Itegratig Physical & Behavioral Health: Plaig & Implemetatio March 31, 2016 A Departmet of Social Services PCMH Presetatio Hosted by Commuity Health Network of CT, Ic. 1
Learig Objectives Idetify the importace of early detectio of behavioral health coditios Defie practice support to overcome barriers to treatmet Uderstad your curret level of itegratio betwee physical ad behavioral health How to best use resources from the Coecticut Behavioral Health Partership 1
Behavioral Health & Global Cocer for Life Expectacy The Natioal Alliace o Metal Illess; Metal Illess Facts ad Numbers; Dr. Ke Duckworth; http://www2.ami.org/factsheets/metalilless_factsheet.pdf Millima Report Summary: Ecoomic Impact of Itegrated Medical-Behavioral Healthcare; April, 2014; America Psychiatry Associatio; www.psychiatry.org Natioal Istitute of Metal Health; www.imh.ih.gov/about/director/2015/mortality-ad-metal-disorders.shtml 2
Leadig Causes of Death, Uited States 7 out of 10 deaths per year are caused by chroic disease CDC: Natioal Ceter for Chroic Disease Prevetio ad Health Promotio: Divisio of Populatio Health: Metal Health ad Chroic Diseases: XU, et al., Natioal Vital Statistics Reports. Vol. 58, No. 19, May 20, 2010. 3
Triple Aim [Pursuig the Triple Aim: The First 7 Years]. Cambridge, Massachusetts: Istitute for Healthcare Improvemet; [2015]. (Available o www.ihi.org) [System-Mided Desig: Optimizig the Microsystem for Workforce Developmet]. Cambridge, Massachusetts: Istitute for Healthcare Improvemet; [2015]. (Available o www.ihi.org) 4
Real World Itegratio Steps i the Itegratio Process Itegratio Reach Establish Care Pathways Approach to Patiet Trasitios Locatio of Itegratio Workforce Shared Itegratio Model Defiitio Idetify Patiet Needs & Access Level of Care Provided Warm had-off or outside referral Physical Locatio for the Itegratio Care Team Care Team Use of the Same Model of Itegratio Uderstadig Care Itegratio from the Groud Up: Five Orgaizig Costructs that Shape Itegrated Practices; Cohe, et al., doi: 10.3122/jabfm.2015.S1.15005 5
Cosult, Coordiate, Collaborate Itegratig Behavioral Health ad Primary Care: Cosultig, Coordiatig ad Collaboratig Amog Professioals; Cohe, et al., doi: 10.3122/jabfm. 2015.S1.150042 6
IMPACT Program Trial Results Improvig Mood Promotig Access to Collaborative Treatmet for Late-Life Depressio Copyright Uiversity of Washigto. AIMS ceter (aims.uw.edu). 7
Evidece-based Team Care for Depressio Copyright Uiversity of Washigto. AIMS ceter (aims.uw.edu). 8
Itegratio Barriers at the Practice Level 9
Health Isurace Portability ad Accoutability Act (HIPAA) HIPAA Privacy Rule Assures protectio of a idividual s health iformatio Facilitates sharig of health iformatio eeded to provide ad promotes the highest quality of care Protects the public s health ad well-beig Is flexible ad comprehesive i coverig the disclosures that eed to be addressed Exceptio Stricter state laws or rules for substace abuse treatmet facilities (42 CFR Part 2) 10
US Departmet of Health & Huma Services (HHS) Proposal 2/9/16 New rule to moderize 42 CFR Part 2 to facilitate the exchage of substace use disorder iformatio while esurig a idividual s cofidetiality Public commet o proposed chages curretly beig received by HHS 11
Where ad How to Begi Behavioral Health Itegratio 12
Gap Aalysis SAMHSA-HRSA Ceter for Itegrated Health Solutios: Behavioral Health Itegratio ad the Patiet-Cetered Medical Home 13
GROW Pathway to Itegratio Tool Safety Net Medical Home Iitiative. Ratzliff A. Orgaized, Evidece-Based Care Supplemet: Behavioral Health Itegratio. Phillips KE, Holt BS, eds. Seattle, WA: Qualis Health, MacColl Ceter for Health Care Iovatio at the Group Health Research Istitute, ad the Uiversity of Washigto s AIMS Ceter; 2014. 14
Depressio Screeig Workflow Safety Net Medical Home Iitiative. Ratzliff A. Orgaized, Evidece-Based Care Supplemet: Behavioral Health Itegratio. Phillips KE, Holt BS, eds. Seattle, WA: Qualis Health, MacColl Ceter for Health Care Iovatio at the Group Health Research Istitute, ad the Uiversity of Washigto s AIMS Ceter; 2014. 15
Ogoig Quality Improvemet (QI) Process Evaluate behavioral health measures based o data/reports Choose ad defie QI project Assess workflows for potetial improvemets Choose realistic, attaiable ad measurable goal Establish timelie for implemetatio ad achievemet of goal Complete QI project to implemet improvemet Assess for goal achievemet Sustai improvemet The QI process is cotiuous ad cyclical, ever stagat Ehacig Outcomes with QI Webiar 16
BH Itegratio Key Success Factors Allocate appropriate time to pla Trasform practice culture Trai staff to implemet ad sustai itegratio Assess ad maage capacity realistically Idetify iteral champios ad exteral stakeholders Utilize available ad free resources 17
CT Behavioral Health Partership (CT BHP) Provider Resources 18
CT BHP Call Ceter Iformatio Phoe Toll Free: 1.877.55.CTBHP or 1.877.552.8247 TTY: 1.866.218.0525 Provider selects 1 for Eglish, 2 for Spaish ad the 3 for the Provider Meu Office Hours Mo Fri 9:00 a.m. to 7:00 p.m. Bi-ligual staff are available durig office hours Traslatio services available through our laguage lie for all laguages Mailig Address 500 Eterprise Dr. Suite 4D, Rocky Hill, CT 06067 www.ctbhp.com 19
CT BHP Network Idividual & Group Practitioers Facilities Alcohol & Drug Couselors Adult Group Homes Board Certified Behavioral Aalysts (Autism Services) Cliical Social Workers Marriage & Family Therapists Professioal Couselors Psychiatrists Psychologists Alcohol & Drug Ceters DCF Residetial Services Ehaced Care Cliics Federally Qualified Health Ceters Hospitals Medical Cliics/School Based Health Ceters Metal Health Cliics Methadoe Maiteace Cliics Rehabilitatio Cliics 20
Covered Services Autism Spectrum Disorder Services Case Maagemet for <19 years of age (after iitial 3 hours) Home-based Services for 21 years of age Itesive I-home Childre & Adolescet Psychiatric Services Multidimesioal Family Therapy Multi-systemic Therapy Fuctioal Family Therapy Home Health Services Outpatiet Services Psychological Testig A descriptio of these services ca be foud i the Provider Maual or Level of Care Guidelies o the CT BHP Website www.ctbhp.com Click For Providers, the Providers Meu 21
Additioal Covered Services Electrocovulsive Therapy Exteded Day Treatmet Itesive Outpatiet Services Adult Group Homes through Departmet of Metal Health & Addictio Services Child Group Homes through Departmet of Childre & Families (DCF) Methadoe Maiteace Partial Hospitalizatio Psychiatric Hospitalizatio Detoxificatio Ipatiet, Residetial & Ambulatory Psychiatric Residetial Treatmet Facility Residetial Treatmet Ceter for Childre through DCF 22
Provider Referrals OR Provider/Member calls CT BHP for referrals 1.877.552.8247 Provider/Member accesses our Olie Provider Directory (ReferralCoect) Provider/Member receives list of BH provider referrals Provider/Member ca cotact BH provider for appoitmet 23 23
www.ctbhp.com 24
www.ctbhp.com For Providers Go to www.ctbhp.com Click o For Providers Click o Providers Meu to access Navigatio Meu 25
CT BHP Website www.ctbhp.com Full service, user-friedly website Covered Services Level of Care Guidelies Fid a Provider ReferralCoect List of Ehaced Care Cliics Achieve Solutios Recovery Iformatio 26
Achieve Solutios 27
Achieve Solutios CT BHP Homepage 28
Achieve Solutios 29
Achieve Solutios Olie library of iformatio about behavioral health care, life evets ad welless resources 6,000+ articles ad tip sheets o over 200 health topics: Behavioral ad physical health ad welless Family care Depressio, axiety, substace abuse Work/life balace Resources How ca Achieve Solutios help? 1. Providers ca prit out articles ad iformatio for members 2. Providers ca direct members to website for iformatio o health ad welless 30
ReferralCoect 31
Olie Provider Directory ReferralCoect How ca ReferralCoect help? 1. Providers ca locate behavioral health providers closest to their practice ad outreach to discuss a collaboratio or referral process 2. Providers ca direct members to search for behavioral health providers closest to their work or home 32
ReferralCoect Click o Fid a Provider Eter Userame & Password ctbhpm for both Click Go 33
ReferralCoect 34
Itegratio Care Best Practices Primary Care Providers outreach to behavioral health providers withi their area Determie the level of collaboratio ad the iformatio shared through Collaborative Care Referral Form or Memoradum of Uderstadig Obtai a siged Release of Iformatio from members for medical/behavioral health iformatio to be shared betwee providers 35
Itegrated Care 36
Itegrated Care Tools Go to: www.valueoptios.com/compay/ Itegrated.htm Click IPAT Assessmet Tool or; Itegratio Tool Kit 37
Itegratio Tool Kit Click Quick Liks or Topics to get started! 38
Itegrated Care Comprehesive Itegrated Tool Kit has a umber of resources for providers ad practices iterested i itegratig care: IPAT Assessmet Tool Coduct Assessmet of your practice to determie level of itegratio Models of Itegrated Care Screeig Tools Articles FAQ s Itegratio White Paper 39
Questios? 40
Thak you for your time! By email: pathwaytopcmh@chct.org By phoe: 203.949.4194 Olie: www.huskyhealthct.org/providers/pcmh.html All PCMH webiars located o the HUSKY Health website page Pathway to PCMH Webiar Recordigs ad Presetatio Materials 41