Integrated Health Care Initiative (IHCI) Collaborative Meeting August 1st, 2018 www.mhahouston.org
Agenda Overview • Lunch & Introductions • Laughter Yoga Team Exercise • Integrated Institution Showcase (Q&A) • Work Groups Panel (Q&A) • Updates & Announcements • Next Steps www.mhahouston.org
Laughter Yoga Team Exercise Janet Carroll, RN, BSN, LMT Certified Laughter Yoga Leader & Teacher www.mhahouston.org
Integrated Institution Showcase (Q&A) The University of Texas at Austin Dell Medical School Integrated Behavioral Health Scholars Program www.mhahouston.org
INTEGRATED BEHAVIORAL HEALTH SCHOLARS PROGRAM University of Texas at Austin, Dell Medical School
IBH Scholars Program Launch in Fall 2017 Program Goal To create a cross-college, interdisciplinary integrated behavioral health education and training program to close the workforce gap in Texas . 4 Year Target: Train 100+ behavioral health graduate students to deliver culturally- competent care, with 90% of graduates working with the medically underserved in Texas.
Mission to Close Workforce Gap Why Culturally Competent, Integrated Behavioral Health? Coordinating physical and mental health care can increase access, improve chronic conditions and reduce healthcare spending. • More than 80% of Texas counties are designated as Mental Health Professional Shortage Areas. Primary care settings are the gateway to BH care. • The people of Texas are highly diverse (40% Hispanic, 12% African- American), but the mental health workforce is not. • Low-income and ethnic-minority residents have disproportionately poorer access to mental health care across the State.
Behavioral Health at UT Austin Different Behavioral Health Graduate Programs, Similar Workforce Goals PSYCHIATRY RESIDENCY PROGRAM (MD) Dell Medical School MASTER’S OF SOCIAL WORK, CLINICAL TRACK (MSSW) Steve Hicks School of Social Work PSYCHIATRIC MENTAL HEALTH NURSE PRACTITIONER PROGRAM (MSN) School of Nursing SCHOOL PSYCHOLOGY(PhD) & COUNSELING PSYCHOLOGY (PhD) College of Education CLINICAL PSYCHOLOGY (PhD) College of Liberal Arts
Enhanced Training Curriculum Integrated Clinical Competency-Based Training Sites Curriculum IBH Scholars Program 14 Social Workers 6 Psychiatric Nurse Practitioners 7 Psychologists Evidence-Based & Interprofessional Diversity Trainings Practice
Program Size Training Targets, By Funding Source Hogg Foundation HRSA BHWET Grant HRSA GPE Grant (2017-2020) (2017-2021) (2016-2019) No stipends, capped only by Stipends for 21 trainees Stipends for 7 trainees available training positions in DellMed IPUs Grant funds also fund evidence-based trainings, dedicated faculty time, and operational program support.
Year 1 Outcomes Successes • Launched full program with a complete cohort of 27 trainees. • Overwhelmingly positive feedback on curriculum, competencies, and field placements from students. • Students showed measureable growth in cultural awareness, knowledge of risk factors in their clinical populations. • Students craved even more interprofessional interaction. • Added 15 new integrated field placement sites for Year 2. • Jointly applied for and received additional grant funding (THECB) to launch innovative UT Behavioral Health Recruitment Fair
Year 1 Outcomes Challenges • Different recruitment timelines, supervision requirements, clinical training cycles and historical practices made it challenging to create a shared program experience. • Placement sites have high workloads, limited space. • Lack of shared understanding about what integrated behavioral health looks like, the roles each discipline can play. • UT Austin behavioral health graduate pipeline lacks diversity. • On-going, sustainable funding will be on our minds for the next 4 years.
Value of the Program Year 1 Graduates • 27 graduates, 10 have accepted positions – All working with the medically underserved – 7 of 10 in integrated settings – 6 of 10 working in public sector • Graduates report: – Increased confidence with integration, the value of other disciplines – Evidence-based training invaluable to their day-to-day practice – Desire to continue working with the medically underserved – Desire to provide culturally-competent care
Timeline Next Steps for IBH Scholars • Addition of psychiatry residents to the Year 2 cohort • Interprofessional seminar extended into June • Broader trainings on diversity, bias • Quarterly supervisor trainings for CEU credits • Behavioral Health Graduate Recruitment Fair at UT Austin • Poster Presentations in October 2018: CFHA Conference (Rochester) and NASW Conference (Arlington)
QUESTIONS? Integrated Behavioral Health Scholars Program
Work Groups Panel (Q&A) www.mhahouston.org
Common Agenda Review www.mhahouston.org
IHCI Framework Review www.mhahouston.org
Service Delivery Mission: The IHCI Service Delivery Workgroup will promote and provide education to support the advancement of integrated health care. This work includes: • Educating on the integration of BH screening/services into primary care • Engaging PCPs in continued learning and enhancement of integration • Hosting educational events for providers • Disseminating resources and information Work Group Recommendations: 16 & 17. IHCI Recommendations Report 2016. Weblink. www.mhahouston.org
Service Delivery Current Agreements & Decisions: 1.Build knowledge base of screening models available and used in our service area 2.Increase education of screening models for providers 3.Educate patients on the various aspects of their care Current Achievable Actions: 1.Gather resources and research as part of work group preparation 2.Gather any known best practice screening models in IHC state-wide and beyond 3.Draft the daily screening process at each member organization involved in the IHCI Work Group, including data such as: start to finish process, internal and external resources available onsite, etc. www.mhahouston.org
Institutions of Higher Education Mission: The IHCI Institutions of Higher Education Workgroup will promote the development of a multidisciplinary workforce prepared to work in integrated team-based settings. This work includes: • Documenting and disseminating relevant information to institutions • Providing education on IHC to students enrolled in preparation programs • Providing educational opportunities on best practices Work Group Recommendations: 14 & 15. IHCI Recommendations Report 2016. Weblink. www.mhahouston.org
Institutions of Higher Education Current Agreements & Decisions: 1.Start with development of an elective to implement IHC at universities 2.Build group’s knowledge base and create a foundational landscape Current Achievable Actions: 1.Gather information and resources on universities currently implementing IHC 2.Create list of top 5 learning objectives for an introductory IHC course for a multidisciplinary audience 3.Create list of universities and boards in the region to collaborate with and possibly launch a conference on integrated health care to start partnerships 4.Determine feasibility of TMC Policy course partnership www.mhahouston.org
Financing Mission: The IHCI Financing Workgroup will engage payers to promote sustainable financing of integrated health care through value-based payment models that remove barriers to integration. This work includes: • Documenting and disseminating relevant information to payers • Providing educational opportunities for payers on novel and proven payment methods to support increased levels of integration Work Group Recommendations: 8, 9, 10, 11, and 12. IHCI Recommendations Report 2016. Weblink. www.mhahouston.org
Financing Current Agreements & Decisions: 1.The IHCI and C3 Initiatives will merge their Financing groups 2.Include a master coder in work group to build knowledge and expertise 3.Build a knowledge base of all the payers in the county (roles and efforts) 4.Throughout all efforts, keep parity at the center of all work and decisions Current Achievable Actions: 1.Identify master coder and hold August call for Q&A regarding same-day billing 2.Create list of all payers in the county and identify those to invite to work group 3.Create list of all the payment models used at each organization involved in work group, including any new efforts/pilots underway www.mhahouston.org
Public Policy Mission: The IHCI Public Policy Workgroup will promote the expansion and sustainability of integrated health care in Texas through advocacy efforts. This work includes: • Supporting advocacy efforts to educate policymakers on IHC • Establishing a legislative agenda for the 86th Legislative Session with concrete legislative actions to support increased levels of integration throughout the health and human services sector Work Group Recommendations: 1 to 7 and 13, 17, 18. IHCI Recommendations Report 2016. Weblink. www.mhahouston.org
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