[NYAPRS Enews] MHW: Health Homes Prompt New Workforce Role for Case Managers

[Harvey Rosenthal]

NYAPRS Note: The following piece emphasizes the importance of the role
of health home care managers and the training that is needed to help
case managers make the transition. See below for details of an exciting
new NYAPRS/NYS Council training program for OMH case mangers and OASAS
MATS workers.

 

Health Care Delivery System Prompts New Workforce Role for Case Managers

Mental Health Weekly  April 30, 2012

 

The implementation of health homes, considered a key part in the
delivery setting of the future, is prompting a change in the role of the
traditional mental health case managers whose skill sets are
transferable to assisting consumers with chronic physical health
conditions, according to field leaders.

"There's a need for an expanded skill set in an era of health care
reform," Joan King, senior integration consultant at the National
Council for Community Behavioral Healthcare, told attendees during the
National Council's annual Mental Health and Addictions Conference in
Chicago earlier this month (see MHW, April 23). 

"Primary care and behavioral health integration is no longer optional,"
she said. "The system is changing."

Mental health case managers can integrate face to face with primary care
providers, King said.

"Case managers have played a critical role in the health care system up
to this point," King said during her session, "Supporting and Developing
Health Navigation Skills in Case Managers and Other Community Based
Staff."

King advised the field to develop its workforce to create healthier
communities. Components such as integrated primary care/behavioral
health practices, Mental Health First Aid and integrated care management
are essential to making that happen, she noted.

"Our understanding is that recovery is happening in the community," said
King. "Community health has a huge impact on the ability of people to
recover." King added, "The movement to care management is part of the
future of case management. Transforming the role of case managers
involves using their existing skills and developing new partners (e.g.,
primary care physicians, federally qualified health centers (FQHCs) and
accessing community-based resources, she said.

"Case managers can be mobile," King said. "It's not an additional task
but a redirection of their traditional work," she said.

"We have to take the holistic approach and bring it up to another level.
We need to work across cultures," King said. "Primary care providers
[PCPs] are very solution-focused."

PCPs focus less on the process and more on plans and outcomes, she said.

Physical health care is essential to the core service of a CMHC's
package, she noted. Health navigation training offered by the National
Council is a one-day session with three follow-up webinars, said King.

The content includes information on key health conditions for people
with diabetes, heart disease and other behavioral health-related
challenges, she noted. Trainees can identify current health trends that
will affect their role, said King.

"We're not trying to turn case managers into nurses," said King.

"It's about trying to help case managers get enough health literacy
skills that they can navigate and use those nurses as consultants."

 

What's in a name?

While there are many disciplines and training levels, there currently is
no consistency in how terms such as care, case, health, behavioral
health managers, coordinator and navigator are used across settings,
said Alexander Blount, Ed.D., director of the Center for Integrated
Primary Care at the University of Massachusetts Medical School.

Mental health and medical cultures define the role differently because
they define the needs of the patient/client differently, he said.

"There is a commonality in the role of [professionals] who keep the
patient, consumer or client connected with the system," said Blount.

The patient-centered medical home (PCMH) is an enhanced form of primary
care delivered in primary care settings or in CMHCs, and requires care
management that addresses all needs of "complex" patients with
challenging medical and behavioral health needs, he noted.

"The patient-centered medical home is sweeping the nation," said Blount.
"The primary care medical doctor is getting back to what primary care is
supposed to be. They're now trying to make [services] attractive and
flexible."

Blount noted that functions for mental health case management generally
included:

* Obtaining basic supports.

* Crisis prevention and intervention.

* Assessment to determine need for services.

* Outcome-/function-focused treatment planning.

* Referral and linkage with chosen services.

* Engaging in/developing helping, trusting relationships.

* Coordinating and adjusting service delivery.

* Advocacy.

 

Care management

Medicare care management for people with a serious mental illness makes
a difference, said Blount. He pointed to a study published in the
February 2010 issue of the American

Journal of Psychiatry, in which lead author Benjamin G. Druss, M.D., and
colleagues tested a population-based medical care management
intervention designed to improve primary medical care in community
mental health settings.

In the study, "A Randomized Trial of Medical Care Management for
Community Mental Health Settings: The Primary Care Access, Referral, and
Evaluation (PCARE) Study," care managers served as an advocate for the
patient as well as a communication conduit between the patient and
specialty medical and mental health provider. During the intervention,
care managers/coordinators provided information to patients about their
medical conditions, and about available medical providers in the
community and upcoming appointments.

According to the study, subjects assigned to usual care were given a
list with contact information for local primary care medical clinics
that accept uninsured and Medicaid patients.

Subsequently, these subjects were permitted to obtain any type of
medical care or other medical services.

At a 12-month follow-up evaluation, the intervention group received an
average of 58.7 percent of recommended preventive services, compared
with a rate of 21.8 percent in the usual care group. Medical care
management was associated with significant improvements in the quality
and outcomes of primary care. 

These findings suggest that

care management is a promising approach for improving medical care for
patients treated in community mental health settings.

Peers are also going to have many roles in the patient-centered care
environment as wellness coaches and navigators, said Blount.

"Peers are going to be [essential] to connecting people to behavioral
health care," he said. Peers will become involved in transportation,
making appointments and reminding consumers of those appointments, and
providing some health teaching, Blount said.

Blount also said that PCMHs are even more important now because "the
cost of health care is strangling our economy." "Primary care can
improve health and reduce costs, if people will use it," he said.
"Primary care needs to be made user-friendly, to attract rather than
coerce people to use." *

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Thanks to generous support from the New York State Department of
Health's Workforce Re-Training Initiative (HWRI), the New York
Association of Psychiatric Rehabilitation Services (NYAPRS) and the New
York State Council for Community Behavioral Healthcare (NYS Council) are
delighted to announce the launch of the New York State Care Management
Training Initiative (NYSCMTI).  

 

NYSCMTI is designed to make a meaningful contribution to the successful
transformation of the health/behavioral health care delivery system here
in New York.  Our primary objective is to prepare SOMH Case Managers and
OASAS MATS staff to deliver high quality, integrated care coordination
services to New Yorkers who qualify for NYS Medicaid Health Home
services.  To achieve this goal, we have designed a dynamic package of
face-to-face and web-based training opportunities to help staff succeed
in their new roles as Health Home Care Coordinators.  

 

We are very pleased to have engaged the New York Care Coordination
Program (NYCCP), a nationally recognized leader in the delivery of
evidence-based training and technical assistance services, to develop,
coordinate and deliver all our web based and face to face trainings.
Starting in May and continuing over the next two years, the NYSCMTI will
offer the following resources/opportunities to eligible staff: 

*	Nine 90 minute webinars designed to introduce new skills and
enhance existing competencies staff need to succeed in their new roles
*	Two (2) day-long face-to-face trainings to be held in convenient
locations across New York where participants can acquire new information
and practice newly acquired skills including (but not limited to)
outreach and engagement, health and behavioral health identification and
coaching, and utilizing a person-centered approach to care. 
*	Full access to the NYSCMTI website stocked with articles, videos
and other learning tools enabling participants to engage in
self-directed learning between scheduled webinars and in-person training
events

 

Please don't miss out on this timely, free opportunity! Go to our link
on survey monkey https://www.surveymonkey.com/s/NYSCMTI today and send
us the name of your case management/MATS supervisor and assure your
staff a place in this important training initiative. Remember this
training is on a first come, first served basis.

 

Commencement of this project is set for May 16th from 2:30 - 4:00pm when
we will be offering a webinar designed for SUPERVISORS of eligible
staff. Please have your supervisors register for this event by sending
us the supervisor's name and e-mail address at 
caremgttraining at nyaprs.org no later than May 14.

 

We look forward to working with each of you. If you have any questions,
please contact Edye Schwartz or Lauri Cole at 
caremgttraining at nyaprs.org. 

 

Best Regards,


 


Harvey Rosenthal                                           Lauri Cole

Executive Director                                          Executive
Director

NYAPRS                                                        NYSCCBH

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The Details

 

Who is Eligible to Take the Training?

NYSCMTI is funded to provide training opportunities to a total of 700
participants (students).  Eligible participants are staff employed in
OASAS and SOMH agencies that currently operate ICM, SCM, BCM, and MATS
services for recipients.  

 

A related training program for Long Island agencies will begin shortly
under the direction of our partners at Clubhouses of Suffolk and the
Mental Health Association of Nassau.  Unfortunately, NYSCMTI did NOT
receive funding to provide training to staff working in agencies within
the 5 boroughs of New York.  

 

Due to the importance of this training to our workforce and the limits
of our grant to fund only 700 students, please ensure that all
appropriate case managers and MATS workers are enrolled and make a
serious commitment to complete all training sessions.

 

Registering Staff

Please use this link, https://www.surveymonkey.com/s/NYSCMTI, to provide
us with information regarding who will act as our contact with your
agency throughout the project.  Ideally this would be the person who
supervises the Case Management/MATS staff you want enrolled in the
Initiative.  

 

Once you give us the supervisor's name and contact information, we will
contact them directly for the list of all the individual students you
wish to enroll in the training.  Upon completion of registration, we
will let you know that your staff have been accepted into the Program.  

 

Once accepted and before the first webinar in June, each student will
need to complete a brief pre-training assessment designed to assure that
our curriculum best meet the needs of all students.   

 

Because we know demand will be high, registration will be conducted on a
FIRST COME, FIRST SERVED BASIS within the prescribed limits under which
we are operating. Our grant requires that we train a certain number of
students in each area of the state for which we are funded. 

 

With this in mind, we have decided to establish a waiting list to manage
requests beyond the 700 slots.          

 

Kick Off Event!  

Commencement of this project is set for May 16th from 2:30 - 4:00pm when
we will be offering a webinar designed for SUPERVISORS of eligible
staff.   During the webinar, we will share information regarding the
curriculum we have planned and leave time for questions and answers
regarding the specifics of this Initiative.  Please don't miss this
session! Have your supervisors register for this event by sending us the
supervisor's name and e-mail address at caremgttraining at nyaprs.org no
later than May 14. Once your supervisor has registered for the webinar,
we will forward the links. We look forward to working with all of you.

 

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