Projects & Impact

AHP has built its business on applying best practices, many of which we have helped to shape, and real-world, hands-on knowledge to improving systems and business practices for our clients.

In all of the work that we do, we are guided by our mission to improve health and human services systems of care and business operations to help organizations and individuals reach their full potential.

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Benchmarks for an Optimal Compensation Strategy

A state department of mental health has engaged AHP to deliver research and consulting services to improve business operations and impact systems of care through recruiting and retaining a high performance professional services workforce. AHP will provide guidelines for an optimal compensation and workforce development strategy to enable contracted provider agencies to effectively recruit and retain highly qualified behavioral health professionals to provide psychiatric services at inpatient and outpatient facilities statewide. Services include those provided to patients and clients by psychiatrists, other physicians, psychologists, and additional professional staff including “doctors on call” to ensure that a psychiatrist is onsite 24 hours per day, seven days per week, 365 days per year at every inpatient site.

AHP will deliver compensation guidelines to include salary ranges, benefit packages, brief job descriptions, and workload estimates for contracted staff. AHP will utilize proprietary salary, benchmarking, and workforce planning data spanning 100 health care organizations in 38 states to develop selected data to benchmark salaries, benefits, brief job descriptions, and patient workload for psychiatrists and psychologists in a number of peer states.

BHbusiness Plus

BHbusiness Plus is funded through a contract with the Substance Abuse and Mental Health Services Administration (SAMHSA). It offers customized, virtual technical assistance and training to behavioral health executives at no cost to participants. The goal is to help behavioral health providers identify and implement customized change projects that expand their service capacity, harness new payer sources, and thrive in the changing health care environment. The program empowers participating organizations to actually make quantifiable changes, rather than just learning how to do so. It links participants into specific learning networks that focus on a specific topic of interest and provides opportunities for networking and peer support. Everyone in a learning network receives hands-on expertise and guidance to initiate, continue, and complete business operations changes.
 
Participants benefit from the following supports:
 
  • focused technical assistance that meets each organization’s business needs;
  • guidance from a dedicated coach that helps participants develop a customized change project;
  • access to a peer group of like-minded providers that empowers organizations to learn from combined experiences to grow their businesses;
  • consultation from leading subject matter experts in the field; and
  • resources designed to be meaningful to learners, providing practical action steps to meet individual challenges.
 
Related resources and publications:
 

Building a Behavioral Health Network with Rural Providers

Facing evolving state and federal requirements for clinical integration, this group of rural behavioral health providers sought AHP’s help to assess their capabilities and begin to build a provider network to better serve their region. Recognizing the competitive risk of more dominant health systems, these smaller providers have banded together and are collaborating with AHP to strengthen their administrative capacity and efficiency and deliver care more effectively. AHP is conducting a readiness assessment of each provider’s capabilities for forming a provider network model with an analysis of strengths and weaknesses, along with recommendations for the most suitable network model to pursue. In addition, AHP is developing a business planning process with a blueprint for implementation for the chosen model. Each organization will receive a feasibility study and business plan for establishing a shared services organization.

Capacity Building to Support the Department of Housing and Urban Development (HUD) and the Centers for Medicare & Medicaid Services (CMS) (also called: CMS Housing Collaborative)

AHP is a subcontractor on the CMS Housing Collaborative, which is focused on building sustainable partnerships across all levels of government to link affordable, accessible, and integrated housing options with long-term supports and services for people with disabilities and chronic conditions. The objectives include:
 
  • to assist people with disabilities, older adults, and those with chronic conditions who are at risk of institutionalization or who currently receive care in institutional settings in finding appropriate housing to live more independent lives; and
  • to assist federal, state, and local agencies and community partners to create a sustainable, collaborative system between housing and human services agencies to support community living for older adults and those with chronic conditions who are at risk of institutionalization or who currently receive care in institutional settings.
 
These are accomplished by evaluating federal, state, and local level training needs, providing TA and training to all levels of government and grantees, and by developing and disseminating practical information and tactical strategies about how to increase collaboration.
 
AHP’s major accomplishments on this project have included providing federal level (HUD/CMS/HHS) cross-training on housing and disability policy, regulations, agencies, services, planning processes, and funding streams; state-level cross training regarding housing and disability policy, agencies, planning processes, services, and funding streams to build effective working partnerships; and overall training for housing agencies and Money Follows the Person (MFP) grantee disability agencies. AHP, in collaboration with New Editions, developed the Rural Housing Toolkit
 
Related resources and publications:
 
  • Downing, S. & Speckman-Randall, E. (2013). Rural Housing Toolkit: Money Follows the Person. New Editions Consulting, Inc. Funded through the Housing Capacity Building Initiative for Community Living Project, a collaboration of the Departments of Housing and Urban Development (HUD) and Health and Human Services (HHS), under the Centers for Medicare & Medicaid Services (CMS) Money Follows the Person (MFP) Rebalancing Demonstration. Retrieved from http://www.neweditions.net/housing/documents/Rural_Housing_Toolkit.pdf  

Colorado Office of Behavioral Health Needs Assessment

The Colorado Office of Behavioral Health (OBH) selected a team led by Western Interstate Commission for Higher Education (WICHE) Mental Health Program to conduct a needs analysis and scan of existing and promising behavioral health models. AHP worked with the WICHE team, which included NASMHPD Research Institute (NRI), to complete 17 tasks. AHP assessed:
 
  • Olmstead v. L.C. legal decision considerations in the provision of state psychiatric beds;
  • integration of behavioral health and physical health care;
  • impact of marijuana legalization and prescription drug misuse on CO OBH service needs;
  • impact of state drug sentencing reform on CO OBH service needs; and
  • state approaches to support employment and housing for mental health consumers.
 
The work on tasks included a literature review, environmental scan, key informant interviews, focus groups, and analysis of existing state-level data. A report was prepared for each task and combined into a comprehensive report that included recommendations for Colorado’s OBH. 
 
Related resources and publication:
 

Detroit Wayne Mental Health Authority [DWMHA] (formerly Detroit-Wayne County Community Mental Health Agency [D-WCCMHA])

Detroit Wayne County Community Mental Health Agency (D-WCCMHA) engaged AHP in 2006 to provide and coordinate technical assistance and evaluation services for eight community mental health centers that received new funding to develop and operate supportive housing and supported employment initiatives. AHP helped implement these Substance Abuse and Mental Health Services Administration (SAMHSA) evidence-based practices (EBPs) to fidelity, together with ensuring the client and its stakeholders had access to timely and ongoing information on program performance.
 
Work occurred over many years (from 2006 through 2015) and involved many tasks and elements. Following are highlights of some of this work:
 

  • 2006–2011: AHP defined and developed a sustainable strategy to implement supported employment and housing initiatives. It also developed guidelines to assist providers in implementing these practices. AHP senior staff facilitated numerous onsite strategic planning and operations management sessions for executive leadership of the nine agencies in the initiative. Other work during this time included:
    • Development of bi-annual fidelity assessments of supported employment and supportive housing models implemented by provider agencies;
    • Provision of extensive on- and off-site technical assistance, training, and mentoring;
    • Development and design of e-learning courses on 1) Permanent Supportive Housing; 2) Planning for Housing; and 3) Role of Housing in Recovery; and
    • Performance of process/outcome evaluations of supported employment and supportive housing initiatives by conducting key informant focus groups and individual-level data collection
       
  • 2011-2015: AHP’s work focused on supported housing initiatives during this period. Key accomplishments include:
    • Redesign of outcomes evaluation to facilitate performance monitoring along with providing technical assistance in the form of training development and implementation;
    • Performance of an overhaul of existing quantitative consumer-level evaluation data, working closely with a local evaluator and project stakeholders. The new system led to a marked increase in provider program engagement that allowed delivery of monthly performance data for eight providers serving 200 active consumers; and
    • Planning and implementation of nine site visits to evaluate provider agencies on an annual basis.
       
  • 2012-2013: AHP worked together with a planning team to design curriculum and develop priority messaging. AHP gathered feedback on draft materials that resulted in development and implementation of a two-day onsite GOI training session, as well as two new online training courses, including:
    1. Critical Time Intervention (CTI) and Permanent Supportive Housing; and
    2. General Organizational Index (GOI) and Permanent Supportive Housing.
 
In addition, AHP implemented a plan to gather service use data for both supportive housing and employment consumers that expanded descriptive information on consumers served. This data demonstrated a reduction in costly inpatient and crisis-related service use following supported employment and supportive housing program enrollment.
 
Related resources and publications:

Developing a Managed Service Organization for an Intellectual/Developmental Disability Services Provider Association

Members of an intellectual/developmental disabilities (I/DD) providers association engaged AHP to help form a management service organization (MSO) in response to imminent changes in the regulatory and business environment driven by the Affordable Care Act. AHP conducted a readiness assessment and then developed an implementation plan and roadmap to guide the group of providers toward establishing the MSO to re-engineer care delivery systems and adopt integrated service solutions and new technology. The comprehensive roadmap outlined the functional processes to put in place and a set of recommendations and procedures to help launch the MSO for the providers.

Developing a Strategic Plan and Pro Forma to Help a Midwestern Provider Association Form a Behavioral Health Network

This provider association engaged AHP to help form a provider network from among its members. AHP developed a robust strategic business operational plan and pro forma by performing in-depth analyses of key business operations areas and developing an action plan. Building on that work, AHP then facilitated the implementation planning process for credentialing and billing. As a result, AHP delivered a comprehensive roadmap outlining the functional processes to institute and a set of recommendations and procedures to help launch the desired network.

Evaluation of the Moms Do Care Project, Expanding Medication-Assisted Treatment (MAT) for Pregnant Women with Opioid Use Disorder

AHP is the evaluator for a Massachusetts Department of Public Health, Bureau of Substance Abuse Services (BSAS) grant to expand medical and behavioral health service systems capacity to engage and retain pregnant and postpartum women in integrated medication assisted treatment (MAT) and health care, and addiction and recovery support services. Funded through the Substance Abuse and Mental Health Services Administration’s (SAMHSA) targeted capacity expansion portfolio, The Moms Do Care Project is being implemented in two communities (one rural and one urban) and focuses on the specific needs of pregnant women with opioid use disorders. Its overarching objective is to provide recovering mothers with increased access to MAT and with individualized services that support sustained recovery, choices about continuing medication, and efforts to maintain custody or contact with their children.

Expected outcomes include increased access and engagement in MAT concurrent with pre-and post-natal care; reduced illicit drug use; and improved health, recovery, and functioning status at the individual level. Systems level outcomes include an increased number of waivered buprenorphine prescribers; increased workforce understanding of opioid dependency in women specific to the needs of pregnant women; reduced negative attitudes of this population among medical providers; and improved integration of primary care and behavioral health services. AHP will assess outcomes through client interviews at three points in time, administrative treatment data, surveys of medical providers, and onsite visits with a range of key informants.

Heartland Health Outreach Research Technical Assistance Project

AHP worked with Heartland Health Outreach (HHO), a community-based organization that provides medical, dental, behavioral health care and housing to vulnerable populations, to identify organizational research strengths and program evaluation needs. AHP conducted key stakeholder interviews with HHO administrators, reviewed HHO research implementation strategies, and recommended health care reform-related performance measurements. AHP also worked with HHO leadership to disseminate its research-related projects at a national level.
 
Related resources and publications:
 
  • Pickett, S.A. & Batia, K. (2015). Integrated Health Care for People with Psychiatric Disabilities: Introduction to the special issue. American Journal of Psychiatric Rehabilitation, 18(1), 1-4. Retrieved from www.tandfonline.com/doi/full/10.1080/15487768.2015.1001689.
  • Pickett, S.A., Luther, S., Stellon, E., & Batia, K. (2015). Making Integrated Care a Reality: Lessons Learned From Heartland Health Outreach's Integration Implementation. American Journal of Psychiatric Rehabilitation, 18(1), 87-104. Retrieved from www.tandfonline.com/doi/full/10.1080/15487768.2015.1001698

HIV Capacity Building Initiative: Project Aspire

AHP serves as the evaluator for a Center for Substance Abuse Prevention (CSAP) HIV Capacity Building Initiative (HIV CBI), Project Aspire. The goal of the grant is to prevent and reduce the onset of substance misuse and transmission of HIV/AIDS among at-risk racial/ethnic minority youth and young adults.

Equinox, a multiservice nonprofit organization, will provide evidence-based substance use disorder (SUD) and HIV/Viral Hepatitis (VH) prevention programming, onsite HIV/VH testing, and substance misuse assessment and counseling services to at-risk minority youth in Albany, NY, through its Youth Outreach Center. Peer Youth Leaders will promote engagement and co-facilitate prevention activities including the Say It Straight intervention. AHP will conduct a community needs assessment and assess program performance by documenting and measuring client outcomes and conducting a process evaluation. The needs assessment will include a review of epidemiological data, including prevalence rates, service gaps and disparities, community readiness to change, and capacity to provide SUD, HIV, and VH prevention and treatment services.

Improving Technological and Business Efficiencies for Federally Qualified Health Centers (FQHCs)

Since 2005, AHP has helped nearly all Massachusetts FQHCs and others in the Northeast and Mid-Atlantic to re-engineer key operational and clinical processes. AHP delivers value to the bottom line through evaluating and improving process mapping and workflow analysis, EHR implementation, identification of barriers and constraints, clinical and operational staff training, and system validation. AHP experts help FQHCs to integrate primary care and behavioral health, conduct strategic planning to meet the requirements of health care reform, and perform protected health information privacy and security assessments. Since 2011, AHP has assisted FQHCs in meeting the Centers for Medicare and Medicaid Meaningful Use.

Increasing Community Participation Among Adults with Psychiatric Disabilities through Intentional Peer Support (IPS Study)

For the National Institute for Disability, Independent Living, and Rehabilitation Research (HHS), under Grant 90IF0098-01-00, AHP will conduct a study examining the comparative effectiveness of Intentional Peer Support (IPS) in improving community living and participation for adults with psychiatric disabilities. IPS is a peer-developed, theoretically based, manualized approach that is unique in conceptualizing peer support as a relationship-based learning process in the context of personal growth and community-building. The study will compare the outcomes of IPS with those of standard peer support services on dimensions including self-esteem, self-discrimination, social connectedness, community participation, and quality of life.

Increasing Financial Stability and Productivity for an Intellectual/Developmental Disability Service Provider

AHP helped to assess and improve key business operations for The Resource Center, a provider of intellectual/developmental disability, primary care, dental, and mental health services in New York State that was facing financial challenges under health care reform. Over a two-year period, AHP conducted a claims analysis and a productivity study, as follows:

  • The analysis identified the causes of financial losses, gaps in the revenue management process, and opportunities for improved pricing strategies and contract negotiation processes.
  • The productivity study analyzed the clinical workflow and its impact on revenue models, revealing both the need to improve productivity and to increase patients to the practice. AHP’s recommendations from all phases of work were quickly implemented by the client. Today operations are more efficient, productive, and profitable.

Integrated Health Care for African Americans with Mental Illness who are Homeless

AHP is collaborating with the Illinois Institute of Technology (IIT) to develop, implement and pilot-test an integrated behavioral health and primary care intervention for homeless African Americans with mental illness. Funded by the National Institute of Minority Health and Health Disparities, in this project, peer navigators—African Americans with lived experience of homelessness and behavioral health problems—connect homeless African Americans with mental illness to medical and mental health care, helping them “navigate” these complicated health systems. AHP and IIT are conducting a randomized controlled clinical trial examining the effectiveness of peer navigators in improving health outcomes for this vulnerable population.
 
Related resources and publications:
 
  • Corrigan, P.W., Pickett, S., Kraus, D., Burks, R., & Schmidt, A. (2015). Community-based participatory research examining the health care needs of African Americans who are homeless with mental illness. Journal of Health Care for the Poor and Underserved, 26(1), 119-133. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/25702732.
  • Corrigan, P.W., Pickett, S.A., Batia, K., & Michaels, P.J. (2014). Peer navigators and integrated care to address ethnic health disparities. Social Work in Public Health, 29, 581-593. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/25144699

Jail Diversion and Trauma Recovery Cross-Site Evaluation

For this project funded by the Substance Abuse and Mental Health Services Administration (SAMHSA), AHP designed and implemented a six-year process and outcome evaluation of 13 grantees, mounting innovative, multilevel state and pilot programs that provided trauma-informed services and supports to veterans involved in the criminal justice system. The goal of the evaluation was to document the implementation of state and local pilot activities by grantees and understand the impact of the pilot program services on client outcomes, in particular behavioral health and recidivism. The key sources of data for the process evaluation include the bi-annual collection of standardized semi-structured reports and two face-to-face site visits. The key sources of data for the client outcomes evaluation include longitudinal in-person interviews and data collected through secondary sources on arrests and services at all 13 sites.

Related resources and publications:
 

  • Stainbrook, K., Hartwell, S., & James, A. (2015). Female Veterans in Jail Diversion Programs: Differences From and Similarities to Their Male Peers. Psychiatric Services. Retrieved from http://dx.doi.org/10.1176/appi.ps.201400442.
  • Stainbrook, K., Penney, D., & Elwyn, L. (2015). The Opportunities and Challenges of Multi-Site Evaluations: Lessons from the Jail Diversion and Trauma Recovery National Cross-Site Evaluation. Evaluation and Program Planning, 50, 26-35. Retrieved from www.sciencedirect.com/science/article/pii/S0149718915000075.

MA-Access to Recovery (MA-ATR) [Commonwealth of Massachusetts, DPH/BSAS]

The Commonwealth of Massachusetts subcontracted AHP to run the federally-funded MA-Access to Recovery (MA-ATR), which is a program designed to give people with substance use disorders wider access to community services that help them recover. Clients choose recovery support services they think will help them most in their recovery by using vouchers they are given to secure these services. MA-ATR’s goal is to enroll over 6,000 individuals within a three-year period.
 
This project is being implemented in the Greater Springfield and Greater Boston areas where there are high incidences of substance use. AHP’s accomplishments in this contract are summarized below.
 
  • Through MA-ATR, AHP created an innovative, nationally acclaimed program called the Career Building Initiative (CBI), designed to address the importance of employment to recovery. Providers were recruited that could provide different kinds of job training and job readiness programs. In addition, in order to eliminate the financial hardships of entering training instead of receiving income from a job, ATR gives every client a work-study benefit of $8 per hour for attendance.
  • AHP developed a provider network integrating traditional substance use providers with non-traditional recovery support supports and faith-based and community agencies.
  • Through MA-ATR, AHP created a client-centered system of care by providing clients with choice of services and providers.
  • AHP customized a curriculum to train eight ATR coordinators on effective engagement techniques, which is a critical skill needed to enroll the target number of clients within the three-year period. ATR coordinators learned follow up techniques such as finding individuals who are experiencing homelessness or are transient.
 
Related resources and publications:
 

National Center for Trauma-Informed Care and Alternatives to Restraint and Seclusion (NCTIC)

AHP is a subcontractor to SAMHSA’s National Center for Trauma-Informed Care and Alternatives to Restraint & Seclusion (NCTIC). A diverse team of staff and consultants, many of them trauma survivors and nationally recognized leaders, provide technical assistance (TA) and participate in developing products and materials under this contract. The National Association of State Mental Health Program Directors (NASMHPD) is the prime contractor for NCTIC.
 
NCTIC supports SAMHSA’s commitment to provide information, technical assistance, and support to increase awareness about the impact of trauma on people with mental health or substance use disorders, as well as people served by public health, education, and corrections systems.
 
A key focus of this work has been to promote alternatives to seclusion, restraint, and other coercive interventions to minimize the likelihood of re-traumatization. The use of trauma-informed approaches has therefore been incorporated into a broad range of service systems, with input from trauma survivors’ perspectives in all aspects of the contract. NCTIC is guided by the fundamental beliefs that people with personal experiences of trauma can and do recover and heal; Trauma-Informed Care is the hallmark of effective programs to promote recovery and healing through support from peers, consumers, survivors, ex-patients, and recovering persons and mentoring by providers; and leadership teams of peers and providers charting the course for the implementation of Trauma-Informed Care are essential.
  
The project has made major strides in addressing SAMHSA’s Trauma and Justice Strategic Initiative goals of creating capacity and systems change in the behavioral health and justice systems; implementing and studying trauma-informed approaches throughout health, behavioral health, and related systems; and reducing the impact of disasters on the behavioral health of individuals, families, and communities.
 
Major accomplishments of the project have included the administration of more than 130 technical assistance events in one year, reaching approximately 10,000 individuals between on-site events, webinars, virtual learning networks (VLNs), and consultation. This project was able to leverage funds with multiple organizations willing to help cover costs for presenting training and technical assistance, which resulted in our ability to present so many events, thereby increasing NCTIC’s visibility and shifting thinking in the field.
 
Specialized TA was provided in Baltimore, MD, to stakeholders from 76 different agencies following major unrest in that city after a teen died while in police custody. In addition, a training curriculum, Trauma-Informed Approach: Key Assumptions and Principles, has been developed to provide a framework for understanding trauma and its impact and prevalence, along with the key principles and implementation areas for trauma-informed approaches; and a General Adult Trauma Screening and Brief Response (GATSBR) toolkit is in development to facilitate screening for trauma in primary care.
 
Related resources and publications:

National Drugged Driving Reporting System (DDRS)

AHP, in collaboration with Carnevale Associates, received both Phase I and II Small Business Innovation Research (SBIR) contracts from the National Institute on Drug Abuse (NIDA) to develop and support the National Drugged Driving Reporting System (DDRS). The project was initiated because current enforcement approaches—developed originally to reduce drunk driving—are not adequate for dealing with the problem of drugged driving. In addition, there is not enough data collected about drugged driving at the local, state, or national level to inform policy and programs fully.  
 
The DDRS team worked with an expert panel of nationally recognized researchers to agree upon a National Minimum Data Set (NMDS) on Drugged Driving to meet the government’s need for data and to understand the magnitude of the problem of drugged driving, as well as identify possible public health prevention strategies. Based on this work, AHP designed the Drugged Driving Survey, an anonymous online survey designed to collect data elements outlined in the NMDS.
 
The DDRS team is partnering with up to three states to collect data on drugged driving. Each state recruits participants through their state Department of Motor Vehicles (DMV). The DDRS team assists with implementation of data collection strategies. After the field test with the initial three states, data collection will expand into other states. 

Related resources and publications:

National Veterans Technical Assistance Center (NVTAC)

The National Veterans Technical Assistance Center (NVTAC) is a partnership among AHP, the National Coalition for Homeless Veterans, and the U.S. Department of Labor’s Veterans Employment and Training Services. Funded under a cooperative agreement for three years, the NVTAC supports the mission of the Homeless Veterans Reintegration Program (HVRP) and its stakeholders.
 
The primary objective of the HVRP NVTAC is to provide a broad range of technical assistance on veterans’ homelessness programs and issues to existing and potential audiences. These include HVRP; HFVVWF (Homeless Female Veterans and Homeless Veterans with Families); IVTP (Incarcerated Veterans Transition Program); SD (stand down) grantees and applicants; employers; Veterans Service Organizations (VSOs); federal, state, and local agency partners such as state and local workforce investment boards; nonprofit organizations including faith-based and community organizations; the general public; and other interested stakeholders. This has been done through:
 
  • developing, conducting, and documenting extensive outreach efforts to national, state, and local employers to increase their awareness of the HVRP, HFVVWF, IVTP, and SD in order to increase employment and training opportunities for homeless veterans and veterans at risk of homelessness;
  • identifying, extracting, documenting, and sharing best practice or other case-study oriented overviews, as defined and directed by VETS; and
  • assisting VETS by suggesting and conducting research and program improvement based studies, as ultimately defined and directed by VETS.
 
Among the major accomplishments in this project, AHP has developed remote service-informed technical assistance and research-driven virtual training for a wide variety of grantees in settings ranging from urban to rural across the nation. Training topics include improving employment outcomes to justice involved veterans, approaches to job driven training in HVRP, and meeting the needs of veterans with behavioral health and other challenges. In addition, NVTAC has provided onsite grantee specific assistance to improve program operations, integrate use of best practices, and to achieve desired outcomes in Boston, Philadelphia, Atlanta, Chicago, Dallas, and San Francisco. NVTAC has developed a number of electronic and print materials including brief video interviews with experienced grantees, briefing papers, research results, and website updates.
 
Related resources and publications:
 

Positioning a Provider of HIV/AIDS Services in the Managed Care Market

AHP developed a strategic plan for this nonprofit provider of services for individuals with HIV/AIDS, focused on new products and services arising from health care reform opportunities, specifically guiding the organization in expanding its services to managed care organizations (MCOs). Once in place, the plan laid a foundation for AHP to help the client develop proposals to solicit contracts for specialized managed care services to the HIV/AIDS and other vulnerable populations. These proposals were submitted to major managed care insurers with plans targeting the Medicaid long term care services markets.

Positioning an Accountable Care Organization to Expand Behavioral Health Services

Inspira Health Network, an accountable care organization (ACO) with three medical centers and more than 100 access points, sought AHP’s help to make rapid, well-informed decisions about the best allocation of its behavioral health resources and facilities to best serve the surrounding community and deliver value to the bottom line. The goal was to research and deliver a position paper for presentation to legislative, business, and community stakeholders that would encourage support for the ACO’s proposed facility and product expansion. In a very tight timeframe, AHP conducted an assessment of the existing and future business environment, researched and defined the product line and proposed expansion, and developed a paper positioning Inspira Health Network and the benefits proposed for the community.

Recovery to Practice

AHP has contracted with the Substance Abuse and Mental Health Services Administration (SAMHSA) on the Recovery to Practice (RTP) workforce initiative to expand and integrate recovery-oriented care delivered by behavioral health providers across systems and service settings by fostering a better understanding of recovery, recovery-oriented practices, and the roles of the various behavioral health professions in promoting recovery.
 
The RTP initiative aims to address applications and recovery-oriented practices within multidisciplinary services and integrated settings. The contract tasks include redeveloping and expanding the RTP website, creating quarterly newsletters and other resources; providing technical assistance and educational events to help promote and support recovery-oriented approaches in integrated and multidisciplinary settings; creating new training modules on interdisciplinary service approaches and homelessness; and developing decision support resources for clinicians.
 
In this project, AHP leads a team that includes the Center for Social Innovation and the Foundation for Mental Hygiene, New York State Psychiatric Institute, Center for Practice Innovation at Columbia University.
 
Key accomplishments of this project include the development and delivery of 12 onsite and 12 virtual technical assistance programs and presentations for diverse audiences of practitioners, administrators, and consumers; the distribution of four magazine style newsletters with practical information on integrating recovery across a variety of topics and practices to a list of more than 6,000 subscribers; the development of a “virtual grand rounds” six-part clinical decision support webinar series that offers real-world training in recovery-oriented practice to clinicians and prescribers; and the creation of two comprehensive training manuals.
 
Related resources and publications:
 

Redesigning Systems for the Substance Use Disorder Field in the Era of Health Care Reform

In 2011, AHP foresaw the coming impact of both the Mental Health Parity and Addiction Equity Act (MHPAEA) and the Affordable Care Act (ACA) on the substance use disorder (SUD) field. Working with the State Associations of Addictions Services (SAAS), the largest national association of SUD treatment and service providers at the time, AHP developed an approach to assess and redesign the nation’s SUD delivery system. Together SAAS and AHP deployed the Readiness and Capabilities Assessment (RCA), a jointly developed survey tool to measure provider ability to meet the expected demands of the new legislation.

Related resources and publications:

Redesigning the Substance Use Disorder Treatment Continuum of Care in Los Angeles County

AHP is working with the Los Angeles County Department of Public Health Substance Abuse Prevention and Control (SAPC) to support the county in developing a state-required plan to opt into the Drug Medi-Cal Organized Delivery System (DMC-ODS) Waiver for adult and adolescent populations. The waiver expands treatment and recovery services and creates a continuum of care for individuals diagnosed with a substance use disorder (SUD).

In partnership with the SAPC leadership and other key stakeholders, AHP is developing the financing formula and the organizational and staffing infrastructure that will support the DMC-ODS. To fully develop the architecture and financing recommendations, AHP is analyzing similar systems, studying rate setting methodologies, providing comprehensive data analysis, evaluating financial formulas, cross-walking ASAM levels of care with standardized code sets, and gathering information on managed care financial operations. AHP will also provide recommendations for a cost-effective training plan to develop the staffing capabilities and readiness for implementation of the new system.

Residential Substance Abuse Treatment (RSAT) Aftercare Study

AHP has been awarded a grant by the National Institute of Justice (NIJ) to conduct a study of the treatment and aftercare services provided under the Bureau of Justice Assistance (BJA) Residential Substance Abuse Treatment (RSAT) Program. The goal of the RSAT Study is to provide NIJ with programmatic knowledge about BJA RSAT-funded treatment and aftercare services. Using a mixed methods design, the study will focus on describing the range and types of substance use treatment, re-entry/release planning activities, and related aftercare services that are provided to offenders through the BJA RSAT program. In particular, the evaluation seeks to identify the application and penetration of evidence-based principles and practices in facilities (jail, prison, juvenile detention) and post-facility with RSAT funds.  

Rosecrance Patient Outcomes Project

Rosecrance Health Networks, a private, not-for-profit behavioral health organization, contracted AHP to analyze its residential treatment data in order to help Rosecrance highlight how its services help adolescents and adults struggling with substance use disorders recover and reclaim their lives. Working with Rosecrance leadership, AHP identified the most compelling information on patient recovery and program success, and made recommendations on how Rosecrance might use those results in marketing its services. As part of this process, AHP examined how Rosecrance meets national and state quality indicators of effective substance use treatment.

SAMHSA’s Homeless and Housing Resource Network

The Substance Abuse and Mental Health Services Administration (SAMHSA) contracted with AHP to provide training and technical assistance (TA) on housing and homelessness to SAMHSA Homeless Program Branch grantees and other homeless housing and service providers operating across the U.S. states and territories. Homeless housing and service programs are united by a vision of ending homelessness by supporting individuals through a process of change as they improve their health and wellness, live a self-directed life, and strive to reach their full potential. HHRN focuses on four of SAMHSA’s strategic initiatives: trauma and justice; military service members, veterans, and their families; recovery support; and data, outcomes, and quality. The goals of this project include:
 
  • promoting the adoption of best practices for serving people who are experiencing homelessness or are at risk of becoming homeless and have chronic mental illness or co-occurring disorders;
  • increasing workforce capacity through TA and training;
  • disseminating information to the homeless services field in support of SAMHSA’s strategic initiatives;
  • collaborating with other agencies and organizations to improve coordination of SAMHSA activities focused on addressing homelessness and building effective partnerships; and measuring meaningful change.
 
The HHRN TA team is led by AHP and includes partners the Center for Social Innovation and JBS International. Key accomplishments of SAMHSA’s HHRN project include:
 
  • conducting 70 webinars on 53 topics;
  • offering 28 virtual learning classrooms to SAMHSA grantees;
  • providing responses to grantee TA requests, including the received provision of onsite training on implementing Homeless Management Information Systems (HMIS) for 11 states;
  • leading workshops at conferences and symposiums and conducting virtual workshops;
  • conducting expert panels;
  • developing two sustainable implementation guides—one that promotes effective collaboration among law enforcement, homeless service providers, and the community and the other that helps direct service staff and people experiencing homelessness how to go about getting or replacing the various types of ID documents.
 
AHP updated, enhanced, and field tested two Evidence-Based Practices KITs focused on people experiencing homelessness—the Permanent Supportive Housing ToolKIT and the Integrated Treatment for Co-occurring Disorders ToolKIT. In addition, HHRN has conducted led multifaceted, interagency policy academies on Chronic Homelessness (CH) and fostered the development of collaborative relationships with federal regional partners.
 
Related resources and publications:
 

Supporting the Illinois Alcoholism and Drug Dependence Association in its Advocacy for Substance Use Disorder and Mental Health Services

AHP has supported long-time client and partner, the Illinois Alcoholism and Drug Dependence Association (IADDA), on several key policy, marketing, and system design initiatives. In 2012, AHP reviewed and analyzed state insurance laws and regulations, and made recommendations concerning substance use disorder (SUD) policy and coverage. Subsequently, in light of Illinois’ decision to expand Medicaid in a coordinated care organization context in 2013–2014, AHP conducted an environmental scan to identify gaps in the statewide system of care that, if filled adequately, would result in an “ideal system design.” In 2014, AHP provided a review and set of recommendations for cost rates of behavioral health services in Illinois. The resulting document showed current rates were under national norms, and the data was used by IADDA in lobbying efforts to adjust provider rates in the state.

Supporting Transition to Health Care Reform for a Large National Behavioral Health/Social Services Organization

AHP worked with this national association and its affiliate members around the country on a range of projects including re-engineering services and delivery systems in response to the requirements and opportunities under the Affordable Care Act. AHP has worked extensively with the national headquarters of the association to identify opportunities for affiliates, including identifying partnerships with health homes and accountable care organizations, exploring new business opportunities, and expanding publicly funded services into the private pay and third party/managed care markets.

Technical Assistance and Training on Women and Families Impacted by Substance Use and Mental Health Disorders (also known as: Women, Children, and Families)

The WCF project supports the Substance Abuse and Mental Health Services Administration's (SAMHSA) advancement of state-of-the-art knowledge around substance use and mental health needs of women and families through supporting leaders, workforce development efforts, product development, and expert consultation. The Women, Children, and Families Technical Assistance Project (WCF TA Project) utilizes a multipronged approach to increase the field’s capability for meeting the needs of women, adolescent girls, and families across the nation, which includes working with policy makers, providers, and leaders committed to improving women's services throughout the nation.
 
Key project components include:
 
  • the development of a series of the Girls Matter! and Women Matter! webinars;
  • the Introduction to Women and Substance Use Disorders and Effectively Addressing Adolescent Girls with Substance Use and Co-Occurring Disorders eLearning curricula;
  • convening expert panels and developing publications including the Guidance Document for Supporting Women in Co-Ed Settings and accompanying Self-Assessment Tool; and
  • creation and implementation of the Women’s Addition Services Leadership Institute (WASLI).
 
AHP also provides expert consultation on gender responsive prevention, intervention, treatment, and recovery support services for adolescent girls, pregnant women, and families with children. Under this project, AHP provides general support for SAMHSA’s WCF and Families agenda, including technical assistance and logistical support, along with some support for the National Association of State Alcohol/Drug Abuse Directors (NASADAD) Women’s Services Network. 
 
AHP has been providing training and technical assistance through the WCF project since 2008. AHP provides subject matter expertise and consultation to SAMHSA, NASADAD, states and community groups on effective interventions, treatment and recovery support for women and families.

Related resources and publications:
   

Technical Assistance to the Center for Mental Health Services (CMHS) Office of the Director

Over several contracts, AHP has conducted studies, provided analysis and technical advice, and reviewed CMHS business operations. In addition, AHP writers are the principal speechwriters for the CMHS Office of the Director. Speeches communicate SAMHSA’s vision, mission, and priorities as they relate to development of a person-centered, recovery-focused, evidence-based, quality-driven system of behavioral health care. Staff members also prepare speeches for meetings of national organizations, SAMHSA grantees, peer-run and recovery organizations, national and international policymaking groups, and congressional committees. In addition, staff members draft posts for SAMHSA’s blog.
 
AHP’s accomplishments in support of the CMHS Office of the Director are both broad and deep. For example, AHP:
 
  • wrote a report to Congress on Borderline Personality Disorder;
  • helped assess the evidence base for the effectiveness of selected behavioral health treatments;
  • examined states’ priorities vis-a-vis health reform;
  • reviewed crisis support programs for people with behavioral health conditions;
  • examined employment of individuals with behavioral health disorders who have criminal justice involvement;
  • conducted an examination of patient activation for behavioral health;
  • developed CMHS program profiles;
  • helped develop materials related to the prevention of mental, emotional, and behavioral disorders;
  • examined the relationship of maternal health and child behavioral health outcomes; and
  • analyzed the extent to which the landmark Supreme Court decision in Olmstead v. L.C. is working for Americans with disabilities, including those with mental and substance use disorders.
 
In addition, because of AHP’s extensive knowledge and experience in working with SAMHSA over its 20-year history, AHP was tapped to help CMHS developed materials to mark the Agency’s 20th anniversary in 2012.
 
Related resources and publications:
 

The Behavioral Health and HIV/AIDS Technical Assistance Center (BH-HIVTAC)

The Substance Abuse and Mental Health Services Administration (SAMHSA) has contracted with AHP on this national technical assistance and training center, which provides services to Center for Substance Abuse Prevention (CSAP) and Center for Substance Abuse Treatment (CSAT) grantees funded through the SAMHSA Minority AIDS Initiative. Through onsite and innovative virtual technical assistance (TA), the BH-HIVTAC provides high-quality services to foster an understanding of the people it serves and support development of integrated services that are culturally and linguistically appropriate for these priority populations and their communities.The goal of this TA and and training is to:
 
  • increase integration of behavioral health prevention and treatment services, including HIV and viral hepatitis, and strengthen linkages to primary health care; and
  • increase capacity for local behavioral health provider networks to develop and expand their substance use prevention and treatment services, particularly those integrating HIV and viral hepatitis prevention services and linkages to primary health care.
 
AHP’s partners on this initiative are the Altarum Institute and the Danya Institute.
 
Among the major accomplishments in this project, AHP hosted a two-day virtual conference for 62 SAMHSA/CSAP grantees. Approximately 150 participants (project directors and staff, evaluators, and SAMHSA staff) attended the conference, which included keynote sessions, plenaries, and three concurrent workshops each day. Additional activities in this initiative have included a variety of highly interactive national webinars, site visits, phone consultations, and small learning networks all designed to strengthen and support grantee effectiveness.   

The Intersection of Violence Against Women and HIV/AIDS: A Cross-Training Guide for Service Providers Office of Women’s Health

AHP received a grant from the Office of Women’s Health (OWH) to research, revise, and then implement a pilot cross-training program for community domestic violence and HIV/AIDS agencies in four cities across the United States to enhance their services to vulnerable, abused women who were either infected or at risk for HIV/AIDS. By educating each agency on the subject matter of the other agency and encouraging collaboration between them, AHP’s goal was to ensure that no matter how the woman entered the system for services, whether through the domestic violence or HIV/AIDS door, both issues would be addressed. After recruiting the requisite service agencies in cities in four states, revising the five-part curriculum and developing presentations, AHP conducted web-based and onsite trainings, including joint sessions with both agencies. The project included a final report that will empower OWH to roll out a national training program.

Transitioning to a Medicaid Managed Care Model for Providers of Services to Individuals with Disabilities

AHP is supporting this provider association in its goal of establishing a long-term Medicaid managed care model for its member organizations that deliver services to individuals with physical disabilities. The managed care model will ensure care coordination between patient primary and mental health services, as well as facilitate their ability to live and work in integrated settings. In addition, the work explores network provider models to create a shared organizational infrastructure that will produce administrative and information technology efficiencies for the new managed care model. AHP is currently conducting readiness assessments and providing recommendations for best practices and models that best fit the organizations while meeting state regulatory requirements.

Uniform Data Systems for Health Centers

AHP, in partnership with John Snow, Inc. (JSI), supports the Department of Health and Human Services (HHS) Health Resources and Services Administration’s (HRSA) Bureau of Primary Health Care (BPHC) in the continual development and improvement of processes, documentation, and technical assistance supporting the annual collection of BPHC and BHPr (Bureau of Health Professionals) Uniform Data System (UDS) program performance data from grantees.

The UDS is a core set of information used for reviewing the operation and performance of the approximately 1,300 health centers (Section 330 Federally-qualified Health Centers [FQHCs]), FQHC Look-Alikes (LALs) and Bureau of Health Workforce (BHW) Primary Care Clinics) nationwide, which tracks information about patient demographics, services provided, staffing, clinical indicators, utilization rates, and financial measures.

Project goals include ensuring the reliability and validity of UDS data by providing training, technical support and UDS reviewer expertise; collaborating with HRSA Electronic Handbook (EHB) system developers to enhance reporting tools and develop various standardized reports; and conducting analyses and developing reports useful to health centers (for program management and performance improvement), project officers (for monitoring and technical assistance), and to HRSA for analyzing the individual and collective impact of health centers in providing primary health care services to the nation’s underserved populations.

Related resources and publications: