2024 BEHAVIORAL HEALTH CONFERENCE RECAP
The half-day Idaho Behavioral Health Association Friday conference included three parts: Opening address from Beth Markley, the Executive Director of the National Alliance for the Mentally Ill (NAMI) in Idaho; followed two panel discussions. The IBHA conference was a huge success as we brought a diverse group of stakeholders including legislators, congressional delegation staff, payers, providers, and patients. Through the discussions held we were able continue to deliberate current gaps, successes, and next steps. IBHA is excited to continue moving forward to fill these gaps and build on the success of CCBHCs, the Idaho Behavioral Health Council, and more!
Panel One | CCBHC’s – Past, Present and Future
Panelists: Alex Adams, Director of Idaho DHW; Heidi Hart, CEO of Terry Reilly; and Brett Beckerson, National Council of Mental Well-Being:
The discussion got underway with Beckerson defining Certified Community Behavioral Health Clinics (CCBHCs). He said these clinics are federally defined, state driven to meet local goals and fill gaps in coverage for clients regardless of means to pay. Clinics are eligible for grant funding of $4 million over four years, which is funding used by Terry Reilly in its operation of one of the five CCBHCs serving Idahoans.
Adams said investing in Behavioral Health access and competitive services is a critical component to Gov. Brad Little’s overall plan to improve behavioral health care and access. To date, Adams said the state has kicked in $12 million for CCBHCs, using a little more than half of so far. He said the goal is to get a CCBHC in eastern Idaho.
Hart was then asked about staffing and challenges to keep and cultivate a talented workforce. She said every community across the state is focused on how to keep staff. Terry Reilly is also considering ways to take on students and interns to provide support and valuable training. She said the team at Idaho Workforce Development Council is also working on this important issue. Beckerson added that in other states, he’s finding that clinics that embrace the CCBHC model can take on an average of 22 new staff. Additionally, he said clinics in Missouri have been able to embed staff into hospital systems, which helps recognize when a patient needs mental health over the more costly emergency care.
Additionally, Beckerson argued that there is a real cost savings by diverting patients into a CCBHC outpatient care rather than traditional hospital/emergency care, or in other cases local jails and even state correction systems. He cited an example of law enforcement in Oklahoma, where tablets embedded in police vehicles enable officers to communicate directly with CCBHCs instead of taking someone dealing with mental health crisis to jail or emergency rooms.
In discussing the importance of state and federal government providing long-term funding, Beckerson said states that don’t commit to longer-term run workforce risks. He cited examples of states like Oklahoma and Missouri poaching talent from Kansas, an early adopter of the CCBHC model. He suggested Idaho could be at risk as CCBHCs grow in Oregon, Washington, Montana, and Utah that are now getting rolling on CCBHCs.
On the question of PPS rates for CCBHCs, Adams said rate-setting is still in its infancy and DHW is trying to better understand the model. Adams also emphasized that CCBHCs fit into the department’s overall goals, especially with the new commitment to improving programs and outcomes in the foster care system relative to issues of substance abuse and behavioral health for parents and kids.
Beckerson said federal funding has been critical to getting CCBHCs up and running in states, and he gave a shout-out to the SAMHSA grant program. These grants have played a significant role in providing high-quality services for everyone – regardless of ability to pay. More specifically, Beckerson acknowledged and credited U.S. Sen. Mike Crapo, R-Idaho, for his strong support and working in a bipartisan strategy to ensure funding through SAMHSA.
FUNDING & COSTS
Hart said the $1 million in annual grant funding helps with reimbursement of costs at the clinic in the absence of a PPS rate.
Adams added that CCBHCs fit into Idaho’s overall approach to fiscal conservatism, and he is confident CCBHCs provide cost savings opportunities when it comes to expanding programming and reach with law enforcement, state corrections, and the courts.
Finally, Hart was asked what success looks like in the future. She said there is always risk in promising better, healthier outcomes with a new care model. “How do we come together and prove the case? To demonstrate the impact?” She alluded to an earlier comment related to efforts to figure out data collection/reporting and the challenge of collecting that.
Panel 2 | United in Behavioral Health Care to Save Lives
Panelists: Michael Panter, Meridian PD Crisis Team Intervention Team Officer; Jared Larson, Idaho Behavioral Health Council; David Welsh, Magellan Healthcare; Lee Flinn, Idaho Crisis and Suicide Hotline; and Kevan Finley, CEO Cottonwood Creek Behavioral Hospital.
Panter opened the discussion by reporting how police crisis teams are seeing more calls for service every year. Thankfully, these teams are getting more training and tools to respond and to educate other law enforcement agencies in Idaho.
Larson also said it’s reassuring to see that Behavioral Health is a priority in a wide range of policy discussions. He cited the emergence and success of Youth Assessment Centers around the state and the four youth crisis centers. He also mentioned that funding is now available to build a Boise facility for the critically mentally ill. Still, he said gaps remain in providing care for Idaho’s most vulnerable children.
Larson also said one of the biggest priorities for the Idaho Behavioral Health Council is addressing the workforce issue. He also said a goal is for Idaho to do a better job of helping the helpers – the first responders, social workers, correction officials, who respond to crisis.
Flinn discussed the success of the 988 suicide hotline. The hotline takes calls 24/7, and Flinn said 85 percent of the calls her team takes are able to be supported using a variety of strategies and resources.
Finley said one of the biggest challenges is the lack of providers when patients leave Cottonwood. There are gaps in education, prevention, and access to care.
COMMENTS ON IDAHO’S SUICIDE RATES
Panter said there is still a belief in Idaho that you need to pull yourself up and out of a suicidal cycle—that there’s a stigma about seeking help. This belief is especially acute in rural parts of the state.
Finley suggested there is a lack of connection, especially with youth who spend more time on phones than socializing. He pointed to a lack of funding for mental health treatment/services.
Flinn echoed the ‘rugged individualism’ stereotype. But she also cited the issues among the LGBQT and Native American communities. She also said firearms remain a complicated factor in suicide. Any individual who calls the hotline and shares they have access to a gun makes the situation more lethal and dangerous.
RESPONSES ON THE BLOCKS TO RECEIVING CARE
Finley again cited the stigma around asking for help when needed. He also said more emphasis and education should be aimed toward getting people treatment before issues become acute.
THE IDAHO BEHAVIORAL HEALTH PLAN
Flinn said the biggest change has been the ability to begin dispatching mobile crisis teams statewide. She said there are two new companies providing this service five days a week and the plan is to expand that in the future.
Welsh added that response times for these teams is 30 minutes, with four teams working around the state. Efforts are also ongoing to connect these units with first responders across the state.
HOPES FOR IDAHO’S BEHAVIORAL HEALTH ECOSYSTEM
Welsh said connecting more people who need services with those services.
Finley wants to see an Idaho where people can get same-day appointments for help rather than using the hospital emergency room. He wants to see more people recognize a need and walk in for care. Too often we end up focusing on suicide, but we really need to understand that it’s a symptom of something else. More funding, education and prevention. “It takes money to get people well.”