FAADA/FCMHC
August, 2013
Diana Murray, RN, MSN
Regional Account Manager
The Joint Commission
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Integration: Behavioral and
Primary Physical Health Care
 Discuss the changing environment in which
today's behavioral health organizations
operate
Discuss the Joint Commission model for
providing integrated behavioral health and
primary physical health.
Discuss Joint Commission standards related
to integrated behavioral and primary physical
care
2 -2
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Objectives
To continuously improve health care for
the public, in collaboration with other
stakeholders, by evaluating health care
organizations and inspiring them to
excel in providing safe and effective
care of the highest quality and value.
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The Joint Commission Mission
Joint Commission
Behavioral Health Care Accreditation
 Accrediting Behavioral Health organizations since 1969
 Accredited over 2,000 Behavioral Health organizations
 Range of settings/services
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 Our focus: helping behavioral health organizations help
the people they serve.
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Mental Health, Addiction Treatment
and Primary Physical Care Traditions
Separate delivery silos
Sequential care, treatment and services
Minimal communication and collaboration
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Distinct professional training
Various provisions of the ACA
 Expanded access to rehabilitative, prevention and
wellness services.
 Incentives to coordinate primary physical care,
mental health, and addiction services.
 Develop capacity to provide services in an effective
and modern mental health system through various
workforce initiatives, including education and
training grants, loan repayment programs, and
primary physical care residency training.
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 Enhances community-based service options for
individuals with a serious mental illness.
ACA: Defines health homes as
“comprehensive and timely high quality services
”
Services provided must include:
 Comprehensive care management
 Care coordination and health promotion
 Comprehensive transitions of care from inpatient to other
settings, including appropriate follow-up
 Referral to community and social support services, if relevant
 The use of health information technology to link services, as
feasible and appropriate
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 Individual and family support, which includes authorized
representatives
Health Homes
Section 2703 of the Affordable Care Act
 States establish health homes through
Medicaid State Plan Amendment
 SAMHSA – HRSA Center for Integrated
Health Solutions
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 Primary physical and behavioral health
integration grants
Primary Physical Health Care
 Basic level of physical health care
 Promotion of physical health and
disease prevention
 Treatment of acute and chronic
illnesses
 Health maintenance and education
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 Early diagnosis of disease or disability
 Building on the Patient Centered
Medical Home experience to create
health homes for Medicaid eligible
recipients with people with serious
mental illness and/or substance abuse
condition
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State Medicaid Plans
The Joint Commission
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Behavioral Health
Home Certification
Joint Commission Accreditation and Certification for
Integrated Behavioral and Primary Physical Care
 Ambulatory Primary Care Medical Home Certification
– Federally Qualified Health Centers tailored with
Behavioral Health when provided
– Ambulatory Care Clinics
 Behavioral Health Home Certification
– 16 Settings and services
– Primary Health care when provided
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– Medical Groups
Concepts Integrated into the
Ambulatory Accreditation Program
Primary Care Medical Home
Certification Standards*
 Patient Centered Care
 Comprehensive Care
 Coordinated Care Superb Access to Care
*Agency for Healthcare research and Quality
Medical Home Model
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 A Systems-Based Approach to Quality and Safety
Behavioral Health
Home Certification
 Accreditation Requirements
– Core Standards
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– Additional BHH Certification Standards
Care, Treatment and Services
 For organizations that elect The Joint
Commission Behavioral Health Home
option
 Define Population in BHH
 Arranges for the history and physical
to occur, if necessary
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 Data collection
Additions to Core Standards
Care, Treatment and Services
 Individual’s short- and long-term physical
health care goals
 Screening and/or assessment for chronic
physical health conditions
 Identification of physical health goals
 Disciplines are collaborative and integrated
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 Individual’s ability to self-manage chronic
behavioral and physical needs
Care, Treatment and Services
 verbal and written communication needs of the
individual served including his or her preferred
language for discussing health care.
 Integration of both physical and behavioral health
needs and goals.
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 The physical health care needs of the individual, The physical health care goals of the individual, How the organization will meet those needs,- How
the organization will help the individual to work
toward achieving his or her goals
Care, Treatment and Services
 Coordination of External Referrals
 Literacy Needs
 Self Management
 Education
 Provides or facilitates the provision of prevention,
screening, and primary physical health care,
treatment, or services as part of integrated care
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 Provides excellent access to integrated care,
treatment, or services
Care, Treatment and Services
 Accountable for Integrated care
 Integrated Team
 Case Management
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 Training and Support
Environment of Care
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Inspects, tests and maintains medical equipment
Human Resources
 Orientation
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 Education and Training
Information Management
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 Health Information Technology
Leadership
 Performance Improvement
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 Clinical Practice Guidelines
Performance Improvement
 Data Collection
 Data Analysis
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 Improves Performance
Record of Care
Contains the following behavioral and
physical health information:
– All behavioral and physical health diagnoses and
conditions that have required care, treatment,or services
– All hospital admissions
– All urgent care and emergency department visits
– Individual’s race and ethnicity
– Self Management goals related to integrated care
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– All hospital re-admissions
Rights and Ethics
 Receive information in a manner he or she
understands
 Collaborate in decisions about his or her care,
treatment, or services
 Functions and services of the behavioral health
home
 End of Life Care
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 Receive information about the staff responsible for
his or her care, treatment, or services
Summary
BHH is not for every Behavioral Health Care
Company
BHH is integration of Behavioral and
Physical Care
Pre-publication Standards
http://www.jointcommission.org/standards_information/prepublication_
standards.aspx
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Majority of standards found in Care
Treatment and Services
Contacts
 Peggy Lavin, Senior Associate Director
– plavin@jointcommission.org
– 630-792-5411
 Evelyn Choi, Senior Business Development Specialist
– echoi@jointcommission.org
 Diana Murray, RN, MSN, Regional Account Manager
– dmurray@jointcommission.org
– 630-792-5295
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– 630-792-5866