Скачать презентацию Harris County Behavioral Health Policy Efforts David S Скачать презентацию Harris County Behavioral Health Policy Efforts David S

3d9ae77a2e9db0d00845ff618896bd37.ppt

  • Количество слайдов: 21

Harris County Behavioral Health Policy Efforts David S. Buck, MD, MPH Karen Love, MHA Harris County Behavioral Health Policy Efforts David S. Buck, MD, MPH Karen Love, MHA February 2007

The Need Harris County jail processed 93, 921 unduplicated inmates in the year ending The Need Harris County jail processed 93, 921 unduplicated inmates in the year ending November 2006 l 24% of inmates have a diagnosable mental illness – about half of whom have a serious, disabling mental illness l 2. 5% of inmates (~2500) are homeless and half of them also have a mental illness l

The Need l Inmates are often released without advance notice to case managers, making The Need l Inmates are often released without advance notice to case managers, making discharge planning problematic l Inmates are often released in the middle of the night with no medication

The Need l Upon release, MHMRA patients may be referred to the Eligibility Center The Need l Upon release, MHMRA patients may be referred to the Eligibility Center for assessment and continuation of care, but often do not follow through due to various circumstances including: Lack of transportation l Lack of ID (TDL, Birth Certificate, SS etc. ) l Lack of proof of income and/or insurance l

The Need l An inmate with mental illness and/or disability is more likely to The Need l An inmate with mental illness and/or disability is more likely to be subsequently arrested and charged with another offense, face a more serious charge, stay twice as long in jail and incur more jail time for an equivalent offense (Nguyen, 2005).

Silos of Care County Jail l MHMRA l Harris County Hospital District l Social Silos of Care County Jail l MHMRA l Harris County Hospital District l Social Service Agences l CPS l Community Clinics l Private BH Providers l

Other Factors Harris County growing rapidly – resources not keeping pace l 30% uninsured Other Factors Harris County growing rapidly – resources not keeping pace l 30% uninsured l The behavioral health care system strained l changes in reimbursement requirements l private insurance priorities l reduction in psychiatric beds & services… l

Community Consensus Patients with high priority needs face increasing difficulty in accessing services l Community Consensus Patients with high priority needs face increasing difficulty in accessing services l Government, social services, public safety, physical and BH providers and advocates agree – access and service delivery system must be addressed l Change is a priority for the community l

Identifying Principles for Improving the Harris County Behavioral Health System Identifying Principles for Improving the Harris County Behavioral Health System

Phase I: Health Indicators Model for interventions to improve population health l Can serve Phase I: Health Indicators Model for interventions to improve population health l Can serve as a basis for developing community goals l Adopted by the Council in November 2005 l

Phase I: Health Indicators www. hcphsc. hctx. net/Reference. Material. asp Phase I: Health Indicators www. hcphsc. hctx. net/Reference. Material. asp

Phase I: Health Indicators (cont’d) Phase I: Health Indicators (cont’d)

Phase I: Health Indicators (cont’d) Phase I: Health Indicators (cont’d)

BH Performance Indicators l Overview: l Interviews l To identify principles, expectations, standards of BH Performance Indicators l Overview: l Interviews l To identify principles, expectations, standards of care, and outcomes l Literature review l Investigate literature referenced in interviews Create Harris County Behavioral Healthcare Report Card l Create mechanism for reporting modeled from healthcare indicator project l

Phase II: Provider Interviews l l What are the principles, expectations, standards of care, Phase II: Provider Interviews l l What are the principles, expectations, standards of care, and outcomes important to evaluating and defining an accountable behavioral healthcare system? Summary of themes that emerged from these interviews: Harris County Interviews Access Social acceptability of mental illnesses Use of community psychiatry literature that identifies principles and ways to measure outcomes Prevention / Screening Need for evaluation Assess quality of care Several outcomes measures Parity for mental and physical treatment

Methodologies in the Literature l l Literature search conducted in community & adolescent psychiatry Methodologies in the Literature l l Literature search conducted in community & adolescent psychiatry to look for systems of care that have evaluation tools on behavioral health MHSIP (Mental Health Statistics Improvement Program): Specifically designed to assess consumer concerns with treatment, not merely global satisfaction with mental health services. l l Report card with domains, concerns, indicators, and measures Indicators included: l l 1) objective measures of provider's commitment to mental healthcare 2) consumer assessment of the convenience, appropriateness, and outcomes of the services the system supports

Phase II: BIG THANKS l l l l l Jack Callahan, JD Sarah Flick, Phase II: BIG THANKS l l l l l Jack Callahan, JD Sarah Flick, MD Thomas Gavagan, MD Mary Lou Heater, RN, NP Sylvia Muzquiz, MD Fred Ramirez Pauline Rosenau, Ph. D John Sargent, MD Kim Szeto Stephen Williams l l l l l John Burruss, MD Avrim Fishkind, MD Sylvia Fitzgerald Andrew Harper, MD Lois Moore, Ph. D Tuan Nguyen, Ph. D Sonja Randle, MD Joe Rubio, Ph. D Steve Schnee, Ph. D Mel Taylor, MSW

Draft Principles Draft Principles

Selected Implications of Report Card: l Explore options for aligning resources more effectively l Selected Implications of Report Card: l Explore options for aligning resources more effectively l l Common eligibility Common set of utilization management tools consumer and family involvement in treatment planning and treatment decisions effective strategies for reducing admissions and long term use of incarceration and institutionalization and their offsetting costs

Phase III: Structuring for Success l Technical Assistance Collaborative engaged: l l On-site environmental Phase III: Structuring for Success l Technical Assistance Collaborative engaged: l l On-site environmental scan/system review Develop strategic option analyses Develop legislative proposal for transformation? Initial Report Due March 1 st

Contact Information David Buck Karen Love dbuck@bcm. tmc. edu karen_love@hctx. net Contact Information David Buck Karen Love [email protected] tmc. edu [email protected] net