1. Integrated Healthcare Southeast IHC “Models” PBHCI Primary Behavioral Health Care Integration (Solo Provider Model) – Two Locations (Urban and Rural) Medical Home with Primary Care Embedded in CMHC FRANKLIN STATION Integrated Healthcare (Solo Provider Model) – One Location (Urban) Medical Home with neither PC nor BH embedded JOHN MALONEY HEALTH CENTER Integrated Healthcare (Partner Model with CMHC and FQHC) – One Location (Urban) Medical Home with BH embedded in PC VAN BUREN HOMELESS SHELTER Integrated Healthcare (Solo Model) – One Location (Urban) within 500 person Homeless Shelter Acute Healthcare and Follow-Up/Referral MOUNT CARMEL MOBILE OUTREACH Integrated Healthcare (Partner Model with CMHC and Hospital System) Several Locations (Urban) Acute PC and BH Care with Follow-Up/Referral

2. Quadrant II BH PH Behavioral Health Setting with Primary Care Capacity Quadrant IV BH PH Behavioral Health Setting with Primary Care and Nurse Care Management Quadrant I BH PH Primary Care Setting with Behavioral Health Consultation Quadrant III BH PH Primary Care Setting with Behavioral Health Capacity Or Consultation

3. Role of Psychiatrists in Integrated Healthcare Varies by Model Varies by Model BH embedded in PC – IMPACT Model BH embedded in PC – IMPACT Model High Frequency of Psychiatric Consultation Ohio Health Homes Ohio Health Homes Psychiatric Role not Clearly Defined and no Mandated Inclusion on Health Home Teams PC embedded in BH – PBHCI PC embedded in BH – PBHCI Higher Frequency of Psychiatric Direct Patient Service with Dual Consultation Roles w/Family Practice Physicians PBHCI Model– Patients Have Most Complex Needs/Issues PBHCI Model– Patients Have Most Complex Needs/Issues Patients have SPMI and have or are Developing Additional and Serious Co-Morbid Conditions Willingness to Take Active Role to Prevent Metabolic Syndrome, Join in Treatment of Co-Morbid Conditions AND Work Aggressively on Tobacco Cessation and Social Justice Issues (Social and Environmental Health)

4. Psychiatric Challenges/Opportunities Cultural Chasm between Family Practice and Behavioral Healthcare Cultural Chasm between Family Practice and Behavioral Healthcare Building of Trust Building of Trust Willingness to Consider Dual Consultation and Responsiveness as a Co-Provider Willingness to Consider Dual Consultation and Responsiveness as a Co-Provider Coding/Billing/Payment “Systems” Coding/Billing/Payment “Systems” Understand/Participate in Population- Based Healthcare Understand/Participate in Population- Based Healthcare

5. IHC, Psychiatrists and the Electronic Health Record Proficiency in Use and Navigation Proficiency in Use and Navigation Proficiency in Use of More than One EHR Proficiency in Use of More than One EHR Use of “Tasking” Function Use of “Tasking” Function “Know-How” Regarding Interoperability “Know-How” Regarding Interoperability “Know-How” Regarding Information Exchange “Know-How” Regarding Information Exchange Participant in “Meaningful Use” Participant in “Meaningful Use”