Behavioral Health-Primary Care Integration Learning Collaborative January 30 th , 2014

1. LEARNING SESSION NUMBER IJanuary 29th & 30th, 20148:00 AM – 4:15 PMThe Riley Center at Southwestern Seminary1701 W. Boyce Avenue, Fort Worth, Texas 76115Room 150

2. Behavioral Health-Primary Care Integration Learning CollaborativeJanuary 30th, 2014

3. Agenda 8:30-8:40 Welcome and Introductions 8:40-8:50 Learning Session Overview 8:50-9:00 The Case for Integrating Behavioral Health and Primary Care in Region 10 9:00-9:10 Intersection Between the Learning Collaborative and DSRIP 9:10-9:20 Introduce Story Board Gallery Walk 9:20-9:30 Break 9:30-10:15 Storyboard Gallery Walk: Meet the Other Provider Teams

4. Agenda 10:15-10:40 Model for Improvement, Part 1 Aim Statements, Monthly Measures, Run Charts 10:40-11:10Team Meeting#1: Revise Aim Statement, Data Collecting, Planning 11:10-noon The Model for Improvement, Part 2: The Plan-Do-Study-Act Testing Cycle Noon-1:00 pm Lunch 1:00-1:20 Overview of Change Package for Behavioral Health: What do we know that works? 1:20-2:00 Panel Discussion: The Integrated Care Imperative-Why We Must Succeed

5. Agenda 2:00-3:15 Introduction to Motivational Interviewing to Behavior Change 3:15-3:25 Break 3:25-3:55 Team Meeting #2: Planning for High Impact Change, Drafting a PDSA Test 3:55-4:10 Teams Share Their Plans for Action Period 1 4:10 Evaluation 4:15 Adjourn

6. Learning Session Welcome and Introductions Aubrie Augustus, RN, BSN, MHA; Senior VP Network Quality, JPS Health Network and Administrative Director, Learning Collaborative

7. Learning Session Overview Gillian Franklin, M.D., MPH Clinical Effectiveness & Integration Specialist Project Manager & Performance Improvement Specialist, Learning Collaborative

8. Learning Collaborative Model (Breakthrough Series Model)

9. Learning Session Overview The Learning Session

10. Goals And Objectives Goal: Participants will learn about the Model for Improvement . Objective: Participants will understand the various aspects of the Model for Improvement and their functions. Instructional Objective: Participants will work on parts of the Model for Improvement (Plan-Do-Study-Act Testing Cycle) to test change.

11. Learning Outcomes Model for Improvement • Full engagement as early adopters Strategies • Process Improvement NOT Research Elements • “Best Practice” Changes • Learning Collaborative Change Methodology • Aim Statements; PDSA Testing Cycle; Monthly Measures; Run Charts etc. Action Period 1

12. Inquiry-driven

13. Formative Feedback

14. The Take Away Knowledge New Skills Immediate Changes Steal Shamelessly Share Relentlessly

15. Wait, Wait Don’t Tell Me!!! What is a proven way to test potential changes without disrupting your organization’s day-to-day operations?

16. Answer Model for Improvement&Plan-Do-Study-Act Cycle

18. Wayne Young, LPC, FACHE Vice-President Operations and Administrator – Trinity Springs John Peter Smith Health Network Director, Behavioral Health Learning Collaborative

19. The Case for Integrating Behavioral Health and Primary Care in Region 10

20. The Case for Integrated Care US Adults Meeting Behavioral Health Diagnostic Criteria

21. The Case for Integrated Care Adults with Medical Conditions, 58% Adults with Mental Health Conditions, 25% 68% of Adults with Mental Health Conditions Also Have Medical Conditions 29% of Adults with Medical Conditions Also Have Mental Health Conditions Source: Druss, B.G., and Walker, E.R. (February 2011). Mental Disorders and Medical Comorbidity. Research Synthesis Report No. 21. Princeton, NJ: The Robert Wood Johnson Foundation.

22. The Case for Integrated Care Total Healthcare Costs of Patients With and Without Depression Melek, S. P. (2012). Bending the Medicaid healthcare cost curve through financially sustainable medical-behavioral integration. Milliman Research Report.

23. The Case for Integrated Care This and next slide reference: Colton CW, Manderscheid RW. Congruencies in increased mortality rates, years of potential life lost, and causes of death among public mental health clients in eight states. Prev Chronic Dis [serial online] 2006 Apr [date cited]. Available from: URL: http://www.cdc.gov/pcd/issues/2006/apr/05_0180.htm.

24. The Case for Integrated Care Percentage of Deaths

25. Questions?

26. The Intersection of DSRIP and the Learning CollaborativeMallory JohnsonManager RHP 10

27. According to the PFM…. Our Learning Collaborativesshould… Regional plans should recognize the importance of learning collaboratives in supporting continuous quality improvement, RHPs will provideopportunities and requirements for shared learning among the approved DSRIP projects in the region. Learning collaboratives should strongly be associated with Performing Provider’s projects and demonstrate a commitment to collaborative learning that is designed to accelerate progress and mid-course correction to achieve the goals of the projects and to make significant improvement in the Category 3 outcome measures and the Category 4 population health reporting measures.

28. What does the Learning Collaborative mean to Region 10 DSRIP Projects? The continuation of the journey we have all been on together! Over the last two years we have all experienced together…

29. What can the Learning Collaborative mean to your DSRIP Projects? • A networking opportunity to learn how other similar projects are doing and best practices occurring in our community • Focus on specific issues where multiple providers will collaborate to see improvement for all • An opportunity to bring performance improvement practices (CQI) to your projects • Recognition that it’s not just about the milestones, but the broader impact of participation in the Waiver, willingness to collaborate with peers, and show improvement at the individual, regional, and state levels

30. TEAM ME

31. Introduce Storyboard Gallery WalkHunter Gatewood, MSW, LCSW

32. Break

33. StoryBoard Gallery Walk: Meet the Other Provider Teams

34. Model for Improvement, Part 1: Aim Statements, Monthly Measures, Run ChartsHunter Gatewood, MSW, LCSW

35. Team Meeting #1: Revise Aim Statement, Data Collecting PlanningHunter Gatewood, MSW, LCSW

36. The Model for Improvement, Part 2: The Plan-Do-Study-Act Testing CycleHunter Gatewood, MSW, LCSW

37. Lunch

38. Overview of Change Package for Behavioral Health: What do we know that works?

39. Wayne Young, LPC, FACHE Vice-President Operations and Administrator – Trinity Springs John Peter Smith Health Network

40. The Case for Integrated Care A standard framework for levels of integrated healthcare Source: SAMHSA

41. What Do We Know that Works? Integrated Medical Care for Patients with Serious Psychiatric Illness. A Randomized Trial Source: Druss, B., et al. (2001). Archives of General Psychiatry, 58, 861-868

42. Improve Screening Rates

43. Improve Coordination

44. The Case for Integrated Care

45. Thank you Questions?

46. Panel Discussion: The Integrated Care Imperative – Why We Must Succeed

47. Panel Discussion • Melanie Cooper • Peer Support Specialist, JPS Health Network • Karen Dunn • Peer Support Specialist, MHMR of Tarrant County • Joan Barcellona • Family Member, Community Advocate • Patsy Thomas • President, Mental Health Connection

48. Break

49. Introduction to Motivational Interviewing to Behavior ChangeScott Walters, PhD.University of North Texas Health Science CenterSchool of Public Health

50. Break