Hello from Tennessee!

For this session we will not be able o use our camera or audio. Next session we will be able to do so.

Hello from North Carolina

Barbourville, KY

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Hello from Maryland

Hello from Oklahoma

Hello from Los Angeles!

Hamilton, Ohio

Hello from Houston, Texas

Yes, no Q&A on my toolbar as well...

atlanta

Cuyahoga County, OH

Eastern Shore of Maryland

Nina pearls, lcsw fm Austin, TX

Nina Perales, lcsw fm Austin Tx

Hello from Dona Ana County, NM

Hello from Colorado!

Hi from Baltimore!

Pasco, Washington. We're in a three city area in southeastern Washington

Hi, from St. Joe indiana

Debbie Pell, Bill Wilson Center, Santa Clara, CA

Hello from Connecticut! Glad to be here

Hello from Georgia!! Look forward to earning with all of you!!

Hello from Albuquerque, New Mexico

learning

Warren, Pennsylvania

Hi all! Thanks so much for joining. Just a few quick reminders: please remember to use the chat box for both the questions and comments (there is no Q&A box on this session today), and also please remember to remain on mute until you would like to speak in the open Q&Z portion towards the end of the session today. Looking forward to our first ECHO session together!

Hello from Detroit Michigan

Good afternoon from Iowa!

Hi Ronni Tyson NASW MI SUD Clinical Supervision Institute 517.775.8776

Hello from Georgia! Community Service Board of Middle Georgia serving 16 counties in central and eastern Georgia.

Washington, DC says Hello!! Especially to Maura. Hi, Maura!! Great to see you.

Project Director for Promoting the Integration of Primary and Behavioral Health Care (PIPBHC SAMHSA discretionary grant)

peer supporter

Also a clinician

administrator

Special Projects

Clinican, Administrator

My role is OTHER: I’m a Sr. Clinical Advisor working at the state level on implementation strategies as well as advocacy and policy.

Other = Adult Peer Support Specialist, Advocate

Hello from Colorado! Community Action Collaborative Coordinator a prevention/diversion model of high cost systems (ER/9-1-1/homelessness/jail)

Hello from Phoenix, AZ

Clinican

Spiritual Counselor,

supervisor for recovery coaches

Hello from UPAC San Diego. I'm a peer support specialist

Clinic Supervisor and COD Clinician (SUDP, LMHC)

Integrated Care Provider

Clinician older adults

Hi from Seasons Center in northwest Iowa.

Hi - Gagan Lamba, Behavioral Health Manager from Iowa Primary Care Association

all of the above, we also have additional medical services like dental, vision, etc.

Organization - OTHER: Consultancy, and Program Development

Mental Health and Other

Behavioral Health Provider, Mental Health Provider, SUD Provider, - All of the above. FQHC

Non-profit care coordination entity

State Health Department/Medicaid policy

acute care hospital with community mental health center

We are an FQHC

Oaklawn psychiatric is both mental health and substance use

Did not allow to chose all that apply.

there was more than one choice

FQHC

Hello, my name is Jose Luis from Valleywise Health. I am the clinical coordinator for an Integrated Behavioral Health in our FQHC.

Hi everyone from the Lone Star State! Looking forward to learning from y'all!

Hello, I am Julio, Lic Clinical Psychologist from Sabater Laboratory for Psychological Innovations Inc in Rhode Island.

no audio

Hi all! It would be great if you could please update (if you have not already) your name in Zoom to include your full name and organization so we can accurately count you as attending today's session. To change your name, please click the three dotted icon on your camera screen and scroll down to "Rename." Thanks and please let me know if you have questions!

Vicki Rahenkamp

Susan Johnson, SVP, Chief Quality and Compliance Officer Choptank Community Health

John P.John MD

sorry, John P. John MD Beacon Light Behavioral Health Systems, warren pa

Kelli Sax-Pahl Crisis Preparation and Recovery

Amy Earnheart, Mountain Community Health Partnership

Tracey McKiernan from Catholic Charities in Cleveland, OH

Vicki Rahenkamp, LCPC Director of Behavioral Health at Choptank Community Health (newly integrating BH in FQHC)

Question: Will this forum support/offer insight about advocacy and policy as it relates to supporting statewide integrated approaches that improve outcomes - specifically focused on rural communities and equity of care? Thank You.

Amy Paul, PsyD, CCO - Crisis Preparation and Recovery, Inc.

Hi Lisa, insofar as these efforts relate to TBC yes (e.g., supporting advocacy for states to fund TBC approaches to ensure integrated approaches can work)

Q: Is there a difference between a Care Management and Case Management staff?

What are the payment arrangements of team-based care?

would a patient end up having different care managers depending on needs

What did you all do for training for team based care? I would like to know how you were able to keep everyone engaged and got buy in for team based care especially in an integrated setting with different disciplines involved

Was the behavioral health case manager a clinician?

Alicia, did you use a specific integrated care model as well?

it sounds like there aren't defined caseloads if all CMs touch all clients.... how are you limiting caseload?

Is your whole team under one roof?

Did you all do telehealth with the team as well ? interested in how this was done with team based intentionality

i have to step away for now. Excellent presentation. Looking forward to the next one. Take Care!

Have you thought about using the various pieces of CCBHC to "create" and ACT like service?

engage the family in supporting him. maybe peer support or drug and alcohol peer support.

Clarification....Would love to hear again how the teams were structured again. Not sure I understood exactly how the teams are comprised.

Allow and encourage the client to attend his care team meeting and have the team address him directly about his concerns and goals

Motivational Interviewing approach may help engage in a client centered way

During my time on the ACT Team we have had several similar clients. What we did most often was to concentrate on engagement and support. We would increase frequency of visits to allow for missed appointments. We would try to visit almost every day to check on him

Help everyone be clear on what patient's top goal is and how team can help him move towards that goal. Is it employment? Reuniting with daughter? Addressing back pain? Then reminding pt what his part is to do so that he and team can work together towards HIS goal

Many times it would fall upon Peer Support to encourage better engagement, improving care

Start with what is available, lower level of care?, is medication assisted treatment available?, are psych providers appropriate?, is Peer Support available? What else is available and appropriate for stabilization?

A client resistant to care for "whatever" reason becomes extremely expensive. Suggest taking him out of team care until he wants to engage. Provide individual care on case-by-case when he comes in or is encountered.

Approach his addiction from a harm reduction prospective instead of total sobriety, perhaps DBT skills training for his resistance to treatment. I know that he was hard to engage in therapy, but would be interested to know if there was a trauma history which would explain some of his inability to engage/trust and some of the "manipulative" behavior. If trauma is there he would need care which was trauma focused.

Well said Dr. Pinheiro. Great observations.

With our sample client, was intoxication a barrier to engagement?

Daniel yes, sobriety was an issue....he was not eager to engage in the tx offered

I appreciate identifying the nuance between structural and dynamics. We often miss that there are multi-layered issues contributing to the outcome.

Were harm reduction techniques utilized with this client? Is there access to a Recovery Coach?

Great discussion. Looking forward to next session. Thank you to the panel and participants. Much appreciated.

Can you please resend the template with instructions? thank you. ljackson@envivesolutions.com

I will be attending tomorrows webinar :)

Did you have a registry you used for organizing the patients risk, and how often did they risk status get adjusted?

Susan, great question, I have that same one

Thank you!! Great Info!!

Thank you!

Thank you!