Assessing Integrative Care for Adults with Serious Mental Illness in New York

• Conducted site visits, surveys, and interviews to examine in detail the three integrated care approaches underway in New York: PBHCI, OMH’s Medicaid incentives, and Medicaid health homes;
• Published its findings and recommendations in a report, “An Examination of New York State’s Integrated Primary and Mental Health Care Services for Adults with Serious Mental Illness,” and accompanying issue brief highlighting key findings from the report. The report and brief were widely disseminated and are featured as resources on the SAMHSA/HRSA Center for Integrated Health Solutions website. Summaries of the report also were featured in Crains, Capital Health Care, and the American Association on Health and Disability newsletters;
• Presented the report’s findings at an NYHealth event, “Behavioral Health and Delivery System Reform: A Conversation with Harold Pincus,” attended by representatives from behavioral health and primary care systems, providers, researchers, New York City and State government officials, and funders; and
• Briefed highlights of the report to stakeholders at Office of the Assistant Secretary of Planning and Evaluation, SAMHSA, and Centers for Medicare & Medicaid Services.

Findings from the RAND report have implications for the ongoing operation of clinics involved in PBHCI, Medicaid incentives, and health homes. In particular, the report’s findings show how these initiatives could be combined to maximize resources for clinics with significant financial and sustainability concerns. It also outlined the extent of technical assistance needed at clinics to coordinate and adopt complementary funding and resource streams. The results of this research highlight the complexities of implementing programs that depend on the cooperation of multiple State-level agencies, whose traditional operating policies and procedures may be distinct and in conflict with those of the other agencies involved. The National Institute of Mental Health also has recognized the value of this research, funding the RAND team to conduct a multimillion dollar research project on the costs and potential cost-savings associated with each of these models of care.