Central California Alliance for Health Approach: Support Providers in

Managing Chronic Non-Cancer Pain

Dale Bishop MD

Current Best Practice Development

Consistent practice with clinical pathways and standard protocols

Safe Prescribing Behavioral/substance use disorder/physical health

integration (multidisciplinary team) Complementary and Alternative Medicine (CAM) integration Access to medication assisted addiction therapy

(Buprenorphine)

 

CCAH Approach: Promote Best Practice

• PCMH development (Coleman RDPI consultation)• Integration of mental health into PCMH

• Identification of Providers with effective programs and encouragement of best-practice sharing

• Meetings with providers and MBHO

• Provider communications since Summer 2013• Promotion of project ECHO (UC Davis)• CAM –

• Acupuncture pilot• Pain specialist pilot• Addiction specialist pilot

• Identification and promotion of mental health counselors with expertise in chronic pain through MBHO

• Half day CME 5/8/15 (Santa Cruz and Monterey) and 5/15/15 (Merced)

Approach Continued: Support Safe Prescribing

Quarterly Provider Communications Identification of patients on high doses Toolkit, references and resources Promotion of CURES Availability of CAM and pain consultations Use of naloxone

Monterey County Prescribe Safe Now Member Plan to require PA for escalations for those on

high doses for chronic non-cancer pain

Next steps Encourage additional County adoption of

prescribe safe model Improve access to medication assisted addiction

therapy (Buprenorphine) Encourage additional County adoption of prescribe safe model

Improve access to SUD programs– Integration of SUD resources in PCMH– Promotion of addiction specialists