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D

Public Workshop Agendas and Participants

INSTITUTE OF MEDICINE

NATIONAL ACADEMY OF SCIENCES

Committee on Quality Assurance and Accreditation Guidelines for Managed Behavioral Health Care

PUBLIC WORKSHOP AGENDA

April 18, 1996

Cecil and Ida Green Building

2001 Wisconsin Avenue, NW, Room 104

Washington, DC

9:00

Welcome and Introductions

Jerome Grossman, Committee Chair

Constance Pechura, Director, IOM Division of Neuroscience and Behavioral Health

Margaret Edmunds, Study Director



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MANAGING MANAGED CARE: QUALITY IMPROVEMENT IN BEHAVIORAL HEALTH D Public Workshop Agendas and Participants INSTITUTE OF MEDICINE NATIONAL ACADEMY OF SCIENCES Committee on Quality Assurance and Accreditation Guidelines for Managed Behavioral Health Care PUBLIC WORKSHOP AGENDA April 18, 1996 Cecil and Ida Green Building 2001 Wisconsin Avenue, NW, Room 104 Washington, DC 9:00 Welcome and Introductions Jerome Grossman, Committee Chair Constance Pechura, Director, IOM Division of Neuroscience and Behavioral Health Margaret Edmunds, Study Director

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MANAGING MANAGED CARE: QUALITY IMPROVEMENT IN BEHAVIORAL HEALTH   Invited Speakers 9:15 Building Accountability Systems for Quality in Managed Behavioral Health Care Margaret O'Kane, President, National Committee for Quality Assurance, Washington, DC 9:30 Discussion 9:40 Implementation of the ASAM Patient Placement Criteria David Mee-Lee, Medical Director, Community Systems, Castle Medical Systems, Honolulu, HI, and Co-Author, Patient Placement Criteria for the Treatment of Psychoactive Substance Abuse Disorders American Society of Addiction Medicine 9:55 Discussion 10:05 Ensuring Meaningful Participation of Consumers in Program Evaluation, Quality Assurance, Service Provision, and Rights Protection Under Managed Care Daniel Fisher, Director, National Empowerment Center, and Medical Director, Eastern Middlesex Human Services, Wakefield, MA 10:20 Discussion 10:30 Break 10:45 PERMS: The American Managed Behavioral Health Care Association (AMBHA) John Bartlett, Executive Vice President for Quality Improvement, Magellan Health Services, Atlanta, GA, and Chair, AMBHA Committee on Quality Improvement and Clinical Services 11:00 Discussion 11:10 Measurement of HMO Performance with Behavioral Health Standards Susan Goldman, Manager of Behavioral Health Services, John Hancock Mutual Life Insurance Company, Boston, MA 11:25 Discussion 11:35 Accreditation of Managed Behavioral Health Care Paul Schyve, Senior Vice President, Joint Commission on Accreditation of Healthcare Organizations, Chicago, IL 11:50 Discussion

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MANAGING MANAGED CARE: QUALITY IMPROVEMENT IN BEHAVIORAL HEALTH 12:00 Quality Activities and the Health Care Financing Administration (HCFA) Robert Valdez, Deputy Assistant Secretary for Health and Director of Interagency Health Policy, HCFA, Washington, DC 12:15 Discussion 12:25 Lunch 1:00 Public Statement Session Time slots appear in 15-minute intervals to allow for a 10-minute presentation followed by a 5-minute discussion period 1:00 Ron Manderscheid, Substance Abuse and Mental Health Services Administration, Center for Mental Health Statistics, Rockville, MD 1:15 Geoffrey Reed, American Psychological Association, Washington, DC 1:30 Mark Parrino, American Methadone Treatment Association, New York, NY 1:45 Linda Kaplan, National Association of Alcoholism and Drug Abuse Counselors, Arlington, VA 2:00 Rita Vandivort, National Association of Social Workers, Washington, DC 2:15 Raphael Metzger, National Coalition of Hispanic Health and Human Services Organizations, Washington, DC 2:30 Sarah Stanley, American Nurses Association, Washington, DC 2:45 William Dennis Derr, Mobil Corporation EAP, Princeton, NJ 3:00 Gwen Rubinstein, Legal Action Center, Washington, DC 3:15 Break 3:30 Elizabeth Edgar, National Alliance for the Mentally Ill, Arlington, VA 3:45 Donald Galamaga, Rhode Island Department of Retardation, Mental Health and Hospitals, Providence, RI 4:00 Elizabeth Hadley, National Association of Insurance Commissioners, Washington, DC 4:15 Linda Bresolin, American Medical Association, Chicago, IL

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MANAGING MANAGED CARE: QUALITY IMPROVEMENT IN BEHAVIORAL HEALTH 4:30 Sybil Goldman, National Technical Assistance Center for Children's Mental Health, Georgetown University Child Development Center, Washington, DC 4:45 Golnar Simpson, National Federation of Societies for Clinical Social Work, Inc., Boston, MA 5:00 Michael Faenza, National Mental Health Association, Alexandria, VA 5:15 Ray Bridge, Northern Virginia Mental Health Consumers Association, Falls Church, VA 5:30 Closing Comments   Reception INSTITUTE OF MEDICINE NATIONAL ACADEMY OF SCIENCES Committee on Quality Assurance and Accreditation Guidelines for Managed Behavioral Health Care PUBLIC WORKSHOP April 18, 1996 WORKSHOP PARTICIPANTS John Bartlett, Executive Vice President for Quality Improvement, Magellan Health Services, Atlanta, GA Linda Bresolin, Director, Department of Women's and Minority Health, American Medical Association, Chicago, IL Ray Bridge, Chair, Northern Virginia Mental Health Consumer's Association, Falls Church, VA Jackie Bryan, Director of Health Policy, Association of State and Territorial Health Officials, Washington, DC Jeff Buck, Acting Director, Office of Policy and Planning, Center for Mental Health Statistics, Substance Abuse and Mental Health Services Administration, Rockville, MD Mady Chalk, Director of Managed Care Initiatives, Center for Substance Abuse Treatment, Substance Abuse and Mental Health Services Administration, Rockville, MD

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MANAGING MANAGED CARE: QUALITY IMPROVEMENT IN BEHAVIORAL HEALTH William Dennis Derr, Manager, Employee Assistance Program, Mobil Corporation, Member, Employee Assistance Professionals Association, Princeton, NJ Elizabeth Edgar, State Issues Coordinator, National Alliance for the Mentally Ill, Alexandria, VA Michael Faenza, President and CEO, National Mental Health Association, Alexandria, VA Daniel Fisher, Director, National Empowerment Center, Lawrence, MA Susan Fitzpatrick, Training Coordinator, On Our Own of Maryland, Inc., Baltimore, MD Donald P. Galamaga, Executive Director, Division of Integrated Mental Health Services, Rhode Island Department of Mental Health and Retardation and Hospitals, Cranston, RI Don Galvin, President, Commission on Accreditation of Rehabilitation Facilities, Tucson, AZ Robert W. Glover, Executive Director, National Association of State Mental Health Program Directors, Alexandria, VA Nancy Goetschius, Health Insurance Specialist, Health Care Financing Administration, Baltimore, MD Susan Goldman, Manager of Behavioral Health Services, John Hancock Mutual Life Insurance Company, Boston, MA Sybil Goldman, Associate Director, National Technical Assistance Center for Children 's Mental Health, Georgetown University, Washington, DC John Gustafson, Executive Director, National Association of State Alcohol and Drug Abuse Directors, Washington, DC Elizabeth Hadley, Associate Counsel for Health Policy, National Association of Insurance Commissioners, Washington, DC Jeff Harris, Senior Policy Analyst, Health Policy Studies Division, National Governors' Association, Washington, DC Judith Hines, Interim Co-Director, Council on Accreditation of Services for Families and Children, New York, NY Robert Huebner, Chief, Health Services Research, National Institute on Alcohol Abuse and Alcoholism, Rockville, MD Corinne Husten, Medical Officer, Office on Smoking and Health, Centers for Disease Control and Prevention, Atlanta, GA Marcia Jones, Health Care Attorney, Division of Health Policy, American Foundation of State, County and Municipal Employees, Washington, DC Linda Kaplan, Executive Director, National Association of Alcoholism and Drug Abuse Counselors, Arlington, VA Nancy Kennedy, Managed Care Coordinator, Center for Substance Abuse Prevention, Substance Abuse and Mental Health Services Administration, Rockville, MD Kenneth A. Kessler, President, American Psych Systems, Bethesda, MD

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MANAGING MANAGED CARE: QUALITY IMPROVEMENT IN BEHAVIORAL HEALTH Chris Koyanagi, Director of Government Affairs, Bazelon Center for Mental Health Law, Washington, DC Beverly B. Long, President, World Federation for Mental Health, Atlanta, GA Bob Lubran, Chief, Quality Assurance and Evaluation Branch, State Programs Division, Center for Substance Abuse Treatment, Substance Abuse and Mental Health Services Administration, Rockville, MD Irene Lynch, Collaborative Support Programs, Aleppos Foundation, NJ Ron Manderscheid, Chief, Survey and Analysis Branch, Center for Mental Health Statistics, Substance Abuse and Mental Health Services Administration, Rockville, MD Thomas McLellan, Professor, Department of Psychiatry, School of Medicine, University of Pennsylvania, Philadelphia, PA David Mee-Lee, Medical Director, Community Systems, Castle Medical Center, Honolulu, HI Raphael Metzger, General Counsel, National Coalition of Hispanic Health and Human Services Organizations, Washington, DC J. Peter Nixon, Senior Policy Analyst, Service Employees International Union, Washington, DC Margaret O'Kane, President, National Committee for Quality Assurance, Washington, DC Mark Paris, Senior Policy Analyst, Mental Health Quality, Directorate of Quality Management, Office of the Assistant Secretary of Defense, U.S. Department of Defense, Washington, DC Mark W. Parrino, President, American Methadone Treatment Association, Inc., New York, NY Lee Partridge, Director of Health Policy Unit, American Public Welfare Association, Washington, DC Linda Peltz, Medicaid Analyst, Medicaid Bureau, Health Care Financing Administration, Baltimore, MD Natan Polster, Adolescent Medicine Newsletter, Washington, DC Lane Porter, DC Health Law Consultant, Washington, DC Lucille Pritchard, National Mental Health Association, Alexandria, VA Susan Probyn, Senior Manager, Quality Improvement Initiatives, American Association of Health Plans, Washington, DC Dan Quinn, Media Associate, Office of News and Public Information, National Academy of Sciences, Washington, DC Geoffrey Reed, Assistant Executive Director for Professional Development, American Psychological Association, Washington, DC Annette U. Rickel, Clinical Psychiatry Professor, Department of Psychiatry, Georgetown University, Washington, DC Larry Robertson, Consultant to the Center for Substance Abuse Treatment, Substance Abuse and Mental Health Services Administration, Johnson, Bassin and Shaw, Silver Spring, MD

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MANAGING MANAGED CARE: QUALITY IMPROVEMENT IN BEHAVIORAL HEALTH Gail Robinson, Mental Health Policy Resource Center, Washington, DC E. Clarke Ross, Executive Director, American Managed Behavioral Health Care Association, Washington, DC Gwen Rubinstein, Health Policy Associate, Legal Action Center, Washington, DC Jenny Schnaier, Health Research Policy Analyst, Research Triangle Institute, Washington, DC Paul Schyve, Senior Vice President, Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, IL Claire Sharda, National Committee for Quality Assurance, Washington, DC Golnar Simpson, National Federation of Societies for Clinical Social Work, Inc., Arlington, VA Sarah Stanley, Director of Nursing Practice, American Nurses Association, Washington, DC Tom Stantis, National Association of State Alcohol and Drug Abuse Directors, Washington, DC Robert Valdez, Deputy Assistant Secretary for Health, Interagency Health Policy, U.S. Department of Health and Human Services, Washington, DC Rita Vandivort, Senior Staff Associate for Mental Health and Addiction, National Association of Social Workers, Washington, DC Linda R. Wolf Jones, Executive Director, Therapeutic Communities of America, Washington, DC Anne Young, Center for Mental Health Statistics, Substance Abuse and Mental Health Services Administration, Rockville, MD

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MANAGING MANAGED CARE: QUALITY IMPROVEMENT IN BEHAVIORAL HEALTH INSTITUTE OF MEDICINE NATIONAL ACADEMY OF SCIENCES Committee on Quality Assurance and Accreditation Guidelines for Managed Behavioral Health Care PUBLIC WORKSHOP AGENDA May 17, 1996 The Arnold and Mabel Beckman Center of the National Academy of Sciences 100 Academy Drive, Lecture Room Irvine, CA 9:00 Welcome and Introductions Jerome Grossman, Committee Chair Margo Edmunds, Study Director   Invited Speakers 9:15 Council on Accreditation (COA): A Unique Combination of Generic Standards and Service-Specific Standards for the Full Array Judith Hines, Executive Director, Council on Accreditation of Services for Families and Children, New York, NY 9:30 Discussion 9:40 Commission on Accreditation of Rehabilitation Facilities (CARF) Accreditation Process and Standards in Behavioral Health Care Tim Slaven, National Director, Behavioral Health Division, Commission for the Accreditation of Rehabilitation Facilities, Tucson, AZ 9:55 Discussion 10:05 Utilization Review Accreditation Commission (URAC) Accreditation Randall Madry, President, Utilization Review Accreditation Commission, Washington, DC 10:20 Discussion

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MANAGING MANAGED CARE: QUALITY IMPROVEMENT IN BEHAVIORAL HEALTH 10:30 Break 10:45 Behavioral Health Care Industry Perspectives on Proposed Performance Indicators Tom Trabin, Vice President, Informatics and Outcomes Initiatives, CentraLink, Tiburon, CA 11:00 Discussion 11:10 Implementing Quality Improvement Programs Peter Panzarino, Medical Director, Vista Behavioral Health Plans, San Diego, CA 11:25 Discussion 11:35 Purchasers' Perspectives on Quality Catherine Brown, Senior Project Manager, Pacific Business Group on Health, San Francisco, CA 11:50 Discussion 12:00 Lunch 1:00 Quality Issues as Seen by Benefits Consultants Michael J. Jeffrey, Associate, William M. Mercer, Inc., Baltimore, MD 1:15 Discussion 1:25 County Perspectives on Performance Measurement Robert Egnew, Director, Behavioral Health Division, Monterey County Health Department, Salinas, CA 1:40 Discussion 1:55 Managed Care, Public-Sector Style Ann Froio, Director of Quality Management, ComCare, Phoenix, AZ 2:10 Discussion 2:20 Technical Challenges for Outcomes Researchers in Health Departments Don Austin, Oregon Health Division and Centers for Disease Control and Prevention, Atlanta, GA 2:35 Discussion 2:45 Closing Comments 3:00 Adjourn

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MANAGING MANAGED CARE: QUALITY IMPROVEMENT IN BEHAVIORAL HEALTH INSTITUTE OF MEDICINE NATIONAL ACADEMY OF SCIENCES Committee on Quality Assurance and Accreditation Guidelines for Managed Behavioral Health Care PUBLIC WORKSHOP May 17, 1996 WORKSHOP PARTICIPANTS Don Austin, Oregon Health Division, Portland, OR Catherine Brown, Pacific Business Group on Health, San Francisco, CA Robert Egnew, President, National Association of County Managed Behavioral Health Directors, Behavioral Health Division, Salinas, CA Ann Froio, Director of Quality Management, ComCare, Phoenix, AZ Mary Graham, Director, Office of Economic Affairs and Practice Management, American Psychiatric Association, Washington, DC Judith Hines, Executive Director, Council on Accreditation of Services for Families and Children, Inc., New York, NY Michael Jeffrey, Associate, William M. Mercer, Inc., Baltimore, MD Marcia Jones, Health Care Attorney, American Federation of State, County, and Municipal Employees, Washington, DC Randall Madry, President, Utilization Review Accreditation Commission, Washington, DC Joan McCrea, Corporate Manager, Hughes Aircraft Company, EAP, Corporate Human Resources, Los Angeles, CA Mary Cesare Murphy, Director, Behavioral Health Accreditation Services, Joint Commission on Accreditation of Health Care Organizations, Oakbrook Terrace, IL Peter Panzarino, Medical Director, Vista Health Plan, San Diego, CA Gail Shultz, California Society of Addiction Medicine, Oakland, CA Tim Slaven, National Director, Behavioral Health Division, Commission for the Accreditation of Rehabilitation Facilities, Tucson, AZ Tom Trabin, Vice President, Informatics and Outcomes Initiatives, CentraLink, Tiburon, CA Nancy Young, Children and Family Futures, Irvine, CA

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MANAGING MANAGED CARE: QUALITY IMPROVEMENT IN BEHAVIORAL HEALTH INSTITUTE OF MEDICINE NATIONAL ACADEMY OF SCIENCES Committee on Quality Assurance and Accreditation Guidelines for Managed Behavioral Health Care FOURTH COMMITTEE MEETING AGENDA June 25-26, 1996 The Foundry Building 1055 Thomas Jefferson Street, NW, Room 2004 Washington, DC 8:30 Continental Breakfast 9:00 Welcome and Introductions Jerome Grossman, Committee Chair Constance Pechura, Director, IOM Division of Neuroscience and Behavioral Health Margo Edmunds, Study Director   Invited Speakers 9:15 Concerns of Mental Health Consumers and Family Members in Managed Care Laura Lee Hall, Deputy Director of Policy and Research, National Alliance for the Mentally Ill, Arlington, VA 9:30 Discussion 9:40 Managed Care and Populations With Special Health Care Needs: Child and Family Mental Health Robert Cole, Director, Washington Business Group on Health, Washington, DC 9:55 Discussion 10:05 Perspectives on Quality Management and Managed Care in the Department of Defense Mark Paris, Senior Policy Analyst, Mental Health Quality, Office of the Assistant Secretary of Defense, Washington, DC 10:20 Discussion 10:30 Break

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MANAGING MANAGED CARE: QUALITY IMPROVEMENT IN BEHAVIORAL HEALTH 10:45 Quality Issues in Managed Care for Seniors Sarah Gotbaum, Director, Managed Care Project, United Seniors Health Cooperative, Washington, DC 11:00 Discussion 11:10 Cultural Competence in Health Care Julia Puebla Fortier, Director, Resources for Cross-Cultural Health Care, Silver Spring, MD 11:25 Discussion 11:35 Coordination of Services for Native Americans Reginald Cedar Face, Public Affairs Specialist, Pine Ridge Hospital, Indian Health Service, Pine Ridge, SD 11:50 Discussion 12:00 Culturally Appropriate Managed Care for Asians and Pacific Islanders Grace Wang, Medical Consultant, Association of Asian Pacific Community Health Organizations, Oakland, CA 12:20 Discussion 12:30 Closing Remarks INSTITUTE OF MEDICINE NATIONAL ACADEMY OF SCIENCES Committee on Quality Assurance and Accreditation Guidelines for Managed Behavioral Health Care FOURTH COMMITTEE MEETING June 25, 1996 PARTICIPANTS LIST Reginald Cedar Face, Public Affairs Specialist, Pine Ridge Hospital, Indian Health Service, Pine Ridge, SD Robert Cole, PhD, Director, Washington Business Group on Health, Washington, DC Sarah Gotbaum, PhD, Director, Managed Care Project, United Seniors Health Cooperative, Washington, DC

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MANAGING MANAGED CARE: QUALITY IMPROVEMENT IN BEHAVIORAL HEALTH Lieutenant Commander Mark Paris, PhD, Senior Policy Analyst, Mental Health Quality, Directorate of Quality Management, Office of the Assistant Secretary of Defense (Health Affairs), Washington, DC Julia Puebla Fortier, Director, Resources for Cross-Cultural Health Care, Silver Spring, MD Laura Lee Hall, Deputy Director of Policy and Research, National Alliance for the Mentally Ill, Arlington, VA Grace Wang, MD, MPH, Medical Consultant, Association of Asian and Pacific Community Health Organizations, New York, NY Observers: Jon Gold, Public Health Analyst, Managed Care Initiatives, Center for Substance Abuse Treatment, Substance Abuse and Mental Health Services Administration, Rockville, MD Robert Valdez, PhD, Deputy Assistant Secretary for Health, U.S. Department of Health and Human Services, Washington, DC Joy Midman, Executive Director, National Association of Psychiatric Treatment Centers for Children, Washington, DC IOM Staff Margo Edmunds, PhD, Study Director Constance Pechura, PhD, Division Director Eugene Lee, Student, MIT/IOM Intern Terri Scanlan, Administrative Assistant Thomas Wetterhan, Project Assistant/Research Assistant Amelia Mathis, Project Assistant