Systems Building


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Sally Baggett
Director of Patient and Family Services
Carolina Health Centers, Inc.

Published in: Health & Medicine
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Systems Building

  1. 1. Home visitation as a component of primary care Behavioral health as a component of primary care The Children’s Center T
  2. 2. Behavioral Health Services Pediatric Medical Home Care Evidence-based Home Visitation Services The Children’s Center
  3. 3. Integrated services to promote the health and well-being of children Carolina Health Centers’ pediatric associates provide a comprehensive primary care medical home. Carolina Health Centers’ Division of Family Resources and Child Development Services provide early child development and parenting services including evidence-based home visitation. The Beckman Center for Mental Health Services provides on-site mental and behavioral health care.
  4. 4. Prenatal assessment of risks yes First Time Families Yes Low income Prior to 28 weeks No Healthy Families Nurse-Family Partnership Special circumstances Yesn o Birth Assessment of risks n o Reach Out And Read yes Tier 1 Risks Healthy Steps for Young Children Tier 2 Risks Yes Edgefield, Saluda, McCormick, Laurens Co. Greenwood or Abbeville County Resident yes Yes yes yes
  5. 5. Our behavioral health model: • Behavioral health counselor employed by Beckman Center but located at The Children’s Center and fully integrated in the care team • Carolina Health Centers manages the clinical operation • Beckman Center manages the revenue cycle • Carolina Health Centers pays a modest annual fee to Beckman to offset the cost of otherwise uncompensated care resulting in expanded access for home visited families • If needed, the behavioral health specialist will accompany the home visitor on home visits to engage the family in mental health services • 5 year track record with excellent results
  6. 6. Reasons to play together Improved Outcomes for Individuals, for Providers, for Systems Better experience of care Better patient compliance with medical providers’ instructions Reductions in risk factors that lead to chronic health conditions Reductions in costs due to ED visits Improved Access to Care Improved recruitment, engagement and retention in home visitation Reductions in “no show” rates in medical settings Oral health example
  7. 7. Improved opportunities for pay for performance and other quality incentives Increased sustainability for home visitation Combined voice for advocacy Enhanced professional development opportunities Improved accountability
  8. 8. System improvements • Provision of a continuum of services to provide the “best fit” for families. • Increased access and decreased barriers to services • Seamless team approach utilizing medical providers, home visitation providers and behavioral health providers. Families hear consistent messaging. • Use of evidence-based guidelines
  9. 9. System improvements • Shared use of electronic records for communication • Improved family identification, engagement and retention. • Use of a standardized screening and assessment process prenatally and at birth • Continuous quality improvement across services using Institute for Healthcare Improvement Breakthrough Series format. .
  10. 10. System improvements • Electronic record keeping / shared staff for reporting/tracking • Identification of high-risk customers • Enhanced care coordination • Support family self-care and enhance problem- solving capacity • Reporting on performance/evaluation • Improved referral pathways to additional community resources
  11. 11. Collaboration Continuum • Compete • Co-exist HC and GCCC until 2001 • Communicate • Cooperate • Coordinate GCCC peds sold to CHC 2001 • Collaborate Multiple legal agreements • Integrate Full merger 2011 after 2 year pilot – still working to improve
  12. 12. Questions ???? Sally Baggett, Director of Patient and Family Services Carolina Health Centers, Inc. 113 Liner Drive Greenwood, SC 29646 (864) 941-8105