McSilver Institute, NYU School of Medicine Partner in NY State Mental Health Overhaul
New York State’s 497 licensed child and adult public mental health clinics have been charged with a huge task: revising their business and clinical practices to align with requirements of the Affordable Care Act (ACA) and accompanying shifts in Medicaid. Under the ACA, clinics will no longer be paid by the volume of patients served, but rather by positive treatment outcomes. Clinic staff will have to further advance the use of evidence-based and brief clinical practices and will have to develop more sophisticated means of managing their business practices by measuring outcomes and connecting their clinical practices to costs.
NYU Silver’s McSilver Institute for Poverty Policy and Research, in partnership with NYU School of Medicine (SOM) and others, is in the third year of a five-year grant from the NY State Office of Mental Health to operate the Clinic Technical Assistance Center (CTAC) that provides mental health clinics statewide with technical assistance, education, and training in evidence-based clinical practices and business/organizational improvement practices.
CTAC is co-directed by Mary McKay, McSilver Professor of Poverty Studies and director of McSilver, and Kimberly Hoagwood of the SOM. McSilver and SOM are working with other partners that provide additional expertise: Coordinated Care Services, Inc.; Institute for Community Living; The Coalition of Behavioral Health Agencies, Inc.; New York Association of Psychiatric Rehabilitation Services (Partners in Recovery); Families Together (in New York State); and the Urban Institute for Behavioral Health. McSilver’s Andrew Cleek oversees the day-to-day operations of the entire project.
Providers have lacked systemic support for agencies to measure agency-wide and client specific outcomes. Filling this gap is key to transforming the clinic system from a volume-based to a value-based driven sector. Through an additional grant from the New York State Health Foundation, McKay and Cleek, assisted by Micaela Mercado and Peter Campanelli (both of McSilver), are going to develop outcome measurement support for NYS mental health clinics.
Both McSilver and SOM are devoting significant research support to monitor how the clinics are adjusting to a changing behavioral heath care environment. McSilver itself is dedicating significant staff and intern time to implement the project, including MSW, MPH, and PhD students. All these elements are in place to support the project now and will remain intact after the grant period ends to ensure sustainability.
IDEAS, an NIMH-funded grant directed by SOM’s Hoagwood and co-directed by McKay, focuses on research and real world implementation of evidence-based best practices. IDEAS, housed at the Child Study Center and directed by Glenn Saxe, is the research arm of CTAC. These research supports will allow for SOM and McSilver—and ultimately the field—a unique understanding of a rapidly transforming healthcare system.
The vast majority of training and technical assistance offered to clinicians is offered virtually, through webinars, special-interest calls, and through collaborative learning communities. Since its inception 315 (63 percent) of all clinics have participated in at least one event CTAC event. More than 1,700 unique individuals and more than 4,100 total people have participated in at least one of the 115 events offered by CTAC.