Title: Mental Health and Physical Health: Barriers to and Strategies for Improved Integration
1Mental Health and Physical Health Barriers to
and Strategies for Improved Integration
Beth Zimmerman and Renee Schwalberg Health
Systems Research, Inc. National Policy Center for
CSHCN AMCHP Annual Meeting March 27, 2001
2Who Are We Talking About?
- Children with Special Health Care Needs
- General population of children
3Context
- Importance of service integration for CSHCN
- Previous studies highlighted fragmentation
between mental and physical health
services/systems - Timely Issue
- Surgeon General Report on Mental Health
4Study Focus
- Purpose of Study Glean lessons about
fostering service integration that can be
applied in other states/communities - Target Audience Child health, mental health,
health care financing communities - Intended Use Promote integration between
physical and mental health service delivery
systems
5HSR Study Approach
- Expert Meeting (October 2000)
- Case Studies (Early 2001)
- Reconvene Expert Advisors (April 2001)
- Final Report (May 2001)
6Research Question Domains
- Barriers and Strategies
- Services and Delivery Systems
- Financing
7Case Study Sites Criteria
- Program maturity
- Diversity of
- Program model
- Strategies used for integrating services
- Source of financing
- Target population
- Location
-
8Case Study Sites
9Primary Integration Strategies
- Cross-Jurisdictional Interagency
Relationships - Care Coordination
- Information Sharing
- Shared Financing
10Integration Strategy Cross-Jurisdictional
Interagency Relationships
- Multiple and diverse agency relationships cut
across jurisdictional lines - Challenge of reconciling different agency
mandates and cultures - Win/Win situation
11Integration Strategy Care Coordination
- Central strategy to promote integration
- Local situation drives care coordination
model - Family involvement defining feature
12Integration Strategy Information Sharing
- Clinical Records
- Informal sharing
- Formal sharing
- Program/Fiscal Management
13Integration Strategy Shared Financing
- Role of grants in launching integration
efforts - Longer term funding required
- Numerous relevant funding streams
- Challenge of blending diverse funding streams
to accomplish common goals
14Conclusions
- Recognition that multiple agencies serve the
same children - Importance of shared decision making
structures at all levels - Leadership to move ahead
- Participation of high-level decisionmakers
with authority to make and keep commitments -
15Conclusions (contd)
- Ongoing involvement of planners in
implementation and monitoring - Structure for and commitment to nurturance
and problem-solving - Importance of evaluation to show return on
investment
16Next Steps
- Finalize Report
- Timeline End of May 2001
- National Center for Children with Special Health
Care needs Web Site - www.jhsph.edu/centers/cshcn