Respect ● Connection ● Curiosity ● Hope (collaborative) HELPING Psychiatry Supportive Services Counseling Integrated Care Supportive Housing Employment Integrated Services of Appalachian Ohio

William Madsen, Ph.D. Founder and Director of the Family-Centered Services Project Bill provides international training and consultation regarding collaborative work with families. He assists community and government programs to develop institutional practices and organizational cultures that support family-centered practice. Bill has spent his professional life straddling the down and dirty world of frontline, public sector practice and the exciting, but more esoteric world of family therapy theorizing. He has developed and currently consults with numerous innovative home-based programs. He has written numerous articles and is the author of Collaborative Therapy with Multi-Stressed Families (2 nd Edition). In 2013, Bill was awarded the American Family Therapy Academy’s Distinguished Contribution Award for Family Therapy Theory and Practice for work largely related to the most recent book.

Kevin Gillespie, RN, MHSA, Executive Director Integrated Services of Appalachian Ohio Kevin has many years of experience combining direct service, system development and administrative management, mostly throughout the Appalachian region of Ohio. He is a registered nurse with much of his work focused on creating collaborative solutions with partners across health and human service systems and in alliance with therapeutic, housing and employment professionals. Related to his responsibilities as Executive Director of Integrated Services and through recent involvement with an array of healthcare reform ventures, Kevin is exploring themes of social innovation to reframe a sustainable local network approach to build a strong home and community dimension for person centered health homes. All of his consulting, teaching and system design work is grounded in a deep appreciation for the ageless cultural knowledge associated with everyday helping.

Kevin Gillespie, RN, MHSA, Executive Director Integrated Services of Appalachian Ohio Kevin has many years of experience combining direct service, system development and administrative management, mostly throughout the Appalachian region of Ohio. He is a registered nurse with much of his work focused on creating collaborative solutions with partners across health and human service systems and in alliance with therapeutic, housing and employment professionals. Related to his responsibilities as Executive Director of Integrated Services and through recent involvement with an array of healthcare reform ventures, Kevin is exploring themes of social innovation to reframe a sustainable local network approach to build a strong home and community dimension for person centered health homes. All of his consulting, teaching and system design work is grounded in a deep appreciation for the ageless cultural knowledge associated with everyday helping.

William Madsen, Ph.D. Founder and Director of the Family-Centered Services Project Bill provides international training and consultation regarding collaborative work with families. He assists community and government programs to develop institutional practices and organizational cultures that support family-centered practice. Bill has spent his professional life straddling the down and dirty world of frontline, public sector practice and the exciting, but more esoteric world of family therapy theorizing. He has developed and currently consults with numerous innovative home-based programs. He has written numerous articles and is the author of Collaborative Therapy with Multi-Stressed Families (2 nd Edition). In 2013, Bill was awarded the American Family Therapy Academy’s Distinguished Contribution Award for Family Therapy Theory and Practice for work largely related to the most recent book.

Our time together today

Everyone in health & human services either is now or soon will be busy preparing for a future of integrated primary care and for some version of person centered health homes. There are so many changes to be made. We will begin to shift our emphasis away from disease toward supporting health. We will also start to reduce use of fee-for-service as a way to pay for and be paid for services. Many confusing changes are on our horizon, ready or not. It probably makes sense to start now with an incremental step-by-step approach.

Things to Think About Patient Centered Medical Homes (PCMH) Person Centered Health Homes (CARF term) Medical Neighborhoods Accountable Care Organizations (ACO) National Committee for Quality Assurance (NCQA) Electronic Health Record (EHR) Meaningful Use

(collaborative) HELPING Respect ● Connection ● Curiosity ● Hope

Four Cornerstones of Collaborative Helping A principle-based approach helps with service design at every level to make sure that care is person(al) centered and that cultural knowledge is as important as evidence based practice. Relational stance becomes “the main thing” so that care providers relate to people as partners in a helping relationship. Telling and listening to life stories told by people we serve along our many diverse pathways of care and support is maybe the most important service we can do. We call this “walking & talking.” We invite the telling of life stories in a mindset of respectful curiosity. All this requires a subtle kind of discipline.

The trick is to make the pivot away from being a percieved expert to become a trusted ally

Helping may be in many ways an intuitive process, but good and effective helping is made easier with a practical framework to organize our best intentions. Collaborative Helping maps are used to frame all of our service design and operations, from fully integrated health homes to specialty behavioral care and everything in between and beyond.

(collaborative) HELPING is drawn from both evidence-based practice and real life stories told about helping relationships by people from across the nation & around the world.

(collaborative) HELPING does draw from Motivational Interviewing, Narrative and Solution- Focused Therapies, Appreciative Inquiry, Multisystemic Therapy, Wraparound and Signs of Safety (from child welfare).

And understanding that substance use (at every level of use) is an important health factor for a good many people, we blend everyday ideas about Harm Reduction into our broad (collaborative) HELPING approach.

But the familiar kind of (collaborative) HELPING we do everyday has as much to do with the knowledge of families, neighborhoods, community and culture as it does with science or evidence based practice. Both are very important and work best together as parts of a holistic principled framework.

Often called “case management” or some other generic term, home and community supportive services occupy a place of critical importance in most all public behavioral health and human service systems in one way or another. Now, home and community work is emerging as a potentially important feature of person centered health homes. They are increasingly identified as community health workers.

So we use a framework of Collaborative Helping to think about a “patchwork quilt” of diverse home and community health related assets to be combined with clinical services to support whole person wellness and to promote healthy neighborhoods & communities.

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EHR can be cool and meaningful use pays, but …