Session F5b October 18, 2014
Joining Forces to Create Momentum to
Overcome Policy
Barriers to Integration
Julie M. Schirmer, LCSW
Chris Bersani, PsyD, ABPP
Cathy M. Hudgins, Ph.D., LMFT, LPC
Bill Gunn, PhD
Rob Cushman, MD
Alejandra Posada, M.Ed.
Collaborative Family Healthcare Association 16th Annual Conference
Session # Saturday, October 18, 2014
Washington, DC U.S.A.
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We have not had
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Identify models of collaborating to advance
IBHPC policy reform,
Understand the potential barriers, resources,
partnerships, breakthroughs and lessons
learned,
Deepen skills, identify partners an
opportunities for taking action in one’s own
region to mobilize forces to enhance
integration.
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A question and answer period will be
conducted at the end of this presentation.
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New England
Integrated Behavioral
Health in Primary Care
Learning Community 
North Carolina Center
of Excellence for
Integrated Care (COE) 
Mental Health America
of Greater Houston
New England States
Consortium Systems
Collaboration (NESCSO)
Health Resources &
Services Administration
(HRSA)
Substance Abuse and
Mental Health America
Services Administration
(SAMHSA)
You can begin your slides here and REMOVE THIS SLIDE
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Emerged from the NC ICARE project.
Team of experts provides state-wide integrated care
technical assistance, support, and outreach to
promote and develop successful, sustainable
Integrated Care.
Supported in part by the Kate B. Reynolds Charitable
Trust.
Under the North Carolina Foundation for Advanced
Health Programs.
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Update and reform policies to
support IC to create a unified,
inclusive IC definition, practice
philosophy, and best practice
strategies
◦ Policy Summit
◦ Steering Committee and
workgroups
◦ Integrated Care Curriculum
Consortium
◦ Benchmarking Task Force
◦ Advocacy
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Engage communities to raise
awareness and promote
community capacity and
collaboration
◦ Presentations to community,
organizations, other groups
◦ Website and social media
activities
Increase the knowledge-base
and readiness to expedite IC
programs’ success and
sustainability
Advance IC through evidencebased IC data collection and
research
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Individualized IC training and assistance:
◦ Assessment of progress using Rives INSIGHT
dashboard tool
◦ Provide targeted resources to advance the
level of integration
◦ Both on-site and phone conference assistance
◦ Connect sites with experts and each other
◦ Providing targeted trainings
Concentrated, focused “launch” assistance
packages provided to developing IC programs
both grant-funded and independently
contracted
Center of Excellence for
Integrated Care (COE)
http://www.ncfahp.org/nc-centerof-excellence.aspx
Under the North Carolina Foundation
for Advanced Programs
http://www.ncfahp.org/
Goals: To enhance
 Education,
 Policy, and
 Quality improvement efforts to support
Integration of Behavioral Health into
Primary Care in New England (IBHPC)
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Identify policy barriers to integration
Health & behavior code expansion to other
than psychologists
Identify efforts and advocate to integrate
BH/PC into state SIM and ACO activities
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Monthly conference call meetings with
academic/foundation/policy champions and
stakeholders
Quarterly meetings with Regional Directors of
SAMHSA, HRSA and CMS
Joint presentations/face-to-face meetings
Position papers (NASW, CMS)
Regional Collaboration among federal
(SAMSHA,HRSA,CMS), state (HHS and Medicaid)
agencies and communities of interest (IBHPCLC)
Supported by NESCSO www.nescso.org and SAMSHA
www.SAMSHA.gov to:
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Develop functioning sustainable partnerships
across six New England state lines.
Share experiential outcomes – lessons learned
and valuable resources.
Champion links within and across Behavioral
Health/Medicaid delivery systems.
Strategize (deep dives) on issues related to
health policy (ACA), technology, data
management, finances, and workforce changes.
Year One Discussion Topics:
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Health Homes – Promoting Integration
through practice
State Innovation Grants and SAMSHA funded
Integration Projects- What is scalable?
Integration –lessons learned and training
resources from Missouri with Dr. Joe Parks.
ACA Mental Health Service Expansion
Behavioral Health Integration (BHI)
Grant Program
Christopher Bersani, Psy.D. ABPP
Senior Public Health Analyst
National Behavioral Health Lead
Health Resources & Services Administration
Boston, MA
Health Center Program
 1,300 Community Health Centers
 9,200 Service Delivery Sites
 21.7 million patients
 1.2 million behavioral health patients
(2013)
 Over 6 million visits
 6,000+ behavioral health providers
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Overview
Behavioral Health Integration (BHI):
 Grant to improve/expand delivery of behavioral
health services through the establishment and/or
enhancement of an integrated primary care
behavioral health model at existing CHCs.
Specifically, this funding opportunity will:
 Increase access to behavioral health services; and
 Increase the number of health centers with
integrated primary care and behavioral health
models of care.
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Summary of Funding
 $54.6 million awarded to support
221 health centers in 47 states and
Puerto Rico with awards of up to
$250,000 each.
 Behavioral health services include
mental health and substance abuse
services.
 Over 450,000 patients will be served
nationwide.
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Eligibility Requirements
 BHI grantees are existing Health Center
Programs.
 Grantees are not a newly funded FY 2013 or
FY 2014 New Access Points (NAP).
 Grantees did not request more than $250,000
in BHI Federal funding in Year 1 or Year 2.
 Grantee demonstrates onsite behavioral
health services are currently provided or will
be added to the scope via the proposed BHI
project.
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Eligibility Requirements
 Grantee demonstrates that at least one new
onsite full-time equivalent (FTE) licensed
behavioral health care provider will be in
place within 120 days of notice of award.
 New FTE can be a single new staff member or
contracted provider, or a combination of p/t
staff members or contract providers equaling
at least 1 licensed FTE.
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Application Requirements
 Grantees must implement a plan for achieving
or enhancing a fully-integrated primary care
and behavioral health services model of care.
The plan must include:
 Use of screening, brief intervention, and
referral to treatment (SBIRT) and other
evidence-based practices.
 Use of a team-based, integrated model of
care.
See Handouts.
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Ineligible Use of Funds
The following uses of funds are not
eligible under BHI:
 Construction costs, including minor
alterations and renovation
 Fixed/installed equipment
 Facility or land purchases
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Work Plan
 Focus Area: Grantees must organize their work plans into
four focus areas and identify key action steps and goals for
each focus area.
 Should describe realistic and measureable results.
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Supplemental Information Form
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Clinical Performance Measure
New Standard Clinical Performance Measure:
 Depression Screening and Follow Up
 Numerator: Report the number of patients age 12 years
and older who were (1) screened for depression with a
standardized tool during the measurement year and, if
considered to be depressed, (2) had a follow-up plan
documented.
 Denominator: Report the number of patients age 12
years and older that were seen as medical patients
during the measurement year.
 Provide baseline data if available (if not available, input
zero)
 Provide a realistic and achievable two-year goal
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Reporting
 Project Timeframe: 2 years (depending on
Congressional appropriations and satisfactory
performance)
 Project Start date: August 1, 2014
 Future UDS reports should demonstrate progress
toward meeting overall BHI patient targets and
goals.
 BHI progress towards meeting goals will also be
required in future Budget Period Progress Report
(BPR) submissions.
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Technical Assistance Contacts
BHI TA page
http://www.hrsa.gov/grants/apply/assistance/bhi
Program Related Questions
• Rene Herbert: BPHCBHI@hrsa.gov or
301-594-4300
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Contact
Christopher Bersani, Psy.D ABPP
Senior Public Health Analyst
617-565-1470
cbersani@hrsa.gov
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Question & Answer Period
Session Evaluation
Please complete and return the
evaluation form to the classroom monitor
before leaving this session.
Thank you!