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Equity for All : Behavioral Health Equity and Same Day Access

Equity for All : Behavioral Health Equity and Same Day Access. SystemLEAD 2018. Virginia is for LEADERS. Brigette Pride Central State Hospital. Dennis Riddick DBHDS Central Office. Angela Torres DBHDS Central Office. Holly Valiulis Loudoun County CSB. Amber Vernon RBHA. OUR GOALS.

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Equity for All : Behavioral Health Equity and Same Day Access

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  1. Equity for All: Behavioral Health Equity and Same Day Access SystemLEAD 2018

  2. Virginia is for LEADERS Brigette Pride Central State Hospital Dennis Riddick DBHDS Central Office Angela Torres DBHDS Central Office Holly Valiulis Loudoun County CSB Amber Vernon RBHA

  3. OUR GOALS Learn more about STEP-VA & Same Day Access Provide helpful recommendations to CSBs Based on principles of behavioral health equity The lens we look through determines what we will see…

  4. Research Questions • How are various CSBs implementing or preparing to implement Same Day Access (SDA)? • Will CSBs be prepared for people seeking SDA that have Limited English Proficiency (LEP), vision impairments, lack of transportation, and other social determinants of behavioral health? • Can all people truly access the CSB on the same day?

  5. Agenda • Literature Review/Introduction • Methodology • Research Data and Conclusions • Recommendations

  6. Behavioral Health Equity • WHO: Health Equity • The fair opportunity for everyone to attain their full health potential regardless of demographic, social, economic or geographic strata1 • SAHMSA: Behavioral Health Equity • Expands the definition of health equity to include “specific attention to mental health and substance use conditions and disorders”2 1 World Health Organization 2https://www.samhsa.gov/behavioral-health-equity

  7. Behavioral Health Equity Continued… • Civil Rights Act (1964) • Americans with Disabilities Act (1990) • U.S. Department of Health and Human Services CLAS Standards (2004)

  8. Behavioral Health Equity at DBHDS • DBHDS created the Office of Health Equity Advancement in April 2018 • Focus on policy, system, and environmental changes related to meeting CLAS standards and addressing behavioral health disparities

  9. Why Behavioral Health Equity and SDA? • BehavioralHealth Equity • Social Disparities: Differences in health status of various groups based on factors that lead to higher rates of certain diseases compared to others1 • SDA is • First contact with CSBs • Main access point for entering services • Initial assessment for services 1https://medlineplus.gov/healthdisparities.html

  10. STEP-VA: System Transformation Excellence and Performance • Uniform set of required services for individuals with behavioral health disorders in Virginia • Same Day Access (SDA) and primary health integration are the first “steps” in STEP-VA • As of September 2018: • 25 CSBs implemented same day access • 9 scheduled to go live with same day access by the end of 2018 • 6 CSBs will go live by June 30, 2019

  11. Research Process

  12. HPR-4 Websites

  13. HPR-4 Website Reviews

  14. HPR-4 Site Visits

  15. General Observations at CSBs • Accessibility • Signs in other languages • Bathrooms (gender neutral, baby changing) • Children areas • Security • Waiting room size/comfort • Location to bus line

  16. Positive Aspects of SDA

  17. Challenges of SDA

  18. Online Survey of all 40 CSBs/BHAs

  19. Conclusions • Most CSBs followed a similar SDA intake process • Inconsistency in how various populations are served • Positive aspects of SDA • Challenges related to SDA

  20. Conclusions Continued… • Most survey respondents • Had familiarity with behavioral health equityand • Saw behavioral heath equity as being an important priority for their agency • And yet… • 60% reported that everyone did have equal Same Day Access

  21. Conclusions Continued… • Populations facing barriers to SDA: • Those in rural settings far from SDA sites • Those facing transportation issues • Those with Limited English Proficiency (including hearing impaired populations) • Those with child care challenges • Those who are transgender or gender expansive • Those with intellectual/developmental disabilities

  22. Given the identified behavioral health disparities, what can be done to increase equity for all Virginians in the context of SDA? Recommendations

  23. Higher Cost • Development and implementation of targeted advertising campaign • Provision of targeted training to address known disparities in each HPR • Exploration of regional/statewide partnerships • In-person interpretation • Telephone interpretation • Transportation

  24. Thank you!

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