Keep Them Rocking at Home: Strategies for Addressing Behavioral Health and Rurality Issues

Transcription

1 Keep Them Rocking at Home: Strategies for Addressing Behavioral Health and Rurality Issues Grantmakers in Aging; October 28, 2015 Becky Hayes Boober, PhD, Senior Program Officer, Maine Health Access Foundation Paulette Parker, MA, Senior Program Officer, Williamsburg Health Foundation

2 How s Your Gray Matter? Pop Quiz

3 Introductions Imagine you are 90 years old. What do you need to thrive at home?

4 Off Their Rocker Blind Man Drives a Mustang : Off Their Rockers Delirium Watch Off Their Rockers star Michael Yama blindly feed the birds, go for a joyride, and fool the younger genera9on. h;ps://youtu.be/mh6xnh8hwrs

5 Strategies Addressing Behavioral Health and Rurality: Thriving in Place (TiP); Screening, Brief Intervention and Referral to Treatment (SBIRT) for Seniors

6 Thriving in Place

7 Why Is TiP Important?

8 Why Is TiP Important? As life expectancy increases, people are more likely to have Disabilities (healthy life span is shorter now) Cluster of diseases (diabetes, heart disease, depression, stroke, Alzheimer s disease) Decades of improvement in the functional status of older Americans stopped in 2002 How do we make aging a time worth celebrating?

9 MeHAF Thriving in Place

10 TiP Emphasis

11 Who Does TiP Serve? Top 5% users (CCT) At risk, chronic health issues Some needs, use of health care system Healthy. Preventive Care.

12 What Do TiP Partnerships Do? 1) Identify persons with chronic health conditions and at risk of hospitalization/ institutionalization; 2) Implement strategies to prevent/delay health status decline; 3) Improve coordination and delivery of costeffective, evidence-based interventions/ supports. 4) Strengthen care coordination among providers and community supports.

13 Examples of Strategies

14 MeHAF Support Grants Learning community, TA Evaluation Policy

15 Maine Opportunities

16 What We ve Learned Needs are often low barrier, but without resources: Snow shoveling Home repairs and heat Social isolation Caregiver support People don t like to be takers. Use members instead. People need purpose.

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18 Aging Baby Boomers Bring Drug Habits into Middle Age Older adults are abusing drugs, getting arrested for drug offenses and dying from drug overdoses at increasingly higher rates The Wall Street Journal March 16, 2015

19 SBIRT for Seniors SBIRT Screening, Brief Intervention, and Referral to Treatment SBIRT is integrated care with screening and brief interventions generally done in primary care settings

20 SBIRT Integration at Its Best Integration now a common term SBIRT makes behavioral health knowledge accessible and actionable for primary care clinicians Uses Motivational Interviewing for Screening and Brief Interventions

21 Factors in Funding SBIRT for Seniors SAMHSA: Of adults screened and reporting heavy drinking, 39% reported reduction at 6 months SAMHSA: Of adults reporting illicit drug use, 68% reported reduction at 6 months Using state-level data, we projected approximately 17% of people 55+ are abusing alcohol

22 Demographic Projections for Greater Williamsburg, Virginia Senior (60+) Population Projections for Greater Williamsburg % 38% 36% 34% 32% 30% 28% 26% 24% 22% 20% Year Williamsburg York County James City County Greater Williamsburg Source: Weldon Cooper Center for Public Service Greater Year Williamsburg James City County York County Williamsburg % 35% 23% 29% % 40% 25% 32% % 40% 23% 32% Source: Weldon Cooper Center for Public Service Note: Weldon Cooper defines seniors as the populaqon over age 60

23 SBIRT for Seniors Our program model has been built on community collaboration Grantee was a community-based service provider

24 Goals and Outcomes Goal for first grant: Train 50 Clinicians, Screen 500 Actual: 300+ Clinicians, Screened % Screened Positive Over 3 years: 2,000+ patients Screened, nearly 600 Clinicians trained

25 SBIRT Present and Future Requires and builds community collaboration Primary care clinicians become supporters Behavioral health clinicians become supporters Sustainability: Medicaid billing codes Being adopted by health systems, and screening instruments added to EMR s Being added to EAP programs WHF program has been adopted by health system

26 SBIRT Present and Future SBIRT being done in many communities Successful SBIRT for seniors: Florida s BRITE program with a 3 year SAMHSA grant SBIRT is a flexible model and off the shelf Success stories can have different endings WHF no longer funding SBIRT but the program is continuing

27 Buzz Session Select a table with a tent card labeling a topic you d like to discuss. When bell rings, go to another table to discuss a different topic.

28 Buzz Session Questions What is a funder s role in making certain people have this to help them thrive at home? What experience to you have with supporting initiatives related to this topic? Who are your best partners for this work? What opportunities and challenges have you encountered?

29 Large Group Sharing: Popcorn Takeaways

30 Case Studies Share your thoughts and experiences with new friends at your table, as related to the case study provided.

31 Questions and Sharing

32 Contact Us Becky Hayes Boober, Sr. Program Officer Maine Health Access Foundation Paulette Parker, Sr. Program Officer Williamsburg Health Foundation

33 Video on Choosing Wisely JuRDkl8