Post on 14-Dec-2015
Integrated Care in the Real World
presented at the
NIDA CTN Steering Committee MeetingWashington, D.C., September 21, 2010, by
John G. Gardin II, Ph.D.Director of Behavioral Health & Research, ADAPT, Inc.Administrator, SouthRiver Community Health Center
Clinical Assistant Professor, Oregon Health Sciences University Medical School
This project was funded by HRSA/DHHS Rural Health Outreach Grant #1D04RH06903-01.00
ADAPT, Inc.Incorporated in 1971Serving 3 countiesSUD: OPT, Res (adult/adolescent)MH: OPT (adult/adolescent)GamblingCorrections/Drug CourtPreventionPrimary Care +
HRSA RHO Grant
To develop an integrated care model situated in free-standing, primary care private practices in Roseburg, Oregon
Barriers to Integrated Care in the Primary Care Setting
Lack of time
Lack of skills
Beliefs and attitudes about SUD/MH
Lack of confidence in SUD/MH treatment
HIPAA/42CFR Part 2
Billing, records
Sustainability
Overcoming Barriers
Staffed by LCSW and establishment of FQHC LA
Full-time co-location in clinic
Adaptation to medical clinic schedule/routine
“Open” cases; brief sessions; available
Modified SBIrT model
Behavioral Medicine billing codes (96150-96155)
Use of EBPs
Results
Screened approximately 2,000 patients/year (20% of total patients per year)
Providing treatment to about 15%; 50% of these are Medicaid patients
30% of Medicaid patients provided 70% of utilization (“frequent flyers”)
64% showed significant improvement (HADS)
Overall medical utilization by Medicaid patients decreased by 13%
For “frequent flyer” Medicaid patients, decreased medical utilization by 33%*
“Frequent flyers” had significantly less (p<.01) medical utilization after BHC sessions for both OPT and ER visits