CONFERENCE RECAP
On September 19, 2023, the Idaho Behavioral Health Association held its first annual conference that focused on education and advocacy for the behavioral health community. This conference put patients, payers, and providers in the same room to discuss changes they would like to see and highlight areas where new techniques or practices have been implemented. The keynote discussions were delivered by the Chief Medical Officer and Chief Executive Officer of the Fletcher Group, Dr. Ernie Fletcher, and Dave Johnson. They started by discussing Idaho's history of behavioral health. Mr. Johnson spoke on how 20% of the Idaho population has some mental health needs, which follows the national average, but Idaho's suicide rate is greater than the national average. Dr. Fletcher focused his time on recovery ecosystems and the importance of establishing these due to their unique impacts on mental health and recovery in a community.
The Idaho Behavioral Health Council (IBHC) is an excellent tool for the state, and he stressed the importance of working with those in the community to see what changes they need. Dr. Fletcher discussed the clinical system and the current process for getting an individual into recovery housing takes time, and this is an area that could be looked at for reform. From his experience, he has learned people will build a system that works if they have sustainable funds to do so and it is essential to measure the outcomes. However, it is crucial to design a system that can accommodate change because those in charge will design what they think will work. However, those who are providing and delivering services will know what they have to do to be successful, and they will adapt the system to fit what they need it to look like. He concluded his speech by touching briefly on Opioid Abatements, the resources available, and new opportunities arise when we bring them all together.
After the keynote, the conference moved into the education panel, moderated by Bobbi Hamilton, Vice President of IBHA. Those on the panel were:
Sara Omundson, Administrative Director for Idaho Supreme Court
Beth Markley, Executive Director of NAMI
Ross Edmunds, Administrator of IDHW Division of Behavioral Health
Wes Trexler, Deputy Director of Idaho Department of Insurance.
Each panel member was asked questions about their background and experience with behavioral health in Idaho. Director Omundson discussed her involvement in behavioral health as co-chair of the IBHC and spoke briefly on the creation of this Council. The Council was created through all three branches of government coming together to create statewide goals. The Council created a four-year strategic plan that outlines what they want to accomplish and stresses their need for private sector involvement and aid.
Director Omundson discussed SIM mapping as one of the projects the Council has been working on. The SIM maps show where resources are located throughout the state, and there is one for each of the seven (7) judicial districts. These maps show not only what resources are available but also where gaps are. She invites the private sector to participate in data collection so they can get a more thorough map.
When asked about resources the courts have for individuals to utilize, she discussed those available for individuals arrested or in the criminal justice system. The courts have coordinators to help find resources or get on Medicaid, but these are for convicted felons. There are also drug courts for when individuals are convicted of a felony. She also mentioned how the courts are working on building up housing options and having guardianship coordinators. Still, they need to remove the stigma that people won’t get help until convicted of a felony.
Director Markley briefly explained the National Alliance on Mental Illness (NAMI) and how the organization works to improve the quality of life for those affected by mental illness. NAMI has facilitated support groups and educational support groups for families and peers. Director Markley spoke about her family's mental illness experience and that Idaho rehabilitation centers can’t offer the same services as out-of-state facilities.
Ross Edmunds, Administrator of the Division of Behavioral Health, discussed some recent strides the division has made, highlighting crisis centers across the state. He also mentioned that they are working on implementing youth crisis centers. Administrator Edmunds also discussed how the Idaho Behavioral Health Plan has historically been fractured, which they are working on; the Division would like to have a greater look at comprehensive care. There is a contract in place that would take inpatient and outpatient individuals covered through Medicaid and those not covered through Medicaid. When asked about the most significant gap that he would like to see fixed, Administrator Edmunds discussed how, under the current system, adults must reach a certain level of severity before the state will help them. He highlighted the desire to have trauma specialists to aid caseworkers in understanding trauma responses and models better. Other panelists voiced support for a better behavioral health workforce, addressing the healthcare worker deserts in the state, and having more experienced and professional caretakers. Part of the problem is that insurance will pay for polar ends of the spectrum, whether it’s counseling or primary crisis/hospitalization, but not the intense services in the middle.
The second panel was monitored by Janice Fulkerson, COO of The Fletcher Group, and focused primarily on advocacy. The panelists included:
Chief Roger Schei, Pocatello Police Department
Sarah Samson, LCSW, Trivium Life Services
Adrean Cavener, Director of Public Affairs and Governmental Relations for Regence BlueShield of Idaho.
The questions were directed towards the panel as a whole, with some specific to the individual. Still, they began with Ms. Samson, LCSW, providing an overview of Trivium Life Services for those who were unfamiliar. Trivium Life Services works closely with the community, the Idaho Department of Corrections (IDOC), those on misdemeanor probation, the Boise Police Department (BPD), and others. She spoke on how BDP is interested in the clinical side of treatment regarding suggestions and interpretations when dealing with individuals. She discussed their harm reduction programs and the harm reduction vending machine, where numerous goods are available to the public, including hygiene supplies, clean needles, and sharp disposals.
One of the questions that prompted a considerable discussion was one about stigmas and working to eliminate them. Chief Schei discussed how officers are trained in de-escalation and that while they do everything they can to de-escalate a situation, they are sometimes forced to take an individual into custody. They don’t ask about insurance but will turn individuals over to a crisis center or hospital. Director Cavener discussed options that insured individuals have and that Regence BlueShield has Care Navigators who will help individuals find the correct way to move forward with insurance. Trivium has a program with Saint Alphonsus where case managers will work with Trivium to see what insurance will cover and get a list of what services will be covered by insurance. They all want to work to reduce barriers to treatment.
Chief Schei also discussed how different Idaho regions have different behavioral health problems. The number one thing we can do is build relationships within the community, and jail is not the solution; he believes that drugs and mental health go hand in hand, and community relations are essential in this sense. One prevention effort that the state could make is having more programs for those convicted of a misdemeanor and shifting more towards this rather than felonies. It is essential to talk about adults, but there is also great importance in talking to juveniles and addressing patterns and behaviors among juveniles.
After a great day of discussions surrounding the resources, needs, gaps, and inter-laps between behavioral health and criminal justice, many joined our networking sections and receptions, where attendees continued these discussions. Many expressed how many great programs there are and how their sectors can get involved to build out these successes. More conversations and follow-up are to be had in the coming months as we move towards the 2024 Legislative Session.
