Behavioral Health Provider Training Project
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1 Behavioral Health Provider Training Project Dr. Lynne McRae, PsyD Associate Director of Behavioral Health Services Nikki Allen, LCSW, LAC Behavioral Health Provider/Trainer
2 Duties of BHP I Duties of BHP II Psychosocial/Clinical Medicaid-Compliant Assessment Diagnose mental health disorders Diagnose substance use disorders Brief (30-45 min) Psychosocial/Clinical Assessment Diagnose mental health disorders Diagnose substance use disorders Show basic knowledge of key chronic diseases, medicines and behavioral aspects of specific disease management Form treatment and dispositional plans and make recommendations Form treatment and dispositional plans and make recommendations Show understanding of relationship of medical and psychological systems Perform brief targeted behavioral health interventions Perform individual psychotherapy Perform individual psychotherapy Perform medically focused behavioral health group therapy Perform group therapy Perform family therapy Perform and bill for substance use treatment/counseling as part of an OBH licensed team Perform group therapy Perform family therapy Perform and bill for substance use treatment/counseling as part of an OBH licensed team
3 5-Module BHP Training Effective BHP Workflow Behavioral Health Interventions for Medical Diseases Brief Intervention Strategies Introduction to Integrated Care and Primary Care Mental Health and Substance Use in Primary Care Benefits to Providers: 1. Well-trained BHP staff to act as consultants in patient care 2. Immediate access to BHPs in medical practice setting 3. Interdisciplinary team approach to care 4. Improved crossdisciplinary knowledge Benefits to Patients: 1. Increased ability to self-manage diseases 2. Same-day access to behavioral care with less stigma 3. Opportunity to explore behavioral aspects of disease management
4 Best Practices and Clinical Transformation Collaborative 7/30/14 Robert Keeley, MD
5 Enhancing Integrated Primary Care with Alcohol/ Substance Abuse Treatment & Care Coordination Lowry Family Health Center, 1010 Yosemite, Denver CO 1 of 8 community health clinics in the Denver Health Safety Network system Robert Keeley, MD Family Practice Samantha Monson, Ph.D. Psychology David Brody, MD, - Internal Medicine Jessica Cram, CAC II Addiction Counseling
6 Essential Elements of Intervention On-site Certified Addiction Counselor, level II 3 Functions Systematic screening and treatment for adult patients with substance and alcohol abuse Baseline intervention and ongoing telephone support for patients improving health behaviors Improptu intervention as needed when contacted by primary care clinicians at clinic
7 Perceived Benefits to Patients and Providers Patient Benefit 20%-30% of adults in Medicaid populations may have substance and / or alcohol abuse CAC adds capability to identify and treat/ refer System Benefit as many as 1 in 5 Medicaid hospital days are due to substance abuse Potential to decrease hospital utilization Potential to improve outcomes for other conditions, e.g. Diabetes, Heart Disease
8 Jay S. Rabinowitz, M.D., F.A.A.P. Brian B. Stanga, M.D., F.A.A.P. Wanda J. Venters, M.D., F.A.A.P. E. Jann Quaife, M.D., F.A.A.P. Amy Gensler, M.D., F.A.A.P. Lauren Finney, M.D., F.A.A.P. Susie DeVere, Office Administrator Richard Hayes, PA-C Michelle Whitner, PA-C Lauren Millet, PA-C Lindsey Einhorn, Ph.D. Jocelyn Petrella, Ph.D. Crystal Joy, Psy.D. Tracy Stam, R.D., C.L.E Parkglenn Way Suite 100 Parker, Colorado Fax Jay Rabinowitz, M.D., F.A.A.P. Lindsey Einhorn, Ph.D.
9 Grant Project 1. Expand behavioral healthcare services to patients having Medicaid coverage. 2. Train psychologists to screen and use brief treatments for substance use/abuse. 3. Explore the feasibility, efficiency of expanding our Electronic Health Record. 4. Continue with existing program evaluation projects and measure outcomes of the proposed project.
10 Benefits to Providers and Patients Patients who utilized our mental health services gave ratings of 4.5 (out of 5) on convenience and 4.1 or 4.2 on all other categories (i.e. satisfaction with services and with appointment times, importance of integrated care). 62% of patients are aware of our mental health services. Of those who had not seen a psychologist in our office, 90% said they would be interested in using us if needed. Our medical providers and psychologists work together. Continuity of care enhances services to families. Daily face-to-face communication and consultation occurs, daily chart review occurs, and in-house bi-directional referrals take place. Our medical providers are very pleased with our mental health services.
11 + Rocky Mountain Health Center Pediatrics: CO Access Grant Update Rachel Herbst Dana Mullen Ruth Rivera Elizabeth Sweeney Presented for RCCO Behavioral Health Integration: How to Best Practices Meeting July 30 th, 2014
12 + Our Project
13 + Benefits to Patients Increased attachment to the medical home Collaborative problem solving Enhanced ability of ALL staff and providers to focus on psychosocial needs Ability to triage, treat and effectively refer for behavioral/mental health needs
14 MEETING THE NEEDS OF E.D. SUPER-UTILIZERS: A TARGETED BEHAVIORAL HEALTH APPROACH IN TEAM-BASED CARE Courtney L. Whitt, PhD Candidate Joseph Longo, PhD [email protected] [email protected]
15 Program Overview [CM] Identify Super-Utilizers [BH] Initial Screen & ER Intervention [BH] Initial Screen & ER Intervention [BH] Assessment & BH Intervention Assessment entails: PHQ 9, GAD 7, PCL C, AUDIT, DAST, &/or BPI & COMM [BH] F/U Assessment F/U Screen If POS T1 &/OR T2, administer the following as appropriate: PHQ 9 GAD 7 PCL C AUDIT DAST BPI COMM Screening for: DEP, GAD, PTSD, ETOH, DRUG, PAIN & Opiate Misuse Risk
![&/or BPI & COMM [BH] F/U Assessment F/U Screen If POS T1 &/OR T2, administer the following as](/docs-images/43/8945912/images/page_15.jpg "appropriate: PHQ 9 GAD 7 PCL C AUDIT DAST BPI COMM Screening for: DEP, GAD, PTSD, ETOH, DRUG, PAIN &")
16 Initial Impressions & Implications Patient Provider Organization/System Increase connectedness to PCMH > Understanding of mind-body connection > Understanding of tx/skills necessary for managing physical & mental health Identification of BH correlates More effectively meet BH needs Challenges Further and more meaningfully integrate integrated care Shared responsibility for managing difficult patients Increasing susceptibility of patient responding to tx Recognition of & problem-solving around other barriers to care/factors that lead to ED utilization (i.e. co-pay, hours, transportation, etc.) Who to target? Most costly/over-utilizer vs. At Risk/> receptivity to intervention Identification of BH correlates & recommendations for managing BH concerns Empirically-based program development & evaluation Empirically-derived recommendations Achievement of RCCO, organization-specific, and other KPIs/$ Potential Solutions Institute interdisciplinary tx planning meetings around high ED utilizing patients? Find additional funding sources, organizational resources, or partnerships in the community? Identify risk predictors from initial data and target those at-risk for early intervention in the future?
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