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The Power of Partnershipsin today’s changing health care landscape
Rebecca Glathar, NAMI UtahAngela Kimball, Oregon Health AuthorityDelia Rochon, Intermountain Healthcare
Change the FRAME SummitNAMI Annual ConventionSan Antonio, TexasJune 27, 2013
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Why is health care changing?
Everyone wants to achieve the Triple Aim goals:
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What is changing?
•New models of financing
•New models of delivering care
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Why is this important to NAMI?• When financing and delivery changes, it changes who gets money and who makes decisions
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What can NAMI do?Leverage your strengths as:
• Educator
• Supporter
• Connector
• Navigator
• Advocate New Opportunities
NAMI’s Strengths
Partners’ Interests
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Behavioral Health Program for the Uninsured
NAMI National Conference
June 26, 2013
Access
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Treatment Works but Inaccessible for Many
84%75%
70%
38%
11%
Percent Receiving Treatment for Different Diagnoses
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The Challenge in Utah
∼101,657 adults and children in Utah are in need of, but not receiving, mental health treatment services
∼45,085 individuals were served by the public mental health system, or less than 31% of the current need
∼ 16,454 individuals were served by the public substance abuse system, or less than 17%, working at capacity
Utah Division of Substance Abuse and Mental Health 2011 Annual Report
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52% receive no treatment at all
48% ER visits, community clinics
Utah Division of Substance Abuse and Mental Health 2009 Annual Report
Uninsured people with mental illness in Utah
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Interventions
Health Promotion
Universal Prevention
Selective Prevention
Early Detection/
InterventionTreatment
Wellness RecoveryCrisis Intervention / Emergent Care
Home SchoolCommunity Organizatio
n
Primary Care Clinic
Outpatient Mental Health
Day Treatment
Residential Facility
Inpatient UnitEmergency Room
Settings
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Intermountain Healthcare Community Benefit
NAMI
Family Counseling Center
Cornerstone Outpatient Services
Volunteers of America – Detoxification Services
4th Street Clinic – Homeless Outpatient Services
Salt Lake County Human Services
Key Stakeholders
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Understanding the Challenge
Navigating the system – knowing where to go for help
Timely access to treatment
Fragmented system of care
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1. Patient advocate in Hospital Meet with patient to review discharge instructions Make appointments for treatment/other essential services Follow patient until connected with services
2. Timely access to treatment Follow up appointments within seven days
3. Integrated services in a coordinated network Partnership to increase access to services Funding to provide a comprehensive spectrum of services
Salt Lake Valley Demonstration ProgramIncrease timely access to appropriate care for the uninsured
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NAMI’s Role
Patient Advocate
Education Classes
Support from mentors
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Interventions
Health Promotion
Universal Prevention
Selective Prevention
Early Detection/
InterventionTreatment Wellness
Recovery
Toward Continuum of Care
Home SchoolCommunity Organizatio
n
Primary Care Clinic
Outpatient Mental Health
Day Treatment
Residential Facility
Inpatient Unit
Coordinated Network
Settings
Over 20 Agencies
Neighborhood Clinic4th Street Clinic
Family Counseling
VMH
VOANAMIUSARA
Cornerstone
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Improved Access to Appropriate Services
Program (n = 1,000)
Baseline
72.9%
23%
% of referrals with scheduled appointment or already in treatment
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Timelier Access to OutpatientPsychiatric Services
Program
Baseline
8.6 days
42 days
Average days until first available appointment - outpatient psychiatric services provider
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Better Engagement in OutpatientPsychiatric Services
Program
Baseline
4.6
1.8
Average number of sessions attended at outpatient psychiatric services provider
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Reduced ED Visits and Admissions
12 months after initial referral
12 months prior to intial referral
98
193
# of ED or inpatient unit admissions among patients who attended at least one session at O/P psychiatric services provider
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Family Counselin
g
VMH
Cornerstone VOA NAMI
USARA
4th Street Clinic
OtherServices
Silo System
Integrated Services in a Community Network
Before the program
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Counselin
gMedicatio
n
Day Treatment
DetoxServices
SupportGroups
PCP Wellness
Community System of Care
Integrated Services in a Community Network
After the program
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The Utah collaboration is mutually beneficial; it helps people living with mental illness, it promotes NAMI and it adds value for community partners
The power of partnerships
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The power of partnershipsNAMI Utah’s collaboration with Intermountain builds on NAMI’s strengths as an:
•Educator
•Supporter
•Connector
•Navigator
•Advocate