Health Strategies. Dr. Dougherty's report, which includes a summary of his analysis, findings and recommended options for moving forward, is enclosed.
This report references an urgency for restructuring that is partially driven by anticipated (Federal) Medicaid regulations. However, since the completion of the report, CMS rescinded several of these regulations (e.g., targeted case management regulations were partially rescinded, and proposed rehabilitation regulations are under review). Given the uncertainty about CMS direction and the importance of working effectively on clinic reform, OMH plans to delay the more intensive work related to ambulatory restructuring until 2010. As was the case with clinic restructuring, OMH expects stakeholder involvement with this effort.
I encourage you to review the enclosed report and to begin thinking about ways that we can collectively improve the system, making it more recovery-oriented, outcome-based and accountable. Any reactions to this report should be submitted to Gary Weiskopf, Project Director. We appreciate your ongoing assistance and collaboration.
Sincerely,
Michael F. Hogan, PhD
Commissioner