INTEGRATION OF BEHAVIORAL HEALTH AND PRIMARY CARE A VIEW FROM THE FIELD 6/11/2015 V. Eisen California Innovations Summit on Integrated Care 1

HEALTHRIGHT 360 Whole person care for low-income adults, youth, and families Substance use disorder treatment, mental health and primary medical care Support services that address the social determinants of health: education, employment prep, transitional housing and housing case management 2

6/11/2015 V. Eisen California Innovations Summit on Integrated Care HEALTHRIGHT 360 Grew through mergers: Haight Ashbury Free Clinics, Walden House, Asian American Recovery Services, Women’s Recovery Association of San Mateo County, North County Serenity House in San Diego County, Lyon Martin Health Services, and took on operation of health center for Glide Foundation (center now called Tenderloin Health Services) Provide services in 7 CA counties, 3 state prisons, 2 county jails, and in 2 juvenile halls. Served 27,000 people last year 3

6/11/2015 V. Eisen California Innovations Summit on Integrated Care OUR MISSION AND MODEL Mission: Build health, give hope, and change lives for people in need. View overall health improvement as our primary purpose—no matter which point of entry. 4 Client SUD Tx MH TxMedical Social Svces

6/11/2015 V. Eisen California Innovations Summit on Integrated Care WHAT’S WORKING Ability to offer MAT for behavioral health and primary care patients Better able to manage needs of chronic pain patients with co- occurring SUD Ability to offer robust continuum of SUD services to primary care patients Improved ability to attend to and manage co-occurring chronic health conditions for SUD clients Decreased ED utilization for SUD clients in residential treatment 5

6/11/2015 V. Eisen California Innovations Summit on Integrated Care CHALLENGES Policy: Same day visit prohibition Policy: Prohibition on any medical care in residential SUD tx Health plan medication formularies: e.g., Vivitrol not in; Klonazepam is (difficult to detect in UA) EHR: Not integrated No clear national standard for SUD treatment outcomes (quality standards more process than outcome oriented) Workforce: Recruitment, training, certification and licensure Building team trust: Same goal, different demands Psychiatrists and mental health clinicians 6