Table 4 Initial Implementation Phase: Innovative Implementation Activities and Strategies for Project EBPs*

State Infrastructure Building and Commitment

• New state position developed to assist in implementation and monitoring of EBPs established

• SMHA considering strategies to penetrate EBP in all licensed programs

• New RFP process developed to help fund EBP projects throughout state

Stakeholder Relationship Building and Communication

• Monthly meetings between state, Toolkit sites, and/or Advisory Councils

• Monthly meetings between NAMI and Toolkit sites

• Monthly meetings and/or calls between technical assistance centers and sites

• Ongoing communication between state and local sites/boards

• Increased collaboration between SMHA and State Medicaid Office

• New collaboration between SMHA, Medicaid and Vocational Rehab Office

• First time meeting held between state NAMI and Office of Consumer Affairs directors

• State and local sites working to implement evaluation process and reassure stakeholders of process

• Developed Clinical Practices Advisory Committee

• Planning EBP conference

Financing

• SMHA working with State Medicaid agency to make billing easier

• Developed new Medicaid billing code and coding guidelines

• Using bundled funding approach to fund EBP

• Exploring Medicaid requirements to qualify consumers to deliver EBP

• Using Medicaid Waiver 1115B to fund EBP

• Position paper written by state to recommend Medicaid reimbursement levels and codes

• Billing of EBP allowed as part of group or individual psychotherapy or day rate for Continuing Day Treatment Program

• Reimbursement codes and rates changed to support EBP

• Created new funding program only for EBP

• New funding formulas integrated into allocation structure, with codes changed in data system and audit process

• Medicaid approval received to reimburse EBP teams through amendment to state plan

• Medicaid rate recalculated to allow more professionals to be reimbursed

• State cost sharing with counties to fund EBPs

Continuous Quality Management

• Distributed SAMSHA's standards of care to local sites

• Developed and using new certification manual

• Developing treatment plan tool to include multiple domains and to be consistent with licensure review

• Developing mental health and substance abuse language guidelines for auditors to use in consistent evaluations

• Developing standards for EBP

• Barriers to standards for EBP teams removed by Medicaid agency

• Regulation changes to revise employment referral and authorization form, individual vocational form and verification of diagnostic process, and employment outcome measurement definition

• Implementing certification process through administrative rule and stakeholder process

• Integrated fidelity measures, technical support and supervision into certification

Service Delivery Practices and Training

• Developing treatment plan tool to include multiple domains and to be consistent with licensure review

• SMHA and consumer community developing partnership to train clinical staff to deliver EBP

• SMHA funding for consumer training and joint teaching to professionals and consumers for EBP

• Implementing shadowing training program

• Administrative rule revised to include fidelity adherence for EBP