1. Welcome, Agenda, Challenges and Potential Solutions Implementing Evidence-Based Practices and Performance Measures for Massachusetts Mental Health Services: An Educational Forum Donald S. Shepard, Ph.D. Sept. 28, 2005 Shepard@Brandeis.edu Tel 781-736-3975 Brandeis University, Waltham MA 02454 Brandeis University

2. Welcome Brandeis University

3. Key questions Brandeis University 1 What are EBPs? To inform key stakeholders about the key concepts and status of evidence-based practices (EBPs) and performance measures in mental health. 2 How can they be implemented? To understand what is needed for successful implementation and the barriers to success. 3 How can we work together to deliver more evidence-based practices? To bring together key behavioral health stakeholders to discuss how to support implementation of these practices in Massachusetts.

4. Participants Brandeis University About 175 Registrants 7 States Represented: MA, CT, MD, ME, NH, NY, VA

5. Sponsors Brandeis University Massachusetts Department of Mental Health Massachusetts Department of Public Health, Bureau of Substance Abuse Services Center for Behavioral Health, Schneider Institute for Health Policy, Brandeis University Suffolk University Department of Public Management Center for Mental Health Services, SAMHSA

6. Agenda Brandeis University

7. Framework Brandeis University Context and Evidence-Based Practices Nationally Performance Measurement (Process and Outcome) Towards Implementation in Massachusetts Participation by providers, interest groups, government Training Incentives Etc.

8. Speakers Brandeis University Performance Measurement (Horgan) Towards Implementation in Massachusetts (Childs, Stelk, Lynch, Funk, Delman, Beinecke) Context and Evidence-Based Practices Nationally (Shepard, Keane, Botticelli, Mandersheid, Leff, Lynde, Ganju, Hermann)

9. Challenges and Potential Solutions Brandeis University

10. A Suggestion: Incentives Brandeis University

11. First Illustration: Setting Goal: Improve retention in substance abuse treatment. “Eighty percent of success in life is showing up.” Woody Allen (1935-, writer, director actor) Setting: Randomized trial of outpatient aftercare based on relapse-prevention at Spectrum Addiction Services in MA Enrolled 123 subjects in experimental arm (after excluding one death) At midpoint: only 32% of clients completed minimal dose of at least 5 sessions Authors: Donald Shepard Jeanne Calabro, James McKay, Craig Love, Jill Tetreault, Hyong Yeom Support: NIDA DA 08739 Brandeis University

12. First Illustration: Counselor Incentive Bonus of $100 for each client who completed at least 5 relapse prevention sessions Additional bonus of $50 for each client who completed 12 relapse prevention sessions Brandeis University

13. Illustration: Results Brandeis University

14. Ongoing project plans: Profiling and incentives in behavioral health care Brandeis University Randomized trial (facilities randomized) Profiling according to “Connect to care” and other measures Case mix adjustment planned Coaching in evidence based practices Recognition and monetary incentives for top performing agencies planned Notes: Collaboration with Connecticut Department of Mental Health and Addiction Services (DMHAS) Part of Brandeis/Harvard NIDA Research Center on Managed Care in Drug Abuse Treatment.