The 1999-2000 Awards for Ethical Practice in Public Sector Managed Behavioral Healthcare were presented at the AACP membership forum during the Fall IPS meeting in Philadelphia. This is the second year of the annual award to recognize ethical conduct in the managed care environment. The award is co-sponsored by H. Steven Moffic, MD and the AACP. This year there were five co-winners of the award, each exemplifying a different model of psychiatric practice:

Dr. Drury is a clinician practicing in Kalispell, Montana. In 1999, as clinician, medical director of the Western Montana Regional Community Mental Health Center, and president of the Montana Psychiatric Association, Dr. Drury was very involved in struggling with the chaos of the state’s Medicaid managed care plan. He helped to lead a statewide protest, advocating for the return of local control for the service delivery system. Throughout this struggle he was noted for his courage, his political skills, but especially, for always keeping the needs of his patients at the core of his efforts.

Greater Oregon Behavioral Health is a private, not-for-profit managed behavioral care company in Oregon that set out with a mission to manage care in a different, more ethical way and to foster cooperation with providers. One of the organization’s strategies was to form a cooperative with agencies and providers so that each of the 13 provider organizations would have a place on the Board of Directors. The organization has been able to maintain appropriate levels of sub capitation to member organizations while still providing additional funds for training, new wrap-around services and developmental projects.

Though Dr. Pollack quipped that the idea of politics and ethics is "almost oxymoronic", his career has demonstrated otherwise. He has had a long interest in health care reform and service delivery systems. He was involved in developing the mental health part of the Oregon health reform plan. In 1999 he was selected as a Robert Wood Johnson Health Policy Fellow and took a sabbatical to spend a year in Washington as legislative staff person in the health office of Senator Edward Kennedy (D-MA). During this year he assisted with the SAMHSA reauthorization bill, was involved in such issues as the Patient's Bill of Rights, privacy and parity, and wrote mental health policy speeches for Senator Kennedy. Through his position he was able to bring increased attention to the needs of the underserved. He continues to educate other AACP members about influencing federal mental health policy.

Dr. Pumariega is Chair of the Department of Psychiatry and Behavioral Sciences at Eastern Tennessee State University. He has focused much of his recent analysis and writing on the topic of Medicaid managed behavioral health care and the related concern of cultural competence. As Chair of the Task Force on Community Systems of Care for the American Academy of Child and Adolescent Psychiatry, he led the production of a document on "Best Principles for Managed Care Medicaid RFPs" which has been influential in a number of states. He has been a leader in developing cultural competence guidelines for managed behavioral health care, an area that had previously not been given much attention.

Dr. Wilson is Director of the Missouri Department of Mental Health. He is one of the few psychiatrists in the country to hold the position of Director of a Department of Mental Health. He has led a slow and thoughtful move towards managed care with a strong emphasis on stakeholders and children. In order to emphasize the importance of the participation of all stakeholders, he has held numerous public meetings and focus groups during the move to managed care. He wanted to know from consumers and families what they wanted and needed, and then set out to look at what aspects of managed care might help to the state to realize these goals. He states that "Our leadership as psychiatrists will be respected if we respect the people using our systems and respect the political process."

All of the awardees were commended for the personal risk that they have taken to promote ethical principles in their practice of psychiatry.

Nominations for the award for community psychiatrists (including yourself), other mental health professionals or support staff, organizations, families or consumers to should be submitted to H.Steven Moffic, M.D., 1200 East Bywater Lane, Milwaukee, Wisconsin 53217, Fax: 414-456-6343, Phone: 414-456-8950; email: rustevie@earthlink.net.