Since 2012, a variety of stakeholders across Indiana have been working collaboratively to build the state's capacity for integrated care. Integrated care refers to the management and delivery of behavioral and physical health services so that clients receive a continuum of preventive and curative services. The process involves the breaking down of silos between behavioral and primary care systems to best meet each patient's unique needs. By working together, primary care and behavioral health professionals can treat the whole person and ensure better health outcomes for their patients.

In order to share innovations, concepts, and outcomes of integrated care in Indiana, the Indiana Division of Mental Health and Addiction, the Department of Family Resources, Mental Health America of Northeast Indiana, and the Indiana Primary Care and Behavioral Health Integration Initiative are hosting the first annual Indiana Primary Care and Behavioral Health Integration Conference on December 7, 2018 and invite you to attend. Learn more about what integrated care can mean for you, your organization, and most importantly, your patients.

Registration is $50/person. Tickets include cost of registration, breakfast, lunch, and 5.0 CEU hours (approved for mental health professionals).

Mental Health America workshops are approved for LSWs, LCSWs, LMFTs, LMHCs, LACs, LCACs, and Psychologists. The Indiana Professional Licensing Agency through the Behavioral Health and Human Services Licensing Board has approved Mental Health America to provide Category One Continuing Education Hours.

Exhibitor booths will also be present at the conference. Register for a booth here: https://exhibitorindianaintegratedcare.eventbrite.com

Agenda

8:00-8:45 AM: Registration and breakfast; visit exhibitor booths

8:45-9:00 AM: Welcome

9:00-9:45 AM: Keynote Speaker - Mindy Klowden

9:45-10:00 AM: Break; visit exhibitor booths

10:00-11:00 AM: Breakout Session Round 1

11:00-11:15 AM: Break; visit exhibitor booths

11:15 AM-12:15 PM: Breakout Session Round 2

12:15-1:30 PM: Lunch

1:30-2:30 PM: Keynote Speaker - Dr. Joseph Parks

2:30-2:45 PM: Break/Snack

2:45-3:45 PM: Breakout Session Round 3

About the Keynotes

Integrated Care Sustainability: National Trends and Best Practices

By: Mindy Klowden, MNM, Director, Training and Technical Assistance, National Council for Behavioral Health

Drawing on the National Council’s more than 8 years of experience providing technical assistance and consulting with providers and states, Ms. Klowden will present a national perspective on integrated behavioral health and primary care. This keynote address will focus on sustainability best practices, including the role of value-based payment and how providers and states can work together to identify and alleviate regulatory barriers.

Ms. Klowden joined the staff of National Council for Behavioral Health in January 2017. She serves as a national consultant and provides technical assistance to states, community mental health centers, primary care clinics and other health care providers on integrated primary care and behavioral health, value-based payment, finance and sustainable business systems, and delivery system reform. Over the last 2 years she has facilitated the Value-Based Payment Innovation Community, presented at numerous conferences, webinars and training sessions, and provided direct coaching to numerous practices. Ms. Klowden lives in Denver, Colorado where she currently serves as the Co-Chair of the Colorado State Innovation Model (SIM) Practice Transformation Committee and sits on the Steering Committee for SIM.

Integrating Primary Care into Behavioral Health Care: Lessons Learned

By: Dr. Joseph Parks, Medical Director, National Council for Behavioral Health

During his keynote presentation, Dr. Parks will provide an overview of processes which can be involved in the implementation of integrated healthcare. His presentation will include key integrated care concepts and definitions, possible staff positions, methods for implementation, data outcomes, and cost savings associated with integrated care. He will also share information regarding certified community behavioral health centers and how they play into integrated care. Finally, he will discuss challenges and lessons learned from integrating primary and behavioral healthcare.

Dr. Parks is the Medical Director for the National Council for Behavioral Health. He has nearly two decades of experience with public health. He was named director of the Missouri HealthNet Division of the Missouri Department of Social Services in 2013. Dr. Parks also holds the position of Distinguished Research Professor of Science at the University of Missouri – St. Louis and is a Clinical Assistant Professor of Psychiatry at the University of Missouri, Department of Psychiatry in Columbia. He practices psychiatry on an outpatient basis at Family Health Center, a federally funded community health center established to expand services to uninsured and underinsured patients in central Missouri.

About the Breakout Sessions

Breakout Session Round 1

Integration of Primary Care and Mental Health Panel

Panelists: Dr. Milton Armston, Director of Behavioral Health Services, Community HealthNet Health Centers, Adrienne Collins, Practice Manager, Meridian Health Services, Megan Creech, Director of Outpatient Services, Hamilton Center, Cindy Dowers, Executive Director of Housing Services, Hamilton Center, and Mindy Klowden, Director, Training and Technical Assistance, National Council for Behavioral Health

Facilitated by: Dr. John Kern, Clinical Professor, University of Washington Department of Psychiatry and Behavioral Sciences

The Division of Mental Health and Addiction’s state integration team will share its strategies and partnerships leveraged to establish a holistic model of care in collaboration with targeted agency types: Community Mental Health Centers, Federally Qualified Health Centers, Community Health Centers and Rural Health Centers. Panelists will provide outcomes of the two year test implementation of the state’s integrated care service delivery model featuring three of the thirteen participating sites. Featuring clinics: Hamilton Center, Inc. (Terre Haute), Community Healthnet (Gary), and Meridian Health Services (Muncie). Learn about integrating care bi-directionally with efforts that require changes across an organizational structure i.e. leadership, workforce, operations, clinical protocols, EHR and more. Keynote speaker Ms. Klowden will join the panel discussion to add insight from a national perspective.

An Introduction to the Healthy Opportunities Office (Focus: Social Determinants of Health)

By: Benjamin Evans, Director of External Agency Affairs, Indiana Family and Social Services and Dr. Jerry Sheward, Chief Medical Officer, Indiana Neuro-Diagnostic Institute (NDI) and Advanced Treatment Center

Earlier this year, FSSA Secretary Dr. Walthall announced the formation of a new division to focus on health equity. One of the key areas this team would focus on is addressing social determinants of health. This initiative, called “Healthy Opportunities,” is dedicated to ensuring Hoosiers have equitable access to social and physical supports needed to promote health from birth through end-of-life. To achieve these goals, FSSA began partnering with state agencies that provide services impacting one or more of the socio-economic or environmental factors impacting our members. This included Indiana State Department of Health, Department of Transportation, Housing and Community Development Authority and Work­force Development. In addition, the team partners with Indiana University and members of the Indiana Health Information Exchanges, as well as several providers, managed care entities and a multitude of community-based organizations. This workshop will highlight and discuss FSSA’s goal to better understand and identify opportunities to proactively address several factors, including conditions in which people are born, grow, live, work and age.

Communication: How Effective Engagement Can Lead to Better Patient Outcomes

By: Toscha Wilkins, CEO/Owner, Soaring Heights Care Management, LLC

Communication is an effective strategy to providing valuable patient care in an integrated system. Focusing on patient engagement, utilization of skills and best practices, this session will address how having patient buy-in and participation can lead to better patient outcomes in an integrated healthcare system.

Are Partnerships a Good Path for Delivering Integrated Care?

By: Rashunda Miller-Reed, Assistant Professor, Purdue University Fort Wayne, Dr. Bradley Isbister, Medical Director, Matthew 25 Health and Dental Clinic, and Jessica Hernandez, Behavioral Health Service Provider, Otis R. Bowen Center

There is a growing demand for patients, or clients, to receive comprehensive care. Despite this demand to combine medical and mental health services, challenges exist. Many of these challenges can be resolved by exploring key questions. In this presentation, we invite attendees to share their own needs and experiences as we discuss our process for developing a successful partnership to meet local healthcare needs.

Breakout Session Round 2

Why Integrated Care? (Peer Perspectives)

Panelists: Kimberly Comer, CRPS, Regional Network and Outreach Coordinator, Peer Support Coalition of Florida and Nallely Garcia Nava, Spokesperson, Live Out Loud Charity

Facilitated by: Amy Brinkley, Bureau Chief at Office of Family and Consumer Affairs, Indiana Division of Mental Health and Addiction

There is a growing awareness and utilization of peer supports and consumer perspectives advisory boards and councils within the state of Indiana and around the country. In fact, true, person centered care demands that consumer voice be at the table in discussions, heard, and considered in different levels of treatment for lasting and effective long term recovery oriented outcomes. In this workshop consumers will share how the implementation of integrated healthcare into their treatment made a difference in their lives and their own personal recovery. Together we will delve into the comprehensive waters of integrated care from the consumers’ perspective with some time for questions and answers.

Using Emergency Department Follow Up Clinics to Close Gaps in Care

By: Beth Keeney, SVP Community Health Initiatives/ COO Primary Care, LifeSpring Health Systems, Dr. Eric Yazel, SVP Medical Services/ Chief Medical Officer, LifeSpring Health Systems, and Misty Gilbert, Vice President for Recovery Services, LifeSpring Health Systems

In this session, attendees will learn how Emergency Department follow up clinics can be utilized to close gaps in care. Often these patients are uninsured or underinsured, do not have access to a primary care provider or cannot access their primary care provider within a timeframe that meets standard of care guidelines, resulting in return trips to the Emergency Department. These inappropriate utilizations cost the patients a tremendous amount of money, divert critical health care resources, and do not improve the overall health indicators of chronic conditions. These patients often have comorbid primary health and substance use disorders or serious mental illness(es). The Emergency Department follow up clinic allows low-barrier, rapid follow up basic health care service provision.

Tobacco Treatment Integration: Moving Beyond Screening

By: Kayla Hsu, Community Outreach Manager, Rethink Tobacco Indiana

Many healthcare consumers have been asked the question, “Do you smoke?” during a healthcare visit at some point in their lifetime. Fewer have been asked about their tobacco use beyond this initial question that many constitute as a “tobacco screening”. Those that suffer from a mental health or substance use disorder have a disproportionately high rate of smoking- consuming nearly 40% of all cigarettes smoked by adults in the United States. The high rate of smoking translates to a significantly high rate of tobacco related diseases for individuals with mental health or substance use disorders. This session will review Tobacco Use Disorder and its relationship with mental health issues and substance use disorders. Participants will learn how to move beyond basic screening questions and how to implement evidence-based tobacco treatment strategies to properly address tobacco addiction and support patient recovery.

Efficient Screening for Cognitive Disorders in Integrated Primary Care

By: Dr. Wayne Hoye, Clinical Psychologist, IU Health Arnett

This presentation is intended to highlight strategies for improving quality of care and health outcomes for older adults with cognitive disorders, as well as efficiently using clinical resources in primary care. As the population ages, the estimated cases of Alzheimer’s Disease are increasing and expected to reach 18.5 million by 2050. Primary care physicians are often the first physicians having contact with patients experiencing cognitive decline, typically initiating medical tests and referring for other evaluations. This presentation will describe methods for efficient cognitive screening during a primary care behavioral health encounter utilizing a stepped approach for the assessment of the most common cognitive disorders seen in primary care. Strategies for evaluating cognitive and functional impairment will be reviewed. The goal is to provide attendees with an efficient strategy for accurately identifying cognitive impairment within the primary care behavioral health encounter leading to better patient outcomes, as well as more cost effective use of primary and specialty care resources.

Breakout Session Round 3

Essential Skills in Improving Health Outcomes in Mental Health Populations

By: Dr. John Kern, Clinical Professor, University of Washington Department of Psychiatry and Behavioral Sciences

This presentation will feature exciting hands-on learning activities exposing participants to the process of population management of physical illness in seriously mentally ill populations.

Project ECHO: Tele-mentoring Program for the Treatment of Opioid Use Disorder

By: Kristen Kelley, Project ECHO Coordinator, Indiana University School of Medicine and Andrea Janota, MPH, ECHO Program Coordinator, Center for Public Health Practice at Indiana University Richard M. Fairbanks School of Public Health

Project ECHO (Extension for Community Healthcare Outcomes) is a guided-practice model that aims to increase workforce capacity by sharing knowledge. A panel of experts at the “hub” site meet regularly with prescribers, behavioral healthcare specialists and peer recovery coaches in local communities, via videoconferencing, to train them in the delivery of care to those treating complex medical conditions such as Hepatitis C and Opioid Use Disorder (OUD), specifically addressing Medicated Assisted Treatment. Through tele-mentoring, ECHO creates access to high-quality specialty care in local communities. TeleECHO clinics can empower healthcare providers and client care coordinators to become leaders in the community and healthcare systems on treating for a variety of complex medical conditions. Project ECHO is free for participants. This initiative is supported through funding from the 21st Century Cures Grant, in partnership with Indiana University School of Medicine and Indiana Prevention Resource Center and IU Grand Challenge.

Integrated Care in a Primary Care Setting

Panelists: Dr. Joshua Harrison, PsyD, HSPP, Clinical Director, Margaret Mary Health, Corianne Vanderkolk, PA-C, CEO, Greene County Health and Beth Wrobel, CEO, HealthLinc Community Health Center

Facilitated by: Elizabeth Burrows, Principal, Burrows Consulting

This will be a panel presentation of Federally Qualified Health Center staff that are providing integrated and primary care in the same setting. Panel presenters will discuss how to start an integrated care program, how to maximize reimbursement for integrated care, and how to gain community support for integrated care.

ICE Data, Population Health Management for Integrated Care, and the ProAct Tool

By: Ahrash Nassiri, Data Quality Analyst, Indiana Division of Mental Health and Addiction, Jason Turi, VP of Population Health, Centerstone, Lindsay Potts, Director of Integrated Health, Centerstone, Maren Sheese, Integrated Care Manager, Centerstone, and Kevin McDonnell, Senior Director of Enterprise Account Management, Relias Learning

Ahrash Nassiri is the data quality analyst for DMHA, and will provide a presentation on Integrated Care Entity data. This presentation will include an overview of the PCBHI program, data collection and management methods, the seven quality measures tracked among ICE sites, current benchmarks, current trends found among ICE populations, and forecasting future trends.

Jason Turi, Maren Sheese, and Lindsay Potts are leaders of a multidisciplinary integrate care team with Centerstone of Indiana. They will provide an overview of population health and value based care in the context of integrated care to impact complex and vulnerable populations. Discussion of the “triple aim”, data that supports the necessity of value based care, and emerging technologies and methods for providing population health management strategies.

Kevin McDonnell is a senior director of enterprise account management for Relias Learning. Mr. McDonnell will provide an overview of the ProAct Tool used by members of the PCBHI program, as well as updates and future interface rollouts from Relias coming in 2019.

a. During his keynote presentation, Dr. Parks will provide an overview of processes which can be involved in the implementation of integrated healthcare. His presentation will include key integrated care concepts and definitions, possible staff positions, methods for implementation, data outcomes, and cost savings associated with integrated care. He will also share information regarding certified community behavioral health centers and how they play into integrated care. Finally, he will discuss challenges and lessons learned from integrating primary and behavioral healthcare.