High-quality, whole-person services for people with mental illness or addictions come from a combination of empowered people, evidence-based and timely services, high-performing organizations, and rich infrastructure.

We know savvy front-line direct service staff members and clinicians are critical. Peers can help guide others along a similar journey to one they have taken. Appropriately trained clinical staff members can deliver effective therapy in individual and group settings.

Ensuring a strong front-line workforce involves the common challenges facing the entire country and the unique circumstances facing the District of Columbia. Workforce development programs need to be enhanced and strengthened at every level, from entry-level community support work to advanced clinical practice. Highly-educated and highly-skilled workers need to be provided incentives to stay in front-line, direct service, community-based roles, with alternative career pathways that allow for intensive specialization instead of promotion only coming through management roles that take people away from providing direct services to people who would value their expertise. Relevant lived experiences need to be acknowledged, with support for teams that include peers, natural supports, and professional activities, all tailored to the unique needs of the person receiving services, with respect for their culture, language, and family experiences.

Provider organizations have to factor billing and compliance into their overall operational plans. There are a variety of ways these goals are met, including through highly-skilled front-line staff members, robust clinical and productivity supervision, technology-enabled billing and quality assurance, and sound back-office practices. District of Columbia Behavioral Health Association members share their experiences and best practices about issues they face with productivity, accreditation, audits, and various other issues that contribute to high-quality, whole-person care.

The road to quality involves finding better ways to pay for what we should value instead of simply paying for what's easy to count. Development and adoption of shared measures of success across regulators, payors, providers, and patients is a core project. We must also be diligent in balancing the minimum standards of quality below which we will not pay for services versus incentives to go above-and-beyond what is needed or desired, with adequate payments to meet the health care triple aims of good health outcomes, good experiences for patients, and appropriate costs.

People deserve their mental health or addiction services to operate at the highest level of technological development. What's visible to people who receive services could be supportive apps, text-based communications with people who are part of their care teams, easy-to-use patient portals, or a variety of other technology tools. Behind the scenes, provider organizations need to understand the latest about electronic health records, field-deployed technology, health care billing systems, and participation in health information exchange.