Fostering Creativity Through Shared Ideas Anita Berry MSN, CNP, APN

1. Illinois Children’s Healthcare FoundationCHILDREN’S MENTAL HEALTH INITIATIVEBuilding Systems of Care: Community by Community Fostering Creativity Through Shared Ideas Anita Berry MSN, CNP, APN Director, Healthy Steps for Young Children Program Advocate Health Care Project Director, Enhancing Developmentally Oriented Primary Care

2. Objectives Participants will be able to • Identify the importance of Integrating primary care and mental health • Understand Enhancing Developmentally Oriented Primary Care (EDOPC) and how they work in Illinois • Clarify the concept of a Medical Home

3. Primary Care and Mental Health What Do Community Resources Tell Us about Communicating With Primary Care Providers? • difficult to access needed records and forms • lack of response to requests for medical records or prescriptions for service • spend too much time on seemingly simple tasks • reaching the appropriate practice staff member, securing signed forms • conflicting information regarding level of detail desired in reports

4. Primary Care and Mental Health What is it All about?

5. AAP Mental Health Task Force Plan* AAP Task Force on Mental Health, June 2010, Pediatrics

6. EDOPC Key Partners Illinois Chapter American Academy of Pediatric Advocate Health Care Healthy Steps for Young Children Program

7. EDOPC Goals • Improve delivery and financing of preventive health and developmental services for children birth to three • Build on existing programs to develop a range of strategies for primary care settings

8. EDOPC Topics for Training • Developmental Screening and Referral • Social and Emotional Development: Screening Strategies for Primary Care Physicians • Identifying Postpartum Depression During Well-Child Visit: Resources for Screening, Referral, and Treatment • Early Autism Detection and Referral • Domestic Violence Effects on Children: Detection, Screening and Referral in Primary Care • Obesity Prevention in the Early Years

9. Additional EDOPC Topics for Training • Effective Discipline in the Early Years • Coordinating Care Between EI and the Primary Care Medical Home Project • Psychosocial Developmental Screening and Referral for Children Aged Five to Eight Years • Coordinating Care Between Early Intervention and the Primary Care Medical Home • Bright Futures Guidelines for Health Supervision (beginning July 2011)

10. EDOPC Methods • On site presentations to entire practice staff and topic specific community resources • Educational Teleconferences • Hospital Grand Rounds or Department Meetings • Web based training • Technical Assistance – email, phone, on site • Local and National Conferences

11. EDOPC Training in Illinois • 1250 primary care providers • 3200 allied healthcare staff • 80% of Federally Qualified Health Centers • 153 private practices • 30 Residency, Nurse Practitioner, and Physician Assistant programs

12. EDOPC Provider Survey Providers who received intense EDOPC training, which includes technical assistance, were more likely to have a higher screening rate than providers with little or no EDOPC training. Trained Little or no training PPD-59% PPD-25% Dev-89% Dev-69% SE-37% SE-17%

13. Medicaid Data Analysis - 2009 • Rise in percent of well child visits with developmental screen 2002 = 15% 2009 = 32% • percent of providers conducting at least one developmental screen in a year increased 2002 = 13% 2009 = 46% • The percent of EI recipients screened for development by primary care provider before beginning EI services 1 2002 = 18% 2009 = 54%

14. So Where Are We Going?

15. Task Force on Vision in Pediatrics

16. Why do this?

18. AAP Task Force on Mental Health* AAP Task Force on Mental Health, June 2010, Pediatrics

19. Proposed Mental Health Screening of Children and Adolescents * AAP Task Force on Mental Health, June 2010, Pediatrics

20. Proposed Screening and Surveillance of Family and Social Environment for Risk Factors* *AAP Task Force on Mental Health, June 2010, Pediatrics

21. Pediatric Primary Care Providers as a Mental Health Provider? ???

22. Developing collaborative relationships

23. Definition of HEALTH/MEDICAL HOME Accessible Family-Centered Comprehensive Continuous Coordinated Compassionate Culturally-effective Care that is: A partnership between primary care physicians/ nurse practitioners and families

24. Care Coordination is Key • Through a Medical Home partnership, PCPs can help the family access and coordinate • specialty care • educational services • in and out-of-home care • family support • other community services • PCPs and Community Resources must work together to coordinate care

25. Summary • Primary care needs to be included in planning for a system of mental health care • EDOPC training and technical assistance improves providers ability to screen, treat, and follow up with children and make appropriate referrals to community resources • A medical home is a partnership to help families access and coordinate care