Transcript Primary Care and Behavioral Health Integration

SAMHSA Standard Title Slide
Primary Care and Behavioral
Health Integration
John O’Brien
Senior Advisor on Healthcare Financing
General Characteristics—People
Individuals in the Public Behavioral Health System
(8 million)
• 61% of the individuals served by SAAs have no
insurance
• 39% of the individuals served by MHAs have no
insurance
• Expect that 90-95% of these individuals will have
OPPORTUNITY to be covered
• Many of these individuals do not have a primary care
practitioner on any regular basis
General Characteristics—Providers
• Almost 1/3 of the SA providers and 20% of MH
providers do not have experience with 3rd party
billing.
• Less than 10% of all BH providers have a EHR that is
nationally certified
• Few have working agreements with health centers
• Staff don’t always have credentials required through
practice acts or MCOs
• Working with National Provider Associations to
address these issues
Strong Evidence That Treatment Works
• Consumer and Family
Education
• Pharmacotherapy—
especially for SUD
• Peer Support Services
(SUD/MH)
• Skill Building
• Assertive Community
Treatment
• Continuing Care for SUD
• Supported Housing and
Employment
• Recovery Housing for
SUD
• Intensive Outpatient
Services
What Is SAMHSA Concerned About?
• People Are Dying Younger
• Younger People in our systems are not exempt
from (or at risk of) chronic conditions
• Significant connection between heart
conditions and drug use--Hospitalizations
• About 1/3 of all cigarette smokers have an
MH/SUD
• 30% of all individuals with a MH/SUD may
have 3 chronic conditions
SAMHSA Approach to Primary Care and
Behavioral Health Integration
• Integration needs to be bi-directional:
– MH/SUD in primary care
– Primary care in MH/SUD settings
• Providers need supports to be effective
• Cant do this alone—CMS/HRSA are important
partners
• States and providers are critical partners in
making a difference
Primary Care and Behavioral Health
Integration
• Program purpose:
– To improve the physical health status of people with
SMI and those with co-occurring substance use
disorders by supporting communities to coordinate
and integrate primary care services into publicly
funded community-based behavioral health settings
• Expected outcome:
– Grantees will enter into partnerships to develop or
expand their offering of primary healthcare services,
resulting in improved health status
SAMHSA’s Primary Care And Behavioral Health
Integration Program
• Population of focus:
– Those with SMI and co-occurring substance
use disorders served in the public
behavioral health system
• Eligible applicants:
– Community behavioral health agencies, in
partnership with primary care providers
– Currently 53 participating providers
Services Delivery
• Facilitate screening and referral for primary care prevention and
treatment needs
• Provide and/or ensure that primary care services and referral be
provided in a community-based behavioral health agency
• Develop a registry/tracking system for all primary care needs and
outcomes
• Build processes for referral and follow-up for needed treatments
with primary care providers
• Offer prevention and wellness support services (>10% of grant
funding)
SAMHSA/HRSA Center for Integrated Health
Solutions (CIHS)
• Technical Assistance Jointly Funded by HRSA and SAMHSA:
– 4.5 million/year work (co-funded with HRSA) a training and
technical assistance center—Center for Integrated Health
Solutions
• Assist with practice development
• Provide assistance to SAMHSA re: consultation to States
http://www.centerforintegratedhealthsolutions.org