# Presentation: 162934

## Implementing the Goals of the President’s New Freedom Commission Report  August 25, 2004

**A. Kathryn Power, M.Ed., Director**
**Center for Mental Health Services**

**Texas Mental Health Foundations Conference**

## The Commission’s Vision

**The Commission’s Vision**

- “We envision a future when
- everyone with a mental
- illness will recover, a future
- when mental illnesses can
- be prevented or cured, a
- future when mental illnesses
- are detected early, and a                            future when everyone with a mental illness at any stage of life has access to effective treatment and supports**—**essentials for living, working, learning, and participating fully in the community.”

**New Freedom Commission**

## The Charge to SAMHSA

- Curie, the administrator of our
- Substance Abuse and Mental
- Health Services Administration,
- HHS will conduct a thorough
- review and assessment of this
- report with the goal of implementing appropriate steps to strengthen our mental health system.”

**The Charge to SAMHSA**

**Secretary Tommy G. Thompson **
**	****July 22, 2003**

## Defining Transformation

**transformation **\*n* (15c) From the Latin roots to change TRANS (across) and FORMA (shape). 1: a change in form, appearance, nature, or character  2: the process of doing so
*The New Freedom Commission described transformation as a vision, a process, and an outcome.*

## Defining Transformation

*...**a continuous process, without end... meant to create or anticipate the future.  *
*...**identifies, leverages, and even    creates new underlying principles for the way things are done.*
*...**identifies and leverages new sources of power.  *
*...**once the process is begun, a profoundly different organization emerges, including changes in structure, culture, policy, and programs.*
**	****	*****Retired Vice Admiral Arthur Cebrowski***
***Special Assistant for Transformation, Department of Defense****** ***

**Defining Transformation**

## The Transformation Equation

**The Transformation Equation**

**T**** = (****V**** + ****B ****+ ****A****) ******** (****CQI****)****2**

**T****ransformation ******** **

**(****C****ontinuous ****Q****uality **
**I****mprovement)****2**

**(****V****ision + ****B****elief **
**+ ****A****ction)**

****

## 
Vision–direction for our work  
Belief–guides our work  
Action–makes our vision and beliefs a reality
Continuous Quality Improvement–ensures our actions reflect the wishes and needs of the community

**V****ision****–***direction for our work  *
**B****elief****–***guides our work  *
**A****ction****–***makes our vision and beliefs a reality*
**C****ontinuous ****Q****uality ****I****mprovement****–***ensures our actions reflect the wishes and needs of the community*

**T = (V + B + A) ******** (CQI)****2**

## Transformation as a Strategy for Innovation

- Continuous Small Steps
- A  focus on core missions, improving what the system is already doing.

## A Series of Many Exploratory Medium Jumps
Pushing the boundaries of core competencies, trying to create something new within the existing paradigm.

- Continuous Small Steps
- A  focus on core missions, improving what the system is already doing.

- A Series of Many Exploratory Medium Jumps
- Pushing the boundaries of core competencies, trying to create something new within the existing paradigm.

## A Series of Many Exploratory Medium Jumps
Pushing the boundaries of core competencies, trying to create something new within the existing paradigm.

- Continuous Small Steps
- A  focus on core missions, improving what the system is already doing.

- A Series of Many Exploratory Medium Jumps
- Pushing the boundaries of core competencies, trying to create something new within the existing paradigm.

- A Few Big Jumps
- New rule sets that leverage new ideas.

## Transformation of Mental Health Care will take...

**Focus on quality and outcomes**
**Adoption and adaptation of best practice models at the community level**
**State, local, public and private sector engagement**

**Transformation of Mental ****Health Care will take...**

## Broad Inventory
Strategic Assessment
Vision Described
Alignment
Investment in Change
Begin to Transform: Record & Model  

**Broad Inventory**
**Strategic Assessment**
**Vision Described**
**Alignment**
**Investment in Change**
**Begin to Transform: Record & Model  **

## Americans Understand that Mental Health is Essential to Overall Health.
Mental Health Care is Consumer and Family Driven.
Disparities in Mental Health Services are Eliminated.
Early Mental Health Screening, Assessment, and Referral to Services are Common Practice.
Excellent Mental Health Care is Delivered and Research is Accelerated.
Technology is Used to Access Mental Health Care and Information.

**The ****Goals**** of a Transformed System**

- Americans Understand that Mental Health is Essential to Overall Health.
- Mental Health Care is Consumer and Family Driven.
- Disparities in Mental Health Services are Eliminated.
- Early Mental Health Screening, Assessment, and Referral to Services are Common Practice.
- Excellent Mental Health Care is Delivered and Research is Accelerated.
- Technology is Used to Access Mental Health Care and Information.

**Goal 1**
**Goal 2**
**Goal 3**
**Goal 4**
**Goal 5**
**Goal 6**

## The Commission’s Recommendations 

**The Commission’s Recommendations **
**Called **
**for Public-Private Partnerships **
** **

## What is a Public-Private Partnership?

*Models of Public-Private Partnerships *
*in the Department of Health and Human Services*

**What is a Public-Private Partnership?**

## Goal 1

**Americans Understand that Mental Health is Essential to Overall Health**

**Goal 1**

**Recommendation 1.1****—****Advance and implement a national campaign to reduce the stigma of seeking care and a national strategy for suicide prevention.**

*“**The National Strategy for Suicide Prevention (NSSP)...requires involving a variety of organizations and individuals and emphasizes coordinating resources and delivering culturally appropriate services at all levels of a public-private partnership.”*

*The Commission added:*

## Goal 3

**Disparities in Mental Health Services are Eliminated**

**Goal 3**

**Recommendation 3.1****—****Improve access to quality care that is culturally competent.**

*“**The Commission recommends forming public-private partnerships for pre-service and in-service training**.”**  *

*The Commission added:*

## Goal 5

**Excellent Mental Health Care is Delivered **
**and Research is Accelerated**

**Goal 5**

**Recommendation 5.2****—****Advance evidence-based practices (EBPs) using dissemination and demonstration projects and create a public-private partnership to guide their implementation.**

*“**The Federal Government should initiate and sustain a public-private partnership, with involvement and support from private foundations, advocacy groups, and professional organizations.”** *

*The Commission added:*

## The Commission’s Recommendation...

*“**The goal of this partnership would be to:*
*Advance knowledge,*
*Disseminate findings,*
*Facilitate workforce development,*
*Recognize those treatments and services,            that should be considered evidence-based, and*
*Ensure they are implemented with adequate financial support.”** *

**The Commission’s Recommendation...**

## The Commission’s Recommendation...

*“**The partnership should comprise all stakeholders including providers, consumers, and families. It should guide and oversee many activities that are currently scattered throughout the public and private sectors, thus eliminating inefficient duplication and encouraging collaboration on potentially beneficial issues. This leadership is needed to bridge the gap between science and service.”*

**The Commission’s Recommendation...**

## Goal 5

**Excellent Mental Health Care is Delivered **
**and Research is Accelerated**

**Goal 5**

**Recommendation 5.3****—****Improve   and expand the workforce   providing evidence-based mental health services and supports.**

*“...**the field needs a comprehensive strategic plan to improve workforce recruitment, retention, diversity, and skills training...To develop this plan, HHS should initiate and coordinate a public-private partnership.”*

*The Commission added:*

## Action Agenda Federal Partners

**DEPARTMENT OF HEALTH ****	****     OTHER **
**    ****& HUMAN SERVICES****	****             PARTNERS**
**AoA****	****	****NIH/NIDA****	****Department of Education**
**ACF****	****	****NIH/NIMH****	****Department of Housing**
**AHRQ ****	****HHS/OS        and Urban Development**
**CDC****	****	**** - ASPE ****	****Department of Justice**
**CMS ****	****	**** - OCR ****	****Department of Labor**
**HRSA ****	**** - OD ****	****	****Social Security Administration**
**IHS****	****	**** - OPHS ****	****Department of Veterans ****	****	****	**** ****SAMHSA**** ****	****Affairs ****	**** ****	**

**Action Agenda Federal Partners**

## Convened Federal partner group 
Reviewed inventories and subcommittee reports
Initiated strategic plan development for CMHS
Designated a SAMHSA matrix workgroup on mental health transformation 
Submitted action agenda to HHS Secretary and obtained departmental clearance 

**Reviewed inventories and subcommittee reports**
**Initiated strategic plan development for CMHS**
**Designated a SAMHSA matrix workgroup on mental health transformation**** **
**Submitted action agenda to HHS Secretary and obtained departmental clearance **

**Developing the First Federal Action Agenda**

## Begin implementing the action agenda items at CMHS/SAMHSA
Establish Federal executive steering committee
Commit to an ongoing transformation process 
Monitor progress across Federal agencies and begin updating the action agenda for FY05 
Expand network of collaborations
Support through SAMHSA grants and contracts

**Establish Federal executive steering committee**
**Commit to an ongoing transformation process **
**Monitor progress across Federal agencies and begin updating the action agenda for FY05**
**Expand network of collaborations**
**Support through SAMHSA grants and contracts**

**With Approval of the First Federal Action Agenda**

## Mental Health State Incentive Grants for Transformation

**A key component of SAMHSA's mental health system transformation strategy**
**Will facilitate the development and implementation of comprehensive State mental health plans**
**The President's budget includes $44 million for this new program**
**Planning is underway for the FY 2005 RFA**

## Why We Need to Engage in Public-Private Partnerships

**Promote flexibility                                      among parties**
**Realize potential                                             cost savings**
**Advance mutual                                           social and organizational objectives**
**Acquire different funding mechanisms**
**Develop novel and creative initiatives**

**Why We Need to Engage in Public-Private Partnerships**

## Why We Need to Engage in Public-Private Partnerships (cont.)

**Facilitate large and complex projects**
**Provide mutual stimulation**
**Eliminate duplicated effort**
**Achieve *****transformation***** more quickly**

**Why We Need to Engage in Public-Private Partnerships (cont.)**

## CMHS, Annie E. Casey Foundation 

***and Rutgers University *****Partnership***** ***

***Results:***** Policy briefs on children’s mental health were produced to distribute throughout the field and on Capitol Hill**

**CMHS **
**Children’s **
**Database**

**Annie E. Casey**
**Foundation **
**Funding of **
**$300,000**

**Rutgers**
**University’s **
**Policy**
**Analysis**

**+**

**+**

## Crossing the Quality Chasm Partnership

***Crossing the Quality Chasm Partnership***

**Institutes of Medicine Report calling                          for major reform in U.S. health policy,         organization, and financing**
**Committee explored implications for the field of mental health and addictive disorders**
**A strategic blueprint for redesign of behavioral health care delivery expected to be released August 2005**
***Partners:****** CMHS, CSAT, Veterans Affairs, National Institute on Drug Abuse, National Institute on Alcohol Abuse and Alcoholism, CIGNA, Annie E. Casey Foundation, and Robert Wood Johnson Foundation  ***

## Why Foundations Are Valuable Partners

**Get things done more quickly because less bound by history, ideology and politics**
**Serve as an effective catalyst in promoting action  **
**Provide additional financial support**

**Why Foundations Are Valuable Partners**

## What Foundations Can Do to 

**Develop an agenda for working                    with public and other private                    groups**
**Create interest groups on mental health among foundations**
**Keep open lines of communications between government and the private sector to stay abreast of efforts and to eliminate duplication**** **

**What Foundations Can Do to **
**Promote Transformation**

## Recovery

**New Freedom Commission**

- “Because recovery will be the common, recognized outcome of mental health services, the stigma surrounding mental illnesses will be reduced, reinforcing the hope of recovery for every individual with a mental illness.”

## Recovery refers to...

**The process by which people                 are able to live, work, learn,                       and participate fully in their           communities**
**The ability to live a fulfilling                      and productive life despite a disability **
**A reduction or complete remission of symptoms **
**The ability to make important decisions affecting one’s own life**

## Recovery is...

**... ****about individuals taking control                of their own lives and not having           others determine their care or              treatment. The concept has                    evolved to mean the process by              which an individual comes to terms             with their disability and learns how to cope. *****Recovery does not imply a cure, but a lifelong journey and process.***

## The dogmas of the quiet past are inadequate to the stormy present. The occasion is piled high with difficulty, and we must rise with the occasion. As our case is new, so we must think anew, and act anew. 

-  Second Annual Message to Congress
- December 1, 1862

*The dogmas of the quiet past are inadequate to the stormy present. The occasion is piled high with difficulty, and we must rise with the occasion. As our case is new, so we must think anew, and act anew.*