In recent years, integrating treatment for mental health and substance use disorders (SUD) with primary care has been the subject of extensive research testing a number of different integration models and specific interventions. While many of these approaches have shown promise in demonstrations or clinical trials, the true test of value is in real-world settings where there are competing demands on scarce resources, strict fidelity to intervention protocols is difficult, and patients have multiple urgent needs. This report, prepared by a team led by Robin Clark and Deborah Gurewich of the University of Massachusetts Medical School, describes the process of providing integrated care for patients with SUD at three sites in central Massachusetts: Edward M. Kennedy Community Health Center, Family Health Center of Worcester, and Community Healthlink. It identifies common practices that improve care coordination for individuals with SUD and concludes with overarching key findings from the study.

This report, prepared by Robert Belfort and Alex Dworkowitz of Manatt, Phelps & Phillips, LLP, provides a review of the primary Massachusetts and federal privacy laws relevant to the exchange of information among physical and behavioral health providers and an assessment of technological and operational challenges faced by providers seeking to integrate care through enhanced data exchange. The report proposes ways in which existing laws could be clarified or amended to better facilitate information exchange and identifies potential operational strategies for minimizing the restrictive impact of existing privacy laws without compromising patient privacy.

The Foundation hosted a webinar with authors Robert Belfort and Alex Dworkowitz of Manatt, Phelps & Phillips, LLP to review key findings from this report on Wednesday, March 30th. Click here to access the webinar slides.

This report, prepared by Margaret Houy and Michael Bailit of Bailit Health Purchasing, LLC, provides a comprehensive review of the policy and regulatory barriers that impede behavioral health integration in Massachusetts and identifies potential options for addressing these barriers. This report is divided into three sections – licensing, privacy, and, reimbursement barriers – and was developed through a review of reports and other secondary sources, agency regulations and checklists, and interviews and a focus group with key stakeholders. Incorporating the input from the focus group, it concludes with a discussion of the top three priorities that, if addressed, would have the most significant impact on removing barriers to integration. This report is intended to serve as a resource summarizing key issues and potential opportunities for policymakers to improve the integration of physical and behavioral health care services.

In 2014, the Foundation partnered with the city of Boston to conduct a thorough analysis of the scope of Boston's substance use addiction problem and selected DMA Health Strategies to conduct the research. With the Mayor’s Office, the Foundation also assembled an Addiction Recovery Advisory Group comprised of addiction experts and community stakeholders to work closely with the researchers. This report, which focuses on how to better align the city of Boston’s addiction and recovery services with demonstrated best practices, will serve as a roadmap for the Mayor’s Office of Recovery Services.

This report by Colleen Barry of the Johns Hopkins Bloomberg School of Public Health explores opportunities and issues around integrating behavioral health care and primary care under the Affordable Care Act (ACA) and payment and delivery system reforms in Massachusetts. The report provides preliminary recommendations on how these major policy changes might be implemented with the goal of improving the coordination, quality and outcomes of mental health and addiction care in the Commonwealth.

This report is based on a survey of 1,982 mental health providers in Massachusetts including psychiatrists, psychiatric clinical nurse specialists, psychologists, social workers, mental health counselors, and marriage and family therapists. It estimates the need for childrens mental health services; assesses child and family mental health service delivery capacity; identifies variation in capacity, including variation by geography, linguistic ability, and cultural competence; and documents challenges to meeting current demand for services.

The district court ruling in Rosie D. v. Romney, and the subsequent remedy now being implemented by state health and human service agencies, have the potential to transform the delivery of mental health services for children with serious emotional disturbances in Massachusetts. This issue brief explores the implications and potential effects of the case and the resulting remedy on the MassHealth program, other state programs, the behavioral health and social service delivery systems, and affected children and their families.