Medical Home & Health Home Accreditation What Are The Options?
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1 Medical Home & Health Home Accreditation What Are The Options? The 2016 OPEN MINDS Performance Management Institute February 11, :15am 12:30pm Brandon Danz, Senior Associate, OPEN MINDS York Street, Gettysburg, Pennsylvania Phone: info@openminds.com All Rights Reserved.
2 Agenda I. Accreditation & Certification Programs For Medical Homes & Health Homes II. III. Health Home Accreditation/Certification Organizations Peggy Lavin, LCSW, Senior Associate Director, Behavioral Health Care Program, The Joint Commission Mina Harkins, MBA, PCMH CCE, Assistant Vice President, Recognition Programs Policy and Resources, National Committee for Quality Assurance Michael W. Johnson, M.A., C.A.P., Managing Director of Behavioral Health, CARF International Susan Griffin, MSM, Surveyor, Standards & Survey Process Committee Member, Independent Consultant, Accreditation Association for Ambulatory Health Care Questions & Discussion All Rights Reserved.
3 Accreditation & Certification Programs For Medical Homes & Health Homes
4 Health Homes & Medical Homes All Rights Reserved.
5 Accreditation/Certification Organizations For Health Homes Or Medical Homes Organization Accreditation/ Certification Accreditation Association for Ambulatory Health Care (AAAHC) Accreditation Commission for Health Care (ACHC) Board of Certification/Accreditation, International (BOC) Center for Improvement in Healthcare Quality (CIHQ) Commission on Accreditation of Rehabilitation Facilities (CARF) Community Health Accreditation Program Council on Accreditation (COA) Healthcare Quality Association on Accreditation (HQAA) The Joint Commission (TJC) National Committee for Quality Assurance (NCQA) Yes No No No Yes No No No Yes Yes All Rights Reserved.
6 Why Pursue Accreditation/Certification? 1. Many states require accreditation/certification as a condition of operating a health home/medical home through Medicaid 2. One of the key benchmarks for measuring the quality of a health care organization 3. Establishes your organization s commitment to being a provider of choice 4. Helps strengthen consumer confidence in your organization, and the quality of services you provide. 5. Assists organizations to document and communicate efficiency, fiscal health, service delivery and national benchmarking 6. Builds foundation for continuous quality improvement and consumer satisfaction 7. Represents agencies as credible and reputable organizations dedicated to ongoing and continuous compliance with the highest standard of quality All Rights Reserved.
7 Peggy Lavin, LCSW Senior Associate Director, Behavioral Health Care Program The Joint Commission
8 Joint Commission Health Home Certification 2016 OPEN MINDS Performance Management Institute February 11, 2016 Peggy Lavin, LCSW, DCSW Senior Associate Director Behavioral Health Care Accreditation Behavioral Health Home Certification
9 The Joint Commission Accreditation & Certification Programs cover the full spectrum of healthcare Goals of accreditation process: Emphasizes direct on-site observations, staff and patient interviews Evaluates staff effectiveness and organizationwide performance Focuses on integration of systems across the organization Provides education and consultative feedback Goals of Certification Process: Provides a framework for specific program management and structure. Provides an objective assessment of clinical excellence. Builds upon accreditation 2
10 Health Homes Certifications By The Joint Commission Behavioral Health Homes (BHH): Community Mental Health Clinics, Child Welfare, Behavioral Health Systems, Opioid Treatment Programs, Hospital Outpatient programs Primary Care Medical Homes (PCMH): Federally Qualified Health Centers (FQHC), Hospital Based Clinics, Group Practices, Universities health Systems 5 3
11 Integrated Care Integrated health care = integration/coordination of health care needs of an individual served (physical, mental, substance use, eating disorders and prevention/wellness promotion) Mental Health and/or Substance Use Agencies: Primary Physical Health Care Behavioral Health Care accreditation requirements (mandatory) Behavioral Health Home Certification requirements (optional) 4
12 The Joint Commission Behavioral Health Home Certification
13 Why Behavioral Health Home At All? (People Encouraging People, Inc of Maryland) Mortality and Morbidity Statistics of our Target Population Demographics : Poverty, Race, Ethnicity Experience with Facilitated Somatic Care Movement to Population Based Management Facilitates Legitimacy in Public Health Arena Promotes Effective and Efficient Use of Resources to Address Aggregated Needs Readiness for Per Person/Per Month Costs and Other Managed Care Matrices 6
14 Why Joint Commission Behavioral Health Home Certification? (People Encouraging People, Inc) Largely treat individuals with complex behavioral and somatic health, social and economic needs The whole enchilada = integrated health care Demonstrates organizational commitment to integrated care Behavioral health home are usually starting out small and rapidly expanding so grow it right! 7
15 Whole person care both physical and behavioral health Support an Individual s right to make decisions about his/her own care, treatment, and services Care Coordination Behavioral Health Home Foundational Concepts Accessible care social support, navigation Flexible approach to how services are delivered Supplement existing requirements 3 8
16 Behavioral Health Home Certification Requirements The BHH standards apply to three types of Health Homes, as endorsed by SAMHSA: In house the behavioral health care organization provides the behavioral health care services and some of the primary physical health care services. Co located partnership the behavioral health care organization arranges for health care providers to offer some basic primary physical health care services on site. Facilitated referral the behavioral health care organization has processes to ensure the coordination of primary physical health care provided off site 9
17 Behavioral Health Home (BHH) Certification Available since Jan 1, 2014 Agency must be accredited under the Behavioral Health Care accreditation program Must have served as a health home for at least 3 individuals Responsible for Coordination and Integration of Mental Health, Substance Use and Physical Health Care Guidelines, not prescriptive requirements Optional Demonstrates the organization s achievement of additional quality measures to ensure health care is coordinated and integrated 10
18 On Site Survey Process On site survey One additional day added to accreditation initial/triennial on site survey One day for extension on site survey Tracers with individuals served in your health home 13 11
19 Joint Commission Behavioral Health Care Accreditation and Health Home Certification The Joint Commission s Gold Seal of Approval TM means your organization has reached for and achieved the highest level of performance recognition available in the behavioral health field. 12
20 Behavioral Health Care Accreditation/ Health Home Certification Team Tracy Griffin Collander, LCSW Executive Director 630/ Peggy Lavin, LCSW Senior Associate Director 630/ Darrell Anderson, BA Senior Business Specialist 630/ Peter Vance, LPCC, CPHQ Field Director 630/ Megan Marx, MPA Associate Director 630/
21 Behavioral Health Care Accreditation Team For Accreditation/Certification Requirements Questions: Merlin Wessels, LCSW Associate Director 630/ Option # 3 (If your question concerns the Life Safety Chapter, please call 630/ and ask for a Joint Commission engineer or engineer@jointcommission.org) 14
22 Pause for QUESTIONS
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