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Concurrent Sessions, Period 1

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Friday, October 17, 2014 - 10:30 AM to 12:00 PM

Sessions vary in length from 20-90 minutes.

Click here for PDF of Period 1 Concurrent Sessions with objectives.

Period 1 Sessions - grid version


A1a: The Case for Utilizing Psycho-educational Multiple Family Groups (MFGs) in Medical Settings:  Our 25-Year Experience with the Ackerman Institute MFG Model

Although psychoeducational multiple family groups (MFGs) have been enjoying increasing popularity in medical settings, they still remain very much underutilized. To take up this challenge, for the past 25 years we have been implementing a manualized version of an MFG in a wide variety of clinical settings, including community hospitals, a tertiary care cancer center, and out-patient settings.  Join us for a whirlwind review of our MFG experiences, and a discussion of why this type of MFG model can be so effective and has been so positively endorsed by participating families.

Peter Steinglass, M.D. President Emeritus, Ackerman Institute for the Family Clinical Professor of Psychiatry, Weill-Cornell Medical College; Talia Zaider, Ph.D. Assistant Attending Psychologist, Memorial Sloan-Kettering Cancer Center Dept. of Psychiatry and Behavioral Sciences;

Key Track: 1.  Content Level: All audiences  (40 minutes)

A1b: Engaging Families to Improve Health Outcomes in Diabetes Care

Based on innovative models, this presentation will describe ways that providers can work with families living with diabetes across both community and tertiary care environments.  Participants in this interactive workshop will be able to (1) describe multiple ways that providers partner with families to better manage health, (2) identify how these collaborative efforts can lower diabetes-related health care costs, and (3) apply these skills in their own professional and community networks to target a broad range of chronic health conditions.

Max Zubatsky, PhD, LMFT  Post-Doctoral Fellow  Chicago Center for Family Health; John Rolland, MD, MPH Clinical Professor, Department of Psychiatry and Behavioral      Neuroscience, University of Chicago Pritzker School of Medicine; Tai Mendenhall, PhD, LMFT Assistant Professor in Family Social Science University of Minnesota; Betty GreenCrow Families Education Diabetes Series: Principal Community Elder Minneapolis, MN;

Key Track: 3.  Content Level: All audiences  (40 minutes)

B1a: Telehealth and Primary Care

This presentation will review and discuss multiple uses for telehealth service delivery within the context of primary care settings.  A strong focus on integrated care models, multidisciplinary teams, and collaboration between health care providers and community organizations and stakeholders is included. Dr. Lesley Manson and Dr. Robynne Lute collectively have twelve years of experience as behavioral health providers utilizing telehealth services in primary care settings. This experience spans the use of such services with pediatric and adult populations, including the seriously mentally ill as well as rural and indigent populations.  Telehealth has received strong empirical support with respect to efficacy and is an effective means for increasing service delivery and service integration.

Lesley Manson, PsyD  Assistant Professor, Licensed Clinical Psychologist; Arizona State University Doctor of Behavioral Health program; Robynne M. Lute, PsyD  Assistant Professor, Licensed Clinical Psychologist, Coordinator of Primary Care Psychology at Forest Institute; Norman Bell, M.D.  Pediatrician at Open Door Community Health Centers;

Key Track: 5.  Content Level: All audiences  (40 minutes)

B1b: Telehealth Behavioral Health Consultation Services: Implementation Strategies & Challenges

The delivery of behavioral health consultation services in primary care via telehealth is a feasible, cost-effective model that can improve patient outcomes by providing access to remote sites where behavioral health resources are limited. Behavioral Health Consultants (BHCs) from Cherokee Health Systems will discuss strategies and challenges for implementation in addition to issues related to workflow, infrastructure, and technology.

Jean Cobb, PhD Psychologist and Behavioral Health Consultant Cherokee Health Systems; J. David Bull, PsyD Psychologist and Behavioral Health Consultant Cherokee Health Systems;

Key Track: 2.  Content Level: All audiences  (40 minutes)

C1a: Trail Blazers: Peer Support in Integrated Health Care: The T&T Experience (Tennessee and Texas)

This presentation will explore the practices of peer support utilized to build and sustain their activities in primary care and mental health settings.  Attendees will gain both an understanding of the key components of peer support as well as practical information about how to implement similar peer support programs within their organizations.

Rick Ybarra, M.A. Program Officer Hogg Foundation for Mental Health; Stephany J. Bryan Program Officer and Consumer & Family Liaison Hogg Foundation for Mental Health; Suzanne Bailey, Psy.D.   Clinical Psychologist and Behavioral Health Consultant Cherokee Health Systems;

Key Track: 5.  Content Level: All audiences  (40 minutes)

C1b: Initial Examination of Characteristics of High Utilizers of an Established Behavioral Health Consultation Service

The Primary Care Behavioral Health (PCBH) model is designed to provide population based care from a generalist perspective.  Good model adherence implies that 85-90% of patients are seen 4 times or less in a given year (Robinson & Reiter, 2007).  To date, there has been little work examining the remaining 10-15% of patients, and particularly the high utilizers of such services.  The purpose of this talk is to examine characteristics of high utilizing patients of an established Behavioral Health Consultation (BHC) service over a 6 year time span (2007-2013).  Basic demographics, including diagnoses, will be explored.  Additional characteristics will include analyses related to involvement with other aspects of our BHC team, including consulting psychiatry, care management and/or AODA care.  An analysis of a subset of patients will explore the potential overlap between high utilizers of the BHC service and medically complex patients.

Meghan Fondow, PhD Behavioral Health Consultant Access Community Health Centers; Elizabeth Zeidler Schreiter, PsyD Behavioral Health Consultant Access Community Health Centers; Chantelle Thomas, PhD Behavioral Health Consultant Access Community Health Centers; Ashley Grosshans, LCSW Behavioral Health Consultant Access Community Health Centers;

Key Track: 4.  Content Level: Advanced  (40 minutes)

D1a: The Search For The Holy Grail: Economic Impact Data of Hospital and Emergency Department Utilization

Data obtained from all of the hospital systems in Madison, WI will be presented showing utilization patterns of 12,000 primary care patients over 10 years, some of whom have a medical home with a community health center which uses the primary care behavioral health model. In addition, the presenters will discuss the challenges associated with obtaining this data as a model for how others may be able to replicate the study and the reasons for obtaining the data as a means of developing a rationale for contracting for incentive payments from insurers.

Neftali Serrano, PsyD, Chief Behavioral Health Officer, Access Community Health Centers; Meghan Fondow, PhD, Behavioral Health Consultant, Access Community Health Centers;

Key Track: 4.  Content Level: Advanced  (40 minutes)

D1b: Successes and Challenges with the Expansion of Open Access Scheduling for Behavioral Health Across Integrated Care Settings

While capitated payment models are emerging, most behavioral health clinicians in primary care continue to work under fee for service models. As such, "no-shows" and late cancelations become both real and indirect costs for behavioral health providers in terms of productivity and lost opportunity to meet the needs of other patients. Last year at CFHA this team presented pilot data on an open access appointment scheduling system which demonstrated a 10% increase in BHC service utilization/availability. Since then we have launched this scheduling system in 3 additional and diverse integrated primary care clinics across the nation. We will present BHC service utilization data and discuss the lessons learned from each site.

David RM Trotter, PhD Assistant Professor Texas Tech University Health Sciences Center Department of Family and Community Medicine; Daniel Mullin, PsyD Assistant Professor UMass Medical School Department of Family Medicine and Community Health; Christine Runyan, PhD Associate Professor UMass Medical School Department of Family Medicine and Community Health; James Anderson, PhD Co-coordinator of Behavioral Science Family Medicine Residency Hennepin County Medical Center; Jeanna Spannring, PhD Primary Care Behavioral Health Fellow UMass Medical School Department of Family Medicine and Community Health

Key Track: 4.  Content Level: Basic  (40 minutes)

E1a: Leadership Practices and Behaviors that Support Integrated Care

Organization leaders play a critical role in creating systems and environments that foster and support integrated care. In this presentation we share leadership practices that we observed among leaders in integrated clinics and heard key informants identify as central to creating strong integrated systems.  We contrast how leadership manifests in practices that are just beginning to integrate care with those with years of experience providing population-based integrated primary and behavioral health care.

Deborah J. Cohen, PhD, Associate Professor, Department of Family Medicine, Oregon Health & Science University; Rose K. Gunn, MA, Research Associate, Department of Family Medicine, Oregon Health & Science University;

Key Track: 7.  Content Level: All audiences  (40 minutes)

E1b: Designing Clinical Space for Integrated Care

An increasing number of health care organizations are implementing models of integrated behavioral health and primary care as a part of routine, patient-centered care. Layout of space in these clinics can present challenges to successful integration or serve to strengthen these models.  In this presentation, we highlight the qualities of a clinic's physical layout that facilitate or hinder collaboration between healthcare professionals. We describe which characteristics promote the interaction between primary care clinicians, behavioral health providers, and ancillary staff to support integration, thereby enhancing patient experience of care. We show how different spatial arrangements can influence team dynamics and share examples of how primary care practices adapt their spaces to better support collaboration among professionals.

Rose K. Gunn, MA, Research Associate, Department of Family Medicine, Oregon Health & Science University; Jennifer D. Hall, MPH, Research Associate, Department of Family Medicine, Oregon Health & Science University; Deborah J. Cohen, PhD, Associate Professor, Department of Family Medicine, Oregon Health & Science University;

Key Track: 7.  Content Level: All audiences  (40 minutes)

F1a: The Development of a Collaborative Model Which Improves Outcomes and Reduces Costs While Providing Care Recommendations for Children and Adolescents with Complex Medical, Psychological and Developmental Problems

This presentation is designed to assist those in attendance to develop and sustain a service delivery model which is based upon multidisciplinary collaborative care. This interactive presentation is ideal for participants embarking upon or refining their collaborative approach to providing care for children and adolescents. Each participant will leave this presentation with an implementable model and forms for immediate use in their own practice.  The collaborative format presented in this session has been developed and utilized by the Child and Adolescent Program Enrichment Services (CAPES) team over the past four years. Standardized forms are utilized by the CAPES team in order to collect and analyze data regarding the effectiveness of the program.

Mary E. Rineer, Ph.D. Director Child and Adolescent Program Enrichment Services (CAPES); Danny W. Stout, Ph.D. Statistician (CAPES volunteer) Child and Adolescent Program Enrichment Services (CAPES); Michael J. Sannito, Ph.D., L.P.C. Family Therapist Child and Adolescent Program Enrichment Services (CAPES); Christopher M. G. Puls, M.D. Child Psychiatrist Child and Adolescent Program Enrichment Services (CAPES);

Key Track: 4.  Content Level: All audiences  (40 minutes)

F1b: Playing by the Rules: Integrated Care's Impact on Quality of ADHD Management

This talk reviews simple roles and procedures that increase adherence to standards of care. Presentation will compare outcome data on physician perceptions of ADHD management, match to standards of care based on data from electronic medical record, and clinical outcomes for ADHD patients from Integrated Primary Care clinics with patients from non-integrated primary care clinics.  Outcomes include percentage of standards met, percentage of patients referred for behavioral therapy, percentage of patients prescribed medications, and rates of diagnosis of ADHD (all variables compared between IPC clinics and traditional primary care clinic).

Tawnya J. Meadows, Pediatric Psychologist, Geisinger Health System; Shelley J. Hosterman, Pediatric Psychologist, Geisinger Health System;

Key Track: 7.  Content Level: All audiences  (20 minutes)

F1c: A penny saved is a penny earned: Pharmacy and behavioral health cost savings in pediatric IPC clinics

Studies demonstrate cost offset from integration of behavioral health and primary care in adult populations and specific areas of population health. However, few studies evaluate cost-offset in the pediatric population. This study shares financial outcomes from a three year pediatric IPC pilot program within the Geisinger Health System. Current data indicate significant savings in pharmacy and behavioral health costs for patients served in IPC clinics verses overall patient population. This program will discuss strategies used to measure cost offset, review findings, and facilitate a discussion of implications and generalizability.

Paul Kettlewell, Pediatric Psychologist, Geisinger Health System; Tawnya J. Meadows, Pediatric Psychologist, Geisinger Health System; Shelley J. Hosterman, Pediatric Psychologist, Geisinger Health System; Vanessa Pressimone, Post-doctoral Fellow, Geisinger Health System;

Key Track: 4.  Content Level: All audiences  (20 minutes)

G1a: Getting Unstuck: A Strategy that Works for Patients, Practices, and Health Systems

We've all heard it: "I can't do that;" "We're too busy;" "We can't afford it." In our work at all levels, individual, practice, and system, we've encountered people and organizations that are "stuck". Through our experience with patients, we have implemented an evidence-based model of brief treatment that works to help get them "unstuck" and moving again towards a lifestyle they value. The same treatment principles can be adapted to move integration forward within a practice or with a health system.  During this presentation, participants will learn the key concepts of a brief treatment model. They will then learn how the same techniques can be used to help a medical practice or health system enhance integrated care.

Mary Jean Mork, LCSW Program Director MaineHealth; Melissa Cormier, LCSW Clinical Program Manager Maine Mental Health Partners; Cynthia Cartwright, MT, RN, MSEd Program Manager MaineHealth;

Key Track: 5.  Content Level: All audiences  (40 minutes)

G1b: Integration in Practice; Tracking the Transformation

Elements of practice redesign have been identified which support quality improvement and practice transformation that are building blocks for sustainable integration and achieving the triple aim. The integration of primary care and behavioral health represents sophisticated practice transformation, requiring practices to be attentive to underlying elements of quality improvement.   The Comprehensive Primary Care Monitor, a self-administered practice tool, accounts for how these elements of practice transformation are applied to and support integration while simultaneously helping practices to self-assess, prioritize their work and monitor progress.  This working session will demonstrate how this tool has been used in practice settings and engage participants to adapt it to their own.

Stephanie Kirchner, MSPH, RD Practice Facilitation Program Manager University of Colorado, Department of Family Medicine; Kyle Knierim, MD Instructor, Practice Transformation Research University of Colorado, Department of Family Medicine; Perry Dickinson, MD Professor University of Colorado, Department of Family Medicine; 

Key Track: 2.  Content Level: All audiences  (40 minutes)

H1: Debating Integrated Care's Unresolved Issues

There is no better locale than Washington DC for integrated care's brightest minds to hash out our field's most pressing controversies:  1) Susan McDaniel vs Paul Simmons: Does the PCMH require a physician to be the team leader?  2) Alexander Blount vs Jeff Goodie vs Andrew Pomerantz: Should the first hire for an integrated clinic be a care manager, therapist, or psychiatrist?  3) Barry Jacobs vs Benjamin Miller: Is a PCMH or Super-Utilizer approach more likely to achieve the Triple Aim?  4) Laura Sudano vs Shelina Foderingham vs Kyle Horst: What are the most awkward moments in integrated care settings?  We will strive for robust empiricism, but might settle for strong rhetoric where we lack solid data.  Regardless, you will leave informed of the latest science and most relevant policy advances.

Randall Reitz, PhD Director of Behavioral Sciences St Mary's Family Medicine Residency; Jodi Polaha PhD Associate Professor of Psychology  East Tennessee State University;

Key Track: 5.  Content Level: All audiences  (90 minutes)

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10/13/2016 » 10/15/2016
CFHA 2016 Conference: "Celebrating the Many Faces and Places of Integration"