Florida Behavioral Health Collaborative to Facilitate Implementation of Best Practice Guidelines for Behavioral Health Medications.

TAMPA, Fla. -- In response to a mandate from the Florida Legislature, the Agency for Health Care Administration (AHCA) and the Department of Children and Families have created the Florida Behavioral Health Collaborative (FBHC), a statewide program managed by The Louis De La Parte Florida Mental Health Institute (FMHI) at the University of South Florida to compile, evaluate, disseminate and facilitate implementation of best practice guidelines for the use of mental health medications among Florida Medicaid beneficiaries.

FBHC is also charged with implementing medication management processes, developing consultative mechanisms and models of disease management, and enhancing Medicaid's existing e-prescribing program to include clinical guidelines for behavioral health pharmacy management. The goals are to improve the quality of prescribing practices and save money.

Originally called the Behavioral Health Pharmacy Management Program, FBHC was created during the 2004 Legislative session with the passage of HB1843. AHCA negotiated agreements with several pharmaceutical manufacturers to fund the program and with FMHI to manage the program. FMHI, in turn, assembled the various niche players needed to carry out the program's mission.

"FBHC is truly a model for the national establishment of best practice medication guidelines to enhance the treatment of behavioral health conditions," says Robert J. Constantine Ph.D, Associate Research Professor, FMHI. "It represents the combination of all the components critical to the successful implementation of a best medication practices program, including state-of-the-art technology, scientific resources and expert involvement from the medical community."

FBHC will provide prescribers with real-time, ongoing access to up-to-date best practices and current medication interaction information, which will be communicated at the point-of-care through wireless handheld technology and the Internet.

FBHC also will convene expert panels, the first of which took place in Tampa and resulted in best practice recommendations for the somatic treatment of bipolar disorder and schizophrenia. The second will focus on best medication practice guidelines for children. Finally, FBHC will hold a series of Community Collaboratives designed to educate the provider community about FBHC, and to foster open discussion of the use of psychotropic medications.

"New classes of mental health medications are now available that are highly effective with substantially decreased side effects, making it possible in many cases to reduce a patient's medication requirements to a single course," says Naakesh A. Dewan, M.D., President, Center for Mental Healthcare Improvement (CMHI), Clearwater, Fla. "Unfortunately, it's difficult for providers to keep current on the most appropriate uses of these drugs, which carry a higher price tag than their 30-year-old predecessors but may allow patients to live more productive lives while incurring fewer costly hospitalizations and acute care interventions. Our job is to provide that information and, through improved prescription practices and quality of care, control costs so open access can be maintained for Medicaid beneficiaries."

CMHI is one of four partners assembled to carry out FBHC's mission. In addition to compiling, evaluating and disseminating the best medication practice guidelines, CMHI will raise public awareness of appropriate medication use and foster improved communications between providers and patients. Other FBHC partners include:

--Comprehensive NeuroScience Inc. (CNS), White Plains, NY, which will evaluate historical prescription data and communicate concerns to participating physicians.

--Florida Council for Community Mental Health, Tallahassee, Fla., which will coordinate the services provided by community mental health centers.

--Gold Standard, Inc., Tampa, which will disseminate best practice information to participating physicians at the point of care, as well as provide prescription histories, interactions screenings and patient compliance information.

Manufacturers of psychotropic medications, including AstraZeneca, Bristol Myers Squibb and Otsuka American Pharmaceutical, Inc., Eli Lilly, Janssen and Pfizer, are providing funding for FBHC.

"The collaboration between all our partners ensures Florida's Medicaid physicians receive the intelligence, information and support needed to enhance the treatment of their behavioral health patients," says Constantine. "FBHC is the only significant cost containment program in the nation, yet rather than focus primarily on cost, we are focused on improving utilization through the establishment and ongoing communication of best practice guidelines to all members of the behavioral health community."