1. 1. Using an Integrated Care Team to Improve Treatment Adherence in a Substance Using Population Carol Murphy Chief Operating Officer Chief Nursing Officer May 7, 2015
2. 2. Using an Integrated Care Team to Improve Treatment Adherence in a Substance Using Population May 7, 20152 Icebreaker
3. 3. Who We Are Using an Integrated Care Team to Improve Treatment Adherence in a Substance Using Population May 7, 20153
4. 4. Mission Brightpoint Health drives dramatic improvements in the health of New Yorkers. Vision Brightpoint Health is a recognized leader in the delivery of high-quality, person-centered, integrated care resulting in improved health outcomes for people, families and communities challenged by health disparities caused by poverty, discrimination and lack of access. Using an Integrated Care Team to Improve Treatment Adherence in a Substance Using Population May 7, 20154 Mission and Vision
5. 5. Using an Integrated Care Team to Improve Treatment Adherence in a Substance Using Population May 7, 20155 Core Values
6. 6. Opened in The Bronx, New York City in 1990 Model developed in response to four co-occurring public health epidemics. Heroin Crack/cocaine Mass Incarceration HIV/AIDS Using an Integrated Care Team to Improve Treatment Adherence in a Substance Using Population May 7, 20156 History of our Integrated Model: Residential Care
7. 7. Using an Integrated Care Team to Improve Treatment Adherence in a Substance Using Population May 7, 20157 History of our Integrated Model: Residential Care
8. 8. Using an Integrated Care Team to Improve Treatment Adherence in a Substance Using Population May 7, 20158 Who Are Our Patients Today? patients with substance abuse diagnosis patients with substance abuse diagnosis + MH diagnosis patients with substance abuse diagnosis + MH diagnosis + medical diagnosis 75% 73% 28%
9. 9. 60.3% 39.7% By Gender Male Female Using an Integrated Care Team to Improve Treatment Adherence in a Substance Using Population May 7, 20159 Who Are Our Patients Today? 0.8% 15.2% 19.5% 30.2% 28.9% 5.4% By Age >20 21 to 30 31 to 40 41 to 50 51 to 60 60<
10. 10. 60.8% 39.2% By Ethnicity Not Hispanic or Latino Hispanic or Latino Using an Integrated Care Team to Improve Treatment Adherence in a Substance Using Population May 7, 201510 Who Are Our Patients Today? 48.9% 39.6% 11.5% By Race Black Other White
11. 11. Why Bridge Substance Use Treatment and Primary and Mental Health Care? Using an Integrated Care Team to Improve Treatment Adherence in a Substance Using Population May 7, 201511
12. 12. Juanitas Story Using an Integrated Care Team to Improve Treatment Adherence in a Substance Using Population May 7, 201512
13. 13. Of all people diagnosed as mentally ill, 29% abuse either alcohol or drugs. Using an Integrated Care Team to Improve Treatment Adherence in a Substance Using Population May 7, 201513 Connection Between Mental Health Treatment and Substance Abuse Treatment Source: National Alliance on Mental Illness 37% of alcohol abusers and 53% of drug abusers also have at least one serious mental illness.
14. 14. Untreated symptoms of a mental health disorder can prevent a patient from remaining clean and sober. Untreated substance abuse issues can make mental health treatment ineffective. Using an Integrated Care Team to Improve Treatment Adherence in a Substance Using Population May 7, 201514 Connection Between Mental Health Treatment and Substance Abuse Treatment
15. 15. Persons with substance abuse disorders have: 9 times greater risk of congestive heart failure. 12 times greater risk of liver cirrhosis. 12 times the risk of developing pneumonia. Using an Integrated Care Team to Improve Treatment Adherence in a Substance Using Population May 7, 201515 Connection Between Substance Abuse and Health Outcomes Source: National Alliance on Mental Illness
16. 16. Our Solution Using an Integrated Care Team to Improve Treatment Adherence in a Substance Using Population May 7, 201516
17. 17. Using an Integrated Care Team to Improve Treatment Adherence in a Substance Using Population May 7, 201517 Our Outpatient Model
18. 18. Outreach (Transportation) Mental Health (Article 31/28) Out Patient Drug Treatment (Article 822) Medical Care Management Primary Care Dental Services Care Coordinator (Health Home) replacement therapy (Buphenoiphinc) Pain Management 18 Brightpoint Healths Homeless FQHC: Our Approach to Treatment Medical Case Manager Office-Based Opioid replacement therapy (Buprenorphine) Outpatient Drug Treatment (Article 822) Using an Integrated Care Team to Improve Treatment Adherence in a Substance Using Population May 7, 2015 Primary Care
19. 19. Using an Integrated Care Team to Improve Treatment Adherence in a Substance Using Population May 7, 201519 Primary Care Team (Integrated Care Model) Med Tech Mental Health Provider Care Manager (Health Home) Medical Provider RN Dental Services Medical Care MangerCase Manager
20. 20. Referral Services Residential TC Programs Detox units 30 Day rehab services Peer support groups and outside 12 step programs Using an Integrated Care Team to Improve Treatment Adherence in a Substance Using Population May 7, 201520 Behavioral Health Services Mental Health Center Mental health assessment Individual and group therapy Psychotropic medication management Co-located Primary Care Medically assisted therapies Opioid replacement therapy Pain management 12 Step programs onsite Outpatient Substance Use Treatment Program Individual and group counseling
21. 21. Strategies Using an Integrated Care Team to Improve Treatment Adherence in a Substance Using Population May 7, 201521
22. 22. Using an Integrated Care Team to Improve Treatment Adherence in a Substance Using Population May 7, 201522 Developed Population Health Registries
23. 23. Using an Integrated Care Team to Improve Treatment Adherence in a Substance Using Population May 7, 201523 Behavioral Health Intervention Provided to all Patients who Present with Need
24. 24. Provide Care Management Support for Homeless Patients Using an Integrated Care Team to Improve Treatment Adherence in a Substance Using Population May 7, 201524
25. 25. Using an Integrated Care Team to Improve Treatment Adherence in a Substance Using Population May 7, 201525 Collaboration with Care Management Programs to Provide Additional Support to Hard to Engage Patients
26. 26. Outcomes Using an Integrated Care Team to Improve Treatment Adherence in a Substance Using Population May 7, 201526
27. 27. 1,407 2,325 3,304 4,246 1,831 2,988 4,738 5,941 726 1,218 1,984 2,584 0 1,000 2,000 3,000 4,000 5,000 6,000 7,000 2011 2012 2013 2014 Mental Health Patients Primary Care Patients Dental Patients Using an Integrated Care Team to Improve Treatment Adherence in a Substance Using Population May 7, 201527 Increasing Access to Services
28. 28. Using an Integrated Care Team to Improve Treatment Adherence in a Substance Using Population May 7, 201528 Things to think about
29. 29. Pain Points for the Community Health Center May 07, 201529 Thank You