Combining forces, gender-affirming care providers from across the country share their secrets to successful patient encounters when meeting with adolescents and their caregivers who have varying degrees of hesitancy in the gender exploration process.

Abstract: In the past decade, gender research has moved from a deficits-based approach to a resiliency-focused lens, but how does that translate to practice? This Extended Learning Opportunity creates a safe environment to learn, practice, and explore gender while building resiliency in our patients, families, and within ourselves. This workshop will be highly interactive including a live-action role-play of an initial gender clinic consultation appointment and participant activities.

This workshop will contain three distinct sections:

1. Anatomy of a gender appointment- model an initial gender consult and discuss ways to include the patient and family in the goal-setting process, as well as avenues for gender exploration that are developmentally appropriate and resiliency-based.
2. Group collaboratives: Small group work to discuss opportunities for advocacy and education within systems, strategies for promoting social affirmation, and medical affirmation steps that promote patient autonomy.
3. Gender exploration: Individual reflection for diving into our own gender euphoria and how this affects the care we provide and promotes our own healing.

Emerging data reveals that real-world integrated care provision often does not align with a specific model. Systems implement integration elements but struggle to achieve sustainable, transformational change. This presentation leverages systemic change management principles to facilitate customized implementation of integration key elements to meet population health needs. We will review processes to assess and manage system facilitators and barriers and methods to select, prioritize, and achieve key integration elements focused on population needs. Participants will apply these processes to develop a customized implementation plan for their home system, identifying next steps and longer range planning towards transformational change.

Suicide continues to be a major public health concern and more and more it is critical for leaders and organizations to have an approach to suicide safer care across their organization, reaching consumers, team members and organizational processes. This workshop will provide a comprehensive overview of what organizations have done and some specific best practices.

This workshop will provide organizational leaders along with clinicians some new thoughts in organizational and clinician response to suicide and specifically how to identify, stratify, report on and track outcomes for individuals at risk.

In particular this workshop will provide specific pathways and in the weeds” operational suggestions to help leaders be successful. Additionally, there will be specific discussions around pathways and recent changes in understanding around organizational and clinician responses to suicide, measuring and thinking about outcomes, health record implementation, and organizational responses.  This includes specific resources and guides for managers around organizational responses as well as sample documents, pathways and training approaches.

Recent controlled trials (see references) have documented relief of chronic non-structural pain or illness (not merely improved coping) from new forms of psychotherapy that focus on trauma, stressful personality traits, unrecognized negative emotions, psychosocial triggers and limitations in self-care skills. Patients suffering from migraine, fibromyalgia, irritable bowel, pelvic pain, medically unexplained symptoms, most cases of long covid, chronic fatigue, and low back pain and many more can benefit. These concepts can readily be used by Mental and Behavioral Health Clinicians in an Integrated Care setting. A series of typical case studies will be presented to illustrate the principles of a successful approach to this population.

This workshop will incorporate several digestible learning frameworks to help bring clarity and thriving amidst the chaos of primary care behavioral health. These learning frameworks will help leaders and clinicians alike unlock the benefits of this approach.

The presenters will describe how identifying a vision and delineating guiding principles helps give cohesion to a PCBH service. Additionally, they will discuss key mindset shifts that further help to unlock the power of primary care. In addition to a vision and mindset shifts, the presenters will explain digestible frameworks that can be implemented right away.

Primary care is a chaotic and demanding environment. There is never enough time, resources, staffing or funds. How can a service, especially a service that hasn’t always been historically included as part of the medical system, thrive in such an environment? That’s exactly the issue the presenters will take on in the presentation.

The presenters will introduce and break down a number of frameworks. These include  delineating the original goals and vision of primary care as a whole as well as the core principles of PCBH. They will present a number of mindset shifts such as having single session or “one at a time” approach to care. Additional frameworks will include how to use functional contextualism, the contextual interview, and the ACCESS-V framework to help clinicians maximize their ability to help their patients.

It is important for clinicians to be well versed in health conditions, evidence-based practice, and theoretical orientations. It is also very important to learn patients’ context as well as use their expertise to collaborate and make pragmatic plans. The presenters will introduce an original diagram to help guide clinicians through this process.

Overall, this presentation is designed to help anyone in primary care behavioral health learn to use digestible pnemomics, frameworks and diagrams that provide clarity amongst the primary care chaos.

The purpose of this workshop is to provide a hands-on training experience on giving effective feedback in the context of clinical supervision in primary care. Participants will understand the importance of feedback in trainee development, discuss evidence-based feedback models, as well as troubleshoot impaired trainee scenarios. This workshop is for behavioral health clinical supervisors who provide or will provide clinical supervision to pre-licensure level behavioral health trainees within the primary care setting.

Clinical supervision is a primary teaching approach used in clinical settings for behavioral health trainees (e.g., clinical mental health counseling, marriage and family therapy, psychology, and social work). While there are competencies specific to clinical supervision in mental health settings, the specifics of clinical supervision by behavioral health professionals in primary care remain nebulous due to minimal guidance on how to be efficient and effective when providing clinical teaching in the primary care setting. The purpose of this workshop is to provide a hands-on training experience on giving effective feedback in the context of clinical supervision in primary care. Although the focus of this workshop will be on clinical supervision within the Primary Care Behavioral Health Consultation Model, this workshop will be effective for those who provide clinical supervision within a hybrid care approach as well. Participants will understand the importance of feedback in trainee development, discuss evidence-based feedback approaches, and troubleshoot impaired trainee scenarios specific to primary care. This workshop is for behavioral health clinical supervisors who provide or will provide clinical supervision to pre-licensure level behavioral health trainees within the primary care setting.

Join the Pediatrics SIG Leadership Team as they provide an overview of the impact of technology use on children and youth and offer practical guidance on its usage across developmental stages. This ELO will also discuss ways technology can enhance the delivery of evidence-based interventions. Participants will have the opportunity to collaborate with Peds SIG leaders to develop a toolkit to address and/or leverage technology use in their clinic.

Abstract

In the realm of pediatric care, the utilization of technology raises concerns regarding excessive screen time, social media engagement, and potential impacts on behavior, including bullying and aggression. However, there is also growing interest in leveraging technology to engage young individuals and deliver interventions in innovative and accessible manners. This ELO aims to examine these dynamics across three developmental stages—early childhood, school-aged, and adolescent—and provide insights into evidence-based practices and research findings concerning technology guidance and interventions for both families and clinicians. Each segment of the session will dedicate time to explore the impact of technology, offer guidance on its usage, and present practical tools tailored to the specific developmental stage. Moreover, participants will have the opportunity to engage in discussions and collaborative activities to assemble resource toolkits applicable to their practice settings.

The session focuses on strategies for policy advancement at state and regional levels, creating a collective learning environment where participants can deepen their understanding of promoting systemic change for health integration. Through discussions on cross-sector collaboration, strategy formulation for shared visions, and incremental policy changes, attendees will explore practical techniques to implement in their own state or region. This session will equip participants with the knowledge and skills necessary for fostering significant policy and practice transformations in health integration, leveraging the expertise of leading professionals in the field. Additionally, the session emphasizes the importance of cultivating long-term relationships with stakeholders across various sectors, highlighting how these partnerships can be a cornerstone for effective change. Attendees will engage in interactive activities to enhance consensus-building and strategic planning, ensuring they leave with actionable insights and a pathway to achieve long-term impact in health policy and integration efforts.

This interactive session will break down the Systematic Caseload Review (SCR), the secret sauce of a successful Collaborative Care (CoCM) program.  All roles on the CoCM team will benefit from this session, including Primary Care Providers, Behavioral Health Care Managers (BHCMs), Psychiatric Consultants as well as implementation leaders. There is a lot that goes into an effective SCR. Participants will learn best practices for preparation, structuring the actual SCR session, as well as follow-up and communication workflows. We will discuss common challenges and possible solutions, as well as measuring the success of your SCR.

Abstract

Collaborative Care (CoCM) is an evidence-based, integrated model for the treatment of common mental health conditions in medical settings. This workshop will focus on a critical component of CoCM, the Systematic Caseload Review (SCR). The SCR is the regularly occurring meeting between a Behavioral Health Care Manager (BHCM) and Psychiatric Consultant in which priority patients are reviewed and treatment recommendations are provided. This interactive workshop will break down team roles, responsibilities and all components leading up to, during, and after the SCR meeting. Preparation for SCR involves reviewing the registry to prioritize patients and support population health management. Participants will learn how to identify patients for consultation using prioritization categories. It is important for the BHCM to gather and efficiently present critical information during SCR. Adequate preparation and setting a structured agenda helps ensure there is time to discuss multiple patients. Participants will also learn best practices for documentation of recommendations as well as communication workflows related to SCR. Participants will consider scenarios that can undermine the effectiveness of SCR, and problem-solve solutions to these scenarios. Lastly, we will discuss metrics for ongoing monitoring and quality improvement of the SCR process.

Designing, implementing and sustaining a successful Collaborative Care (CoCM) program requires a strong vision, detailed clinical workflows, and the ability to recognize and resolve implementation challenges. This workshop will cover the fundamentals and key components for implementation to fidelity. This will include the five core principles of CoCM and strategies for implementing them at both programmatic (e.g., billing, workflows) and clinical (e.g., measurement-based treatment to target with brief evidence-based behavioral interventions) levels. In addition, participants will engage in interactive activities focused on visioning, workflows, and solving implementation challenges. Ample time will be provided for questions and discussion.

Abstract - Collaborative Care (CoCM) is an evidence-based, integrated care model for the treatment of behavioral health conditions in medical settings. Efficacy of CoCM has been demonstrated by more than 90 randomized controlled trials worldwide but significant practice change is required to effectively implement and sustain CoCM. This multi-component, team-based clinical intervention only works when clinical team members know their roles well and are prepared to overcome clinical and programmatic challenges. This workshop will cover the key components, both programmatic and clinical, for implementation to fidelity. This will include the five core principles of CoCM and strategies for implementing them at both programmatic (e.g., billing, workflows) and clinical (e.g., measurement-based treatment to target with brief evidence-based behavioral interventions) levels. When these principles are combined and effectively implemented CoCM programs function well. When implemented to fidelity, the clinic team will be poised to bill the CPT codes for the model and bring effective behavioral health care to a larger population in need of care. In addition, participants will engage in activities focused on visioning, workflows, and resolving implementation challenges. Ample time will be provided for questions and discussion. This session is most appropriate for program leaders and clinicians who are interested in learning about the fundamentals of CoCM and its effective implementation. The workshop will be led by Diane Powers, Co-Director of the University of Washington AIMS Center, and Dr. Patty Gibson, psychiatrist and co-founder of the Arkansas Behavioral Health Integration Network. The AIMS Center has been providing implementation support to diverse healthcare organizations, both nationally and internationally, for over 20 years and Diane will draw on that deep knowledge and expertise for this workshop. Similarly, Dr. Gibson will bring her clinical expertise and implementation experience to the session.

This presentation provides a description of an interdisciplinary, collaborative care approach to improving blood pressure control for patients across service lines, including primary care, community psychiatric rehabilitation, and behavioral healthcare home services. The approach involves identification and communication of out-of-range blood pressure readings to the team, scheduling appointments across disciplines, and providing education to staff and patient. The goal was to intervene with sufficient frequency to get patients' blood pressure lower, and data from the PDSA cycle shows that at the 6 month follow up, 90% of patients showed a reduction in BP from baseline, with 17% falling within the normal range.

Given the nationwide shortage of behavioral health professionals, there is a clear need to offer scalable and sustainable training in person-centered communication. This session will describe efforts at developing and deploying artificial intelligence bots (via ChatGPT4) to as a training tool to supplement didactic course offerings in motivational interviewing. Initial data related to fidelity to motivational interviewing, feasibility of integration into courses, and potential future directions will be explored.

Part of the medical provider track

Education that promotes the development of cultural humility and cultural responsive clinical work among healthcare providers may help address healthcare disparities faced by underserved and minority populations. Community Engagement Experiences and directed self-reflection may be pedagogical techniques best suited to address this area growth with healthcare providers. This study examined a Community Engagement Experience and directed self-reflection teaching strategy’s effect on the development of cultural humility among student behavioral health providers. Masters level student participants (N = 7), engaged in a Community Engagement Experience providing mental healthcare to an underserved population in 2023. Participant reported experiences were synthesized into four categories: self-reflection, acclimation, service work, and growth. Results indicate Community Engagement Experiences paired with directed self-reflection to be a promising teaching modality in the development of cultural humility with behavioral health providers and other healthcare professionals. Implications and areas of future inquiry are discussed.

This session describes the development of an integrated behavioral health program in a large primary care clinic over the course of two years from initial implementation. We describe iterative developments over the course of the program, barriers and facilitators to program implementation, and perceived impact of the program as measured by the Practice Integration Profile. Target audience is primary care providers, administrators, and staff who have either recently or will soon implement an integrated behavioral health program and will learn how to apply and measure the impact of their program over time.

Nationally, rates of behavioral health disorders in children are increasing and there is a shortage of behavioral health and pediatric specialists to support his growing need. Pediatricians seek to increase their competence in caring for children with behavioral health needs within the medical home. Using the ECHO Model and a multidisciplinary group of specialists, the authors provided education to primary care providers (PCPs) about behavioral health topics that commonly present to primary care. In this session attendees will learn about how the ECHO model can be used to increase PCP’s capacity to care for target populations and thus decrease health disparities in behavioral health care.

Teaching in residency education and integrated care requires faculty and clinicians to devise efficient strategies for engaging learners (Stalmeijer et al., 2013) as well as patients to enhance evidence-based practice and teaching. Clinical teaching encounters deliver important content “just-in-time” for medical learners to put the knowledge to use (Rourke et al., 2016). One innovative way to improve the impact of these "just-in-time" teaching encounters and share knowledge in a visually appealing manner to patients is through infographics, which can be effective when strategically and meaningfully designed (Yarbrough, 2019). Infographics in medical education have been used to summarize important content, impart procedural knowledge, and facilitate faculty development (Orner et al., 2020). This presentation will focus on teaching participants how infographics can be used in a busy clinic environment, to impart just the right amount of information and to enhance learning during patient visits and precepting.

This presentation will describe the development, implementation, and results of a family medicine residency education program to address obesity prevention in underserved youth in Fort Worth, Texas. The program consisted of educational topics on patient and community engagement. The use of the Americans in Motion - Healthy Interventions framework and tools were used to design an interprofessional group medical education visits for youth and their parent/guardians and for community based health education presentations at several organizations in the neighborhoods that the clinic served. This approach was successful in improving overweight/obesity knowledge, attitudes, and practice patterns for residents in clinic, increased knowledge and health behavior practices in group medical participants, and increased positive engagement with the community in the underserved area that the clinic served.

In the state of Tennessee, 13% of all women with a recent live birth reported symptom of post-partum depression according to the United Health Foundation (2024). This prevalence is greater in those who identify as a person of color, are under the age of 24, and/or are new to America (refugee/immigrant). ConnectUs Health, an FQHC located in Nashville, TN serves an elevated number of recently immigrated patients, as well as those who live in the surrounding communities, with many of the patients at a higher risk of social and behavioral health needs. This session will provide an in-depth look at the team- based processes that were developed to identify needs, provide resources, and implement interventions early in pregnancy. The team includes Certified Nurse Midwives, a Women's Health Nurse Practitioner, a Behavioral Health Consultant, a Doula, a Psychiatric Mental Health Nurse Practitioner, and Community Resource Navigators who provide care from the first positive pregnancy test up to a year after birth.

This session brings CFHA members and the AHRQ Academy for Integrated Behavioral Health and National Integration Academy Council (NIAC) together to discover what they can do together to advance the field of integrated behavior health. The session concludes with steps toward collaborating as organizations in top areas of need identified by session participants. Historical context and purposes for the two organizations set the stage for this interactive conversation between session participants and leaders of both organizations.

Relapse Prevention Planning (RPP) is a technique borrowed from substance use disorder care that has been used in the treatment of depression and other common mental health conditions treated in primary care for over 25 years. Despite the strong evidence base for including this as part of an effective integrated care program, Relapse Prevention Planning is often overlooked or done in a cursory way. This activity-based session will use patient cases and other activities to explore the key components of an effective Relapse Prevention Plan, how to introduce it to patients, optimal timing, using the plan with the care team, helping patients optimize the use of the plan as a self-management strategy, and other considerations.

Through research developed over the past 30 years, adverse childhood experiences (ACEs) are recognized for their influence on youth, adults, and communities; often identified as toxic stressors. Researchers have more recently focused on factors that buffer the long-range effects of these traumatic experiences. The Protective and Compensatory Experiences Survey (PACES) was developed to assess factors that moderate the effects of ACEs (Morris et al., 2014). The presenters for this session have led systemic trainings, practice, and research publications related to the ethical and relational use of questions pertaining to ACEs, PACES, and adverse adult experiences in school, military, and primary care health systems. This session will focus on an overview of (a) ACEs, PACES, and adult adverse experiences, (b) practices of concern and practices that promote systemic and ethical interactions when incorporating ACEs and PACES measures in school, military, and primary care health settings, (c) findings from use of ACEs and PACES in school, military, and primary care health contexts.

The Veterans Health Administration (VHA) launched a national Competency-based Training (CT) for VHA Integrated Primary Care (IPC) healthcare professionals in 2017. Since that time, more than 4500 healthcare professionals have been trained via this multi-phase CT comprised of self-directed learning, face-to-face training, and role-play skills demonstration utilizing a train the trainer model. Recently, innovative products have been designed and added to the CT to enhance training experiences of participants and trainers. This panel discussion will provide an overview and demonstration of key innovations (e.g., a metaphor to simplify complex topics, videos, and training tools) with ample time to dive deeper into the innovations during panel discussion in response to audience questions. Our target audience is those interested in innovative methods to engage participants and maximize training of integrated healthcare team members, and attendees will have the opportunity to learn about and actively discuss innovative products to enhance IPC trainings.

The integration of behavioral health pharmacy services in primary care not only increases access to brief and effective mental health care, but it also provides a practical and valid method to address psychotropic medication management need for patients with mild to moderate mental health disorders (Pomerantz et al, 2008). This level of integration also bridges the gap between primary care and psychiatry (Silvia, RJ, 2014). With about 80% of all psychotropic medication being prescribed in primary care and about 90% of benzodiazepines being prescribed in this context as well (Olfson, et al, 2019), it is imperative to find new ways of increasing awareness of best use of these medication for a variety of different diagnoses. Furbish and colleagues in their 2017 study found that a pharmacist-physician collaboration lead to lower rates of benzodiazepine prescriptions for both anxiety and insomnia diagnoses, we are interested to see if we found the same through an integrated care model approach.

This session provides and overview of the current state of reimbursement for behavioral health integration, with a focus on Collaborative Care and General Behavioral Integration. The presenters will provide a broad overview of barriers and specific advocacy efforts that have yielded changes in the reimbursement of integrated behavioral health.

The Collaborative Care Model (CoCM) is an evidence-based model for mental health care that improves access, clinical outcomes, and patient satisfaction with demonstrated efficacy in community health settings and for historically marginalized individuals. Wide-spread implementation is currently limited by sustainability concerns including lack of a reimbursement structure that maintains fidelity to the original model, particularly in rural and underserved areas (Copeland et al., 2022; Lombardi et al., 2023). This presentation will detail practical experiences and lessons learned from implementing a grant funded psychiatric CoCM pilot program in two rural FQHC settings with existing integrated behavioral health models that transitioned to an enduring billable service. Presenters will describe how federal funds supported development, implementation, and preparation to bill for services. This session is intended for leaders at FQHC organizations, academic-community partnerships, evaluators, and researchers.

As individuals age, the impact that medications can have on them changes as the functions of their bodies naturally change. At the same time, older adults are more likely to have chronic conditions which often are managed by medications. Deprescribing is a term used to describe the process of assessing the risks and benefits of medications and helping patients to reduce the interactions and side effects of medications by determining what is needed and what is not and discontinuing medications for which there is a greater cost than benefit. This process can take time and can be anxiety provoking for patients, especially if medications that are managing pain, anxiety, or sleep are involved. This presentation will discuss how Behavioral Health Consultants/ Specialists can support providers and patients through this process and empower patients to manage their health conditions effectively with behavioral change.

This presentation illustrates the implementation process for pre-clinic huddles across two primary care healthcare systems. The primary aims of these projects were to promote greater behavioral health integration and to improve team communications and quality patient care within their family medicine, pediatric, and ob/gyn primary care clinics. This presentation outlines approach strategies used to address staffing challenges, poorly defined team member roles, and barriers to interprofessional communication.

Medical Assistants– Day in and day out they show up and care for our patients with often limited acknowledgement. They are the first face many of our patients see and can set the tone for a patient’s experience. As we continue to innovate what integrated care means, how can we better incorporate the skills and rapport of our MAs? Join us in this discussion as we share the emerging results of pilot programs that pair MAs with BHCs to further our integration efforts!

In response to the long-standing challenges and risk of poor health outcomes associated with traditional models of behavioral health services, Merakey’s Reverse Integration System of Care (SOC) brings the individuals served, their families, and supports together to improve outcomes for those with complex behavioral health challenges, multi-system involvement, and need. The SOC approach emphasizes that types and combinations of services should be based on the individualized needs of every person walking through the door, with “no wrong door” as the entry point. Rather than traditional “intakes” for specific service, a SOC embodies a philosophy of assessment and referral. Individualized assessment and treatment planning determines the intensity and type of services and supports that would be most beneficial to the individual. This requires understanding that “one size does not fit all.” We will walk through three models of Reverse Integration: CCBHC clinics, COE in a Methadone clinic, innovative program involving coordination of 13 different programs into one System of Care.

Clinicians who might engage in program evaluation, quality improvement, and/or research on their innovative ideas may feel intimidated by the process given a variety of potential challenges. We will present a case example of a clinician innovator’s journey partnering with integrated care researchers to collect pilot data to evaluate a promising transdiagnostic group intervention. After briefly describing the intervention and setting (5 minutes), we will share a variety of challenges (e.g., lack of dedicated time, complex human subjects research review process) that the clinician innovator faced along the way as well as how she navigated them (20 minutes). Then attendees will break into small groups and complete an interactive activity to facilitate brainstorming solutions to barriers faced at their own sites (20 minutes). To conclude we will debrief as a large group (15 minutes) and share ideas for practical yet powerful next steps that clinician innovators can take to maintain momentum toward research and evaluation.

This presentation reports on a qualitative study with Hispanic/Latinx patients (n=20) with unmanaged type 2 diabetes on their knowledge, preferences, and insights related to type 2 diabetes self-management and programming. Interview data were analyzed using rapid analysis procedures and indicate that patients face cultural, economic, and environmental barriers to diabetes self-care and healthcare. This presentation will engage participants in discussing ideas for the development of programs and pathways that enhance equitable access to culturally appropriate diabetes care.

Despite commonalities shared between second-wave (CBT) and third-wave (ACT) behaviorism, there has historically been a friendly (or sometimes not-so-friendly) rivalry between the two approaches that may leave some clinicians feeling like they have to “pick a side” and practice only one approach or the other. However, several research studies have shown that these two approaches can be combined to effectively treat common mental and behavioral health concerns. Accordingly, this presentation will highlight how cognitive defusion (ACT) and cognitive restructuring (CBT) can be combined within the same brief intervention to effectively treat a wide variety of presenting concerns commonly seen within integrated behavioral health settings. Participants will receive copies of a novel, 1-page handout (created by the presenter) that incorporates both approaches and can be used for both providing psychoeducation during visits and for helping patients make practical changes in their lives between visits.

Behavioral health financing has long been a challenge for organizations implementing behavioral health integration (BHI) in many regions, specifically in California due to complexities with health plans carving out behavioral health coverage (among other issues). In this presentation, we will present findings from a series of California interviews with provider organizations, health plans and other stakeholders. Interviewers were asked about current practices, challenges, workarounds and solutions they would recommend improving the efficiency of BHI payment with an eye toward sparking implementation and program sustainability. Our team will highlight interview themes and opportunities for statewide alignment between provider organizations that could improve patient care, improve value, provide workforce support as well as provide value-based care. .

Suicide is a public health crisis and ranks among the leading causes of death in the U.S. for most age groups. Emerging digital behavioral health (dBH) technologies show potential to detect, stratify, and intervene — regardless of when or where SI occurs. This session presents two studies assessing a dBH platform's effectiveness in detecting hidden suicide risks in patients from various healthcare systems, payor networks, and organizations who used the platform as an adjunct to their traditional care. The first study explored the use of natural language processing (NLP) to detect SI and enable intervention. The second study used dBH-administered ecological momentary assessment (EMA) of affective and physiological states to predict the 30-day risk of SI based on responses to self-harm questions.

The landscape of primary care has changed drastically over the past few years, yet the basic tenants remain the same. With burnt-out PCPs, extreme staffing shortages, and financial struggles, putting patients first and team-based care becomes more challenging, and things that we know will help seem the most challenging to achieve. Can integrated care help heal and if so, how? This presentation will discuss specific initiatives and share complete training programs developed in active primary care practices that are assisting in reducing PCP stress, revitalizing our teams, and increasing financial sustainability.

Scope of practice (SOP) defines the outer parameters of the permitted activities of a specific profession. As behavioral health clinicians (BHCs) in integrated settings, our scope intentionally blurs with the scope of other disciplines. This can be both a source of liberation and anxiety–especially since BHC scope of practice has never been clearly defined. This session will present a new model for defining BHC scope of practice, including ethical considerations and application to training, on-boarding, credentialing, and advocacy.

This presentation directly aligns with the conference theme of innovating in the pursuit of healing by addressing a common neurological disorder (dementia) and utilizing technology to find an innovative way to arrive at the most accurate diagnosis possible and develop effective treatment goals. This presentation will examine workflows of an integrated care team. It will also address incorporating the family into treatment and providing community resources for patients living with dementia.

Supporting medication management is a critically important part of the role of a behavioral health provider, yet it is something many clinical social workers and licensed counselors did not receive training in during their professional education. This interactive session will focus on the skills and knowledge a behavioral health provider needs to effectively support patients taking medications as part of their treatment plan. These include how to gather information from patients, medical considerations that can affect psychiatric medications, patient education about medications, helping patients navigate multiple medication trials, and scope of practice when discussing medications with clients. We will also discuss misconceptions about medications and how to approach common scenarios that can derail a medication trial.

Transgender youth continue to face numerous disparities in health outcomes and healthcare delivery. Patients have limited access to safe, welcoming, and knowledgeable mental health and medical care. We present an integrated care pathway at a Federally Qualified Health Center in Washington State based on the Primary Care Behavioral Health (PCBH) model. Our integrated group of primary care physicians, psychologists, pharmacists, nurses, and medical assistants support pediatric patients and their families with non-medical and medical gender-affirming care while also supporting their primary care needs. Our model undermines several systemic barriers to care and aims to alleviate the health disparities faced by this underserved, and frequently politically maligned population of children.

This session reviews the evolution of the "Canadian" Collaborative Care Model and the forces that have shaped it. It describes the key components of the model including team-based care, support for self-management, building capacity within primary care and changing service delivery design to support collaboration as well as the core activities of Integrated Care. Finally it describes the ways in which integrated can assist in addressing wider problems facing many health care systems including improving access, family physician burnout, reducing the mortality gap and changing the trajectory of children at risk, with examples from different Canadian projects.

This session is intended primarily for beginning behavioral health providers working in a primary care medical setting (although we will be thrilled to have interested colleagues and collaborators across all disciplines join us and share their experiences and expertise). The primary goal for this session is open Q & A! All sessions require pre-defined learning objectives, so we will begin with a brief (but hopefully relevant and helpful) didactic presentation. First, we will provide a rapid review of the Primary Care Behavioral Health (PCBH) model. Then, we will briefly introduce Plan-Do-Study-Act (PDSA), a quality improvement model commonly used in healthcare settings, and provide examples of how a BHC might utilize it in their work. We will do our best to maximize the time available for Q & A, so bring your questions and be ready to share your own wisdom!

This session will serve as a primer on serving gender diverse patients within primary care settings. We will provide education on gender diversity, common presenting needs of this population, and current advancements in both integrated care and gender affirming care that make providers in primary care settings especially well-suited to offer services to this patient population. The focus will be on mental health support in the context of the primary care setting. Additionally, we will review current WPATH requirements and potential roles and contributions of various primary care team members.

The warm handoff (WHO) has long been considered an essential element of integrated behavioral health (IBH) and seen as critical to improving patient access and engagement with behavioral health services. While some studies have demonstrated that WHOs have the desired effect of improving engagement with behavioral health, other studies have revealed contradictory results. The presenters will share results from a study examining the impact of WHOs on patient access and behavioral health services engagement utilizing a large dataset, spanning 2018-2023 and collected from 10 integrated primary care clinics. The presenters will also engage attendees in exploring how they may leverage EHR data in their home institutions to explore the impact of WHOs.

Single session therapy has been used in Europe for many years in the form of walk-in clinics to help offer mental health services when there are long wait times for a standard course of therapy. If you work in integrated care, you know the value of being able to jump right in. Single session therapy offers a specific skill set to keep the parameters of the discussion narrow and to allow a clinician to move quickly. One session can make a big difference in the patient's immediate disposition by developing an action plan together and relying on outside support and assistance. This modality can fit into just about any model of integrated care (and you can bill for it!).

Evidence-based psychosocial interventions (EBPIs) delivered in integrated primary care (PC) have the potential to improve population health, particularly for rural patients with little access to specialty services. As a part of a quality improvement project designed to increase EBPI use by rural behavioral health providers (BHPs) in the Veterans Health Administration (VHA), a modified, low intensity, graduated training model for Problem-Solving Training for Primary Care (PST-PC) was developed and marketed to a variety of BHPs working in integrated care settings. The new training model, Problem-Solving Training for Integrated Care (PST-IC), was rolled out in November 2023 with a pilot cohort of BHPs working in rural VHA integrated care settings. Participant feedback following the training indicates a high degree of satisfaction with the new model, and post-training data collected regarding implementation suggests PST-IC skills are being integrated into training participants’ clinical practice. This presentation will spur discussion among frontline rural BHPs, program leaders, and researchers about improving accessibility and usability of EBPI training to enhance outcomes for hard-to-reach rural populations.

This session will include research evidence of racism in the occurrence of health disparities that plague many communities of color, particularly those in low-income areas. Additionally, in this session a community-based research and intervention approach to reduce racism-related and other health disparities will be set forth and described. Finally, examples of how this approach has been effectively used in low-income Black communities to reduce a health disparity disease and/or increase health promoting behaviors will be presented.

This session will be live during the conference. People can join by Zoom if they are not at the conference.

Join Zoom Meeting

https://us02web.zoom.us/j/83768186917?pwd=Xiba0RFC9isoPnZsHGCvUVoJwmMh24.1

Meeting ID: 837 6818 6917
Passcode: 086006

Dinner recognizing luminaries - includes luminaries, CFHA BOD and staff.

HealthPoint has been training Behavioral Health students, interns, and post-docs in the PCBH model of care for 20 years. We want to celebrate this anniversary by inviting alumni of HealthPoint to an event on Thursday evening. If you worked or trained with us at any point since 1971, please join us for food and drinks. RSVP by completing the form at: https://forms.office.com/r/buKrHgR7dh

Dr. Allred will provide the location before the event. Contact Robert Allred with any questions here.

Join your PCBH colleagues at a this social event. (Self paid. Open to everyone)

More details to follow. 

The United States is increasingly diverse. Latinos comprise 19.1% of the U.S. population, and are expected to comprise well over 25% of the population by 2050. But a variety of health disparities threatens the future wellbeing of Latinos and, by extension, the nation. These disparities are driven by non-medical elements – the social determinants of health (SDoH) – in which Latino experience inequities. These SDoH issues, ranging from a lack of healthcare access to unaffordable housing to experiences of discrimination and a lack of representation, have been built into governmental laws, economic policies, school systems, neighborhoods, businesses, research, and healthcare. Reducing health disparities requires communicating advocacy and action for system changes to improve social and environmental factors and create more equitable living conditions for Latinos. That is the aim of the Salud America! program at the Institute for Health Promotion Research (IHPR), led Dr. Amelie G. Ramirez at UT Health San Antonio. Salud America! is a national, theory-based, Latino-focused communication network that creates and digitally shares culturally relevant news, stories, videos, and action tools for grassroots health policy and system changes that address SDoH and health inequities. From helping people create resolutions on racism as a public health crisis to providing a data visualization dashboard for people to quickly identify local health equity issues, Salud America! is communicating with its vast network of followers to share news, data, and action opportunities to promote system changes that can help set the stage for reduced health disparities across the U.S.

The treatment of behavioral health conditions in adolescents is a critical component of mental health care, as this developmental stage is pivotal for psychological and emotional growth. Effective management of these conditions requires a comprehensive understanding of psychopharmacology to ensure that medications are used appropriately, considering the unique physiological and psychological aspects of adolescent patients. The incorporation of psychopharmacological knowledge into treatment plans can significantly improve outcomes for young individuals by reducing symptoms, improving quality of life, and preventing long-term consequences associated with untreated mental health issues. Applying psychopharmacological expertise in adolescent behavioral health is essential for fostering resilient, healthy individuals and communities.

Cognitive decline is a condition that impacts many older adults and which can have a significant impact on how they participate in their healthcare. While there are many screeners that give a bird’s-eye view of a person’s cognitive functioning (including the MMSE, MoCA, and SLUMS) these alone do not comprehensively represent the challenges and strengths of the individual. Many older adults who score in the mildly cognitively impaired range or lower are referred to neurologists or neuropsychologists for further evaluation which can include costly and lengthy tests and scans with questionable benefit. Moreover, this additional evaluation does not necessarily provide information that is useful to the patient, their families or their healthcare team in a timely fashion. For the past three years, our Arizona clinics have been providing brief neuropsychological assessments within our walls with a focus on determining the cognitive strengths and challenges of the patient as well as their current functional abilities and the goal to provide practical information for the patient and their families regarding safety, quality of life, functional assistance in addition to providing meaningful information to the healthcare team regarding their needs for any accommodations in communication, ability to manage their healthcare independently, and future planning for their healthcare. This presentation will describe the evolution of this project, the impact it has had on our patients and how a company that aspires to the PCBH model in value-based care is finding creative, quality interventions that are cost-effective.

Collaborative Care (CoCM) was first conceived about 30 years ago at the University of Washington. Since then, over 90 randomized controlled trials worldwide have proven that it is significantly more effective at treating mental health conditions in medical settings like primary care than usual care. The AIMS Center has spent 20 years supporting hundreds of healthcare organizations implementing CoCM for various behavioral health conditions experienced by diverse patient populations. We have learned some things along the way and this session will share those lessons.

Journey with a panel of leaders through a storytelling discussion about integrated behavioral health leadership in a variety of primary care settings. Panelists will intimately share their lived challenges implementing integrated behavioral health in primary care to give voice and space to the scars that develop through leading innovation efforts. Panelists will also discuss strategies they have implemented to remain connected to their whys and values while enduring the difficult journey. Participants will have the opportunity to begin understanding the universality of professional suffering and its presence within integrated behavioral health teams. This presentation serves to remind participants that they do not have to wear their integrated behavioral health scars alone.

Care-coordination at all levels of care have become challenging with the constant changes of healthcare and staffing shortages. As a result, it is important for healthcare systems and individual providers alike to assess whether their care coordination efforts are benefiting their patients and organization. One way to do this is to utilize quality improvement strategies such as PDSA, chart audits, prioritization matrix and teach back. Highlight the importance of collaborating with community stakeholders and healthcare partners to decrease readmissions.

In the complex world of health care, technological innovation has the potential to drive efficiency, reduce burden, and improve care delivery. Yet, even the most powerful technology is limited by the organizational change needed to make it effective. Complex problems demand more than a tech solution. This is especially true in healthcare, where a purely tech-driven approach often falls short. Technology cannot simply be thrown "over the fence" and expected to solve deeply rooted issues.

In this presentation,we will share the critical distinction between a software solution and service-enabled technology. We'll explore what these differences mean, alongside the relevant expectations and constraints, and then turn to how this applies to technology supporting Integrated Behavioral Health (IBH) models.

These models are increasingly reliant on technology - from validating screening tools and outcomes data to CoCM registries. We will scrutinize the roles, benefits, and limitations of relevant technological tools and discuss specific strategies for leveraging technology to enhance workflows, improve access, outcomes, and program sustainability. Technology, when thoughtfully implemented, positions healthcare systems towards Quintuple Aim.

We will also explore the intersection of systems change, technology, and program analytics. This includes addressing the inherent limitations of technology and the indispensable role of human expertise and clinical judgment. While technology can augment and support the delivery of healthcare, it cannot replace the nuanced insights and empathetic care provided by skilled clinicians.

Behavioral health clinicians working in smaller, rural integrated behavioral health centers will often find themselves in the challenging position of seeing multiple members of the same family, or seeing patients who are close friends or coworkers. This presentation will review recommendations for navigating ethical challenges within PCBH programs, highlighting differences between PCBH and traditional/specialty mental health approaches to ethics, as well as highlighting challenges unique to rural PCBH programs. The presenters will also share examples, lessons learned, and tips/tricks that they’ve learned practicing PCBH in a variety of different rural clinics serving several different types of patient populations.

Do you practice what you teach? Most of us, particularly those of us in helping professions, hold so much as we walk alongside our patients. Who holds you? Come, hold, and be held together in a time dedicated for self-reflection and self-compassion.

Supervision plays a crucial role in the growth and development of providers, helping them enhance their clinical skills. However, family-centered behavioral health providers face unique challenges when supervising in an integrated healthcare environment. This presentation will discuss strategies for navigating these complexities and offer considerations for engaging in family-centered supervision in integrated healthcare settings.

The presentation will discuss how integrating lawyers into the healthcare setting through medical legal partnerships (MLPs) addresses the social determinants of health. The session will provide an overview of the MLP’s innovations in screening, outreach, and training in response to the pandemic, racial inequity, technological advancements and the community’s needs. The target audience includes service providers, healthcare providers, attorneys, and community partners. Using the example of a successful MLP in a pediatric setting, participants will learn about the MLP model, best practices for implementing and sustaining an MLP and similar community partnerships, and common legal remedies that target and reduce adverse health outcomes in the client population.

This session provides attendees with a roadmap for the design, implementation, and evaluation of healthcare provider well-being programming. A current case study will illustrate effective program evaluation and “just in time” adjustment through the life of a project. Attendees will complete their own mapping using a comprehensive program evaluation formula (M.I.S.S.I.O.N.; Linfield & Posavac, 2019).

It is not easy to stay on top of new research, so come learn about new evidence-based behavioral interventions suitable for integrated primary care. Then, a more in-depth discussion led by Dr. Cully on his brief CBT for depression designed for integrated primary care settings to target depression within the context of somatic symptoms will occur. A discussion will follow on how to implement these interventions in real life practice.

Historically, integrated primary care (IPC) has served as the first-line and sometimes only point of treatment for many mental and behavioral health conditions. With a soaring demand for primary care provider (PCP) and BHPs’ limited time and resources in IPC clinics, the need for additional care management and scaffolding of care between patient appointments would greatly aid in the treatment of mental health concerns in IPC settings. Mobile health (mHealth) apps can provide a means to address healthcare disparities and combat common barriers to accessing behavioral health care experienced by underserved populations in IPC settings. Utilizing Hertlein and Blumer’s (2014) Couple and Family Technology (CFT) Framework this presentation addresses IPC providers’ perceptions around needed changes that would facilitate increased adoption and sustained use of mHealth apps in behavioral healthcare within IPC settings. Findings from a recent study that inform new provider and clinic workflows that incorporate the use of mHealth apps into clinical treatment, as well as identify areas of potential change both in behavioral health service delivery processes and the structure of IPC settings needed to sustain the use of mHealth apps in these settings are discussed. Additionally, findings of the study that identify key stakeholders within the clinical and larger system who are instrumental in integrating mHealth app use within behavioral health care in IPC settings and further pushing the IPC healthcare system into the digital age are presented. This session will address challenges, barriers, and benefits of using mHealth applications in the behavioral health treatment within Integrated Primary Care clinical environments. Process and structural changes needed in clinic workflows, policies, and training within IPC will be discussed.

While behavioral health integration into primary care has been well-established, the process of integrating behavioral health programs into medical specialty clinics is an innovative endeavor to further serve the goal of making our communities healthier. This presentation describes the process and experience of establishing a new behavioral health program in outpatient Neurology specialty clinics over the first year of implementation. We review lessons learned about our model, growth, as well as patient and provider perspectives. Presenters will be available for questions and consultation for attendees interested in implementation of integrated behavioral health services in their healthcare system specialty clinics.

Pediatric mental health stigma – misconceptions and fear of judgement, creates barriers to seeking and obtaining care.  This can often lead to the marginalization of children and families and the perpetuation of symptoms and distress. This session includes strategies to normalize mental health concerns in the primary care setting, such as using certain terminology, ways to introduce a provider in WHOs, and appointment strategies to address potential self-stigma. Attendees will be empowered to use these recommendations in their own practice to help decrease mental health care stigma with children, families, and within care systems.

Hidradenitis Suppurativa (HS) is a debilitating inflammatory condition causing painful lesions, often undiagnosed for a decade despite affecting up to 4% of the population, with women of color disproportionately affected. This stigmatizing ailment increases risks of mental health disorders and substance abuse, compounded by challenges accessing interdisciplinary care, especially in rural and marginalized communities. A novel approach integrating dermatology and behavioral health in group medical visits at a rural FQHC offers promise in improving patient experience, outcomes, and healthcare costs, with potential for further quality improvement initiatives and enhanced support for HS patients in primary care.

Part of the medical provider track

The August 2023 wildfires in Lahaina, Maui destroyed a community and displaced the majority of its members, requiring a coordinated effort between county, state, and federal agencies. While the existing emergency plan accounted for basic physical and medical needs, it largely neglected survivors’ immediate mental health needs. The result was a grassroots effort by local organizations and independent practitioners to respond to the acute mental health needs of the community. This presentation will review the disaster response timeline for the Maui wildfires and how the community’s mental health needs were assessed and addressed, from the viewpoint of an FQHC in that community.

To assess the impact of increased fruits and vegetables on the health of patients with chronic health conditions such as high blood pressure, high cholesterol, Type 2 Diabetes, and Obesity (BMI > 35). The Produce Prescription Pilot Program set out to determine if consuming fresh fruits and vegetables improves patients’ health. The program lasted approximately 16 consecutive weeks from July 1 through October 31, 2023, and participants received a box of fresh fruits and vegetables with tailored recipes on a weekly basis delivered to their residence. Participants were required to meet with a member of their care team (PCP, RD, BHC) at least once a month. These visits were designed to complement a participant’s routine medical care. Participants received recipes to support the preparation and consumption of the provided fruits and vegetables during the program. Participants health indices and health behaviors were measured through pre/post program surveys, as well as pre/post vitals and bloodwork. There was a significant change in participants health and health behaviors.

A journey through the efforts of regional interdisciplinary primary and specialty care teams surrounding increasing engagement and support for transgender and gender diverse patients and their families. Current projects include an ongoing regional interdisciplinary team meetings for systems engagement, advocacy, consultation, and collaboration. Development of a regional shared resource list and specialty referral list to aid in placing referrals with gender affirming providers. Additionally, implementation of Electronic Consultation model by which medical/behavioral health providers can submit request for consultation through EMR and receive consultation from providers with knowledge and expertise in gender affirming care.

The transition from military to civilian life after being found medically unfit for duty can be accompanied by uncertainty about the future, emotional distress, significant changes in finances and family life, and even thoughts of suicide (Hoffmire et al., 2022; Lee-Tauler et al., 2024). Military women may have unique experiences during this transition in relation to the physical and mental health conditions prompting separation and the support they receive (Boros & Erolin, 2021; Eichler et al., 2021; Lacks & Lamson, 2018). This presentation will provide an overview of the medical separation process and the findings of qualitative interviews with 18 women who were either undergoing medical separation from the U.S. military or who had medically separated within 12 months of the interview. Themes from the interviews include gender and sex-specific factors related to participants’ medical condition, the impact of the transition on identity (e.g., as a mother), the impact of the transition on families and relationships, and support received throughout the transition, particularly in relation to suicide risk. The presentation will conclude with recommendations for supporting women who are medically separating from the military.

This workshop will assist participants with transforming good ideas into successfully developed and submitted journal papers and funding proposals.  We will identify participants’ key concerns about developing their work. The workshop will have two main focuses: 1) elicit participants’ feedback about how the FSH editors can support their scholarly work and 2) provide didactic and hands-on experience turning your writing ideas into a finished written product. Participants are encouraged to bring ideas for manuscripts or proposals at any stage of development. These will be used for constructive critique and discussion by other participants.

Participants are encouraged to bring ideas for manuscripts or proposals at any stage of development. These will be used for constructive critique and discussion by other participants.

Families, Systems and Health is the CFHA Journal

Roundtable “Discussion Groups” are highly interactive and provide attendees ample time to share thoughts and ask questions about a topic. The concept is to exchange information around a particular subject and foster lively conversation among table guests. 

HOW IT WORKS

• A list of the Discussion Group topics and facilitators will be listed in the CFHA conference mobile app.
• Discussion Group topics will be posted on a round tables in the Ballroom. Seats will be reserved for the designated Facilitator; up to 9 seats will be available for conference attendees.
• Boxed lunches will be available at 11:45 as morning sessions adjourn. Conference registrants will pick up a lunch and find a seat at one of the 40+ tables holding Discussion Groups.
• The Facilitator will begin discussions at 12:05. Start with a brief introduction about their experience and work in the subject – no more than 5 minutes.
• Discussions end no later than 1:15 PM to allow transition time for afternoon sessions that convene at 1:30 PM.

Through collaboration with the Medical College and the Integrated Behavioral Health Team at Jefferson Health an introduction and shadowing experience for medical students was created. Students were asked about their experience and assessed knowledge of Integrated Behavioral Health before and after the rotation. Come explore results and lessons learned about the program offering, along with next steps.

This interactive presentation will discuss the development and maintenance of an innovative internal VA SharePoint (SPO) as a “Frequently Asked Questions” (FAQ) platform specific to IPC. The platform allows for continuous revision and update of the most relevant VA policy and IPC practice information, including embedded videos, graphics, document libraries, and other resources. The authors will discuss the creation/maintenance of this platform within VA and explore additional resources more widely available to the IPC community. Discussion of the FAQ content and sharing of resources between participants will be encouraged.

Since 2017, more than 4500 healthcare professionals have been trained in Integrated Primary Care (IPC) through the Veterans Health Administration (VHA) national Competency-based Training (CT). This presentation will focus on recent innovations and enhancements to CT featuring the addition of eight interactive learning groups. Learning groups were designed to augment previously asynchronous, independent-study content, tailoring training for collaborative care managers in response to needs identified by leaders and trainers in IPC. We will discuss selection methods for learning group content and format, and present participant knowledge and satisfaction data. Our target audience includes those interested in methods for training integrated healthcare team members for high fidelity, collaborative practice, and attendees will learn about content relevant to the training of collaborative care managers specifically as well as the process for tailoring and enhancing training materials more broadly.

This workshop will review data and findings from research of Concert Health data set of over 78,000 patients who have particpated in Collaborative Care . Data reveals best practices and delivery, engagement and outcomes in addition to outcomes across ages, regions, populations and payers.

A systems analysis of changes involved in the successful integration of behavioral health into primary care often fails to take into account the “sub-systems” we call human beings. The change, which we can also call “learning” of health professionals, can be understood in the same systems terms as organizations. Using the work of Gregory Bateson on systems and learning, we will discuss these changes as they have been studied in the implementation of the Patient Centered Medical Home model of primary care. Finally, we will describe clinical practices that can move the process of 2nd order change (or 2nd level learning) much faster, to the benefit of patients and health professionals.

What are the common narratives about integrated care? How might those narratives implicitly or explicitly influence the viewpoints disseminated and methodologies used in the field? A panel of Families, Systems, and Health editors will explore the potential barriers and facilitators impacting integrated care's continued evolution and adoption.

Over 60% of the population to not get sleep and insomnia is one of the commonest problems encountered in primary care. This workshop discusses the importance of sleep and the consequences o and presents a framework for understanding, assessing and treating commonly encountered sleep problems. This includes the five stage sleep cycle, the circadian cycle and the sleep wake cycle and how changes in these can contribute to sleep problems.It differentiates between a primary sleep disorder and primary or secondary insomnia, and the potential consequences of each of these and summarises their management. It presents a comprehensive but relatively succinct assessment framework for a sleep problem in primary care outlines the 4 major approaches to managing a sleep problem – sleep hygiene strategies, CBT for insomnia, the use of medications and the use of OTCs.

This engaging session is designed to inspire and empower women leaders by providing them with transformative strategies to overcome imposter syndrome, assert their strengths with confidence, and cultivate a supportive network. Attendees will leave equipped with actionable insights to elevate their leadership journey in behavioral health and beyond, fostering an environment of empowerment and collective success.

It is crucial to train Family Medicine Residents in mental and behavioral health and provide exposure to integrated behavioral health in primary care. This session will overview aspects of a multi-component Primary Care Training Enhancement Program, including the implementation of a grant-funded Behavioral Health Consultant (BHC) focused on resident education. The presentation will present preliminary data on BHC microteaching (targeted learning opportunities), will share data tracking methodologies to capture teaching moments between the BHC and Family Medicine providers, and will synthesize lessons learned through aligning behavioral health training initiatives. After attending this presentation attendees will be equipped to (1) describe strategies to align multiple behavioral health initiatives to enhance Family Medicine Resident training opportunities, (2) describe strategies to maximize Family Medicine Resident learning through microteaching opportunities with a BHC, and (3) describe strategies and lessons learned for interdepartmental innovation and collaboration.

This presentation aims to equip behavioral health (e.g., psychology, social work, marriage and family therapy, clinical mental health counseling, school counseling) students and new professionals for their role in the integrated workforce. More specifically, attendees will gain practical information and resources on job acquisition in integrated care settings. This panel will include trainees who recently completed as well as recently started clinical training rotations in integrated care along with clinical supervisors at these training sites. Topics include finding and interviewing for integrated care positions, specifically trainees from professional counselor and school counseling backgrounds given the recent reimbursement changes through the Centers for Medicare and Medicaid Services for professional counselors and marriage and family therapists.

Veterans with certain medical conditions (e.g., chronic pain, cancer) are at higher risk for suicidal ideation and may have mental health comorbidities but are not actively engaged in mental health services. This presentation will describe an innovative five-year demonstration project implementing embedded behavioral health consultants in select VHA specialty medicine settings, focused on offering same day access to mental and behavioral health care, engaging more Veterans at the right time and in the right place to advance whole person focused integrated healthcare. Preliminary qualitative and quantitative data from the first year of program implementation will be shared, including discussion of enablers and barriers to integration and attention to observed differences by specialty medicine clinic setting. Appropriate for frontline staff, champions, and leaders, this content seeks to aide attendees in their own planning efforts to expand integrated care beyond the primary care setting.

Integrated behavioral health (IBH) is a field rich with stories from behavioral health providers who have first-hand experience implementing IBH models into primary care settings. Qualitative interviews are a great research method for capturing how providers have “innovated in the pursuit of healing,” as they overcome the many inherent hurdles of IBH. This interactive workshop is designed for IBH implementers and leaders who want to learn how to identify the challenges, strategies, and leadership skills needed to successfully implement IBH using qualitative research interviews. Through a didactic lecture, interspersed with worksheets and small group discussions, attendees will: (1) learn the steps for conducting qualitative research interviews and (2) develop an interview guide. Findings from a qualitative study of behavioral health providers in New Jersey will be used as a case example, complementing the small group exercises.

The presentation explores the transformative power of Certified Community Behavioral Health Clinics (CCBHCs) in driving integrated healthcare delivery through a data-driven tiered approach to care coordination. Grounded in the principles of patient-centered care and whole person health, and supported by existing literature on integrated care models, the presentation explains how providers can use existing data sources to develop and implement innovative care coordination strategies. Attendees, including healthcare administrators, clinicians, and policymakers, will gain insights into the use of data to drive integrated care coordination and the rationale behind adopting a tiered approach within their organizations. Through real-world case studies and practical strategies, participants will learn how to optimize patient outcomes, break down silos between service providers, and foster collaborative solutions, ultimately advancing the pursuit of whole person care within integrated healthcare settings.

This workshop aims to describe the pervasive nature of ageism within health care systems and its detrimental effects on older adults. Participants will receive extant research and practical strategies to combat ageism, fostering a more inclusive and empathetic approach to elder care. By the end of this session, attendees will be empowered with actionable insights to improve collaborative health care practices ensuring older individuals receive the dignity and quality of care they deserve.

Join us for a discussion regarding ways to enhance relational health in primary care through brief, efficacious interventions. This workshop will lay out a training & learning collaborative that was intended to increase the internal capacities of behavioral health clinicians in primary care for children and families birth to five. This interactive, panel-led workshop will lay out the design and results of the workshop; and all participants will also learn a valuable, evidence-based tool that promotes relational health for children and families.

The integrated care movement has greatly increased the accessibility and availability of mental health services over the last 30 years, across various models (e.g., MFT, PCBH, COCM). As integrated care providers, we must be nimble, compassionate, effective, and efficient to make the best clinical decisions in the moment, to address primary care demand, intersectionality, patient readiness, and serve the quintuple aim: this training addresses those vital skills for beginner and intermediate clinicians. This presentation will provide a combination of education on highly useful clinical techniques (“practice hacks”) and “in the moment” practice case scenarios to maximize effectiveness in primary care’s limited time, patient engagement and buy-in, and compassion. Selected examples of patient-centered and GATHER-oriented techniques include: (1) Considerate questions: how to efficiently elicit disclosure on the core of what is impacting your patient (2) Listening for “change talk”: what are your patient’s specific word choices revealing to you about their readiness to change (3) The “Advise” step: how to turn an uncomfortable part of the visit into gentle guidance and empowered patient-centered education (4) “Playing Reverse Jenga” in patient visits, where you build the tower up securely, to effectively focus on positive functional outcomes for presentations with complexity and comorbidity

As Summit Health was growing rapidly, a necessary shift in the existing model of care took place to allow for coverage of over 200 PCPs in 40+ locations. iPads were embedded in every office and a hotline for hallway handoffs was created. The care navigation program was created. BHCs began seeing patients all over the state using a virtual platform. There have been wonderful successes and celebrations along with some definite pain points and things we wish we could do over. Whether you want to use a remote BHC in one office or many, part-time or full-time and you have a widening geographic reach, this is the presentation for you!

Description coming soon.

This session describes the process of developing, implementing and evaluating a training program for master's level trained mental health providers embedded in primary care clinics within an academic medical center. This presentation describes the process of developing the training program and the content used, implementation of the program and outcomes associated with the training.

Since the elimination of the DEA x-waiver in January 2023, any clinician with a DEA license that includes Schedule III medication can now prescribe buprenorphine for the management of Opioid Use Disorder.  This means more primary care providers can now utilize FDA-approved medication to help their patients living with OUD.  But are those providers adequately equipped to meet the need and help turn the tide on the opioid epidemic?  In this session, we hope to inspire integrated care teams to learn more about OUD and consider adding life-saving medication options to their integrated behavioral health skill set.

When you think of behavioral health, what is your first thought? Is it substance use and mental health? Is it substance use, mental health and physical health? Now when you think of integration, what is your first thought? Is it bringing behavioral health services into primary care settings? While those answers are correct, there are multi-faceted approaches to health integration that address the whole patient while improving access to care. This presentation explores the transformative potential of integration focusing on substance use, mental health, healthcare, non-medical drivers of health as well as risk and protective factors. Utilizing the four quadrant model as a guide, strategic partnerships with diverse agencies can create a comprehensive approach to meet the individual where they are at. While primary care is a key access point for patients, encompassing a diverse array of organizations and potentially unconventional partnerships can allow for communities and organizations to expand the scope of integration. This presentation will highlight how our organization has identified and pursued partnerships to enhance the integration of care, strengthen access points and provide a holistic approach. We will discuss how we identified partnerships, the importance of each partnership as well as identify practical strategies based on our past, present and future efforts.

This quality improvement study explores the utility of implementing CoCM with fidelity at a federally qualified health center (FQHC) while considering social drivers of health, treatment adherence, time in CoCM care, psychiatric and medical conditions and psychopharmacology. The findings of this study indicate that CoCM delivered with fidelity can support FQHCs in improving depression remission rates at 12 months +/- 60 days after initial diagnosis. This presentation will provide an overview of the design and findings of this quality improvement study and case studies of patients included in the study.

We will report on integration and patient health outcomes from the Integrating Behavioral Health and Primary Care for Comorbid Behavioral and Medical Problems (IBH-PC) study that ended in 2023. This pragmatic trial, which included 42 primary care practices across the United States, used the Practice Integration Profile as a measure of integration and the PROMIS-29 as a measure of patient health. We found that practices with higher levels of primary care and behavioral health integration have healthier patients. Additionally, we found that practices that engaged with the IBH-PC practice transformation toolkit were able to increase their level of integration. Finally, we found that practices with scores on the Practice Integration Profile > 65 had patients with improved physical and mental health. We will discuss implications of these results for researchers, clinicians, and other stakeholders.

Clinical practice in Integrated Behavioral Health (IBH) settings requires skills and knowledge that often differs significantly from those required for practice in specialty mental health settings, and yet training for IBH settings remains sparse and unstandardized. This presentation will review the results of a Delphi study in which the 21 behavioral health experts identified the fundamental skills, interventions, and academic knowledge to prepare future behavioral health providers for effective practice in IBH settings. An exploration of the skills and knowledge identified by behavioral health experts will occur, with emphasis on items that may currently be missing from the majority of graduate behavioral health training programs. Afterwards, presenters will connect the identified skills and knowledge with popular models of behavioral health integration, including the Primary Care Behavioral Health Model, Collaborative Care Model, and co-located therapy models. This presentation will end with the presenters facilitating a discussion centered on current graduate training for behavioral health providers and ways in which educators can advocate for IBH to be more intentionally incorporated into graduate-level training programs.

This session will discuss a quality improvement project to enhance patient experience in planning and preparing for vaginoplasty. An overview of the project rationale, timeline, and outcomes from perspectives of patients, care persons, and providers who are delivering the presurgical education seminar will be discussed.

HealthPoint has been training behavioral health learners in the Primary Care Behavioral Health (PCBH) model of care for 20 years. Join us for a discussion of lessons learned during this time and suggestions for best practices when training learners in integrated care.

Implementation of a 6-month demonstration project to assess the viability and sustainability of expansion of integrated care using the PCBH model in an FQHC with scarce resources. Pre- and post- measures of provider and patient satisfaction, productivity, reach, and model fidelity will be reviewed. Learnings and recommendations regarding supports needed for making the financial case will be discussed.

The Collaborative Care Model (CoCM) is an evidence-based model for treating common behavioral health problems like depression and anxiety in primary and specialty care settings including pediatrics, geriatrics, and reproductive health. Despite 90 randomized controlled trials demonstrating its effectiveness over the past 20 years, myths about the model persist. This presentation will bust several commons myths including: We’re already treating depression and don’t need to do anything differently. We already work collaboratively. Patients will get better care from a specialist.

This presentation will be an interactive panel hosted by the Measurement-Based Care (MBC) and Value-Based Care (VBC) Workgroups that provides an understanding of the importance of MBC and VBC in integrated care settings. Participants will learn why MBC and VBC are relevant to their patients and integrated care team, discuss pragmatic implementation strategies, troubleshoot common barriers, and address financial implications including value-based contracts. This panel is for healthcare (behavioral health and medical) providers and administrators who are implementing or preparing to implement measurement-based care and/or value-based contracts within the primary care setting. The panel will foster lively conversations with attendees and be an engaging experience for al

This is the 6th iteration of the CFHA debate, a forum for wrangling with our evidence-base and best practices. This year’s question is “Does universal behavioral health screening do more harm than good?” One team of debaters will make the case that universal screening is proven by research to improve clinical, operational, and financial outcomes in integrated primary care. The other team will push back, asserting that we’re mandating too much screening, and as a result, overwhelming our systems, burning out our clinicians, and frequently just going through the motions. We’ll look closely at universal screening for depression, anxiety, substance use, intimate partner violence, and trauma. After the debate, the audience will vote to recognize which team made the better case and then we’ll engage the audience to grapple with the realities and best practices for screening at the frontline of patient care.

This presentation will review case studies demonstrating the effectiveness of including peer support as part of the integrated care team in order to promote consumer driven series and increased engagement in long term recovery. The efforts in these cases have focused on early integration of peer services, changes in processes and workflows to support consumer needs first, and enhanced wraparound care planning. A case will be made that peer support services in collaboration with behavioral health, substance use treatment, primary care, and crisis services can lead to greater consumer engagement and more success in consumer’s long term wellness.

The National Academies of Sciences, Engineering, and Medicine (NASEM) provides a definition of high- quality primary care in their 2021 paper, “[High quality] primary care provides comprehensive, person-centered, relationship-based care that considers the needs and preferences of individuals, families, and communities.” Anyone who has ever worked in the fast-paced and often chaotic primary care setting knows this is a lofty and most likely an aspirational “north star.” The question then becomes, how do we work towards making this more of a reality? One such strategy is helping clinicians develop contextual interviewing skills in which they learn how to conceptualize patients’ health values through patients’ “love-work-play” context. In this one of a kind presentation, the presenters will provide a short didactic and then launch into a contextual interview role play in which frequent pauses are taken to discuss what questions could be asked next in order to see in “real-time” an effective love-work-play interview.

The California Quality Collaborative (CQC) and Collaborative Family Healthcare Association (CFHA) will highlight the technical assistance approach, lessons learned and progress of CalHIVE Behavioral Health Integration (CalHIVE BHI), a three-year California-based improvement collaborative dedicated to accelerating behavioral health integration in primary care practices across the state. Presenters will describe effective techniques and challenges faced as the collaborative aligns and provider organizations receive tailored support as they plan for and launch implementation of either the Primary Care Behavioral Health model or the Collaborative Care Model. In this project, CQC, with successful experience driving quality improvement and system transformation for ambulatory health care providers, partners with CFHA, bringing together their expertise integrating physical and behavioral health. We'll explore strategies that balance individualized attention with broad-based guidance, all aimed at enhancing patient care and mitigating provider burnout. This session will provide valuable insights into the practical aspects of delivering technical assistance that helps organizations build the capacity to launch and sustain integrated care in a diverse range of healthcare settings.

Focused on quality improvement using PDSA cycles within a real-world health care setting, Swedish Medical Group launched a pilot program within their Primary Care Behavioral Health (PCBH) program. We sought to automate PHQ-9 repeat screening at 4 – 8 months to better capture evidence of depression treatment response and reengage patients in care if needed. Pilot results successfully demonstrated capture of treatment response (50% reduction in PHQ-9) and remission (PHQ-9 < 5), as well as insights pertaining to improved patient experience. Leaders of clinical operations and behavioral health integration programs will learn how to design and implement similar efforts in their clinics and organizations to better capture data related to depression treatment response within their clinical settings.

Healthcare providers – across both mental health and biomedical disciplines – represent some of the highest risk professionals in Western culture(s) for burnout and compassion fatigue. At the same time that they report being wholly-committed to (and loving) what they do, they are oftentimes overwhelmed with the intensity and/or chronicity of their caseloads, workplace and/or interdisciplinary politics, administrative demands, and tendencies to under-report personal struggles or seek help. In this presentation, empirically- and theoretically-conceptualized understandings of this problem, alongside research-proven strategies to prevent and/or mitigate it, will be shared.

Interested in learning more about how to use the functional contextual interview (FCI) with pediatric patients and families? Want practical tips and practice? If so, this is the presentation for you! During our time we will provide understanding for the shifts in the FCI to make it work for peds within the PCBH GATHER framework, give practical tips and model the FCI, and practice together!

A large community primary care clinic effectively implemented a stepped-care protocol for pediatric patients with externalizing behaviors including brief parent management training (PMT) in-the-exam room, full application of PMT, and training for physicians on trauma-informed interaction and PMT skills to use with pediatric patients. We aim to share the lessons learned from analysis of three years of data about predictors of primary care PMT dropout, learning outcomes of physicians training in the PMT skills, and the feasibility of implementation of this comprehensive program

Primary care departments and settings can often benefit from enhancing their research capacity. Family medicine organizations have created the Building Research Capacity (BRC) program to train individuals how to develop research capacity. Based on lessons taught during the BRC fellowship participants will learn strategies for enhancing research capacity in their primary care environments.

Families are a significant part of patients’ overall health and wellness, and often play an important role in patients’ chronic disease management. This presentation will review recent research conducted on family support and chronic disease management to inform family-centered primary care. Utilizing quantitative data collected with Latino/a/x patients with diabetes and qualitative data collected with African American patients with hypertension and their family members, we will explore key strategies for implementing family-centered approaches.

This project aimed to improve cardiovascular health disparities among South Texas children. We engaged in multiple interactive sessions with elementary school students to instill lasting positive health behaviors. Topics of sessions included general cardiovascular health, exercise, and nutrition information.

University student mental health has become a growing concern since the COVID-19 pandemic with depression and anxiety increasing threefold(1) and suicidal ideation reported up to 20%(2) among students. Most individuals do not seek support due to multiple barriers including mental health stigma, low perceived need, financial burdens, and cultural concerns.(3) This presentation will describe and provide initial outcomes of an innovative combination of evidence-based, interprofessional trainings to address emerging and crisis mental health needs on college campuses. The ASSISTS (Awareness, Screening, Support, Intervention, and Skills Training for Students) program is anchored in Mental Health First Aid (MHFA) with adapted Screening, Brief Intervention, and Referral (SBIRT) to treatment and Crisis Intervention Training (CRIT). Through this culturally-informed combination of trainings, students, faculty, and staff are better equipped to provide immediate support and facilitate referrals to integrated care and related services, as appropriate.

Unlicensed behavioral health staff can meaningfully support patients and families in Primary Care, and the position offers a viable career pathway in healthcare. This poster describes Cambridge Health Alliance's approach to integrating Mental Health and Family Care Partners for it's safety net patient population, the role and clinical impact of their work and opportunities for further expansion. The approach can be a model to other systems seeking to promote a diverse workforce and improve behavioral healthcare.

The University of Texas Rio Grande Valley Maternal Health Research Center INTRODUCTION Pregnancy and the postpartum windows are critical life transitions for women that can be leveraged to prevent maternal health disparities. Obstetrics and gynecology patients commonly present with chronic pain, substance abuse, obesity, and/or concerns about intimate partner violence. Many of these conditions are co-morbid. Hispanic women living in the US-MX border region disproportionately experience structural determinants and conditions (e.g., poverty, low socioeconomic status, lack of access to health care) associated with shorter life expectancy and adverse health outcomes across the life course. These structural determinants lead to a higher prevalence of chronic, mental, infectious disease and persistent health disparities in border populations. Place-based stressors such as poverty and/or poor housing along with psychosocial risks such as depression work synergistically and are important drivers of health disparities in our border region. These psychosocial and behavioral risks in Hispanic women require a multi-level and systemic approach to address. We aim to establish a maternal health research center at the University of Texas Rio Grande Valley (UTRGV), the second largest Hispanic serving institute in the US. The goals and objectives of the UTRGV Maternal Health Research Center (MHRC) follow. Goal 1: The UTRGV MHRC will plan and implement maternal health research studies to inform relevant, culturally appropriate and peer led interventions to address health disparities in our region and beyond. Goal 2: Increase the capacity for maternal health disparity research at UTRGV. Goal 3: Develop manuscripts to be published in peer-reviewed scientific journals. Goal 4: Disseminate and translate research findings into practice.

A long-standing integrated primary care clinic in the Eastern Panhandle of WV went through numerous model evolutions over a 5 year period. Subtle changes to the model in July of 2021 have lead to big impacts in access to care, unique patients seen, same day visits, and clinic morale. Data presented on poster will highlight metrics before and after the model changes. Data will also include PCP and staff opinions of model changes and satisfaction with program.

Leveraged human centered design to understand gaps in mental health care for children & adolescents. Prototyped a digital platform (Mental Health Advisor) to support children’s mental health through providing assessment, results, referrals, and treatment tools. Implementing & scaling MHA across Mayo Clinic.

The heightened need for skilled behavioral health professionals in primary care in Puerto Rico has been compounded by socioeconomic hardships and the lasting effects of significant natural disasters. The Train-Deploy-Monitor model was conceived to address this need while creating a framework for workforce development in integrated primary care. The model intertwines comprehensive training, strategic intern deployments across primary care centers and hospitals, and ongoing performance evaluations to produce adept practitioners ready for interprofessional work. We evaluated the progress of 45 clinical psychology interns across successive cohorts from 2018 to 2024. Interns were predominantly PsyD students (73%), with a significant majority being female (89%) and Hispanic or Latino (100%). Additionally, a notable proportion of the interns came from disadvantaged backgrounds (31%) and over half reported a rural residential background (58%). Data was gathered through supervisor evaluations and intern reports. We utilized descriptive statistics and paired t-tests to assess performance improvements in the competencies of science, professionalism, and application, and substance use and opioid use disorder (SUD/OUD) management. Statistically significant improvements were identified with competency scores rising from an initial average of 3.4 to 4.7 in science, 3.6 to 4.7 in professionalism, and 3.4 to 4.7 in application, and 3.4 to 4.3 in SUD/OUD competencies (p < .05 for all categories).Additionally, we paired samples t-test to analyze the variation in case discussion rates from the first (Q1) to the fourth quarter (Q4) of internship. This rate serves to quantify interprofessional interactions. The analysis revealed a statistically significant increase from Q1 to Q3 and Q4. These findings endorse the Train-Deploy-Monitor model as an effective approach for preparing students for the demands of integrated care, suggesting a promising avenue for building up the behavioral health workforce in regions confronting similar healthcare challenges. 

Introduction: The Interdisciplinary Integrated Primary and Behavioral Healthcare (I2PBH) Initiative currently trains University of Texas Rio Grande Valley (UTRGV) mental health graduate-learners to deliver Integrated Behavioral Health (IBH) services through the evidence-based Primary Care Behavioral Health (PCBH) model in the RGV - a medically underserved Hispanic region along the US-Mexico border.

Methods/Project Description: The I2PBH initiative trains up to six graduate students each year from four mental health disciplines (Social Work, Clinical Mental Health Counseling, Rehabilitation Counseling, and Psychology) with an emphasis on basic as well as advanced theory and clinical skills in the PCBH model. Students also serve as Behavioral Health Consultants (BHC), working alongside healthcare professionals in a primary care setting, to meet set practicum/internship requirements. As BHCs, they work alongside healthcare providers and other health profession trainees in three Area Health Education Center (AHEC) Primary Care Clinics and one mobile clinic, located within rural counties of South Texas. Student trainees complete trauma-informed, culturally adaptive PCBH-focused coursework (e.g., Foundations of IBH; Clinical Skills for the BHC) in conjunction with advanced PCBH-oriented clinical supervision, digitally enhanced training - Mixed-Reality Simulations, and asynchronous distance learning via virtual platforms (e.g., Blackboard, Zoom). Based on a discipline-agnostic approach, this teaches PCBH-specific competencies while also providing concurrent, primary-care-focused clinical experiences, resulting in a behavioral health workforce that is primary-care ready and trauma-informed. Results/Outcomes: Utilizing the PPAQ subscales, significant changes in the adherence to essential behaviors when providing IBH services in a primary care setting has been observed [before training (M=46.25; SD= 9.74), after training (M=161.25;SD=7.89); {t(3)=-21.86, p<.001}]. Post-test mean is 161.25, indicating that trainees' scores are in the preferred level of model fidelity. Secondly, in the ISVS scale, the mean of trainee's total score is 133.56 out of 147, with an average mean score being 6.36 out of 7. Our post-tests demonstrate that after training, our participants have improved their interprofessional attitudes, beliefs, and competencies. Conclusions: The I2PBH initiative increases the presence of culturally concordant, primary care competent BHCs on the frontlines to function as primary care provider extenders for all behaviorally informed needs of patients, thus increasing access and delivery of whole-person care.

Cognition is a major driver of effective teamwork (Tannenbaum & Salas, 2020); the extent to which team members possess a shared understanding of key factors as well as the team’s goals, priorities, and vision. Having increased shared cognitions amongst a care team can lead to increased effort from all team members and improved routine coordination. Improving patient experience is a major goal of healthcare (Berwick et al., 2008) and with the rise in integrated care there has also come an emphasis on team work and collaboration (Donnelly et al., 2019; Freedy et al., 2019). This poster presentation will describe a quality improvement effort that occurred at a family practice primary care site as part of a FQHC in Southwest Ohio. The results of such efforts will also be reported and described in further detail.

To improve accessibility, cultural applicability and patient engagement in PCBH with the Hispanic/Latinx population of HSO. Demographic data will be collected from Hispanic HSO patients, patients that are seen for BHC services, and the amount of visits they have been seen. Exploration of the somatization of mental health concerns in Hispanic patients and recognition of cultural context and stigma of mental health. Providing translated and culturally appropriate BHC materials for patients, as well as having the availability of both Hispanic/Latinx male and female providers with varying Spanish fluency to provide optimal care.

Primary care physicians have a unique opportunity to detect suicide risk and connect patients with effective treatment. Over 83% of individuals who die from suicide have a healthcare visit in the year prior to their death, and 50% within the preceding 4 weeks. Competing demands during clinic visits, limited behavioral health resources, and lack of standard workflows can lead to lost opportunities for suicidality screening and assessment. In this session, we will share an approach to suicidality screening and assessment that is evidence-based, integrated into existing electronic health record workflows, and involves collaboration across disciplines. We will also review strategies for increasing behavioral health integration to support suicide prevention efforts within an academic health system.

Introduction: The Fortify Resilience Initiative focuses on building and sustaining a culture of wellbeing in The University of Texas Rio Grande Valley (UTRGV) School of Medicine's Graduate Medical Education residency programs. To address the multitude of threats to physician wellness and mitigate the silent, but pernicious effects of burnout on these physician learners serving in the RGV, this initiative has strengthened existing wellbeing pathways while expanding additional solutions that work to sustain wellness and resilience. Methods/Project Description: This initiative maintains three key drivers (Access Strategy, Empowerment Initiatives, and System Redesign) that all work to address and enhance components central to wellbeing management. The premier driver provides continuous access to direct online clinical/coaching services, annual wellness check-ins, monthly live-online learning sessions with skill development practical labs to all medical residents and clinical faculty of the institution. The "Fortify Resilience" wellbeing mobile application, allowing users to periodically self-assess and receive suggestions to improve self-management has entered its pilot phase, while establishment of program-specific Wellness Committees through our focus group informed guide "Promoting Well-being & Preventing Ill-being within Program Committees: A Team Based Toolkit for Well-being Champions," continues as the project's second driver. A faculty development pathway to train faculty to full competency over current wellbeing methodologies is underway with an inaugural cohort, which aims at securing a lasting presence of institutional expertise, represents the third driver. Results/Outcomes: Following the introduction of these interventions, positive trends are observed in the individual wellbeing items of the annual provider wellness surveys for 2022 and 2023. Service utilization and attendance rates continue to grow per academic annum, with a rise in provider satisfaction rates, as insights into the adoption rates of individual medical specialties/program-specific responses to the interventions have been discerned through the project's rapid cycle quality improvement process. Conclusions: This initiative aims to signal a divergence from the practice of simply measuring the level of provider burnout present in the system to reinforce a focus on cultivating a systemic culture that advances the proponents of what actively and passively promotes provider wellbeing through prevention/promotion/protection intervention strategies targeted at individual, program, and system levels to address existing gaps that spread risk and vulnerability.

Introduction: Integrated care models have many benefits, including accessibility, patient satisfaction, reduction in stigma of mental health care, and improved coordination (Jackson et al., 2013, Miller-Matero et al., 2018). The warm handoff (WHO) is a technique often used in integrated care to improve patient engagement and better utilize the multidisciplinary team. Prior literature has noted barriers toward understanding the impact of WHOs, including variable implementation and complexities in an outpatient setting (Beehler, 2021), with a noted need for staff buy-in to implement such an approach (AHRQ, 2018). Given the existing literature and barriers, this study set out to examine perceptions and utilization of warm handoff model within high-volume resident driven integrated primary care/internal medicine clinic. Methods: Sample included 7 internal medicine attendings and 34 resident physicians. All participants completed an 8-item questionnaire assessing perceptions, utilization, and barriers of warm handoff services for integrated behavioral health, pharmacy, and case management services. Objective data on frequency of warm hand utilization by referring providers was additionally collected through system medical records. Results: 24% of providers selected that they provide warm handoffs weekly or more, 28% monthly, 35% rarely (once every few months), and 12% of providers have never provided a warm handoff. The most selected reasons for why the providers use warm handoffs included: extending care provided at a clinic visit (86%), to help patient understand the service (79%), team member can more immediately address patient need (76%), and improves access (76%). 98% of respondents identified the patients benefit from the warm handoff and 90% identified that the physician provider benefits from the warm handoff. When asked about barriers for warm handoffs, 78% of providers selected that they were too busy in clinic, 74% identified that patients were unable to wait, and 55% identified that multidisciplinary providers were too busy. The month prior to the lecture, the psychology team completed 19 warm handoffs (brief intro and full appointments). In the month following the lecture, the team completed 41 warm handoffs (brief intro and full appointments). Conclusions: This work highlights that understanding the perception of the warm handoffs from providers is helpful in addressing barriers. Further, it demonstrates that a brief educational didactic on the benefits of the warm handoff increase rates of warm handoffs in a busy resident driven academic internal medicine clinic.

Abstract
Nationally, over fifty percent of primary care practices in rural, frontier, and inner city locations are not part of organized health care systems and encounter challenges in accessing healthcare services and advanced data access technology that supports decision support, monitoring, and risk prediction. Lack of access to available information is a leading cause of medical errors.

Patients in these practices are among the 68% of the adult population with two or more chronic diseases, often requiring enhanced care to function optimally. Primary care practices are left with limited access to information technology necessary to support risk identification and decision support for enhanced care. Experience from the EvidenceNOW Southwest project confirmed the challenges faced by practices to report even the most basic data, such as blood pressure. These clinical and access to technology challenges place large numbers of patients at an elevated risk of inadequate access and delivery of healthcare, particularly in the insufficient treatment of chronic health conditions. With behavioral co-morbidities.  Quality of life is compromised, outcomes are limited, and there is an increase in avoidable healthcare utilization.

Problem
The current focus of care is on treating advanced and often costly stages of illnesses, yielding outcomes of varying efficacy. A leading factor in medical errors is lack of access to needed data. Insufficient attention is devoted to strategies that prioritize early detection and intervention. This deficiency is compounded by a lack of time to utilize available technologies for upstream identification and interventions aimed at early disease detection and intervention.

Presently, there is no broadly used mechanism to discern high-risk patients within a panel, and a notable underutilization of technology in assessing and intervening with these high-risk patients. Addressing these issues is imperative for improving the overall effectiveness and efficiency of our healthcare system.

The Opportunity
We are implementing a cloud-based, interoperable data platform resulting in AI-supported assessment and interventions aimed at early risk identification, decision support, and rapid intervention for patients. We will utilize the RE-AIMPRISM framework to evaluate practice implementation, patient outcomes, and utilization. This work expands the framework used in the Diabetes Prevention Project, which demonstrated early risk identification and intervention follow-up decreases risk, can impact disease progression, and diminishes overall spending.

Plan
Using a rapid cycle learning approach, we have developed a learning community that includes 5 small independent primary care practices in rural and inner-city locations to determine and implement workflows resulting in early panel-wide identification of high-risk patients or patients moving towards becoming high-risk. This project will use technology and AI in the identification of risk and develop workflows that efficiently manage these processes and then evaluate the impact on clinical, patient-reported, and organizational outcomes, costs/utilization, and responsiveness.

Specific Aims

• Aim 1: Assess whether the use of AI-assisted risk identification and resulting enabled workflows to improve care delivery can be successfully implemented in community-based primary care practices with limited resources./p>
• Aim 2: Determine the effectiveness of this infrastructure to improve workflows that increase efficiency, effectiveness, and utilization within rural primary care practices and optimize care for at-risk patients with multiple chronic diseases and negative social determinants of health.
• Aim 3: Identify patient, provider, organization, and system facilitators and barriers associated with practice and patient outcomes, utilization, and costs.
• Aim 4: Create workflows and AI tools to support efficiencies in the electronic consult programs, automate data retrieval summarization and decision supports, and share those summaries with specialists and primary care providers.

Increasing preventive health use in Black women may reduce disparate health outcomes, but, little is known how Black women define and learn about preventive health. This qualitative study examined 39 Black college women’s sources of knowledge and conceptualizations of preventive health care. Results showed that participants learned about preventive care behaviors from primarily women family members, health organizations, academic courses, media, and personal experiences. Additionally, Black college women rarely included recommended screenings and vaccinations in their definitions of preventive. These findings highlight the need for increased prevention efforts and discussions around preventive health in primary care settings.

Nearly 20 years since Robinson and Reiter’s guide that introduced Primary Care Behavioral Health (PCBH) as a model of integrated care (Robinson and Reiter, 2006), PCBH has been promoted to reduce turnover among primary care providers by integrating Behavioral Health Consultants (BHCs) into primary care teams (Reiter et al., 2018; Serrano et al., 2018). Building on this insight, this systematic review examines research on the effects of PCBH integration on employee burden and job dissatisfaction among the primary care workforce since the publication of Robinson and Reiter’s guide. This on-going systematic review provides recent developments in the integration of BHCs into primary care with regard to workforce outcomes, and thus addresses audiences with a general understanding of PCBH and who want to learn more about the intersection of behavioral health integration and the healthcare workforce. Results from screening studies that cite Robinson and Reiter (2006) thus far indicate at least 45 articles advocating for integrating behavioral health, with at least two empirical studies exploring the effect of co-location and proximity on health outcomes or on patient outcomes. There is need for research on workforce outcomes like burden, with a growing research stream of articles examining integrated behavioral health and its effect on burnout (Leun et al., 2020).

Data from a pilot of a responsive parenting intervention in pediatric primary care were used to assess associations between responsive feeding practices and bedtime behaviors. Results found that consistency in bedtime behaviors increased from 1 to 6 months of age, and that higher responsive attention in feeding practice scores were associated with lower consistency in bedtime behaviors. Implications include learning to promote flexibility in responsive parenting interventions.

This poster will describe a study that investigates how behavioral health patients in a rural/suburban family medicine resident training clinic utilize the resources of their primary care physician (PCP) prior to an initial visit with an integrated behavioral health team. It will describe utilization metrics (i.e., number of visits, number of phone calls, number of laboratory tests and imaging studies ordered, number of medications prescribed, and length of visits) that took place during the 12 months prior to initial behavioral health visits. The study also investigated whether the presence of trauma diagnoses impacted utilization, as previous research suggests individuals with trauma diagnoses may utilize more PCP resources. The poster will also describe the integrated behavioral health model employed in the training clinic.

Transdiagnostic treatments are evidence-based in individual and group formats and can help efficiently treat a wide variety of mental health concerns. We adapted the Unified Protocol for Transdiagnostic Treatment of Emotional Disorders (UP), which incorporates cognitive-behavioral therapy and emotion science, for telehealth delivery as a brief group intervention (five 60-minute classes) for Primary Care Behavioral Health settings. We conducted a pilot open trial (N=18) to evaluate feasibility and acceptability as well as pre-post changes in mental health outcomes. Results suggested good feasibility, high acceptability, and promising signals of effectiveness, but further research is needed. Utilization of transdiagnostic treatments as well as telehealth and group formats may help to increase efficiency of and access to care.

Background: The life expectancy of people with SMI is 10-25 years shorter than the general population, with leading causes including T2DM and cardiovascular diseases. To better understand health management needs of clients with SMI, the purpose of this study was to explore the subjective experience of T2DM self-management among people with SMI. The research question was, what facilitating factors and barriers were encountered by people with SMI while managing their T2DM?

Population: This qualitative photovoice study recruited 10 participants from an integrated care clinic using these criteria: age 18 to 65 years, a SMI diagnosis, a hemoglobin A1C level of 5.7% or higher, and capability to complete all study tasks. Method: Based on principles of community-based participatory research (CBPR), we provided cameras to participants to take photos about issues in the community. Participants completed three rounds of photo assignments and group meetings. We used the SHOWED discussion guide to facilitate group discussions. All meetings were recorded and transcribed. Data were analyzed using grounded theory methods, including open coding, axial coding, and selective coding. A computer program, NVivo 14, was used to assist in data analysis. Results: Facilitating factors of T2DM management for people with SMI included maintaining mental wellness, self-efficacy, community resources, and peer education. Barriers included stress, mental illness symptoms, homelessness, and a lack of agency. Cultural upbringing was both a facilitating factor and a barrier. A quadrant model was created to delineate the findings.

Conclusion: For people with SMI, it is critical to manage symptoms of mental illness to keep their T2DM in check. This study provides valuable information to inform the development of T2DM lifestyle interventions that incorporates the voice of people with comorbid SMI and T2DM.

Adverse childhood experiences (ACEs) have a significant impact on physical and mental health throughout an individual's life. While there is extensive research on ACEs assessments in primary care (PC), there is less understanding of protective factors, which are essential for fostering resilience. This systematic review, utilizing Ungar's Socio-ecological Resilience Model, explored how protective factors are evaluated in PC screenings for ACEs and their potential effects on patient health outcomes. Searches were conducted in PubMed, PsycINFO, and CINAHL databases up to September 30, 2022, without restrictions on language or country. A comprehensive search strategy across these databases identified 764 initial studies. After removing duplicates and undergoing a two-stage review process with inter-rater agreement (Cohen's κ = .583, .677), 27 studies met the inclusion criteria. These studies screened adult patients (≥18 years) for ACEs in PC settings and assessed at least one protective factor. The results were qualitatively synthesized, revealing significant variability in the specific protective factors measured. According to Ungar's model, frequently assessed individual factors included relationships, identity, and power/control, while community/social factors such as cohesion, material resources, and social justice were also common. Only two studies adequately addressed cultural adherence. These findings highlight potential gaps in understanding how specific protective factors can enhance biopsychosocial-spiritual health in PC settings, particularly within diverse cultural contexts. The review emphasizes the need for PC research to expand its focus to a broader range of protective factors and their potential to alleviate the effects of ACEs. It underscores the importance of Ungar's Socio-ecological model for its comprehensiveness while calling for more culturally sensitive assessment tools and interventions. Identifying the most effective protective factors in PC settings could enable targeted support and optimize patient health outcomes.

This project explores the implementation and impact of a Primary Care Behavioral Health (PCBH) workforce development pipeline aimed at increasing behavioral health access for primary care settings across the Texas-Mexico border. The workforce development pipeline provides graduate students from four mental health disciplines at the University of Texas Rio Grande Valley - psychology, clinical mental health, social work, and rehabilitation counseling - a pathway to receive PCBH training during their Master's training and an opportunity to become a PCBH fellow post-graduation. Students who opt into the PCBH training pathway receive the necessary PCBH clinical skills and knowledge, through coursework, clinical practice, and routine clinical supervision, to effectively integrate behavioral health into primary care settings. This poster presentation will review the structure of the PCBH pathway and the impact on trainees, with a focus on transition of one of the graduate students to be a PCBH fellow post-graduation.

This session will offer insights into the start-up of integrated behavioral health services within a hospital-based pediatric oncology clinic. Practical steps for building a new program, clinical team insights, and patient-family experiences will be highlighted. The session will conclude with lessons learned and tips for successful start-ups.

Join your Families and Health colleagues at a dinner. (Self paid)

More details to follow. Registration will be limited. Contact Brittany Huelett at bhuelett@twu.edu to express your interest or with any questions.

Join your medical colleagues at a dinner. (Self paid)

More details to follow. Registration will be limited. Contact Jen Thomas at medical-director@cfha.net to express your interest or with any questions.

Join your CoCM colleagues at a dinner. (Self paid)

More details to follow. Registration will be limited. Contact Tisha Deen at tldeen@uams.edu to express your interest or with any questions.

This session will unpack West Side United’s approach to forming a healthcare collaborative committed to eradicating the 14-year life expectancy gap between Chicago’s downtown and 10 communities on Chicago’s West Side.  The presenter will highlight the origins of the collaborative, key partnerships, community engagement strategies and core strategies that impacted Chicago’s response to COVID-19, Vaccine Equity and more.

The ability to establish psychological safety is necessary to create conditions for a functionally healthy team in a collaborative care environment. It is critical to patient engagement and trust-building, and can lead to improved problem identification, care management, and patient safety. Despite its recognized importance, psychological safety building rarely shows up as a targeted skill for development in training programs in the health professions. In this presentation, we will present the value of leveraging emotional intelligence (EI) skills as foundational to the creation psychologically safe interactions through understanding oneself and one's impact on others. We will present our work with medical students and residents in developing targeted EI skills and de-stigmatizing self-disclosure to support psychological safety building with others. Participants will have the opportunity to reflect on their own pertinent EI skills in an activity related to psychological safety building.

The perinatal period (pregnancy through 12 months postpartum) is a time of increased vulnerability to mental health conditions. In fact, depression is the most common complication of childbirth and suicide/overdose is the leading cause of death in the postpartum period. To address this issue, the American College of Obstetrics and Gynecology (ACOG) recommended in their Clinical Practice Guidelines that women be screened for depression and anxiety during the perinatal period to improve identification of mental health conditions and connecting patients to care. Collaborative Care Management (CoCM) is a model of integrated care that facilitates screening, identification, and early intervention with behavioral health conditions, and has demonstrated efficacy in the perinatal population; however, the uptake of this model has been slow and many OB/GYN practices remain hesitant to adopt behavioral health screening and management into their practices. We intend to discuss the unique challenges faced when working with OB/GYN practices to adopt CoCM and how we addressed these challenges. Additionally, we intend to discuss facilitators and barriers to success, as well as outcome data from a 5-year CoCM program in an OB/GYN clinic.

Lack of access to mental health treatment continues to plague the United States healthcare system (SAMHSA, 2022) and has only worsened during the COVID-19 pandemic (Czeisler et al., 2020). Integrated care approaches, such as the Primary Care Behavioral Health (PCBH, Reiter et al., 2018) model, aim to address these access barriers by fully imbedding behavioral health providers within primary care teams. However, simply embedding such BHPs may not address access concerns if traditional mental health approaches are simply replicated or even scaled down. Thus, embracing concepts such as Single Session or Moment at a Time approaches, which continue to grow in popularity and research supporting its effectiveness (Deisenhofer et al., 2024; Ghosh et al., 2023; Shen et al., 2023), are being embraced within PCBH settings to amplify the model’s inherent intent to provide accessible high-quality care. This presentation will detail Community Health of Central Washington’s journey in embracing and implementing a Moment at a Time approach within its PCBH service. Specifically, outcomes regarding patient experiences, visit descriptions (e.g., average number of visits, length of visits), and unique patients served will be presented, as well discussions of how this Moment at a Time approach has influenced CHCW’s BHPs joy with their work.

This workshop introduces the GATHER Reflection and Planning Tool and provides several case examples of its use with new Behavioral Health Consultants (BHCs). This tool helps new BHCs and those that train or supervise them to efficiently initiate new behaviors linking to each of the 6 elements in the GATHER description of the Primary Care Behavioral Health (PCBH) model. While brief, the tool (1) provides specific guidance for developing both visit and team related skills, (2) encourages self-reflection and a systematic approach to learning during the early months of starting a PCBH service, and (3) supports a good conversation between new BHCs and their mentors and/or supervisors. The optimal impact of integrated behavioral health services depends on the quality of training that new Behavioral Health Consultants (BHCs) receive in their first few months of practice. High quality training may support higher levels of job satisfaction and retention among new BHCs. This presentation will provide case examples of two BHCs participating in GATHER coaching over a 6-month period, one a new professional in a rural healthcare clinic and the other an experienced professional staring a BHC practice in an Indian Health Service clinic. Participants will view reflections from the new BHCs and then work with a learning partner to generate ideas for learning plans to help the BHCs get a strong start. Participants will also view GATHER element scores for each case over a 6-month period and consider ways to use them as indicators of progress. The GATHER Reflection and Planning Tool is a useful tool for mentors and new BHCs to use to assure a strong start.  

We will briefly review common barriers to accessing psychological evaluations and then present implementation data from a novel assessment clinic piloted within an integrated care setting. The goal of the assessment clinic is to provide brief, focused psychological evaluations to address barriers to care (e.g., long waitlists; Hine et al., 2018; Stringer, 2023) in an innovative way. Using a RE-AIM framework (e.g., Holtrop et al., 2021), we will describe and evaluate implementation of our health care system’s brief assessment clinic, while also engaging attendees in activities related to replicating and/or modifying this type of assessment clinic in their own integrated care settings to improve access to care.

This presentation will explore the findings of a Delphi study where the purpose was to identify the pertinent supervisory needs of novice behavioral health clinicians in integrated primary care (IPC) settings. Prior researchers have indicated that behavioral health trainees in integrated care settings have reported receiving unsatisfactory supervision (Kracen et al., 2023; Li et al., 2022), highlighting a significant concern in the training of future behavioral health providers in primary care settings. This presentation will provide attendees with the final list of 68 statements that a group of 12 interdisciplinary behavioral health trainees identified as pertinent supervisory needs of novice behavioral health clinicians when transitioning into IPC settings. A discussion of current supervisory practices in IPC settings will occur, allowing for presenters and attendees to explore ways in which supervision can be enhanced to promote comprehensive training for new clinicians in IPC. This presentation will end with an exploration of future directions for supervisors, educators, and researchers as they continuously evaluate and improve the practice of supervision in IPC settings.

This presentation features a) a new framework for delivery of structured microteaching by imbedded behavioral health clinicians on interdisciplinary teams; b) a panel of experts (Jennifer Funderburk, Stacy Ogbeide, Angela Lamson, Jodi Polaha, Christina Abby, and a BH student) critiquing our microteaching approach and providing feedback for refinements; c) audience Q&A discussion.

Due to the ongoing need for behavioral health services in primary care with decreased resources, we will walk through program evolution and the pilot program. Join us as we explore the results of a pilot program initiative to increase access to Integrated Behavioral Health across Jefferson Health. We will discuss lessons learned and areas of future growth.

Less than 10% of patients with Alcohol Use Disorder (AUD) are getting any treatment and less than 4% of patients are prescribed FDA approved medication for AUD. Because treatment for AUD may help to reduce symptoms, morbidity, and mortality, and there is minimal harm in both pharmacotherapy and psychosocial treatments, this presentation will go over these evidence-based treatments that can and may be used in the integrated behavioral healthcare setting. Target audience is for clinicians who have a general understanding of the topic and the language of the topic with an interest in learning more about Alcohol Use Disorder. All disciplines are welcome. 5 minutes: Introduction/negative impact of AUD 10 minutes: Screening and associated Treatment Plan 10 minutes: Acute/intoxicated patient 10 minutes: Psychosocial Management 15 minutes: FDA approved medications for AUD 10 minutes: Q & A

The Pediatric Physician’s Organization at Children’s (PPOC) is a statewide network affiliated with an academic medical center in the Commonwealth of Massachusetts, serving approximately 500000 children in the State. With more than 80 independently owned practices affiliated with the network, 500 PCPs, and 100 integrated BHCs, the PPOC has significantly increased access to BH, and its focus on education and BH quality measures has improved the quality of BH care for children in the State. There are multiple challenges to achieving a systematic approach to integrated care delivery in a broad and diverse context like the PPOC network. Nevertheless, there have been many successes and accomplishments. This presentation will examine the PPOC BHIP program from its inception more than a decade ago, reviewing its educational and quality components, programmatic outcomes, challenges, successes, and evolution, followed by a glimpse at program strategy and future projects for the years to come. In the last part of the presentation, participants will be able to direct questions and engage in a discussion with the presenters.

This presentation will focus on how researchers and patient/community advisors can partner to address a public health problem. We will describe our collaboration, involving a diabetes-focused translational advisory board consisting of community health workers in Texas taking on pre-diabetes in our predominantly Latinx (Hispanic) communities. Multidisciplinary speakers will discuss our community based participatory research (CBPR) approach and guide attendees in use of CBPR principles, using several learning methods to generate new CBPR ideas for clinicians, researchers and community health workers.

Collaborative Care is the most evidence-based model for integrated behavioral health care with over 90 randomized controlled trials demonstrating its effectiveness. This moderated panel will feature experts from three states, New York, Michigan, and Arkansas, in varying stages of Collaborative Care implementation. They will share stories and lesson learned from their respective states including common challenges and facilitators likely to be encountered in any state, along with potential unique state factors.

Yakima Valley Farm Workers clinics launched a virtual telehealth program for rural schools, addressing pediatric behavioral and physical health needs. Aimed at Hispanic and Native American families, the program reduces barriers to care and stigma surrounding behavioral health services. It emphasizes collaboration between clinics and schools to support students' behavioral needs. This presentation reviews the program's evolution, implementation, and future directions.

The goal of this presentation is to present program evaluation data and quality improvement opportunities from the implementation of the Practice Integration Profile 2.0 (PIP, Mullin et al., 2019; Rose et al., 2023) used to measure the integration of behavioral health services in a primary care setting. This presentation will describe the process in which PIP 2.0 was utilized and how resulting data was used to pursue a secondary assessment of integration and additional quality improvement opportunities in collaboration with the PIP Development Team. Attendees will leave presentation with practical knowledge about implementing PIP 2.0 and using obtained data to enhance quality of integrated behavioral services.

Philadelphia, PA has the highest overdose rate of the ten largest cities in the U.S. at 89.7 per 100,000 in 2023 (PDPH, 2023). People with substance use disorder (SUD) often experience a wide variety of personal, social and environmental barriers to connecting to and stabilizing in sustained SUD treatment. These include medical and mental health conditions, housing, transportation, income and employment, childcare, and stigma from traditional healthcare services. Integrated Care is not new, but usually explores how medical services integrate behavioral health into their programs. The Merakey Parkside program is traditionally behavioral health-centered program, focused on substance use disorders, but has integrated a social outreach team, a police diversion team and an integrated health infectious disease program along with child play area, employment resources, and transportation assistance and relationships with local hospitals and outpatient clinics to promote a system of care approach to substance use and addiction treatment. This presentation will focus on our mobile outreach teams and how they connect people with SUD to sustainable outpatient care with extensive resources.

This presentation examines the impact of women leaders who have navigated crises in healthcare. It will explore ways that women leaders have advanced health equity and inclusion, strengthened corporate governance, and mobilised resources to transform healthcare. This presentation will further discuss the lessons learned, resilience, and crisis management strategies.

Part of the medical provider track

There is a high level of unmet mental and behavioral (MBH) health need among child and adolescent patients and primary care providers – including Family Medicine practitioners – are often the first to identify these needs. The shortage of child and adolescent psychiatric providers, combined with an overburdened mental healthcare system, creates many barriers for patients to access psychiatric care. Co-locating MBH psychiatry services in a primary care setting builds the capacity of clinics to address patient needs while offering training opportunities to upskill current and future Family Medicine providers in supporting the MBH needs of their child and adolescent patients. This presentation will describe the development, implementation, and evaluation of a co-located child and adolescent psychiatric consultation clinic within an academic family medicine center and how this clinic is serving as an educational mechanism for family medicine physicians.

Resilience and healing are built through community. As BIPOC clinicians, it is imperative to gather support from each other so that we continue to make innovative changes in the field of psychology and integrated care. A minority of psychologists in the US are people of color, approximately 15%, (Lin, 2018) which indicates the need for connection amongst BIPOC psychologists within our organizations. In this presentation, we will discuss how we created and implemented a behavioral health BIPOC group within our organization that served as a space for mentorship and support. We discuss the challenges and victories as well as future directions for the group.

Piedmont Health Services (PHS) implemented Medication Assisted Treatment (MAT) for Opioid Use Disorder (OUD) in 2016 at one community health center. Through team-based learning, use of evidence-based practices, and innovating a flexible workflow, we have expanded integrated treatment to eight community health centers (and soon to be nine!). PHS’s successful multisite integration of MAT across clinics shows how MAT care can help patient’s flourish and promote healing across multiple domains.

Historically, integrated primary care (IPC) has served as the first-line and sometimes only point of treatment for many mental and behavioral health conditions. With a soaring demand for primary care provider (PCP) and Behavioral Health Providers (BHPs) limited time and resources, the need for additional care management and scaffolding of care between patient appointments would greatly aid in the treatment of mental health concerns in IPC settings. Mobile health (mHealth) apps can provide a means to address common barriers to accessing behavioral health care experienced by underserved populations in IPC settings. Two pilot studies were conducted to investigate the use of two mHealth apps deployed across multiple IPC clinics to address patients with depressive and trauma related symptoms. To better understand barriers contributing to recruitment challenges, healthcare professionals (N = 11) that would be involved in incorporating these apps into the clinical space were interviewed. Findings from these interviews indicate general support exists for this kind of digital intervention; however, barriers to its implementation persist. In this presentation we will discuss the lessons learned from working with healthcare providers, administrators, and staff to integrate two mHealth apps into the behavioral healthcare delivered across multiple IPC clinic sites. Consideration for future implementation strategies and workflows will be given and larger system level variables will be discussed. Additionally, findings from key stakeholders within the clinical and larger system who are instrumental in integrating mHealth app use within behavioral health care in IPC settings and further pushing the IPC healthcare system into the digital age are presented.

PCBH can be defined as a team-based primary care approach to managing behavioral health problems and biopsychosocial-influenced health conditions. The model's main goal is to enhance the primary care team's ability to manage and treat such conditions, with resulting improvements in primary care services for the entire clinic population. For the RGV, a PCBH focused delivery system (clinical and educational), in which PCPs and BHCs are trained to provide routine, population-based, biopsychosocial care in the RGV, can increase parity for mental health access, minimize toxic effects of culturally bound stigma, reduce fragmentation of physical-mental health and stave off the effect of an expanding OUD crisis for a majority Latino population. A PCBH-ready workforce is a regional solution to reduce health disparities and promote culturally sensitive solutions to whole-person care.

In the landscape of CoCM, the traditional approach of session-based billing can reduce access, patient engagement, and limit overall program sustainability. This presentation explores specific strategies for moving beyond session-based billing to include a task and time-focused billing approach in CoCM practices. By adopting this strategic shift, CoCM teams can unlock enhanced efficiency, flexibility, and resource utilization – ultimately improving patient access, and clinical outcomes. Through a comprehensive examination of the challenges posed by session-based billing and the benefits offered by expanding to a task and time-focused approach, this presentation offers insights, practical strategies, and real-world examples to empower CoCM teams to improve their practices and foster sustainability. We will review specific non-patient facing tasks that meet criteria for CoCM minutes and improve clinical outcomes.

The population of older adults in America is an extremely diverse one. Working with these individuals in the healthcare system provides many challenges. Many geriatric providers use a system of 5Ms to approach health: Multi-complexity, Medications, Mobility, Mentation, and what Matters. This presentation will discuss these in the context of the primary care team and adds W, Who, Where, and What to help professionals understand their older patients in a more complete context in order to provide the best care for them.

Transitioning from a primary care behavioral health model (PCBH) into integrated specialty care can be daunting! During this presentation you will learn the ACTUAL HOW from our Integrated Care team who expanded into four specialty care clinics: Neuroscience, OB/GYN, Endocrinology, and Pediatric Medical Specialties. The service expansion is based upon the PCBH model of care (Reiter et al., 2018; Robinson & Reiter, 2016), in which behavioral health consultants (BHCs) are providing episodic and focused interventions and working as part of the specialty health care team. This session will be practical heavy: how we got started, the questions we asked, tools we used, and how we supported BHCs in this transition. You will get to hear straight from our BHCs who will share their actual experiences: both the amazing and the awful. Finally, we will discuss future directions – expansions into other specialty settings and how we plan to evaluate our model – and how you can do this work, too!

A trailblazing medical organization has successfully augmented its established Primary Care Behavioral Health (PCBH) program by adopting the Collaborative Care Model (CoCM). Rather than transitioning entirely, this organization broadened its care delivery by integrating bachelor's level Behavioral Health Care Managers into the CoCM framework. The use of bachelor’s level Behavioral Health Care Managers ensures that all team members are operating at the peak of their professional capacities. These team members have become integral parts of this expanded care model. The expanded training provided to the bachelor’s level team members will be discussed, including lessons learned from the initial pilot of CoCM adoption. Their inclusion enriches both the PCBH and CoCM programs, leading to improved patient outcomes and enhanced care efficiency. This strategic approach exemplifies an effective model of integrated health care delivery. Further, this innovation has allowed for enhanced opportunities for career pathways internally by investing in internal training opportunities as well as creating a pipeline for existing fellowship programs. We will discuss efforts to coordinate the expansion of CoCM within an already existing PCBH training program, leading to opportunities for diversifying the care team with various interdisciplinary professionals.

As Primary Care Behavioral Health grows in popularity and implementation, programs are beginning to iterate and evolve the model to ensure accessibility for patients and collaboration with medical providers. This presentation will provide an overview, results, and lessons learned regarding a related innovation done at Community Health of Central Washington that piloted a BHC and PCP being paired together to see every patient on the PCPs schedule one day a week. Both the BHC and PCP will describe the process of implementation (including barriers), qualitative/experience comments from patients, providers, and medical support staff, and overall lessons learned from the pilot and innovation. Lastly, the presenters will conclude with hints and tips for participants interested in incorporating this level of collaboration into their own clinics!”

In the demanding landscape of healthcare, professionals are frequently confronted with challenges that extend far beyond clinical duties. Burnout, toxic stress, and emotional exhaustion have become prevalent issues affecting the well-being of healthcare providers. This presentation delves into the multifaceted nature of adverse occupational experiences in healthcare, exploring their root causes and pervasive impact on individuals and institutions alike. Through an in-depth examination of current research and real-world experiences, this session illuminates the importance of supporting healthcare providers beyond their immediate clinical responsibilities. It discusses strategies for recognizing, addressing, and mitigating burnout and toxic stress within healthcare settings. Furthermore, it emphasizes the critical role of organizational culture, leadership support, and peer networks in fostering resilience and well-being among healthcare professionals. Drawing from evidence-based practices and practical insights, this presentation offers actionable recommendations for creating supportive environments that prioritize the holistic health and wellness of healthcare providers. By acknowledging the challenges beyond the bedside and advocating for comprehensive support systems, we can empower healthcare professionals to navigate adversity and thrive in their vital roles of care and compassion. 

The Life Beyond Long COVID workshop is a 3-module, 4-to-6 session series of psychoeducational classes created by a team of embedded psychologists in the South Texas VA’s COVID Convalescence Clinic. These classes target key health areas negatively impacted by Long COVID including sleep, fatigue, and brain fog. Presenters will provide an overview of the class content as well as strategies for attendees to incorporate these interventions into their own clinical practice.

Evaluation and process improvement project to assess the needs of primary care behavioral health providers to increase competence and confidence surrounding gender affirming care and knowledge of World Professional Association of Transgender Health, Standards of Care version 8 (WPATH SOC8) letters of support within primary care model. A work group consisting of integrated behavioral health providers has developed and implemented a survey to assess the knowledge, skills, and experience of current providers as well as gather information on interest in training and preferred modalities. Templates for visit content, documentation, and letter writing have been developed and are currently in beta testing with work group members. Development of training course including multiple modules for providers to complete as desired will be rolling out this summer.

Integrating addiction medicine into primary care is a critical approach to addressing the ongoing addiction and overdose public health crisis, especially in underserved and rural areas where addiction specialty services are limited. The Primary Care Addiction Medicine (PCAM) team from Waco Family Medicine will share their experience integrating addiction medicine into the fabric of a primary care system. Attendees will gain practical insights into implementation of this clinical model, the role of the team in accomplishing goals, and patient perspectives regarding receiving addiction treatment in their medical home.

This session will describe the successes and challenges of the creation, dissemination and implementation of integrated behavioral health services in the Military Health System over a 14-year period. The presenters will use C. J. Peek’s “Three World View” (Clinical, Operational and Financial) as a guiding platform for the presentation. Presenters will detail factors believed to be important in any health system or clinic start-up of integrated behavioral health services and provide guidance on potential pitfalls and how to anticipate and mitigate them.

People often don’t realize how you, as clinicians, administrators, researchers, can assist in helping answer important questions that can help support the evidence behind PCBH and identify the fundamentals to improve its success when implemented, but you can. By reviewing two existing frameworks describing the active ingredients and mechanisms of PCBH, this presentation will assist you in learning how you can help. You will learn about those frameworks and how you can in small ways incorporate it into your program evaluation or research efforts to assist.

You're comfortable with the shallow end: treating depression and anxiety.  Come explore the deeper waters of treating chronic medical conditions!

While BHCs can greatly enhance the primary care management of chronic illnesses, these services are limited by our lack of basic knowledge about medical conditions and an understanding of how BHCs can ethically practice at the top of our licenses in this area.  Back for a second year, this ELO will equip BHCs with the basics of treating diabetes, functional neurological disorders/somatic symptom disorders, and chronic pain and provide a template to situate BHC services within the primary care team with other chronic illnesses. 

Abstract

This workshop, returning for the second year, will provide an overall conceptualization of the role of the BHC in co-managing medical conditions in a primary care clinic. This will include a model that can be applied to all medical conditions and ethical considerations to allow the BHC to proceed with confidence and clarity.  This rubric will be applied to 3 chronic medical conditions (diabetes, functional neurological disorders/somatic symptom disorders, and chronic pain) so the participants will gain medical knowledge and a vision for how to apply it.

Our presentation team includes 3 BHCs, 2 family physicians, and a clinical pharmacist who will be paired to provide the education for the 3 medical conditions.  Participants will rotate through more personalized training with each of the pairs.

Preventable overdose deaths continue to impact our communities. We need to do better in behavioral healthcare at screening for and engaging individuals who are at risk for overdose: nearly 70% of patients who die by a prescription opioid overdose had been seen in a clinical setting within one month of death. We offer an evidence-informed overdose safety planning tool that can be integrated into behavioral and primary care clinical practice and scaled across multidisciplinary healthcare settings to help mitigate overdose risks through patient-centered engagement and support. Structured in the SBIRT model and rooted in principles of motivational interviewing, this tool includes essential steps and best practices for effective clinical approaches to harm reduction and overdose prevention, including best practices for use in integrated behavioral healthcare settings. Learn about the Zero Overdose safety planning tool and its applicability in clinical settings.

Integrated primary care in pediatrics is growing rapidly but many smaller and independent practices not affiliated with higher education or large medical facilities often are left out of opportunities (funding and otherwise) to develop an integrated care program to support patients with mental health needs. In one Northern New England independent pediatric practice, integrated care was achieved by assessing what resources were available and using them to address the shared mission of supporting the whole health of children, youth, and their families. This session will focus on the legal, financial, and clinical issues related to developing an integrated care program. During this interactive presentation, participants will learn about (a) the successes and challenges of this several year effort, (b) resources utilized to grow the practice, (c) the impact of this effort upon wait list data for mental health services, and (d) demonstration data investigating impact of parent education and support upon parental self-perceived competence and confidence.

Primary care behavioral health (PCBH) has been shown to reduce burnout for primary care physicians (PCPs) (Zubatsky et al., 2018), but how are behavioral health consultants (BHCs) impacted by burnout? In the realm of specialty mental health, research has found that nearly half of psychotherapists experience moderately high levels of burnout with correlations to younger age, less work experience, and being “overinvolved in client problems'' (Simionato & Simpson, 2018). While literature on how burnout impacts BHCs is sparse, Zubatsky et al. (2020) suggests that BHCs experience relatively lower levels of burnout compared to clinicians who do not work in integrated settings. So, what is the secret to experiencing less burnout? The presenters will provide a brief review of the literature on burnout in primary care, share their unique perspectives and experiences, and offer suggestions for BHCs at any stage in their career.

Since its inception 40 years ago, Hope Clinic, an intentional faith-based community organization, has viewed people as whole persons attempting to flourish within a challenging community environment. In commitment to its mission to partner with “YOU/ the community,” and to address the myriad of needs within a very diverse setting, Hope Clinic has worked to integrate its services (including primary care, dentistry, food services…) through innovation, change of culture and organizational processes. The work and encouragement of CFHA, and the efforts of those it represents in championing integrated care has served as an encouragement and fueled in part the move in building stronger interprofessional collaboration within the organization and with the greater community. It has been suggested that the main reasons to engage integration is to grow an organization’s capacity to comprehensively address the broad range of whole-person health needs through linkages across the community (see Robinson et al., 2021); Bitton et al., 2018). Implementing integrated, community oriented primary care that addresses social determinants of health may also achieve health equity that in fact meets a communities’ needs (Satcher & Rachel, 2017). Hope Clinic has been able to utilize the foundational concepts of integrated care in carrying out its missional aligned, team-based care through unique partnerships with churches, nationally recognized academic institutions, hospital systems, a large cadre of volunteers, and clients themselves. Attendees who are working to foster community focused, “whole person” care built upon community partnerships will learn and be challenged to consider how to approach organizational change, find innovation in integrating a large cross section of services, to provide integrated care with largely volunteers who are very diverse, and to work from an intentional faith perspective. The organizational and client outcomes, challenges, and strategies taught will parallel the Comprehensive Theory of Integration model (Singer et al., 2020) that identifies five levels of concern in working toward integration. The presentation will include active participation in considering one’s own steps and approaches for organizational change.

Implementing and sustaining innovations in high fidelity integrated care programming is challenging and requires intentional planning by leaders who are informed by implementation science (e.g., Ritchie et al., 2019). Multiple implementation science frameworks propose that successful implementation of clinical innovations, such as integrated care, is influenced by several key domains, including the context of the setting(s) within which they are implemented, characteristics of the recipients of the innovation, and characteristics of the innovation itself (Kirchner et al., 2022). When rigorously applied, leaders spark the uptake, quality, and adherence to evidence within integrated primary care and fuel the outcomes desired by their system leadership and stakeholders. This presentation will provide participants with an overview of evidence-informed implementation activities (e.g., implementation planning guides, communication strategies, and best practices in partner engagement) within the context of integrated care and provide opportunities for leaders to practice and apply these techniques to enhance innovations in their settings. The target audience includes integrated care team leaders interested in applying evidence-informed strategies to advance innovations and enhance integrated care within their system.

We will utilize clinical records from patients screened in integrated primary care settings to identify patterns and differences in who engages in behavioral health care after screening at risk for depression, anxiety, or substance misuse, and how that engagement impacts outcomes. The purpose of the analysis is to identify if there is disproportionate utilization based on personal demographics, geography, or other structural factors. For providers, identifying these patterns can provide a starting point for adapting patient engagement approaches to increase retention and improve outcomes across patients. At the health system level, the results help to identify training and capacity needs to better support all types of patients. Attendees will learn specifically about the role that rurality plays in engagement in care as well as the impacts of integrated primary care in Montana, a large, frontier state.

We introduce a collaborative Mental Health Care model (SCOPE-MH). Initially developed in a medium-sized urban hospital, the model has been successfully implemented in seven additional sites over the past five years. Our discussion will focus on how these diverse sites have adapted the original model to cater to the specific needs of their populations, while also addressing the challenges and opportunities encountered throughout the implementation process.

Medical trauma is the experience of traumatic stress as a result of interactions with the healthcare system, and may be an overlooked traumatic experience that has a variety of biopsychosocial concerns that will present in primary care settings. This presentation will provide attendees with an introduction to medical trauma as a healthcare phenomenon, including the interacting processes related to the development of medically-induced traumatic stress, categorizations of medical trauma, and the associated risk factors and biopsychosocial consequences. The use of the Enduring Somatic Threat (EST) model as a way to conceptualize the development, maintenance, and experience of medical trauma will be proposed and compared to traditional conceptualizations of traumatic stress. The presenters will then transition to ways in which interdisciplinary primary care providers can identify and address medical trauma through the Primary Care Behavioral Health (PCBH) model. The presentation will end with an exploration of the ways in which PCBH systems and clinicians can work to create trauma-informed primary care spaces to adequately prevent and/or respond to medical trauma experienced by their patients.

The Veterans Health Administration (VHA) recently enhanced multiple phases of its national Competency-based Training (CT) for Integrated Primary Care (IPC) through which more than 4500 healthcare professionals have been trained since CT’s inception in 2017. This presentation will cover innovations to the concurrent training of collaborative care managers and behavioral health providers as a foundation for optimizing patient care and improving team functioning in integrated care settings. We will discuss the iterative process of CT development, key data on participant ratings of training satisfaction and applicability of knowledge, as well as pass rates of role plays to demonstrate key competencies. Our target audience is those interested in methods for training integrated healthcare team members for high fidelity and collaborative practice, and attendees will learn about innovative methods for enhancing content while reducing cognitive load for trainers and participants.

Across the country, opioid overdose deaths continue to climb. As an FQHC serving King County in the State of Washington, HealthPoint has looked for ways to provide low-barrier access to MOUD while remaining committed to our mission to provide great primary care to our community. This presentation will discuss how approaching MOUD from an integrated perspective using the PCBH model, leveraging BHCs, nurses, and other team members, we’ve been able to achieve this goal. We’ll share lessons learned as we’ve adapted over the years, and make recommendations for other integrated settings.

The Pediatric Integrated Primary Care Research Consortium (PIPCRC) is a collective of a pediatric integrated primary care clinicians and scholars. This session will describe the rationale for the formation of the PIPCRC, articulate the opportunities and challenges associated with carrying out multi-site integrated care research, and reflect on lessons learned in carrying out two original, multi-site research projects. We will additionally highlight next steps for the PIPCRC and opportunities for CFHA members to be involved in scholarly collaborations.