Illinois Children’s Healthcare FoundationCHILDREN’S MENTAL HEALTH INITIATIVEBuilding Systems of Care: Community by Community

Fostering Creativity Through Shared Ideas

Anita Berry MSN, CNP, APNDirector, Healthy Steps for Young Children Program

Advocate Health CareProject Director, Enhancing Developmentally Oriented Primary Care

Objectives

Participants will be able to • Identify the importance of Integrating primary

care and mental health• Understand Enhancing Developmentally

Oriented Primary Care (EDOPC) and how they work in Illinois

• Clarify the concept of a Medical Home

Primary Care and Mental Health What Do Community Resources Tell Us about Communicating With Primary Care Providers?

• difficult to access needed records and forms • lack of response to requests for medical records or

prescriptions for service• spend too much time on seemingly simple tasks

– reaching the appropriate practice staff member, securing signed forms

• conflicting information regarding level of detail desired in reports

Primary Care and Mental Health What is it All about?

AAP Mental Health Task Force Plan*

AAP Task Force on Mental Health, June 2010, Pediatrics

EDOPC Key Partners

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Illinois Chapter American Academy of Pediatric

Advocate Health Care Healthy Steps for Young

Children Program

EDOPC Goals

• Improve delivery and financing of preventive health and developmental services for children birth to three

• Build on existing programs to develop a range of strategies for primary care settings

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EDOPC Topics for Training• Developmental Screening and Referral• Social and Emotional Development: Screening

Strategies for Primary Care Physicians• Identifying Postpartum Depression During

Well-Child Visit: Resources for Screening, Referral, and Treatment

• Early Autism Detection and Referral• Domestic Violence Effects on Children:

Detection, Screening and Referral in Primary Care

• Obesity Prevention in the Early Years8

Additional EDOPC Topics for Training

• Effective Discipline in the Early Years• Coordinating Care Between EI and the Primary

Care Medical Home Project • Psychosocial Developmental Screening and

Referral for Children Aged Five to Eight Years• Coordinating Care Between Early Intervention

and the Primary Care Medical Home• Bright Futures Guidelines for Health

Supervision (beginning July 2011)

EDOPC Methods• On site presentations to

entire practice staff and topic specific community resources

• Educational Teleconferences• Hospital Grand Rounds or

Department Meetings• Web based training• Technical Assistance – email,

phone, on site• Local and National

Conferences

EDOPC Training in Illinois• 1250 primary care providers

• 3200 allied healthcare staff

• 80% of Federally Qualified Health Centers

• 153 private practices

• 30 Residency, Nurse Practitioner, and Physician Assistant programs

EDOPC Provider Survey

Providers who received intense EDOPC training,which includes technical assistance, were morelikely to have a higher screening rate thanproviders with little or no EDOPC training. Trained Little or no trainingPPD-59% PPD-25%Dev-89% Dev-69%SE-37% SE-17%

Medicaid Data Analysis - 2009

• Rise in percent of well child visits with developmental screen 2002 = 15%

2009 = 32%

• percent of providers conducting at least one developmental screen in a year increased 2002 = 13% 2009 = 46%

• The percent of EI recipients screened for development by primary care provider before beginning EI services 12002 = 18% 2009 = 54%

So Where Are We Going?

Task Force on Vision in Pediatrics

Why do this?

AAP Task Force on Mental Health*

AAP Task Force on Mental Health, June 2010, Pediatrics

Proposed Mental Health Screening of Children and Adolescents *

AAP Task Force on Mental Health, June 2010, Pediatrics

Proposed Screening and Surveillance of Family and Social Environment for Risk Factors*

*AAP Task Force on Mental Health, June 2010, Pediatrics

Pediatric Primary Care Providers as a Mental Health Provider?

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Developing collaborative relationships

Definition of HEALTH/MEDICAL HOME

AccessibleFamily-CenteredComprehensiveContinuousCoordinatedCompassionateCulturally-effective

Care that is:

A partnership between primary care physicians/ nurse practitioners and families

Care Coordination is Key

• Through a Medical Home partnership, PCPs can help the family access and coordinate – specialty care – educational services– in and out-of-home care– family support– other community services

• PCPs and Community Resources must work together to coordinate care

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Summary• Primary care needs to be included in planning for

a system of mental health care

• EDOPC training and technical assistance improves providers ability to screen, treat, and follow up with children and make appropriate referrals to community resources

• A medical home is a partnership to help families access and coordinate care

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