MINNESOTA INTEGRATED BEHAVIORAL HEALTH (IBH) PROJECT JUDY BERGH, MINNESOTA FLEX PROGRAM COORDINATOR
FLEX FOCUS AREA: POPULATION HEALTH Understand Community Health Needs of Critical Access Hospitals (CAHs) Determine community health issues and trends Enhance the health of rural communities through community and population health improvement Assist CAHs to develop strategies for engaging with community partners and targeting specific health needs
STEP ONE: ASSESSMENT COMMUNITY HEALTH NEEDS ASSESSMENTS (CHNA) Analyzed 59 CHNAs from MN CAHs Behavioral health one of two most frequently cited needs 16 said it was the top priority Identified need for community partnerships Described goals to integrate behavioral health and outreach
OTHER ASSESSMENTS Local Public Health (LPH) Department Findings Aggregated LPH findings identified access to behavioral services was the top identified need statewide Office of Rural Health and Primary Care (ORHPC) Community Forums Need for access to behavioral health services was identified as a significant need at multiple regional community listening sessions held throughout the state Identification of Rural Mental Health Shortage Areas
STEP TWO: IDENTIFY A CONTRACTOR/PARTNER WHO CAN-- Monitor CHNAs Establish an advisory council Identify CAHs to participate in behavioral health cohorts Conduct customized onsite and remote technical assistance to CAHs Identify measures and collect data Evaluate and share the results
PARTNERS Minnesota Flex Program Rural Health Innovations (RHI) Office of Rural Health and Primary Care National Rural Health Resource Center
STEP THREE: IMPLEMENT THE PROJECT Understand the need Assess CAH readiness Plan to collaborate Build community collaboration Evaluate
NEED
CRITICAL ACCESS HOSPITAL COHORTS • Cohort 1: 2015-16 Five participating CAH • Cohort 2: 2016-17 Four participating CAH • Cohort 3: 2017-18 Four participating CAH • Special Project — Wilderness Accountable Care Organization (ACO) 2017-19
CAH READINESS Essential Organizational Components • Leadership • Strategic Planning • Patients, Partners and Communities • Measurement, Feedback and Knowledge Management • Workforce and Culture • Operations and Processes • Impacts and Outcomes
CAH READINESS (CONT.) Essential Operational Components • Addresses behavioral health needs in transitions of care • Screens all patients for depression and substance abuse • Provides support to all patient care staff on managing their own behavioral health • Maintains an updated resource directory • Invests time and energy building relationships with behavioral health resources in their community • Have credentialed behavioral health providers on staff
COLLABORATION
GOALS AND TARGET POPULATION Goals • Increase understanding of how to access outpatient services • Enhance Coordination of Care • Decrease Emergency Department and Inpatient Admissions Target Population • People who present in ED in behavioral health crisis (refine by age and diagnosis)
CURRENT PROJECTS RHI Support Activity Individual CAH Project Examples Roving Therapist Cohort face to face meetings Resource Guide Individual site visits Regular phone calls with cohorts for Universal Release of Information Form peer sharing and support Regular phone calls with individual hospitals for 1:1 support Help with identifying outcome measures
WILDERNESS HEALTH ACO Six CAHs in NE Minnesota ACO of nine hospitals Requested opportunity to be cohort focusing on stigma and how to make each CAH community a Mental Health Friendly Community
EVALUATION
FUTURE Development and sharing of Toolkit of Best Practices for sharing with other CAHs and their communities Presentation of information in multiple venues Sustainable integration of behavioral health
MINNESOTA INTEGRATED BEHAVIORAL HEALTH PROJECT For more information on Flex management of the IBH project Minnesota Flex Program Judy Bergh judith.bergh@state.mn.us For more information on IBH : Rural Health Innovations (RHI) Kami Norland and Alyssa Meller knorland@ruralcenter.org ameller@ruralcenter.org
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