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The Philadelphia Behavioral Health System

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by

Christina Buckley

on 27 April 2010

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Transcript of The Philadelphia Behavioral Health System

The Consumer Satisfaction Team Who we are
Mission
Staff Background
Problem Definition
Policy Entrepreneur Policy Stream Philadelphia 30 years ago
The Three Streams 1. State Funds 2. City, State, and Federal Funds 3. Medicaid ByBerry Community Based Care Fee-for-Service
Homelessness Points of View Heavy Users Richard Surles
Grant for Heavy Users
Consolidation Plan Political Stream Mood of Residents Criticism and Dissatisfaction with System Supporters of Surles Plan Window of Opportunity Closed Part I Policy Entrepreneur Estelle Richman Mental Health Expert from Cleveland Brought to PA by State's new commissioner for Mental Health Arrived in time to see closing of ByBerry State mandates Medicaid covered must join HMO HMOs taking over-BHOs subcontracted to deal with behavioral health capitation "Carve Out" companies 1996. Philly Advocates and others who are worried about the health care lobbied the state to "carve out" behavioral health Medicaid dollars from the physical health contracts given to HMOs New Problem Health Department does studies to determine proper capitation rate State agrees to pay $70 per person per year HMOs Vs. Richman/CBH Policy Stream Political Stream What do you think? Stakeholders City Counsel For Public
Health Department/Richman Advocates For Private State HMOs/Surles Federal Government Window of Opportunity In early 1996, the state, under a new administration, accepted the "carve out" plan Impact of Media City Counsel must decide whether to give money to Public or Private Sector. Who will recieve funding for the coordination of care? Problem Now what? Surles is gone and the people are still unhappy Solution Consumer Satisfaction Team- Annual Board Meeting Money goes to Public Sector The CBH Success of Public Sector Our team continues to design and execute new projects as changes in behavioral health services and service delivery are defined. http://www.dbhmrs.org/transformation-video City State Patients Coalition for the Responsible Closing of Philadelphia State Hospital ByBerry
Coalition for the Responsible Closing of the Philadelphia State Hospital
Litigation led to formation of CST Managed Care Richman Advantages of HMOs State agreements with HMOs Mixed Results Surles Returns Increased criticism of BHOs CBH Part II HealthChoices Better coordination of services Significant savings Increased access to treatment Greater accountability More involvement in planning and monitoring services
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