Appendix_A_Current_Issues_of_Interest.pdf

APPENDIX A – CURRENT ISSUES OF INTEREST TO HRSA

Though not a comprehensive list, here are some topics of current interest to the COE and each bureau:

COE

Integrated treatment models:

o Developing integration policies/procedures, conducting huddles, SBIRT, trauma screening, warm handoffs, clinical workflows, integrated approach/team-based integration models, care coordination, referral protocols, case management, peer support o Initiating and sustaining medication assisted treatment (MAT) programs including engagement/recruitment, assessment for level of care, induction, retention, maintenance, and tapering, office management, DATA 2000 waiver training, and alternative therapies o Patient-centered care, stigma, trauma-informed care, social determinants of health, suicide prevention, cultural competency, community engagement to reduce stigma and increase linkages to care o Integrated care practices that transcend the life-cycle: MCH, adolescents, young adults, adults to older adults/aging o Clinical MAT for perinatal women and adolescents o SBIRT o Motivational interviewing o Evidence Based Practices (EBPs) for Home Visiting and Healthy Start programs o Integration of behavioral health into MCH primary care o Promoting two generations of mental health o Increase the knowledge of adverse childhood experiences and the use of trauma-informed policies, procedures and practices among health professionals caring for

MCH populations in HRSA-funded settings

Workforce:

o Building trusting, multidisciplinary teams and community partnerships o Practice transformation, culture change/shift, patient-centered treatment design o Recruitment and Retention of behavioral health workforce

E.g., care/case managers, care coordinators, paraprofessionals, social workers, psychologists, psychiatrists, addiction psychiatrists, substance use disorder counselors etc. in rural and urban areas

Workforce development and readiness

Ongoing training programs for behavioral health staff

Clinical Workflow and Informatics:

o Electronic Health Record enhancements and data sharing/exchange o Implementation of effective tools and practices (e.g., motivational interviewing, universal depression, trauma, and substance use disorder screenings, and SBIRT) o Data-informed decision making o Telehealth (e.g. tele-behavioral health, tele-psychiatry, tele-psychiatry consultations) o Prescription Drug Monitoring Program enhancements (e.g., data integration and utilization)

Service to System Coordination and Financial Sustainability:

o Financial sustainability (e.g., Medicaid reimbursement models, same-day billing) o Prevention, screening and treating special populations (e.g., children, adolescents, pregnant women, individuals with co-morbidities, homeless individuals, and veterans) o CDC Opioid Prescribing Guideline implementation o Pain management guidelines and alternatives o Medication management, addiction treatment and recovery, overdose reversal, harm reduction, risk management, overdose prevention, naloxone and other prevention training o Establishing partnerships for referrals o Integration of care with management of infectious disease complications of SUD, and other co-morbidities o Establishing partnerships for referrals (e.g., from opioid treatment programs, emergency departments, community mental health centers, and criminal justice diversion programs) o Developing individual and group treatment programs

Behavioral Health Workforce

The role of multidisciplinary, coordinated care teams and education/training for skills to serve as a member of a coordinated care team, in particular in a primary care setting;

Training and education of the next generation and the existing provider workforce on treatment protocols for opioid use;

Innovations in workforce pipeline development (for example: para professionals transitioning to professional occupations) in rural and urban areas;

Culturally competent care to meet the needs of specific population groups;

Developing a trauma-informed workforce;

Billing/reimbursement strategies and the business model to sustain workforce;

HIV/AIDS

Understanding how to leverage Ryan White HIV/AIDS Program providers and services to address behavioral health needs for clients of the program;

Engaging and re-engaging people living with HIV who are not in consistent care and on treatment for HIV;

Sharing TA information on integration through existing mechanisms (for example: the

TARGET Center careacttarget.org/);

Maternal and Child Health

Promoting 2 generations of mental health;

Increase the knowledge of adverse childhood experiences and the use of trauma-informed policies, procedures and practices among health professionals caring for MCH populations;

Tele-behavioral health in school-based health/mental health centers;

The impact of trauma and opioid misuse on children and families;

https://careacttarget.org/

Integrating a trauma-informed approach in health care and home visiting settings serving mothers, infants, children, adolescents, young adults and families;

Best practices in serving women and families experiencing opioid misuse or addiction, including support for babies born with neonatal abstinence syndrome;

Screening adolescents ages 12 and older and young adults for major depressive episodes in primary care as part of adolescent and young adult health, including in school-based health/mental health centers.

Primary Care/Health Centers

Integrated care models

Workforce capacity building, recruitment and retention

Clinical workflow and informatics

Service to system coordination and sustainability

Stigma

Special populations (e.g., pregnant women, homeless, rural, aging, agricultural workers, etc.)

Strategic partnerships

Geographic disparities

Incorporating addiction (e.g. opioid use disorder) services into integration models, Diversion, pain management;

Assuring that technical assistance on integrated care takes into account varying state

Medicaid reimbursement policies, state licensing laws, and availability of the behavioral health workforce;

The integration and development of health information technology to facilitate care integration;

Depression screening and follow-up and SBIRT implementation: screening tools, team member roles, workflows, brief interventions, treatments documentation in the Electronic

Medical Record, and billing;

Suicide prevention;

Trauma-informed care capacity building;

Tele-mental health and tele substance use disorder treatment as part of integrated models of care;

Rural Health

Training, developing, and maintaining behavioral health paraprofessional workforce in rural areas

Tele-mental health and tele-substance use disorder treatment, including:

Direct clinical services (psychotherapy/counseling/substance use treatment);

Direct clinical services (psychiatry);

Distance learning/workforce development (e.g. Project Echo);

Providing clinician support/consultation and care coordination (e.g. MCPAP for

Moms);

Effective use of peers/community health workers;

Sharing best clinical practices regarding rural integrated care;