The Greater Baton Rouge Area’s Behavioral Health Collaborative, 2004-Present A greater understanding of system weaknesses and development thru multi-sector participation Collect and share system wide data for planning, development, implementation and CQI Target specific populations Educate providers and the public of services and processes, admission criteria

Examples of Developing and Implementing Evidence-based, Accountable Programs with Measurable Outcomes Crisis Stabilization Unit with Mobile Linkage to Treatment Services Integrated BH & Primary Care Services Jail In-reach and Discharge Planning/Engagement School Based Counseling OB Clinic Screening/Treatment Services Crisis Intervention Team (CIT) Training Synthetic Marijuana Prevention Messaging

Integrated BH & Primary Care Services Problem: People with SMI are being diagnosed, late or never, with common treatable chronic medical conditions that lead to disability and early death at younger ages than those in the general public. Approach: Develop coordinated and integrated primary care services for publicly funded community-based behavioral health settings and co-locate BH brief interventionists into PC settings. (Needs to be resuscitated) Partners: ARC ($500k), SAMHSA/PBHCI ($1.9M), FQHCs, Hospital-linked primary care clinic, Local EDs, LSU Clinic System, OPH, CAHS.

The Majority of MH Needs are Met by Physical Medicine Providers Approximately 75% of all MH appointments are provided in primary care offices. The vast majority of need can be managed outside of the mental health system. There is an extreme shortage of psychiatrists and MH professionals worldwide.

“In pursuit of our bold goal, Humana will be guided by its core values” -Thrive Together- We focus on shared success by breaking down silos, inviting collaboration and mentoring others. We believe in, and act with, positive intention to create an environment of trust and integrity.

Integrated Behavioral Health & Primary Care Focus Problem: There are multiple problems for delivering seamless integrated care.

Heath B, Wise Romero P, and Reynolds K Heath B, Wise Romero P, and Reynolds K. A Review and Proposed Standard Framework for Levels of Integrated Healthcare. Washington, D.C.SAMHSA-HRSA Center for Integrated Health Solutions. March 2013

KEY ELEMENT: COMMUNICATION COORDINATED KEY ELEMENT: COMMUNICATION LEVEL 1 LEVEL 2 Minimal Collaboration Basic Collaboration at a Distance Heath B, Wise Romero P, and Reynolds K. A Review and Proposed Standard Framework for Levels of Integrated Healthcare. Washington, D.C.SAMHSA-HRSA Center for Integrated Health Solutions. March 2013

KEY ELEMENT: PHYSICAL PROXIMITY CO-LOCATED KEY ELEMENT: PHYSICAL PROXIMITY LEVEL 3 LEVEL 4 Basic Collaboration Close Collaboration Onsite Onsite with Some System Integration Heath B, Wise Romero P, and Reynolds K. A Review and Proposed Standard Framework for Levels of Integrated Healthcare. Washington, D.C.SAMHSA-HRSA Center for Integrated Health Solutions. March 2013

KEY ELEMENT: PRACTICE CHANGE INTEGRATED KEY ELEMENT: PRACTICE CHANGE LEVEL 5 LEVEL 6 Close Collaboration Full Collaboration in a Approaching an Transformed/Merged Integrated Practice Integrated Practice Heath B, Wise Romero P, and Reynolds K. A Review and Proposed Standard Framework for Levels of Integrated Healthcare. Washington, D.C.SAMHSA-HRSA Center for Integrated Health Solutions. March 2013

Key Messages To address complex problems with limited resources we must rely on a full understanding of the problem from many facets through an inclusive, collaborative process. We must redesign our services to support earlier, and at times, more intensive interventions, for people with mental health needs and addictive behaviors. We can improve the physical health and emotional well being of the population through normalized and convenient access and specialty collaboration.

What’s Driving Integration? Consumers Providers Payors Affordable Care Act: Meaningful Use Triple Aim: Population Health Experience of Care Per Capita Cost

Integrated Care Perception of Current System: Desired Characteristics of System: 1. 2. 3. 1. 2. 3.

What Issues Must be Addressed for Integrated Care to Work? Service Delivery – Level of Integration, Care Coordination/Communication, Health/ Wellness, Screening/Assessment Tools, Patient Placement Criteria, Treatment Continuum (EBP) Finances - Health Insurance Marketplace/Exchange, Third Party Billing, Medicaid, Dual Eligibles Infrastructure - Workforce Development, Performance Outcomes, Business Capabilities Rules/Regs - Health IT/EHR, Compliance, Contracts, MOUs, Confidentiality

Alignment of Problem Statement & Objectives Original Problem Statement: There are multiple problems for delivering seamless integrated care. Updated Problem Statement: (Why is this being undertaken and what factors need to be considered?) Objectives: (What we plan to accomplish to improve health outcomes.)

What Needs to be Done Before our Next Meeting What Needs to be Done Before our Next Meeting? Proposed Next Meeting Date: July 22nd