Cross-System Financing Project Overview

1. Cross System FinancingProject Overview Sponsored by The Robert Wood Johnson Foundation Session One June 13th and 14th

2. Background of Project • Funding for addiction and mental health services is getting more complex and categorical. Multiple funding sources create a maze of: • Eligibility • Administrative • Program and reporting requirements • Service coverage

3. Background of Project • State and local mental health and substance abuse administrators continue to face: • Shrinking or static budgets • Increased demands on their remaining resources • Increased reporting requirements that have good intentions but almost impossible to track • Reform and efficiency are the order of the day

4. Background of Project • The results: • Individuals and families qualify for some but not all services that promote recovery/resiliency • Providers can no longer knit funding together to offer a continuum or services—make daily choices between operations and quality care • The treatment gap is widening and the limited blending and braiding strategies don’t apply

5. What Are the Project’s Outcomes? • Developing a shared mission or purpose for the project • Developing and implementing a cross system financing plan • Developing templates or source documents that can be used by other states/jurisdictions • Develop a permanent network of state and local mentors for other states/jurisdictions • Identify key lessons learned from participant’s experience regarding factors that facilitated and impeded cross system financing strategies

6. What Are Some Possible Tools that You Can Use? • Potential Products Include: • Resource mapping matrix • Memorandums of Understanding/Agreement • Proposed or enacted legislation or regulations that will advance the cross system financing strategy • Draft or implemented changes in contracting processes, products (e.g. contracts with providers) • New payment strategies for population and services • Changes in the information system/data collection processes that will allow participants to track their clients, services and expenditures • Plans for Co-Location of Services

7. Who Is the Project Team? • Connie Pechura—Robert Wood Johnson Foundation—SAPT • John O’Brien—TAC/Resources for Recovery • Suzanne Gelber and David Rinaldo—The Avisa Group • Allison Colker—National Conference of State Legislators • Jennifer O’Connor—National Governor’s Association

8. What Is Their Role? • Help you advance your plans and strategies by: • Structuring the learning session and tailoring subsequent session based on your needs • Be a resource to participants on specific topics and strategies • Facilitate conversations with participants and peers that have experiences with what works and didn’t in their jurisdictions • Gentle prodding

9. How Did You Get Here? • You were nominated and selected using the following criteria: • Have experience with coordinated funding—now you are taking it to the next level • Have the tools to coordinate funding—you need a way to use those tools for your strategy • Have leadership that have expressed an interest to undertake these strategy • Have significant pressures to develop and implement a strategy • Alright—yes you are fun to work with and aren’t shy about sharing victories and defeats

10. What Will We Cover? Focus on Big Pieces of the Puzzle: • Leadership and Obtaining Policy Buy-In—Developing a clear strategy for getting initial and ongoing buy-in for the strategy(s) with stakeholders • Prioritizing Services and Use of Funding Streams—Which services, populations and funding streams present the greatest opportunities and challenges for coordinating purchasing • Developing the Necessary Management Structures—Identifying the “rules” for how the participating agencies will make decisions about the design and implementation

11. What Will We Cover? • Addressing Critical Purchasing and Financing Issues—Focusing on basic and critical financing and administrative challenges such as joint rate setting and contracting with providers. • Assessing Infrastructure Needs and Capacities—Assessing your information and fiscal management payment, contracting and reporting systems. • Regulations—Understanding the current limits and flexibility offered under various federal and state regulations that govern the use of funds.

12. What Will We Cover? • Ensuring Accountability and Stakeholder Process—constructing a process for public payers and their multiple constituencies to oversee the ongoing initiative. • Enhancing Provider Capacities—Changes made by state and local payers greatly impact the network of providers and practitioners who deliver services to public mental health and substance abuse clients. • These areas are not necessarily linear nor are they mutually exclusive

13. What is the Proposed Process? • The Sessions: • 5 proposed—schedule/topics/locations in packet • “Teachable” moments from experts and peers • Interaction among teams to support and challenge strategies • Team time—uninterrupted time to work with your jurisdiction • Between Sessions • Homework that is relevant • Webcasts or other “meet me” calls on specific topics • Gentle prodding • The Resources • Team • Library • Web site—www.advisagroup.com • Ultimately—We Want to Shift the Learning • From the team and featured speakers to your peer participants • From internal to the learning session to others who are needing your smart strategies

14. What is the Focus of the First Session? • Overview • The Public Purchasing Environment • Leadership and Buy-In • Understanding Funding Streams—how are we spending our money for mental health and substance abuse? • Developing/fine tuning your baseline strategy • Letting us know what you need

15. Leadership • Leadership is the foundation for any successful initiative • Leadership must be: • Shared—can’t just be one individual • Develop collaborative relationships • Able to make decisions and not be afraid to revisit those decisions • Consistent but not stagnant • Cultivating the next generations of leaders, visionaries and project managers

16. Where Are You on The Collaboration Scale? Sid Garner, Children and Family Futures

17. Knowing and Using Your Available Funding Streams • Require that you know what they are, where they are and how to use them—”a fiscal tel” • Understand that many of these funding streams are more static—offering opportunities versus panic • Move the focus of “my” money, “your” clients and “those providers” to “our” strategy • Know the possibilities and limits to changing funding and purchasing practices • Federal requirements versus myths • State regulations versus agency policies

18. Simple Ground Rules • Have fun • Ask Questions • Challenge us/Challenge Each other • Homework • Attrition Happens