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Report: The Financial Impact of Workforce (2018). Resource Type: Publication. Description: This report covers the costs associated with a provider vacancy at a health center beyond the dollar value and provides recommendations for steps to bolster a plan for recruitment and retention to avoid these costs in the future. More Details...
Behavioral Health Integration Compendium: Curated Guidance and Resources from Experienced Organizations, developed with Chiron Strategy Group (2018). Resource Type: Publication. Description: Many health centers collaborate with external behavioral health providers or provide co-located or integrated behavioral health services within their health center. Some of the most significant challenges are determining which data to share, how to store it within the Electronic Health Record, and how to use it within primary care. This compendium of literature and resources offers some guidance related to behavioral health data integration, complete with key health center considerations for each. Many health centers collaborate with external behavioral health providers or provide co-located or integrated behavioral health services within their health center. Some of the most significant challenges are determining which data to share, how to store it within the Electronic Health Record, and how to use it within primary care. This compendium of literature and resources offers some guidance related to behavioral health data integration, complete with key health center considerations for each. Click on each heading below to access the original pieces being profiled. Integrating Behavioral and Primary Care — Technology and Collaboration This article focuses on the challenges of integrating data between primary care and behavioral health. It discusses a number of concerns, and approaches that have been taken, including the benefits of developing structured data within the EHR. Health Center Takeaway: Patient consent for sharing sensitive health information can be integrated into the EHR, which will allow for greater information sharing while complying with Federal privacy expectations. Can technology shape the future of behavioral health? This article includes a number of different ways that technology plays a part in integrated behavioral health, highlighting: Adoption of telehealth as a means to augment care; Inclusion of behavioral health data in Health Information Exchanges, citing the experience of Arizona; and An example of an application being developed with NIH support that hopes to provide collaborative care tools to patients. Health Center Takeaway: Health centers are encouraged to investigate whether insurers will reimburse for telehealth and what is required to do so, to see if developing a telehealth program might augment the availability of behavioral health services for your patients. HITEQ has a number of resources related to telehealth. Integrated Behavioral Health Partners Three Case Studies on Behavioral Health Data Sharing Three California case studies where organizations shared behavioral health data. The website includes details regarding mental health data, substance use data, consent, methods of sharing, and challenges. Health Center Takeaway: Use these examples of different approaches to consent and level of information sharing to foster conversation among your leadership on how to create greater data integration. Center for Health Care Strategies Integrating Physical and Behavioral Health Care in Medicaid Toolkit Section IV: Information Exchange CHCS has developed a rich resource for behavioral health integration. This section focuses on information exchange, and has a number of helpful resources identified. Health Center Takeaway: The last two resources are integrated care plan templates; if you have an external behavioral health partner, consider how you might share data between the two organizations in a standardized format. Patient-Centered Primary Care Institute Behavioral Health Integration: Obstacles & Successes Lessons learned from this interview: Change the mindset from the bringing together of two services to truly integrating whole health Shift from historic care delivery methods to a focus on achieving better health outcomes Building trust with primary care providers is essential Health Center Takeaway: Determining what patients need will help guide the type of integration services your health center develops, which can include different approaches for different sites. SAMHSA’s Quick Start Guide to Behavioral Health Integration for Safety-Net Primary Care Providers This guide helps any health center think about where it is in the process of integrating behavioral health, with a number of embedded links for additional information. Key areas of Administration, Workforce, and Clinical Practice. Health Center Takeaway: Use this guide to identify barriers to a fully-developed program, and find resources to help overcome them. Zufall Health Center Integrated Behavioral Health and Primary Care Change Package Zufall Health Center partnered with a local behavioral health system to create an Integrated Behavioral Health system, using grant funding to help support the pilot. This collection of lessons learned focuses on: Leadership Commitment Clinical Information Systems and Measurable Improvement Integrated Care Delivery Clinical Decision Support Patient/Family Engagement Health Center Takeaway: Leadership must assess organizational capacity to collaborate, and then collect baseline data on health outcomes, including preventative screenings, ED visits, hospitalizations as some of the early steps. Implementing measurement and management of key clinical outcomes are critical next steps. NCQA Mainstreaming Behavioral Health Care NCQA has developed a Distinction in Behavioral Health Integration, which allows recognition of Patient Centered Medical Homes who have integrated care teams in place using evidence-based protocols and ongoing quality measurement and improvement. Health Center Takeaway: Many health centers have achieved recognition as a Patient Centered Medical Home PCMH or are along the way. Aligning behavioral health integration work to earn this Distinction can help provide a roadmap for implementation of integration activities, and externally create validation for potential funders. How Intermountain Healthcare's Mental Health Integration is Improving Care Intermountain Healthcare is a large health system, with 22 hospitals and 180 clinics. It has been developing Mental Health Integration services for a number of years, with three key components: Their mental health assessment tool activates a team consultation workflow to determine which patients are referred. They designed an operational system in which mental health specialists and nurse care managers are included in the primary care staff, through full-time co-location or frequent rotation.They evaluate the program regularly to monitor patient outcomes, team effectiveness and the culture of healthcare delivery from the perspective of the patient and the care provider. Health Center Takeaway: Integrating behavioral health takes time. Intermountain Healthcare has created an efficient process to develop programs and they plan for two years to implement and become revenue-neutral. Health centers would benefit from a long-term approach with a commitment of upfront internal or external funding. Deeper Reading If you are looking for more in-depth reading on the topic, visit the following links for longer articles. Electronic Health Record Challenges, Workarounds, and Solutions Observed in Practices Integrating Behavioral Health and Primary Care This Journal of the American Board of Family Medicine article describes the electronic health record EHR-related experiences of practices striving to integrate behavioral health and primary care using tailored, evidenced-based strategies from 2012 to 2014; and the challenges, workarounds and initial health information technology HIT solutions that emerged during implementation. Behavioral Health Information Network of Arizona: 2014 HIMSS HIE Community Roundtable This HIMSS presentation describes the design and implementation of a Health Information Exchange in Arizona that integrates behavioral health data and is 42 CFR Part 2 compliant. Useful for any health center leadership involved in such a project with their affiliated Health Information Exchange. More Details...
Providing Trauma-Informed Care at Health Centers for HIV-Positive Men Who Have Sex With Men (2018). Resource Type: Publication. Description: This brief offers health centers an introduction to providing trauma-informed care for HIV-positive men who have sex with men (MSM). The overall aims are to help health center staff understand the disproportionate prevalence of trauma and stress-related disorders among HIV-positive MSM, recognize the relationship of trauma to overall health and decreased engagement in primary care among HIV-positive MSM. This brief will also outline the promising practices in trauma-informed care to improve engagement of HIV-positive MSM in behavioral health and primary care. More Details...
SO/GI Data Collection Demonstration Videos (2018). Resource Type: Other. Description: These videos demonstrate best practices in sexual orientation and gender identity data collection. They address common questions and issues that arise for frontline and clinical staff when asking patients about their sexual orientation and gender identity. We hope these videos can provide a valuable training tool for health care staff looking for sample language and best practices. More Details...
Treating Global Health At Your Doorstep Starts with a Good Patient History: The most potent, cost-effective, and accurate diagnostic tool that we have even in our advanced age of technology remains an accurate and comprehensive linguistically and culturally appropriate patient history. (2018). Resource Type: Archived Webinar. Description: Technology is a vital part of our society. It has been critical in the advancement of medicine; however, in some cases there is an overdependence by clinicians on diagnostic technology which may impede a fuller understanding of the circumstances of patients in the exam room. The most potent, cost-effective, and accurate diagnostic tool that we have even in our advanced age of technology remains an accurate and comprehensive linguistically and culturally appropriate patient history. In this webinar, Dr. Ed Zuroweste and Dr. Laszlo Madaras, who collectively have over 50 years of practice in primary care, ask the question, “Has it become so normal to ask for tests for the most basic assessments that part of the art of medicine is being lost?” The presenters will explore the value of taking a culturally and linguistically appropriate history from the patient together with a thorough – and focused – physical exam. Spending a few minutes with the patient asking open-ended questions may save time and money by: getting the correct diagnosis and treatment plan; preventing expensive, unnecessary, and potentially harmful tests; reducing the number of specialists who may not need to see the patient; and even possibly improving patient satisfaction. The session will look at the impact of global health conditions on primary care practice in the United States and describe what primary care clinics can do to more systematically prepare for emerging diseases. At the conclusion of the webinar, participants will be able to: More Details...
Integrated Supportive Housing and Health Center Partnerships Serving Older Adults with Complex Needs: Understanding unique health needs of homeless and formerly homeless aging population (2018). Resource Type: Archived Webinar. Description: Webinar presentation on effective integrated health and housing partnerships to serve the health needs of older adult populations - both currently and formerly homeless. More Details...
The Role of Medical-Legal Partnership in Promoting Health Equity (2018). Resource Type: Publication. Description: This article shares how more than nearly 400 hospitals, health centers, and clinics across the U.S. are using legal services to treat issues–including housing, access to insurance, and stable guardianship–that drive health inequities. This commentary was published as part of a special edition of Health Affairs on “Advancing Health Equity.” More Details...
The Health Center CIO’s Guide to HIPAA Compliant Text Messaging: 2018 Updates on Methods for Successful Electronic Patient Engagement (2018). Resource Type: Publication. Description: This slide deck provides health centers with information and a presentation template overview of the HIPAA and electronic PHI risks related to texting and messaging that are important for health center leadership and IT managers to understand in making organizational decisions for these types of tools. This slide deck provides health centers with information and a presentation template overview of the HIPAA and electronic PHI risks related to texting and messaging that are important for health center leadership and IT managers to understand in making organizational decisions for these types of tools. Key considerations covered within this slide deck: Important to understand new changes to enforcement of HIPAA as it relates to portable devices, texting, and emailing of PHI. HIPAA privacy and security rules need not act as an obstacle to texting, but compliance requires planning and diligence. All forms of communication involve some level of risk. Text messaging merely represents a different set of risks that, like other communication technologies, needs to be managed appropriately to ensure both privacy and security of the information exchanged. More Details...
Medicaid Accountable Care Organizations: A Case Study with Boston HCH Program (2018). Resource Type: Publication. Description: This case study examines how these changes to ACOs will impact BHCHP and other Massachusetts HCH programs—and how these issues might be common to other states implementing (or considering) ACOs as part of their health care delivery redesign. More Details...
How Medical-Legal Partnership Services Can Help Address the Opioid Crisis (2018). Resource Type: Publication. Description: This issue brief from the National Center for Medical-Legal Partnership examines how legal services delivered alongside medical and behavioral health services can help support successful recovery from substance use disorders. More Details...
Housing Opportunities for Persons with HIV/AIDS and HOPWA Modernization: HUD Policy Brief Understanding the Impact of Housing Policies for Health Centers (2018). Resource Type: Publication. Description: HOPWA (Housing Opportunities for Persons with AIDS) is the federal housing program which provides both housing subsidies and services for vulnerable populations. Legislative changes in 2016 to the allocation and eligibility requirements under the program provide new opportunity for Health Centers to collaborte with their local communities to support the federal goal to eliminate HIV/AIDS. This series translates federal housing policies to help health centers understand the impact and how to coordinate and adapt programming to create the most beneficial outcomes for clients. More Details...
Beyond the Walls: Effectively Utilizing Community Health Workers and Clinical Home Visitors as Part of the Team (2018). Resource Type: Archived Webinar. Description: In this webinar, we will focus on team members who work with patients in various capacities beyond the walls of the exam room but make an enormous contribution to clinical outcomes. Participants will learn about their connections to the team, and the effective outcomes that result from their patient engagement. More Details...
Effective Social Media Management for Health Centers: Infographic Poster (2018). Resource Type: Publication. Description: Maintaining a good name in the digital era is becoming increasingly important as social media tools and platforms continue to expand the services they offer. As a health center, having a professional social media presence is becoming an influential channel in which to engage patient populations. Maintaining a good name in the digital era is becoming increasingly important as social media tools and platforms continue to expand the services they offer. As a health center, having a professional social media presence is becoming an influential channel in which to engage patient populations. These channels enable physicians and health groups to communicate and share information quickly while reaching millions of people. However, these same channels and other social media activities also create new challenges for the patient-physician relationship. In the current health care environment, health centers often don’t have the time or resources to effectively manage their own social media presence. The HITEQ Center has gathered this brief list of tips and resources to help health centers get started with managing and maintaining a professional and engaging social media presence for their health center. Think Before You Post Above all else, make sure that you are complying with all privacy and security requirements before you post to social media. It is better to be slow in responding, rather than unknowingly violating HIPAA regulations. Have 2-3 people review a post before submitting. When dealing with patient information, be cognizant of the standards of patient privacy and confidentiality just as you would in any other context. There are boundaries to the patient-physician relationship that must be maintained—online and off. Never post identifiable patient information online and monitor your own internet presence to ensure that personal and professional information are kept separate. Also, be wary of inadvertently committing an act that constitutes medical malpractice. The National Association of Community Health Center’s NACHC guide to social media and medical malpractice relates two main areas of concern when it comes to social media, technology, and medical malpractice: 1 Committing an act that constitutes potential malpractice; and 2 the impact of social media use on a potential or pending malpractice proceeding. Know Your Audience Understanding your audience is key if you want to ensure patient and stakeholder engagement. The message you want to disseminate should resonate with your target audience. NACHC’s guide to Social Media for Health Centers relates that it is important to not stray too far from the types of topics that brought people to your site in the first place. Try to understand how a user might receive your message if you want it to stick. Doing so can help you engage with past, current, and potential patients through meaningful and relevant content. This can encourage discussions and build credibility. Understanding your audience is also a great way to get to know your patients and stakeholders; it can help you learn about their experiences with the health center, identify their pain points, and uncover new ways to improve care. Engage Your Population Respond to all messages, including both praise and criticism. As Dr. John Halamka writes, “We don’t make excuses. We try to take it offline as soon as we can. We send a direct message to the reviewer.” Customer service shouldn’t stop when you go online. Developing an online relationship with patients and stakeholders is critical in upholding your health center’s values in customer service and relations. Enhancing online communication between the physician and patient is one way to maintain that relationship. This means responding to their comments and questions, especially if it’s a complaint, is a professional and timely manner. Immediately connect with the user to resolve the issue. Practice Quality Having a social media presence comes with the responsibility to report violating content. The AMA writes that if you “see content posted by colleagues that appears unprofessional… bring that content to the attention of the individual, so that he or she can remove it and/or take other appropriate actions.” Also, recognize that your own actions online and the content you post may negatively affect you or your health center’s reputation. Be aware of the consequences and how they can undermine your reputation and public trust. More Details...
Diabetes Clinical Management and Periodontal Care for Diabetic Patients Individuals Experiencing Homelessness (2018). Resource Type: Archived Webinar. Description: This session will focuses on providing up-to-date standards of the American Diabetes Association guidelines for screening diabetic patients with periodontal disease, clinical recommendations for treatment and management of patients diagnosed with diabetes, the role of oral health and dental conditions for effective screening, and health center experiences in supporting patients in diabetes management. Successful strategies for how health centers have adapted their treatment and management of diabetes for individuals experiencing homelessness are also shared. More Details...
Health Center Strategies for Addressing the Opioid Crisis: The Opioid Crisis and the Impact on Homeless Populations (2018). Resource Type: Archived Webinar. Description: Health Centers and supportive housing providers are confronting the opioid crisis head on in communities across the country with positive results. This webinar explores practical approaches and funding strategies to address the impact of the Opioid Crisis on homeless and vulnerable populations. More Details...
Introduction to the Health Care for the Homeless Model of Care (2018). Resource Type: Archived Webinar. Description: This archived webinar gives an overview of the HCH Program and the models of care used by HCH sites nationwide. Participants will also learn strategies in implementing the HCH model of care in medical practice. More Details...
Calories, Cavities, and Kids: The Role of Dental Professionals in Addressing Childhood Obesity (2018). Resource Type: Archived Webinar. Description: The webinar addresses the role of dental professionals in addressing childhood obesity More Details...
Health Centers Strategies for Diabetes Screening and Prevention for Children, Adults, and the Elderly webinar (2018). Resource Type: Archived Webinar. Description: This webinar explores diabetes prevention and care strategies across the lifespan. Presenters discuss standards of care in the screening and prevention for children, adults, and the elderly, sharing experiences from the field. Case examples of successful diabetes prevention programs, adult clinical treatment, and geriatrics care focused on vulnerable populations of children and adults of all ages are provided. More Details...
Health Center Strategies for Diabetes Screening and Prevention for Children, Adults and the Elderly (2018). Resource Type: Archived Webinar. Description: This webinar explores diabetes prevention and care strategies across the lifespan. More Details...
Health Center Strategies for Diabetes Screening and Prevention for Children, Adults and the Elderly (2018). Resource Type: Archived Webinar. Description: This webinar explores diabetes prevention and care strategies across the lifespan. More Details...
This project is supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) as part of an award totaling $6,625,000 with 0 percentage financed with non-governmental sources. The contents are those of the author(s) and do not necessarily represent the official views of, nor an endorsement, by HRSA, HHS, or the U.S. Government. For more information, please visit HRSA.gov.