Overview
In this interview, Jorge R. Petit, Founder/CEO of Quality Healthcare Solutions, LLC, speaks with Jihoon Kim, CEO of InUnity Alliance (asapnys.org / coalitionny.org). Jihoon discusses his strategic vision and priorities for addressing the growing mental health and addiction crisis in New York, emphasizing the importance of community-based care and overcoming stigma and disparities.
Interview Transcript
This transcript has been lightly edited for clarity.
David Minot: Hi, and welcome to the Behavioral Health News Spotlight and Excellence interview series, where we feature exceptional leaders and innovative healthcare solutions that are raising the standards of care in the behavioral health community. My name is David Minot, and I am the executive director of Mental Health News Education, the nonprofit organization that publishes Behavioral Health News and Autism Spectrum News. Our mission is devoted to improving lives and the delivery of care for people living with mental health conditions, substance use disorder, and autism, and supporting their families in the professional communities that serve them. Today, we’re speaking with Jihoon Kim, CEO at InUnity Alliance, which was founded in 2023 from the merger of two longstanding organizations, the Coalition for Behavioral Health and the Alcoholism and Substance Abuse Providers of New York.
InUnity Alliance is a leading voice for all New Yorkers living with addiction and mental health conditions, their loved ones, and service providers, offering advocacy, training, and education while working collaboratively with the robust network of diverse partners and its membership of 250 addiction and mental health care providers statewide. Leading our interview is Dr. Jorge Petit, founder and CEO of Quality Healthcare Solutions, LLC. Jorge is a community psychiatrist leading the behavioral health sector to innovate and transform healthcare for those most in need, including people with intellectual and developmental disabilities, those struggling with mental health and substance use challenges, individuals in poverty, facing eviction or homelessness, and all those marginalized, unemployed, and disadvantaged. Jorge is also a board member of Mental Health News Education. I’m excited to learn more about InUnity Alliance and its impact on behavioral health in New York State. Jorge, the mic is all yours.
Jorge Petit: Thank you, David, and good afternoon to you. I’m so excited to have this opportunity to talk with you today. I have worked for decades in the New York City health and behavioral healthcare sector and collaborated with the two prior organizations that recently merged to become InUnity Alliance. I’m really looking forward to what the newly appointed CEO is thinking and planning. So, first question:
Can you share with us your strategic vision and priorities for InUnity Alliance in your first year, especially as it relates to and how we’re going to address this growing mental health and addiction crisis in New York?
Jihoon Kim: Thank you, Jorge. It’s great to be here. First, I’ll say that our strategic vision and our priorities in the first year, but also in the upcoming years, are always going to be rooted in the everyday experiences of our membership, the communities that they serve, and the people who are receiving services from the community-based organizations.
So, as David said in the intro, InUnity Alliance came about as the merger of two long-standing associations, and now we have a statewide association representing 250 community-based organizations that are providing addiction and mental health services. And I’ve been spending a lot of my recent weeks and months traveling the state and just completed a tour in Western New York, Finger Lakes, the North Country, and the Capital Region, and have plans to spend more time also in New York City, Long Island, and Central New York, and the Southern Tier. I think in my time in government, the most important thing was not to legislate or dictate or regulate from the Capitol and the halls of Albany. It was really to meet people where they are, including the people who are receiving services, as well as the people who deliver those services.
In my short time here, four months exactly to date, the main issues that I’m hearing over and over again are about inadequate reimbursement rates, the historic workforce challenges, especially in the human services and mental health sectors, and also stigma and the disparities that exist. When I talk about stigma, it’s not just stigma about the people who receive services, but it also exists in the layers of bureaucracy between government organizations, insurance companies, and the like.
I think there’s a disparity between how we look at the services and the providers that deliver the services in addiction and mental health care versus big age health care. One of the challenges that I experienced in government that I’m hearing a lot about from my members is about citing issues, citing OTPs, citing other clinics. I don’t think you would actually have those same kinds of issues if you were going into a community and to legislators and talking about bringing an urgent care clinic or a hospital into a community.
So, why is there a disparity in how my members are being treated by government and others as it relates to their services? So those are some issues that impact the daily lives of New Yorkers who are trying to access addiction or mental health care services. And it’s deeply rooted in stigma, that we’ve overcome a lot of it, but I do believe there’s still a lot more work to do.
I think the other thing, Jorge, is that we have to define the problem and talk about it honestly. I think one of the things that I’ve been spending a lot of time doing in traveling the state is meeting with providers across the continuum of care as it relates to the overdose crisis. And I think what I’m hearing over and over again, regardless of what part of the state I am in, is that people are genuinely concerned, providers are genuinely concerned about a lot of government officials who seem to have taken their finger off the panic button as it relates to overdoses. I think the CDC came out with provisional overdose numbers not too long ago, and I have heard many leaders in healthcare talking about the policy changes and investments over the last couple of years that have worked.
I would argue the opposite because of the over 6,000 deaths in New York State two years in a row. One example is Western New York in the Buffalo area, which is on pace to exceed its overdose numbers from the last two years. They’re projected to have over 400 overdoses this year.
Those are unacceptable numbers. Fentanyl is the leading cause of death amongst any category right now, any category. And you layer that on top of the overdose rates in New York at a statewide level have ticked down very, very little, according to the latest CDC numbers. It still is like the sixth leading cause of death in the top 10 leading causes of death historically. Just behind strokes, I believe. So, I think those overdose numbers are unacceptable, especially as it relates to people of color, particularly men, especially black men, and those over the age of 55. Those numbers are rising sharply. I think you have to always look at the data in full context, not just the top lines.
And those are the realities. You can also make the same argument as it relates to suicide numbers suicide rates and analyzing those rates that have been around for a long, long time. We are seeing suicide numbers not being abated by all of the investments that are being made at a national and state level.
And we have to ask the question, why is that the case? I think it’s because, ultimately, we have to be honest about the facts on the ground so that government officials will not continue to use their facts or their sets of facts to deprioritize addiction and mental health services under the guise of tight budgets. I think one of the most important things is that we’re using data honestly to say there is an existing system of care within addiction and mental health where you have a continuum of services offered by community-based providers who have been talking about underfunding for quite a long time, actually since deinstitutionalization. They have been arguing about the need for more investments into community-based providers. And I certainly think that when I talk about traveling the state and starting where my members are and the people that they serve, that connects directly to the information that we’re sharing with people in positions of power who can actually make policy changes and the right strategic investments into the providers who are doing the really difficult work day in and day out.
And I have a couple of other points on this topic because I have a lot to say about this. Third, I think one of the strategies that I’m really grateful for is the work that both John Coppola, formerly of ASAP, and Amy Dorin, formerly of the Coalition for Behavioral Health, have done to merge the two organizations. Not everyone goes down this road of mergers because it’s not easy, and I think everyone ultimately wants to ensure that the priorities of whatever agencies that are merging are both retained in the new organization, and they both have done tremendous work, including with the respective boards. And I appreciate all of what they have done and their guidance over the last four months.
They did actually end their terms as consultants at the beginning of July, and I’m excited to say that I’m building a strong team here. Sarah DuVall started as our policy director in early June, and we have Amanda Semidey coming in as our Chief Operating Officer next week. So that’s part of my strategy is that we’re going to build a dream team here at InUnity Alliance where we are not only providing expert services and technical assistance to our members, but we’re thinking about how the work that we’re doing with our membership relates to the kind of policy and advocacy we have to do in a statewide and national level.
And then finally, I will say, Jorge, for your audience that may not be familiar with my most recent background, is in government. I had the privilege of serving Governor Kathy Hoch was the Deputy Secretary, overseeing all of the mental hygiene and human services agencies, including OMH and OASAS, OPWDD, and others.
I believe that my lengthy history in government and the most recent position I had directly overseeing the states investments and policy decisions on addiction and mental health services can really empower InUnity Alliance where I can advise and empower the entire InUnity Alliance membership based on deep understanding of the players and politics that inform decisions in Albany and also in City Hall here in New York City. So that’s my long-winded answer.
Jorge: Great. Thank you for that. It’s super exciting. Congratulations on your four-month anniversary and your recent hires. I do think this does fill me with a lot of excitement and hope because the leveraging the power that each of these organizations had in their own right and coming together, but also, with your experience in government, I do think there is this opportunity where at the inflection point in really being able to enhance the advocacy and the steering some of those public dollars in a more data-driven way. I love that you’re talking about data and really trying to hone in our capability to be able to address these issues, not in this global fashion where I think historically we’ve done a little bit of everything everywhere, but really focusing in on those communities that are most impacted, whether it’s targeting issues brought up around older Black men and overdose deaths or some of the rising rates of suicidality among LGBT and all these other sort of disparities that exist.
How do you plan on advocating for a more commonsense approach to funding and procurement based on data, rather than relying on the existing mechanisms?
Jihoon: Yeah, I mean, that’s a great question. I think it’s interesting and I think you can kind of go either way with the strategy here. I think ultimately, when you’re thinking about just focusing on New York State government and state investments, there are always more priorities that a governor and their fiscal people will inherit and have to manage and deal with than there are dollars to go around.
That’s just the reality. I think it really boils down to helping to reprioritize how government should be looking at the broader behavioral health sector, given what we know is happening on the ground as it relates to overdose rates, as it relates to suicidality, and suicide completion, especially as it pertains to particular groups. I think there’s always this risk, and I saw this, and I admit, I think my time in government, there’s always this desire or kind of a knee-jerk reaction that you want to announce something flashy, that you think everyone’s going to be like great.
What I learned in my time in government, including being one of the main architects of the governor’s $1 billion investment in mental health in two years ago, was that there’s an existing infrastructure of providers. I can just pick out of a hat the membership of InUnity Alliance. Small, large, where there are experts who have been doing this work forever. I think really what it boils down to is listening to the voices of the people on the ground, not only from my perspective as the new CEO of InUnity Alliance, as I get to learn my membership and really what their priorities are, but also for government officials to say, “Hey, you really do need to listen to people on the ground.”
I think this happened within the healthcare system during COVID, where you had a healthcare establishment saying, “Hey, you really need to listen to us. We’re the experts. We know what works in our communities. You really need to help us figure out and organize around the fact that communities across New York State, with all of its beautiful diversity, have a lot of common ground in what we know works.”
I think what we know works is community-based care that is very low threshold, meaning there are very little barriers, whether that’s insurance barriers, payment barriers, whatever the barriers that exist, and really investing in those services. InUnity Alliance is made up of many member organizations that really deliver services where people are in their communities. What I’ve seen and what’s beautiful about the community-based network is that you’ll have an organization in the Bronx that says, hey, we started off providing medication-assisted treatment, and we have an article 31 mental health clinic. What we realize with a lot of the people coming through our doors is we have lots of rates of folks who don’t have a place to live. We need to open a shelter, or we need to open some kind of other transitional living program. We also recognize that a lot of people have un-healthcare needs.
We have members that actually have FQHCs and other whole suites of services that really meet the people where they are. What I would say is we know what the data is showing, even with the governor’s investments over the last two and a half years in mental health and the opioid settlement dollars actually going out the door over the last two years. We still see numbers that reflect that there’s historic underinvestment in the existing infrastructure of community-based providers that actually better serve the needs of the average New Yorker who has unmet needs. Yes, there are people who are going to need to go inpatient for a period of time sometimes. There are people who may need an inpatient level of stay for addiction, but generally speaking, much as it is with broader health care services, people do not stay hospitalized inpatient in some of those more costly settings for the duration of their recovery. When we’re talking about mental health, mental health disorders, and substance use disorders, we know that, for the most part, people will need some level of services for the rest of their lives. In that case, it makes the most sense to invest in the community-based system of care.
Jorge: I fully agree. As you were talking, I was thinking about a couple of follow-up questions. One of them, you talk about the voice of the community-based providers. Having been on that side, but also in government side, I do think sometimes we’re not necessarily talking with each other. We’re talking maybe at each other. I think that being able to bridge some of that between community-based providers and government is really critical. One thing that I have come to realize is it’s really critical that we try to figure out how to elevate the voice of the individual we serve. I think that there are initiatives underway, and there are different organizations and different settings and where the voice of the individual we serve might have a larger valence. I do think that sitting in government, we sometimes don’t really think about the impact of what we say or do, or even community-based providers coming up with their strategic plan for the next three years without really bringing into the conversation those individuals served, whether they’re in a supportive housing unit, or in a CCBHC, or in a peer recovery program. I do think we have to figure out, and this is not a question. It’s more a rhetorical framing, but I do think we need to figure out how do we elevate those voices differently.
I’m hoping that we’ll think about that in the Alliance as it’s moving forward in terms of how we embrace some of those voices. So, just a quick pivot then in terms of thinking about where we are today post-COVID and all of the issues that have come out of the lockdown and the workforce crisis. I think when I was at a large not-for-profit organization, our biggest issue was workforce, right? High turnover rates, low wages, recruitment, and retention were really complicated. The billion dollars that the governor put in the budget actually ultimately translates into programs that require individuals to be hired, whether it’s a nurse, a social worker, or a doctor, and everyone is scrambling to find those resources.
From the perspective of InUnity Alliance, what are your thoughts about where and how you can mobilize the community-based providers around thinking about initiatives or programmatic ways of addressing some of those issues related to recruitment and retention of workers in our sector?
Jihoon: I always start with a conversation about the workforce that is also rooted in my own experiences. I worked as a direct care worker in a non-profit with men with both mental health disorders and intellectual and developmental disabilities, and this really feels like it was ages ago, but I still say to this day in any job interview I had because I’ve worked in this field for a while, including in government, is that it was my favorite job because there was a direct tangible impact in the lives of individuals that you can see every single day when you went to work. But I also say, as part of that story, I always had aspirations to go to graduate school. It ended up being in social work, and it was impossible for me to balance going to grad school, having to have another internship in grad school, and keeping that job.
I wish I could have done it all, but I couldn’t. And I think about it in hindsight because if I were to stay at that organization or a similar organization, I probably would have had to work three or four different jobs. And what would have probably happened is I probably would have worked my way up through like an administrative kind of position within the organization.
And in many ways, I would have left the lower wages job behind in an interest to just be able to pay the bills. I think about this a lot, too, because as I was in government, there were lots of stakeholders coming to me asking for increased wages. And ultimately, the turnover rates in the workforce crisis are directly related to historic underinvesting in this field and recognizing that the nominal cost of living adjustments that, depending on the whims of that budget year, would either make it into the budget or not make it into the budget, that’s not a reliable source of revenue for organizations that have to do multi-year planning as it relates to their services. So, the turnover rates are directly related to underpaid low-wage employees. It’s not only about wages, but that is one of the main reasons why jobs that already lead to high burnout results in high turnover. The wages are just simply inadequate, Jorge. So, we need to raise the wages of the entire industry. People are literally leaving these jobs for higher-paying, low-wage jobs and working multiple of them. I mean, there are ideas such as developing like true career ladders for direct care staff, whether it be through mentorship or training programs, so that they can grow and promote within the organization.
But that also does lead to potentially the ranks of middle and upper management being taken care of while there will continue to be this challenge with the lower paid jobs, which is I think, the bulk of the jobs in most of these organizations and even low and forgiveness opportunities, those are, to a large extent is to help people on a career path within the organization and growing up the career ladder. I do think that there are some initiatives underway, right? There are some initiatives underway, whether it’s in the IDD sector or other sectors where there are some incentives being offered to the nonprofit sector. There’s currently a push for a bill to expand the existing government pension benefits to the nonprofit industry, particularly in this field. That’s something that MHANYS has been leading the effort on, and it’s something that in union line supports. Now that I am the CEO of my own nonprofit organization, I recognize that there are ways, even within a limited budget, for you to be able to take care of employees, keep them happy, keep them motivated, especially in these very high-stress jobs.
I think there are those kinds of incentives. I think one of the things that is also lost in the conversation about the workforce is what an organization can actually do internally to help the workforce. I think supervision is something that is not talked about that often. I’ll give you an example of how recently I’ve been meeting with a lot of organizations that have begun to or try, have been trying to expand their use of peers.
The peer model is something that is not new but has been growing as of late, and I am proud that InUnity Alliance, one of the things that we continue to do as part of the merger and with the work that ASAP was doing, is continuing to expand upon the peer certification and recognizing that we have the certified recovery peer advocates, but we also have been developing other certifications, including a peer supervision professional credential, really with the goal of supervising and supporting this critical workforce. I think that’s a good model and example of other types of support that employees in very high-stress jobs, where they probably would leave for another job that is paying similar or a little more that’s not in the same kind of field to make sure that they’re supported, especially with their high level of stress.
I think also related, providers do need to build in systems of care for their employees, including like enhanced and flexible pay time policies, as well as other management strategies to engage the employees, all things that we’re also thinking about internally for InUnity Alliance staff. But I think there are internal strategies that can be employed that only go so far, to be quite honest. I think, ultimately, it comes back to what the InUnity Alliance is going to do with our membership in advocating with a very loud but also strategic voice as it relates to the sector. And when we’re talking about the workforce, it’s to help government officials reprioritize all their priorities. I know that with all the priorities that lay before any governor or any budget director, they’re going to look at what remains after negotiating internally with all their other priorities.
I think that’s unacceptable. I think we need to reframe the problem statement so that people understand, especially, and I know with this governor, she cares deeply about issues related to mental health and addiction, but it’s really helping them to reprioritize how that should be in like the tier A level of investments that they’re thinking about to make sure that the existing community-based system of care is robustly supported, not only with investments but any beneficial policy changes.
Jorge: Yeah, I know that’s super important, but it’s related. I was thinking as you were talking about how we shore up sort of just the foundational underpinning of how we’re paying our staff, especially our direct service providers. And I keep on thinking about the fact that if you’re trying to create career ladders and build in supervision, peer monitoring, supervision, and coaching to be able to ultimately help individuals stay within their trajectory and actually move on, those aren’t reimbursable services.
How do we address the fact that we have so many healthcare plans? While parity around commercial rates has improved, it’s still not ideal. From your perspective, how can we push managed care organizations to work more collaboratively and meaningfully with providers? This includes not just the providers themselves, but also independent practice associations, some of which are clinically integrated and seeking contracts with managed care on behalf of their members. How do we get them to start paying attention to these critical issues for the entire sector?
Jihoon: Yeah, that’s a great question. One of the things I hear most about from members is about inadequate reimbursement rates, right? And I think that’s directly related to your question about ensuring that there are these kinds of strategic partnerships where we’re not just pointing the finger at each other, right? I mean, trust me, I’m very familiar with a lot of the finger-pointing that happens as it relates to insurance companies and then community-based organizations. And, I mean, Kudo goes to the New York State Council for their work, really elevating the issue of the inadequate rates on the commercial insurance side, right? I think what was passed and what was enacted in the recent budget, thanks to the work of our sister organization, the provider association, is that there is a requirement that commercial insurance companies pay at least Medicaid rate as a floor for the outpatient, OMA, no license services starting next year.
And that in and of itself is historic, right? I think when you couple that with, and this is where I don’t know how much people understand, what network adequacy looks like within behavioral health outside of folks who work in behavioral health care. But the insurance companies understand what it looks like, right?
They do. They certainly understand what they fully acknowledge and recognize that there are inadequate networks as it relates to addiction and mental health clinics. The other thing that couples that are coupled with the Medicaid rate as a floor for commercial insurance is regulations regarding network adequacy requirements that will really help to ensure that insurance companies are negotiating in good faith with community-based organizations and like psychiatrists and others who are really like they look at the commercial reimbursement rates and why would they go in-network, right? Like they’re, they can even just their going rate, which is reasonable to begin with, which is far above what commercial insurance reimburses.
So the question that I started asking in my time in government is why would a psychiatrist go into network? It’s like deplorable the rate. So, what incentive can we provide? So, in addition to the Medicaid rate as a floor for a lot of these outpatient OMH and OHSLICS and services, there are going to be new network adequacy requirements where if an insured and enrollee cannot find an in-network provider within ten days, the insurance company has to actually pay, allow that person to go out of network and pay the in-network rate. I think when you think about the economics of it, what we hoped, from my time in government, what we had hoped that that would do, and we still have to see if it plays out this way, coupled with the better parity on the reimbursement rate, is that they will negotiate in good faith with these clinicians to try to get more of them in network so that they can have adequate networks where they’re reimbursing at something that is at least on par with Medicaid. Jorge, I mean, I don’t think it’s lost on you as someone who’s run an organization that delivers services. Honestly, talking about the Medicaid rate as the floor should shock people. When you talk to the person who says, hey, Jihoon, you were deputy secretary. My kid cannot find a psychiatrist. Can you help me?
What I always end up doing is feeling powerless in many of those conversations, and that’s happening now as a CEO of InUnity Alliance, where ultimately, I have to go through the whole process with them. Who is your insurance carrier? What is your in-network benefit coverage for your plan?
Going through all of that, have you tried finding someone within your network? All of that, ultimately, what it amounts to is that there are these prohibitive floors established throughout any enrollee insurance coverage where, quite frankly, at the end of the day, when someone needs help, especially for mental health or addiction services, they’re not going to find someone in network. That’s just the reality. I think that’s one important issue. We have a long-standing existing relationship, both through the coalition and ASAP, where we have a strategic partnership and a good relationship with the Health Plan Association.
I think ultimately, at the end of the day, we’ve had these conversations with them since I joined InUnity Alliance, where it’s really continuing the conversation for me, for my time in government, where we need to better partner on these issues. I don’t want to make a finger point here, but I want to make the reality very clear for New Yorkers who are trying to access services. When they have health insurance, they wonder why they still cannot find coverage. A lot of that is related to reimbursement rates. When providers are not being reimbursed adequate rates, then they’re not going to be able to reduce those wait lists. It really is incumbent on both the community-based providers and the insurance companies to ensure that we’re working in partnership so that we can really solve this problem for all New Yorkers.
Jorge: Yeah, it does resonate deeply with me in terms of the complexity of this and that. I do think we’ve got an incredibly inequitable system of care where access to services is not affordable, timely, or even meaningfully accessible in any reasonable way. I have similar issues where people will call me constantly about trying to find psychiatric care for their loved ones. It shouldn’t be this complicated. It shouldn’t require you, me, or some others to figure out where and how to connect people to services. But sticking with that idea in terms of equity, the 1115 waiver, we’re working on it. We have the NOFA (notice of funding availability) going out for the social determinative care networks. The waiver is based on reading health equity.
Where and how do you think InUnity will fit into the thinking, planning, strategy, and implementation of initiatives aimed at making service access more equitable? What are your thoughts on this?
Jihoon: I appreciate that. The 1115 waiver is huge. It’s a hot topic for many providers and experts serving different populations throughout New York. I worked on part of that in my time in government.
I didn’t work directly on the healthcare side of things. I think there are opportunities with InUnity Alliance that we’ve already been providing for a lot of our members. We’ve provided free webinars and learning collaboratives for Unity Alliance members directly related to the 1115 waiver. We’re going to continue to develop strategic partnerships. I know that the SCN announcement was delayed a little bit towards the end of the summer or early fall. We have been in contact with many different organizations that have applied for that so that we can actually leverage those relationships as well as the opportunities built into the SCN model. I think the other thing that is equally, if not more exciting, is all the workforce dollars that are available through the 1115 waiver. I think there’s an opportunity there where we’re going to continue to work in close partnership with a lot of organizations throughout New York State who have already reached out because there are many organizations that are very excited about what’s happening with the merger to create InUnity Alliance and people have reached out to set up time to talk about 1115 and potentially partnering given InUnity’s broad membership of addiction and mental health providers throughout New York State. I think one of the things that I will say is that there’s always good news and bad news with anything. One of the things that I was very disappointed not to see in the 1115 waiver was the part that would provide Medicaid services to incarcerated individuals prior to their release. We understand that the state has developed a process in partnership with some community-based organizations and advocacy organizations to get this reprioritized InUnity Alliance. We are also thinking of other ways that we can keep the attention on this issue because we know for a fact that our jails and prisons for many New Yorkers, especially those living in poverty, especially those who have been part of marginalized groups historically, that they become the facto service delivery system, unfortunately. It’s unconscionable that Medicaid has to turn off and then turn back on when we know that within 72 hours of release, especially for someone who is on medication-assisted treatment or recovery for an SUD, they’re at the most vulnerable state.
That is no time to lose. I think we are hopeful, and we will continue to advocate for the state to actually include and submit that part of the waiver that was left out of the last waiver. There’s some more news to come about that, Jorge, but we will save that for a future date.
I think the 1115 provides a lot of opportunities, and it’s actually a good example of places where we can partner closely with folks outside of traditional mental health and addiction organizations where we’re thinking about the whole system of care for an individual.
Jorge: That’s great. Thank you for that response. As I’m thinking about the waiver and all these different sectors that we talked about and partnerships, I mean, you mentioned partnerships multiple times. I do think, again, so we’re at this potentially unprecedented time where our ability to be able to really foster partnerships that are meaningful because I do think that not every one of your members can do everything for everyone in their community.
How do we bring together the different components of New York’s rich and diverse healthcare ecosystem so that everyone is rowing in the same direction? From my experience, many are focused on just staying afloat rather than considering how to partner differently with community-based providers. Platforms like yours could bridge city and state government, various stakeholders, and non-traditional, non-medical providers as part of the waiver in thinking about the SCNs. Additionally, we need to include private entities in this conversation. Even though they are for-profit and compete with not-for-profits for workforce, they are an integral part of the ecosystem. So, How can we better integrate all these elements? Sometimes it feels like we’re all just spinning our wheels. What are your thoughts on creating a comprehensive partnership to tackle these challenges effectively?
Jihoon: You raise a good point. I think this kind of goes back to when we’re advocating, right? I think there are some kind of bread-and-butter policy advocacy issues, and they all boil down to the survival of the non-profit sector and the survival of community-based organizations. People put their heads down, and they work hard. Some have more of a cushion in their fiscal budget, in the fiscal year budget, so they can do some innovative things. Many are not even at a place where they can contemplate how AI and all these evolving and emerging technological advancements can even incorporate that because they’re so worried day to day about their workforce, having enough people doing their care work and paying their bills and keeping their doors open, right? I think, ultimately, this all ties into advocacy because when you think about it, everyone is so worried about their piece of the pie, right?
And I understand why. This is normal when you’re just used to not being prioritized by the government, right? And it’s not even prioritizing the sense of giving us billions of dollars; don’t ask questions, just give us money. That’s not the case. I think sometimes that’s how government looks at community-based organizations, but that’s not what it is. Some of it is about policy flexibilities and regulatory relief, but I think ultimately we have an advocacy agenda where whether you are a not-for-profit, a for-profit, whether the issue we’re advocating for is maybe 2% from your business perspective of concern to you, or if it’s 80% of concern to you based on what your portfolio looks like, we have the opportunity as InUnity Alliance to advocate for everyone’s needs as if all 250 organizations were all saying the same thing. That’s the beauty of the advocacy world, and the association world is that not only do we allow somebody to not have to be the one having that difficult conversation with a state agency commissioner or their office or the governor’s office or DOB for fear that there might be some kind of reprisal, not that people are vindictive and are going to do things like that, but there is always that fear.
We don’t want to stick our necks out on this. We have an advocacy organization in the InUnity Alliance that can do that for you. I can give you one example of a way that this kind of concept really played out well with the restoration of some cuts that were in the enacted budget. We advocated strenuously throughout the budget negotiation process and then post-budget enactment, state budget enactment for the restoration of $11.4 million in vocational and educational services and programs that Oasis had that the governor’s budget had included as cuts in the Oasis budget. I think from an InUnity Alliance membership perspective, I think it impacted maybe five to 10% of our members at most, but we as an association did a call for a letter-writing campaign, phone calls, and advocacy where ultimately the state did something unprecedented and they actually, with something that was in the enacted budget, $11.4 million in cuts, it was actually $8.4 because the legislature restored $3 million of it. They restored the entire program post-budget enactment, which honestly is unheard of. I think two things. One, that’s a good example of where we had the entire membership get very motivated because I think everyone saw this could be us. This could be that program that’s kind of on the margins of people even being aware of what it does and how it benefits people in recovery from an addiction, that we can be next. And I think we kind of hit on the nerve of people’s concerns, which also leads to that, put your head down, work very hard, keep your business open, provide services, let someone else advocate for us.
We don’t have time for that. Also, to give our members insight into what happens when you put all of your advocacy together under the umbrella of an advocacy organization to say, this is unacceptable; we’re in the middle of an overdose epidemic, and you’re cutting services that help people in recovery. So I think that’s a good example. And I know that I didn’t directly answer some other parts of that question, but you’re right. I think we’re in this part. We’re at this critical moment where everyone recognizes, especially coming out of COVID, that there was this kind of sleeping pandemic of unmet mental health and SUD needs. It really emerged to the surface, where it felt like a lot of people were scrambling to try to throw spaghetti at the wall and see what sticks.
But it’s not time for us to get competitive. I think it really boils down to starting where the person is. And what I will say is, whether it’s InUnity Alliance, an association that serves people with IDD, or an association that serves people primarily in the foster care system, we’re actually talking about the same people. And I think at the association level, we’ve recognized that. So we’re going to partner very closely with a lot of our like our sister and peer advocacy organizations to really unite forces in this upcoming budget because we realize that what we cannot show is any kind of competitiveness in, amongst associations, because we’re all talking about the same people that our members serve, regardless of what kind of license you have from the state.
Jorge: Yeah, that’s super critical. And I’m glad to hear that because the number of stakeholder groups that are out there, associations that represent sort of different parts of the sector, make it really difficult for, let’s say, larger organizations that have sort of very portfolios to be able to really figure out how do you meaningfully lean into, InUnity or supportive housing or whatever it may be, right? So, it’s good to hear that you guys are thinking about partnering up. You’re right. I think what it comes down to is we serve some of the hardest to engage and treat individuals with complex care, multiple diagnoses where development of disabilities, mental health substance use, and homelessness are all of the things that really make this population so vulnerable. Folks need to be very innovative and creative about where and how we’re going to provide services in a very integrated, comprehensive, holistic manner.
You briefly mentioned AI, and I can’t resist asking about the influx of technology-assisted care solutions. How do AI technologies like machine learning, natural language processing, and big data analytics come into play in your strategy? Where do you see InUnity having some level of influence with these technologies, if you’ve formulated your thinking around that?
Jihoon: It’s a timely question, not only because everyone’s talking about it, but because it’s probably the one kind of group that has lobbied me for time on my calendar more in the last four months than any other group. And rightfully so. I think there are huge benefits. I think, even in my time in government, it was like just emerging over the time that I worked in the governor’s office where you went from people questioning whether there were maybe like administrative efficiencies you can find for any organization, whether it was a community-based mental health provider or a for-profit company, there are, there are actually ways to leverage technology, emerging technology as including artificial intelligence with training of the workforce and providing other administrative efficiencies. I think there are a lot of benefits when it comes to these, those daily administrative tasks and tons of paperwork, where there are tremendous opportunities for not only cost savings for a nonprofit organization but also to perhaps eliminate a lot of human error as it relates to the administrative task. I think the trick, honestly, though, is that what more people are talking about is not necessarily the administrative, like the business side of things. It’s really about how and what role AI plays in the actual delivery of services, right? That’s a tricky one.
The tricky one is that I think telehealth was a good example of an efficiency that was necessary during COVID. And there are a lot of parallels that I think warrant being very intentional. And to some extent, I’m not saying like slow things down, but maybe some of it’s slow things down. Because I think ultimately what I recognize with a lot of the organizations that make up InUnity is they’re not even at a place where they can potentially be thinking about, do I leverage AI into my business model and into my service delivery? The existing technology, infrastructure, billing system needs, and data collection needs of the behavioral health system have been lacking for a long time, right? I think it was never fully included when EHR was being launched on a broader healthcare level by the feds.
So it’s really, really lacking. As I consider the role of AI, I believe there may be members of the InUnity Alliance and professionals within the behavioral health sector who could benefit from early adoption. In a sense, they might serve as pioneers or ‘guinea pigs,’ exploring the potential advantages and applications of AI sooner rather than later. But I think there is huge potential. I do think that we should be very careful that we ensure it’s person-centered, that we address any of the racial, ethnic, and cultural disparities that always exist within technology and healthcare, and that, ultimately, it will be for them in the best interests of the people that InUnity Alliance members serve. I think if we could answer all of those questions, then I think it’s the kind of thing that, as an association, we would be trying to leverage and figure out how this benefits our members. But I have a lot of, I think a lot of people have more questions right now than answers, but I also know that there are some emerging technologies that have been around for a while but are emerging to behavioral health providers that you’ll see more and more and more incorporated into the business model over the next couple of years. We’re always looking to be kind of ahead of the curve, but on this one, I think it makes sense to be strategic as well as watch and see what comes of it in many ways.
Jorge: That’s a reasonable approach, I think. There is just a lot out there, and it’s important to be able to sift through that and figure out what might or might not be meaningfully relevant for providers and the people we serve. We’ve covered a lot of territory in this last hour, so again, thank you so much for joining us.
Before we wrap up, is there anything that I haven’t asked you or anything that you wanted to share that we haven’t covered?
Jihoon: Yeah, I mean, what I will say, Jorge, is I’m having a lot of fun, right? It feels weird to say that because anyone who knows me from my time in government it was one of the highlights of my career working for Governor Huckle as its deputy secretary, but it was also stressful in very, very different ways. I love the engagement with people on the ground providing services to people in need, right?
And I think ultimately, in any kind of government job, you just end up feeling detached from that reality, right? I thoroughly enjoyed the four months, learned a lot from Amy Dorn and John Capolla, and am grateful to them as InUnity Alliance continues to grow and plot out our strategic vision and plans for the next couple of years. And I really appreciate the time that you’ve given me this morning. You and David have given me this morning to chat a little bit about our vision and what I think people can expect in the coming years.
Jorge: Well, again, thank you so much for joining us. I wish you tremendous luck. I mean, InUnity Alliance is a critical piece of our healthcare ecosystem, so I’m really excited about all the things you’re going to be doing with your team, and hopefully, we’ll be able to check in again at some point down the road and see how things are going. But again, best of luck to you, and congratulations on the role!
David: I echo what Jorge said. It sounds like an amazing opportunity, and I’m really looking forward to seeing how things evolve. So, I’d like to thank you, Jihoon Kim, for sharing your time and expertise with us today and Dr. Jorge Petit for leading this enlightening discussion.
If you’d like to learn more about InUnity Alliance, please visit coalitionny.org and asapnys.org. If you found this conversation valuable, I encourage you to visit behavioralhealthnews.org, where you’ll find a wealth of information on important mental health and substance use disorder topics, including in-depth articles, resources, and more interviews with leaders in the field. You can also subscribe to receive our quarterly issues and stay informed about the latest developments in behavioral health.
Once again, thank you all for joining us today, and stay tuned for our next installment of the Behavioral Health News Spotlight on Excellence Interview Series.
