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NYP/Q DSRIP PPS PC / BH Integratin Cmmittee Meeting Title: Facilitatr(s): Lcatin: NYP/Q DSRIP Primary Care / Behaviral Health Integratin Prject Meeting Date: Meeting M. D Urs, RN Time: NYPQ 56-45 Main Street; Junir Cnference Rm July 3, 2017 11:00 AM 12:00 PM Dial in: Dial in: 1-(866) 692-4538 Passcde: 26098085# Meeting Purpse: DSRIP Prject Implementatin Implementatin Plan Deliverables Respnsible Dcument # Tpic Persn 1. Welcme & Purpse M. D Urs - 2. Apprve Meeting Minutes 06/05/17 M. D Urs NYPQ PCBH Meeting Minutes 6 5 17.dcx Upcming Deliverables: DY3 Deliverables fr Mdel 1: Milestne #1 C-lcate behaviral health services at primary care practice sites. All participating primary care practices must meet 2014 NCQA level 3 PCMH r Advance Primary Care Mdel standards by DY 3. Metric# 1.1: All practices meet NCQA 2014 Level 3 PCMH and/r APCM standards by the end f DY3. Due by DY3Q4 (March 2018 ) 3. Minimum Dcumentatin: List f participating NCQA-certified and/r APCapprved physicians/practitiners (APC Mdel requirements as determined by NY SHIP); Certificatin dcumentatin. M. D Urs Brightpint Ambulatry Care Center ( bth are n track fr 2014 NCQA level 3 PCMH certificatin ) Brightpint cllcated internally Child Center f NY- Theresa Lang (TL n track fr 2014 NCQA level 3 PCMH certificatin ) Metric# 1.2: Behaviral health services are c-lcated within PCMH/APC practices and are available. Due by DY3Q4 (March 2018 ) Page 1 NYP/Q PPS 3.a.i Primary Care / Behaviral Health Integratin

NYP/Q DSRIP PPS PC / BH Integratin Cmmittee Minimum Dcumentatin: List f practitiners and licensure perfrming services at PCMH and/r APCM sites; Behaviral health practice schedules. Task Step # 7: Outline a timeline/rll-ut schedule f all participating clinics that shws anticipated clinic start dates & availability. Due by DY3Q1 (June 2017) PMO has created a PC:BH timeline t be cmpleted by March 2018 The clinics will run 2 days/week (7hrs.) Pediatrics Clinic will hire LSW Adults Clinic will hire Licensed Psychlgist/Physiatrist r Psych. Nurse Practitiner Task Step # 9: Train staff t ensure full understanding f peratinal prcesses, sensitivity, cultural cmpetency, and behaviral health related medical recrd plicies. Due by DY3Q4 (March 2018 ) Brightpint has cmpleted their wrkflws and is in the prcess f getting buy-in and then will wrk n training. Child Center f NY, TLCC, ACC, ACQC- status? PCBH PROJECT OVERVIEW.pptx Task Step # 10: Recruit behaviral health care prviders based n need f site (Physician/Scial Wrker/etc.) Due by DY3Q4 (March 2018 ) Brightpint and MHPWQ are currently in the recruiting prcess status? Task Step # 11: Create scheduling templates fr new prviders & patients. Due by DY3Q4 (March 2018 ) -------------------------------------------------------------------------------------------- Mdel 2: Milestne #5 C-lcate primary care services at behaviral health sites. Metric# 5.2: Primary care services are c-lcated within behaviral Health practices and are available. Due by DY4Q4 (March 2019) Minimum Dcumentatin: List f practitiners and licensure perfrming services at behaviral health site; Behaviral health practice schedules. Task Step # 6: Outline a timeline/rll-ut schedule f all participating clinics that shws anticipated clinic start dates & availability. Due by DY3Q3 (December 2017) Task Step # 8: Train staff t ensure full understanding f peratinal prcesses, sensitivity, cultural cmpetency, and behaviral health related medical recrd plicies. Due by DY4Q4 (March 2019) Page 2 NYP/Q PPS 3.a.i Primary Care / Behaviral Health Integratin

NYP/Q DSRIP PPS PC / BH Integratin Cmmittee Task Step # 9: Recruit r re-allcate primary care prviders t sites based n need (MD vs. NP vs. PA) Due by DY4Q4 (March 2019) Task Step # 11: Create scheduling templates fr new prviders & patients. Due by DY4Q4 (March 2019) --------------------------------------------------------------------------------------------- DY4 Deliverables: Bth Mdel 1 and Mdel 2: Milestne #3: Cnduct preventive care screenings, including behaviral health screenings (PHQ-2 r 9 fr thse screening psitive, SBIRT) implemented fr all patients t identify unmet needs. Due by DY4Q4 (March 2019) BH prviders shuld shw prf f preventative screenings ther than depressin/bh screening. Metric # 3.1: Plicies and prcedures are in place t facilitate and dcument cmpletin f screenings. Due by DY4Q4 (March 2019) Minimum Dcumentatin: Dcumentatin f the plicies and prcedures used t cnduct preventive care screenings, including behaviral health screenings. Received plicies and prcedures frm Brightpint, NYPQ, ACQC, Pending-MHPWQ & Child Center f NY (need preventative care screenings ) ---------------------------------------------------------------------------------- Metric # 3.2: Screenings are dcumented in Electrnic Health Recrd. Due by DY4Q4 (March 2019) Minimum Dcumentatin: Screenshts r ther evidence f ntificatins f patient identificatin and screening alerts; EHR Vendr dcumentatin. ------------------------------------------------------------------------------------------ Metric/Deliverable 3.3: At least 90% f patients receive screenings at the established prject sites (Screenings are defined as industry standard questinnaires such as PHQ-2 r 9 fr thse screening psitive, SBIRT). Due by DY4Q4 (March 2019) Minimum Dcumentatin: Rster f identified patients. Number f screenings cmpleted. ---------------------------------------------------------------------------------------- Metric/Deliverable 3.4: Psitive screenings result in "warm transfer t behaviral health prvider as measured by dcumentatin in Electrnic Health Recrd. Due by DY4Q4 (March 2019) Minimum Dcumentatin: Sample EHR demnstrating that warm transfers have ccurred. Page 3 NYP/Q PPS 3.a.i Primary Care / Behaviral Health Integratin

NYP/Q DSRIP PPS PC / BH Integratin Cmmittee SBIRT fr Perfrming Prvider Systems (PPS) Webinar n July 17, 2017 Duglas G. Fish, MD, NYS DOH Medical Directr, Divisin f Prgram Develpment & Management, and Charles W. Mrgan, MD, Medical Directr, NYS OASAS will cnduct the webinar Screening, Brief Interventin and Referral t Treatment (SBIRT) fr Perfrming Prvider Systems (PPS) n Mnday, July 17th 10:30 am 12:00 pm. 4. The tpics t be cvered are: hw screening, diagnsing and addressing substance use disrders (SUDs) prmtes DSRIP gals f reducing avidable ED and in-patient hspital utilizatin; Why Screening, Brief Interventin and Referral t Treatment (SBIRT) is a critical cmpnent f the integratin f behaviral health int primary care; Hw individuals with chrnic medical cnditins wh have a cmrbid SUD, have healthcare csts 2-3 times higher cmpared with individuals withut a cmrbid SUD; Hw nly 1 ut f 6 adults are asked by their primary care physician abut their drinking. If yu are interested in registering fr this webinar, please cntact Gerry King at Gerry.King@asas.ny.gv by COB July 12th. 5. Questins & Open Discussin - - 6. Adjurn - - Page 4 NYP/Q PPS 3.a.i Primary Care / Behaviral Health Integratin

NewYrk-Presbyterian/Queens PPS Prject 3.a.i Primary Care Behaviral Health Prject Cmmittee Meeting July 3rd, 2017 11:00 am 12:00pm EST Attendees: R. Crupi (NYPQ), M. D urs (NYPQ), M. Buglin (NYPQ), C. Dunkley (NYPQ), P. Cartmell (NYPQ),M. Hay (NYPQ), S. Schauman (NYPQ) Tpic Discussin Actins 1. Agenda: Welcme & Purpse Meeting minutes apprval DY3 Deliverables DY4 Deliverables SBIRT fr PPS Webinar Questins & Discussins N/A 2. Meeting minutes: C. Dunkley 3. DY3 Deliverables :C. Dunkley Cmmittee reviewed meeting minutes frm 6/05/17 meeting. DY3 Deliverables fr Mdel 1: Milestne #1 C-lcate behaviral health services at primary care practice sites. All participating primary care practices must meet 2014 NCQA level 3 PCMH r Advance Primary Care Mdel standards by DY 3. Metric# 1.1: All practices meet NCQA 2014 Level 3 PCMH and/r APCM standards by the end f DY3. Due by DY3Q4 Minimum Dcumentatin: List f participating NCQAcertified and/r APC-apprved physicians/practitiners (APC Mdel requirements as determined by NY SHIP); Certificatin dcumentatin. All NYP Queens clinics have submitted fr 2014 Level 3 PCMH certificatin. ACC has received their certificatin and the remaining 2 (JH and TLCC) are awaiting the status. Metric# 1.2: Behaviral health services are clcated within PCMH/APC practices and are available. Due by DY3Q4 M. D Urs apprved and P. Cartmell secnded the mtin. Please send a list f all PCMH certified prvider t the PMO. The PMO will reach ut t partners t wrk n creating a timeline fr Clcatin.

Tpic Discussin Actins Minimum Dcumentatin: List f practitiners and licensure perfrming services at PCMH and/r APCM sites; Behaviral health practice schedules. Task Step # 7: Outline a timeline/rll-ut schedule f all participating clinics that shws anticipated clinic start dates & availability. Due by DY3Q1 The PMO presented the Mdel 1 timeline t the cmmitted and added edits t task dates. The clinic will run 2 days week/ 7 hrs. Pediatric clinic is recruiting LSW Adult clinic will recruit a Psych. NP Task Step # 9: Train staff t ensure full understanding f peratinal prcesses, sensitivity, cultural cmpetency, and behaviral health related medical recrd plicies. Due by DY3Q4 Athena can prvide wrkflws Task Step # 10: Recruit behaviral health care prviders based n need f site (Physician/Scial Wrker/etc.) Due by DY3Q4 MHPWQ and Brightpint are currently recruiting prviders t wrk nsite at clinics. J Lavin can reach ut t Clumbia fr a Psychiatric NP. Task Step # 11: Create scheduling templates fr new prviders & patients. Maureen and Maria will have a separate meeting t build the business plan fr apprval. This may be a risk if the hspital des nt apprve the business plan then the sites will be unable t c-lcate. Due by DY3Q4 Mdel 2: Milestne #5 C-lcate primary care services at behaviral health sites. Metric# 5.1: PPS has achieved NCQA 2014 Level 3 PCMH r Advanced Primary Care Mdel Practices by the end f DY3.Due by DY4Q4 PMO will update edits fr Mdel 1 timeline. Send PMO any wrkflws and training sign in sheet fr trainings f staff. PMO will prduce business plan fr NYPQ t apprve. Maria is currently inquiring the rates fr the BH prviders PMO will get mre clarificatin n which sites need t c-lcate PC services at BH site and bring feedback t the cmmittee. Minimum Dcumentatin: List f participating NCQAcertified and/r APC-apprved physicians/practitiners (APC Mdel requirements as determined by NY SHIP);

Tpic Discussin Actins Certificatin dcumentatin. Metric# 5.2: Primary care services are c-lcated within behaviral Health practices and are available. Due by DY4Q4 Minimum Dcumentatin: List f practitiners and licensure perfrming services at behaviral health site; Behaviral health practice schedules. 4. DY4 Deliverables: M. D Urs Task Step # 6: Outline a timeline/rll-ut schedule f all participating clinics that shws anticipated clinic start dates & availability. Due by DY3Q3 Task Step # 8: Train staff t ensure full understanding f peratinal prcesses, sensitivity, cultural cmpetency, and behaviral health related medical recrd plicies. Due by DY4Q4 Task Step # 9: Recruit r re-allcate primary care prviders t sites based n need (MD vs. NP vs. PA) Due by DY4Q4 Task Step # 11: Create scheduling templates fr new prviders & patients. Due by DY4Q4 DY4 Deliverables due March 2019 Milestne #3: Cnduct preventive care screenings, including behaviral health screenings (PHQ-2 r 9 fr thse screening psitive, SBIRT) implemented fr all patients t identify unmet needs. Metric/Deliverable 3.1: Plicies and prcedures are in place t facilitate and dcument cmpletin f screenings. Pending plicies frm MHPWQ & CCNY Minimum Dcumentatin: Dcumentatin f the plicies and prcedures used t cnduct preventive care screenings, including behaviral health screenings. --------------------------------------------------------------------- Metric/Deliverable 3.2: Screenings are dcumented in Electrnic Health Recrd. SBIRT screenings need t be built int Athena Minimum Dcumentatin: Screenshts r ther evidence f ntificatins f patient identificatin and screening alerts; EHR Vendr dcumentatin. --------------------------------------------------------------------- Metric/Deliverable 3.3: At least 90% f patients receive screenings at the established prject sites (Screenings are Please send deliverable dcuments t the PMO PMO will gain mre clarificatin n

Tpic Discussin Actins 5. SBIRT fr PPS Webinar: C. Dunkley defined as industry standard questinnaires such as PHQ- 2 r 9 fr thse screening psitive, SBIRT). Minimum Dcumentatin: Rster f identified patients. Number f screenings cmpleted. --------------------------------------------------------------------- Metric/Deliverable 3.4: Psitive screenings result in "warm transfer t behaviral health prvider as measured by dcumentatin in Electrnic Health Recrd. Minimum Dcumentatin: Sample EHR demnstrating that warm transfers have ccurred. Warm Handff is defined as internal referrals such as walking the patients ver t a behaviral health prvider. SBIRT fr Perfrming Prvider Systems (PPS) Webinar n July 17, 2017 Duglas G. Fish, MD, NYS DOH Medical Directr, Divisin f Prgram Develpment & Management, and Charles W. Mrgan, MD, Medical Directr, NYS OASAS will cnduct the webinar Screening, Brief Interventin and Referral t Treatment (SBIRT) fr Perfrming Prvider Systems (PPS) n Mnday, July 17th 10:30 am 12:00 pm. The tpics t be cvered are: hw screening, diagnsing and addressing substance use disrders (SUDs) prmtes DSRIP gals f reducing avidable ED and in-patient hspital utilizatin; Why Screening, Brief Interventin and Referral t Treatment (SBIRT) is a critical cmpnent f the integratin f behaviral health int primary care; Hw individuals with chrnic medical cnditins wh have a cmrbid SUD, have healthcare csts 2-3 times higher cmpared with individuals withut a cmrbid SUD; Hw nly 1 ut f 6 adults are asked by their primary care physician abut their drinking. Metric 3.3 and the timeframe the 90% needs t be achieved by. Once the sites are cllcated please prvide a sample EHR demnstratin a warm transfer. If yu are interested in registering fr this webinar, please cntact Gerry King at Gerry.King@asas. ny.gv by COB July 12th.