Consensus Building Has Always Guided Lydia Conley’s Work
Lydia Conley: Listening to disparate voices and finding consensus are essential to developing sound public policy priorities.
Learning how to craft public policy equipped Lydia Conley with the skills she brings to her job as president and CEO of the Association for Behavioral Healthcare, a Natick-based nonprofit that advocates for community-based mental health and addiction treatment services.
This is her story.
When, fresh out of college, I started working as a legislative aide in the Massachusetts House of Representatives in 1997, my mind was swirling with questions. How do people make their voices heard at the state house? Who listens to stakeholders and their disparate issues? How do you reach consensus and set priorities?
I still think of these questions – along with the answers I’ve formulated in the intervening 20 years of my journey to becoming the leader of a statewide advocacy organization for community-based mental health and addiction services providers. My work in public policy actually began before I graduated from UMass Amherst, during an internship with state Rep. John Stefanini, who represented my hometown of Framingham.
After earning a bachelor’s degree in English, I joined Rep. Stefanini’s office full time as a legislative aide. That put me in regular contact with constituents from the district and provided invaluable experience in the pressing issues of the time, including health care.
I further expanded my knowledge after joining the Mental Health & Substance Abuse Corporations of Massachusetts Inc. – now known as the Association for Behavioral Healthcare (ABH). All credit goes to then-president/CEO Elizabeth (Betty) Funk, who recruited me and also accommodated my desire to go to law school at night. It was quite a juggling act, but I earned my J.D. from New England Law in Boston in 2005. Betty was an incredible woman leader, a mentor to me, and an effective voice for the behavioral health profession on Beacon Hill.
As a program specialist and later a policy director, I learned the intricacies of the behavioral health care system and the complexities of providers’ service delivery models. I staffed ABH’s billing committee, “following the money” like a Watergate-era journalist as I learned how funding flows through the health care system. That was key to seeing the big picture of the profession.
In 2008, I became policy director at the Massachusetts Department of Transitional Assistance, eventually becoming assistant commissioner. I oversaw programs designed to help individuals obtain job training and skills for employment – and gained new appreciation for the people working in state government. Often unfairly derided as faceless bureaucrats, they were, and are, an amazingly talented and committed group of people.
As much as I enjoyed my work in state government, I was surprised to learn that it is sometimes easier to get things done from the outside than from the inside, because as an external stakeholder you’re not constrained by the same complex operational interdependencies or resource constraints under which our governmental partners work.
I rejoined ABH in 2014 as a vice president. My work soon focused on how behavioral health care priorities fit into the broader goals of MassHealth through the Section 1115 Medicaid waiver process. Among other things, it meant collaborating with state agency partners, health plans, and providers to ensure that the inclusion of important substance use disorder residential rehabilitation services into a Medicaid benefit not only did not disrupt care but improved access to services.
After Vic DiGravio—who steadily led the organization for many years, building it to an organization with 80 members who serve approximately 81,000 Massachusetts residents daily across the state—departed for a new venture, the ABH board chose me to succeed him as CEO in 2019, just months before the COVID-19 pandemic hit.
While it was exceptionally difficult to manage through the crisis—and remains so—I’m pleased we were able to provide stable leadership and advocacy to our members, and by extension the communities they serve.
Three weeks into the pandemic, amid lockdowns that forced the closure of mental health clinics and addiction treatment centers, our members’ revenue plummeted nearly 50%, threatening their viability as well as patient access to care. The solution was a huge pivot to telehealth, led by state officials, enabling clients to continue seeing their therapists and ensuring that virtual services would be covered.
Since those harrowing early days of the pandemic, the need for mental health and addiction treatment services has only increased. At the same time, decades of budgetary challenges in behavioral health care have grown, laying bare the need for equitable reimbursement to support the delivery of high-quality services.
Throughout my career I have found that listening to disparate voices and finding consensus are essential to developing sound public policy priorities. With my own family having been affected by mental health and addiction, I also know that having empathy for others is just as important.