1. Making It Work: Integrated Care from Start to Finish (571082) Jeri Turgesen, PsyD, Behavioral Health Consultant, Providence Medical Group Laura Fisk, PsyD, Wellness Center Behaviorist, Yamhill Community Care Organization Seamus McCarthy, MTP, PhD, Director of Operations and Integration, Yamhill Community Care Organization Benjamin Calvert, MD Providence Medical Group Mary Peterson, Phd/ABPP/CL, George Fox University Collaborative Family Healthcare Association 17 th Annual Conference October 15-17, 2015 Portland, Oregon U.S.A. Session # C5a Saturday October 17, 2015

2. + Faculty Disclosure The presenters of this session have NOT had any relevant financial relationships during the past 12 months.

3. + Learning Objectives At the conclusion of this session, the participant will be able to: Identify the motivating factors for healthcare administrators to support an integrated care model. Identify the key stages in program development for a multi-site integrated care program. Understand how to communicate impact of the integrated model from a pilot project. Learn a primary care provider’s perspective of before and after integrated care.

4. Bibliography / Reference 1.Beacham, A. O., Kinman, C., Harris, J. G., & Masters, K. S. (2012). The patient­centered medical home: Unprecedented workforce growth potential for professional psychology. Professional Psychology: Research And Practice, 43(1), 17­23. 2.Blount, F. A., & Miller, B. F. (2009). Addressing the workforce crisis in integrated primary care. Journal of Clinical Psychology in Medical Settings, 16(1), 113­119. 3.Nash, J. M., Khatri, P., Cubic, B. A., & Baird, M. A. (2013). Essential competencies for psychologists in patient centered medical homes. Professional Psychology: Research and Practice, 44(5), 331­342. 4.Patient Protection and Affordable Care Act, 42 U.S.C § 18001 et seq. (2010). 5.Torrence, N. D., Mueller, A. E., Ilem, A. A., Renn, B. N., DeSantis, B., & Segal, D. L. (2014). Medical provider attitudes about behavioral health consultants in integrated primary care: A preliminary study. Families, Systems, & Health, 32(4).

5. + Learning Assessment A learning assessment is required for CE credit. A question and answer period will be conducted at the end of this presentation.

6. + Making it Work: Multiple Perspectives 1. Healthcare administrator 2. Program Developer 3. Pilot program Implementation 4. Primary Care Provider perspective.

7. + Yamhill Community Care Organization Re-thinking Health!

8. + Program Development Recruiting Model Cadence Limited pool Training Bootcamp Competency Based

9. + Program Implementation Behaviorist Learning Collaborative In clinic support Monthly team meetings Clinic consultation Emphasis: Clinician Support Model adherence Burnout

10. + Satisfaction

11. +  Building relationships  Communicating what matters Development Assessment & Feedback Developing a Pilot Program

12. + Pilot Program Outcome Results PCP Visit prior BHC Visit PCP Visit One Year after BHC Visit(s) (Time varied on most recent PCP visit) MetricsAveragesMetricsAverages BMI (79% of pts) 32.32 (Min: 14.8; Max: 65.4) BMI (79% of pts) 32.49 (Min: 15.4; Max: 70) A1C (17% of pts) 7.17 (Min: 4.8; Max: 14) A1C (19% of pts) 7.03 (Min: 4.8; Max: 13.9) Cholesterol* (19% of pts) 188.63 ( Min: 116; Max: 351) Cholesterol (19% of pts) 179.5 ( Min: 120; Max: 284) # of PCP Visits** (1 yr prior to BHC visit) 5.16 (Min: 1; Max: 20) # of PCP Visits (since BHC visit) 2.58 (Min: 0; Max: 15) # of ER Visits* (1 yr prior to BHC visits) 0.57 (Min: 0; Max: 16) # of ER visits (since BHC visits) 0.32 (Min: 0; Max: 8) #of Clinic Contact** 5.96 (Min: 0; Max: 36) #of Clinic Contact 3.44 (Min:0; Max:25) Note. Significance is indicated * = p<.05, ** = p<.01

13. + Dr. Calvert: Family Practice Staff stress: patients with behavioral need Limited resources Acute and Semi-acute issues during busy clinic Coordination of care Closing the loop/Feedback Behaviorist support for team. Access: Warm Handoffs Acute Concerns Inter-professional collaboration Follow-up EMR Rounding BeforeAfter

14. + Questions?

15. + Session Evaluation Please complete and return the evaluation form to the classroom monitor before leaving this session. Thank you!