What We Do Matters: Julia Kotchevar, MA

Vision + Empathy + Outcomes

This month, we hear from Julia Kotchevar about her work on the Consulting team. In particular, she shares her perspective on the inequities in behavioral health, which does not have parity with traditional physical health care models. She provides insight into what those inequities look like, the consequences for fragile people, and how our work helps states solve problems to create better outcomes.

Behavioral health has always operated on the edges of the health care system. States cobble together systems designed to serve the people who end up in emergency rooms or might hurt themselves or others. The system is often haphazard, at best. Grants or state funding or pieces of managed care or fee-for-service health care systems pay for a few therapy sessions, crisis intervention, emergency department diversion, and medication. But none of these systems are designed to truly help people who are simply left to suffer without help through the pain caused by behavioral health conditions.

In my career as a state official responsible for ensuring vulnerable people receive services, one of the first lessons you learn is that effective financing and policy structure are how people get services and supports. If you can’t wrap some structure and funding around a system, you get nothing but fragmented services that support some, but not all, who so desperately need help. Most states do not have the capacity to do this by themselves. We help states solve problems and create better outcomes for people.

Prior to working at Myers and Stauffer, I was asked to lead a state’s mental health system that had gone into crisis because the supported housing system for people with serious mental illness had been found to be unsafe and unhealthy for those living there. The state was paying house costs for people to live in filthy, decrepit, vermin-infested hovels.

There were many reasons why it happened, but one reason was the rate structure simply was inadequate to cover housing costs, and it had pushed people into lower and lower-quality housing until case managers viewed this insect-infested house as the only option over homelessness.

Myers and Stauffer developed a regional rate structure that reflected the housing costs in the very different regional housing markets so the state could adequately fund proper housing. This left me, as the state official, free to strengthen oversight, regulation, training, and policy development that would work along with funding to make sure something like this never happened to people again.

Myers and Stauffer creates the structure that health care systems stand on. We are the financial underpinning and accountability system that states need for the mental and physical health care systems to be vibrant and correctly working to meet the needs of the individuals they serve. I am so proud of the work we do to help states solve problems and create better outcomes for people.”

Get to Know Julia

Julia provides policy and analytic support to clients related to the delivery and financing of long-term care services and supports, behavioral health services, and public health services. Prior to joining Myers and Stauffer, she served as Administrator of the Nevada Division of Behavioral and Public Health. She also served as the State Health Official and the Mental Health Director. She oversaw the operations of the public health agency, health care regulatory and planning functions, the substance abuse and treatment system, and the adult behavioral-health services program.

Julia also served Nevada as the Deputy Director of the Nevada Department of Health and Human Services, the Deputy Administrator and Chief of Disability Services in the Division of Aging and Disability Services where she oversaw the operations of all the Nevada Home and Community-Based Waiver Services programs serving elders, persons with disabilities, persons with intellectual disabilities, and the early-intervention system for infants and toddlers with disabilities. She served as an Executive Branch Auditor for the Division of Internal Audits, and as an Analyst in the Nevada Division of Child and Family Services.  Additionally, she worked internationally doing relief work related to the development of primary health and maternal and infant care in disaster areas or underserved regions.

“I want to provide some rationale for why I chose the three words I did for my story. Honestly, they are probably the three words that best describe what is most important in how I do my work.

Vision, Empathy, Outcomes are what I see as the three pillars for success.

Vision is so critical and is more than just an idea or a statement. It is the purpose behind the future we are creating through whatever work we engage in. It provides both an expectation and a mechanism for accountability. When I worked for the state, I shortened our official mission statement down to a brief tagline: dignity, independence, and self-determination for all.  I wrote it on my white board, and I used it constantly to judge whether we should do or not do something. How does this policy/choice/decision further the dignity, independence, and self-determination for vulnerable people? If we can’t answer that, then we need to rethink what we are doing.

Empathy is the “how.” How we act toward each other, toward people we serve, toward people to whom we are accountable. Empathy is what allows people to be different in this world and still be respected and valued. Empathy is what holds teams together during crunch time and ensures that we do not sacrifice dignity for expediency. It may be more efficient to treat people as a group and seek conformity, but it is not more respectful, nor does it foster a diverse and dynamic world where all people can thrive.

Outcomes are the results, and they are inherently dependent upon vision. How do you course-correct if you don’t know your destination? Our clients frequently struggle with identifying outcomes that are fair and reflective of meaningful measures of success. Vision allows the creation of meaningful outcomes and is the measure of accountability that determines if we achieved the vision or not. Unfair outcomes are usually those where stakeholders feel like they either don’t measure a meaningful outcome or they don’t measure something the stakeholder has control over.

I once had a program budget outcome measure that said 90 percent of all children will achieve normal developmental levels by age three. Well, not only was that absolutely not our program goal, it wasn’t even developmentally appropriate for children. It certainly wasn’t a reflection of our vision, and it absolutely did not treat children and families with dignity and empathy. Without vision and empathy, outcomes can go very wrong. WITH vision and empathy, they can demonstrate accountability and be invaluable measures of success.

When I think about Myers and Stauffer’s core values, I feel like they are the tools for success that I need and use to ensure we can provide vision, empathy, and outcomes for our clients and for the vulnerable people they support.”

Positive Impacts 

Myers and Stauffer is proud to help our clients serve those who are most vulnerable. Our staff feel empowered to know that their hard work and dedication each day makes a difference. We believe it and so do the millions of individuals helped by the clients we serve. We will release new stories each month highlighting associates and their stories. Follow along with our LinkedIn, Twitter, and Instagram for more information