Behavioral Health and Primary Care Integration Administrative Infrastructure Issues Diana Knaebe, President/CEO Heritage Behavioral Health Center Decatur, IL

So you want to integrate primary and behavioral health care Things to consider –What are you hoping to achieve –For what purpose –What is it going to take –What do you need to consider –Have you identified partner entities

Administrative Infrastructure Issues Ready, Set, Go? –Maybe we better make sure we understand where each organization is coming from first Levels of Integration –Does each organization have a goal in mind? Has this been articulated? –Does not have to be total integration/merger

Administrative Infrastructure Issues Intentions –What is each organization hoping to achieve? –May need to spend a considerable amount of time determining this up front. –Different languages/cultures –Corporate values/philosophies –What does the partnership mean to each entity?

Identifying your Target Population How was the population identified? –Four Quadrant –Looking at payer source What common characteristic(s) does your target population share besides their SMI status? –Usually economically disadvantaged – indigent, Medicaid, complicated physical issues – diagnoses

Administrative Infrastructure Issues Physical Space –Where located –Co-location Some primary care services at behavioral health center Some behavioral health services at primary care Total shared space

Administrative Infrastructure Issues Establishment of Expectations, Outcomes –Financial Benchmarks Who bills for what services How much revenue is currently anticipated/actual If working to maximize revenue, will this be shared, how?

Administrative Infrastructure Issues –Clinical Expectations – what is the expected volume encounters/productivity –Staffing – what is the model Who hires whom, philosophy of staff if at off site How many hours at site How are staff regarded Supervision On-going clinical meetings –Conflict resolution pathways –Clinical Protocols –Standardized Care »Best Practices

Administrative infrastructure continued Process is Developmental and Incremental –Takes some risk on parties involved –Lots of patience –Trust – going back to intention –Continues to Evolve –Keep going back to your intentions, which may also change and evolve over time

Resource The SAMHSA-HRSA Center for Integrated Health Solutions, run by the National Council for Community Behavioral Healthcare under a cooperative agreement from the U.S. Department of Health and Human Services, is funded jointly by the Substance Abuse and Mental Health Services Administration and the Health Resources Services Administration. The CIHS promotes the development of integrated primary and behavioral health services to better address the needs of individuals with mental health and substance use conditions, whether seen in specialty behavioral health or primary care provider settings. – _solutions