Department of Mental Health
Symposium Agenda
9:00-9:10
9:10-9:30
9:30-10:30
Bill Eaton
Phil Leaf
Panel
Chair: Josh Sharfstein
Secretary, Maryland
Department of Health and
Mental Hygiene
10:30-10:45
10:45-11:00
11:00-12:00
12:00-12:30
12:30-1:15
1:15-1:45
Audience Q & A
Break
7 Breakout Groups
Groups report back
Lunch
Richard Frank
Harvard Medical School
Department of Health Care
Policy
Panel
Chair: Charles Milligan
Deputy Secretary for Health
Care Financing, State of
Maryland
1:45-2:45
2:45-3:00
3:00-3:15
3:15-4:15
4:15-4:45
4:45-5:00
5:00-6:30
Audience Q & A
Break
8 Breakout Groups
Groups Report Back
Phil Leaf or Bill Eaton
Wine and cheese reception
Welcome and opening comments
Introduction to the Public Health Approach
Improving Behavioral Health: the Public Health Approach
Amanda Harris
Chief Operating Officer, Pathways to Housing
Dave Oslin
Associate Chief of Staff for Behavioral Health,
Philadelphia Veterans Affairs Medical Center
Ron Manderscheid
Executive Director, National Association of County
Behavioral & Developmental Disability Directors
Carl Bell
President, Community Mental Health Council, Chicago
Chacku Mathai
Associate Executive Director, New York Association of
Psychiatric Rehabilitation Services
E2133, E2527, W2303, W2205, W2207, two in Feinstone
What do ACA and Parity Act mean for the future of
mental health care in the US? Mental Health Care reform
101
Financing Mechanisms for Behavioral Health Care
Reform: Opportunities and Challenges
Carolyn Quattrocki
Executive Director,
Governor’s Office of Health Care Reform
Howard Goldman
Editor, Psychiatric Services
Barbara Leadholm
Office of Behavioral Health, MassHealth
Rita Vandivoort, Senior Public Analyst, HRSA
Anna Marsh, Deputy Director, CMHS
E2133,W2017,E2527,W2300,W2205,W2207,Feinstone(2)
Closing comments
624 N. Broadway  Baltimore, Maryland 21205  (410) 955-3910
Department of Mental Health
Morning Breakout Sessions: The Public Health Approach: Opportunities and
Challenges
Group 1
Group 2
Group 3
Group 4
Covering the whole
population
How to serve those with
dual diagnoses
How to organize services
for children and adolescents
Process and outcomes of
performance management
Room W2207
Lisa Colpe (Chair)
Chet Schmidt
Alan Levitt
Alexander Cowell
Elspeth Ritchie
Carol Payne
Josh Sharfstein
Charles Milligan
Room E2527
Eric Strain (Chair)
Jackie Duval-Harvey
Frances Randolph
Susan Cycyk
Jeffrey Buck
Tami Mark
Robert Findling
Carolyn Quattrocki
Amanda Harris
Room W2205
Jane Plapinger (Chair)
Robert Heinssen
Sarah Duffy
Kirsten Beronio
Thomas Bornemann
William Narrow
Tom Croghan
Richard Frank
Pierre Alexandre
Note taker: Anna
Flynn
Note taker: Lareina
LaFlair
Room W2303
Larry Wissow (Chair)
David Dean, Jr
Anna Marsh
Sandra Spencer
Heather Ringeisen
Judith Teich
Dave Oslin
Howard Goldman
Mariana Salamoun
Al Zachik
Note taker: Lindsey Grimm
Note taker: Ramin Mojtabai
Group 5
Group 6
Group 7
Deciding which programs are
successful
Feinstone Hall
Sharon Larson (Chair)
Peggy Swarbrick
Chacku Mathai
Harold Perl
Colleen Barry
Ron Mandersheid
Barbara Leadholm
Rita Landgraf
Gerard Gallucci
Laysha Ostrow
The place of primary care
Reducing disparities
Feinstone Hall
Joyce West (Chair)
Jill Rogers
Joseph Gallo
Bernadette Cullen
Anita Everett
Charlotte Mullican
Kamala Allen
Carl Bell
Rita Vandivort-Warren
Room E2133
Bradley Karlin (Chair)
Kevin Keegan
Jim Lafferty
Marie Mann
Alexander Ross
John O'Brien
Lisa Townsend
Chacku Mathai
Note taker: Sarah Racz
Note taker: William Eaton
Note taker: Emma McGinty
624 N. Broadway  Baltimore, Maryland 21205  (410) 955-3910
Department of Mental Health
Afternoon Breakout Sessions: Financing Mechanisms for Behavioral Health Care
Reform: Opportunities and Challenges
Group 1
Group 2
Group 3
Organizing finance
mechanisms for children
and adolescents
Room W2207
Chet Schmidt (Chair)
Marie Mann
Heather Ringeisen
Judith Teich
David Dean, Jr
Sandra Spencer
Richard Frank
Integrating funding
streams for dual
diagnoses
Room E2527
Chacku Mathai (Chair)
Jeffrey Buck
Eric Strain
Larry Wissow
Charles Milligan
Financing prevention and
identifying resulting cost
savings
Room W2303
Bernadette Cullen (Chair)
Kevin Keegan
Joseph Gallo
Alan Levitt
Jane Plapinger
Susan Cycyk
Jim Lafferty
Carolyn Quattrocki
Note taker: Lindsey
Grimm
Note taker: Lareina
LaFlair
Note taker: Anna Flynn
Group 5
Group 6
Financial implications of
electronic health
records
Financing ancillary
services and providers
(e.g., case managers,
psychiatric nurses)
Feinstone Hall
Frances Randolph (Chair)
Charlotte Mullican
Jackie Duval-Harvey
Jill Rogers
Dave Oslin
Rita Vandivort-Warren
Robert Heinssen
Pay for performance
Note taker: William Eaton
Note taker: Christina Pate
Feinstone Hall
William Narrow (Chair)
Sharon Larson
Anna Marsh
Lisa Townsend
Robert Findling
Lisa Colpe
Barbara Leadholm
Note taker: Michelle
Colder-Carras
624 N. Broadway  Baltimore, Maryland 21205  (410) 955-3910
Group 7
Room E2133
Thomas Bornemann (Chair)
Tom Croghan
Kamala Allen
Peggy Swarbrick
Gerard Gallucci
Amanda Harris
Group 4
Financing non-medical
services
Room W2205
Anita Everett (Chair)
Joyce West
Bradley Karlin
Tami Mark
Kirsten Beronio
Carol Payne
Alexander Cowell
Rita Landgraf
Laysha Ostrow
Note taker: Sarah Racz
Group 8
Risk adjustment and
risk sharing
arrangements in
insurance market
Room W2017
John O'Brien (Chair)
Sarah Duffy
Alexander Ross
Harold Perl
Carl Bell
Note taker: Ramin
Mojtabai
Department of Mental Health
Charges for Morning Breakout Sessions
Morning Group 1: Covering the whole population
1.
What are the priority groups not currently covered and who would be left out after the
implementation of the healthcare reform?
2.
What would be the impact of Supreme Court decision regarding Medicaid expansion of
ACA on coverage of near-poor population?
3.
What would be the impact of implementation of ACA on mental health care disparities?
Morning Group 2: How to serve those with dual diagnoses
1. What are the best models for mental health care and substance use disorder
integration/coordination?
2. What will be the impact of the ACA on the coordination of substance abuse and mental
health care services?
3. How can we best define and measure outcomes in dual diagnosis services?
Morning Group 3: How to organize services for children and adolescents
1.
What is the best setting for administration of mental health services to children and
adolescents?
2.
What place will the schools have in provision mental healthcare of children and
adolescents after implementation of the health care reform?
3.
What would be the impact of the ACA on coordination of mental health services in
primary care and specialty mental health services?
Morning Group 4: Process and outcomes of performance management
1.
What measures do we need to use for performance measurement?
624 N. Broadway  Baltimore, Maryland 21205  (410) 955-3910
Department of Mental Health
2.
The "when" and the "how" of measuring performance management.
3.
What would be the impact of the ACA on measurement of process and outcome in
performance management?
Morning Group 5: Deciding which programs are successful
1.
How should we define success?
2.
How should we measure success?
3.
How should we incentivize successful programs under the ACA?
Morning Group 6: The place of primary care
1.
What would be the role of medical homes in management of mental health conditions?
2.
How do we get primary care to take on new roles for management of substance abuse
and mental disorders?
3.
What is the best model for coordinating mental health services with medical services?
Morning Group 7: Reducing disparities
1.
Would ACA reduce the disparities in access to mental health care?
2.
Would ACA reduce disparities in quality of mental health care?
3.
How can services be optimized to reduce disparities in access and quality?
624 N. Broadway  Baltimore, Maryland 21205  (410) 955-3910
Department of Mental Health
Charges for Afternoon Breakout Sessions
Afternoon Group 1: Organizing finance mechanisms for children and adolescents
1. How would financing mental health care for children and adolescents change under the
ACA?
2. What are the financial implications of the alternative models of delivery of children
mental health services?
3. How can mental health and substance abuse prevention programs be optimally
incorporated in child mental health services?
Afternoon Group 2: Integrating funding streams for dual diagnoses
1. What are the challenges in integrating funding streams for dual diagnoses services after
health care reform?
2. What are the implications of changes in block grants after the health care reform?
3. What would be the challenges in challenges staffing of integrated dual diagnosis
services?
Afternoon Group 3: Financing prevention and identifying resulting cost savings
1.
How should we measure cost savings associated with prevention programs?
2.
How would prevention services be funded under the ACA?
3.
Can prevention services be included as part of the essential package of mental health
services?
Afternoon Group 4: Financing non-medical services
1.
How would housing services be funded under the ACA?
2.
How would employment services be funder under the ACA?
624 N. Broadway  Baltimore, Maryland 21205  (410) 955-3910
Department of Mental Health
3. What are the essential non-medical services left out after the implementation of the
ACA?
Afternoon Group 5: Financial implications of electronic health records (EHR)
1.
How much would EHR save health care costs?
2.
How can EHR be best designed to safeguard patients' privacy?
3.
How can EHR be best designed to improve quality of mental health services?
Afternoon Group 6: Financing ancillary services and providers (e.g., case
managers, psychiatric nurses)
1.
How would the financing of ancilliary services change under ACA?
2.
What would be the staffing needs for ancillary services and providers?
3.
What are the financial implications of new technologies in the delivery of mental health
services (e.g., tele-psychiatry)?
Afternoon Group 7: Pay for performance
1. Have we learned any lessons from prior experience with pay for performance in delivery
of physical healthcare that is transferable to mental healthcare?
2. What have we learned from prior experience with pay for performance in delivery of
mental healthcare in the US and other countries?
3. How can we make gains in targeted outcomes of pay for performance generalizable to a
broader set of mental health outcomes?
Afternoon Group 8: Risk adjustment and risk sharing arrangements in insurance
market
1. Would risk adjustment and risk sharing arrangements be successful in reducing adverse
selection for the mentally ill in insurance exchanges?
624 N. Broadway  Baltimore, Maryland 21205  (410) 955-3910
Department of Mental Health
2. What are the information needs for risk adjustment?
3. What are the implications of failure of risk adjustment and risk sharing arrangements in
insurance markets for financing of mental healthcare?
4. Are risk adjustments and risk sharing arrangements different among psychiatric
patients and patients with other chronic health conditions?
624 N. Broadway  Baltimore, Maryland 21205  (410) 955-3910
Department of Mental Health
Panelist and Presenter Biographies
Carl Bell, M.D., F.A.P.A.,
F.A.C.P.
Richard Frank, PhD
Howard Goldman, MD,
PhD
Barbara Leadholm,
MSN, MBA
Philip Leaf, PhD
Carl Bell is the CEO and President of the of the Community
Mental Health Council, Inc, a large not-for-profit community
mental health centers in the U.S. He is also Director of the
Institute for Juvenile Research and a clinical professor of
psychiatry and public health at the University of Illinois School
of Medicine. After graduating from the University of Illinois in
1967 with a Bachelor’s of Science Degree in Biology, he went
on to Meharry Medical College where he graduated with an
M.D. His postgraduate training in psychiatry was at the Illinois
State Psychiatric Institute in Chicago.
Richard G. Frank, PhD, is the Margaret T. Morris Professor of
Health Economics in the Department of Health Care Policy at
Harvard Medical School. He is also a research associate with
the National Bureau of Economic Research. Dr. Frank received
a BA in economics from Bard College and a PhD in economics
from Boston University.
Howard H. Goldman is Professor of Psychiatry at the University
of Maryland School of Medicine. He is a mental health services
and policy researcher, who is the author of 300 publications in the
professional literature. Dr. Goldman is the editor of Psychiatric
Services. He served as the Senior Scientific Editor of the Surgeon
General's Report on Mental Health for which he was awarded the
Surgeon General’s Medallion. Dr. Goldman received his M.D.
from Harvard University and Ph.D. in social policy research from
Brandeis University.
Barbara Leadholm has served as Commissioner of the
Department of Mental Health since 2007. Under her leadership,
the agency has made significant strides in implementing the
Community First initiative as part of its continuum of quality
services for people with serious mental illness. She earned her
Master of Science in Psychiatric Nursing from Boston College
and her Master of Business Administration from Boston
University.
Dr. Leaf is a professor in the Department of Mental Health at
the Johns Hopkins Bloomberg School of Public Health and
director of the Center for Prevention of Youth Violence. His
624 N. Broadway  Baltimore, Maryland 21205  (410) 955-3910
Department of Mental Health
Ron Manderscheid, PhD
Anna Marsh, PhD
Chacku Mathai, CPRP
work focuses on preventing youth violence and promoting
positive youth development. Dr. Leaf is also senior associate
direct of the Johns Hopkins Urban Health Institute. He received
his PhD from the University of Wisconsin.
Ron Manderscheid, serves as the Executive Director of the
National Association of County Behavioral Health and
Developmental Disability Directors. The Association represents
county and local authorities in Washington, D.C., and provides
a national program of technical assistance and support.
Concurrently, he is Adjunct Professor at the Department of
Mental Health, Bloomberg School of Public Health, Johns
Hopkins University, and President of ACMHA—The College for
Behavioral Health Leadership. Dr. Manderscheid serves on the
boards of the Employee Assistance Research Foundation, the
Danya Institute, the FrameWorks Institute, the Council on
Quality and Leadership, and the International Credentialing and
Reciprocity Consortium. He also serves as the Co-Chair of the
Coalition for Whole Health. Dr .Mandersheid received his PhD
from University of Maryland.
Dr. Anna Marsh is Deputy Director of the Center for Mental
Health Services (CMHS) in the Substance Abuse and Mental
Health Services Administration (SAMHSA) of the U.S.
Department of Health and Human Service (DHHS). She has
worked for SAMHSA and its predecessor agency, the Alcohol,
Drug Abuse, and Mental Health Administration, since 1985. Dr.
Marsh received her Ph.D. in Psychology from Yale University,
where she was a Fellow at the Bush Center in Child
Development and Social Policy. She received her B.A. in
Psychology from George Washington University.
Chacku Mathai has over twenty-five years experience in mental
health and community based services in a wide variety of roles
including peer advocate, peer support meeting facilitator, selfhelp educator, community organizer and educator, community
residence manager, psychiatric rehabilitation practitioner,
trainer and program administrator. He currently serves as the
Associate Executive Director for the New York Association of
Psychiatric Rehabilitation Services and is an implementation
partner for the New York State Center of Excellence for the
Integration of Care (CEIC) and the SAMHSA Recovery to
624 N. Broadway  Baltimore, Maryland 21205  (410) 955-3910
Department of Mental Health
Practice Resource Center for Mental Health Professionals.
Charles Milligan, JD,
MPH
David Oslin, MD
Amanda Harris, MPH,
LGSW
Joshua Sharfstein, MD
Charles Milligan was appointed deputy secretary for health care
financing at the Maryland Department of Health and Mental
Hygiene in March 2011. In this role, he is responsible for the
state’s Medicaid program. Previously Mr. Milligan was executive
director of The Hilltop Institute at the University of Maryland,
Baltimore County (UMBC), which is a public sector consulting
and research organization that provides services to the
Maryland Medicaid program, other state and local agencies, the
federal government, and private foundations. Earlier in his
career he was Medicaid and SCHIP director for the state of
New Mexico. Mr. Milligan holds a J.D. from Harvard Law
School, an M.P.H. from the University of California at Berkeley,
and a B.B.A. from the University of Notre Dame.
David Oslin is an Associate Professor of Psychiatry at the
Philadelphia Veterans Affairs Medical Center and the University
of Pennsylvania Medical Center. Dr. Oslin is the Director of the
VISN 4 Mental Illness, Research, Education, and Clinical
Center (MIRECC) and the Associate Chief of Staff for
Behavioral Health at the Philadelphia VAMC. The MIRECC and
BHL support research on comorbidity and integrated care,
respectively, and facilitate a number of research projects for
post-doctoral fellows and faculty. He is the author of over 75
research publications and 30 chapters, books, or editorials. Dr.
Oslin received is MD from University Of Virginia School Of
Medicine.
Amanda Harris is the Chief Operating Officer at Pathways to
Housing in DC. The mission of Pathways to Housing DC is to
end homelessness for people living with psychiatric disabilities
by providing housing first and giving support and treatment for
their recovery and integration into the community. Ms. Harris
received her Master of Art, Philosophy, and Public Policy from
George Washington University and Master of Social Work from
University of Michigan.
Josh Sharfstein is the Secretary of the Maryland Department of
Health and Mental Hygiene. Previously, he served as the
Commissioner of Health in Baltimore, Maryland and as the
Principal Deputy Commissioner of the U.S. Food and Drug
624 N. Broadway  Baltimore, Maryland 21205  (410) 955-3910
Department of Mental Health
Carolyn Quattrocki, JD
Rita Vandivort-Warren,
MSW
Administration. In these positions, Dr. Sharfstein has pursued
creative solutions tlongstanding public health problems -including drug addiction, school failure, unsafe consumer
products, and most recently, cheap, candy-flavored cigars. Dr.
Sharfstein received his MD from Harvard Medical School.
Carolyn Quattrocki is the Executive Director of Maryland
Governor O’Malley’s Office of Health Care Reform. Prior to her
appointment, she served as a Deputy Legislative Officer and
health policy advisor in the Governor’s Legislative Office, with
primary responsibility for health care, insurance, and labor
issues. Ms. Quattrocki has a law degree from Yale University
and a B.A. from Northwestern University.
Rita Vandivort-Warren is a Public Health Analyst on financing
services and government project officer in the Quality
Improvement and Workforce Branch, Division of Services
Improvement, Center for Substance Abuse Treatment,
Substance Abuse, Mental Health Services Administration. She
currently manages, among other federal projects, the SAMHSA
Spending Estimates Project, which determines the total national
expenditures on mental health and substance abuse services
from all public and private sources. She handles numerous
other assignments in financing and organization of services,
integrating state cross system databases, blending funding for
children’s mental health and substance abuse services,
financing services expert to grantees and is the CSAT lead on
Medicaid issues. Ms. Vandivort-Warren received her Master’s in
Social Work from University of Missouri-Columbia.
624 N. Broadway  Baltimore, Maryland 21205  (410) 955-3910