Session # G2
October 28, 2011
2:15 PM
Julia Beatty, MD, Assoc. Medical Director, The HealthCare Connection
Brenda Coleman, MHPA, Principal, BJC HealthCare Consulting
Tony Dattilo, MA, CEO, Greater Cincinnati Behavioral Health
John Francis, MSSW, Executive Director, Centerpoint Health
Dolores Lindsay, MPA, CEO, The HealthCare Connection
Edward Shelleby, PhD Psychology, Director of Special Projects and
Quality Improvement, Central Community Mental Health Board
Collaborative Family Healthcare Association 13th Annual Conference
October 27-29, 2011 Philadelphia, Pennsylvania U.S.A.
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Faculty Disclosure
I/We have not had any relevant financial relationships
during the past 12 months.
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Learning Assessment
A learning assessment is required for CE credit.
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Need/Practice Gap &
Supporting Resources
 People in Ohio with Severe Mental Illness (SMI) die 32.2
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years earlier than the rest of the population (Miller,
Paschall, Svendsen, 2006)
Studies show that 60% of patients with SMI die of
preventable health conditions
Access to primary care is limited/a problem for SMI clients
By report a large percentage of SMI clients have poorly
controlled chronic health problems, e.g., Diabetes,
Hypertension
Care for SMI clients is fragmented–not coordinated.
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Objectives
1. Identify the key contributing factors for the
successful integration of primary care and
behavioral health services
2. Articulate the reasons for setting realistic
performance objectives. It’s A Journey!
3. Identify the pros and cons of partnering with a
Federally Qualified Health Center (FQHC)
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Expected Outcome
At the end of this session, participants will:
 Understand the benefits of integrating care using
the co-location model
 Identify barriers and success factors
 Articulate pros/cons of partnering with a FQHC
 Understand the importance of setting realistic
performance expectations
 Recognize and know: “Rome was not built in a
day.”
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OUR PARTNERSHIP CO-LOCATION MODEL
Independent, Parallel
Clinical Processes
Behavioral Health Clinic Site
MH
intake
Psychiatrist
Case Manager
Client
Referral
Partnership’s
Client Flow
Supervising PC Physician
MD & APN
PC
intake
Support Staff: LPN &
MA
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The Partners
The HealthCare Connection
 Federally Qualified Health Center (FQHC)
 National Committee for Quality Assurance , Patient
Centered Medical Home recognition
 Seven locations serving 18,000 patients annually
 Mission: Provide quality, culturally sensitive and
accessible primary care focusing on the medically
underserved, underinsured and uninsured in northern
Hamilton County Ohio and surrounding areas
 Oldest FQHC in Ohio. Founded in 1967
www.healthcare-connection.org
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The Partners
Centerpoint Health
 Comprehensive behavioral health provider formed in 2008
through merger of three local community behavioral
health agencies
 Five office locations + four treatment sites serving 7,000
clients annually in Hamilton County, Ohio
 Mission: Strengthen communities served by providing the
best quality mental health care to children, adults and
families
 Services: Adult Outpatient, Child Case Management, Adult
Case Management, Adult Support, and Crisis & Prevention,
including the 24/7 suicide hotline for Hamilton County
www.centerpointhealth.org
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The Partners
Central Community Health Board of Hamilton County
 A Private, non-profit corporation founded in 1970.
 Provides comprehensive mental health and drug
treatment, alcoholism referral services and HIV
prevention services to Hamilton County, Ohio residents.
 Mission: Provide the best possible mental illness,
substance abuse and HIV prevention and treatment
services
 Services: Case management, psychotherapy, partial
intervention, emergency and long-term residential,
psychiatric , addictions and methadone treatment.
www.cchbinc.com
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The Partners
Greater Cincinnati Behavioral Health Services
 A comprehensive mental health agency serving adults
with severe mental illness in the Cincinnati area.
 300 care professionals serve over 4,000 adults annually
 Rehabilitation services at 10 locations
 Provides psychiatric, nursing, counseling, care
management, residential, vocational, day programs
and others
 SMI clients include the homeless, incarcerated, and
those with many dual disorders.
www.gcbhs.com
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Key Factors for Successful Integration
 Shared mission, goals, and be comfortable
with risk. Roles and responsibilities clearly
defined (MOU) Handout 1
 Committed boards, executives, and senior
leaders
 Mutually understanding the need to work
to determine the right payer mix and be
realistic about what it will take to achieve
objectives (financial and service)
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Key Factors for Successful Integration
 Management level “champion” in each
organization
 The “right” providers and staff in the “right
seats on the bus”
 Strong inter/intra organizational
communication systems
 Primary care office location easily accessible
to clients and psychiatrists
Handout 2
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Pros of Partnering with a FQHC
 Have similar missions
 Experience serving underserved at-risk
populations
 Primary care billing system in place
 Have a system approach to health care
 Are familiar with public health policy
 Federal level support (i.e. funding and
enhanced Medicaid rate)
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Pros of Partnering with a FQHC
 Shared client populations. May already
serve SMI individuals at other locations
 Federal level support (i.e. funding and
enhanced Medicaid rate)
 PCMH expectation and requirements
closely mirror behavioral health
accreditations (i.e. CARF)
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Cons of Partnering with a FQHC
 Learning curve. Operates in a different
world (billing, reimbursement, funding,
clinical language)
 FQHC not in service area
 FQHC not widely known or respected in
the community. Is this the right partner?
 FQHC and behavioral health agency
uncertain or lukewarm about establishing
a relationship
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Set Realistic Performance
Measures/Objectives
Determine the right number and types of
objectives. Measure what really matters. This
will help in:
 Making administrative decisions
 Course correcting as needed
 Building success
 Finding/applying for new money
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Set Realistic Performance
Measures/Objectives
 Maintaining funding
 Clinical decision making
 Replication
 Maintaining focus
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Our Primary Care Performance
Measures
 # Visits
 % Insured Visits
 # Visits/Work Day
 % Appointments Kept
 # Unduplicated Patients
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Our Primary Care Performance
Measures
 % Insured Patients
 Net Gain/Loss
 Revenue/Visit as % of Cost/Visit
 Cost/Patient
Handout 3
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Our Primary Care Performance
Measures
 % Diabetic Patients with most recent HgA1c < 8
 % Hypertensive Patients with most recent BP
under 140/90
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Questions & Answers
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Session Evaluation
Please complete and return the
evaluation form to the classroom monitor before
leaving this session.
Thank you!
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