The Joint Commission Behavioral Health Accreditation Provider Roundtable. June 5, 2012

Transcription

1 The Joint Commission Behavioral Health Accreditation Provider Roundtable June 5, 2012 Discussants Heidi Wallace and Denise Dunn Hazelden Center City, MN Sharon Singleton Bonnie Brae Liberty Corner, NJ Mike McKasson Adult and Child Mental Health Center, Inc. Indianapolis, IN Facilitator Mary Cesare-Murphy, Ph.D. Executive Director

2 If you re NOT hearing Audio To access the audio for this webinar, please use your phone to dial: Passcode: 47507

3 The Joint Commission is: Independent Not-for-profit Private sector, non-governmental organization Our Mission Statement: To continuously improve health care for the public, in collaboration with other stakeholders, by evaluating healthcare organizations and inspiring them to excel in providing safe and effective care of the highest quality & value. Our focus: helping behavioral health organizations help the people they serve

4 Specialized Integrated Treatment for Addiction and Trauma hazelden.org

5 Heidi Wallace, MA, LPC, NCC, MAC Clinical Director Hazelden Newberg, Oregon (503) Denise Dunn, MA, LADC Training Manager for Regional Intake Services Hazelden Center City, MN (651)

6 Hazelden helps restore hope, healing, and health to people affected by addiction to alcohol and other drugs. Copyright, The Joint Commission

7 Trauma and Addiction 75% of women and men in substance abuse treatment report abuse and trauma histories (SAMHSA/CSAT, 2000). These individuals frequently need integrated treatment of both issues in order to sustain recovery.

8 Trauma and Addiction Treating both Addiction and Trauma together If not treated, relapse potential is high Risk of re-traumatizing Treatment offers great opportunities for the individual Treating both regardless whether there is a diagnosis of PTSD

9 Treatment Modalities Seek models that believe the use of biological and physiological aspects are important Supports the use of pharmacological interventions Cognitive behavioral therapy Physical action associated with it

10 Hazelden s Trauma-informed services approach: Core Values: Safety Trustworthiness Choice Collaboration Empowerment

11 Treatment Modalities Addiction and Trauma Recovery Integration Model (Atruim) Trauma Affect Regulation: Guide for Education and Therapy (Target) Trauma Recovery and Empowerment Model (TREM) EMDR CBT DBT Yoga and exercise Exposure therapy (used with caution in early recovery) Equine Assisted Learning

12 Combined with the 12 Steps Seeking Safety by Lisa Najavits, Ph.D CBT and Solution Focused Focus on Safety and Education Therapist Process Integrate Praise and Accountability Focus is not on pathology, but attention to the present and future and client strengths.

13 Clinician self care Remember consult, Consult, CONSULT with peers and supervisors It takes a village sometimes (team approach) Remember making sure we are practicing what we preach Balance Taking time for play and to have fun Rest Exercise Nutrition

14 Sharon Singleton, MS Bonnie Brae Liberty Corner, NJ

15 Bonnie Brae s Brae Builders Copyright, The Joint Commission

16 Purpose The purpose of the program is to develop social, emotional, and practical life skills to successfully transition from high school to employment, job training, or post secondary education.

17 Goals of the Program Employment Readiness Community Integration Social Skills and Activities of Daily Living Personal Advocacy Educational Enrichment

18 Four Social Competencies Learning to know Understanding consequences to actions and behaviors Learning to be Exhibiting self awareness Learning to live together Displaying trust Learning to do Being able to achieve task-oriented objectives

19 Evaluation Form Goal in School for the Week: Goal for Brae Builders for the Week:

20 MON TUE WED THU FRI On-Time (i.e. classes, breakfast, lunch, on-site, group) Properly Dressed (i.e. No pants on the Ground, No hats in class, No IPod s, Boots, Brae Builder Shirt) Cooperative (Working well with volunteers, peers and staff) Safe, Responsible Behavior (in school and on-site) Respectful (Courteous to volunteers, staff and peers) Self-Motivated (ready to work in school and onsite, seeking work, asking for help) Willing to Learn (patient, attentive in all areas) Hard-Working (quantity of work, volume, speed, amount) Team Player (communicating to peers, staff and volunteers) Participation in Group (appropriate feedback, attentive) Additional Comments

21 Evaluation Form Con t Strengths: Areas of Improvement: Payroll: Adjustments: Total: Adjustment Reasons: Teacher Comments: Student Signature: Teacher Signature:

22 Accomplishments 13 Complete Homes Built in Franklin Township and Bridgewater after 4 years The students have begun to work on a duplex (houses 14/15) in Lambertville and house 16 in Franklin Township. Total of 45 students involved in the last four years Because of the nature of residential facilities, the program filters through students throughout the year. Most of the students ages 16+ apply for a spot.

23 Accomplishments Transformed from a labor intensive program, to a social, mentoring style program When the program began, the students were given the hard-labor jobs at Habitat by the site supervisors. The boys were getting bored and frustrated. It has now transformed into more of a mentoring experience with the seasoned volunteers.

24 Awards Received Vocational Partnership Award from Raritan Valley Habitat for Humanity for our efforts in 2008 In 2010, the Brae Builder program received the Innovation in Special Education Award for New Jersey. This coveted honor is awarded by the New Jersey Board of Education Presented a workshop at the National Conference for American Association for Children s Residential Centers

25 Mike McKasson, LCSW Director, Adult Services Adult and Child Mental Health Center, Inc Indianapolis, IN (317)

26 Who is Adult and Child Center? Community Mental Health Center 501(c)3 Service area: Marion (Indianapolis) and Johnson Counties Employees: Approximately 380 F.T.E.s Population: Adults with Serious Mental Illness and Children with Serious Emotional Disturbance Services: 85 % of provided services are communitybased Large array of Behavioral Health & Child Welfare Services Passionate about Evidenced-Based Practices

27 Innovations Through Partnerships Partnership with Universities Partnership with Federally Qualified Health Center Homeless Providers Partnership with Community Hospitals

28 Focus of Presentation Partnership with University through the ACT Center Partnership with FQHC to implement PBHCI

29 Who is the ACT Center? Long history of collaboration between IUPUI and Adult & Child Clinical-academic partnership TA center established 2001, DMHA grant Diverse team (Trainers, Researchers, Clinicians, Consumers, & Family Members) RISP Numerous grant awards Passionate about evidenced-based practices and recovery (e.g., SE, IDDT, IMR) Training Center EBP Implementation Study MHTS

30 What is the RISP? NIMH grant (federal money) ~$500,000 per year over 5 years Infrastructure focus: Bridging the gap between research and practice Content focus: improving the recovery orientation of ACT and other MH services

31 What is the RISP? Interventions and Practice Research Infrastructure Program (IP-RISP) The National Institute of Mental Health (NIMH) seeks research partnerships between community-based, clinical/services settings and research institutions to enhance the national capacity to conduct research that will inform mental health services research science, service delivery, program dissemination and implementation, and mental health policy.

32 Several Aims to Achieve Aim 1: Focuses on building infrastructure at Adult & Child Research Using evidence to guide practice Creating mutual learning environment Aim 2: Conduct 3 pilot studies Measuring recovery orientation of ACT Pilot of NAMI provider education program ACT + IMR in culturally diverse population

33 FQHC Collaborations Copyright, The Joint Commission

34 Background/Partnership History Since 2001, Adult & Child has maintained partnerships with IUPUI School of Psychology through the ACT Center. Since 2004, Adult & Child has maintained partnerships with WindRose Heath Network (a FQHC) to co-locate and integrate a social worker in each of their primary care facilities. Adult Child has a 10 year history of Evidenced-Based Practices implementation; for example, IDDT, IMR ACT, DBT, IMPACT, CBT, and SE have all been integrated into clinical services.

35 Background/Partnership History The 2008 opening of Countyline Family Health Center marked the addition of a truly integrated service site targeting persons with Mental Illness and co-occurring mental illness and substance abuse disorders. Nurses are included on each Community Treatment Team (CTT) and regularly assess, and coordinate the physical needs of CTT consumers. Adult & Child is a host site for the UMass Certificate in Primary Care Integration Program and graduated 7 staff from this program. Currently training 6 staff members. July Successful billing of Evaluation & Management CPT codes at Countyline FHC office.

36 Heartfelt Health Alliance Copyright, The Joint Commission

37 SAMHSA Pledge for Wellness Grant Award

38 A person with SMI has the following Odds of dying from the following causes, compared with the general population: Cause Times more likely to die Heart Disease 3.4 Diabetes 3.4 Accidents 3.8 Respiratory ailments 5 Pneumonia, influenza 6.6

39 602 enrolled consumers at Adult & Child compared to General US Population Chart A-2 % with Axis III Diabetes Asthma COPD Heart Disease Smoke Targeted SMI Population General US Population 71.59% 19.1% 13.3% 18.9% 39.7% 60.7% 33.09% 7.8% 7.7% 10.06% 36.3% 20.8% Variance %* +11.3% +5.59% +8.84% +3.40% % US Population Statistics taken from *

40 Barriers to Primary Medical Care for persons with SMI In a 2003 study titled, Barriers to Primary Medical Care Among Patients as CMHC (Miller, Druss, Dombrowski and Rosenheck found that: 14% of consumers reported they had no usual source of medical care 14% of those consumers with a usual source of care, reported that they used the ER for their routine medical care

41 Barriers to Primary Medical Care for persons with SMI Nearly two-thirds were unable to identify their primary care provider by name 40% indicated that coordination between medical care and mental caregiver was poor 45% reported that their mental health provider did not asked them about medical issues 39% reported that their medical provider did not ask about their mental health issues

42 Project Goal and Objectives By integrating the delivery of primary and behavioral health care service in this population, this project hopes to: Implement consumer mental and physical illness self management, improve identification and control of symptoms related to mental and physical illness. Decrease morbidity of physical disease in this population, Decrease inpatient psychiatric days,

43 Project Goal and Objectives Decrease medical inpatient days, Decrease inappropriate emergency room visits, Increase the medical cost offset within this population, and Help to prevent the onset and/or progression of targeted health conditions.

44 Individual Grant Program Measures Colorado Symptom Inventory SF-12 MH and physical health diagnoses PCP information

45 Health and Wellness Activities H.O.P.E Wellness and Recovery Center implemented the first of a series of wellness groups: Heart Healthy Nutrition Smoking Cessation Diabetes Education and Nutrition Stress Management Illness Management and Recovery

46 Staffing Primary Care Physician Two Nurse Care Managers (NCM), who will provide training, education, and supervision to Nurse Care Coordinators (NCC), currently embedded on each SMI team. Peer recovery specialist to help consumers engage in services. One LPN/MA to support the clinic One Charge Nurse Seven Community Treatment Team Nurse Care Coordinators One Research Assistant Contract with IU (ACT Center) for Evaluation of Project

47 Project Components This project will implement the following components recommended by the National Council for Community Behavioral Healthcare in their April 2009 paper titled Behavioral Health/Primary Care Integration and the Person-Centered Healthcare Home Adult&Child will use regular screening or mental illness, cooccurring addictions, and primary care issues including outcome measurement to identify the needs of the population. A Supervising Primary Care Physician to provide direct support to Nurse Care Managers, and direct primary care to consumers. Providing primary care in a behavioral health setting will allow the SMI population to receive primary care services in an environment they already trust and are accustomed to in a manner tailored to their specific needs.

48 Project Components Embedded Nurse Care Managers will train, supervise and support Nurse Care Coordinators (NCC) who are embedded on each SMI team. Each NCC will be responsible for care management of each identified consumer, wellness education, coordinating primary and behavioral health care efforts, monitoring symptoms, and coaching consumers toward self-care. These contacts are primarily face to face, not telephone based. Use of behavioral health evidence based practices and primary care best practices to improve health status and motivate consumers toward self-care. Adult&Child is experienced in the provision of evidence based practices and will routinely use techniques like Motivational Interviewing, Problem solving Therapy, Illness Management and Recovery, or IMPACT, to encourage a consumer to engage or maintain self-care efforts. The project will also use primary care best practices outlined in the Health Disparity Collaborative for Asthma, Diabetes, and Cardiovascular Disease.

49 Project Components Implement individual wellness programs, in addition to peer facilitated Chronic Disease Self-Management for those diagnosed with, or at risk of developing, a chronic disease. Illness prevention programs like exercise, nutrition education, disease education, smoking cessation, and general medical education will be introduced to the entire SMI population. Peer Support Specialists will be charged with supporting the wellness education (health, nutrition, medication, and exercise) efforts of the NCC on each team and will coach each consumer toward wellness in group and individual formats.

50 Questions? 50

51 Accreditation Resources Available from The Joint Commission Behavioral Health Care Accreditation Team: Complimentary conference calls & webinars Standards Interpretation Group Introduction to mentor organizations Account Executive More information at:

52 Joint Commission Behavioral Health Care Accreditation 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. 52

53 Upcoming Events Complimentary Webinars*: - Aug 7 Behavioral Health Standards Overview - Sep 11 How to Achieve Behavioral Health Accreditation - Nov 13 The Joint Commission On-Site Survey Process * Already conducted webinars posted at:

54 Behavioral Health Care Accreditation Team Mary Cesare-Murphy, PhD Executive Director 630/ Peggy Lavin, LCSW Senior Associate Director 630/ David Wadner, PhD Field Director 630/ Merlin Wessels, LCSW Standards Interpretation Group 630/ Evelyn Choi, MS Senior Accreditation Specialist 630/ Cynthia Leslie, APRN, BC, MSN Standards Interpretation Group 630/