Table 4.
Initial Implementation Phase: Innovative Implementation Activities and Strategies for Project EBPs*
Innovations: Initial Implementation | ACT | FPE | IDDT | IMR | SE |
State Infrastructure Building and Commitment | |||||
• New state position developed to assist in implementation and monitoring of EBPs established | X | X | |||
• SMHA considering strategies to penetrate EBP in all licensed programs | X | ||||
• New RFP process developed to help fund EBP projects throughout state | X | ||||
Stakeholder Relationship Building and Communication | |||||
• Monthly meetings between state, Toolkit sites, and/or Advisory Councils | X | X | X | X | X |
• Monthly meetings between NAMI and Toolkit sites | X | ||||
• Monthly meetings and/or calls between technical assistance centers and sites | X | X | X | ||
• Ongoing communication between state and local sites/boards | X | X | |||
• Increased collaboration between SMHA and State Medicaid Office | X | X | X | X | X |
• New collaboration between SMHA, Medicaid and Vocational Rehab Office | X | ||||
• First time meeting held between state NAMI and Office of Consumer Affairs directors | X | ||||
• State and local sites working to implement evaluation process and reassure stakeholders of process | X | ||||
• Developed Clinical Practices Advisory Committee | X | ||||
• Planning EBP conference | X | X | |||
Financing | |||||
• SMHA working with State Medicaid agency to make billing easier | X | ||||
• Developed new Medicaid billing code and coding guidelines | X | X | |||
• Using bundled funding approach to fund EBP | X | ||||
• Exploring Medicaid requirements to qualify consumers to deliver EBP | X | ||||
• Using Medicaid Waiver 1115B to fund EBP | X | ||||
• Position paper written by state to recommend Medicaid reimbursement levels and codes | X | ||||
• Billing of EBP allowed as part of group or individual psychotherapy or day rate for Continuing Day Treatment Program | X | ||||
• Reimbursement codes and rates changed to support EBP | X | ||||
• Created new funding program only for EBP | X | ||||
• New funding formulas integrated into allocation structure, with codes changed in data system and audit process | X | ||||
• Medicaid approval received to reimburse EBP teams through amendment to state plan | X | ||||
• Medicaid rate recalculated to allow more professionals to be reimbursed | X | ||||
• State cost sharing with counties to fund EBPs | X | X | |||
Continuous Quality Management | |||||
• Distributed SAMSHA's standards of care to local sites | X | ||||
• Developed and using new certification manual | X | ||||
• Developing treatment plan tool to include multiple domains and to be consistent with licensure review | X | ||||
• Developing mental health and substance abuse language guidelines for auditors to use in consistent evaluations | X | ||||
• Developing standards for EBP | X | ||||
• Barriers to standards for EBP teams removed by Medicaid agency | X | X | |||
• Regulation changes to revise employment referral and authorization form, individual vocational form and verification of diagnostic process, and employment outcome measurement definition | X | ||||
• Implementing certification process through administrative rule and stakeholder process | X | ||||
• Integrated fidelity measures, technical support and supervision into certification | X | ||||
Service Delivery Practices and Training | |||||
• Developing treatment plan tool to include multiple domains and to be consistent with licensure review | X | ||||
• SMHA and consumer community developing partnership to train clinical staff to deliver EBP | X | ||||
• SMHA funding for consumer training and joint teaching to professionals and consumers for EBP | X | ||||
• Implementing shadowing training program | X | X | |||
• Administrative rule revised to include fidelity adherence for EBP | X |
* EBPs:
ACT = Assertive Community Treatment
FPE = Family Psychoeducation
IDDT = Integrated Dual Diagnosis Treatment
IMR = Illness Management and Recovery
SE = Supported Employment