Integrated Health Care Initiative (IHCI) Collaborative Meeting - - PowerPoint PPT Presentation

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Integrated Health Care Initiative (IHCI) Collaborative Meeting

August 1st, 2018

• Lunch & Introductions
• Laughter Yoga Team Exercise
• Integrated Institution Showcase (Q&A)
• Work Groups Panel (Q&A)
• Updates & Announcements
• Next Steps

Agenda Overview

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Laughter Yoga Team Exercise

Janet Carroll, RN, BSN, LMT Certified Laughter Yoga Leader & Teacher

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Integrated Institution Showcase (Q&A)

The University of Texas at Austin Dell Medical School Integrated Behavioral Health Scholars Program

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University of Texas at Austin, Dell Medical School

INTEGRATED BEHAVIORAL HEALTH SCHOLARS PROGRAM

Program Goal

To create a cross-college, interdisciplinary integrated behavioral health education and training program to close the workforce gap in Texas. 4 Year Target: Train 100+ behavioral health graduate students to deliver culturally- competent care, with 90% of graduates working with the medically underserved in Texas. IBH Scholars Program Launch in Fall 2017

Mission to Close Workforce Gap

Why Culturally Competent, Integrated Behavioral Health? Coordinating physical and mental health care can increase access, improve chronic conditions and reduce healthcare spending.

• More than 80% of Texas counties are designated as Mental Health

Professional Shortage Areas. Primary care settings are the gateway to BH care.

• The people of Texas are highly diverse (40% Hispanic, 12% African-

American), but the mental health workforce is not.

• Low-income and ethnic-minority residents have disproportionately poorer

access to mental health care across the State.

Behavioral Health at UT Austin

Different Behavioral Health Graduate Programs, Similar Workforce Goals

PSYCHIATRY RESIDENCY PROGRAM (MD) Dell Medical School MASTER’S OF SOCIAL WORK, CLINICAL TRACK (MSSW) Steve Hicks School of Social Work PSYCHIATRIC MENTAL HEALTH NURSE PRACTITIONER PROGRAM (MSN) School of Nursing SCHOOL PSYCHOLOGY(PhD) & COUNSELING PSYCHOLOGY (PhD) College of Education CLINICAL PSYCHOLOGY (PhD) College of Liberal Arts

IBH Scholars Program

Enhanced Training Curriculum

Integrated Clinical Training Sites Interprofessional Practice Competency-Based Curriculum Evidence-Based & Diversity Trainings 14 Social Workers 6 Psychiatric Nurse Practitioners 7 Psychologists

Hogg Foundation

(2017-2020) No stipends, capped only by available training positions in DellMed IPUs

HRSA GPE Grant

(2016-2019) Stipends for 7 trainees

HRSA BHWET Grant

(2017-2021) Stipends for 21 trainees

Program Size Training Targets, By Funding Source

Grant funds also fund evidence-based trainings, dedicated faculty time, and

• perational program support.

Successes

• Launched full program with a complete cohort of 27 trainees.
• Overwhelmingly positive feedback on curriculum, competencies, and

field placements from students.

• Students showed measureable growth in cultural awareness, knowledge
• f risk factors in their clinical populations.
• Students craved even more interprofessional interaction.
• Added 15 new integrated field placement sites for Year 2.
• Jointly applied for and received additional grant funding (THECB) to

launch innovative UT Behavioral Health Recruitment Fair

Year 1 Outcomes

Challenges

• Different recruitment timelines, supervision requirements, clinical

training cycles and historical practices made it challenging to create a shared program experience.

• Placement sites have high workloads, limited space.
• Lack of shared understanding about what integrated behavioral health

looks like, the roles each discipline can play.

• UT Austin behavioral health graduate pipeline lacks diversity.
• On-going, sustainable funding will be on our minds for the next 4 years.

Year 1 Outcomes

Year 1 Graduates

• 27 graduates, 10 have accepted positions

– All working with the medically underserved – 7 of 10 in integrated settings – 6 of 10 working in public sector

• Graduates report:

– Increased confidence with integration, the value of other disciplines – Evidence-based training invaluable to their day-to-day practice – Desire to continue working with the medically underserved – Desire to provide culturally-competent care

Value of the Program

Timeline Next Steps for IBH Scholars

• Addition of psychiatry residents to the Year 2 cohort
• Interprofessional seminar extended into June
• Broader trainings on diversity, bias
• Quarterly supervisor trainings for CEU credits
• Behavioral Health Graduate Recruitment Fair at UT Austin
• Poster Presentations in October 2018: CFHA Conference

(Rochester) and NASW Conference (Arlington)

Integrated Behavioral Health Scholars Program

QUESTIONS?

Work Groups Panel (Q&A)

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Common Agenda Review

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IHCI Framework Review

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Mission: The IHCI Service Delivery Workgroup will promote and provide education to support the advancement of integrated health care. This work includes:

• Educating on the integration of BH screening/services into primary care
• Engaging PCPs in continued learning and enhancement of integration
• Hosting educational events for providers
• Disseminating resources and information

Service Delivery

www.mhahouston.org Work Group Recommendations: 16 & 17. IHCI Recommendations Report 2016. Weblink.

Current Agreements & Decisions: 1.Build knowledge base of screening models available and used in our service area 2.Increase education of screening models for providers 3.Educate patients on the various aspects of their care Current Achievable Actions: 1.Gather resources and research as part of work group preparation 2.Gather any known best practice screening models in IHC state-wide and beyond 3.Draft the daily screening process at each member organization involved in the IHCI Work Group, including data such as: start to finish process, internal and external resources available onsite, etc.

Service Delivery

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Mission: The IHCI Institutions of Higher Education Workgroup will promote the development of a multidisciplinary workforce prepared to work in integrated team-based settings. This work includes:

• Documenting and disseminating relevant information to institutions
• Providing education on IHC to students enrolled in preparation programs
• Providing educational opportunities on best practices

Institutions of Higher Education

www.mhahouston.org Work Group Recommendations: 14 & 15. IHCI Recommendations Report 2016. Weblink.

Current Agreements & Decisions: 1.Start with development of an elective to implement IHC at universities 2.Build group’s knowledge base and create a foundational landscape Current Achievable Actions: 1.Gather information and resources on universities currently implementing IHC 2.Create list of top 5 learning objectives for an introductory IHC course for a multidisciplinary audience 3.Create list of universities and boards in the region to collaborate with and possibly launch a conference on integrated health care to start partnerships 4.Determine feasibility of TMC Policy course partnership

Institutions of Higher Education

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Mission: The IHCI Financing Workgroup will engage payers to promote sustainable financing of integrated health care through value-based payment models that remove barriers to integration. This work includes:

• Documenting and disseminating relevant information to payers
• Providing educational opportunities for payers on novel and proven

payment methods to support increased levels of integration

Financing

www.mhahouston.org Work Group Recommendations: 8, 9, 10, 11, and 12. IHCI Recommendations Report 2016. Weblink.

Current Agreements & Decisions: 1.The IHCI and C3 Initiatives will merge their Financing groups 2.Include a master coder in work group to build knowledge and expertise 3.Build a knowledge base of all the payers in the county (roles and efforts) 4.Throughout all efforts, keep parity at the center of all work and decisions Current Achievable Actions: 1.Identify master coder and hold August call for Q&A regarding same-day billing 2.Create list of all payers in the county and identify those to invite to work group 3.Create list of all the payment models used at each organization involved in work group, including any new efforts/pilots underway

Financing

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Mission: The IHCI Public Policy Workgroup will promote the expansion and sustainability of integrated health care in Texas through advocacy efforts. This work includes:

• Supporting advocacy efforts to educate policymakers on IHC
• Establishing a legislative agenda for the 86th Legislative Session with

concrete legislative actions to support increased levels of integration throughout the health and human services sector

Public Policy

www.mhahouston.org Work Group Recommendations: 1 to 7 and 13, 17, 18. IHCI Recommendations Report 2016. Weblink.

Current Agreements & Decisions: 1.Focus on pushing forward policies that will not have a substantial fiscal note associated with them Current Achievable Actions: 1.Gather individual legislative priorities by each member organization to either build from, support or lead as a group 2.Review the final 86th legislative agenda by the September work group meeting – Large focus on MCOs, gun violence, Harvey, school safety foreseen 3.Gather information on recommendation 3, 13, 18 and Collaborative Care codes

Public Policy

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Work Group Strategic Plan Template

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Mission: Initial Goal Specifics Measure(s) Attainable Actions Relevancy Timeline What exactly is to be accomplished (Who, What, Where, Why) How will we demonstrate and evaluate the extent to which the goal has been met? What are the actions to achieve the goal? How does the goal tie into the key responsibilities? How is it aligned to objectives? Prioritize here also. Set 1 or more target dates, the "by when" to guide the goal to successful and timely completion (include deadlines, dates and frequency) Recommendation XYZ Recommendation XYZ Recommendation XYZ Integrated Health Care Initiative XYZ Work Group Mission statement

Updates & Announcements

MHA-GH Staff

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Friday, October 5th, 2018 2:30 PM – 4:00 PM “Common Behavioral Health Interventions for Medical Conditions in Primary Care” By Dr. Stephanie Chapman,

Behavioral Health Clinical Team Lead, TCH Health Plan The Center for Children and Women

Who’s Invited? The IHCI Network!

Networking Event

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Evaluation Pathway

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Source: Collective Impact Forum. FSG. “A Framework for Performance Measurement and Evaluation of Collective Impact Efforts” We are here! Q3 2018

10-Year Report

Accomplishments Q4 2025

Biennial Report

Progress to date Q4 2024

Biennial Report

Progress to date Q4 2022

Tentative Initiative Timeline

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2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 Early Years (3) Middle Years (5)

18 Guiding Recommendations Developed

Q2 2016

IHCI Launched

Q2 2015

IHCI Report Published

Recommendations Q4 2016

Action Plans Finalized

Work Groups Q4 2018

Stakeholder Meetings

Q3 2015

Today

2nd Collaborative Meeting Q3 2018 Late Years (2) Retreat Interviews Policy Project

Collaborative & Work Group Meetings

Q1 2017 – Q3 2018 Quarterly/Bimonthly

Collaborative & WG Meetings / Action Plans Implementation

2019 - 2025 Exact Milestones TBA

5-Year Report

Progress to date Q4 2020

Demonstration Projects / Learning Communities Launched

• Next Meeting: November 14th, 2018. RSVP

– Integrated Health Care Organization Showcase – Work Groups Panel: Final Action Plans – Updates: Final Initiative Timeline

• Work Groups: September 19, 20 & November 6, 8

Next Steps

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Thank You!