1. WILLIAM GUNN, PH.D. -- DIRECTOR OF PRIMARY CARE BEHAVIORAL HEALTH, NH-DARTMOUTH FAMILY PRACTICE RESIDENCY PROGRAM AT CONCORD HOSPITAL, CONCORD, NH AND CATHY M. HUDGINS, PH.D., LPC, LMFT -- ASSISTANT PROFESSOR/DIRECTOR OF THE RADFORD UNIVERSITY CENTER FOR INTEGRATED CARE TRAINING AND RESEARCH Developing Regional Initiatives to Promote Integrated Care, Share Knowledge, and Influence Policy Collaborative Family Healthcare Association 14 th Annual Conference October 4-6, 2012 Austin, Texas U.S.A. Session #D1b October 5, 2012

2. Faculty Disclosure Please include ONE of the following statements: I/We have not had any relevant financial relationships during the past 12 months.

3. Objectives Introduce regional initiatives related to integrated care in which the presenters are currently involved. Discuss the benefits of organizing regional initiatives for funding, expanding, training, and promoting integrated care systems. Discuss how regions could be defined. Invite participants to join further discussions on developing regional divisions across the country.

4. Learning Assessment A learning assessment is required for CE credit. Attention Presenters: Please incorporate audience interaction through a brief Question & Answer period during or at the conclusion of your presentation. This component MUST be done in lieu of a written pre- or post-test based on your learning objectives to satisfy accreditation requirements.

5. Background The evolution of CFHA as a national initiative Regional initiatives began to form

6. Defining Your Region How are regions defined?  Geographically  Politically  Economically  Intellectually  Others?

7. Regional Partnerships Community-based partners  Mental Health  Medical Academic partners  Researchers  Training programs Government partners Other stakeholders

8. Benefits of Forming Regional Initiatives Information exchange and transfer to build more efficient, effective Integrated Care systems Funding  Collaborative projects to present to funding sources Influence on policy Furthering Integrated Care as a model of care

9. New Hampshire Experience Very small state – 1.2 million lives, 50% very rural Ten areas served by health centers and mental health centers Variable cooperation and varying models Most have some degree of integration but all separate entities

10. New Hampshire: The Beginning 2008, first meeting in the fall, called the NH collaborative sponsored by the newly formed Mental Health Council Only involved people in programs which had invested some programming in integration Mostly FQHC’s, some mental health center involvement Mostly clinicians

11. Beginnings (cont.) Half-day meetings on a Friday morning First two years met every other month Some administrators, finance officers present Focus was on clinical models and sharing best (sustainable) practices One health center had engaged Intermountain with a grant

12. Beginnings (cont.) Stimulated by research project from Antioch NE University, Jim Fauth, principal investigator Funded by a local foundation, the Endowment for Health Five health centers involved, local control of process, each center chose its own focus – diabetes, chronic pain, etc.

13. 2009-2011 Meetings moved to twice a year, plenary talks from local innovators from Massachusetts, Vermont, and Maine Continued “check ins” and shared successes and barriers Began to look at financial barriers and ways that these issues can be addressed Continue to have good involvement

14. Current April 2012 – meeting with Maine representatives and discussion of forming a regional collaborative with New England States Current name is the Northeast Learning Community, values statement and mission evolving – Education, Advocacy, Quality improvement Representatives from all six states identified, monthly phone calls

15. Partnership with other Organizations Family Medicine Education Consortium – formerly Northeast STFM, focused on promoting primary care and developing initiatives that are cutting edge in primary care CFHA – a model for developing regional “chapters’ or “learning communities in the country

16. Virginia Initiative: The Beginning Bill McFeature, Director of Southwest Virginia Community Health Centers Integrative Behavioral Health Care Services Virginia Health Association Meeting in 2009 focused on Integrated Care, featuring Kirk Stroshal SVCHS’s growth and outreach

17. Regional Partnerships and Outreach Growing support by the Virginia Community Health Association and the Virginia Community Foundation The first Regional Integrated Care Conference at Radford University, Co-sponsored in 2011 The Development of the Radford University Center for Integrated Care Training and Research in 2011

18. Regional Initiatives Cont’d Multi-disciplinary consulting Team formed to provide training sessions for the state and beyond The Mid-Atlantic Integrated Care Conference in 2012 Community partnership projects to attract grant funding Future projects

19. Conceptualizing Your Region What makes sense in your region? What are your community’s needs and capacities? Current initiatives and partnerships?

20. Conclusion A dream you dream alone is only a dream. A dream you dream together becomes reality. - John Lennon

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