When Ken Libertoff started planning for his future in the 1960s, he admits that he was more concerned with sports than helping those in need. A student at the University of Connecticut, this Husky “had actually gone to school more to play basketball than to focus on social issues.”
But fate had other plans for Libertoff, who began working in a community-based program for teenagers in New Haven, Conn. after earning a bachelor's in English. His work suited him, and it wasn't long before he dedicated himself to social issues full time.
He returned to school-Harvard, to be exact-and earned his doctorate in clinical psychology. His dissertation focused on creating social policies to support runaway teens, which led him into a nationwide consulting career in youth and community program development.
But Libertoff's self-proclaimed attraction “to hopeless causes” would bring him back to New England for the long haul. In 1981, the executive director position at the Vermont Association for Mental Health (VAMH)-one of the oldest citizen's organizations in the state-opened up, and Libertoff got the job.
“[VAMH] was in desperate straits, particularly financially, and therefore I wouldn't say it was the most attractive position,” Libertoff says of the organization. “But it fit my personality.”
Dedication leads to statewide reform
Even with a new leader, VAMH's future was in doubt. As one of the few organizations in the state looking to actively increase awareness of and services for people with mental illness and substance use disorders, the short-staffed association's message had not been heard.
Libertoff changed that within a matter of months. “It was the dedication of the citizen board members along with the decision on my part to slowly build [VAMH] into an organization with a solid membership base,” he says. “In some ways, the first year of work was like a political campaign.”
By reshaping VAMH's message into one that resonated with any Vermonter, whether directly affected by mental illness or not, Libertoff gained the support of citizens, businesses, and the behavioral health community alike. So it was only natural that he then took the association's message to the statehouse.
“There was a terrible void, an ill representation of Vermonters who wanted to see expanded mental health and substance abuse treatment until then,” he says. “In some ways, we were one of the few groups that were trying.”
Libertoff established the VAMH as “an aggressive presence” in Montpelier. With a hand in deliberations leading to budget and policy decisions, he laid the foundation for a stronger, more accessible behavioral healthcare system-one that would even achieve parity with its primary care counterparts.
In fact, Libertoff started working toward parity in the mid-1980s, a good decade before Vermont's legislature would pass the bill. “It was a long campaign,” he says. “It had some setbacks and challenges, but our goal was to pass the nation's most comprehensive bill.”
The bill-which Libertoff wrote “on my kitchen table on a cold and snowy December evening”-finally passed in 1997. He collected his experiences and “lessons learned” throughout the decade-long campaign in a book, Fighting for Parity in an Age of Incremental Health Care Reform.
“To be honest, it's still a much stronger piece of legislation than, for example, the federal parity bill,” Libertoff says.
Going out on top
Libertoff made waves at the state capitol by promoting another piece of industry-changing legislation in 2009. Concerned about the corrosive effect of pharmaceutical industry spending in the healthcare industry, Libertoff advocated for full disclosure of transactions between the two.
“In no state do you have access to that information,” Libertoff points out. “The enormous financial relationship between the pharmaceutical industry and doctors has had a profound and … unsatisfactory influence on over-prescribing patterns, and this is certainly true in the field of mental health.”
The pharmaceutical companies fought back with their traditional weapon of choice: money, and lots of it. But still, they failed. As of 2011, the state of Vermont will require total disclosure, banning gifts, meals, and other incentives given to providers by pharmaceutical companies in the process.
On the wings of this success, Libertoff made his decision to retire from his position at VAMH. He will hand over the reins to his still-unnamed successor at the end of 2010.
“This is the moment in time where I've been here for 30 years and feel that I'm still both vigorous and near the top of my performance,” he says. “I really have loved what I do, but it seemed like an excellent time to move on and have others continue building on what we've accomplished.”
While the industry may mourn the loss of a fierce and accomplished advocate, it can rest easy in the prospect of gaining a teacher. Libertoff's only solid plans, as of yet, are to spend more time with family, though he says that going back to consulting-which he had continued intermittently throughout his career in both the U.S. and South Africa-could be an option.
“I guess I take some pride in feeling like a typical 16-year-old teenager when asked, ‘What are you going to do?’” he says. “The answer is I don't know. I've been working very hard not to make any commitment at this point.”
Behavioral Healthcare 2011 January-February;31(1):48