SAMHSA Standard Title Slide

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SAMHSA Standard Title Slide
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Primary Care and Behavioral Health Integration

• John OBrien
• Senior Advisor on Healthcare Financing

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General CharacteristicsPeople

• Individuals in the Public Behavioral Health
  System (8 million)
• 61 of the individuals served by SAAs have no
  insurance
• 39 of the individuals served by MHAs have no
  insurance
• Expect that 90-95 of these individuals will have
  OPPORTUNITY to be covered
• Many of these individuals do not have a primary
  care practitioner on any regular basis

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General CharacteristicsProviders

• Almost 1/3 of the SA providers and 20 of MH
  providers do not have experience with 3rd party
  billing.
• Less than 10 of all BH providers have a EHR that
  is nationally certified
• Few have working agreements with health centers
• Staff dont always have credentials required
  through practice acts or MCOs
• Working with National Provider Associations to
  address these issues

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Strong Evidence That Treatment Works

• Consumer and Family Education
• Pharmacotherapyespecially for SUD
• Peer Support Services (SUD/MH)
• Skill Building
• Assertive Community Treatment

• Continuing Care for SUD
• Supported Housing and Employment
• Recovery Housing for SUD
• Intensive Outpatient Services

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What Is SAMHSA Concerned About?

• People Are Dying Younger
• Younger People in our systems are not exempt from
  (or at risk of) chronic conditions
• Significant connection between heart conditions
  and drug use--Hospitalizations
• About 1/3 of all cigarette smokers have an MH/SUD
• 30 of all individuals with a MH/SUD may have 3
  chronic conditions

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SAMHSA Approach to Primary Care and Behavioral
Health Integration

• Integration needs to be bi-directional
• MH/SUD in primary care
• Primary care in MH/SUD settings
• Providers need supports to be effective
• Cant do this aloneCMS/HRSA are important
  partners
• States and providers are critical partners in
  making a difference

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Primary Care and Behavioral Health Integration

• Program purpose
• To improve the physical health status of people
  with SMI and those with co-occurring substance
  use disorders by supporting communities to
  coordinate and integrate primary care services
  into publicly funded community-based behavioral
  health settings
• Expected outcome
• Grantees will enter into partnerships to develop
  or expand their offering of primary healthcare
  services, resulting in improved health status

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SAMHSAs Primary Care And Behavioral Health
Integration Program

• Population of focus
• Those with SMI and co-occurring substance use
  disorders served in the public behavioral health
  system
• Eligible applicants
• Community behavioral health agencies, in
  partnership with primary care providers
• Currently 53 participating providers

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Services Delivery

• Facilitate screening and referral for primary
  care prevention and treatment needs
• Provide and/or ensure that primary care services
  and referral be provided in a community-based
  behavioral health agency
• Develop a registry/tracking system for all
  primary care needs and outcomes
• Build processes for referral and follow-up for
  needed treatments with primary care providers
• Offer prevention and wellness support services
  (gt10 of grant funding)

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SAMHSA/HRSA Center for Integrated Health
Solutions (CIHS)

• Technical Assistance Jointly Funded by HRSA and
  SAMHSA
• 4.5 million/year work (co-funded with HRSA) a
  training and technical assistance centerCenter
  for Integrated Health Solutions
• Assist with practice development
• Provide assistance to SAMHSA re consultation to
  States
• http//www.centerforintegratedhealthsolutions.org