Mental health agencies take on larger role coordinating all care

The fitness group walked in loops on the path with 51-year-old member Cindy as its unofficial cheerleader.

“You got flames coming out of your feet, you’re going so fast!” she yelled to one walker, who had charged ahead. She gushed over the new shoes a young man was wearing, and teased a twenty-something group leader about being too young to know who fitness guru Richard Simmons was.

“She helps me with my mental health and I teach her about the old fogey programs,” Cindy joked.

This was not a typical exercise group; it’s run by a mental health agency and part of a statewide effort to bring together mental and physical health care for thousands of people with serious mental illness, chronic medical conditions and high health care costs.

As part of it, 15 local mental health agencies now serve as “behavioral health homes,” designed to play a larger role in their clients’ overall health. That means coordinating their medical and behavioral health care, offering wellness programs, tracking things like diabetes and blood pressure, and addressing barriers – such as past experiences with trauma – that can keep clients from getting the care they need.

A demonstration project

Connecticut’s behavioral health homes, which began operating earlier this year, are intended for people with severe, persistent mental illness and at least one chronic medical condition, who incur at least $10,000 in Medicaid claims per year. Stockford estimates up to 17,000 people could qualify.

The program is a demonstration project, meant to test the hypothesis that those involved would get better care by using behavioral health as the home base for care. Agencies must measure a wide range of outcomes, including those related to reducing preventable hospitalizations, homelessness, client satisfaction and how well clients' chronic conditions are controlled.

The federal health law gave states a new funding option for programs like the behavioral health homes. For the first two years, Connecticut can receive federal reimbursement for 90 percent of the Medicaid expenses incurred in the program, and Harrington said that officials expect that once that expires, the program will be cost-neutral. The state is spending $10 million to start up the behavioral health homes, largely for the mental health agencies to hire additional staff.