Welcome, Agenda, Challenges and Potential Solutions Implementing EvidenceBased Practices and Perform

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Welcome, Agenda,Challenges and Potential
SolutionsImplementing Evidence-Based Practices
and Performance Measuresfor Massachusetts Mental
Health ServicesAn Educational ForumDonald S.
Shepard, Ph.D.Sept. 28, 2005

• Shepard_at_Brandeis.edu
• Tel [phone]
• Brandeis University, Waltham MA 02454

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Welcome
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Key questions
 
1 What are EBPs? To inform key stakeholders
about the key concepts and status of
evidence-based practices (EBPs) and performance
measures in mental health.  
2 How can they be implemented? To understand
what is needed for successful implementation and
the barriers to success.  
3 How can we work together to deliver more
evidence-based practices? To bring together key
behavioral health stakeholders to discuss how to
support implementation of these practices in
Massachusetts.  
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Participants
 
About 175 Registrants
7 States Represented MA, CT, MD, ME, NH, NY, VA
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Sponsors
 
Massachusetts Department of Mental
Health Massachusetts Department of Public Health,
Bureau of Substance Abuse Services Center for
Behavioral Health, Schneider Institute for Health
Policy, Brandeis University Suffolk University
Department of Public Management Center for Mental
Health Services, SAMHSA
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Agenda
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Framework
 
Context and Evidence-Based Practices Nationally
Performance Measurement (Process and Outcome)

• Towards Implementation in Massachusetts
• Participation by providers, interest groups,
  government
• Training
• Incentives
• Etc.

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Speakers
 
Context and Evidence-Based Practices
Nationally (Shepard, Keane, Botticelli,
Mandersheid, Leff, Lynde, Ganju, Hermann)
Performance Measurement (Horgan)
Towards Implementation in Massachusetts (Childs,
Stelk, Lynch, Funk, Delman, Beinecke)
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Challenges and Potential Solutions
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A Suggestion Incentives
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First Illustration Setting

• Goal Improve retention in substance abuse
  treatment.
• Eighty percent of success in life is showing
  up.
• Woody Allen (1935-, writer, director actor)
• Setting Randomized trial of outpatient aftercare
  based on relapse-prevention at Spectrum Addiction
  Services in MA
• Enrolled 123 subjects in experimental arm (after
  excluding one death)
• At midpoint only 32 of clients completed
  minimal dose of at least 5 sessions
• Authors Donald Shepard Jeanne Calabro, James
  McKay, Craig Love, Jill Tetreault, Hyong Yeom
• Support NIDA DA 08739

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First IllustrationCounselor Incentive

• Bonus of 100 for each client who completed at
  least 5 relapse prevention sessions
• Additional bonus of 50 for each client who
  completed 12 relapse prevention sessions

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Illustration Results
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Ongoing project plans Profiling and incentives
in behavioral health care

• Randomized trial (facilities randomized)
• Profiling according to Connect to care and
  other measures
• Case mix adjustment planned
• Coaching in evidence based practices
• Recognition and monetary incentives for top
  performing agencies planned
• Notes Collaboration with Connecticut Department
  of Mental Health and Addiction Services (DMHAS)
• Part of Brandeis/Harvard NIDA Research Center on
  Managed Care in Drug Abuse Treatment.

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