The Affordable Care Act: a generational change

One of the few bits of good news for Americans with behavioral health conditions to come out of any presidential administration dominated the proceedings of ASU’s 13th Annual Summer Institute held in Sedona from July 17-20.

The collective sigh of relief emanating from the 400 attendees from Arizona behavioral health, substance abuse, and child welfare organizations and agencies, was an indicator of how significant the passage of The Affordable Care Act really is. The new health law, upheld by the Supreme Court in early July, offers access to psychiatric care at the level of coverage equivalent to any other medical condition, paving the way for individual health insurance for all Americans without exclusion of those with pre-existing mental illness.

“Not since 1965 and The Medicare Act has there been such momentous change in health care delivery,” said keynote speaker Captain Jon T. Perez, Substance Abuse and Mental Health Services Administration (SAMHSA) regional administrator for District IX, which covers the area extending from Arizona to the Pacific island of Palau.

“But there is so much going on and so much yet to be defined, we cannot allow ourselves to go along with whatever gets decided by others," Perez added. "We have seats at the table now, and if we don’t take them, someone else will.”

The subject that Perez said must be urgently addressed is the tricky business of health care integration.

Integrated health care is a system characterized by high levels of collaboration, communication, sharing of records, and establishment of a comprehensive plan for wellness by a team of physicians, psychologists, social workers and other health practitioners. It’s holistic foundation and responsiveness to the whole person, not just their illness, is viewed as the future of health care, even while a host of implementation questions remain unanswered. How do you hold a system of care accountable? How do you bring a cardiologist and a social worker into a clinical setting as equal partners in patient outcomes?

“We need to talk about a multi-dimensional integration model,” Perez said. “It’s about the patient at the center of a coordinated care team. We have specialties and different skills, but we need to be much more connected. The rigid hierarchy of traditional health care delivery can’t work in that setting.”

Conference attendees are very aware of the challenges. Summer Institute is a sellout every year, with many returning participants. The theme of this year’s gathering – Business and Service Alignment for Health Outcomes – came out of attendee requests for more information on business issues in behavioral health care. The 55 sessions on the agenda focused on topics such as board governance, strategic planning, fund development and clinical supervision. 

In his welcoming remarks, conference organizer Michael S. Shafer, director of the Center for Applied Behavioral Health Policy, housed in ASU's College of Public Programs, said, “The implications of The Affordable Care Act for the behavioral health, mental health and addiction treatment community are profound. No other health discipline will be as impacted in terms of changes to practice and routine, health information exchange and licensure.”

Perez agreed and said what is happening in behavioral health demands innovation and collaboration.

"Go ahead and use the evidence base to design your organization, but you need to also be a leader and take the next step. You won’t know what that is at first, but go ahead and take it, because this is generational change and innovation is the way forward,” Perez said.

Amy Ashley,
Policy/Research Technical Writer
Center for Applied Behavioral Health Policy