Tag Archives: National Council for Community Behavioral Healthcare

The Partnership: Choosing the Right Model for Your Integrated Healthcare Services

Determining the Model

How do partnering Community Behavioral Health Centers (CBHC) and  Community Health Centers (CHC) determine the ideal model for their foray into integration? There are many factors to consider such as:

  • What are the needs of the individuals served by the partnering organizations?
  • What are the needs of the community?
  • What resources do the organizations bring to the partnership?

Now that the partners have a solid foundation and clear vision for their collaboration, it is time for the careful planning that is necessary to make it a reality.  There are effective tools available to assist organizations in working through this very important process. (Please note that these suggestions and resources are not limited to community providers.) 

The MH/Primary Care Integration Options scale  is available on the SAMHSA-HRSA Center for Integrated Health Solution website. This is very helpful for leading the discussion among the members of the implementation team. The scale assists the partners not only in determining the current reality but also mutually deciding on the desired level of integration: Minimal Collaboration, Basic Collaboration from a Distance, Basic Collaboration On-Site, Close Collaboration/Partly Integrated, and Fully Integrated/Merged in each of these key functional areas:

  1. Access: How do individuals access services?
  2. Services: Are the services separate and distinct or are the primary care and behavioral health services seamless? Or perhaps somewhere in between.
  3. Funding: Do the partners share resources or are they separate?
  4. Governance: Are there separate boards of directors for each organization?
  5. Evidence-based Practices: Do the organizations administer the PHQ-9 or disease registries, for example, and share the results?
  6. Data: Do the partners share information? Do the providers have access to the partner’s EHR?

This assessment process is most effective when stakeholders from each organization are included. Ideally, representatives are included from clinical, management, and administrative departments, as well as a few individuals who use the services. It’s very helpful to have frontline staff and board members to take part as well.  Call center and reception staff offer a unique perspective that leadership frequently finds enlightening.

Other useful tools available include the National Council’s Success in the New Healthcare Ecosystem: Mental Health & Substance Use Provider Readiness Assessment prepared by Dale Jarvis.   This allows provider organization management teams to assess their organization’s readiness for engaging in the changing healthcare system.

Another tool to consider is the COMPASS-PH/BH  created by Zia Partners.  This self-assessment tool is used for primary care/behavioral health integration for implementation of a Comprehensive Continuous Integrated System of Care.

Making the Vision into a Reality

Once the ideal model of integration has been determined, the journey begins to make it a reality. Be sure to stop by for the next installment in the series.

What tools or methods have you found to be helpful when selecting a model for your healthcare integration endeavor?

I would love to hear from you! Please email your suggestions to me at behavioralhealthintegration@gmail.com for inclusion in a future post.

 

Behavioral Health – Primary Care Integration: Choosing a Model

Which Models Work Best?

There are several model programs for behavioral health and primary care integration in the United States that are currently demonstrating outstanding results, such as Cherokee Health Systems, Intermountain Healthcare, and Washtenaw Community Health Organization. However, to quote Dale Jarvis, of Dale Jarvis and Associates, a national consultant specializing in payment and reimbursement system redesign, financial modeling, and business systems design for healthcare purchasers and providers: “All healthcare is local.”  Behavioral health – primary care partnerships can learn much from the model programs but will need modification to meet the unique needs of their communities. A model that is successful in a rural community may not be effective in an urban setting. State regulations greatly impact the success of various models as well, especially if the model relies heavily on funding sources that may have significant differences from state to state.

The promotion of  behavioral health and primary care integration has been identified nationally as holding promise for improved health outcomes and increased efficiency in the use of healthcare dollars. The United States Department of Health and Human Services, (HHS)  is funding 56 Primary and Behavioral Healthcare Integration (PBHCI) projects in an attempt to identify effective means of integrating healthcare. HHS, in collaboration with the Office of the Assistant Secretary for Planning and Evaluation (ASPE), seeks to answer three questions about the integration of primary and behavioral healthcare, as noted in this excerpt from the 10/21/10 SAMHSA webinar, Primary and Behavioral Healthcare Integration by Trina Dutta:

  1. Outcome Evaluation: Does the integration of primary and behavioral health care lead to improvements in the behavioral and physical health of the population with serious mental illness (SMI) and/or substance use disorders served by the grantees’ integration models?
  2. Process Evaluation: Is it possible to integrate the services provided by primary care providers and community-based behavioral health agencies (i.e., what are the different structural and clinical approaches to integration being implemented)?
  3. Model Evaluation: Which models and/or respective model features of integrated primary and behavioral health care lead to better mental and physical health outcomes?

(Contractor: RAND Corporation)

In a collaborative effort between the Substance Abuse and Mental Health Services Administration (SAMHSA) and the Health Resources and Services Administration (HRSA) a training and technical assistance center, the Center for Integrated Health Solutions, is available for PBHCI grantees and other organizations that are integrating behavioral health and primary care services. The Center for Integrated Health Solutions is a division of the National Council for Community Behavioral Healthcare.