Rodger Kessler Ph.D. ABPP Coordinator, Primary Care Behavioral Health

1. A Survey of Mental Health, Substance Abuse and Behavioral Health in NCQA Patient Centered Medical Home Practices Rodger Kessler Ph.D. ABPP Coordinator, Primary Care Behavioral Health Fletcher Allen Blueprint for Health Research Director, Collaborative Care Research Network, National Research Network American Academy of Family Physicians Research Assistant Professor, Department of Family Medicine Center for Translational Science

2. Collaborators • Rodger Kessler, PhD, ABPP • CCRN Research Director CCRN, Senior Scientist, AAFP NRN Principal Investigator • Benjamin F. Miller, PsyD, CCRN Administrative Director, Senior Scientist, AAFP NRN Co Investigator • Wilson Pace, MD, Director AAFP NRN Co Investigator • Sara Scholle Ph.D. Vice President of Research NCQA Co Investigator

3. Acknowledgement • This project would not be possible without the support of the Patient Centered Medical Home Collaborative and the National Research Network of the American Academy of Family Physicians

4. Secretary Sibelius speech December 16, 2009 • “We know that these integrated care models can be especially effective when they combine behavioral and physical health conditions… • The challenge is to spread these models, especially to smaller practices that may not have the same experience dealing with mental health and substance abuse problems.”

5. Background: • There is a great deal of interest concerning inclusion of mental health, substance abuse and behavioral health as part of the Patient Centered Medical Home (PCMH) redesign of primary care • The National Committee for Quality Assurance (NCQA) has promulgated standards and metrics to determine if a primary care practice meets criteria for a level 1, 2, or 3 PCMH • These standards do not currently include elements that address the integration of mental health, behavioral health, or substance abuse

6. We currently have a knowledge gap and an opportunity • We do not systematically know how practices respond to patient presentations that require attention to mental health, substance use or behavioral health issues • We would like to understand what current PCMH practices are doing regarding mental health, behavioral health, and substance use

7. Survey Goal: • To understand NCQA certified PCMH practices’ current responses and future plans to patients whose presentations include mental health, behavioral health, and substance use problems

8. Design: • We propose to create a questionnaire and survey all NCQA recognized PCMH practices (at all levels of recognition) to better understand the current activities within practices

9. We will: • Develop and pilot test the questionnaire • Develop the survey methodology • Execute the survey • Once the data are collected, we will analyze the survey data and prepare reports

10. Dimensions surveyed • Current responses to behavioral health presentation • What activities related to behavioral health are performed within the PCMH practice? • If behavioral health services are offered within the practice, who offers them? • Communication between medical and behavioral health providers • Are there future p[alans for anything different in response to behavioral health need? • What are barriers to satisfactory behavioral health access and treatment for PCMH patients?

11. Timeline • We expect to be in the field by May • We will intially report 90 days after data is collected