1. WRBHO Monthly Provider Meeting July 13, 2012 WESTERN REGION BEHAVIORAL HEALTH ORGANIZATON WITH BEACON HEALTH STRATEGIES, LLC AND COORDINATED CARE SERVICES, INC

2. Agenda Welcome/ Introduction of New Meeting Format - Adele Inpatient Experience Forum Update – Val One-on-One Provider Meetings for Q1 Data Review: Update- Adele & John Inpatient Review Questions Template: Adele & Chris June 7 BEST Meeting- Discussion Group Feedback- John HANYS BH Readmission Project –Adele Q and A -All

3. New Meeting Format Webinar being used to improve ability to share information Feedback will be invited

4. Inpatient Experience Forum Update First Forum was held on July 11 in Rochester  Good turnout  Approach was well received by service recipients Other Forum dates:  Olean – July 27  Buffalo – August 15  Ithaca- August 20

5. One-on-One Inpatient Provider Meetings All scheduled meetings will have taken place by this afternoon. We have learned a great deal and appreciate everyone’s willingness to meet with us. Feedback suggested that inpatient providers would benefit from additional information concerning the questions we are asking. Therefore a new Inpatient Review Questions Template has been developed

6. Inpatient Review Questions Template 1 st version highlights the rationale and explanations for those questions being asked that are currently subject to some confusion. This draft version will go out to inpatient providers later today. An extended version (with more questions covered) will be issued in the very near future. A conference call is being scheduled to obtain feedback from providers on the updated template. Sample follows:

7. Sample of Review Question Template Category/ Rationale Question AskedExplanation Diagnostic Categories- Needed to better understand the level of complexity of the needs of the clients being served Please provide Axes I through VThe State Offices require that we capture this information. A MH Axis I diagnosis must be provided for all inpatient psychiatric hospitalizations. A Substance Use Axis I must be provided for all Inpatient Detox and Rehab admissions. Deferred (799) is not an option.

8. June 7 BEST Meeting- Discussion Group Feedback Three topics were discussed, each representing an opportunity for system improvement based upon 1 st Q data  Increasing SPOA referrals  Engaging peers and families to support a more effective discharge  Improving inpatient/outpatient communication 10 different groups – 3 to 4 each discussed one of the above topics.

9. June 7 BEST Meeting- Discussion Group Feedback Questions asked included:  What is currently working?  What are barriers to service use?  Key components to success?  Recommendations for change?  If there was one question that could be answered to help move the process forward, what would it be?  If we could do one thing differently, what would it be? Summary of these discussions will be distributed early next week….

10. A Preview of What You Will Read… Peer and Family: What changes would you make?  A Peer Services sign-off needs to be included as a checklist option on the Discharge Plan for each individual  Place peers in the EDs  Figure out a way to pay for it.

11. A Preview of What You Will Read… Increase use of SPOA: What changes would you make?  Streamline SPOA application and place it on-line  Use family advocate in SPOA engagement conversation to increase success  Reduce turnaround time of decision to increase ROI for facility completing application

12. A Preview of What You Will Read… Inpatient to Outpatient communication: If you could do one thing to impact communication?:  Build relationships with your system partners and understand their needs as well as yours  Foster a peer to peer connection  Inpatient and outpatient physicians should manage the care of the individual together  Make it a requirement to communicate.. A standard of practice

13. Discussion Group Feedback: Next Steps Summaries to be sent out early next week Share information with your team Next Provider call: Discuss next steps for region

14. HANYS BH Readmission Project Are any providers involved? Is there anything the WRBHO can do to be helpful

15. Questions? Next Meeting: August 10 at 10:00