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2016 Behavioral Healthcare Champions.

The 2016 Behavioral Healthcare Champions Award program recognizes four individuals who have been nominated for their dedication, courage, inspiration and excellence in their roles as executives of behavioral health organizations.

These leaders were selected from dozens of outstanding nominees who are making a difference in the development, delivery and effectiveness of mental health and substance-use disorder treatment services. Each has the vision to adapt to an evolving market and overcome challenges in order to ensure long-term sustainability.

The 2016 Behavioral Healthcare Champions are:

* Kathe Dellacecca, MSW, system vice president for behavioral health, Sinai Health System in Chicago

* Robert Ferguson, director, Jaywalker Lodge in Carbondale, Colo.

* Steven Sharfstein, MD, president and CEO, Sheppard Pratt Health System in Baltimore

* Ray Tamasi, president, Gosnold on Cape Cod in Falmouth, Mass.

Please join us as the Behavioral Healthcare Champions are recognized at a special ceremony during the National Conference on Addiction Disorders (NCAD), which will be held Aug. 18-21 at the Sheraton Denver Downtown in Denver. Profiles of each Champion also are available on behavioral.net.

--Julie Miller, Editor in Chief

Kathe Dellacecca

System Vice President for Behavioral Health, Sinai Health System

Chicago, Illinois

In less than two years since joining Sinai Health System, Kathe Dellacecca has made major strides in reshaping the way behavioral health services are delivered in some of Chicago's most underserved urban areas.

In 2012, Sinai leaders completed a series of community needs assessments and determined that behavioral health would be the top priority in the hospital system's strategic planning. In Dellacecca, Sinai found an executive who had traveled down this path before, albeit in a smaller, rural location. Dellacecca, a 25-year industry veteran, took on a similar challenge of revamping a hospital system's behavioral healthcare programming during her six-plus years with Lakewood Health System, based in Staples, Minn.

"Creating services for underserved areas has always been a huge passion of mine," says Dellacecca, who officially joined Sinai as system vice president for behavioral health in November 2014. "I've felt that one of my strengths is to be able to develop programming that meets the needs of the community--being able to listen to community members and align services to what they are looking for and need."

Since Dellacecca came on board, progress at Sinai has been swift. The most noteworthy accomplishment thus far in her tenure has been the opening of Sinai's crisis stabilization unit at its Holy Cross Hospital. The 24-hour outpatient observation unit is the first of its kind in the Chicagoland area. The program is designed to help facilitate getting patients in a psychiatric crisis out of the oftentimes chaotic environment of an emergency department and into a safe, therapeutic space where they can receive a rapid assessment and treatment. Patients can then be moved to a lower level of care.

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The benefits of the crisis stabilization unit have been tangible. Prior to its July 2015 opening, psychiatric patients faced an emergency department wait time of 18 to 48 hours. Now, the wait is down to an average of just three hours, and 56% of patients are discharged to a lower level of care, reducing costs in the process.

The crisis stabilization unit at Holy Cross can serve up to 12 patients at a time and as of mid-June had served 914 patients in 2016. After its successful launch, the program will expand next spring, as Sinai opens a new larger unit that will increase capacity to 32 patients. The $4 million project will take the program's footprint from 1,800 square feet at Holy Cross to 13,000.

Future plans

Dellacecca and her department aren't sitting back in the meantime, however. A $4 million, 24-bed inpatient unit at Holy Cross is slated to open in September. Plus, through a partnership between Sinai and Catholic Charities of the Archdiocese of Chicago, two programs are finding a home just across the street.

In October 2014, Catholic Charities acquired the Sisters of St. Casimir Motherhouse property adjacent to Holy Cross. The building will be home to a Sinai community mental health center, which is slated for a July launch, and a 50-patient intensive outpatient program coming in the fall.

Partnerships are a key component of Dellacecca's vision. In addition to Sinai's work with Catholic Charities, the hospital system is also collaborating with the Cook County Sheriff's Department.

"Our goal is to create an entire continuum from housing and job training to intensive residential treatment for folks that are suffering from behavioral health," she says. "We're experts in some of that, but there are community partners that are experts in others."

A nationally recognized partner will work with Sinai on an effort to integrate its behavioral health and primary care services over the next 18 months, with the official announcement coming soon, Dellacecca says.

Ultimately, Dellacecca says, a willingness to collaborate with other organizations--even competitors--can be the most effective way to achieve progress and better serve patients.

"We're all in the business to help patients and help people get access to care," Dellacecca says. "That's why it's so gratifying here at Sinai to be able to pull these partners in and say, 'Let's work together.' There's no point in trying to go down the same road separately."

--Tom Valentino

Bob Ferguson

Director, Jaywalker Lodge

Carbondale, Colorado

Early recovery can be one of the most challenging times in a patient's life, even for those who demonstrate excellent outcomes from treatment experiences. Bob Ferguson, director of Jaywalker Lodge, created his business and clinical model to address the unique needs of those in early recovery and those who have had multiple treatment episodes in their past.

"My early recovery lasted 10 years," Ferguson says. "That's not uncommon. My treatment experience was wonderful, and I had patient caregivers and family that supported my second and third attempts."

But not every individual has such support. That's why Jaywalker Lodge In Carbondale, Colo., is differentiated by its specialized program for men who have ongoing challenges in recovery. A seasoned clinician who has held positions with several organizations and has visited hundreds of treatment centers, Ferguson says the Jaywalker model offers a shift from a "containment" approach within the treatment setting to an approach that emphasizes living an engaged life through community Involvement.

"One frustration I experienced was that focus on containment where we don't get out much, and we don't leave the containers," he says. "But there's a huge upside to community engagement for men In early recovery."

Avenues for new bonding experiences Is one such upside. Ferguson knows that bonding among men is more likely to occur through activities than through structured group sessions that rely on verbal exchanges.

Working together on a service project to clean up a neighborhood after a natural disaster or to distribute food or supplies creates the right environment for men In recovery to establish trust among the group. It reframes the man's world view, Ferguson says. Giving back in this way also creates a sense of pride, which can counterbalance the shame some men might feel in the recovery process.

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"They are tired of screwing up, and they want to show you they can contribute," Ferguson says.

Challenge becomes opportunity

The lodge was originally slated to open in 2005 in a ranch setting on rural land in Colorado, but local zoning Issues nixed the project. Jaywalker instead opened its first 16 beds In a hybrid district In a downtown area. Ferguson says the open-community model seemed risky, but it was the only feasible option at the time. Strategically, he knew he had to win over the community by being a good corporate citizen as well as a good neighbor. He introduced himself door-to-door, provided his phone number and invited community members to visit the lodge. Meanwhile, he created codes of conduct for patients to guide them through expectations within the community.

The model has proven to be beneficial for the men he calls "Jaywalkers" and for the neighborhood as well. Jaywalker has since grown to 55 beds and now has three levels of care.

But with the growth comes higher expectations for the organization as a whole. For example, Ferguson has held out his business as an ethical treatment center that never engages in patient brokering or misleading marketing. In fact, Jaywalker Lodge has an ethics policy on its public website for consumers and referral sources. Ferguson says he sees it as a competitive advantage.

"That means sometimes doing things that aren't comfortable like giving a refund or referring to another program when a patient does not line up with your services in the best way," he says.

But Ferguson says obviously no treatment center operator gets out of bed In the morning with the intent to do harm to patients. His advice to other executives is to be authentic.

"A lot of what we are alarmed by In the industry can be rectified by alignment in the messages we preach to our clients about having a moral compass and how we operate our businesses," he says. "We need to walk our talk."

--Julie Miller

Steven S. Sharfstein, MD

President and CEO, Sheppard Pratt Health System

Baltimore, Maryland

After more than 30 years with Sheppard Pratt Health System, Steven S. Sharfstein, MD, retired in July. His tenure included the roles of vice president and medical director, as well as his most recent role as president and CEO of the Baltimore-based mental health and psychiatric not-for-profit organization.

A direct-care clinician and a political advocate, Sharfstein tells Behavioral Healthcare that his work in treatment has informed his advocacy and vice versa.

"Before Sheppard Pratt, I was involved in a number of activities, including working with the White House and Rosalynn Carter on their mental health initiative, which was responsible for the Mental Health Systems Act of 1980," he says. The legislation provided grants to community mental health centers.

He also worked for the National Institutes of Health for four years and helped to develop the consultation-liaison psychiatry service. In more recent years, he's addressed state provisions for involuntary treatment to help families secure care as well as addressing gun control laws in light of suicide rates.

It's difficult to take an honest look at the mass shooting incidents in this country and not talk about gun policy, Sharfstein says.

"The fact that we don't have commonsense gun control creates risk factors for those few who may have mental illness to hurt lots of people," he says. "Of course, most mass shooters are not people with mental illness. They are obviously troubled people but are not in the same category as someone with schizophrenia or bipolar disorder or dementia."

Sharfstein says debating the horror of mass shootings often distorts the conversation about what is needed to improve mental healthcare and leads to the erroneous assumption that people with mental disorders are dangerous. While he sees the need for legislation, he believes gun policies and mental health policies should be wholly separate. The focus of any regulation should be centered on the need to increase the percentage of people with diagnosable disorders who actually receive treatment.

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Forward progress

Sheppard Pratt Health System, a private not-for-profit organization in Maryland, offers mental health, substance use and special education services. It grew from a single psychiatric hospital more than 100 years ago to its 38 locations today that serve 60,000 people each year.

In 1986, Sharfstein joined Sheppard Pratt as medical director. At the time, length of stay for inpatient services was 80 days across all age groups. Today, the average time has decreased to 11 days as the system has transformed to emphasize a continuum care. The number of admissions has also increased tenfold under his leadership.

"For folks who came here, treatment was focused on their disorder, but there was poor outpatient coverage, so the concept was that they would be here until they got better or until their insurance ran out--whichever came first," he says.

The model shifted as managed care payers changed reimbursement, and now outpatient services are in demand. Sharfstein says he was proud of the way the organization made the transition across the various specialties with clinicians who had been accustomed to the previous model. Additional services and levels of care were added to expand Sheppard Pratt's capabilities.

As the industry looks to place more patients in community-based care today, the demand continues to exceed the supply of accessible providers. Of the 10,000 discharges completed by Sheppard Pratt per year, about half continue to lower levels of care within the health system's network, while some go to other community providers. However, there is still a large gap of patients who aren't able to access continuing care in their own communities, Sharfstein says.

"Funding is problematic," he says. "There's still a lot of work to be done. There are gaps in funding, and that is reflected in the gaps for people who need care."

Those who are homeless and those engaged in the criminal justice system are especially vulnerable, he says.

For the future, Sharfstein recommends that providers take advantage of the current trend toward integration. Coordinating behavioral and medical care will offer synergies and improved outcomes.

"Putting that together is a task for the future," he says. "Many organizations are looking creatively within the context of that opportunity, and there will be reimbursement for that as well."

--Julie Miller

Ray Tamasi

President, Gosnold on Cape Cod

Falmount, Massachusetts

In his own words, Ray Tamasi, president of Gosnold on Cape Cod, has "a very dissatisfied nature with things."

The Falmouth, Mass.-based not-for-profit substance abuse and mental Illness treatment facility has limited resources to fund research and development, but that doesn't stop the wheels from turning in Tamasi's head, as he's always pondering ways to improve Gosnold's standard of care.

"I like to go onto the edges of things that aren't being done," he says.

Those mental exercises lead to breakthroughs such as Gosnold's two-pronged Overdose Intervention Program (OIP). Working with 17 local police departments and two area hospitals, Gosnold recovery managers, recovery specialists and interventionists reach out to overdose patients to discuss potential next steps for a possible course of treatment.

By bringing care outside of its four walls and directly to overdose patients--whether it is at their homes or in emergency rooms--Gosnold aims to reduce readmissions to treatment facilities, Tamasi says.

"When you bed people, by definition, they are more advanced in their illness," Tamasi says. "The likelihood of sustained remission is compromised because they are at more advanced stages. We are trying to get to people earlier."

Personal intervention

The first phase of the Gosnold OIP launched last year after Tamasi participated in an interview with a Boston television station to discuss the opioid crisis. When the segment aired, Tamasi noted that a local police department also interviewed for the piece had begun sending officers to the homes of overdose patients to discuss treatment options. Sensing it was a situation where Gosnold could be of use, Tamasi made a phone call.

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"Police departments knew who the victims were and where they lived. What we brought to the equation was expertise, the ability to engage and connect with folks," Tamasi says. "We vet recovery specialists to ensure they have the right personality and personal skills. This outreach is a very brief opportunity, so you have to be able to engage quickly, put people at ease and establish trust. Let's face it, when the individual sees a police officer approaching the door, that doesn't always trigger, 'Oh, the policeman is my friend. He's trying to help me.'"

Through its OIP, Gosnold is now working with police departments across southeastern Massachusetts. In 70% of visits over the program's first year, patients have agreed to try entering treatment.

"Police departments everywhere are beginning to become more sensitive to how individuals who often intersect with the law are suffering with mental illness and addiction," Tamasi says. "Those conditions are what precipitates some of the activities that result in an arrest. I think it has helped the police to see these individuals who suffer in a different light.

"It's had the benefit of creating a community partnership across lines that historically have not always worked cooperatively, and I think it has helped the community see the police in a different light as well."

The success of the partnerships with local law enforcement has led to the second phase in the OIP: a working relationship between Gosnold and South Shore Hospital in Weymouth and Tobey Hospital In Wareham, Mass. Gosnold personnel are embedded in the emergency departments at the two hospitals during peak hours, helping patients that have presented with an opiate overdose or any substance/ alcohol-related medical condition. Additional hospitals have expressed an interest in joining the program, Tamasi says.

In the meantime, he will keep brainstorming ways that Gosnold can expand and evolve its offerings.

"Much of my attention is spent in trying to bring behavioral health service into the mainstream of medical care, whether that's emergency rooms, where we have done work very successfully, or into primary care specialty medical practices," Tamasi says. "It's all based on the premise of developing services that reduce the readmission rate for patients who go to rehab and bringing services into the mainstream in a more preventive and early intervention way.

"Conceptually, that's the way I think about how we might develop services to take care of individuals."

--Tom Valentino
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Author:Miller, Julie
Publication:Behavioral Healthcare
Geographic Code:1U3IL
Date:Jun 22, 2016
Words:2904
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