Copyright, The Joint Commission Integration: Behavioral and Primary Physical Health Care 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
FAADA/FCMHC
August, 2013
Diana Murray, RN, MSN
Regional Account Manager
The Joint Commission
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Objectives
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
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The Joint Commission Mission
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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Accrediting Behavioral Health organizations since 1969
Accredited over 2,000 Behavioral Health organizations
Range of settings/services
Our focus: helping behavioral health organizations help the people they serve.
Joint Commission Behavioral Health Care Accreditation
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Mental Health, Addiction Treatment and Primary Physical Care Traditions
Separate delivery silos
Sequential care, treatment and services
Distinct professional training
Minimal communication and collaboration
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Various provisions of the ACA Expanded access to rehabilitative, prevention and
wellness services.
Incentives to coordinate primary physical care, mental health, and addiction services.
Enhances community-based service options for individuals with a serious mental illness.
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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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
Individual and family support, which includes authorized representatives
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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Health Homes
Section 2703 of the Affordable Care Act
States establish health homes through Medicaid State Plan Amendment
Primary physical and behavioral health integration grants
SAMHSA – HRSA Center for Integrated Health Solutions
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Primary Physical Health Care
Basic level of physical health care
Promotion of physical health and disease prevention
Early diagnosis of disease or disability
Treatment of acute and chronic illnesses
Health maintenance and education
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State Medicaid Plans
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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The Joint Commission
Behavioral Health
Home Certification
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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
– Medical Groups
Behavioral Health Home Certification
– 16 Settings and services
– Primary Health care when provided
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Concepts Integrated into the Ambulatory Accreditation Program
Primary Care Medical Home Certification Standards*
Patient Centered Care
Comprehensive Care
Coordinated Care Superb Access to Care
A Systems-Based Approach to Quality and Safety
*Agency for Healthcare research and Quality Medical Home Model
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Behavioral Health
Home Certification
Accreditation Requirements
– Core Standards
– Additional BHH Certification Standards
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Care, Treatment and Services
For organizations that elect The Joint Commission Behavioral Health Home option
Define Population in BHH
Data collection
Arranges for the history and physical to occur, if necessary
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Additions to Core StandardsCare, Treatment and Services
Individual’s short- and long-term physical health care goals
Screening and/or assessment for chronic physical health conditions
Individual’s ability to self-manage chronic behavioral and physical needs
Identification of physical health goals
Disciplines are collaborative and integrated
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Care, Treatment and Services 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
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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Care, Treatment and Services Coordination of External Referrals
Literacy Needs
Self Management
Education
Provides excellent access to integrated care, treatment, or services
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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Care, Treatment and Services Accountable for Integrated care
Integrated Team
Case Management
Training and Support
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Environment of Care
Inspects, tests and maintains medical equipment
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Human Resources
Orientation
Education and Training
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Information Management
Health Information Technology
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Leadership
Performance Improvement
Clinical Practice Guidelines
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Performance Improvement
Data Collection
Data Analysis
Improves Performance
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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 hospital re-admissions
– All urgent care and emergency department visits
– Individual’s race and ethnicity
– Self Management goals related to integrated care
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Rights and Ethics Receive information in a manner he or she
understands
Collaborate in decisions about his or her care, treatment, or services
Receive information about the staff responsible for his or her care, treatment, or services
Functions and services of the behavioral health home
End of Life Care
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Summary
BHH is not for every Behavioral Health Care Company
BHH is integration of Behavioral and Physical Care
Majority of standards found in Care Treatment and Services
Pre-publication Standards http://www.jointcommission.org/standards_information/prepublication_standards.aspx
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Contacts Peggy Lavin, Senior Associate Director
– 630-792-5411
Evelyn Choi, Senior Business Development Specialist
– 630-792-5866
Diana Murray, RN, MSN, Regional Account Manager
– 630-792-5295