Home visitation as a component of primary care Behavioral health as a component of primary care The Children’s Center T
Jan 14, 2015
Home visitation as a component of primary care
Behavioral health as a component of primary care
The Children’s Center
T
Behavioral HealthServices
Pediatric
Medical Home Care
Evidence-basedHome VisitationServices
The Children’s
Center
Integrated services to promote the health and well-being of
children Carolina Health Centers’ pediatric
associates provide a comprehensive primary care medical home.
Carolina Health Centers’ Division of Family Resources and Child Development Services provide early child development and parenting services including evidence-based home visitation.
The Beckman Center for Mental Health Services provides on-site mental and behavioral health care.
Prenatal assessment of
risksyes
First Time Families
YesLow incomePrior to 28
weeks NoHealthy Families
Nurse-Family Partnership
Specialcircumstances
Yesno
BirthAssessment
of risks
no
Reach OutAnd Read
yes
Tier 1Risks
Healthy Steps forYoung Children
Tier 2Risks
Yes
Edgefield, Saluda, McCormick, Laurens Co.
Greenwood or AbbevilleCounty Resident yes
Yes
yes
yes
Our behavioral health model:
• Behavioral health counselor employed by Beckman Center but located at The Children’s Center and fully integrated in the care team
• Carolina Health Centers manages the clinical operation
• Beckman Center manages the revenue cycle• Carolina Health Centers pays a modest annual fee to
Beckman to offset the cost of otherwise uncompensated care resulting in expanded access for home visited families
• If needed, the behavioral health specialist will accompany the home visitor on home visits to engage the family in mental health services
• 5 year track record with excellent results
Reasons to play togetherImproved Outcomes for Individuals, for Providers, for Systems
Better experience of care Better patient compliance with medical providers’ instructionsReductions in risk factors that lead to chronic health conditionsReductions in costs due to ED visits
Improved Access to CareImproved recruitment, engagement and retention in home visitationReductions in “no show” rates in medical settingsOral health example
Improved opportunities for pay for performance and other quality incentives
Increased sustainability for home visitationCombined voice for advocacyEnhanced professional development opportunitiesImproved accountability
System improvements
• Provision of a continuum of services to provide the “best fit” for families.
• Increased access and decreased barriers to services
• Seamless team approach utilizing medical providers, home visitation providers and behavioral health providers. Families hear consistent messaging.
• Use of evidence-based guidelines
System improvements
• Shared use of electronic records for communication
• Improved family identification, engagement and retention.
• Use of a standardized screening and assessment process prenatally and at birth
• Continuous quality improvement across services using Institute for Healthcare Improvement Breakthrough Series format..
System improvements
• Electronic record keeping / shared staff for reporting/tracking• Identification of high-risk customers• Enhanced care coordination• Support family self-care and enhance
problem-solving capacity• Reporting on performance/evaluation• Improved referral pathways to additional
community resources
Collaboration Continuum
• Compete• Co-exist HC and GCCC until 2001• Communicate• Cooperate • Coordinate GCCC peds sold to CHC 2001• Collaborate Multiple legal agreements• Integrate Full merger 2011 after 2 year pilot – still working to improve
Questions ????
Sally Baggett, Director of Patient and Family Services
Carolina Health Centers, Inc.113 Liner DriveGreenwood, SC 29646
(864) 941-8105