KentuckyPrimary Behavioral Health Care Integration

> Karen Chrisman, JD MA CHP CSCS> Staff Attorney> Governor’s Office of Electronic Health Information

http://www.khie.ky.gov/

• Query based model• CCD exchange• 200+ “Live” facilities• Participation Agreements from 108 of approximately 130 hospitals in the Commonwealth • 27 of 29 Participation Agreements are CAH• No further consent needed state• Kentucky Cabinet for Health and Family Services (CHFS)

funds and provides support to the Commonwealth’s 14 CMHCs but does not have direct control of the centers

Kentucky HIE Background

Primary Behavioral Health Care Integration

Pennyroyal Center

received a grant under the PBHCI initiative

Pennyroyal Center has a primary care

license

KHIE delivered KHIE CCD to Pennyroyal

with Medicaid claims data

and all “live” provider lab

results10-31-2012

Pennyroyal will share

consolidated CCD with medical trading

partners (needs 42 CFR

Part 2 language)

Current live medical trading

partners Baptist Health, Madisonville,

Lourdes Hospital, Paducah

11-01-2012

Community Mental Health Center

KHIE CCD to Pathways with Medicaid claims data and all “live” provider lab

results (requires development)

Pathways shares consolidated CCD with

medical trading partners, primary care providers

currently live King’s Daughters Medical Center, Fleming County Hospital,

St. Claire Regional Medical Center (ready

with connection to Care Connect)

Primary Behavioral Health Care Integration

Primary Behavioral Health Care Integration

Community Mental Health Center

Currently teaming with primary care

providers

KHIE CCD to Kentucky River

Community Care with Medicaid claims data, all

“live” provider lab results

Kentucky River identified team practices: ARH, Quantum Healthcare, Mercy Medical Clinic.

KRCC co-located with St. Joseph Martin but

unable to share medical records Will use KHIE to

deliver KRCC CCD consolidated with

Medicaid claims data, all “live”provider lab results.

Primary Behavioral Health Care Integration

Community Mental Health

Center

Partnering with FQHC Primary

Plus

KHIE CCD to Comprehend with Medicaid claims data, all “Live”

provider lab results including

St. Claire Regional Medical Center

and Fleming County Hospital

Comprehend using KHIE to

deliver Comprehend CCD,

Medicaid data and lab results to

Primary Plus

• KHIE required modifications Must release all patient data Must release all patient data to all

providers in the HIE Must release all types of data Must release all data for all uses TPO

• TPO is also required by the GOEHI participation agreement• Requires a 6 month consent period• If another consent is not signed within 6

months the consent expires

Consent Form

Importance of explaining use of health information for treatment

Background explaining source and development of the consent form gives it credibility

Importance of explaining form for release of behavioral health records and 42 CFR Part 2 only

Finding

Goal to determine if consumers understood the consent form

Consumer Input

The patient needed assistance from medical office staff, advocate, or mental health mentor to complete the form

Finding

Goal to determine if consumers agreed form needed staff assistance for completion

Consumer Input

Consumer Input

Open comments received:

Form should have larger font even if increased number of pages

Signature from guardian only allowed if guardianship order produced

Suggestion that KHIE video Kentucky doctors discussing the use of KHIE and how it helps doctors treat patients

Behavioral Health Education Center Partnership

UK HealthCare CECentral

Mission StatementUniversity of Kentucky HealthCare CECentral delivers high-quality live and enduring continuing professional development activities to health care professionals using evidence-based practice, adult learning principles and innovative web-based technology.

Vision StatementUK HealthCare CECentral aims to be the premier provider of continuing professional development for health care professionals in Kentucky and to establish our educational and technological resources worldwide.

PurposeUK HealthCare CECentral provides health care professionals continuing professional development activities to increase knowledge, competence and performance levels for better patient-centered care, improved patient safety and enhanced clinical outcomes.

UK HealthCare CECentral

KHIE will be hosting Behavioral Health Education Center modules on the University of Kentucky HealthCarewebsite. http://www.cecentral.com/behavioralhealth

UK HealthCare CECentralplans to issue statementsfor up to 1 hour of creditper module for AMA PRACategory 1 Credit™,Social Work andPsychology to eligibleparticipants completingthe CE Activity.

UK HealthCare CECentral

Planned Modules for Behavioral Health CE Credit include:

I. An OverviewII. Integrated Care IIII. Integrated Care

IIIV. Consent Form

OverviewV. Consent Form

Case Studies

KHIE & UK HealthCare CECentral collaborated in developing a needs assessment, learning objectives, goals, expected outcomes and an evaluation tool for the CE Activity.

UK HealthCare CECentral

Activity Modules

Overview

• What is KHIE?• National Perspectives• Behavioral Health

Overview

Integrated Care I

• Overview of IC• Reflection from a

Primary Care perspective on IC

Integrated Care II

• Traditional IC• Pennyroyal’s

Story• Non Traditional IC

• Kentucky River

Consent Form I

• Overview• Why, Who,

When?• Form Details

• Screen Demo

Consent Form II

• Cases in Consent• Patient

Situations• Options

• Refusal?

UK HealthCare CECentral will issue statements of continuing education credits to eligible participants once training has been completed.

Training

I. IntroductionII. BackgroundIII. Connectivity

I. Connectivity Option 1: Participants with CCD Capability

II. Connectivity Option 2: Participants without CCD Capability

IV. Presentation• The KHIE Connection

Partnering to Improve PATIENT Health Outcomes

KHIE Consent Form for Behavioral Health Centers

V. Patient Consent and Authorization Form for Disclosure of Certain Health Information to the Kentucky Health Information Exchange

VI. Kentucky Health Information Exchange Consent Explanation for Behavioral Health Patient Records

VII.Training for the KHIE Consent Form for use in Behavioral Health Centers

I. Consent Explanation FormII. Rules Regarding Consent

Kentucky Behavioral Health Stakeholders Training ManualTable of Contents

Projected Consent Form Use

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Western

State

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61

24

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125

84

118

50

7

121

43

113103

8

Average Daily Census

Kentucky State-OwnedBehavioral Health Facilities

For additional information contact:Karen.Chrisman@ky.gov

For information on Kentucky’s Behavioral

Health Training Manual contact Charlese Blair at

Charlese.Blair@ky.gov