The Power of Peers for Tobacco and Cancer Control Practices

Transcription

1 The Power of Peers for Tobacco and Cancer Control Practices Thursday, August 3 rd, 2017, 3:00pm EDT Presented by: Wendy White Tiegreen, MSW Nigel Greenaway Moderated by: Dawn Randolph, MPA

2 Welcome! Dawn A. Randolph, MPA DIR Consulting, LLC Health Financing Consultant, National Behavioral Health Network for Tobacco & Cancer Control Lea Simms Project Coordination, Policy & Practice Improvement Coordinator, National Behavioral Health Network for Tobacco & Cancer Control National Council for Behavioral Health 1

3 Housekeeping How to join the webinar? GoToWebinar INSTRUCTIONS: Join the webinar: Call in using your telephone: +1 (914) Access Code: Audio PIN: Shown after joining the meeting To ask a question: type it into the Q&A pod. Technical difficulties? Call Citrix Tech Support at

4 Jointly funded by CDC s Office on Smoking & Health & Division of Cancer Prevention & Control Provides resources and tools to help organizations reduce tobacco use and cancer among people with mental illness and addictions 1 of 8 CDC National Networks to eliminate cancer and tobacco disparities in priority populations Visit and Join Today! Free Access to Toolkits, training opportunities, virtual communities and other resources Webinars & Presentations State Strategy Sessions Community ofpractice #BHtheChange

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6 Today s Agenda Welcome & Housekeeping State perspective: Rationale for using Peers, data, history, and funding Mechanisms Peer Health Worker perspective: integrating Peers, Peer certification, and recruiting Peers Moderated Q &A 5

7 Why utilize peers for wellness programs? 6

8 Guest Speaker #1 Wendy White Tiegreen, M.S.W. Director, Medicaid Coordination and Health System Innovation Georgia Department of Behavioral Health & Developmental Disabilities 7

9 State of Georgia Department of Behavioral Health & Developmental Disabilities USE OF PEER SUPPORTS FOR WELLNESS CHOICES WENDY WHITE TIEGREEN, MSW

10 Current Georgia CPS Workforce 1555 Approximately 2,500 Certified Peer Specialists are certified in Georgia. 439 Whole Health Youth Adult MH CPSs Adult AD Parent Forensic April 2017 Georgia Department of Behavioral Health and Developmental Disabilities 9

11 Georgia: Brief History of Peer Support 1999 First Medicaid Billable Peer Support Service 2006 NASMH PD Mortalit y Report* 2007 CMS State Medicaid Directors Transmittal ** 2010 Medicai d CHIPR A Grant to develop Parent and Youth Peer Support 2012 Medicaid Approval for Addictive Disease Peer Support 2017 Medica id State Plan Approv al for Parent and Youth Peer Suppor t 2001 Adult Mental Health Certificati on State Event 2007 Addition of Wellness Elements to Peer Support Definitio n 2007 CMS PRTF Demo Waive r for Parent and Youth Peer Suppo rt 2012 Medicai d Approva l for Peer Support Whole Health 2013 BIP and MFP for Parent and Youth Peer Suppor t National Event * ** Georgia Department of Behavioral Health and Developmental Disabilities 10

12 Why the Lived Experience approach? A natural ally: Someone who has walked in the same shoes Peer perspective models self-management while encouraging health activation. Lived experience (including challenges accessing health as a person with a behavioral health issue) creates a niche role in supporting and motivating the individual toward health, wellness, and resiliency. Peer practitioners are trained in strengths-based approaches which are essential to health teams Georgia Department of Behavioral Health and Developmental Disabilities 11

13 Georgia: Peer Support Whole Health and Wellness Modified Medicaid Rehab Option State Plan to add: support and coaching interventions to individuals to promote recovery and healthy lifestyles and to reduce identifiable behavioral health & and physical health risks and increase healthy behaviors intended to prevent the onset of disease or lessen the impact of existing chronic health conditions by teaching more effective management techniques that focus on the individual s self-management and decision making about healthy choices which ultimately extend the members lifespan. Georgia Department of Behavioral Health and Developmental Disabilities 12

14 Georgia: Peer Support Whole Health and Wellness Georgia Department of Behavioral Health and Developmental Disabilities 13

15 Georgia: Peer Support Whole Health and Wellness CPS Training: Whole Health Action Management (WHAM) oengaging in person-centered planning to identify strengths and supports in 10 science-based whole health and resiliency factors; osupporting the person in writing a whole health goal based on personal motivation and person-centered planning; osupporting the person in creating and logging a weekly action plan; ofacilitating WHAM peer support groups which create new health behaviors; obuilding the person s Relaxation Response skills to manage stress; obuilding the person s cognitive self-management skills to avoid negative thinking. Georgia Department of Behavioral Health and Developmental Disabilities 14

16 Georgia: Peer Support Whole Health and Wellness Specific Interventions Include: Skills development for sharing basic health information; Promoting awareness regarding health indicators; Assisting the individual in understanding the idea of whole health and the role of health screening; Supporting behavior changes for health improvement; Building skills on the use of wellness tools (e.g. relaxation response, positive imaging, wellness toolboxes, daily action plans, stress management, etc.) to support the individual s identified health goals; Georgia Department of Behavioral Health and Developmental Disabilities 15

17 Georgia: Peer Support Whole Health and Wellness Specific Interventions, continued: Working with the individual in his/her selection of incremental health goals; Teaching/modeling/demonstrating skills such as nutrition, physical fitness, healthy lifestyle choices; Promoting and offering healthy environments and skills-development to assist the individual in modifying his/her own living environments for wellness; Supporting the individual as they practice creating healthy habits; Personal self-care, self-advocacy and health communication; Assisting in the coaching related to disclosing history, discussing prescribed medications, asking questions in health settings Georgia Department of Behavioral Health and Developmental Disabilities 16

18 Georgia: Peer Support Whole Health and Wellness Assistance will be provided to the individual to facilitate his/her active participation in the development of the Individualized Recovery Plan (IRP) health goals which may include but not be limited to attention to dental health, healthy weight management, cardiac health/hypertension, vision care, addiction, smoking cessation, vascular health, diabetes, pulmonary, nutrition, sleep disorders, stress management, reproductive health, human sexuality, and other health areas. Georgia Department of Behavioral Health and Developmental Disabilities 17

19 Georgia: Peer Support Whole Health and Wellness TECHNICAL ELEMENTS Meets all CMS Required elements Health-trained CPSs are the lead practitioners Partnered with an agency-designated Behavioral Health Registered Nurse/s who provides technical medical advice, referral, and support as requested and as necessary Georgia Department of Behavioral Health and Developmental Disabilities 18

20 Georgia: Peer Support Whole Health & Wellness Health-Certified CPSs have the ability to function in a variety of settings: Emergency Room FQHC Community BH Center RN providing medical technical support Health-Trained Certified Peer Specialist

21 Spotlight on Georgia: Research Schizophrenia Research Journal, February 2010, The Health and Recovery Peer (HARP) Program: A peer-led intervention to improve medical self-management for persons with serious mental illness (Druss, et.al.) At six month follow-up, participants in the HARP program had a significantly greater improvement in patient activation than those in usual care and in rates of having one or more primary care visit Intervention Advantages were observed for physical health related quality of life (HRQOL), physical activity, medication adherence. Georgia Department of Behavioral Health and Developmental Disabilities 20

22 Spotlight on Georgia: Research Mental Health Weekly, September 2013, Peers easing strain of mental health workforce issues : Peers coaching people about their general health is a natural fit for peer specialists who approach services from a strength-based, recovery-oriented perspective DHHS AHRQ features PSWHW as a Policy Innovation State Medicaid Program Designates Physical Health and Wellness Services Provided by Mental Health Peers as Reimbursable Service Georgia Department of Behavioral Health and Developmental Disabilities 21

23 Spotlight on Georgia: Research Consumers showed improvements in their overall health (Lingle & Darnell, 2009). Cobb/Douglas Community Service Board (PBHCI grantee using CPSs as health team members) determined significant improvements in cardiometabolic risk factors with particular note to hypertension, smoking status (breath CO) and client blood sugar levels ( 3.pdf) Georgia Department of Behavioral Health and Developmental Disabilities 22

24 Know your local resources Georgia Department of Behavioral Health and Developmental Disabilities 23

25 Public Health State Funds Insurance FQHCs VA Peer Support Medicaid 1115b Medicaid 1915i MHBGs Medicaid Rehab Option SATBG Medicaid Medical Benefits Private Health Foundations P R E V E N T I O N Georgia Department of Behavioral Health and Developmental Disabilities 24

26 Potential Funding Mechanisms FUNDING MECHANISMS: Consider the current or potential mechanisms used for funding and financing behavioral health and/or health and wellness State Medicaid Plans, Waivers, Health Homes grants, FQHCs Accountable Care Organizations (ACOs), insurance exchanges, disease management/health coaching programs Structure of reimbursement stand-alone service with a fee-for-service-unit rate, pay-for-performance/outcomes, Pay for-practitioner: peer professional as a health coach. NO MATTER THE FUND SOURCE, TRACK YOUR SUCCESS, AND THEN USE YOUR DEMONSTRABLE EVIDENCE TO LEVERAGE FUNDING IN THE FUTURE. Georgia Department of Behavioral Health and Developmental Disabilities 25

27 Guest Speaker #2 Nigel Greenaway Whole Health Peer Workforce Development Project Coordinator for the Georgia Mental Health Consumer Network Georgia Certified Peer Specialist, a Certified Psychiatric Rehabilitation Practitioner, a Certified IT and Network Technician. Wellness Recovery Action Plan (WRAP) facilitator and a Whole Health and Wellness Coach. 26

28 The role and certification of peers as coaches in whole health and wellness How have you changed or added to the Peer Specialist Certification to include Whole Health and Wellness? 1 st we had Georgia Peer Wellness Initiative: Taught peer specialists, consumers and peer support programs and communities how to provide health and wellness education Maintain peer support wellness groups Create self-directed wellness plans, and improve health and fitness. 2 nd replaced this program in 2013 with WHAM (Whole Health Action Management) training and provided a specialty credential Whole Health and Wellness Coach certified by the State of Georgia. 27

29 The role and certification of peers as coaches in whole health and wellness How have you changed or added to the Peer Specialist Certification to include Whole Health and Wellness? 3 rd Peer Support Whole Health and Wellness services delivered by Certified Peer Specialists (CPSs) Credential is reimbursable by Medicaid in Georgia. The Georgia Mental Health Consumer Network (GMHCN) supports CPSs using WHAM training 4 th CPSs will have a direct impact by reducing: Physical ailments Improving behavioral health Increasing the longevity of the peers we support. 28

30 How many CPSs are WHAM certified? There are 1630 Certified Peer Specialists that have graduated in Georgia. As of July CPSs have successfully completed WHAM training and have earned the credential of Whole Health and Wellness Coach. There is a waiting list because of the demand for the credential. 29

31 What is your experience with recruiting and training peers? Great demand for the training. More applicants than spots available. Recruitment generally involves sending an to all CPSs with an announcement of the trainings. Publish the WHAM announcement on Georgia Mental Health Consumer Network s Website. 30

32 How do you help certified peers get a job after training? WHWC are referred to the Job Board for prospective employment or referrals by word of mouth. There is a very high demand for the WHWC credential. Many CPSs have stated that the WHAM training enhances their opportunity for employment. 31

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34 Tobacco Treatment Training Rocky Mountain Tobacco Treatment Specialist Certification (RMTTS-C) Program CHOICES in New Jersey Council for Tobacco Treatment Training Programs

35 Tobacco Treatment Specialist Training The Tobacco Free Florida Cessation Program at FSU s Area Health Education Center funds the Tobacco Treatment Specialist (TTS) Training FSU has trained approximately 15 Peer Specialists as Tobacco Treatment Specialists Peer Specialists are delivering tobacco cessation groups at Centers for Independent Living, drop-in centers, and behavioral health organizations

36 Tobacco Treatment Specialist Training Training was nationally accredited in 2010 by the Association for the Treatment of Tobacco Use and Dependence >Currently one of only 16 accredited training programs in the U.S. FL offers a certification for Tobacco Treatment Specialists through the FL Certification Board which also certifies Peer Recovery Specialists Peers from other states are eligible for certification in FL.

37 Role of Tobacco Treatment Specialists (TTS) Work in a variety of settings: > Hospitals, clinics, and other medical settings > Behavioral health organizations > Community organizations like Centers for Independent Living, drop-in centers Understand the science behind tobacco addiction, nicotine withdrawal symptoms, and effective treatments for tobacco use Provide information about effective treatments, including medications Help prevent relapse through support and follow-up Work with a variety of specific populations including those with specific health issues Serve as educational resources for organizations, healthcare providers, and the general public regarding tobacco use treatment issues

38 TTS Training Schedule September 12 th through 14 th, 2017 in St. Petersburg January 30 th through Feb. 1 st, 2018 in Tallahassee May 1 st through 3 rd, 2018 in Orlando For more information and registration links: > Training Fees: > $250 for Florida residents > $470 for other state residents For more information contact Andrée Aubrey, AHEC Director, at andree.aubrey@med.fsu.edu

39 Peer Wellness Coaching Supervisor Manual Publisher: Collaborative Support Programs of New Jersey Editor: Margaret Swarbrick Published: 2010 Free download at _Wellness_Coaching_Supervisor_Manual_Freehold_NJ_Collaborative_Support_P rograms_of_new_jersey_institute_for_wellness_and_recovery_initiatives 38

40 Questions? To ask a question, type it into the Q&A box in your webinar window.

41 Jointly funded by CDC s Office on Smoking & Health & Division of Cancer Prevention & Control Provides resources and tools to help organizations reduce tobacco use and cancer among people with mental illness and addictions 1 of 8 CDC National Networks to eliminate cancer and tobacco disparities in priority populations Visit and Join Today! Free Access to Toolkits, training opportunities, virtual communities and other resources Webinars & Presentations State Strategy Sessions Community ofpractice #BHtheChange

42 Health Financing Webinar Series: Aug. 3: The Power of Peers for Tobacco and Cancer Control Practices Aug. 16: Partnering with Public Housing to Reduce Tobacco Use Sept. 13: Cracking the (CPT) Code for Tobacco Cessation & Cancer Prevention Oct. 11: Finding New Financing for Tobacco Cessation & Cancer Prevention Efforts Cancer Control Webinar Series: Aug. 8: Applying Best Practices to Develop Survivorship Care Plans for Behavioral Health Populations Sept. 12: Promising Practices to Track, Monitor and Address Needs Across the Cancer Continuum in Behavioral Health Populations Oct. 17: Financing Cancer Control Practices for Behavioral Health Populations Other Webinars: Additional Opportunities Aug. 23: Thinking Outside of the Box: Creative Approaches to Tobacco Cessation Aug. 31: Overcoming Implicit Bias in Tobacco Cessation for Behavioral Health Populations Sept. 26: The Intersection of Tobacco, E-Cigarettes, and Marijuana Use

43 Thank you for joining us! As you exit the webinar, please do not forget to complete the evaluation survey. Questions? Please contact Lea Simms at