What California Counties are Doing to Promote Whole Health

Joyce Ott, Peer Consultant CA Institute for Mental Health Small County Care Integration

Collaborative

Boe-Anna Gorsuch & Roslynn Santos Trinity Milestones Wellness Center Peer Staff

WWT Workshop March 13, 2013

Learning Objectives After completing this workshop participants will be able to:

Define whole health and why health models are the emerging services and supports in all states.

Define the Eight Dimensions of Wellness used in whole health models

Understand what national interventions are driving mental health integration including the Morbidity/Mortality studies, NASMHPAD Triple Aims and CIMH Co. Integrations Collaborative approach.

Improve options for local employment opportunities through paid peer positions

Identify 2 or more health programs currently offered in the California county mental health delivery system?

Provide feedback and tools to other phone participants, offering additional ideas and activities currently in their community.

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What is Whole Health?

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Eight Dimensions of Wellness Emotional—Coping effectively with life and creating satisfying

relationships Environmental—Good health by occupying pleasant, stimulating

environments that support well-being Financial –Satisfaction with current and future financial situations Intellectual —Recognizing creative abilities and finding ways to

expand knowledge and skills Occupational—Personal satisfaction and enrichment from one’s

work Physical—Recognizing the need for physical activity, healthy foods

and sleep Social—Developing a sense of connection, belonging, and a well-

developed support system Spiritual—Expanding our sense of purpose and meaning in life

4http://www.promoteacceptance.samhsa.gov/10by10/dimensions.aspx#eightdimensions

Factors Driving Improvement

Morbidity and Mortality Studies:

USA Today: Mental Illness Linked to Short Life

“Adults with serious mental illness treated in public systems die about 25 years earlier than Americans overall, a gap that’s widened since the early 90s, when major mental disorders cut lifespan by 10 to 15years…. ”

USA Today May 3, 2007

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Causes of Morbidity & Mortality

What are the Causes of Morbidity & Mortality in People with Serious Mental Illness?

While suicide and injury account for about 30- 40% of

excess mortality, about 60% of premature deaths in

persons with schizophrenia are due to “natural causes”

– Cardiovascular disease – Diabetes – Respiratory diseases – Infectious diseases

http://www.nasmhpd.org/search.aspx?SearchTerm=morbidity%20and%20mortality

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National Triple Aims Intervention

1) Improve the overall health of the population being served.  Identify which person requires special services, such as complex care management or coordination of services

2) Improve the care experience, which goes beyond simply providing the right type of care.

The patient-centered medical home (PCMH) will play a critical role in the care experience by designating a personal provider and care team who are responsible for coordinating each patient’s medical and behavioral healthcare activities.

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National Triple Aims

3) Provide the best care possible while lowering the per-capita costs of care over time.

While this will be difficult to accomplish, applying evidence-based care and eliminating duplicative or unnecessary procedures – with help from information management technologies such as electronic health records (EHRs) – will give the industry the best chance of success.

Triple Aim-HealthPartners is redesigning the health care delivery model

http://www.healthpartners.com/public/about/triple-aim/

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Questions

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CERTIFIED PEER SPECIALISTS “Being able to bill Medicaid for Certified Peer

Specialists for their services provides sustainable funding for a new workforce”

“In the mental health field, a workforce that has first hand knowledge of how to successfully combat the debilitating effects of stigma and negative self image…”

www.magellanhealth.com/training/webinars/nov2010handout.pdf Evolving Peer Support: Recovery Coaching, Whole Health, and system Integration

Carter, Rosalynn (2010), Within Our Reach –Ending the Mental Health Crisis. Rodale, 153.

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Creating Peer Employment Opportunities

Local Collaborations and Natural Supports

Mental Health and Alcohol and Drug Services

Physical Health & Mental Health Providers.

Pharmacy education around medication management and drug interactions

Non traditional healing: Cultural practices of Native Americans and other organic and holistic  heritage, beliefs and costumes.

Clients, families and communities

CIMH Integration training to county collaboratives

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“A growing body of evidence suggests that hiring more peers* to work in the mental health system and expanding peer‐run crisis respite centers and crisis residential facilities offer a cost effective opportunity to achieve wellness and recovery. Support from the Affordable Care Act and MHSA Workforce Education and Training could sustain California’s leadership in the transformation of the public mental health system of care”

Tina Wooten, California Mental Health Managers In Recovery 2013.

* Peers – People with lived experience in the mental health system including family members, care givers, parents of children and clients/consumers/survivors

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The Power of Peers HANDOUT

Peer Employees Modeling Wellness Trinity County Milestones Wellness Center

Peer Staff

Boe Anna Gorsuch - TCBHS Health Challenge The goal of the programWho participates

Roslyn Santos - Individual Health Challenge Individual goal to get healthy & save moneyJoining a county intervention program

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Questions

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Caller Feedback:

What health activities are

promoted by your county mentalhealth services?

Group Discussion with Callers

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Thanks for Joining Us

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Handouts

Whole Health and Mental Health IntegrationPeer Support Newsletter

Magellan's Peer Support Whole Health and Wellness e-newsletter!

Creating Peer Employment Opportunities NASMHPD Whole Health Coaches

Georgia’s Peer Support Expansion into Whole Health Coaches

The Power of Peers Managers in Recovery

Opportunities for Peer Services in Healthcare Reform Blog by Sharon Kuehn www.peersnet.org

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Resource

Georgia’s Peer Support Expansion into Whole Health Coaches http://www.integration.samhsa.gov/health-wellness/NASMHPD-CIHS_GA_Peer

_Whole_Health_Coaches.pdf

Evolving Peer Support: Recovery Coaching, Whole Health, and system Integration

www.magellanhealth.com/training/webinars/nov2010handout.pdf

Opportunities for Peer Services in Healthcare Reform

Blog by Sharon Kuehn www.peersnet.org

Pillars of Peer Support Services Summit III www.pillarsofpeersupport.org/POPS2011.pdf

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Resources

Primary Care and Behavioral Health integration http://www.cimh.org/Initiatives/Primary-Care-BH-Integration.aspx

Tool Kit for the California Community Mental Health Workforce. http://www.cimh.org/LinkClick.aspx?fileticket=N4evyS5-39s%3d&tabid=36

Healthcare Reform: http://www.cimh.org/Initiatives/Primary-Care-BH-Integration/Webinars.aspx

California Primary Care and Mental Health Integration Initiatives http://www.cimh.org/Initiatives/Primary-Care-BH-Integration.aspx

• Supporting Change http://www.cimh.org/Portals/0/e/Performance%20Report%20Printing/CiMH%20Change

%20Methods.pdf

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Resources

Magellan's Peer Support Whole Health and Wellness e-newsletter http://www.magellanhealth.com/training/pdfs/pswhOct12.pdf

Florida’s Peer Support Whole Health and Resiliency Initiative http://sites.magellanhealth.com/media/332083/

pswh_newsletter_program_spotlight_florida.pdf

CA Mental Health Medi-Cal/ Medicade Section 1115 Waiver Demonstration http://www.dhcs.ca.gov/provgovpart/pages/waiverrenewal.aspx Medi-Cal Policy Committee http://www.cmhda.org/go/committees/medicalpolicycommittee.aspx

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