1. Worcester Health Facilitating Organizational Change Jennifer LaMade, Core Service Agency Director Doris Moxley, Addictions Director Tracy Tilghman, Mental Health Director

2. Worcester Health Why do we need Integrated Care?

3. Worcester Health What is Integrated Care in Worcester County? Mental Health Addictions Intellectual Disabilities Somatic Care

4. Worcester Health Worcester County Co-occurring History Fall, 2001: Applied SAMHSA Grant Spring, 2002: Leadership attended national conference Fall, 2002: SAMHSA Grant received December, 2002: Charter signed Change Agents Selected, Training begins COMPASS administered for agency self- survey

5. Worcester Health Worcester County Co-occurring History Action Plans developed by each agency Identified target areas for change: Welcoming, Accessibility and Integrated Developed data measurement tools for prevalence of Co-occurring Disorders within the Health Department, Quadrant and Stage of Change

6. Worcester Health Worcester County: Co-occurring Safety Net Project (2007) AGH Emergency Dept AGH Inpatient AGHS Physician Practice Worcester County Jail Law Enforcement WCHD Crisis Response WCHD Mental Health WCHD Substance Abuse WCHD Case Mgmt WC Social Services WC Juvenile Services WC Civil & Criminal Justice Services WC Parole & Probation Homelessness Providers MH Crisis Bed Providers WC Local Mgmt Board WC Core Service Agency EMS Personnel Other Crisis Related Services Patients / Families

7. Worcester Health Worcester County Public Safety Net

8. Worcester Health Quadrant II ↑ Behavioral Health ↓ Medical Health  Served by specialty behavioral health system that coordinates with primary care physician.  Primarily served by WCHD due to extensive needs of client. Quadrant IV ↑ Behavioral Health ↑ Medical Health  Served in both the specialty behavioral health system and medical specialty system.  Client shared through all services to include collaboration among providers ( PCP, AHC, WCHD). Quadrant I ↓ Behavioral Health ↓ Medical Health  Served in any primary care setting.  May require a psychiatric consultation, but returns to primary care physician.  Primarily served by patient’s primary care physician (PCP). Quadrant III ↓ Behavioral Health ↑ Medical Health  Served in primary care / medical setting with behavioral health staff on- site.  Primarily served by the Atlantic Health Center (AHC). Adapted from the National Council for Community Behavioral Healthcare, 2002