SW 6102Individual

Learning Plan

INTEGRATED CAREMartin Hammar

Health care financing • Employer

funded• Gov’t

sponsored• Incident

driven• Fee for

ServicePrivate/Public

Insurance

• Premiums escalate

• # uninsured grows

• Cost of care

Health costs

• Control costs

• Denial of coverage

HMO’s/PPO’s

The Affordable Care Act

Mental Health Care

Institutional Care

• Segregated• Total care

Community Care

• SMD• MH care

Integrated Care

• Medical• Psycho-social

Current funding for CMH

MD;OP;CPST;

PH

Fee for service

Metered

Hard caps

Tiered rates

Systemic Approach

Outcome measures

Health Indicators

Development of Integrated Care

Medicaid Health Homes

Team Leader

Care Manager

HH Specialis

tHH Specialis

t

Care Manager

HH Specialis

tHH Specialis

t

Ψ MD

PCP

How integrated is integrated?FullyPartly IntegratedBasic On-Site

Basic DistanceMinimal

Reynolds, 2013

1st Level↓BH↓PHPCMH

2ndLevel ↑BH↓PHMHH

3rdLevel ↓BH↑PHPCMH

4thLevel ↑BH↑PHMHH

Care Management Location

(Reynolds, 2013)

Patient Centered Medical Homes

PCP

SpecialtyMH

BHC

BHC? You mean a social worker.

ShouldPt.

FunctioningExam RoomsBrief/

focused

Teams

10 min > 0

Any age

Shouldn’t

Prefer specialty MH

Prefer Ψ D/O

Prefer hour sessions

Quiet setting

Be pt. team leader

Lack BH training BFI

(Robinson & Reiter, 2006)

ReferencesBettelheim, A. (1999, April 16). Managing managed care. CQ Researcher, 9, 305-328. Retrieved from http://library.cqpress.com/cqresearcher/

Clemmitt, M. (2010, June 11). Health-care reform. CQ Researcher, 20, 505-528. Retrieved from http://library.cqpress.com/cqresearcher/

Gralnick, A. (1987). Toward the Ideal State Mental Hospital: The Human Equation. American Journal of Psychotherapy, 41(2), 231. Retrieved from Academic Search Complete database.

HHS.gov (2013). The Affordable Care Act’s Prevention and Public Health Fund in Your State: Ohio. Retrieved from http://www.hhs.gov/aca/prevention/oh.html

Mackelprang R.W,  & Salsgiver R.O. (1996). People with disabilities and social work: historical and contemporary issues. Social Work, 41(1), 7-14.

Murray, M. (2006). The rise and fall of the state hospital system. UN Chronicle, 43(2), 38-43. Retrieved from Academic Search Complete database.

Martin, J. (1956). Inside the asylum. Saturday Evening Post, 229(14), 23-70

ODMH. (2012, April). Ohio Medicaid Health Home Informational Forum 1: An Applied Approach to Implementing CBH Health Home. Ohio Department of Mental Health. Retrieved from: http://mentalhealth.ohio.gov/assets/medicaid/health-home-web-page/health_home_informational_forum_presentation_1.pdf

Reynolds, D. (2013, Feb 11). Models of integration Ohio health home TTA Webinar. National Counsel for Behavioral Health. Retrieved from: http://www.mh.state.oh.us/assets/medicaid/health-home-web-page/february-11-2013-models-of-integration-webinar-presentation.pdf

Returning the mentally disabled to the community : government needs to do more : Department of health, Education, and Welfare and other federal agencies : report to the Congress / by the Comptroller General of the United States. (1977). Washington : General Accounting Office, 1977..

Robinson, P. & Reiter, J. (2006). Behavioral Consultation and Primary Care: a Guide to Integrating Services. New York:Springer

Waite, D. (1999) History of construction of the Athens state hospital . In J. Waite (ed.), Master Plan and Feasibility Study for the Kennedy Museum ( Buffalo: John G. Waite Associates), 3-15.

Ziff, K., Thomas, D., & Beamish, P. (2008). Asylum and community: the Athens Lunatic Asylum in nineteenth-century Ohio. History of Psychiatry, 19(76), 409-432. doi:10.1177/0957154X07082618.