View materials from this event hosted by Department of Health Care Finance, DBH Training Institute, & Integrated Care DC on May 9, 2023. The in-person workshop was designed for behavioral health providers and other organizations seeking to prepare for the integration of behavioral health into the District’s Medicaid Managed Care Program. Presenters shared information and facilitated exercises to help leadership, clinical and operational staff, and other stakeholders develop the organizational competencies needed to succeed in managed care, including an understanding of managed care principles, how to communicate effectively with managed care partners, and how to effectively demonstrate the value of care through quality measurement and population health.
Fentanyl continues to have an increased presence in the drug supply necessitating reconsideration of prevailing treatment approaches for OUD. This session will explore inadvertent exposure and aspects of OUD treatment that may require updating given the high level of fentanyl now experienced in DC.
Health Management Associates invites you to join us for a lunch and learn workshop to learn more about Overdose Prevention and how to save a life in DC. In this interactive lunch and learn we will discuss DC’s Naloxone Distribution Program and the organizations currently providing Naloxone and provide:
an overview of DC’s Standing Order and Samaritan Law
an overview of the uses of opioids
information on how naloxone stops an overdose and provide information on the action steps to take to save a life and stop an overdose.
Where and how individuals can access naloxone, syringe services, and fentanyl test strips in DC.
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.
During this brief presentation, Kristan McIntosh, LMSW, shares an overview of what a Certified Community Behavioral Health Clinic (CCBHC) is, discusses why it is an important opportunity to build behavioral health system capacity, and talks about some upcoming opportunities to become (or partner with) a CCBHC.
This hour-long presentation will discuss the Value-Based Payment framework and where the Medicare bundled payment available to Opioid Treatment Programs (OTPs) fits. It will also include information about how to appropriately bill the bundled payment in various situations, and when to bill separately for additional services.
This one-page self-assessment can be utilized before individual or group MAT appointments; this tool aligns with ASAM criteria allowing the provider to plan for the current session and to aid in treatment planning. With a slight modification, this could also be used by persons not on MAT in preparation for individual or group appointments for substance use disorders. Critical questions required for all telehealth appointments are reviewed, such as the address and phone number where the person can be reached today.
The Department of Health Care Finance (DHCF) awarded grants to local organizations to support new telehealth services for residents in Wards 7 and 8 as well as residents of homeless shelters and public housing developments. These projects connect patients to specialists using interactive audio, video, or other new technology. DHCF also awarded grants to local organizations to support telemedicine services among the District’s medication-assisted therapy (MAT) network of providers, including providers authorized (“waivered”) to treat opioid dependency with buprenorphine. During this session, we will hear from the three Tele-MAT grantees about their programs’ successes, challenges and lessons learned. An overview of Tele-MAT will be provided in part 2 of this series on January 25, 2021, 12:00pm - 1:00pm ET.
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 one-page handout will help patients understand when they will start buprenorphine, based on the last time they used opioids and their current level of symptoms. It describes how to take buprenorphine in order for it to help with cravings and withdrawal symptoms, what dose of medication to take when starting and afterwards, and other important information about buprenorphine.
This short take talks about the added importance of building trust and integrating culturally and linguistically evidence-informed social, physical and behavioral health services during pregnancy. The short take place particular emphasis on pregnant people who use drugs because historically stigma, racism and other isms have often meant their care has not been clinically appropriate.
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 short take video demonstrates how to teach and use guided imagery with your patients/clients for stress management. Guided imagery leverages the mind-body connection to efficiently relax the body through the use of imagination.
This short take video is a demonstration of how to use progressive muscle relaxation as a strategy for stress reduction with your patients/clients. This technique for relaxation was developed in the 1920s by Dr. Edmund Jacobson. This technique has been now used for decades to address stress, anxiety, and depression and is used proactively as a strategy to maintain positive mental health and improve quality of life as demonstrated in studies.
This short take video demonstrates how to teach deep breathing techniques to a patient/client as a strategy for stress management. Abdominal breathing is the term often used to describe this breathing technique. The term belly breathing is often used with pediatric patients/clients. Breathing exercises can help individuals with stress or anxiety disorders. Abdominal breathing can mitigate hyperarousal in the body when under stress and help to focus the mind.
Cognitive Behavioral Therapy (CBT) is a type of psychotherapeutic treatment that helps people learn how to identify and change maladaptive thought patterns that have a negative influence on behavior and emotions. This short take video will cover the key principles of CBT and a few basic techniques that are utilized for various conditions.
Contingency management is an evidence-based treatment plan for substance use disorder. This type of treatment, a major topic in media and public policy circles, promotes behavior change and reinforces positive behaviors. This short take video discusses contingency management treatment in more detail and how to increase its use in more practices.
There are a variety of strategies and interventions to help individuals cope with the impact of trauma on their wellness and functioning. Many evidence-based treatments and promising treatments involve the teaching and use of skills to help the individual cope with trauma. One category of those skills is helping individuals to connect and get grounded in their body as a way to cope with and manage affect dysregulation, intrusive thoughts and imagery, distress and dissociation. Many new treatments for PTSD and trauma-related disorders are emerging that are focused primarily on working with the body to bring about relief. "Getting into the body" skills can be integrated into treatment for PTSD and trauma-related disorders or used in a consultation model to build mastery with the individual and support functional restoration.
There are a variety of strategies and interventions to help individuals cope with the impact of trauma on their wellness and functioning. Many evidence-based treatments and promising treatments involve the teaching and use of skills to help the individual cope with trauma. One category of those skills is helping individuals to connect with and experience their emotions a way to cope with and manage affect dysregulation, intrusive thoughts and imagery, distress and dissociation. "Experiencing emotion" skills can be integrated into treatment for PTSD and trauma-related disorders or used in a consultation model to build mastery with the individual and support functional restoration.
Problem-Solving Therapy (PST) is a form of therapy that provides people with tools to identify and solve problems that arise from life stressors that can have a negative impact on their day-to-day lives. Its aim is to improve individuals’ overall quality of life and can be used to treat depression, among other conditions. It is based on a model that takes into account the importance of real-life problem-solving including how to manage real-life stressors when they arise. The presentation will cover key PST principles and tools that can be used in everyday life.
There are many evidence-based techniques that are easy to learn and practice, with good results in individuals struggling with physical and mental health challenges. This workshop with briefly introduce participants to some of the more common and effective practices including progressive muscle relaxation, guided imagery, diaphragmatic breathing, relaxation response, and mindfulness-based stress reduction. Speakers: Shannon Robinson, MD (HMA), Marsha Johnson, MSW, LCSW (HMA)
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.
This interactive virtual workshop is part two of a two-part series to support providers ongoing efforts to implement and sustain innovative models of telehealth following the COVID-19 public health emergency. Topics include best practices to support behavioral health care delivery through telehealth; improving patient engagement through telehealth and DC telehealth policy and priority updates.
https://www.integratedcaredc.com/wp-content/uploads/2021/08/Webinar-Telehealth-in-a-Post-Pandemic-Era-Sustainable-Approaches-to-Support-Integrated-Care.mp4 Webinar This interactive virtual workshop is part one of a two-part series to support providers ongoing efforts...
Results suggest that cannabis use during adolescence is associated with altered neurodevelopment, particularly in cortices rich in cannabinoid 1 receptors and undergoing the greatest age-related thickness change in middle to late adolescence.
Substance use disorder treatment professionals are paying increased attention to implementing patient-centered care. Understanding environmental and organizational factors associated with clinicians’ efforts to engage patients in clinical decision-making processes is essential for bringing patient-centered care to the addictions field. This study examined factors associated with patient-centered care practices in substance use disorder treatment.
NIH study suggests a link between cannabis use and higher levels of suicidal ideation, plan, and attempt. An analysis of survey data from more than 280,000 young adults ages 18-35 showed that cannabis (marijuana) use was associated with increased risks of thoughts of...
Controlled substances (CS) diversion in health systems can lead to serious patient safety issues, harm to the diverter, and significant liability risk to the organization. Diversion driven by addiction puts patients at risk of harm, including inadequate relief of pain, inaccurate documentation of their care in the medical record, exposure to infectious diseases from contaminated needles and drugs, and impaired healthcare worker (HCW) performance. In addition to patient harm, there are regulatory and legal risks to the organization, including fraudulent billing and liability for resulting damages, and decreased community confidence in the healthcare system. These guidelines provide a detailed and comprehensive framework to support organizations in developing their CS diversion prevention program (CSDPP) in order to protect patients, employees, the organization, and the community-at-large. Ultimately, each organization is responsible for developing a CSDPP that complies with applicable federal and state laws and regulations but also one that applies technology and diligent surveillance to routinely review process compliance and effectiveness, strengthen controls, and seek to proactively prevent diversion.
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).
IBHA recommends that health systems, insurance plans, and others looking to measure progress toward integrating behavioral health in primary care use the 2017 PCPCH Standard 3.C.3 as the integration metric of choice. At the system level, IBHA concurs that measuring practice-level progress toward adopting excellent integrated care delivery models in the most meaningful way to affect system change.
Untreated drug and alcohol use contributes to tens of thousands of deaths every year and affects the lives of many more people. We have effective treatments, including medications for opioid and alcohol use disorders, that could prevent a significant number of these deaths, but they are not being utilized widely enough, and people who could benefit often do not even seek them out. One important reason is the stigma around those with addiction.
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.
Adolescents are at the highest risk for experiencing health problems related to substance use. This resource provides an overview of screening adolescents for substance use disorders including assessments and tips.
This brief video provides an overview of fentanyl strip testing to identify the presence of fentanyl in unregulated drugs for people who use drugs (PWUD). It also includes a brief demo of how to use fentanyl test strip testing to detect the presence of fentanyl in their drug supply.
Testing for fentanyl test strips can identify the presence of fentanyl in unregulated drugs. They can be used to test injectable drugs, powders, and pills. Being aware if fentanyl is present allows people to implement appropriate harm reduction strategies to reduce the risk of an overdose.
Presented by Sari Frankel, DC Department of Behavioral Health.
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.