Intake and Screening

1. Intake and Screening • Intake - Front Desk – Reception generally not reimbursable • Initial Screening/Assessment and/or /Existing Consumer Visit With A Clinician • Is this a billable BH service? • For what credential? • Are you billing for it? • What can you do to make this billable? • Different clinician credentials • Include billable services (i.e., collecting vitals for all patients on BH side)

3. Remember, it’s all about Behavior Change? Individuals & organizations change voluntarily when they. . . • Become interested in or concerned about the need for change • Become convinced that the change is in their best interests or will benefit them more than cost them • Organize a plan of action that they are committed to implementing • Take the actions that are necessary to make the change and sustain the change

4. Health PromotionPrograms for Persons with Serious MI • Reducing obesity and improving fitness in adults with SMI is challenging but possible, and requires a multi-component, intensive, evidence-based approach • The best studies demonstrate modest results in reducing obesity but better results in improving fitness • What works better? Intensive manualized programs that combine coached physical activity and dietary change lasting at least 6 months (or more). • Clinically significant weight loss is likely to be achieved by some, but improved fitness by more….. both are important for heart health

5. A Life in Recovery

6. Tackling Challenges to the Integrated Health Workforce

7. PBHCI Workforce • Expand the role of consumers and their families to participate in, direct, or accept responsibility for their own care • Expand the role and capacity of communities to identify local needs and promote health and wellness • Implement systematic federal, state, and local recruitment and retention strategies • Increase the relevance, effectiveness, and accessibility of training and education • Actively foster leadership development among all segments of the workforce • Enhance available infrastructure to support and coordinate workforce development efforts

8. Building the Integrated Health Workforce • Producing and implementing integrated health education curriculum and resources for • Psychiatrists Working in Primary Care • Consumers serving as Peer Educators • Case Managers as Health Navigators • Addiction Professionals Working in Primary Care • Primary Care Physicians Working in Behavioral Health Settings • Care Management in Primary Care for current Behavioral Health Workforce • Mental Health First Aiders in Rural Community Health Centers • Social Worker Standard of Practice and Field Placement

9. CIHS and Financing • Analyzing integrated health staffing and billing structures; • Supporting state dialogues on efforts to address same day billing, identified billing codes; • Sharinglessons learned from integration sites from across the country; • Training and presentations for PCAs, individual TTA to health centers; and • Fostering private foundation support for state and local integration efforts.

10. Billing and Coding Infrastructure • Staffing – Sample of needed expertise • Chief Financial Officer • Payables and Receivables staff • Claims Processers • Knowledge of Payer Requirements • Private Payers • Medicaid • Medicare • Technology supports • Accurate, good documentation of services

11. Maximizing Who Can Bill, for What, and By Whom – Interim Billing Worksheets • Point in time review of each states Medicaid program on what may or may not be reimbursable in your state for integration using currently available codes • Point in time review of Medicare reimbursement • Link CPT, Diagnostic Code and Credential • One of many tools – a place to start the conversation and billing locally and in a state • Do not GUARANTEE you will be paid based on the worksheet • Worksheets Available at: • www.integration.samhsa.gov

12. Sustainability Checklist • Administrative Sustainability • Organizational Infrastructure • Human Resources • Health Information Technology • Clinical Sustainability • Patients/Consumers • Medical Staff • Behavioral Health Staff • Financial Sustainability • Billing and Reimbursement

13. Decision Points When Considering A Model Source: Rick Hankey, LifeStream Behavioral Health

14. Integration with SU Self-Management Recovery Principles in PC Trauma Informed Care • Suicide Prevention • Transitions of Care • Children & Adolescents • State Regulations

15. A Few Questions to Ponder • Will your partnership position your organization to be successful in the future? • How much control are you willing to give up? • Will your staff adapt to a new model of practice and actually support the integration? • Are you able to demonstrate that you are accountable for cost, quality and experience outcomes/value? • How will you ensure that your integration efforts are focused on empowering consumers to lead healthier lives? • Are we willing to give it the time it takes? Integration is a process, that takes intention and time to make it happen.

16. Energy and persistence conquer all things.~Benjamin Franklin

17. The resources and information needed to successfully Integrate primary and behavioral health care Laura Galbreath, Director Online: integration.samhsa.gov Phone: 202-684-7457, ext 231 Email: laurag@thenationalcouncil.org Twitter: @laura3530