Transcript IBHP Learning Community

IBHP Learning Community
Learning Community Conference Call Agenda
Monday, October 27, 2008
12:00 to 1:30 p.m.
Agenda Item (time)
Welcome and Review
of Agenda (5 minutes)
Update from IBHP
Team Members
(20 minutes)
Roll call and approval of agenda items: Mary Rainwater
Data Developments: Gary Bess Associates
CiMH Policy Project: Mandy Johnson
Training Updates: Barb Lurie
Mentoring Component Update; Schedule of LC meetings 2008/2009: Mary Rainwater
Update from
Grantees
(20 minutes)
MHSA Planning Process Activities at the Local Level: all
New or Informative Developments within IBHP projects: all
Learning Topic/
Presentation
(40 minutes)
Enhancing collaboration between primary care and behavioral health providers: all
Next LC Call and
Suggested Topics
(5 minutes)
Tuesday, November 25
Noon to 1:30 p.m.
Discussion Topic: Clinical Approaches in Primary Care Settings
IBHP Learning Community
Conference Calls
 November 25, 2008
Clinical Approaches in
Primary Care Settings
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January 27, 2009
February 23, 2009
April 28, 2009
May 26, 2009
June 22, 2009
Calls will be from noon to 1:30 p.m.
Convenings
 December 11, 2008
Los Angeles
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March 26-27, 2009
August 2009 (tba)
Mentoring Interests
1. Expanding Primary Care / Behavioral Health
collaboration
2. Skill-building for PCPs and BH professionals
3. Developing PEI models
4. Enhancing Care Management
5. Expanding access to BH services
6. Advancing cross-system collaboration
7. Reducing stigma
Mentoring Interests
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Most clinics are interested in having an on-site
site visit from a mentor agency
(64% yes, and 24% maybe)
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Clinics are primarily interested in conducting
informal consultation and discussion between
visiting mentors and professional staff
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Almost all clinics (91%) are interested in going
on a site visit to a mentor agency
MHSA Activity Reports
 Attend SAAC meetings regularly and will be attending the Community Forum for
my SPA on December 10. I have also applied to be on the Steering Committee
for SPA 4, which will be meeting extensively in January and February to go
through PEI data and make funding recommendations. Steering Committee will
be picked at November SAAC meeting. (Eisner Pediatric & Family Medical Center)
 Attend three monthly Mental Health Council meetings (Children and Youth, Adult
and Older Adult) which review a variety of issues affecting the system and give
feedback to the County Mental Health Director. Lately the primary focus has
been reviewing and providing input on the County’s PEI plans which currently
contain little in the way of opportunities for our primary clinics. (Council of
Community Clinics, San Diego)
 We had 2 meetings with County Behavioral Health Dept. and other service
providers for specialty mental health services to introduce ourselves and talk
about how we might better serve the community together. This week I received
a copy of the County’s plan and activities over the past year. Most of the
activities appear to be an expansion of traditional specialty behavioral health
activities. We are not involved at this point. (Avenal Community Health Center)
MHSA Activity Reports
 We attend PEI Planning Meetings with a specific focus on promoting use of
funds to integrate behavioral health and primary care at primary care sites.
(LifeLong Medical Care)
 We subcontract with two of the Full Service Partnerships to provide primary
care providers as part of their Assertive Community Treatment teams (and
we provide psychiatry care for one of the teams). (LifeLong Medical Care)
 Served on the County’s PEI Planning Committee. Report has been issued,
and plan has been filed with the State for approval. PC integration
discussed but did not win overall support. Plan has large suicide focus,
initial part will be a survey to assess the suicide issue, our largest mortality
indicator. SFCCC is beginning to track new MHSA County funds. Working
with CPCA on State funds. (San Francisco Community Clinic Consortium)
IBHP Activity Reports
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We have developed a very interesting structure for an Integrated Behavioral
Healthcare Conference on November 19, which starts at 4pm and includes
dinner. Four presenters will each present for about 45 minutes, giving a
brief overview of their skills and knowledge. Attending clinics will choose
one to provide a ½ day of technical assistance at their site. (Council of
Community Clinics, San Diego)
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County Mental Health staff have visited five clinic sites, and they appeared
pleasantly surprised by the knowledge and interest the clinics possess
regarding Integration. (Council of Community Clinics, San Diego) At each site the
County initiated discussion about transferring stable County clients to the
clinics for treatment. While interest varied widely, the discussion was useful
in:
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outlining existing barriers to such a model, and
identifying target subpopulations with unique objectives for which our
organizations would coordinate treatment
 stable County clients will transfer to the clinics per an agreed upon protocol,
 clients who continue receiving treatment from County will be connected to
one of the clinics as a medical home, and
 Clinic patients with severe and persistent symptoms will transfer to County
Mental Health System.
IBHP Activity Reports
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We had a breakthrough meeting between our PCP who had been very much
against integration, part-time psychologist (also serves as Behavioral Health
Director), CEO, BHC, and substance abuse counselor who works as part of
our primary care team. The physician was able to describe how he sees
integration working, at least initially, and wants to have monthly meetings
with the whole team to discuss treatment. The PCP was invited to observe
me doing a consult, and CEO agreed that some patient time would be
blocked for this. Outcome: The next day this PCP came to my office to
discuss a patient, then took me to the exam room and introduced me to the
patient. He stayed in the exam room briefly to observe how I start a consult.
(Avenal Community Health Center)
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We are opening our clinic on Sunday 10/26 specifically to serve farm
workers who can’t make it any other day. We will schedule approx. 40
patients, and all will be seen by the medical provider, the dentist, and our
Integrated Behavioral Health team. We are using this day to test how seeing
every pt. as part of their first visit might work. (Avenal Community Health Center)
IBHP Activity Reports
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Created social worker of the day system at one clinic to create real time
access for patients/providers in the primary care clinic (LifeLong Medical Care)
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Established mental health representation on i2i work group (LifeLong Medical
Care)
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Reconfiguring case conferencing at primary care clinic to create better
efficiency and ability to cover more cases (LifeLong Medical Care)
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We are hoping to have an in-house visit with our mentor to generate
enthusiasm with senior staff and providers. (Eisner Pediatric & Family Medical
Center)
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On-site assessment of current Integration efforts is being conducted by VP
of Development, former CEO of Mental Health Center, to develop training
and policies. Developing RFP for trainers on Medi-Cal Billing. Determined
Short Doyle work will be completed in conjunction with County Health
Department. Working with County to develop RFP to conduct clinic
readiness assessment for Short Doyle contracting. Medicare FQHC
postponed till early 2009. (San Francisco Community Clinic Consortium)
Collaborating with Primary Care Providers
Suggested Topic Areas:
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Marketing behavioral health services to PCP's
Providing feedback to PCP's
Engaging PCP's who may be reluctant to utilize
behavioral health services
Working with PCP's to formulate and implement
patient treatment plans
Keeping PCP's knowledgeable about behavioral
health issues