AACP and the New Year

Is it me, or are things REALY happening at an unprecedented, accelerating pace in community psychiatry these days? In our community mental health center in the last 6 months we have had a JCAHO visit, new billing codes, this week we go live with a completely new Electronic Medical Record (EMR) that includes scheduling, clinical care, electronic prescribing AND billing (i.e., a lot to learn in one fell swoop). We incorporated (sort of) adaptation to the new CPT codes and we are developing a strategy for DSM 5 training.

Maryland is ahead of many states in the development of health exchanges, which will include mental health benefits that are commercially based (i.e., inpatient and outpatient services) for newly covered individuals. In Maryland, Medicaid expansion benefits will include the full array of Medicaid mental health rehabilitative benefits for those individuals - all of which is likely to result in more people at the front door. We already have a great deal of difficulty in managing the demand side on our own front door. When this expansion group has coverage, we anticipate an even greater gap between request for services and actual first visit.

Then there is a whole set of projects related to integrated care that we are working on. This includes our working with community psychiatry therapists being deployed to local primary care clinic sites as well as participation in a new state Medicaid program that supports health homes for our seriously mentally ill consumers. That one starts at the end of the summer; so I take that to mean we have about a month to adopt the EMR, make a plan for DSM 5, reengineer our intake process and then commence planning for the health home option.

This whole list of all these things are the kind of phenomena that usually occur only once every ten years or so, right now, they are convergent in the same short time period. There must be some sort of astronomy term for a series of usual cosmic events that occur unusually close in time. Cataclysmic comes to my automatic-negativethought mind; however, as we put on our "transformation agent" badges and CMHC warrior game face every day, we are ever hoping for astronomical, immeasurably great results. Fifty years from the birth of Community Mental Health in the United States, we are continuing to adapt and progress.

AACP members have been at the helm of American community psychiatry since its inception. As we adapt and move forward, we have many big ideas to consider and anticipate. The process for this has been laid out in a project we have called El-Futuro. Our beloved previous president Hunter McQuiston has written extensively about the AACP El-Futuro project which is a kind of organic strategic planning process that we hope will shape community psychiatry for the next decade. Over the next year, in addition to El-Futuro, we hope to make revisions to the many position papers AACP has crated over the past decade, and to roll out a certifi cation examination and process in community psychiatry. A paraphrase of our driving mission is that AACP strives to equip psychiatrists to adapt and progress in their jobs and roles as community psychiatrists. Thank you for your membership in AACP and I hope to be a good president for us and the consumers we serve through our practice.

Anita Everett, MD, DFAFA Anita Everett MD, DFAFA
Section Director
Community and General Psychiatry
Johns Hopkins Bayveiw Medical Center