Table 4

Table 4
Initial Implementation Phase: Innovative Implementation Activities and Strategies for Project EBPs*
Innovations: Initial Implementation	ACT	FPE	IDDT	IMR	SE

*State Infrastructure Building and Commitment*
• New state position developed to assist in implementation and monitoring of EBPs established			X	X
• SMHA considering strategies to penetrate EBP in all licensed programs				X
• New RFP process developed to help fund EBP projects throughout state					X
*Stakeholder Relationship Building and Communication*
• Monthly meetings between state, Toolkit sites, and/or Advisory Councils	X	X	X	X	X
• Monthly meetings between NAMI and Toolkit sites				X
• Monthly meetings and/or calls between technical assistance centers and sites	X		X	X
• Ongoing communication between state and local sites/boards			X	X
• Increased collaboration between SMHA and State Medicaid Office	X	X	X	X	X
• New collaboration between SMHA, Medicaid and Vocational Rehab Office					X
• First time meeting held between state NAMI and Office of Consumer Affairs directors			X
• State and local sites working to implement evaluation process and reassure stakeholders of process		X
• Developed Clinical Practices Advisory Committee				X
• Planning EBP conference	X				X
*Financing*
• SMHA working with State Medicaid agency to make billing easier			X
• Developed new Medicaid billing code and coding guidelines		X	X
• Using bundled funding approach to fund EBP	X
• Exploring Medicaid requirements to qualify consumers to deliver EBP		X
• Using Medicaid Waiver 1115B to fund EBP		X
• Position paper written by state to recommend Medicaid reimbursement levels and codes				X
• Billing of EBP allowed as part of group or individual psychotherapy or day rate for Continuing Day Treatment Program				X
• Reimbursement codes and rates changed to support EBP					X
• Created new funding program only for EBP					X
• New funding formulas integrated into allocation structure, with codes changed in data system and audit process	X
• Medicaid approval received to reimburse EBP teams through amendment to state plan	X
• Medicaid rate recalculated to allow more professionals to be reimbursed	X
• State cost sharing with counties to fund EBPs	X			X
*Continuous Quality Management*
• Distributed SAMSHA's standards of care to local sites			X
• Developed and using new certification manual	X
• Developing treatment plan tool to include multiple domains and to be consistent with licensure review			X
• Developing mental health and substance abuse language guidelines for auditors to use in consistent evaluations			X
• Developing standards for EBP					X
• Barriers to standards for EBP teams removed by Medicaid agency	X				X
• Regulation changes to revise employment referral and authorization form, individual vocational form and verification of diagnostic process, and employment outcome measurement definition					X
• Implementing certification process through administrative rule and stakeholder process	X
• Integrated fidelity measures, technical support and supervision into certification	X
*Service Delivery Practices and Training*
• Developing treatment plan tool to include multiple domains and to be consistent with licensure review			X
• SMHA and consumer community developing partnership to train clinical staff to deliver EBP				X
• SMHA funding for consumer training and joint teaching to professionals and consumers for EBP				X
• Implementing shadowing training program	X				X
• Administrative rule revised to include fidelity adherence for EBP					X

* EBPs: ACT = Assertive Community Treatment FPE = Family Psychoeducation IDDT = Integrated Dual Diagnosis Treatment IMR = Illness Management and Recovery SE = Supported Employment
Magnabosco Implementation Science 2006 1:13 doi:10.1186/1748-5908-1-13