Promoting Integration of Primary & Behavioral Health Care ... · 10/26/2017 · • Identify...
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Promoting Integration of Primary & Behavioral Health Care (PIPBHC) Meet & Greet October 26, 2017
Transcript of Promoting Integration of Primary & Behavioral Health Care ... · 10/26/2017 · • Identify...
Promoting Integration of
Primary & Behavioral
Health Care (PIPBHC)
Meet & Greet
October 26, 2017
Disclaimer
The views, opinions, and content expressed in this
presentation do not necessarily reflect the views, opinions, or
policies of the Center for Mental Health Services (CMHS), the
Substance Abuse and Mental Health Services Administration
(SAMHSA), the Health Resources and Services Administration
(HRSA), or the U.S. Department of Health and Human
Services (HHS).
Linda Ligenza,
TTA Liaison,
Vermont
Aaron Williams
TTA Liaison,
New York
Kathy Dettling
TTA Liaison,
Kentucky
Aaron Surma
Manager, Quality
Improvement
Brie Reimann
Director
Larry Fricks
Deputy DirectorAndrew Philip
Deputy Director
Emma Green
Project Manager
Meet CIHS
Meet CIHS
Jeff Capobianco
Senior Integrated
Health Consultant
Kristin Potterbusch
Director, HIV &
Behavioral Health
Madhana Pandian
Coordinator
Mindy Klowden
Director, Training &
Technical Assistance
Roara Michael
Coordinator
Tony Salerno
Senior Integrated
Health Consultant
Nick Szubiak
Director, Clinical
Excellence in Addictions
Hannah Huntt
Manager,
Communications
UT
(1)
AZ
(2)NM
(1)
WY
MT ND
SD
NE
KS
OK
(1)
TX
(2)
LA
(1)
AR
MO
(3)
IA
(1)
MN
(2)WI
(2)MI
(13)
IL
(5)
IN
(3)
KY
(1)
WV
(2)
OH
(6)
MD
OR
(1)
CA
(8)
AK
(1)
HI
(1)
NV
ID
WA
CO
(1)
NJ (4)
DE
MA (6)
NH (2)
CT (1)
VT
PA (6)
NY (14) RI
ME
(1)
ALMS
TN (2)
SC
1
NC (3)
VA
(3)
FL
(11)
GA
DC (1)
Region 82 Grantees
Region 531 Grantees
Region 418 Grantees
Active SAMHSA PBHCI Grantees by HHS Regions*
Region 102 Grantees
Region 911 Grantees
Region 218 Grantees
Region 110 Grantees
Region 74 Grantees
Region 312 Grantees
Region 65 Grantees
* Grantees that are currently active,
Cohort VII-IX. There are 113 active
grantees.
State Introductions
Your elevator speech on PIPBHC
• Key players involved in grant
• Overall focus for PIPBHC work
• Goals/activities to highlight
Purpose of Grant Program
1. Promote full integration and collaboration in clinical
practice between primary and behavioral healthcare;
2. Support the improvement of integrated care models for
primary care and behavioral health care to improve the
overall wellness and physical health status of adults
with a serious mental illness (SMI) or children with a
serious emotional disturbance (SED); and
3. Promote and offer integrated care services related to
screening, diagnosis, prevention, and treatment of
mental and substance use disorders, and co-occurring
physical health conditions and chronic diseases.
PIPBHC- Role of the States
• Select and monitor partners (sub-grantees)
• Identify consumers most in need of integrated services
• Summarize policies that are barriers to integration and action steps
• Identify informal partnerships (e.g., community behavioral health
centers, health centers, school-based health centers, substance use
treatment facilities)
• Develop a report for Secretary of HHS on performance measures
necessary to evaluate patient outcomes and facilitate evaluations
across participating projects
• Submit sustainability report – 2nd and 4th years of grant
• Establish advisory council (that may already exist at the State level)
among mental health, substance use, primary care, and children’s
services)
Defining “Integration”
• “The care that results from a practice team of primary
care and behavioral health clinicians, working together
with patients and families, using a systematic and cost-
effective approach to provide patient-centered care for
a defined population.” (AHRQ, 2013).
• Integrated care models occur along a continuum from
coordination to co-location to fully integrated care.
Clinics may be integrating through direct hire,
partnership models, virtual integration, or mergers and
acquisitions.
• In pediatric practices, integration focuses on
prevention, developmental screening, and early
intervention.
Heath B, Wise Romero P, and Reynolds K. A Review and Proposed Standard Framework for Levels of Integrated Healthcare. Washington, D.C.SAMHSA-HRSA Center for Integrated Health Solutions. March 2013
The Quadruple Aim
Improved Health Outcomes
Improved Experience of Care
Reduced Per Capita CostImproved Provider
Satisfaction
Integrated Care
What is Our State’s Vision for the Future of Integrated Care?
What state initiatives support integration?
CIHS Areas of Expertise
• Data collection and monitoring
• Quality improvement
• Partnerships
• Clinical EBPs
• Cultural competency
• Prevention and promotion
• SBIRT
• Tobacco cessation
• MAT
• Trauma-informed care
• Wellness
• Health Information Technology
• Population health management
• Policy analysis
• Strategic Planning
• Finance, sustainability and value-based payment
What Technical Assistance Will CIHS Offer?
Individualized TA to
sub-grantees (in
partnership with the state)
• Successfully deliver
integrated, team-based care
and implement all required
components of the grant
Individualized TA
with states
• Assess facilitating factors
and regulatory barriers
• Establish necessary
systems and protocols to
successfully implement all
required components of the
grant
• Establish required quality
improvement plans
• Develop sustainability plans
Key Areas of Technical Assistance Defined in
the Enabling Legislation
(PHS Act Section 520k, as amended, Dec 2016.)
• Development and selection of integrated care models
• Dissemination of evidence-based interventions in
integrated care
• Establishment of organizational practices to support
operational and administrative success
• Other activities, as the Secretary determines
appropriate
How will CIHS
Technical Assistance be Delivered?
• Quarterly coaching calls
• Site visits
• Learning communities
• Grantee roundtables
• Problem-solving via phone and email
• Resources and materials
• National meetings
Common Challenges
• Data collection and clinical quality
improvement processes
• Client engagement
• Cultural differences between behavioral health
and primary care
• Workforce: training, readiness and pipeline
• Health Information Technology and Exchange
• Payment methodologies that do not sufficiently
support integrated, team-based care
Discussion Question
What areas of TTA are you most in need of at
this time?
Sample Resources for States
State Level Integration Approaches/Lessons Learned:2011 CMS Guidance for Stateshttp://www.healthtransformation.ohio.gov/LinkClick.aspx?fileticket=0zJCWaw_O3Q%3D&tabid=1222013 University of Colorado State of Evidence for Integration 2013http://farleyhealthpolicycenter.org/wp-content/uploads/2014/08/Kwan-Nease-2013-Evidence-for-integration.pdf2014 Common Wealth Fund Guidance for Stateshttp://www.commonwealthfund.org/~/media/files/publications/fund-report/2014/aug/1767_bachrach_state_strategies_integrating_phys_behavioral_hlt_827.pdf2014 State Approaches to Integrating Physical and Behavioral Health Services for Medicare-Medicaid Beneficiaries: Early Insightshttps://www.chcs.org/media/State_Approaches_to_Integrating_Physical_and_Behavioral_Health.pdf2017 Integrating Behavioral and Physical Health for Medicare-Medicaid Enrollees: Lessons for States Working With Managed Care Delivery Systemshttp://www.integratedcareresourcecenter.com/PDFs/ICRC_Intgrt_Bhvrl_Hlth_Dual_Benis.pdfMinnesota Accountable Health Model: Continuum of Accountability Matrix (see:http://www.dhs.state.mn.us/main/groups/sim/documents/pub/dhs16_181668.pdf)
Contact Us
Kentucky
• Roxanne Castaneda, Primary SAMHSA GPO
• Kate Schlatter, Alternate SAMHSA GPO
• Kathy Dettling, CIHS Liaison
New York
• Tenly Biggs, Primary SAMHSA GPO
• Mariam Chase, Alternate SAMHSA GPO
• Aaron Williams, CIHS Liaison
Vermont
• Joy Mobley, Primary SAMHSA GPO
• Fola Kayode, Alternate SAMHSA GPO
• Linda Ligenza, CIHS Liaison
