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IBHP Learning Community

IBHP Learning Community. Learning Community Conference Call Agenda Monday, October 27, 2008 12:00 to 1:30 p.m. Conference Calls November 25, 2008 Clinical Approaches in Primary Care Settings January 27, 2009 February 23, 2009 April 28, 2009 May 26, 2009 June 22, 2009

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IBHP Learning Community

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  1. IBHP Learning Community Learning Community Conference Call Agenda Monday, October 27, 2008 12:00 to 1:30 p.m.

  2. Conference Calls November 25, 2008 Clinical Approaches in Primary Care Settings January 27, 2009 February 23, 2009 April 28, 2009 May 26, 2009 June 22, 2009 Calls will be from noon to 1:30 p.m. Convenings December 11, 2008Los Angeles March 26-27, 2009 August 2009 (tba) IBHP Learning Community

  3. Mentoring Interests • Expanding Primary Care / Behavioral Health collaboration • Skill-building for PCPs and BH professionals • Developing PEI models • Enhancing Care Management • Expanding access to BH services • Advancing cross-system collaboration • Reducing stigma

  4. Mentoring Interests • Most clinics are interested in having an on-site site visit from a mentor agency (64% yes, and 24% maybe) • Clinics are primarily interested in conducting informal consultation and discussion between visiting mentors and professional staff • Almost all clinics (91%) are interested in going on a site visit to a mentor agency

  5. MHSA Activity Reports • Attend SAAC meetings regularly and will be attending the Community Forum for my SPA on December 10. I have also applied to be on the Steering Committee for SPA 4, which will be meeting extensively in January and February to go through PEI data and make funding recommendations. Steering Committee will be picked at November SAAC meeting. (Eisner Pediatric & Family Medical Center) • Attend three monthly Mental Health Council meetings (Children and Youth, Adult and Older Adult) which review a variety of issues affecting the system and give feedback to the County Mental Health Director. Lately the primary focus has been reviewing and providing input on the County’s PEI plans which currently contain little in the way of opportunities for our primary clinics. (Council of Community Clinics, San Diego) • We had 2 meetings with County Behavioral Health Dept. and other service providers for specialty mental health services to introduce ourselves and talk about how we might better serve the community together. This week I received a copy of the County’s plan and activities over the past year. Most of the activities appear to be an expansion of traditional specialty behavioral health activities. We are not involved at this point. (Avenal Community Health Center)

  6. MHSA Activity Reports • We attend PEI Planning Meetings with a specific focus on promoting use of funds to integrate behavioral health and primary care at primary care sites. (LifeLong Medical Care) • We subcontract with two of the Full Service Partnerships to provide primary care providers as part of their Assertive Community Treatment teams (and we provide psychiatry care for one of the teams). (LifeLong Medical Care) • Served on the County’s PEI Planning Committee. Report has been issued, and plan has been filed with the State for approval. PC integration discussed but did not win overall support. Plan has large suicide focus, initial part will be a survey to assess the suicide issue, our largest mortality indicator. SFCCC is beginning to track new MHSA County funds. Working with CPCA on State funds. (San Francisco Community Clinic Consortium)

  7. IBHP Activity Reports • We have developed a very interesting structure for an Integrated Behavioral Healthcare Conference on November 19, which starts at 4pm and includes dinner.  Four presenters will each present for about 45 minutes, giving a brief overview of their skills and knowledge.  Attending clinics will choose one to provide a ½ day of technical assistance at their site. (Council of Community Clinics, San Diego) • County Mental Health staff have visited five clinic sites, and they appeared pleasantly surprised by the knowledge and interest the clinics possess regarding Integration.  (Council of Community Clinics, San Diego)At each site the County initiated discussion about transferring stable County clients to the clinics for treatment.  While interest varied widely, the discussion was useful in: • outlining existing barriers to such a model, and • identifying target subpopulations with unique objectives for  which our organizations would coordinate treatment • stable County clients will transfer to the clinics per an agreed upon protocol, • clients who continue receiving treatment from County will be connected to one of the clinics as a medical home, and • Clinic patients with severe and persistent symptoms will transfer to County Mental Health System.

  8. IBHP Activity Reports • We had a breakthrough meeting between our PCP who had been very much against integration, part-time psychologist (also serves as Behavioral Health Director), CEO, BHC, and substance abuse counselor who works as part of our primary care team. The physician was able to describe how he sees integration working, at least initially, and wants to have monthly meetings with the whole team to discuss treatment. The PCP was invited to observe me doing a consult, and CEO agreed that some patient time would be blocked for this. Outcome: The next day this PCP came to my office to discuss a patient, then took me to the exam room and introduced me to the patient. He stayed in the exam room briefly to observe how I start a consult. (Avenal Community Health Center) • We are opening our clinic on Sunday 10/26 specifically to serve farm workers who can’t make it any other day. We will schedule approx. 40 patients, and all will be seen by the medical provider, the dentist, and our Integrated Behavioral Health team. We are using this day to test how seeing every pt. as part of their first visit might work. (Avenal Community Health Center)

  9. IBHP Activity Reports • Created social worker of the day system at one clinic to create real time access for patients/providers in the primary care clinic (LifeLong Medical Care) • Established mental health representation on i2i work group (LifeLong Medical Care) • Reconfiguring case conferencing at primary care clinic to create better efficiency and ability to cover more cases (LifeLong Medical Care) • We are hoping to have an in-house visit with our mentor to generate enthusiasm with senior staff and providers. (Eisner Pediatric & Family Medical Center) • On-site assessment of current Integration efforts is being conducted by VP of Development, former CEO of Mental Health Center, to develop training and policies.  Developing RFP for trainers on Medi-Cal Billing.  Determined Short Doyle work will be completed in conjunction with County Health Department.  Working with County to develop RFP to conduct clinic readiness assessment for Short Doyle contracting.  Medicare FQHC postponed till early 2009. (San Francisco Community Clinic Consortium)

  10. Collaborating with Primary Care Providers Suggested Topic Areas: • Marketing behavioral health services to PCP's • Providing feedback to PCP's • Engaging PCP's who may be reluctant to utilize behavioral health services • Working with PCP's to formulate and implement patient treatment plans • Keeping PCP's knowledgeable about behavioral health issues

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