1. Behavioral Health Primary Care Integration Using the Kentucky Health Information Exchange Karen Chrisman Governor’s Office of Electronic Health Information

3. CCD exchange Participation Agreements From 96 of approximately 130 hospitals in the Commonwealth No further consent needed state Kentucky Cabinet for Health and Family Services (CHFS) funds and provides support to the Commonwealth’s 14 CBHCs but does not have direct control of the centers Behavioral Health Background

4. Sub Award Press Release

5. KHIE required modifications Must release all patient data Must release all patient data to all providers in the HIE Must release all types of data Must release all data for all uses TPO TPO is also required by the GOEHI participation agreement Requires a 6 month consent period If another consent is not signed within 6 months the consent expires Consent Form

6. GOEHI Executive Director KHIE Project Manager Behavioral Health Project Lead and other members as required Objectives Developed: Business requirements Consent requirements Considered additions to CCD CCD Components CCD Technology Workgroup

7. Behavioral Health Providers No Participation Agreement with a behavioral health provider before March, 2012 Behavioral health providers needed meaningful use support Additional attention to 42 CFR Part 2 As a state agency, KHIE required additional contracting with the community behavioral health centers Adapted KHIE processes and provided site visits Engaged the Regional Extension Centers within one week of award announcement Behavioral Health Providers

8. There was no standard CCD connection Began KHIE vendor onboarding process July 2012 Delivery of the KHIE CCD to Pennyroyal is in test Pennyroyal has created a CCD with a Kentucky Medicaid patient using vendor software Process to connect Behavioral Health Vendor to KHIE KHIE vendor will provide CCD in production environment KHIE vendor will deliver Pennyroyal CCD in test environment Onboarding Behavioral Health Vendor

9. KHIE will only respond to the query from Pennyroyal because KHIE recognizes this security certificate. This ensures that a known KHIE provider is receiving the information. Pennyroyal has signed the GOEHI Participation Agreement which requires Pennyroyal to use the data from KHIE only for a permitted use. NetSmart provides a security certificate that is unique to Pennyroyal KHIE Security

10. What about Consent?? Only area consent is required in KHIE Behavioral health providers are valuable information sources Behavioral health providers already have a consent process KHIE scheduled site visits to study behavior health provider consent workflow KHIE has reached consensus on the state consent form

11. Training

12. SAMHSA-HRSA Center for Integrated Solutions PowerPoint Presentation Michael R. Lardiere, Vice President Health Information Technology and Strategic Development The National Council for Community and Behavioral Healthcare Introduction Patient Consent and Authorization Form for Disclosure Of Certain Health Information to the Kentucky Health Information Exchange Consent Explanation Health Information Exchange Services Behavioral Health Assessment CCD Examples: KHIE CCD Screen Shot KHIE example CCD Behavioral Health example CCD

13. Healthcare IT News “5 Things to Know About CCD” KHIE Virtual Health Record VHR Example Health Information Exchange and 42 CFR Part 2 Compliant Consent PowerPoint Presentation Maureen Boyle, PhD SAMHSA KHIE Update KHIE Training PowerPoint

14. M aking Sense of Consent General Rules Informed Consent Patient Parent Legal Guardian According to Kentucky Statute Who may consent? From Whom/To Whom Amount & Kind of Information Disclosure

15. Aid in treatment and care coordination Purpose At any time with written notice Doesn’t stop disclosure of info permitted by law Revocation Specified time frame or 6 months from date signed Effective Period Patient, parent, legal guardian Proof of legal representation required (Court Order) Signature M aking Sense of Consent

16. SAMHSA Stakeholders Kickoff MeetingMarch 12, 2012 Pennyroyal/Netsmart Weekly Status CallWeekly KHIE/REC by-weekly touch pointBi-Weekly (March – July 2012) SAMHSA Grantee Status CallMonthly KHIE Monthly Update CallMonthly (March – October 2012) National Council for Comm Behav Healthcare Conf April 14-17, 2012 Pathways - Official Intake CallMay 1, 2012 KY Health Info Management Association MeetingJune 4, 2012 Site Visit Pennyroyal CenterJune 13, 2012 SAMHSA - UK CECentral Meeting July 16, 2012 National Council Sub Award Consent meeting July 17, 2012 KHA Advisory Committee MtgJuly 26, 2012 SAMHSA Consent Mtg-Washington DCAugust 7, 2012 REC/QIO/KHIE Joint Training SessionAugust 15, 2012 GOEHI Privacy and Security MeetingAugust 20, 2012 PAIMI Consumer GroupAugust 28, 2012 UK CeCentral/KHIE Behavioral Health MtgSeptember 13, 2012 Bost Forum-HIE-SDE PresentationSeptember 17, 2012 SAMHSA Stakeholders Statewide Mtg/TrainingSeptember 18, 2012 Voices for Healthy KentuckySeptember 28, 2012 Multi-State Coordination and Communication WebinarOctober 9, 2012 Kentucky Primary Care Association ConferenceOctober 15, 2012 PC-BH Collaboration Universal ConsentOctober 16, 2012 KHIE/Pathways Site VisitOctober 18, 2012 Outreach

17. Primary Behavioral Health Care Integration Pennyroyal Center received a grant under the PBHCI initiative Pennyroyal Center has a primary care license KHIE delivered KHIE CCD to Pennyroyal with Medicaid claims data and all “live” provider lab results 10-25-2012 Pennyroyal will share consolidated CCD with medical trading partners 12-15-2012 Current live medical trading partners Trover Medical Center, Madisonville, Lourdes Hospital, Paducah 11-01-2012

18. Primary Behavioral Health Care Integration Community Behavioral Health Center KHIE CCD to Pathways with Medicaid claims data and all “live” provider lab results 12-01-2012 Pathways shares consolidated CCD with medical trading partners, primary care providers currently live King’s Daughters Medical Center, Fleming County Hospital, St. Claire Regional Medical Center 1-31-2013

19. Primary Behavioral Health Care Integration Community Behavioral Health Center Currently teaming with primary care providers KHIE CCD to Kentucky River Community Care with Medicaid claims data, all “live” provider lab results Kentucky River identified team practices: ARH, Quantum Healthcare, Mercy Medical Clinic. Will use KHIE to deliver KRCC CCD consolidated with Medicaid claims data, all “live”provider lab results to these providers

20. Primary Behavioral Health Care Integration Community Behavioral Health Center Partnering with FQHC Primary Plus KHIE CCD to Comprehend with Medicaid claims data, all “Live” provider lab results including St. Claire Regional Medical Center and Fleming County Hospital Comprehend using KHIE to deliver Comprehend CCD, Medicaid data and lab results to Primary Plus

21. Psychiatric Hospitals in KentuckyBedsCounty Central State Hospital192Jefferson Cumberland Hall91Christian Eastern State Hospital323Fayette Kentucky Correctional Psychiatric Center97Oldham Lincoln Trail Behavioral Health System140Hardin Northkey Community Care-intensive Services57Kenton Our Lady of Peace396Jefferson Ridge Behavioral Health System110Fayette Rivendell Behavioral Health Services125Warren River Valley Behavioral Health80Daviess The Brook - Dupont88Jefferson The Brook Hospital - KMI98Jefferson Western State Hospital495Christian Behavioral Health in Kentucky Community Mental Health Centers (CMHC)CityCounty Adanta SomersetPulaski Bluegrass LexingtonFayette Communicare, Inc. ElizabethtownHardin Comprehend, Inc. MaysvilleMason Cumberland River CorbinWhitley Four Rivers Behavioral Health PaducahMcCracken Kentucky River Community Care, Inc HazardPerry Lifeskills, Inc. Bowling GreenWarren Mountain Comp. Care Center PrestonsburgFloyd NorthKey CovingtonKentucky Pathways, Inc. AshlandBoyd Pennyroyal Regional Center HopkinsvilleChristian River Valley Behavioral Health OwensboroDaviess Seven Counties Services, Inc. LouisvilleJefferson The MORE Center LouisvilleJefferson Transitions, Inc. BellevueCampbell

22. Identified – Future Needs Kentucky State-Owned Behavioral Health Facilities

23. For additional information contact: Karen.Chrisman@ky.govKaren.Chrisman@ky.gov or Polly.Mullins-Bentley@ky.gov