Development of an Evaluation Framework for ADAMH-Funded Integrated Care Services

ADAMH Board of Franklin County

Request for Proposals

Development of an Evaluation Framework for

ADAMH-Funded Integrated Care Services

Introduction:

The Alcohol, Drug and Mental Health Board of Franklin County (ADAMH) is seeking a research entity to help it design an evaluation framework for integrated primary and behavioral healthcare services funded by the ADAMH Board. This framework will allow ADAMH to recognize the strengths and challenges of these services so that purchasing decisions can be made that best serve the consumers in our system of care.

 The selected vendor will be the preferred vendor to partner with ADAMH on funding opportunities that allow us to implement a long-term evaluation of these services. ADAMH currently funds four programs within our system of care. Additional funding for other providers and programs will be distributed.

According to an ASPE Research Brief from the U.S. Department of Health and Human Services:

The Affordable Care Act will provide one of the largest expansions of mental health and substance use disorder coverage in a generation. Beginning in 2014 under the law, all new small group and individual market plans will be required to cover ten Essential Health Benefit categories, including mental health and substance use disorder services, and will be required to cover them at parity with medical and surgical benefits. The Affordable Care Act builds on the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA, or the federal parity law), which requires group health plans and insurers that offer mental health and substance use disorder benefits to provide coverage that is comparable to coverage for general medical and surgical care.

While almost all large group plans and most small group plans include coverage for some mental health and substance use disorder services, there are gaps in coverage and many people with some coverage of these services do not currently receive the benefit of federal parity protections. The final rule implementing the Essential Health Benefits directs non-grandfathered health plans in the individual and small group markets to cover mental health and substance use disorder services as well as to comply with the federal parity law requirements beginning in 2014.

Jointly, these two laws possess the potential to significantly impact the delivery of behavioral healthcare in that unprecedented demand for mental health and substance abuse treatment services will be created. To gain some perspective on the extent of future demand, consider the law’s primary intended beneficiaries: the uninsured. The number of individuals in Franklin County that lack health insurance under the age 65 is estimated at 160,970. Under the ACA, many of these uninsured individuals will be able to find affordable health insurance plans, which must provide mental health and substance abuse treatment as part of their essential health benefits.

The law promotes Behavioral Health Screening and Integration with Primary Health. The ACA will assist communities with the coordination and integration of primary care services into publicly-funded community mental health and other community-based behavioral health settings. Section 2703 of the Affordable Care Act, allows States to establish health homes through their Medicaid program. Ohio House Bill 198 establishes the Patient Centered Medical Home (PCMH). The PCMH model of care promotes partnerships between patients and their primary health-care providers to improve care coordination and bolster individuals' health outcomes. Patient care is coordinated using state-of-the-art tools such as registries, information technology, health information exchange and other means to assure that individuals get appropriate care when and where they need.

The Medicaid health home option presents an opportunity for behavioral health agencies to optimize consumers’ overall health and wellness, build on the experience they have developed in integrated healthcare, and carve out an important niche in the evolving healthcare system.

Background:

ADAMH is a local, levy-funded agency that plans, funds, and evaluates behavioral healthcare services in our community. ADAMH does not provide any direct alcohol, drug, or mental healthcare services, but instead contracts with more than 35 non-profit organizations.

One of ADAMH’s goals is to increase access to mental health and substance use services for uninsured people residing in Franklin County through an integrated primary and behavioral healthcare approach. This aligns with ADAMH’s “Access to Integrated Care” strategic result, which intends to foster the development of additional capacity and locations for the delivery of integrated care, in diverse geographic locations throughout Franklin County for individuals with mental health and substance use disorders.

Currently funded programs include:

• Maryhaven’s program uses the co-location model at two federally-qualified health centers to annually serve 360 patients.
•  North Community Counseling Centers, Inc., in partnership with Columbus Neighborhood Health Center, will begin providing integrated care at the South Side Health Complex in Columbus in fall, 2013.
• Southeast’s Integrated Care Project expands the use of a co-location model to two federally-qualified health centers to annually serve 1,500 patients.
• Southeast’s Franklin Station Project will provide integrated primary and behavioral health care services in commercial space at Franklin Station, a 100-unit apartment community constructed by the Columbus Metropolitan Housing Authority.

These services are designed to:

•  Expand behavioral healthcare access in primary care settings;
• Increase ready access for persons in primary healthcare to receive services in behavioral health;
• Providing psychiatric consultations to primary care physicians regarding medication needs;
• Improve access to primary care services;
• Improve prevention, early identification and intervention to reduce the incidence of serious physical illnesses, including chronic disease;
• Increase availability of integrated, holistic care for physical and behavioral disorders;
• Provide a better overall health status for consumers.

Deliverables:

• Business case for increasing access to mental health and substance use services for uninsured people residing in Franklin County through integrated primary and behavioral healthcare approaches.
• Agreed-upon program performance measures for integrated primary and behavioral health care models funded by ADAMH.
• Agreed-upon consumer health care outcomes for integrated primary and behavioral health care models funded by ADAMH.
• Agreed-upon consumer behavioral health care outcomes for integrated primary and behavioral health care models funded by ADAMH.
• Comparative analysis of program models that identifies strengths and weaknesses of each model of integrated primary and behavioral health care funded by ADAMH inclusive of estimates of cost savings by model.

Eligibility:

The vendor will be associated with a major university and have experience working with public healthcare systems and obtaining federal resources.

Cost Estimates:

Final proposal should include total costs not to exceed $30,000.

Proposal Information:

1.     Project summary (one page, single-spaced)

2.     Background and experience

3.     Proposal (not to exceed 15 double-spaced pages, excluding references and appendices)

4.     Work plan, including a timeline that identifies the start date, end date, and step-by-step completion dates. The work plan should contain two phases. Phase one of the work plan will focus on the development of an agreed upon evaluation framework for the evaluation of the two to three models of integrated primary and behavioral health care currently being funded by ADAMH. Phase two of the work plan will focus on seeking outside funders (public and/or private) to invest in conducting the evaluation of the various models of integrated primary and behavioral health care and the subsequent publication of the research findings and/or best practices to inform future ADAMH system investment and public policy.

5.     Project staff curricula vitae

6.     Project budget, including a breakdown of all costs.

Selection Criteria:

1.     Overall quality and clarity of project proposed;

2.     Quality of described deliverables, including data used and strengths of methodology;

3.     The applicant’s experience and qualifications, and ability to work with the ADAMH and meet ADAMH’s specifications;

4.     The reasonableness of budget and timeline request in view of the proposed study components.

Email questions and your bid to Aaron Riley, Planning and Evaluation Specialist, at ariley@adamhfranklin.org.