February 23, 2011
The board of Counseling Services, Inc. of Saco has announced that effective March 1, 2011 the agency will join Maine Mental Health Partners, one of the first nonprofit integrated mental healthcare delivery systems in the nation.
The agreement positions Counseling Services, Inc. to seize opportunities arising from the new federal healthcare reform law while at the same time expanding the footprint of the Maine Mental Health Partners network into York County, the fastest growing county in the state.
Founded in 1963, the nonprofit Counseling Services, Inc. delivers comprehensive mental health treatment and support programs to people of all ages at 12 locations in York County and one in Westbrook. Services include crisis intervention and stabilization, psychiatric services, traditional counseling and complementary therapies, home-based treatment, housing services, and peer support. The agency employs 350, has an annual operating budget of $20 million, and annually serves 8,000 York and Cumberland County residents.
Historically, ninety-five percent of all treatment provided by Counseling Services, Inc. has been funded by MaineCare, the State's Medicaid program. With millions of dollars in cuts to MaineCare funding in state budgets of recent years, Counseling Services, Inc. three years ago began exploring opportunities to partner with an organization that shared its vision of developing a more accountable and efficient mental health delivery system while maintaining high-quality treatment for clients.
At about the same time, Maine Mental Health Partners, a subsidiary of the MaineHealth integrated healthcare delivery system, was established to build a network of providers that coordinate their treatment approaches and share administrative functions and clinical resources to more effectively provide mental health treatment and reduce the overall cost of care delivery in Maine's southernmost 11 counties.
In addition to Counseling Services, Inc., the Maine Mental Health Partners network includes three community mental health agencies, one psychiatry practice, and the Spring Harbor Hospital psychiatric hospital in Westbrook. All told, the system employs nearly 1,200 staff in locations from Belfast to Kittery who serve an estimated 25,000 Maine people with a combined annual budget of $77 million.
"Healthcare reform will drive providers to deliver increasingly higher quality service at lower cost," noted Maine Mental Health Partners President Dennis King. "We believe an important key to maintaining quality at a reduced cost is breaking down the silos in which providers operate, eliminating duplication across sites, standardizing treatment approaches, and leveraging economies of scale. Counseling Services, Inc. shares this vision and will work within our system to achieve these goals in service to their clients and their families."
As York County's most comprehensive provider of mental health and substance abuse treatment, Counseling Services, Inc. will also help fill existing gaps in the Maine Mental Health Partners network of services. "CSI provides crisis beds, housing services, and peer social clubs that are missing from our southern Maine system today," King said. "These services will help improve care and reduce cost by averting the need for more intensive and restrictive services, such as emergency room care and psychiatric hospitalization."
Counseling Services Inc. CEO Jeannine Lepitre said joining the Maine Mental Health Partners network is the right strategic decision for her agency. "One of our goals was to place CSI in the best possible position to adapt to current and coming changes, such as continued MaineCare rate fluctuations and healthcare reform," Lepitre stated. "We also want to play a leadership role in creating a more efficient and effective mental health system so that our clients can receive continuity of care and the best treatment possible. This is a win-win situation - for our clients, our agency and Maine Mental Health Partners, and the State of Maine."
Under their membership agreement, Counseling Services, Inc. will immediately begin working with Maine Mental Health Partners and its other member organizations to build a common information technology platform that will enable electronic health records to be shared across member sites. Lepitre noted that shared records will speed the delivery of care by enabling one provider agency, such as an outpatient clinic, to pick up a client's treatment regimen at the precise place where another provider, such as a psychiatric hospital, leaves off.
Other highlights of the agreement include Counseling Services, Inc. working with its new partners to expand services to underserved regions of Maine, to share a pool of psychiatrists, and to effectively wrap services around medical facilities in the MaineHealth system to assure that people with both physical and mental health ailments receive timely and appropriate treatment.
"We look forward to delivering our services in primary care offices, where upwards of one-third of patients are estimated to have a mental disorder," Lepitre noted. "We also wish to work more closely with medical specialty clinics, as well as with nursing homes and assisted living facilities, where as many as 80 percent of residents experience psychiatric or behavioral challenges."
King, who is former board chair of the National Association of Psychiatric Healthcare Systems and a governing council member of the American Hospital Association's Section for Psychiatric and Substance Abuse Services, said the Maine Mental Health Partners model is, to his knowledge, one of the first integrated mental health delivery systems of its kind in the United States.
"If you look around the country, it is difficult to find a system that is doing what we are doing here in Maine to rationalize the delivery of mental healthcare," King stated. "Most states have created outpatient clinics around their psychiatric hospitals, but few have gone the next step and reached out to community-owned mental health centers to integrate with them in both a clinical and financial manner."
This is in line with a national movement to create accountable care organizations (ACOs), King noted, in which a group of providers work cooperatively to manage a defined population's total spectrum of care. While primary care delivery is the foundation of ACOs, they also seek to coordinate their clients' preventive, specialty, emergency, hospital, and post-hospital care to achieve the best clinical outcomes and to gain greater efficiencies.
As part of the MaineHealth system and its family of leading high-quality providers, Maine Mental Health Partners is poised to play a key role in improving mental health treatment within the context of the larger healthcare delivery system. King said healthcare reform will bring an increasing number of providers together to effectively manage the health of individuals across a variety of treatment settings, both mental and physical. He said he believes integrated and accountable care is better for consumers, but it is not necessarily easy to provide.
Mental health treatment is in so many ways viewed as separate and apart from the rest of healthcare," King noted. "You see it in primary care, where mental health issues are frequently not diagnosed or treated appropriately. Mental health insurance plans are carved out separately from medical insurance plans. The state's Medicaid budget tracks dollars devoted to mental health services separately from those devoted to all other types of medical care. The whole system is designed to operate separately from the medical care infrastructure, but here we are, trying to bring these two pieces back together and treat each person in a holistic manner. It's the right thing to do, but we realize that there are many miles to go before we sleep."
Counseling Services, Inc.'s Lepitre said her agency welcomes the challenges and rewards of working within such a system. "One of the greatest advantages of joining a system like this is the ability to provide our clients with not only a more complete array of behavioral health services, but also better access to appropriate medical care."
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