BRIGHTBRIGHTBBehavioral health ehavioral health RResources esources IIntegrated with ntegrated with

GGood ood HHealth care ealth care TTechniquesechniques

Prestera Center for Mental Health Services, Inc.Prestera Center for Mental Health Services, Inc.Valley Health Systems, Inc.Valley Health Systems, Inc.

West Virginia Mental Health Consumers Association West Virginia Mental Health Consumers Association Cohort IIICohort III

Learning Community IVLearning Community IVGlenn Ratliff Glenn Ratliff

Glenn.ratliff@prestera.orgGlenn.ratliff@prestera.org304.525.7851, extension 1104304.525.7851, extension 1104

Background/Partnership HistoryBackground/Partnership History• Prestera Center – Largest community mental health center in Prestera Center – Largest community mental health center in

West Virginia. West Virginia. – Provide mental health and substance abuse treatment to over 19,000 Provide mental health and substance abuse treatment to over 19,000

children, families and adults each year. children, families and adults each year. – Serve 8 counties in 50+ locations. Serve 8 counties in 50+ locations.

• Valley Health Systems, Inc.– Valley Health Systems, Inc.– – Provides primary and preventative care in 28 locations in 2 states.Provides primary and preventative care in 28 locations in 2 states.– Serves more than 68,000 patients yearly. Serves more than 68,000 patients yearly.

• West Virginia Mental Health Consumers Association – West Virginia Mental Health Consumers Association – 25 years experience. 25 years experience.

– Operates 6 statewide Wellness and Recovery/ Drop-in centers, 18 Operates 6 statewide Wellness and Recovery/ Drop-in centers, 18 offices. offices.

– Offers peer recovery network, peer support specialists, and Offers peer recovery network, peer support specialists, and community supports. community supports.

About our Program About our Program • Integration model:Integration model: IMPACT Evidence based depression care IMPACT Evidence based depression care

– Collaborative care is the cornerstoneCollaborative care is the cornerstone– Care managerCare manager– Designated psychiatristDesignated psychiatrist– Measurement of depressive and other symptoms with validated measurement toolsMeasurement of depressive and other symptoms with validated measurement tools– Stepped care goal of 50% reduction in symptoms within 10-12 weeks Stepped care goal of 50% reduction in symptoms within 10-12 weeks

• Strategy used to incorporate primary care:Strategy used to incorporate primary care: – Proven effective in Primary Care Proven effective in Primary Care – Nurse care manager is the key (functions like a behavioral health case manager) Nurse care manager is the key (functions like a behavioral health case manager) – Consumers are comfortable and familiar with case managementConsumers are comfortable and familiar with case management

• Enrollment target:Enrollment target: – Expanded services to Prestera’s clients who have Serious Mental Illness (SMI) Expanded services to Prestera’s clients who have Serious Mental Illness (SMI) – Wellness Recovery Action Plan (WRAP) Wellness Recovery Action Plan (WRAP) – Health and wellness activities Health and wellness activities – 500 SMI clients per year 500 SMI clients per year

About our ProgramAbout our Program• Special populations served:Special populations served:

– Behavioral health consumers with serious and persistent mental illnessBehavioral health consumers with serious and persistent mental illness

• Program setting:Program setting: – Rural AppalachiaRural Appalachia

• Wellness services offered:Wellness services offered: – Smoking CessationSmoking Cessation– Cooking Matters Cooking Matters – YogaYoga– Chair YogaChair Yoga– ZumbaZumba– WRAPWRAP– Walking Walking

About our ProgramAbout our Program• Peer Contributions:Peer Contributions:

– Prestera partnered with The West Virginia Mental Health Consumers Association to provide Prestera partnered with The West Virginia Mental Health Consumers Association to provide WRAPWRAP

– Two Steering Committee MembersTwo Steering Committee Members– Peer assistance with evaluationPeer assistance with evaluation– Peer review of all program materialsPeer review of all program materials– Peer voice in choice of wellness activitiesPeer voice in choice of wellness activities

• EHR vendor:EHR vendor: – Care Logic by Qualifacts since July 2010Care Logic by Qualifacts since July 2010

• Any other unique information:Any other unique information:– On site labOn site lab– Construction of Integrated Construction of Integrated Primary/Behavioral Health Primary/Behavioral Health and Wellness clinic and Wellness clinic using state fundsusing state funds

Who We AreWho We Are• 2 Nurse Practitioners2 Nurse Practitioners• Registered NurseRegistered Nurse• Wellness CoachWellness Coach• Office Manager Office Manager

• WRAP CoordinatorWRAP Coordinator• Program Program CoordinatorCoordinator• Licensed Licensed PsychologistPsychologist

HITHIT

• Prestera is collaborating with two other PBHCI grantees, Prestera is collaborating with two other PBHCI grantees, Community Mental Health Affiliates, Inc. and Milestone Community Mental Health Affiliates, Inc. and Milestone Center.Center.

• Progress to dateProgress to date– Joined West Virginia Regional Health Information Technology Joined West Virginia Regional Health Information Technology

Exchange Center, WVRHITEC, with at least monthly contact. Exchange Center, WVRHITEC, with at least monthly contact. – In stage two of three of our EHR vendor, Care Logic, being In stage two of three of our EHR vendor, Care Logic, being

certified by Quest. certified by Quest. – Feature Spec document has been completed and final approved Feature Spec document has been completed and final approved

by the collaborators. by the collaborators. – Overall Grantee Certification completed by end of July 2012. Overall Grantee Certification completed by end of July 2012.

Consumer ProfileConsumer Profile

• 53% between ages of 25-4453% between ages of 25-44• 92% Caucasian Appalachians 92% Caucasian Appalachians • 38 % unemployed and disabled38 % unemployed and disabled• 52 % own or rent residence52 % own or rent residence

– However 47 consumers had a total of 1115 reported However 47 consumers had a total of 1115 reported nights of homelessnessnights of homelessness

• 80% of consumers use tobacco80% of consumers use tobacco• Other popular substances of choice are alcohol Other popular substances of choice are alcohol

and prescription Opioidsand prescription Opioids

Plans for the FuturePlans for the Future• SustainabilitySustainability

– Third party billing Third party billing – Community resourcesCommunity resources

– State supportState support

– Foundation grant fundingFoundation grant funding– Cost benefit savings demonstrated through evaluationCost benefit savings demonstrated through evaluation

• Health Home ActivityHealth Home Activity– West Virginia is preparing a state plan amendment.West Virginia is preparing a state plan amendment.– Target population include people with a severe and persistent mental illness. Target population include people with a severe and persistent mental illness. – Community mental health centers can be a medical home.Community mental health centers can be a medical home.– West Virginia plan to be officially submitted by July 1, 2012. West Virginia plan to be officially submitted by July 1, 2012.

• What you hope to accomplish within the next six monthsWhat you hope to accomplish within the next six months– Analyze outcome data to determine additional services neededAnalyze outcome data to determine additional services needed– Seek out partnerships with area organizations for additional wellness activitiesSeek out partnerships with area organizations for additional wellness activities– Continue to identify and address possible barriers to program enrollmentContinue to identify and address possible barriers to program enrollment