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SAMHSA Standard Title Slide

SAMHSA Standard Title Slide. Primary Care and Behavioral Health Integration. John O’Brien Senior Advisor on Healthcare Financing. General Characteristics—People. Individuals in the Public Behavioral Health System (8 million) 61% of the individuals served by SAAs have no insurance

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SAMHSA Standard Title Slide

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  1. SAMHSA Standard Title Slide

  2. Primary Care and Behavioral Health Integration John O’Brien Senior Advisor on Healthcare Financing

  3. General Characteristics—People Individuals in the Public Behavioral Health System (8 million) 61% of the individuals served by SAAs have no insurance 39% of the individuals served by MHAs have no insurance Expect that 90-95% of these individuals will have OPPORTUNITY to be covered Many of these individuals do not have a primary care practitioner on any regular basis

  4. General Characteristics—Providers Almost 1/3 of the SA providers and 20% of MH providers do not have experience with 3rd party billing. Less than 10% of all BH providers have a EHR that is nationally certified Few have working agreements with health centers Staff don’t always have credentials required through practice acts or MCOs Working with National Provider Associations to address these issues

  5. Strong Evidence That Treatment Works • Consumer and Family Education • Pharmacotherapy—especially for SUD • Peer Support Services (SUD/MH) • Skill Building • Assertive Community Treatment • Continuing Care for SUD • Supported Housing and Employment • Recovery Housing for SUD • Intensive Outpatient Services

  6. What Is SAMHSA Concerned About? People Are Dying Younger Younger People in our systems are not exempt from (or at risk of) chronic conditions Significant connection between heart conditions and drug use--Hospitalizations About 1/3 of all cigarette smokers have an MH/SUD 30% of all individuals with a MH/SUD may have 3 chronic conditions

  7. SAMHSA Approach to Primary Care and Behavioral Health Integration • Integration needs to be bi-directional: • MH/SUD in primary care • Primary care in MH/SUD settings • Providers need supports to be effective • Cant do this alone—CMS/HRSA are important partners • States and providers are critical partners in making a difference

  8. Primary Care and Behavioral Health Integration • Program purpose: • To improve the physical health status of people with SMI and those with co-occurring substance use disorders by supporting communities to coordinate and integrate primary care services into publicly funded community-based behavioral health settings • Expected outcome: • Grantees will enter into partnerships to develop or expand their offering of primary healthcare services, resulting in improved health status

  9. SAMHSA’s Primary Care And Behavioral Health Integration Program • Population of focus: • Those with SMI and co-occurring substance use disorders served in the public behavioral health system • Eligible applicants: • Community behavioral health agencies, in partnership with primary care providers • Currently 53 participating providers

  10. Services Delivery Facilitate screening and referral for primary care prevention and treatment needs Provide and/or ensure that primary care services and referral be provided in a community-based behavioral health agency Develop a registry/tracking system for all primary care needs and outcomes Build processes for referral and follow-up for needed treatments with primary care providers Offer prevention and wellness support services (>10% of grant funding)

  11. SAMHSA/HRSA Center for Integrated Health Solutions (CIHS) Technical Assistance Jointly Funded by HRSA and SAMHSA: 4.5 million/year work (co-funded with HRSA) a training and technical assistance center—Center for Integrated Health Solutions Assist with practice development Provide assistance to SAMHSA re: consultation to States http://www.centerforintegratedhealthsolutions.org

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