Behavioral Health Newsletter

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• Behavioral Health Newsletter
• July 2009

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Have You Accessed MEDI Yet?

• The HFS Medical Electronic Data Interchange is
  called MEDI.
• For registered providers, MEDI can

• alert you to your high-risk disease management
  consumers so that you can address these risks
  during treatment planning,
• alert you that the Your Healthcare Plus team may
  advice these consumers and will support their
  providers plan of care,
• identify a consumers assigned primary care
  doctor so that providers can establish more
  timely communications with one another, and
• verify Medicaid and other service eligibility,
  which is especially useful when a consumer
  presents for service without their Medicaid
  card.

• If your billing staff is already using MEDI,
  consider adding a printed copy of the summary of
  eligibility benefits (MEDIC screenshot) to the
  front of the medical record.to give clinicians
  access to the above information. Administrators
  needing support to bring MEDI to their clinical
  staff can contact felicia.vertin_at_mckesson.com or
  visit http//www.myhfs.illinois.gov/.
• Click on this link to view the MEDI flyer

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Benefits of a Mental Health Action Plan

• An action plan can provide consumers with
  valuable self-management information about how to
  recognize early symptoms and take appropriate
  treatment steps to help avoid or minimize health
  crises.
• A written action plan
• helps consumers understand their plan of care,
• reinforces provider instructions between office
  visits, and
• encourages consumers to take an active role in
  managing their health.
• The Your Healthcare Plus staff encourages
  consumers to initiate conversation with their
  providers about action planning for their needs.
• The next time you are serving a high-risk disease
  management eligible consumer, please consider
  the use of an action plan.
• Click on this link to see an example of a Mental
  Health Action Plan
• For questions or comments, please contact
  debra.foppe_at_mckesson.com

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Behavioral Health Providers Can Move Clinical
Metrics Too

• The Illinois Department of Healthcare and Family
  Services (HFS) has consulted with national and
  local provider organizations to identify key
  clinical indicators (criteria used to measure
  performance for achieving health outcomes) that
  are critical when managing certain medical
  diagnoses.
• For example, a consumer that also has diabetes
  will have a better chance of achieving desirable
  health outcomes when his/her HbA1C results are
  assessed and factored into the treatment plan,
  and if his/her blood pressure can be safely
  maintained below 130/80.
• When behavioral health providers encourage
  consumers to have timely medical evaluations,
  they are supporting compliance goals that can
  extend and enhance the lives of consumers.
• If you would like more information about the
  clinical indicators we are monitoring for Your
  Healthcare Plus consumers, please contact
  shalonda.knox_at_mckesson.com.

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Partnering with the Primary Care Provider and
the Medical Home

• A Medical Home is the doctors office or clinic
  where consumers see their assigned primary care
  provider (PCP) for medical care.
• Medical Home assignments are managed through the
  Primary Care Case Management program (also known
  as Illinois Health Connect).
• If the PCP assignment does not reflect the
  consumers choice, the consumer can make a
  change by callingIllinois Health Connect at
  1-877-912-1999.
• When the PCP and behavioral health providerswork
  in collaboration, both the medical and the
  behavioral health outcomes improve for
  consumers.
• Behavioral health providers can help our shared
  consumers understand the importance of regular
  PCP visits.

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Your Healthcare Plus Behavioral Health
Specialists

• Did you know

• The Your Healthcare Plus program uses behavioral
  health specialists as an integral part of care
  coordination teams across the state.
• Behavioral health specialists are registered
  nurses with concentrated study/experience in
  mental health. In their role with the Your
  Healthcare Plus program, they do not provide
  therapy. Instead, they support consumer and
  provider care coordination needs, so that
  consumers can access quality healthcare services
  at the right level and at the right time.
• Your Healthcare Plus is a free service provided
  by HFS to extend resources to disease management
  eligible consumers and their providers.
• Your Healthcare Plus behavioral health
  specialists can be reached by calling
  1-800-973-6792, option 2.
• The Your Healthcare Plus Nurse Advice Line is
  another resource for consumers. They can use this
  service when they are sick, hurt, or need
  healthcare advice. Registered nurses are
  available 24 hours a day, 7 days a week, and can
  be reached by calling 1-800-973-6792, option 1.

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Consumer Recognition

• Consumers who work hard to bring successful and
  desirable changes to their lives receive
  recognition from the staff of the Bobby E. Wright
  Center.
• We want to thank Dr. Chappell and her staff,
  along with the Board of Directors for the Bobby
  E. Wright Center, for allowing us to participate
  in this special event.
• Click on this link for more details and contact
  information on this annual event

We invite other agencies to let us know about
special consumer programs, so that we can
highlight them in our future newsletters.
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Program Success Through Collaboration

• HFS, in collaboration with the Department of
  Human Services/Division of Mental Health (DMH),
  identified provider facilities throughout DMH
  Region 1 that were most likely to have encounters
  with Your Healthcare Plus disease management
  consumers.
• We proudly report that the partnership between
  HFS, DMH, and our behavioral health providers has
  resulted in the majority of the DMH Region 1
  facilities using a process to identify Your
  Healthcare Plus disease management consumers and
  to work in collaboration with one another to
  extend more resources to our shared consumers.
• While we continue to improve and build on this
  process, it is clear that DMH Region 1 providers
  have responded extremely well to our outreach
  efforts.
• This success has allowed us to move into DMH
  Region 2 with the same process of
  identificationand outreach.
• We extend our heartfelt thanks to HFS, DMH, our
  providers, and the Your Healthcare Plus team for
  making this success possible.

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Your Healthcare Plus Program Year 2 Results

• HFS director Barry S. Maram announced that during
  fiscal year 2008, the second year of the states
  Your Healthcare Plus disease management program,
  the state achieved 104 million in net savings
  triple the savings achieved during the previous
  fiscal year. (This reflects the savings after
  paying for the costs of the program.) In addition
  to saving the state money, the program is
  providing care coordination support to over
  220,000 people enrolled in Medicaid, and the Your
  Healthcare Plus consumer satisfaction rate
  continues to be high.
• For more information on one of the largest and
  most comprehensive disease management programs in
  the country, visit http//www.hfs.illinois.gov/dm/
  . We offer special thanks to DMH, at both the
  administrative and staff levels, for facilitating
  a partnership with the behavioral health provider
  community. Their efforts have achieved truly
  remarkable results.

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Consumers Who Are Hesitant

• It is still vitally important that we continue
  vigorous outreach to all high risk disease
  management eligible consumers even those who
  are hesitant to participate in the Your
  Healthcare Plus program.
• When a a consumer is hesitant to participate in
  the Your Healthcare Plus program, the provider
  can help by doing the following
• Respect the consumers decision-making, but seize
  the opportunity to address this as a treatment
  issue in the plan of care.
• Apply the same provider therapeutic skills that
  are often needed to bring an actionable level of
  consumer understanding and acceptance, as when a
  consumer refuses medication or any other
  resource/treatment that is deemed beneficial.
• Provide recommendations to the designated Your
  Healthcare Plus staff for addressing
  hesitancy/refusal, or provide updates on any
  progress.
• Provider influence will continue to have
  astounding win-win results for us and our shared
  consumers.

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Thank You for Reading Our Behavioral Health
Newsletter

• Thank you from the Your Healthcare Plus
  behavioral specialist team
• Felicia Vertin
• Diane Turner
• Erica Rawlings
• Louise Hull
• Debra Foppe
• Fawzia Shuayb
• Shalonda Knox
• Please contact us at 1-800-973-6792
• We look forward to hearing from you and
  continuing our partnership!