April 28, 2017: DCPCA Testimony- The Budget Oversight of the DC Department of Behavioral Health

Good morning Chairperson Gray and distinguished members of the committee.  My name is Patricia Quinn, Director of Policy and External Affairs for the DC Primary Care Association (DCPCA.) DCPCA works toward a health system that helps everyone in the District get and stay well, no matter the color of their skin, the language they speak, where they live, how much money they have, or who they love.  As you know, our partners in this work are community health centers who serve nearly 1 in 4 District residents. We work to build a healthier DC by strengthening safety net community-based primary care. Today I am here to provide testimony on the budget oversight of the DC Department of Behavioral Health.

I begin by applauding Director Royster’s efforts to develop a truly integrated Department of Behavioral Health that does not artificially and inefficiently silo substance use disorder treatment from the other aspects of the Department’s work.  Much of our testimony focuses on what it will take to build a 21st century behavioral health system in the District, and we believe Dr. Royster’s realignment can contribute to that evolution.

Critical to any 21st century system is the technology infrastructure that supports communication between patients, providers, and payers over time and across sites of care; including both physical health care and behavioral health care.  While the District and its Health Information Exchange (HIE) Policy Board have made significant investment and progress in creating an HIE that links hospital and ambulatory care, DBH clinical data (and that of its network of providers) remains unavailable to the rest of the system of care. While Dr. Royster to some degree inherited the failures of the icams system, we count on her to have a plan for finally linking behavioral health information into the District’s HIE system.

Recommendation: Invest in interoperability of DBH data system to the District’s HIE

Another area of investment for which DCPCA has consistently advocated is a Districtwide behavioral health needs assessment that can help us fundamentally answer the question: Does the District have the range and the quality of behavioral health resources we need where we need them?  Absent an answer to this pressing question, policy makers are working in the dark about what and where to invest resources. We do have data that indicates the second most common reason for hospitalization of District residents is mood disorders; the fourth is schizophrenia and other psychotic disorders.  A needs assessment completed in 2012 noted a shortage of behavioral health professionals practicing in Ward 7 and 8, and a pressing need for programs that are culturally and linguistically appropriate.

Recommendation: Invest in a robust Behavioral Health Needs Assessment

As mentioned during previous testimony, DCPCA remains committed to increasing access to behavioral and substance use disorder services within FQHCs, especially those in Wards 7 and 8.  While not strictly a budget issue, we will take this opportunity to urge DBH to support efforts to allow FQHCs to provide substance use disorder treatment within the context of primary care by eliminating current obstacles associated with DBH data and billing requirements.

Recommendation: Eliminate barriers to FQHC provision of substance use disorder treatment

We thank you for the opportunity to testify, and for your work and partnership in building a healthier DC. I am happy to answer any questions now or going forward.