Mental Health/substance Abuse Treatment Mergers Continue, with Mixed Feelings on Substance Abuse Side: Merger Proponents Cite Value of Braided Funds, Medical Integration, While Critics Fear 'Loss of Voice'

By Knopf, Alison | Behavioral Healthcare, November-December 2013 | Go to article overview

Mental Health/substance Abuse Treatment Mergers Continue, with Mixed Feelings on Substance Abuse Side: Merger Proponents Cite Value of Braided Funds, Medical Integration, While Critics Fear 'Loss of Voice'


Knopf, Alison, Behavioral Healthcare


Mergers are always touted for their hoped-for cost savings and improvements in patient care and recent behavioral health mergers are no exception. Nationwide, mergers between state-level mental health and substance abuse administrations, as well as mergers between treatment providers and trade groups are changing the landscape of the field.

But the process isn't always easy: culture clashes and turf battles are common.

A few notable mergers preceded the enactment of the Affordable Care Act (ACA), which has been a key driver of mergers and consolidations throughout healthcare. Since 2008, the federal Substance Abuse and Mental Health Services Administration (SAM HSA) has placed increasing focus on the integration of mental health and substance abuse treatment, settling on "behavioral" healthcare as the name for both. Under the rubric of co-occurring disorders, SAMHSA has encouraged treatment providers, whether they are licensed to treat mental illness or substance abuse, to adopt "no wrong door" policies, pledges to assist any patient who seeks care for any behavioral disorder.

Integration grants

In 2010, SAMHSA in coordination with the Health Resources and Services Administration, awarded a four-year, $5.3 million grant to the National Council for Behavioral Health to establish a national assistance center to integrate primary care, substance abuse, and mental health services. The assistance center was designed to help 56 treatment organizations that received integration grants from SAMHSA, as well as some of the HRSA-funded Federally Qualified Health Centers (FQHCs), which provide primary care services. One key integration strategy involves placing substance abuse and mental illness treatment within the FQHC.

In 2011, SAMHSA began a full-court press to focus on "behavioral health." And, although a statutory change would be required by Congress before it could happen, the idea of "blending" the federal block grants for substance abuse and mental health continued to swirl, both in the offices of state directors of those funds and at SAMHSA. The substance abuse constituency was concerned, because it stood to lose the most--the substance abuse block grant is three times bigger than the mental health block grant, a reflection of the fact that publicly funded mental health services are largely covered by Medicaid, while substance abuse treatment services aren't. Nevertheless, a flurry of mergers ensued, some of which are described below.

2011 state mergers

Louisiana's Department of Health and Hospitals (DHH) merged the Office for Addictive Disorders with the Office of Mental Health, creating the new Office of Behavioral Health, which serves as a third-door administrator. In announcing the consolida-don, DHH Secretary Bruce D. Greenstein said there is now a "no wrong door approach to serve individuals with mental illness and addictive disorders."

Also in 2011, the New Jersey Division of Addiction Services (DAS) merged with the state's Division of Mental Health Services (DMHS). For both Louisiana and New Jersey, the state goals were improving patient care and at the same time saving money.

That was also the year that New York Gov. Andrew M. Cuomo named the members of the Spending and Government Efficiency (SAGE) Commission that is redesigning the state's government. It is not known yet whether there will be a merger between the Office of Mental Health (OMH) and the Office of Alcoholism and Substance Abuse Services (OASAS), but already there are huge changes in payment, with managed care for substance abuse treatment becoming a reality. The process has been transparent, according to providers and state officials, who have authorized the OMH and OASAS to contract with managed behavioral healthcare organizations.

South Dakota in 2011 abolished the former Division of Alcohol and Drug Abuse, and instead left mental health officials at the helm of the Department of Social Services, which became the home for both the mental health and drug alcohol divisions.

The rest of this article is only available to active members of Questia

Sign up now for a free, 1-day trial and receive full access to:

  • Questia's entire collection
  • Automatic bibliography creation
  • More helpful research tools like notes, citations, and highlights
  • Ad-free environment

Already a member? Log in now.

Notes for this article

Add a new note
If you are trying to select text to create highlights or citations, remember that you must now click or tap on the first word, and then click or tap on the last word.
One moment ...
Project items

Items saved from this article

This article has been saved
Highlights (0)
Some of your highlights are legacy items.

Highlights saved before July 30, 2012 will not be displayed on their respective source pages.

You can easily re-create the highlights by opening the book page or article, selecting the text, and clicking “Highlight.”

Citations (0)
Some of your citations are legacy items.

Any citation created before July 30, 2012 will labeled as a “Cited page.” New citations will be saved as cited passages, pages or articles.

We also added the ability to view new citations from your projects or the book or article where you created them.

Notes (0)
Bookmarks (0)

You have no saved items from this article

Project items include:
  • Saved book/article
  • Highlights
  • Quotes/citations
  • Notes
  • Bookmarks
Notes
Cite this article

Cited article

Style
Citations are available only to our active members.
Sign up now to cite pages or passages in MLA, APA and Chicago citation styles.

(Einhorn, 1992, p. 25)

(Einhorn 25)

1

1. Lois J. Einhorn, Abraham Lincoln, the Orator: Penetrating the Lincoln Legend (Westport, CT: Greenwood Press, 1992), 25, http://www.questia.com/read/27419298.

Cited article

Mental Health/substance Abuse Treatment Mergers Continue, with Mixed Feelings on Substance Abuse Side: Merger Proponents Cite Value of Braided Funds, Medical Integration, While Critics Fear 'Loss of Voice'
Settings

Settings

Typeface
Text size Smaller Larger
Search within

Search within this article

Look up

Look up a word

  • Dictionary
  • Thesaurus
Please submit a word or phrase above.
Print this page

Print this page

Why can't I print more than one page at a time?

Full screen

matching results for page

Cited passage

Style
Citations are available only to our active members.
Sign up now to cite pages or passages in MLA, APA and Chicago citation styles.

"Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences." (Einhorn, 1992, p. 25).

"Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences." (Einhorn 25)

"Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences."1

1. Lois J. Einhorn, Abraham Lincoln, the Orator: Penetrating the Lincoln Legend (Westport, CT: Greenwood Press, 1992), 25, http://www.questia.com/read/27419298.

Cited passage

Welcome to the new Questia Reader

The Questia Reader has been updated to provide you with an even better online reading experience.  It is now 100% Responsive, which means you can read our books and articles on any sized device you wish.  All of your favorite tools like notes, highlights, and citations are still here, but the way you select text has been updated to be easier to use, especially on touchscreen devices.  Here's how:

1. Click or tap the first word you want to select.
2. Click or tap the last word you want to select.

OK, got it!

Thanks for trying Questia!

Please continue trying out our research tools, but please note, full functionality is available only to our active members.

Your work will be lost once you leave this Web page.

For full access in an ad-free environment, sign up now for a FREE, 1-day trial.

Already a member? Log in now.