Integration: Behavioral and Primary Physical Health Care

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Integration: Behavioral and Primary Physical Health Care

FAADA/FCMHC

August, 2013

Diana Murray, RN, MSN

Regional Account Manager

The Joint Commission

Client name/ Presentation Name/ 12pt - 2

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Objectives

Discuss the changing environment in which today's behavioral health organizations operate

Discuss the Joint Commission model for providing integrated behavioral health and primary physical health.

Discuss Joint Commission standards related to integrated behavioral and primary physical care

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The Joint Commission Mission

To continuously improve health care for the public, in collaboration with other stakeholders, by evaluating health care organizations and inspiring them to excel in providing safe and effective care of the highest quality and value.


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Accrediting Behavioral Health organizations since 1969

Accredited over 2,000 Behavioral Health organizations

Range of settings/services

Our focus: helping behavioral health organizations help the people they serve.

Joint Commission Behavioral Health Care Accreditation


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Mental Health, Addiction Treatment and Primary Physical Care Traditions

Separate delivery silos

Sequential care, treatment and services

Distinct professional training

Minimal communication and collaboration


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Various provisions of the ACA Expanded access to rehabilitative, prevention and

wellness services.

Incentives to coordinate primary physical care, mental health, and addiction services.

Enhances community-based service options for individuals with a serious mental illness.

Develop capacity to provide services in an effective and modern mental health system through various workforce initiatives, including education and training grants, loan repayment programs, and primary physical care residency training.


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ACA: Defines health homes as

“comprehensive and timely high quality services”Services provided must include:

Comprehensive care management

Care coordination and health promotion

Comprehensive transitions of care from inpatient to other settings, including appropriate follow-up

Individual and family support, which includes authorized representatives

Referral to community and social support services, if relevant

The use of health information technology to link services, as feasible and appropriate


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Health Homes

Section 2703 of the Affordable Care Act

States establish health homes through Medicaid State Plan Amendment

Primary physical and behavioral health integration grants

SAMHSA – HRSA Center for Integrated Health Solutions


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Primary Physical Health Care

Basic level of physical health care

Promotion of physical health and disease prevention

Early diagnosis of disease or disability

Treatment of acute and chronic illnesses

Health maintenance and education


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State Medicaid Plans

Building on the Patient Centered Medical Home experience to create health homes for Medicaid eligible recipients with people with serious mental illness and/or substance abuse condition


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The Joint Commission

Behavioral Health

Home Certification


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Joint Commission Accreditation and Certification for

Integrated Behavioral and Primary Physical Care

Ambulatory Primary Care Medical Home Certification

– Federally Qualified Health Centers tailored with Behavioral Health when provided

– Ambulatory Care Clinics

– Medical Groups

Behavioral Health Home Certification

– 16 Settings and services

– Primary Health care when provided


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Concepts Integrated into the Ambulatory Accreditation Program

Primary Care Medical Home Certification Standards*

Patient Centered Care

Comprehensive Care

Coordinated Care Superb Access to Care

A Systems-Based Approach to Quality and Safety

*Agency for Healthcare research and Quality Medical Home Model


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Behavioral Health

Home Certification

Accreditation Requirements

– Core Standards

– Additional BHH Certification Standards


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Care, Treatment and Services

For organizations that elect The Joint Commission Behavioral Health Home option

Define Population in BHH

Data collection

Arranges for the history and physical to occur, if necessary


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Additions to Core StandardsCare, Treatment and Services

Individual’s short- and long-term physical health care goals

Screening and/or assessment for chronic physical health conditions

Individual’s ability to self-manage chronic behavioral and physical needs

Identification of physical health goals

Disciplines are collaborative and integrated


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Care, Treatment and Services The physical health care needs of the individual, -

The physical health care goals of the individual, - How the organization will meet those needs,- How the organization will help the individual to work toward achieving his or her goals

verbal and written communication needs of the individual served including his or her preferred language for discussing health care.

Integration of both physical and behavioral health needs and goals.


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Care, Treatment and Services Coordination of External Referrals

Literacy Needs

Self Management

Education

Provides excellent access to integrated care, treatment, or services

Provides or facilitates the provision of prevention, screening, and primary physical health care, treatment, or services as part of integrated care


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Care, Treatment and Services Accountable for Integrated care

Integrated Team

Case Management

Training and Support


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Performance Improvement

Data Collection

Data Analysis

Improves Performance


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Record of Care

Contains the following behavioral and physical health information:– All behavioral and physical health diagnoses and

conditions that have required care, treatment,or services

– All hospital admissions

– All hospital re-admissions

– All urgent care and emergency department visits

– Individual’s race and ethnicity

– Self Management goals related to integrated care


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Rights and Ethics Receive information in a manner he or she

understands

Collaborate in decisions about his or her care, treatment, or services

Receive information about the staff responsible for his or her care, treatment, or services

Functions and services of the behavioral health home

End of Life Care


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Summary

BHH is not for every Behavioral Health Care Company

BHH is integration of Behavioral and Physical Care

Majority of standards found in Care Treatment and Services

Pre-publication Standards http://www.jointcommission.org/standards_information/prepublication_standards.aspx


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Contacts Peggy Lavin, Senior Associate Director

– [email protected]

– 630-792-5411

Evelyn Choi, Senior Business Development Specialist


– 630-792-5866

Diana Murray, RN, MSN, Regional Account Manager


– 630-792-5295

Integration: Behavioral and Primary Physical Health Care

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