PCBH services not only facilitate change at the individual level but impact the family system. Conversely, family engagement in PCBH services can expedite the achievement and sustainability of an individual’s health goals. Strategies will be discussed that can help enhance family engagement within the PCBH model of care.
The diagnosis of a long-term health condition can be frightening and overwhelming for many people. Behavioral health professionals working in integrated care settings have the unique opportunity to intervene early to assist individuals with adjusting and adapting to the new demands for behavior change that accompany a new diagnosis.
A core skill in caring for patients in primary care is the ability to dose and titrate care for individual patients in a way that produces quality outcomes for the patient and allows a provider to care for populations of patients effectively. This session will increase the mindfulness and skills clinicians employ for dosing and titrating care from within the PCBH model.
Loss and grief are common and often come up during primary care encounters. Grief can be caused by separations, incapacity, bereavement, migration, job loss, birth, retirement, or professional loss. We will focus on addressing grief related to the loss of a loved one in this webinar. One-third of people affected by loss can experience physical or mental health problems, such as increased risk of heart disease, suicide, psychosomatic disorders, and psychiatric issues. However, loss can also lead to personal growth. Behavioral Health Consultants can help PCPs and patients prepare for grief and build coping skills for better health outcomes.
We often think of the treatment plan as a document to complete. However, it can be a tool to engage and empower the person served in their own recovery process. In this interactive webinar we will learn the core components of the treatment planning process from a person-centered and engagement-focused lens.
There are three main approaches to helping people make a change, directing, following, and a middle-of-the-road approach of guiding. Motivational Interviewing (MI) promotes guiding as an approach to discovering and uncovering an individual’s motivations, concerns, values, and options. This refresher workshop will provide the opportunity to directly practice using MI skills to build discrepancy and move conversations towards enhancing commitment to change.
Understanding, measuring, working to improve quality performance are critical to ensuring that patients have positive outcomes and providers are satisfied—they’re also critical to ensure your practice is meeting its regulatory requirements and maximizing payment opportunities. As the District of Columbia carves in behavioral health care to managed care arrangements and requires more providers to be in value-based care arrangements, it is even more imperative that quality measurement and improvement is understood and infused across your organization—from providers, to leaders, to auxiliary staff.
This two-part series will describe the quality measurement basics and why it matters, and then treatment planning for population health. In Part 1, we will explore why we need to infuse a culture of quality within healthcare organizations, including an understanding of what we value, who we serve, and who we are accountable to. Presenters will emphasize the importance of all staff understanding quality and its impact on our patients, staff and organization. We will review the basics of measurement and key measures in quality focused on integrated care.
In making the transition from practicing outpatient behavioral health to primary care behavioral health, clinicians often wonder, how can I do my work in 20 minutes, and is it really possible to make a meaningful difference in this amount of time? This training answers this question directly by simulating a 20 minute behavioral health consultation and discussing as a group each stage of the encounter, best practices, and the strengths and challenges that arise.
In this first workshop, will spend the majority of the time directly practicing foundational OARS skills to evoke interest and commitment to making health behavior changes.
The session will address the realities of health behavioral change and subsequent adherence in integrated, primary care settings, and key lifestyle interventions and recommendations that transcend many evidence-based guidelines for chronic conditions (e.g., diabetes, hypertension, etc.). The session will discuss the importance of filtering evidence-based medicine guidelines through the prism of contextual and compassionate healthcare to increase the probability of patients embracing and implementing such interventions.
This webinar discusses the concept of functional contextualism and the impact this philosophy has on the therapeutic orientation of focused Acceptance and Commitment Therapy (fACT). Specifically, the session will present fACT concepts such as the Contextual Interview, philosophical underpinnings, and influences of psychological flexibility. The session will also cover the philosophy of functional contextualism/fACT fits well within the Primary Care Behavioral Health philosophy.
This session will provide an open opportunity for DC Primary Care and Behavioral Health providers, practice administrators, care managers to drop in with questions or technical assistance requests. In this session, we will follow up on any questions or issues raised and unanswered in the first two sessions.
Every behavioral health care visit concludes with a plan that engages patients in active self-management. This webinar covers the steps to creating a collaborative plan with the patient that they can confidently implement between visits.
DC-based Medical Home Development Group, which successfully piloted CRISP DC HIE’s consent management tool, will discuss how it used the tool in its workflow and lessons learned. CRISP DC will also join the session to highlight key features and benefits of the consent management tool.
This session will focus on enhancing care coordination for patients with SUD and the importance of gaining permission to release information. We will review scenarios such as:
A 35-year-old patient is seeing her PCP. The patient has Type I diabetes and has been much better controlled since she has been in treatment for OUD for the past 5 years. Recently, the patient experienced some life stressors, lapsed and has not been back to treatment for two weeks.
A 60-year-old patient has just recently started treatment for co-occurring depression and AUD after discussing treatment for many years with the PCP. He has hypertension and diabetes, and the alcohol use has been exacerbating these conditions for years. The PCP is concerned about the patient’s ability to stay in treatment as the patient has recently lost his job and is separating from his partner of many years.
Staying informed of a patient’s recovery status can impact how you treat other health conditions and is an important component of their overall care. Have you hit barriers when trying to get the clinical information you need care for your patient? Are you aware of the new pathway to obtain this information? In this session, we will focus on consent management, how to talk with your patients about consent, the basics of 42 CFR Part 2, myth busting, use cases, and FAQs. We will introduce CRISP DC’s Consent Management tool, including a history of its development, gaps it will address, and key features and why this is a priority in the District.
This highly interactive webinar will address the structure of the BHC visit from PCP screening for behavioral health conditions and implementing a warm handoff to the steps BHCs take when conducting a rapid and targeted functional assessment.
Xylazine is rapidly increasing in the illicit drug supply. A powerful animal sedative, xylazine causes respiratory depression, bradycardia, and hypotension, raising the risk of overdoses and complicating the reversal of overdoses. Xylazine also causes unique skin lesions and risk for severe infections. This quick take gives basic information about xylazine.
Because many women and persons of childbearing age pregnant with SUD may not readily share information with providers and because pregnancy is a period where the motivation for change is extremely high, positioning providers to identify and care for this population has great potential for establishing a recovery path and changing lives. This webinar will review the risks and effects of SUD among women of childbearing age, pregnant and parenting persons and their affected infants, including screening and treatment considerations, breastfeeding decisions and ideal mechanisms for engagement and support of women and other pregnant persons on their recovery journey. We will also cover the short and long-term effects of SUD exposure on the infants, including non-pharmacologic alternative interventions and follow-up considerations.
This short take covers the basic concept of the Screening, Brief Intervention, Referral to Treatment (SBIRT) model. It reviews the reasons for why this approach is important, where SBIRT is delivered. Finally, each component of the model is briefly described.
The front of this handout reviews what providers need to know, do and have a plan for prior to individual or group telehealth sessions. The back of the handout reviews important features of Zoom (TM) for those staff using Zoom (TM) as a platform for delivering telehealth sessions.
This Clinical Guide provides comprehensive, national guidance for optimal management of pregnant and parenting women with opioid use disorder and their infants. The Clinical Guide helps healthcare professionals and patients determine the most clinically appropriate action for a particular situation and informs individualized treatment decisions.
This toolkit was designed to help community providers care for pregnant and parenting people who use drugs in a holistic manner. The kit includes information about stigma reduction, trauma-informed care, and legal services. While the guide was developed IN NY, there are engagement and other information that is useful regardless of location.
SAMHSA supported the development of this guide in 2018 to promote evidence-informed care for pregnant and parenting women who have OUD. It includes modules on prenatal care, postnatal care, infant care, and more.
Patients with poorly controlled diabetes, coronary heart disease, and depression have an increased risk of adverse outcomes. In a randomized, controlled trial, we tested an intervention designed to improve disease control outcomes for diabetes and/or heart disease and coexisting depression. Patients with one or more parameters of poor medical disease control (ie, HbA1c ≥8.5, or SBP >140, or LDL >130) and a Patient Health Questionnaire-9 (PHQ-9) ≥10 were randomized to the TEAMcare intervention or usual care (N = 214). This article will describe the TEAMcare health services model that has been shown to improve quality of care and medical and psychiatric outcomes.
The current need for social distancing and isolation related to the COVID-19 pandemic has necessitated a quick expansion of the provision of mental health services via remote platforms. This tip sheet provides some tips for evaluating and treating suicidal individuals remotely via telehealth.
This guide contains a foreword and five chapters. The chapters stand alone and do not need to be read in order. Each chapter is designed to be brief and accessible to healthcare providers, healthcare system administrators, community members, policymakers, and others working to meet the needs of people at risk for, experiencing, or recovering from SMI and/or SUD.
The goal of this guide is to review the literature on the effectiveness of telehealth modalities for the treatment of SMI and SUD, distill the research into recommendations for practice, and provide examples of how practitioners use these practices in their programs.
To establish the reliability and validity of the Family CAGE (an acronym indicating Cut down on drinking; Annoyed by complaints about drinking; Guilty about drinking; had an Eye-opener first thing in the morning), a four-item instrument intended to assess family alcohol-related problems.
This change guide is designed to assist primary care clinicians and leaders to integrate care for patients with unhealthy alcohol and/or other drug use into routine medical care. As behavioral health care is increasingly integrated into medical settings, especially primary care, the focus is often on depression and anxiety. Care for alcohol and/or other drugs is often omitted or minimized, likely reflecting: stigma, lack of workforce training/education, and the traditional separation of care for alcohol and other drugs from traditional health care (e.g., primary care, emergency care, and behavioral health, etc.). This guide expands on and updates the widely recognized model of Screening, Brief Intervention, and Referral to Treatment (SBIRT).
When two disorders or illnesses occur in the same person, simultaneously or sequentially, they are described as comorbid.
Comorbidity also implies that the illnesses interact, affecting the course and prognosis of both.1,2 This research report provides information on the state of the science in the comorbidity of substance use disorders with mental illness and physical health conditions.
Registries are important population health tools that allow organizations to collect, organize, aggregate, and utilize the information for a variety of purposes. Maintaining registries for certain disease states such as depression or diabetes provides easy access to results, identification of care gaps, and level of improvement and can lead to adjustments in care as needed. This Short Take video provides an introduction to registries and how to use them.
An online resource to provide broad access to resources to clarify best practices to support and improve the care for substance-exposed mothers and newborns. The toolkit includes resources to support screening, assessment, and level of care determination; treatment; transitions of care; and education.
The California Department of Health Care Services (DHCS) has implemented the California Medications for Addiction Treatment (MAT) Expansion Project to address the opioid epidemic throughout the state. This website serves as a separate yet complementary resource to the DHCS MAT Expansion Website and provides resources and information related to the four MAT Expansion Project initiatives operated by Health Management Associates.
The California MAT Expansion Project aims to increase access to MAT, reduce unmet treatment need, and reduce opioid overdose-related deaths through the provision of prevention, treatment, and recovery activities. The project focuses on individuals experiencing homelessness, youth, rural, and tribal populations with limited MAT access. The California MAT Expansion Project, composed of nearly 30 initiatives, is funded by grants from the Substance Abuse and Mental Health Services Administration (SAMHSA).
HMAedu.com is an educational resource specifically designed for training treatment teams about addiction, pain, and behavioral health. With over 25 hours of education through the lens of patient-centered care, users can explore topics of interest or follow the suggested curriculum path. Once a user signs in, the learning management system automatically loads modules that are pertinent to the user’s level of training. This automation allows for consistency in messaging to all providers without delivering information beyond the scope of practice. Each course starts with a TED Talks-style overview that is followed by patient-focused modules of 3-10 minutes each. Each module is traced for completion and can be reported back to the client and individual for tracking purposes.
There is a need for an organizing model that assists practices and policy-makers to prioritize the steps of integration implementation and the need for both technical assistance and funding for key program elements. In order to advance evidence-based integration of general health care in BH settings, clinics have become intensely interested in the underlying steps they can take to implement and advance specific general health practices.
Based on a targeted literature review and input from diverse stakeholders, the framework presented in this report seeks to provide BH clinics and other organizing entities, such as New York State's (NYS) Behavioral Health Care Collaboratives (BHCC) and Behavioral Health Independent Practice
Associations (IPA), with practical guidance using a continuum-based road map approach on the intentional and incremental steps to achieve and advance key subdomains of integrated care for community BH clinics.
What is less clear has been how to accomplish that at scale, given the varying types of primary care practices and, in particular, the resource limitations of small and medium-size practices and the complexity of the models that are currently the evidence-based standards for integrating medical and behavioral care. This framework seeks to fill that gap by delineating a series of steps that providers can take to move toward the integration of behavioral health services into their primary care practices.
The goal of the ICTA program is to improve care and Medicaid beneficiary outcomes within three practice transformation core competencies:
Delivering person-centered care across the care continuum
Using population health analytics to address complex medical, behavioral health, and social needs; and
Engaging leadership to support value-based care.
This document provides more detail, including sub-elements for each core competency.
The Alcohol Use Disorders Identification Test (AUDIT) is a 10-item screening tool developed by the WHO to assess alcohol consumption, drinking behaviors, and alcohol-related problems.
Screening and brief intervention provides an opportunity for clinicians to intervene early and potentially enhance medical care by increasing awareness of the likely impact of substance use on a patient’s overall health.
During the webinar, the presenter will focus on ways to address health equity issues and key considerations for providing linguistically effective services. The presenter will discuss best practices and models to support patients in these challenging times.
Understanding the brain chemistry associated with opioid use disorder treatment is essential: Medications for Addiction Treatment (MAT) restores depleted dopamine in the brain so people impacted by OUD can regain functioning. Recognizing this, therapy and support services for OUD are most effective when provided in accordance with a person's healing process and readiness to engage in treatment.
The American Society of Addiction Medicine (ASAM) has established specific criteria for patient assessments and level of care determinations pertaining to substance use disorder (SUD) – providing the underpinnings for effective treatment and recovery from addiction. This webinar will provide attendees with practical tools and tips for implementation of Screening Brief Intervention and Treatment (SBIRT) including assessments, workflows, and reimbursement.
This webinar will describe how stigma impacts perceptions and resultant SUD care for patients and providers alike. Presenters will also share key concepts and case studies to illustrate ways to address stigma and tools that can be incorporated into their clinical practice.
This module offers a 25-minute video of the neuroscience of addiction as a chronic brain disease presented by HMA’s Corey Waller, MD, MS, FACEP, DFASAM, with emphasis on Opioid Use Disorder (OUD).
"This lecture was developed for audiences of all backgrounds to absorb. From patients to nonspecialist docs. The intent was to move people past the preconceived notion that addiction is a moral failing or choice, to the reality that it is a chronic brain disease that creates maladaptive connections in large swaths of the brain. Over the hundreds of lectures, I have given in my career, I have come to realize that running through 30+ articles in a 70 slide PPT does not move people emotionally. But a good story will. The lecture has coalesced into a story form that is much more compelling than digging through the dense science of voxel dysmorphology, BOLD fMRI technology, and all of the structures postulated to drive craving. If I need a custody officer to "get it" or an administrator to understand the concept, I cannot give them the same lecture I would give a psychiatrist, addiction psychologist, addiction doc, or a neurologist."
The webinar presents policy and reimbursement implications for changes regarding Medicare and Medicaid and the impacts on key provider decisions concerning selecting, implementing, and building a business case for new telehealth services to support patients in these challenging times.
This webinar focused on the appropriate screening and assessments for substance use disorders, including the difference between screening and assessment, brief interventions for substance-related issues, and medications for opioid use disorder.
