The Dr. Robert Bree Collaborative Meeting January 21 st , 2015| 12:30pm – 4:30pm
Agenda November 20th Meeting Minutes and Revised Bylaws Approve minutes Approve revised bylaws Addiction and Dependence Treatment Report and Recommendations Adopt Report and Recommendations Bree Implementation Team Update Coronary Artery Bypass Surgery Bundled Payment Model Approve Roster Membership Spotlight: CHI Franciscan Health Hospital Readmission Measures Update The Plan for a Healthier Washington Slide 2
November 20th Meeting Minutes Slide 3
Bylaws – Page 11 Slide 4
Bylaws – Page 12 Slide 5
Bylaws – Page 13 Slide 6
Bylaws – Page 16 Slide 7
Opportunity for Public Comment Slide 8
Welcome New Bree Member Paula Lozano MD, MPH Assistant Medical Director, Department of Preventive Care Group Health Cooperative Slide 9
Addiction and Dependence Treatment Tom Fritz ADT Workgroup chair, Retired, Previously CEO, Inland Northwest Health Services January 21 st , 2014
Substance Use Disorder Screening, Brief Primary, Prenatal, Intervention, Brief Emergency Room Treatment, Referral to Settings Treatment Slide 2
Workgroup Members Name Title Organization Tom Fritz (Chair) Chief Executive Officer, Bree Member Inland Northwest Health Services Charissa Fotinos, MD, MS Deputy Chief Medical Officer Health Care Authority Linda Grant, MS, CDP Director Evergreen Manor Vice President of Outreach Services and Tim Holmes, MHA MultiCare Behavioral Health Administration Co-Director, Adolescent Substance Abuse Ray Chih-Jui Hsiao, MD Seattle Children’s Hospital Program, First Vice President of the WSMA Scott Munson Executive Director Sundown M Ranch University of Washington Addiction Rick Ries, MD Associate Director Psychiatry Residency Program Terry Rogers, MD CEO, Bree Member Foundation for Health Care Quality Snohomish County Human Services Ken Stark, MEd, MBA Director Department Addiction Medicine, Family Medicine Jim Walsh, MD Swedish w/Obstetrics Observers Zosia Stanley, JD, MHA Policy Director, Access Washington State Hospital Association Slide 3
Public Comment Survey 53 respondents to online survey plus additional emailed comments Slide 4
Other Psychologists (2) Washington State Society for Clinical Social Work Family therapist (addictions), legislative committee member of the Washington State Society of Clinical Social Work Washington Advocates for Patient Safety Maternal Fetal Medicine care provider WA Coalition Clinical researcher (2) Non-profit Healthcare Advancement Organization Specialty Treatment Providers Outpatient Pain & Addiction specialist Private, non profit: harm reduction emphasis 3rd party employer rep Non-Profit Association Case manager/RN in Aging and Long Term Care Chemical Dependency Treatment Facility (2) Slide 5
Problem Statement 93% agreed with recommendation problem statement (4% no; 4% neutral) Changes: Alignment with DSM-5 Substance use disorder definition Clear definition as chronic, relapsing-remitting disease Added prenatal care settings throughout More clearly defined scope of work Not recommending specific treatment modalities Not recommending changes to areas outside of the medical system (e.g., criminal justice) Expanded definition of drugs to include “and medical purposes” Added discussion of SB 6312 and HB 2572 (integration of mental health, chemical dependency, and primary care) Clear discussion of benefit of SBIRT to impact those at low levels of use Slide 6
Substance Use Disorder Framework Slide 7
Reduce stigma associated with alcohol and other drug screening, intervention, and treatment 81% agreed with recommendation 1 (6% no; 13% neutral) Changes: Added “culturally competent” Clear definition as chronic, relapsing-remitting disease Slide 8
Reduce stigma associated with alcohol and other drug screening, intervention, and treatment Train health care staff how to have non-judgmental, empathetic, culturally competent , and accepting conversations about alcohol and drug misuse Train health care staff on the prevalence of alcohol and other drug misuse, the impact of alcohol and other drug misuse on other health conditions, and the importance of screening for alcohol and other drug misuse Increase the number of people who see alcohol and other drug misuse screening as a usual part of care and are comfortable discussing alcohol and other drug misuse as a chronic, relapsing-remitting disease on a continuum Slide 9
Increase appropriate alcohol and other drug use screening 81% agreed with recommendation 2 (9% no; 9% neutral) Changes: Clearly state we are not recommending a specific tool Changed screening for those over 13 (age of consent for treatment) from 12 Added acknowledgement of common occurrence of other mental health diagnoses (e.g., anxiety, depression) Recommend that patients be screened as appropriate for anxiety and depression, but discussing screening, intervention, and treatment for these co-occurring disorders in more detail is out of the scope of this document Added discussion of screening pregnant women and screeners validated for pregnant women. Added that older adults may need special consideration Slide 10
Increase appropriate alcohol and other drug use screening Increase the number of appropriately trained staff who utilize an evidence-based screening tool Increase annual alcohol and other drug misuse screening, starting with an initial primary care visit, using a validated, scaled screening tool Implement universal alcohol and other drug misuse screening in primary, prenatal , and emergency rooms (ER) Slide 11
Increase capacity to provide brief intervention and/or brief treatment for alcohol and other drug misuse 85% agreed with recommendation 3 (9% no; 13% neutral) Changes: Added “Provide pregnant women misusing alcohol or other drugs with coordinated, wrap-around care with involvement of appropriate primary, addiction, obstetric, and pediatric providers” Slide 12
Increase capacity to provide brief intervention and/or brief treatment for alcohol and other drug misuse Increase the number of appropriately trained staff who provide brief intervention and/or brief treatment in the primary, prenatal, and ER settings Increase the number of patients who screen positive for alcohol and other drug misuse who receive appropriate brief intervention and/or brief treatment Follow-up with patients as appropriate who have received brief intervention and/or brief treatment Manage adolescents with addictions collaboratively with child and adolescent addiction specialists, if possible Provide pregnant women misusing alcohol or other drugs with coordinated, wrap-around care with involvement of appropriate primary, addiction, obstetric, and pediatric providers Enhance ability to triage patients to appropriate level of care if not improving Increase the accessibility of consulting with qualified behavioral health providers Slide 13
Decrease barriers for facilitating referrals to appropriate treatment facilities 87% agreed with recommendation 4 (8% no; 6% neutral) Changes: Added discussion of SB 6312 and HB 2572. Recommendations are meant to acknowledge the limitations of the current system; recommend steps to improve health care quality, outcomes, and affordability; and support mental health, chemical dependency, and primary care integration in Washington State Added aspirational goals, not recommendations (e.g., patients would be able to detoxify in one facility and then transfer to another chemical dependency treatment facility) Slide 14
Decrease barriers for facilitating referrals to appropriate treatment facilities Increase the number of patients who screen positive who are referred to and receive care at an appropriate chemical dependency treatment facility consistent with the American Society of Addiction Medicine criteria Track patients as they receive appropriate recovery care Contact patients after they receive appropriate treatment to facilitate rapid return to function Increase cross-site communication and data sharing Increase chemical dependency resources sufficient to facilitate successful patient recovery for publicly and privately-insured individuals Address the workforce shortage for certified chemical dependency professionals including training, continuing education, and wages Slide 15
Recommend
More recommend
