Programmatic Supplement to the Cooperative Agreement With the National Association of State Mental Health Program Directors

This notice is to provide information to the public concerning a planned programmatic supplement to an ongoing cooperative agreement between the Substance Abuse and Mental Health Services Administration's (SAMHSA) Center for Mental Health Services (CMHS) and the National Association of State Mental Health Program Directors (NASMHPD). The ongoing cooperative agreement funds the Technical Assistance Center for State Mental Health Planning. The programmatic supplement is being provided to address a need that arose from the recommendations of the SAMHSA Conference--Partnerships for Change. The conference highlighted national and State trends in organizing and financing public mental health and substance abuse care. Federal and State officials received strong encouragement to expand their collaboration across levels of government and between mental health, substance abuse, and Medicaid agencies to prepare for rapid changes in their roles, responsibilities, and funding. A particularly acute need identified was a core set of quality assurance and performance measures that public purchasers of managed behavioral health care services could use to monitor the new contracting mechanism. In the absence of a core set of measures, it is possible that persons with severe and persistent mental illnesses, chronic substance abuse disorders, and children and adolescents with serious emotional problems may be placed into managed care systems with inadequate safeguards and controls. In fact, the network of community- based services that has been developed with great difficulty over the last three decades may be jeopardized if public sector managed care contracts lack essential performance standards and quality assurance guidelines. The NASMHPD Board of Directors, in close collaboration with the NASMHPD Research Institute, and the Boards of Directors of the National Association of State Alcohol and Drug Abuse Directors (NASADAD) and the American Public Welfare Association (APWA), have all identified as their top mutual priority the development of performance measurement indicators that could be used by States that are letting contracts for Medicaid managed behavioral health care. NASMHPD, which represents the State mental health agencies in every State, has a long history of facilitating the voluntary collection of uniform mental health data across States. NASMHPD has worked with State mental health agencies and CMHS on the Mental Health Statistics Improvement Program (MHSIP) to foster the collection, analysis, and reporting of data which are useful for systems management, policy decisions, evaluation, performance assessment, and research in the States, as well as nationally. State health care reform efforts and the introduction of managed care financial arrangements have placed new demands on States for quality assurance and accountability information. NASMHPD's Technical Assistance Center cooperative agreement with CMHS represents a unique capacity that does not exist anywhere else. The NASMHPD Technical Assistance Center works closely with every State mental health agency. A supplement to the existing cooperative agreement will allow the NASMHPD Technical Assistance Center to develop a consensus among State mental health, substance abuse, and Medicaid agencies around the collection of information about managed care that can be used internally by States for quality assurance and contract monitoring purposes, while, at the same time, assuring cooperation across States so that data items and data collection procedures are uniform so that valid national and cross-state comparisons can be made. Therefore, SAMHSA's CMHS has determined that a supplement to the existing cooperative agreement with NASMHPD should be made to carry out this important work. This notice is not a request for applications; only NASMHPD is eligible to apply for the supplement to the existing cooperative agreement. If the NASMHPD supplemental application is recommended for approval by the Special Review Committee, funds will be made available.