Behavioral Health Providers in Primary Care: Competencies, Onboarding, and Team Culture for Successful Integration Emma C. Gilchrist, MPH Benjamin F. Miller, PsyD Eugene S. Farley, Jr. Health Policy Center Department of Family Medicine University of Colorado School of Medicine

Objectives Describe eight core competencies for behavioral health providers working in primary care Identify strategies for onboarding behavioral health providers Discuss professional practices for other care team members in integrated primary care practices 2

What do you think needs to be in place for successful integration? 3

What are the core competencies for the behavioral health provider and other members of the primary care team? 4

Core Competencies for Behavioral Health Providers Working In Primary Care 5

Written to apply broadly: Across a continuum from prevention to illness Across the lifespan Across the generations Across a biopsychosocial continuum Person-centered and culturally sensitive 7

Core Competencies for Behavioral Health Providers Working In Primary Care 1.Identify and assess behavioral health needs as part of a primary care team 2.Engage and activate patients in their care 3.Work as a primary care team member to create and implement care plans that address behavioral health factors 4.Help observe and improve care team function and relationships 8

Core Competencies for Behavioral Health Providers Working In Primary Care 5.Communicate effectively with other providers, staff, and patients 6.Provide efficient and effective care delivery that meets the needs of the population of the primary care setting 7.Provide culturally responsive, whole-person and family-oriented care 8.Understand, value, and adapt to the diverse professional cultures of an integrated care team 9

Hiring and Onboarding 10

Hiring Clear description of culture and vision Multi-level participation in hiring process 11

Onboarding How organizations socialize employees to the practice’s culture, models of care, and workflow Helps new providers and staff obtain the knowledge, skills, and behaviors needed to effectively deliver care Hall J, Cohen DJ, Davis M, Gunn R, Blount A, Pollack DA, Miller WL, Smith C, Valentine N, Miller BF. Preparing the workforce for behavioral health and primary care integration. The Journal of the American Board of Family Medicine Sep 1;28(Supplement 1):S

Onboarding Interprofessional shadowing EHR training Supervision Strategic scheduling Clinical skills refinement Clinic resource familiarization 13

Ongoing training Mentoring Supervision Training Opportunities 14

Care Team Professional Practices 15

Care Team Professional Practices Consulting – seeking advice or input from another clinician with different professional expertise Coordinating – two or more clinicians working in parallel to care for the same patient Collaboration – two or more clinicians working together to care for the same patient Cohen DJ, Davis M, Balasubramanian BA, Gunn R, Hall J, Peek CJ, Green LA, Stange KC, Pallares C, Levy S, Pollack D. Integrating behavioral health and primary care: consulting, coordinating and collaborating among professionals. The Journal of the American Board of Family Medicine Sep 1;28(Supplement 1):S

Care Team Professional Practices Strong teams Roles for clinical and non-clinical members of the care team – Patient assessments/screeners Scheduling Communication 17

Care Team Professional Practices Shared mission and vision Shared electronic health record Shared physical space 18

Resources 19

Thank you! Farleyhealthpolicycenter.org 20