Karen Burkett, PhD, RN, PPCNP-BC Tanya Froehlich, MD, MA Developmental and Behavioral Pediatrics, Cincinnati Children s Hospital Medical Center

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Addressing the Behavioral Health Needs of Disadvantaged Children and Adults on Ohio Medicaid: Multidisciplinary Collaborative Training for Ohio s Health

1 Addressing the Behavioral Health Needs of Disadvantaged Children and Adults on Ohio Medicaid: Multidisciplinary Collaborative Training for Ohio s Health Care Providers Karen Burkett, PhD, RN, PPCNP-BC Tanya Froehlich, MD, MA Developmental and Behavioral Pediatrics, Cincinnati Children s Hospital Medical Center

2 MedTAPP Acknowledgement This program is partially funded by the MedTAPP Healthcare Access (HCA) Initiative and utilizes federal financial participation funds through the Ohio Department of Medicaid. Views stated in this presentation are those of the program faculty only and are not attributed to the study sponsors, the Ohio Department of Medicaid or to the Federal Medicaid Program. MedTAPP HCA Initiative funding supports teaching and training to improve the delivery of Medicaid services and does not support the delivery of Medicaid eligible services.

3 UC MedTAPP Partners 3

4 UC Medicaid Technical Assistance and Policy Program (MedTAPP) Healthcare Access Initiative Project Purpose: To increase the abilities of healthcare providers across Ohio to care for the behavioral and mental health needs of socioeconomically disadvantaged children and adults Project Goals: 1. Recruit and retain practitioners to serve the Ohio Medicaid Population. 2. Facilitate partnerships among the UC Academic Health Center and with the Medicaid-serving primary health, mental health, and school-based health agencies in our region. 3. Develop and/or enhance residency programs to better serve a culturally diverse Ohio Medicaid population across the lifespan. 4. Plan and implement interprofessional education opportunities and best integrated care practices into curriculum and training modules.

5 FY16-17 MedTAPP Achievements Primary Care Training for PCPs Integrated Care Case Simulations Riverview East Community Health Center (School-Based Health Clinic) Multidisciplinary Collaborative Rounds

6 Goal of MCR Promote best integrated care practices through a monthly interprofessional curriculum and training involving multiple disciplines: psychiatry fellows nurse practitioners in a post-master s psychiatric/mental health program family medicine residents developmental-behavioral pediatric fellows

7 MCR Components Expert-led didactic curriculum for core learners in: Nursing Family Medicine Psychiatry Developmental/Behavioral Pediatrics Panel discussions with families, non-medical services providers

8 MCR Components Case discussions presented by core participants, assigned by discipline Post-session online discussion board Online clinical resource toolkits

9 MCR Content Social Determinants of Health Interprofessional Competencies

10 MCR Content Developmental Issues Mental Health Issues

11 Social Determinants of Health: Food Insecurity and Benefits Alphabet Soup Andrew F. Beck, MD, MPH, Community Health, Cincinnati Children s & Deanna White, Legal Aid Case: 4 year old child seen for evaluation of developmental delay; father was distressed over no money or food to feed the children Online toolkit Discussion board: We have added the food insecurity screening to our initial intakes at the Children's Home and it should be added to our ongoing visits, as well.

Working with Medicaid Payers: Services, Resources

Director, Managed Care Organization, Cincinnati

Organizations (Caresource, Paramount) and

Discussion board question: Would I contact the

12 Working with Medicaid Payers: Services, Resources & the Medical Home Colleen Kraft, MD, Medical Director, Managed Care Organization, Cincinnati Children s Panel Presentation: Managed Care Organizations (Caresource, Paramount) and Over-the-Rhine Low-Cost Pharmacy Online toolkit Discussion board question: Would I contact the client's plan if I find that their contracted transportation company is subpar?

Positive Parenting Supports in the Medical Office

Developmental/Behavioral Pediatrics, Cincinnati

aggressive and violent behavior directed at his mother.

advice to the parent if during the appointment they

13 Positive Parenting Supports in the Medical Office Setting Stephanie Weber, PsyD, Clinical Psychologist Developmental/Behavioral Pediatrics, Cincinnati Children s Case: 13-year-old Caucasian male with aggressive and violent behavior directed at his mother. Online toolkit Discussion Board: How does one offer advice to the parent if during the appointment they punish or continue to scold the child while you are trying to interact with the child?

14 Discussion Board Question: Do the patients have to show disability for two years to get Vocational Rehabilitation services or is it open to any timeframe? Developmental Disabilities in Adults Jason Woodward, MD, MS, Developmental/Behavioral Pediatrics, Cincinnati Children s Panel presentation on Ohio Developmental Disability Agencies On-line toolkit

Cincinnati Children s Case: Hispanic 16 year

diagnosed with ADHD, sleep problems, OCD

15 Trauma-Focused Care Barbara Boat, PhD, Center for Safe & Healthy Children, Cincinnati Children s Case: Hispanic 16 year old witnessed domestic violence and diagnosed with ADHD, sleep problems, OCD Online toolkit Discussion question I understand toxic stress can change gene expression. Have we known this all along but did not have the data to support it?

A Taste of Motivational Interviewing for Substance Use Disorders Jonathan Steinberg, PhD, Clinical Psychologist, Cincinnati Veterans Administration Case: 17 year old male for psychiatry evaluation

16 A Taste of Motivational Interviewing for Substance Use Disorders Jonathan Steinberg, PhD, Clinical Psychologist, Cincinnati Veterans Administration Case: 17 year old male for psychiatry evaluation after hospitalization for overdose on recreational drugs On-line toolkit Discussion board: I thought it was a really good comparison of persuasion to motivational interviewing. This helped me better understand the mechanics behind MI. I also thought the two students who volunteered did a wonderful job in the role playing.

17 Multidisciplinary Collaborative Rounds

18 MCR Dissemination Dissemination effort launched 7 video-recorded sessions and online resource toolkits offered to: Crossroad Health Center (Federally Qualified Health Center) providers Society for Developmental and Behavioral Pediatrics members Most popular content: Social/Behavioral/Developmental Issues Surviving Poverty Positive Parenting ADHD I liked that [the speaker] explained in detail the services available to families. This will definitely help me in practice. Crossroad s providers requested MORE videos

19 Partnering to develop knowledge- sharing networks Benefits of partnering Leverages already-developed materials/programs Can reach more providers Demonstrates statewide partnerships

20 Partnering with Professional Associations Expanding MCR availability with new partners AAP (American Academy of Pediatrics) Ohio Association of Advanced Practice Nurses (OAAPN)

21 Partnering to Develop New Networks New MedTAPP goal: Develop active knowledge-sharing networks Cross-Dissemination Local/Regional/National Dissemination With MedTAPP Sites on Behavioral Health: Building Mental Wellness Case Western Reserve U Dissemination with: Health Departments Federally Qualified Health Centers (FQHCs) Professional Associations

22 Dissemination Plus. Continuing Education (CMEs) Applied for online enduring CME credit for selected learning modules with toolkits to trial in focused areas of behavioral health & underserved populations Modules will live on Cincinnati Children s continuing education server When approved will be ready to offer online modules with toolkits to health care partners including: professional associations health departments FQHCs other MedTAPP sites

23 MCR Lessons Learned It works to step in the same river twice for seminal content Learners want interactive sessions in-person or remotely Experiential learning is valued (toolkits, screen/referral tools) Connecting patients/families to services is applied learning

24 MCR Lessons Learned Interprofessional training enhances skills across disciplines Online discussion & questions are crucial to remote learning For enduring learning online short modules are best Partnering with other MedTAPP sites leverages quality programs AND speeds dissemination

25 Interdisciplinary Team Members UC College of Nursing Diana McIntosh, PhD, RN, PMHCNS-BC Karen Bankston, PhD, RN Gordon Gillespie, PhD, RN Suzanne Perraud, PhD, RN, PMHCNS-BC Katy Cosse, MPH Kathleen Fulton, MPH Cincinnati Children s Hospital Medical Center Karen Burkett, PhD, RN, PPCNP Jen Bowden, MD Tanya Froehlich, MD, MA Emily Harris, MD Suzanne Sampang, MD Michael Sorter, MD UC College of Medicine Jerry Friemoth, MD Joe Kiesler, MD Hilary Mount, MD Saundra Regan, PhD Anisa Shomo, MD Barb Tobias, MD Dan Hargraves, MSW Chris White, MD Community Partners Marilyn Crumpton, MD, MPH (Health Department) Debbie Gingrich, LISW-S (Children s Home) Ann Saluke, MD (Primary Care/Children s Home) Susan Shelton (MindPeace) Francine Wolgin, MSN (Interact for Health) 25

26 Questions?

APNA 30th Annual Conference Session 2032: October 20, 2016

APNA 30th Annual Conference Session 2032: October 20, 2016 Inspiring Future Leadership with Inter-professional Training for Advanced Practice Psychiatric Nursing Students at a School/Community Health Center American Psychiatric Nurses Association Annual Conference