New Mexico Hospital Association Presentation to Behavioral Health - PowerPoint PPT Presentation

New Mexico Hospital Association Presentation to Behavioral Health Subcommittee August 20, 2020

Ne New M Mexico Ho Hospital As Association ( (NM NMHA) HA)  Repr presents 46 h hospi pital als on state and federal legislative and regulatory public policy issues  Aut utho horitat ative voice for media, researchers and policy makers on hospital practice, finance, workforce and What is New complex data analysis used in public policy initiatives Mexico  Leade ader and C and Convener - Steady, statewide leader and convener for hospital members, government officials, Hospital organizations and stakeholders  Par Association? artne ners w with o othe hers to improve health status of NM residents, best practices, innovation (e.g., NM DOH Medical Advisory Team (MAT), Washington State Hospital Association  Adv dvocat ates f for the he common go good, collective interests of members and patients, in an ever-changing health care environment

The he B Beha havior oral H Health T h Task For orce (BHTF) F) i is Who is the com ompos osed of of l leadershi hip a and nd k key s staff f from om: NMHA  NMHA free standing behavioral health facilities and hospitals that have psychiatric settings Behavioral  All hospitals treat patients with mental health and Health Task substance use issues every day. At an increasing rate, and more so now. Force?

Hos ospi pital Ci City Designa nated Ps Psych. h. B Beds CD CD1 Cen entral Des eser ert Beh Behavioral H Hea ealth Albuquerque 26 Ce Cente ter Haven Behavior oral H Hos ospi pital of of Albuquerque 48 Licensed Albu buqu querqu que Lovel elace e Med edical C Cen enter er Albuquerque 44 Psychiatric Presb sbyteri rian Kaseman H Hos ospi pital Albuquerque 46 Univers rsity of of New Me Mexico H o Hospi ospital Albuquerque 91 CD2 CD Hospital Gerald Ch d Champi pion on Regi gion onal Me Medi dical Alamogordo 38 Cente Ce ter Beds, New Art rtesia General H Hos ospi pital Artesia 15 Lea ea R Reg egional M Med edical Cen enter er Hobbs 15 Mexico Mesilla illa Valle lley H Hospit ital Las Cruces 88 Easter ern New M Mexi xico Med edical C Cen enter er Roswell 25 (2019) Pea eak Beh Behavioral Hea ealth Ser ervices es, LLC Santa Teresa 88 Gila ila Regio ional M l Medic ical C l Center Silver City 10 CD CD3 San an Juan R uan Regional nal M Medical al C Cent nter Farmington 13 Santa Fe 11 CHRISTUS TUS St. V Vincen ent R Reg egional Med edical C Cen enter er Tot otal ( (appr pproximate) 558

Par articipat pation in B BH gr H groups ps  UNM Behavioral Health Coalition  HSD  B2W (Bridges to Wellness)  Pew Charitable Trusts, Recent Advisory Group substance use project  Behavioral Health Pew invited by Gov. BHTF Collaborative Lujan Grisham for multi-  Participants in HSD year study of substance Efforts Treatment Connections BH use disorder and referral platform treatment and to provide recommendations for for NM.

 BH hos hospital p providers are on f on front ont line nes, every bit as much as medical, surgical Today’s hospitals  Del Delayed ed c care e has made for more acute needs Focus  People never in the system before are no now i in n the s e system em Our BH Hospital  Our ur c cur urrent nt he health c h crisis has made some Community system weaknesses more apparent  Learni ning ngs a and nd sol olut utions ons have risen during these difficult times, and they should continue and/or be strengthened

Yvette Romero Clinical Manager of Behavioral Health Services yvette.romero@stvin.org CHRISTUS St. Vincent Regional Medical Center Santa Fe

Wit ith C Covid id-19, w what w we a e are e seei eeing? Behavioral Delayed care health  Increased severity and acuity (e.g. providers depression, suicide attempts, hospitalization, broken treatment process, are front increased substance use, greater youth and pediatric needs) line  Prediction: Surge in volume of both overall providers cases and acute cases paired with medial needs

Wit ith C Covid id-19, w what w we a e are e seei eeing? New patients Patients  Increase in New Mexicans experiencing new to first-time BH issues (e.g. depression, anxiety, isolation, substance misuse) needing  Increase in first-time seekers of BH BH services  Patients not sure how to find/access services services  Coverage barriers  Stigma

Wha hat we’ve d done one Addressing  Outreach to patients, family members, community organizations (e.g. mail, email, text, calls, radio, intensified newspaper and other public service and advertising) needs  Collaborated with regional hospitals to triage, help get BH patients from EDs to treatment facilities  Developed processes for Covid positive (and negative) patients  Instituted and expanded telehealth services

Mary Perez, Executive Director Adult Psychiatric Center meperez@salud.unm.edu University of New Mexico Albuquerque

Breaking d down barri rriers rs Expanded use of telehealth across BH services shows great promise to improve patient access Telehealth and care and technology

Sol olut ution: on: Pro roblem: Make telehealth an Patients might get a Universal option for BH patient referral for inpatient or care in Emergency access in outpatient treatment, Departments— but often no direct, emergency statewide. immediate connection with a BH professional rooms is made.

Pro roblem: Sol olut ution: on: Limited access to Peer Ensure adequate Support Workers, reimbursement for despite the strongest Peer Support Workers scientific evidence that (PSWs) and support patients do best with Peer training and deploying PSW involvement. of PSW statewide. Reimbursement is support inadequate and peer support workers are concentrated in northern NM, not available statewide.

Sol olut ution: on: Pro roblem: NMHA member Timely referrals to Treatment appropriate levels of hospital care are difficult, with Connect- participation in dire consequences for Treatment ions patients and families. Connections - HSD Providers may have referral led BH online go-to contacts, but referral service. there has been platform inconsistent coordination and continuity.

Kelley Whitaker, CEO K.Whitaker@fundltc.com Central Desert Behavioral Health Hospital Albuquerque

Breaking d down barri rriers rs Making provisions from emergency public Planning health orders and waivers permanent and integrating BH providers across New Mexico’s and system make us all better prepared. Payment

Probl blem: Solut So ution: BH, and BH hospitals Inclusion,  Full inclusion of BH not fully included in facilities NM DOH MAT integration planning, during Covid, Hub and Spoke model: and in “normal” times. collaboration, of BH communication, integration. across  Include BH providers in NM health Emergency Medical Service Tracking and system Recording System and normal chains

Sol olut ution: on: BH Pro roblem: Leverage BH The healthcare hospital workforce faces high expertise on caring providers: rates of burnout and for staff mental Covid-related “moral health needs, Role injury.” including those of models for hospital staff caring for Covid patients, physical Covid patients who health are staff.

Probl blem: Sol olution on: : Payment drives  Same mechanics of practice. Lack of reimbursement for payment or payment remote treatment parity discourages Reimburs- and in-person access to treatment treatment and optimal treatment ement  Payment parity for patients. parity for across all insurance carriers Telehealth  Preserve payment parity for telephone only visits for dementia patients and others

Sol olution on: : Pro roblem:  Allow a facility fee Some costs and that covers hospital resource requirements platform and tech are unique to infrastructure. expansion and  Support New Beyond successful patient care Mexico internet via telehealth, and they improvement. parity for are not reimbursable.  Consider Telehealth mechanisms to support shifting labor costs and needs: patient education, IT support, etc., so system works well.

Tenika Sosa-Gonzalez Director of Behavioral Healthcare Services Tenika.Gonzalez@LPNT .net Memorial Medical Center Las Cruces

Breaking d down barri rriers rs Expanding successful programs and practices Growing for statewide coverage helps patients and providers. the good

Pro roblem: Sol olut ution: on: Adverse childhood Incorporate trauma events (ACE) impact informed care best- New Mexicans at high practices across rates and can increase Trauma New Mexico whole-person informed healthcare healthcare needs solutions. throughout the life- Care course.

Sol olut ution: on: Pro roblem: Develop BH transfers more coordinated effort patients than any other specialty, yet there is for BH focused, no designated hospital Transport transport. Pediatric BH transportation. patients are sometimes flown to appropriate care, at great expense and increased risk. All competes for resources with other ED patients.