Making the Behavioral Health - Primary Care Marriage Work

1. Making the Behavioral Health - Primary Care Marriage Work Collaborative Family Healthcare Association 13th Annual Conference October 29, 2011 Presenter: Cheryl Holt, MA, NCP, BCCP

2. How is the Integrated Healthcare PartnershipLike a Marriage? Stages of Partnership • Partner Selection: Dating • Formalizing the Partnership: The Wedding • The New Partnership: The Honeymoon • Problems Within the Partnership: The Honeymoon is Over • Making it Work: Marital Counseling • The Mature Partnership: Growing Old Together

3. Formula for a Successful Behavioral Health – Primary Care MARRIAGE Vision Communication Compromise Outcomes VC2O

4. VISION DATING: Partner Selection • Mutual Attraction • Determining Potential • Wooing and Courting • Proposal The WEDDING: Formalizing the Partnership • Merging of Goals • Co-location • Finances

5. COMMUNICATION Early Phase: The HONEYMOON • Identify a Common Language • Sharing Decision-Making • Synergy Problems within the Partnership (AKA The HONEYMOON is OVER!) • Addressing Internal Conflicts • The Use of Candor • Temper Expectations

6. COMPROMISEMaking it Work MARITAL COUNSELING: • Developing Shared Solutions • Delegate Trust • Create Empowerment • Determine Expectations

7. OUTCOMES The MATURE PARTNERSHIP • The Whole is Greater than the Sum of its Parts • Accountability • Enhanced outcomes through blending of resources

8. Individual Health Outcome Indicators • Quarterly • Weight • Height • Body Mass Index (BMI) • Blood pressure • Annual • Blood glucose or Hemoglobin A1C • Lipid profile

9. Services Outcome Indicators • Track total number of clients: • Receiving primary care services • Screenings for • Hypertension • Obesity • Diabetes • Co-occurring substance use disorders • Tobacco product use

10. Outcomes Data for Decision-Making • Aggregate Data • Provide population health data • Quality improvement • Planning • Standard Set of Indicators • Make effective clinical decisions and • Inform the evaluation of future healthcare initiatives

11. Cultural Integration Understanding and Respect • Workflow • Funding streams • Restrictions • State and federal requirements • Pecking order • Who liaisons with whom

12. CEO CEO COO VP CMO Director Director Asst VPs Medical Center Directors MedicalManager Clinical Manager Clinical Supervisor Clinical Supervisor Behavioral Health Provider Providers Prescriber Clinician CSB FQHC CMO Clinical ClinicSupervisor

14. Dedicated to promoting the development of Integrated Primary and Behavioral Health Services to better address the needs of individuals with mental health and substance use conditions, whether seen in specialty behavioral health or primary care provider settings.

15. About the Center In partnership with Health & Human Services (HHS)/Substance Abuse and Mental Health Services Administration (SAMHSA), Health Resources and Services Administration (HRSA). Goal: To promote the planning, and development and of integration of primary and behavioral health care for those with serious mental illness and/or substance use disorders and physical health conditions, whether seen in specialty mental health or primary care safety net provider settings across the country. Purpose: To serve as a National Training and Technical Assistance Center on the bi-directional integration of primary and behavioral healthcare and related workforce development To provide technical assistance to PBHCI grantees and entities funded through HRSA to address the health care needs of individuals with mental illnesses, substance use and co-occurring disorders

16. The Center for Integrated Health Solutions is dedicated to increasing the number of: • Individuals trained in specific behavioral health related practices • Organizations using integrated health care service delivery approaches • Consumers credentialed to provide behavioral health related practices • Model curriculums developed for bidirectional primary and behavioral health integrated practice • Health providers trained in the concept of wellness and behavioral health recovery

17. Center for Integrated Health Solutions • Target Populations • SAMHSA Primary & Behavioral Health Care Integration (PBHCI) Grantees • HRSA Grantees • General Public • Services • Training and Technical Assistance • Knowledge Development • Prevention and Health Promotion/Wellness • Workforce Development • Patient Protection and Accountable Care Act Monitoring and Updates

18. Technical Assistance Menu • Individual Technical Assistance: • Phone consultations, e-mail, site visits • Group Learning Experiences: • Learning Communities • Webinars • Trainings • Practical Web-Based Resources (CIHS website, e-newsletter, discussion boards) • Tools: • Toolkits/Guidelines • Training Curricula • Fact Sheets

19. CIHS Steering Committee John Gardin, PhD, ACS ADAPT, Inc. Jorge Girotti, PhD Hispanic Center of Excellence, Dept. of Medical Education, Univ of IL Ellen Healion, MA Healing Hands Across Long Island Kenneth Jue Founder, InSHAPE Roger Kathol, MD, CPE Department of Internal Medicine and Psychiatry, University of Minnesota Paul Lingenfelter, PhD State Higher Education Executive Officers Organization Tom McLellan, PhD Treatment Research Institute Jim O'Connell, MD Boston Health Care for the Homeless Joseph Parks, MD Missouri State Department of Mental Health Janice Petersen, PhD First Vice Chair National Prevention Network Harold Pincus, MD Columbia University Fred Rachman, MD Alliance of Chicago Richard Rawson, PhD UCLA Integrated Substance Abuse Programs Stephen Somers, PhD Center for Healthcare Strategies Patricia Taylor Faces and Voices of Recovery Don Thacker Shawnee Mental Health Center, Inc • William Anthony, PhD • Center for Psychiatric Rehabilitation, • Boston University • Thomas Bornemann, Ed.D • Carter Center Mental Health Program • Richard Brown, MD, MPH • Department of Family Medicine, Univ. of WI • Tonier Cain • National Advocate and Team Leader for the • National Center for Trauma Informed Care • Carl Clark, MD • Mental Health Center of Denver • Regina Dickens, EdD, LCSW • NC Center of Excellence for Integrated Care • Michael Fitzpatrick • National Alliance on Mental Illness

20. SAMHSA/HRSA Center for • Integrated Health Solutions • The resources and information needed to successfully Integrate primary and behavioral health care For information, resources, and technical assistance, contact the CIHS team at: Online: CenterforIntegratedHealthSolutions.org Phone: 202-684-7457 Email: Integration@thenationalcouncil.org

21. CONTACT Cheryl Holt, MA, NCP, BCCP Director of Training and Technical Assistance SAMHSA – HRSA Center for Integrated Health Solutions National Council for Community Behavioral Healthcare 1701 K St. NW, Suite 400 Washington, DC 20006 678-520-7054 cherylh@thenationalcouncil.org Social Media Behavioral Health – Primary Care Integration listserve: http://lists101.his.com/mailman/listinfo/pc-bh-integration @nationalcouncil @cherylholt • Behavioral Health Integration blog: • BehavioralHealthIntegration.com • Behavioral Health Integration