Integrated Behavioral Health Grassroots Statewide Systems Transformation: If Idaho Can Do It You Can Too!

• Jennifer Yturriondobeitia, MSW Executive Director for Cornerstone Whole Healthcare Organization• Amy Walters, PhD Behavioral Health Director for St. Luke’s Humphrey’s Diabetes Center• Anne Daggett, LCSW Behavioral Health Programs Manager for St. Luke’s Health Partners

Session # E7b

CFHA 20th Annual ConferenceOctober 18-20, 2018 • Rochester, New York

Faculty DisclosureThe presenters of this session have NOT had any relevant financial relationships during the past 12 months.

Conference ResourcesSlides and handouts shared in advance by our Conference Presenters are available on the CFHA website at http://www.cfha.net/?page=Resources_2018

Slides and handouts are also available on the mobile app.

Learning ObjectivesAt the conclusion of this session, the participant will be able to:

• Understand how a grassroots movement can create systems transformation to impact access to behavioral health services.

• Understand how to create a statewide learning collaborative to support behavioral health providers and foster the growth for integrated behavioral health services in primary care.

• Identify key strategies to promote change in policies, payment models, and stakeholder engagement for integrated behavioral health.

1. Corso, K. A., Hunter, C. L., Dahl, O., Kallenberg, G. A., & Manson, L. (2016). Integrating Behavioral Health Into The Medical Home: A Rapid Implementation Guide. Phoenix , Maryland, USA: GreenbranchPublishing.

2. Robinson, P. J., & Reiter, J. T. (2016). Behavioral Consultation and Primary Care Second Edition. New York: Springer Science+Business Media.

3. Miller-Matero, L., Dykuis, K. E., Albujoq, K., Martens, K., Fuller, B. S., Robinson, V., & Willens, D. E. (2016). Benefits fo Integrated Behavioral Health Services: The Physician Perspective. American Psychological Association, 34(1), 51-55.

4. Lanoye, A., Stewart, K. E., Rybarczyk, B. D., Auerbach, S. M., Sadock, E., Aggarwal, A., & Austin, K. (2016). The Impact of Integrated Psychological Services in a Safety Net Primary Care Clinic on Medical Utilization. Journal of Clinical Psychology, 1-12.

5. Ray-Sannerud, B. N., Dolan, D. C., Morrow, C. E., Corso, K. A., Kanzler, K. E., Corso, M. L., & Bryan, C. J. (2012). Longitudinal Outcomes After Brief Behavioral Health Interventions in an Integrated Primary Care Clinic. Family, Systems, & Health , 30(1), 60-71.

Bibliography / Reference

Learning Assessment1. Who needs to start the systems transformation?

2. Who needs to be involved?

3. Where do you start?

4. What is the impact of a grassroots systems transformation?

Mental Health in IdahoNo Medicaid ExpansionMost counties lack community mental health services (especially in rural/frontier areas)Ranked 48th in Mental Health (consistently in bottom 4 states)2016, 8th highest suicide rate in the U.S. (57% higher than national average) Suicide 2nd leading cause of death for Idahoans ages 15-34 (males up to age 44)

Addressing NeedEarly integration efforts existed but no mechanism available to exchange ideas, develop innovative projects, fund and provide trainings or support, etc.St. Luke’s Health Partners (SLHP – Clinically Integrated Network) improve BH network and addressed BH access – opportunity Statewide Healthcare Innovation Plan (SHIP – CMMI Grant) Catalyst for integration in primary care – BH population was not being address but identified as an important need.

Background & HistorySLHP’s Behavioral Health Network workgroup & state of Idaho sponsored Behavioral Health Integration Sub-Committee for SHIP recognized the ”need”

Creation of the grassroots movement for Idaho Integration Behavioral Health Network (IIBHN)

Goal: To develop a professional learning collaborative to enhance and support the growth of Integrated Behavioral Health Programs through peer to peer support, advancing clinical education and facilitating statewide training opportunities

Public Health

Primary Care

SLHP

DHW

Each stakeholder wanted to integrate behavioral health & had resources to contribute.

Recognizing Key Stakeholders

IIBHN Founding Stakeholders

Complexity of an Idea or InnovationIdeasWhat is Behavioral Health Integration?ProjectWhat do we focus on?

DevelopmentHow to develop and implement?

Scale UpHow to outreach and share resources across the state?LaunchWhen and how should the project start?

Stakeholders

Strategic PlanningResources & TA

Goals & Objectives

Vision & Mission

Piecing Together the Learning Collaborative

IIBHN Core Goals

Training opportuniti

es

Develop local

expertise

Professional networks

Policy and advocacy

Advance integration

Idaho Integrated Behavioral Health NetworkVisionLocal networks of BHCs across the state of Idaho that facilitate sharing of best practices, promotion of integrated behavioral health, and are connected to a larger state guiding body that supports this vital healthcare role through technical assistance and advocacy.

LeadershipThe current IIBHN leadership represents multiple organizations from across the state of Idaho who are committed to developing and sustaining a network of talented behavioral health consultants across the state, supported by local and state leadership.

Northern

Eastern

Central

IIBHN Public Health District HubsRoles and responsibilities as conveners:Planning meetingsFacilitating meetingsProviding administrative support

PHD HUBs:Regional Learning Collaboratives provide a neutral space to pursue the group’s vision across the state.

Transformation Goals1. Provide education on different integration models regarding

implementation, best practices, and resources,

2. Facilitate opportunities for statewide and local professional network development among BHCs and administrators on a regular basis,

3. Identify a common readiness tool and promote utilization of the NCQA guidelines for integrated behavioral health,

4. Position the Idaho Integrated Behavioral Health Network as a key policy, advocacy, and technical assistance resource in the state of Idaho, and

5. Educate specialty behavioral health providers on integrated care and provide resources to improve co-management environment.

RHCs FQHCs SHIP

Public HealthFMRI

SLHPIndependentPC ClinicsPayers

DHW

IIBHN Expanded Partnerships

Health Systems

Academic Institutions

Patient Advocacy Groups

Specialty Care

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Non-Profit Partners

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Health Systems Roles for Transformation

St. Luke’s Health Partners Behavioral Health StrategiesTrainings

Coaching

Technical Assistance for practice facilitation and systems transformation

Value based contracting with Payers

Funding support for behavioral health innovative

Workforce Development (Professional Development/Internship Opportunities)

Impact of Systems TransformationIIBHN development

IIBHN conference

Access and direct patient service in primary care and speciality medical services

Workforce development

Clinical and operational training

New role for Health Systems

Collaboration with providers and facilities

Collaboration with academic institutions

Payment models for behavioral health integration

Payer engagement for value based contracts

Systems Transformation Outcomes

Sustainable IBH Transformation Strategy

Learning Collaborative across the state

Statewide learning conference

IBH Advocacy payment & policy

Rapid expansion of integrated behavioral health across the state

IBH learning community

Cadre of local experts (Technical Assistance & Support)

Funding opportunities & support for innovation for IBH

Environment for collaboration and resource sharing

Support for innovative BH service delivery

Q & AJennifer Yturriondobeitia / 208-899-9012 /jeny@ynotinnovators.comAmy Walters / 208-331-1155 / awalters@slhs.orgAnne Daggett / 208-995-7510 / anne@slhs.org

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