SUMMARY REPORT
MEETING 1
Date: Wednesday, April 27th, 2011
Time: 11AM – 12:30PM
Host: UCLA Integrated Substance Abuse Programs (ISAP) & CA Alcohol and
Drug Programs (ADP)
Integration Learning Collaborative (ILC) Objectives
· Continue discussions and expand from work conducted during CA’s Integration Forum in December 2010
· Learn from other counties’ integration activities/initiatives to gain resources, skills, knowledge, and ideas to support similar movement in one’s own county.
· Gain technical and social support to improve specific clinical and operational areas in need of assistance and further development within various integration pursuits.
· Engage in active communication and share experiences to gather ideas, solutions, and lessons for current and future work around integration.
Responsibilities
· Facilitator Requirements: Coordinate agendas/calls/presenters, set up conference calls/forums for information sharing, encourage/facilitate discussions, provide suggestions and technical assistance (TA)
· County Requirements: Participate, ask questions, contribute to solution-based discussions, suggest topics, request for TA
Logistics
§ All meeting materials will be posted on the Integration Learning Collaborative Website: http://www.uclaisap.org/Affordable-Care-Act/html/learning-collaborative/california-SUD-Health-Care-Integration-Learning-Collaborative.html
§ Email correspondence from UCLA will be sent regularly to remind participants of next calls, provide any updates/changes, and distribute important and relevant resources/information
§ If you have questions, comments, feedback for UCLA, please notify:
o Grace Kim – or 310.267.5399
o Valerie Pearce – or 310-267-5306
Key Discussion Points
Dr. Rawson made the following introductory points.
§ There are two levels of behavioral health integration that should be noted of as two separate ideologies:
o Integration with a lower case “i”.
§ Integrating substance use services with mental health
o Integration with a CAPITAL “I”.
§ Integrating both substance use and mental health services into the larger health system.
§ Although each are significant priorities, we are planning to focus our discussions around the latter, Integration with a CAPITAL “I”.
§ Integration is a key component in preparing for health care reform, which remains to be a high priority among the ADP Directors.
§ UCLA’s observations to date across county integration initiatives, as well as other state models, consist of the following:
o BH Integration comes in many forms, shapes, and sizes
o Everyone is still trying to figure this out
o The shorter the screener tools used, the better
o Normalizing screening for SUD is a crucial piece to success
o Co-locating staff into primary care settings is one model for integration, but requires a lot of preparation, training, and highly motivated staff to make it work (i.e: staying visible, offering help to manage difficult patients, making oneself a part of the PC team)
County Reported Needs/Questions
Counties indicated that they would be interested in having the following questions addressed on future Learning Collaborative calls.
§ Integration Activities in Other Counties
o What are the different models counties are using to promote integration in their various organizations? How can these models be tailored to different settings/environments (brief treatment, pharmacotherapy, etc)?
o What are some effectively implemented SBI tools (i.e. WHO 3-item ASSIST) that counties can utilize?
o What strategies are being utilized to facilitate the integration process?
o How does having county contracted clinics and/or directly operated county clinics affect the operationalization of BH integration initiatives?
o What are some of the challenges/barriers and what has been done to overcome them?
o What are some important lessons learned?
§ Interaction with the Primary Care Provider (PCP)
o What is the best way to approach medical personnel?
o How do you address and overcome resistance?
o How can the SUD field be viewed positively and considered valuable to the PC world?
o What are the roles and duties of the behaviorist at a primary care clinic (PCC)?
o How do you engage the PCP to develop and sustain their capacity for SBIRT?
o What incentives are available for the PCP to do SBIRT?
o In addition to existing SBIRT and medication-assisted treatment services, what are useful methods for difficult patient management within the PCC?
o What are some strategies to reduce the burden that occurs in FQHCs and PCCs from SUDs?
§ Preparation for Health Care Reform
o How will HCR affect the SUD field?
o What changes should be made now and to what capacity?
o How will newly eligible clients be accommodated and what should be done to expand existing resources?
o How can we stay apprised of information coming down the pike from the federal level?
§ Electronic Health Records/Confidentiality Issues
o How will 42CFR and other confidentiality barriers be overcome?
o What are different strategies/methods for charting and collecting data?
o How are providers exchanging information and gaining access to PC records?
§ Performance Management/Dashboards/Data
o What are the various measurement strategies to document how counties and providers are making progress (efficacy and feasibility)?
o How will benchmarks be established to drive the agenda moving forward?
o How can the SUD field demonstrate meaningful use?
§ Financing
o What are some creative financial resources to support and sustain integration activities?
o How can partnerships and contracts be established to fund initiatives?
Content Plans for Upcoming ILC Meetings
§ Counties will be identified to present on the status of their BH integration projects following with Q and A to address the various elements involved.
§ Additional technical assistance will be provided as needed
§ A follow up email will be sent to all attendees to provide UCLA with a summary of their county’s BH integration activities and/or plans addressing the following priority areas identified during today’s discussion:
o What activities or intervention(s) have you selected to implement
o What setting(s) have you selected to target and why
o What staff have you selected to work in these settings and/or to address the target population, and why
o What preparations have you conducted to set the stage either within AOD settings and/or in MH or PC settings
o Are there specific trainings that you have conducted or will need to conduct
o Describe any activities you have conducted to engage with non-AOD providers (i.e. MH and/or PC providers)
o Describe your experience to date (i.e.: resistance, challenges, solutions, etc.)
o Have you considered how to measure the feasibility or efficacy of the activities/intervention, if so what and why
o How are you planning to document what occurs and how have you addressed information sharing/confidentiality/privacy issues
o Are these activities/interventions occurring among county contracted facilities or directly through county programs
o What is working, what is not working, etc.
Schedule for Upcoming ILC Meetings
· All future calls are tentatively scheduled for the 4th Wednesday of every month @ 11:00AM (possibly 12PM).
· Next meeting falls on May 25, 2011; UCLA will discuss the option with Tom Renfree to incorporate the next ILC meeting during the CADPAAC agenda, perhaps within the UCLA block of time on the Wednesday agenda.
· A confirmation email from UCLA will follow.
Next Steps
· County administrators to email Valerie Pearce () or Grace Kim () to provide a 15-20 minute presentation of their BH integration activities occurring and/or in the planning stages (as described above in the Section: Content Plans for Upcoming ILC Meetings).
· Information about the SAMHSA-HRSA Center for Integrated Health Solutions (CIHS) Integrated Health Provider Learning Collaborative RFA (due date: May 20, 2011) will be emailed to the ILC group list.
· All meeting materials will be posted and available on the ILC website.
APPENDIX 1 – ATTENDEES
COUNTY PARTICIPANTS
MBA
Ø Lassen (MaryJo Streible and Anita Harsh)
Ø Nevada (Mary Lowe)
Ø Sutter & Yuba (Nancy Lee)
Ø Amador (Pat Bartosiewicz)
Ø Kings (Brenda Randle)
SMALL
Ø No representatives on this call
MEDIUM
Ø Kern (Lily Alvarez)
Ø Santa Cruz (Bill Manov)
Ø Solano (Andrew Williamson)
Ø Stanislaus (Madelyn Schlaepfer)
LARGE
Ø Fresno (David Koch)
Ø Los Angeles (Wayne Sugita)
Ø Orange County (Brett O’Brien)
Ø San Bernardino (Dianne Sceranka)
Ø San Diego (Marshall Lewis)
Ø San Francisco (Alice Gleghorn)
Ø Santa Clara (Mark Stanford)
ORGANIZATION PARTICIPANTS
Ø ADPI (Victor Kogler)
Ø CAADPE (Albert Senella)
Ø CTC (Rich Bradway)
Ø CADPAAC (Tom Renfree)
ADP Participants
Ø Amy Peterson
UCLA Participants
Ø Richard Rawson
Ø Valerie Pearce
Ø Darren Urada
Ø Beth Rutkowski
Ø Grace Kim
Ø Stella Lee
Ø Elizabeth Nelson
APPENDIX 2 – Agenda and Relevant Materials
AGENDA
§ Identify goals and objectives for the ILC
§ Set a regular meeting time for each month
§ Identify what we will want to accomplish for the first set of calls
§ Discuss potential expert speakers to bring in for future discussions and/or presentations
§ Discuss other specific technical assistance and training needs for integration efforts
§ County representatives to describe briefly and informally where their county is with integration project(s) and/or ideas
Materials Disseminated for this meeting
§ PPT Presentation - California’s SUD/Health Care Integration Learning Collaborative (ILC) – Meeting 1
§ CA Forum on Integration Forum Summary Report
§ CIHS Provider Learning Collaborative RFA
CA Integration Learning Collaborative 2
Summary from Meeting 1: April 27, 2011