[PC-BH-Integration] New to List

Fri Mar 13 15:45:39 EDT 2009

I appreciate the mention of the program at Umass.  We had a site in
Indianapolis this fall.  The program is designed to address this
specific problem, folks who are good in specialy mental health who
naturally struggle when they get to primary care.  The program is
described at
http://www.integratedprimarycare.com/Certificate%20Program_Email.htm

Alexander Blount

-----Original Message-----
From: pc-bh-integration-bounces at lists101.his.com
[mailto:pc-bh-integration-bounces at lists101.his.com] On Behalf Of Trusa
Grosso
Sent: Thursday, March 12, 2009 4:37 PM
To: pc-bh-integration at lists101.his.com
Subject: Re: [PC-BH-Integration] New to List

Jody,
It sounds like you may have to step back and ask yourself if you are
trying to put a square peg into a round hole.  That is to say are you
trying to provide traditional mental health services in a primary care
setting?  Both you and the health center staff sound frustrated trying
to make this work.  I have found that primary care and mental health
have very disparate cultures and expectations.  Primary care is very
fast paced and not particularly amenable to hour-long assessments or
therapy sessions.  Primary care providers traditionally want immediate
consultation and a care plan that includes recommendations for what they
are to do next.  If we as mental health providers are to effectively
work within the primary care service delivery system, we have to adopt a
consultative practice pattern with brief, time-limited follow up.
Otherwise, you end up with a backlog of patients who can't get in to see
you.  
I suggest you sit down with the health center and address expectations
from culture right down to billing and work flow.  Certainly making use
of the medical codes will go a long way, but not every case fits in that
category. Then search the literature for the right integration model
that will meet the expectations of the health center as well as your
organization.  I have never had the pleasure of attending the training
at U Mass, but you may find it helpful in enhancing your practice
patterns to coincide with the needs of the primary care setting.  Good
luck!

Trusa Grosso, LCSW, DCSW
Director of Satellite Operations
The Center for Mental Health, Inc. 
Noblesville, IN
(317) 776-3730

-----Original Message-----
From: pc-bh-integration-bounces at lists101.his.com
[mailto:pc-bh-integration-bounces at lists101.his.com] On Behalf Of Mary
Jean MORK
Sent: Thursday, March 12, 2009 12:09 PM
To: pc-bh-integration at lists101.his.com
Subject: Re: [PC-BH-Integration] New to List

Hello, Have you considered using the Health and Behavior codes if you
are offering behavioral support for a medical diagnosis? These are
specifically intended for medical concerns, and not mental health
diagnoses - when there is an underlying physical illness or injury where
a biopsychosocial factor may be affecting the medical treatment. The
Medicare rules are fairly clear about the intention and documentation
required. Medicare in some regions (like ours in New England) limits
this to PhD's only, but the states can decide if Medicaid will allow
LCSW's to also deliver this. Our state (Maine) does. Because kids
generally have Medicaid (or Commercial) and not Medicare, this is worth
looking into. Let me know if you want any more specifics. Thanks, Mary
Jean

Mary Jean Mork
Program Manager
SHH/MMC/ Maine Health
39 Forest Ave
Portland, Maine
662-2490

>>> Jody Rowell <jrowell at cliffordbeers.org> 2/14/2009 10:55 AM >>>
Hi, our primary care integration with a FQHC is failing.  As an LCSW I
am there for 4 hours a week.  I have been providing consultation to the
medical clinicians, seeing kids and their parents briefly, and hooking
them up with other MH external services as indicated.  Because I am the
only child therapist there it doesn't seem particularly helpful to do a
full hour assessment (90801) to provide a few sessions, especially since
there is an enormous amount of backlog.  In addition, I would need a
translator with me for a large majority of the assessments and
treatment.  Currently there are over a 100 kids on the shared list.  Our
MH clinic is billing the FQHC for my time.  The FQHC is struggling
financially and is feeling that they cannot continue to pay for my
presence even though they find it valuable.  I am not billing enough to
cover my time there.  Upcoding through FQHC codes is nearly impossible
because most of the peds are reluctant to do the 10 min warm transfer
because of their own insane schedules.

If I sound a little desparate it is because I am worried that all the
work we have done combined with the incredible need means we will loose
this project.

Any ideas would be very much appreciate.  Jody

On Fri, Feb 13, 2009 at 3:24 PM, Jaffy Phillips <jaffy at pobox.com> wrote:

> Hi,
>
> I've just recently signed up to join this list-serve. My impression is
that
> I am to send an email to this address by way of introduction? If so,
here
> goes:
>
> I've been practicing as a psychotherapist for several years, and am 
> currently back in school for a Master's in Public Health, focussing on

> health policy. I have a strong interest in collaborative care, and I
am
> currently working on a research paper for the Massachusetts Health
Data
> Consortium, exploring the barriers to and possibilities for
implementation
> of shared electronic medical records between behavioral and
non-behavioral
> providers in Massachusetts.
>
> Thanks for letting me join in the conversation.
>
> Jaffy
>
>
> Jaffy Phillips, MA
> Psychotherapist in private practice
> Health Policy Intern: Massachusetts Health Data Consortium MPH 
> student: Boston University School of Public Health
>
>
>
> _______________________________________________
> Reply to this message to send to the group Help can be found at 
> http://lists101.his.com/mailman/listinfo/pc-bh-integration
> or call Bob Beckwith at (301) 984-6200
>

--
Jody L. Rowell, MSSW, LCSW, Advocate
Clifford W. Beers Guidance Clinic
93 Edwards Street
New Haven, CT 06511
(203)772-1270 x-238 (203)772-0051 (F)
jrowell at cliffordbeers.org 

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