Nurse Education Practice Quality and Retention- Interprofessional Collaborative Practice: Behavioral Health Integration (NEPQR-IPCP:BHI) Program FY 2016 Pre-Review Orientation Kasey Farrell Division of Nursing and Public Health U. S. Department of Health and Human Services Health Resources and Services Administration (HRSA) Bureau of Health Workforce (BHW)

NEPQR-IPCP:BHI Overview HRSA and BHW Mission Program Goals Program Purpose Eligibility Program Requirements Reviewer Considerations Funding Preference Questions

Bureau of Health Workforce Mission Improve the health of underserved and vulnerable populations by strengthening the health workforce and connecting skilled professionals to communities in need. Collaboration Accountability Innovation HRSA Mission Improving health and health equity through access to quality services, a skilled health workforce and innovative programs.

Workforce Supply Priorities Program Design Academic & Community Partnerships Interprofessional Practice & Training Rapid Cycle Evaluation/Data Driven Research and Resources Bureau of Health Workforce Preparing a Diverse Workforce Improving Workforce Distribution Transforming Health Care Delivery

NEPQR-IPCP:BHI Program Goals Improve early identification, quality of treatment and population outcomes for depression and substance use disorders. Increase access and reduce barriers to behavioral health services through the integration into routine primary care in rural, underserved and vulnerable populations. Provide capacity building resources and invest in long-term sustainability for community-based settings, such as Nurse Managed Health Centers. Improve workforce competencies through interprofessional collaborative practice and education.

NEPQR-IPCP:BHI Program Purpose Address disparities in behavioral health treatment and outcomes for vulnerable and underserved/rural populations. Invest in the Advanced Practice Registered Nurse (APRN) as a critical provider of primary care services. Expand existing interprofessional primary care teams. Train interprofessional providers and students in competencies critical for successful, sustainable integrated models of care.

NEPQR-IPCP: BHI Eligibility Schools of nursing accredited by a body approved by the U.S. Department of Education Health care facilities Partnership of such a school and facility All applicants must possess the capacity to deliver high quality, integrated team-based, nurse-led primary care and behavioral health services to patients and their families in community-based settings.

NEPQR-IPCP: BHI Requirements Provide interprofessional, team-based primary care services. The primary care provider MUST be an APRN. Add at least one onsite, licensed behavioral health provider full-time equivalent to the existing team. The resulting team should include the primary care provider, behavioral health provider, care coordinator, and consulting psychiatric provider at a minimum. Implement IMPACT and SBIRT into routine primary care. Utilize the Center for Integrated Health Solutions’ Standard Framework for Levels of Integrated Healthcare to determine the organization’s baseline level and to monitor progress. Utilize an interoperative health IT system to support integrated healthcare. Utilize a RCQI method to guide improved outcomes.

Reviewer Considerations Ensure ALL program requirements are met. Ensure ALL required attachments are included. Accreditation documentation is only required for applicants that are, or are partnered with, a school of nursing. Applications should not exceed 65 pages. Evaluate each application against the funding opportunity guidelines not each other. Provide unbiased, expert assessment of the proposed program based on the NEPQR-IPCP:BHI purpose and goals. Services provided must address BOTH mental health (depression) and substance use disorders.

Reviewer Considerations Team Definition: An RN can occupy more than one role but cannot occupy all roles as this is an interprofessional program. Programs that include interprofessional education are considered most competitive. Level of Integrated Healthcare: Based on the program requirements, applicant organization(s) must submit an application that meets the Level 3 criteria which corresponds to “co-located” care with basic collaboration onsite, although grant activities as outlined in the FOA constitute a Level 5 (single organization; shared systems). Project Director: Only one allowed and must be a licensed RN.

Reviewer Considerations Indirect Cost Rate: There is not a cap as in previous NEPQR-IPCP FOAs; carefully review the budget and the feasibility to support the goals/objectives. Technical Assistance: Applicants are required to allocate no less than $25,000 towards program sustainability beyond the 2 year funding period. The plan should be based on the applicant organization(s) needs. Potential components include: a needs assessment; consultant/coach; learning communities; staff training. EMR/Health IT System: Reasonable infrastructure costs such as licensure, shared treatment planning/billing, care mapping, and patient tracking that facilitate an integrated care model.

Reviewer Considerations Underserved Community/Target Population: Can be those with a federally-designated Health Professional Shortage Area (HPSA) or serving a federally-designated Medically Underserviced Area (MUA) or Population (MUP). The designation may also be made based on prevalence data. Funding Preference(s): Include: (1) substantially benefits rural populations; (2) substantially benefits underserved populations; and (3) helps meet the public health nursing needs in state and local health departments. Applicants must confirm the practice site and/or population served based is eligible based on HRSA guidelines. Applicants must only quality for one and receive no advantage for meeting multiple preferences.