MCPAP 2.0: What’s Changing, What’s Not, and What’s New Barry Sarvet, MD Chief of Psychiatry, Professor and Chair, Dept of Psychiatry The University of Medical School at Baystate MCPAP Statewide Medical Director John Straus, MD 1 MCPAP Founding Director Today’s Speakers

Barry Sarvet, MD Chief of Psychiatry, Baystate Health Professor and Chair, Dept. of Psychiatry The University of Massachusetts Medical School at Baystate MCPAP Statewide Medical Director

John Straus, MD MCPAP Founding Director

2 How did we get here?

Strategic Strategic Plan Redesign Assessment

3 Strategic Assessment: Successes

Groundbreaking solution

Highly regarded

Replicated nationally

4 Strategic Assessment: Challenges

Unrealistic Performance Misperceptions Expectations Improvement • Care • Ability to “fix” • Variation Coordination the BH across teams System

Changing Healthcare Environment

5 Recommendations for Modifications Many more recommendations than could be implemented within current mission and available resources

• Refine MCPAP’s mission • Clarify MCPAP’s role within the children’s behavioral healthcare system • Make enhancements to the model to more effectively respond to today’s healthcare environment

6 Strategic Plan

MCPAP Mission Statement: MCPAP provides collaborative support to pediatric primary care providers (PCPs) and their patient-care teams to enhance their ability to promote and manage their patients’ behavioral health as a fundamental component of overall health and wellness. Through consultation and education, MCPAP improves the pediatric team’s competencies in screening, identification, and assessment; treating mild to moderate cases of behavioral health disorders; and in making effective referrals and coordinating the care for patients who need community-based specialty services.

7 Strategic Plan MCPAP Goals: 1. Provide accessibility for face-to-face assessments throughout the region. 2. Provide continuity of case consultation with the same consultant over time and ability for PCPs to obtain consults for the same case over time 3. Use data to improve MCPAP performance 4. Develop and maintain collaborative working relationships with key stakeholders including the Health Policy Commission (HPC), Accountable Care Organizations (ACOs), payers, physician organizations, and health systems that are driving change in their primary care practices 5. Serve as a key informant to health care and policy stakeholders to identify gaps in the statewide behavioral health service system

8 Strategic Plan MCPAP Goals: 6. Promote the collaborative care model in pediatric primary care which includes the ability to have psychiatric consultation 7. Complement practice-based behavioral health resources to maximize efficiency and effectiveness 8. Promote the use of behavioral health clinical practice guidelines in pediatric primary care 9. Promote strategies for tracking and coordinating care for patients requiring specialty behavioral health services 10.Maintain consistency across MCPAP Teams in delivery of core functions, with flexibility to meet unique geographical or PCP practice needs

9 What is Not Changing?

Same locations + Boston Children’s Hospital for face-to-face assessments

Most MCPAP psychiatrists Telephone and team members remain Consultation the same

Response Monday - 9:00 am- within 30 Friday 5:00 pm minutes

10 What is Changing?

Three Regional Teams:

West/Central Boston North Boston South Team Team Team Boston Children’s Mass. General Hospital, Baystate Medical Hospital & Center & North Shore & UMass Memorial Medical Center McLean Southeast Medical Center 844.926.2727 855.627.2763 844-636-2727

11 What is Changing?

MCPAP will be more responsive to the healthcare environment in which many practices are evolving to:

• Focus on developing person-centered medical home models; • Implement various models of Integrating behavioral health and primary care; • Affiliate with networks of care through Accountable Care Organizations (ACOs), health systems, and physician organizations.

12 What is Changing? MCPAP will assume a more proactive approach to supporting the primary care practice’s ability to manage behavioral health by:

• Promoting a collaborative care model, supporting various models of integration

• Promoting use of behavioral health clinical practice guidelines for pediatric primary care

• Providing training and consultation on tracking and coordinating care for patients receiving care within the practice and those requiring specialty behavioral health services

13 What is Changing? Two child and MCPAP as “key adolescent Resource & Referral information psychiatrists resource” to work simultaneously Change from care statewide children’s on each Regional coordination behavioral health Team system Enhanced capacity to Track and report on provide face-to-face Collaborative process specific indicators assessments within ten with primary care upon request from business days practices using existing key stakeholders resources where Expanded capacity to available provide robust practice- Stakeholders to include PCPs, state focused education and Tracking and follow-up agencies, legislators training activities become the responsibility of the primary care practice

14 What is New? As an enrolled practice you will experience: • A larger group of rotating psychiatrists answering requests for telephone consultation; however, in most instances you will continue to have access to the psychiatrists you know well.

• Connection with a child and adolescent psychiatrist “MCPAP liaison” who will get to know your practice well: how you currently manage behavioral health, goals evolving how you manage behavioral health, goals for integration and or certification if any, access to resources from affiliations with networks or health systems.

• Use of clinical guidelines to inform consultation and education activities (currently in development)

• Practice-focused consultation and education activities

• Consultation and education on care coordination

15