AACP Position Statement:

Principles of System Design and Financing for Universal Health and

Behavioral Health Care Coverage

The American Association of Community Psychiatrists (AACP) is dedicated to the promotion of health and wellbeing for all persons with mental and substance use disorders. These conditions are often complicated by co-morbid medical conditions and social factors, such as poverty, that can undermine the ability to fully and independently function and to enjoy productive and meaningful life in the community. AACP recognizes the value of population-based health care planning and services that improve the health and mental health of communities.

Therefore, AACP strongly endorses and urges Congress to authorize a universal health care program as soon as possible. This program should be available nationally, administered by state, regional, or local authorities, and adherent to certain minimum standard principles. Whatever financing mechanism is developed, a single-payer system or another approach that reduces administrative waste and increases accountability, the following principles should be pursued and achieved.

General Principles for Universal Coverage

In order to assure that a universal coverage program will be effective and of sufficient quality, AACP endorses the aims articulated by the Institute of Medicine, in particular that services be equitable, patient-centered, timely, safe, effective, and efficient. The following system design principles must be considered as minimum standards:

1. Universal access and portability of coverage
2. Maximization of consumer choice of providers and treatment options
3. Consumer-driven service planning
4. Assurance of continuity of care
5. Emphasis on health promotion and illness prevention
6. Culturally appropriate and sensitive services provided by a sufficiently diverse and culturally competent workforce
7. Identification and support of the use of effective, evidence-based interventions and payment methods that increase the probability that effective treatments will be provided
8. Support for design and implementation of population-based service delivery

Essential Behavioral Health Principles

In addition to these general principles, the particular needs of persons with mental and substance use disorders require specific responsive protections:

1. Parity and non-discrimination in services for persons with mental health and substance use disorders
2. Assurance of welcoming, accessible, and recovery-oriented services for highly vulnerable and complex populations
3. Provision of comprehensive biopsychosocial services that reduce the disabling impacts of chronic conditions and prevent the progression of less severe conditions
4. Facilitation of delivery system and reimbursement models that promote coordination, collaboration, and eventual integration of mental health, substance use, primary care, and social services
5. Access to all appropriate, evidence-based, and cost-effective pharmacological and non-pharmacological treatments for mental and substance use disorders
6. Effective recruitment, training, and support for a competent and sustainable behavioral health workforce