What California Counties are Doing to Promote Whole Health

1. What California Counties are Doing to Promote Whole Health Joyce Ott, Peer Consultant CA Institute for Mental Health Small County Care Integration Collaborative Boe-Anna Gorsuch & Roslynn Santos Trinity Milestones Wellness Center Peer Staff WWT Workshop March 13, 2013

2. Learning Objectives After completing this workshop participants will be able to: • Define whole health and why health models are the emerging services and supports in all states. • Define the Eight Dimensions of Wellness used in whole health models • Understand what national interventions are driving mental health integration including the Morbidity/Mortality studies, NASMHPAD Triple Aims and CIMH Co. Integrations Collaborative approach. • Improve options for local employment opportunities through paid peer positions • Identify 2 or more health programs currently offered in the California county mental health delivery system? • Provide feedback and tools to other phone participants, offering additional ideas and activities currently in their community.

3. What is Whole Health?

4. Eight Dimensions of Wellness • Emotional—Coping effectively with life and creating satisfying relationships • Environmental—Good health by occupying pleasant, stimulating environments that support well-being • Financial –Satisfaction with current and future financial situations • Intellectual —Recognizing creative abilities and finding ways to expand knowledge and skills • Occupational—Personal satisfaction and enrichment from one’s work • Physical—Recognizing the need for physical activity, healthy foods and sleep • Social—Developing a sense of connection, belonging, and a well-developed support system • Spiritual—Expanding our sense of purpose and meaning in life http://www.promoteacceptance.samhsa.gov/10by10/dimensions.aspx#eightdimensions

5. Factors Driving Improvement • Morbidity and Mortality Studies: • USA Today: Mental Illness Linked to Short Life “Adults with serious mental illness treated in public systems die about 25 years earlier than Americans overall, a gap that’s widened since the early 90s, when major mental disorders cut lifespan by 10 to 15years…. ” • USA Today May 3, 2007

6. Causes of Morbidity & Mortality What are the Causes of Morbidity & Mortality in People with Serious Mental Illness? While suicide and injury account for about 30- 40% of excess mortality, about 60% of premature deaths in persons with schizophrenia are due to “natural causes” • – Cardiovascular disease • – Diabetes • – Respiratory diseases • – Infectious diseases • http://www.nasmhpd.org/search.aspx?SearchTerm=morbidity%20and%20mortality

7. National Triple Aims Intervention • Improve the overall health of the population being served.Identify which person requires special services, such as complex care management or coordination of services • Improve the care experience, which goes beyond simply providing the right type of care. The patient-centered medical home (PCMH) will play a critical role in the care experience by designating a personal provider and care team who are responsible for coordinating each patient’s medical and behavioral healthcare activities.

8. National Triple Aims • Provide the best care possible while lowering the per-capita costs of care over time. While this will be difficult to accomplish, applying evidence-based care and eliminating duplicative or unnecessary procedures – with help from information management technologies such as electronic health records (EHRs) – will give the industry the best chance of success. Triple Aim-HealthPartners is redesigning the health care delivery model http://www.healthpartners.com/public/about/triple-aim/

9. Questions

10. Creating Peer Employment Opportunities CERTIFIED PEER SPECIALISTS • “Being able to bill Medicaid for Certified Peer Specialists for their services provides sustainable funding for a new workforce” “In the mental health field, a workforce that has first hand knowledge of how to successfully combat the debilitating effects of stigma and negative self image…” www.magellanhealth.com/training/webinars/nov2010handout.pdf Evolving Peer Support: Recovery Coaching, Whole Health, and system Integration Carter, Rosalynn (2010), Within Our Reach –Ending the Mental Health Crisis. Rodale, 153.

11. Local Collaborations and Natural Supports • Mental Health and Alcohol and Drug Services • Physical Health & Mental Health Providers. • Pharmacy education around medication management and drug interactions • Non traditional healing: Cultural practices of Native Americans and other organic and holistic  heritage, beliefs and costumes. • Clients, families and communities • CIMH Integration training to county collaboratives

12. The Power of Peers HANDOUT • “A growing body of evidence suggests that hiring more peers*to work in the mental health system and expanding peer‐run crisis respite centers and crisis residential facilities offer a cost effective opportunity to achieve wellness and recovery. Support from the Affordable Care Act and MHSA Workforce Education and Training could sustain California’s leadership in the transformation of the public mental health system of care” Tina Wooten, California Mental Health Managers In Recovery 2013. * Peers – People with lived experience in the mental health system including family members, care givers, parents of children and clients/consumers/survivors

13. Peer Employees Modeling Wellness • Trinity County Milestones Wellness Center Peer Staff Boe Anna Gorsuch - TCBHS Health Challenge • The goal of the program • Who participates Roslyn Santos - Individual Health Challenge • Individual goal to get healthy & save money • Joining a county intervention program

14. Questions

15. Group Discussion with Callers • Caller Feedback: What health activities are promoted by your county mental health services?

16. Thanks for Joining Us

17. Handouts • Whole Health and Mental Health Integration • Peer Support Newsletter • Magellan's Peer Support Whole Health and Wellness e-newsletter! • Creating Peer Employment Opportunities • NASMHPD Whole Health Coaches • Georgia’s Peer Support Expansion into Whole Health Coaches • The Power of Peers • Managers in Recovery • Opportunities for Peer Services in Healthcare Reform • Blog by Sharon Kuehn www.peersnet.org

18. Resource • Georgia’s Peer Support Expansion into Whole Health Coaches • http://www.integration.samhsa.gov/health-wellness/NASMHPD-CIHS_GA_Peer_Whole_Health_Coaches.pdf • Evolving Peer Support: Recovery Coaching, Whole Health, and system Integration • www.magellanhealth.com/training/webinars/nov2010handout.pdf • Opportunities for Peer Services in Healthcare Reform Blog by Sharon Kuehn www.peersnet.org • Pillars of Peer Support Services Summit III • www.pillarsofpeersupport.org/POPS2011.pdf

19. Resources • Primary Care and Behavioral Health integration • http://www.cimh.org/Initiatives/Primary-Care-BH-Integration.aspx • Tool Kit for the California Community Mental Health Workforce. • http://www.cimh.org/LinkClick.aspx?fileticket=N4evyS5-39s%3d&tabid=36 • Healthcare Reform: • http://www.cimh.org/Initiatives/Primary-Care-BH-Integration/Webinars.aspx • California Primary Care and Mental Health Integration Initiatives • http://www.cimh.org/Initiatives/Primary-Care-BH-Integration.aspx • Supporting Change • http://www.cimh.org/Portals/0/e/Performance%20Report%20Printing/CiMH%20Change%20Methods.pdf

20. Resources • Magellan's Peer Support Whole Health and Wellness e-newsletter • http://www.magellanhealth.com/training/pdfs/pswhOct12.pdf • Florida’s Peer Support Whole Health and Resiliency Initiative • http://sites.magellanhealth.com/media/332083/pswh_newsletter_program_spotlight_florida.pdf • CA Mental Health Medi-Cal/ Medicade • Section 1115 Waiver Demonstration • http://www.dhcs.ca.gov/provgovpart/pages/waiverrenewal.aspx • Medi-Cal Policy Committee • http://www.cmhda.org/go/committees/medicalpolicycommittee.aspx