NAMI CA 2019 Presentation: Mental Health and the Justice System

/

At the California National Alliance on Mental Illness (NAMI) Annual Conference 2019 in Newport Beach, California, Telecare’s Sarah Nudel and Robin Weintraub were honored to present on the Behavioral Health Court Model, a specific program type designed to serve individuals who have mental health needs and are involved with the criminal justice system. We are pleased to share the presentation below.

Mental Health and the Justice System: Behavioral Health Court Model Puts Teams on the Same Page

Telecare Corporation has provided services to individuals with serious mental illness and co-occurring justice involvement issues for more than 15 years. The focus of this year’s NAMI CA presentation was the Behavioral Health Court (BHC) model, a treatment modality that Telecare offers for the community through programs in Orange County and San Diego County, California.

Program Model Overview

The BHC model has been a productive and effective model to support individuals with serious mental illness who are on probation, to help them regain and maintain stability, fulfill the obligations of their probation requirements, prevent recidivism into the criminal justice system, and take steps toward a healthier future, a more stable life, and meaningful roles in the community.

The Behavioral Health Court Model is a collaborative process with multiple stakeholders. Here’s the BHC role breakdown:

Mental Health Professionals

  • Focus on mental health treatment

  • Sensitive to privacy

  • Recovery-focused

  • Community linkages

  • Mental health visits at home/in the field

  • Teach effective choice-making

  • Power aware

  • Seek to awaken internal motivation

Justice Partners

  • Focus on accountability

  • Community supervision

  • Monitor conditions of release (COR)

  • Community linkages

  • Perform visits and searches at home

  • Focused on compliance, not choice

  • Power-over

  • Use COR and sanctions as external motivation

AB1971.jpg

Learn More About the Model

Program length is a minimum of 18 months, but members typically stay 2-3 years.

BHC is a day program model where clients participate in groups based on where they are in their recovery process in the program. Programming focuses on evidence-based practices to support recovery, reduce criminogenic behaviors, and support the individual in making forward progress in the program. Case managers link members to community resources.

After graduation, members are transferred to outpatient clinics at an equal or lower level of care depending on the presenting need.

Contact Information:

Telecare Welcomes New SVP and Chief Human Resources Officer, Sharon Heckel

/
sharon heckel new_opt_opt.jpg

Telecare is pleased to welcome and introduce the newest member of our executive team, Sharon Heckel. Sharon recently joined Telecare as Senior Vice President and Chief Human Resources Officer, bringing over 25 years of human resources management and consulting experience in health services and other industries to Telecare.

“We are delighted to welcome Sharon to the Telecare family, serving in this crucial role," said Anne Bakar, Telecare President and CEO. "She brings a wealth of experience from larger healthcare organizations, as well as entrepreneurial experience from her work in startup environments, family-owned businesses, and consulting. She understands the importance of adapting to the the changing reimbursement climate while reinforcing the culture and values that bind us together. She has already had a positive impact on our workforce planning and process of engagement.”

Most recently, as Vice President of Human Resources at Clorox, Sharon was responsible for the successful delivery of HR functions and development of a positive employee experience across Clorox’s domestic and international operations.

“I am thrilled to be part of Telecare," said Sharon. "The company's mission, the strength of our employee population, and the unique needs of the people we serve drew me here. I look forward to working with Telecare to seal our reputation as an employer of choice in behavioral health, providing our employees with fulfilling jobs and meaningful careers.”

SUTS Conference 2018: Reaching the “Unreachable” with Co-Occurring Education Groups

/

Across the nation, 60 million adults aren’t receiving adequate primary care, 33% of adults with serious mental illness aren’t receiving any mental health services, and 90% of people with substance use conditions aren’t receiving any care for their substance use.

Yet individuals with co-occurring SMI and substance use are often among the highest utilizers in their systems of care. At Telecare, these co-occurring conditions are very prevalent: 70% of our clients are also dealing with substance use. The majority of these individuals do not recognize that their substance use is affecting their health and wellness, aren’t currently considering treatment, and aren’t considering a change in their use of substances. 

In August 2018, Telecare’s Vice President of Operations, David Heffron, and Director of Special Projects - Substance Use Treatment Services (SUTS), Scott Madover, presented at the Substance Use Disorder Statewide Conference put on by the California Department of Health Care Services. We are pleased to share their presentation, “Reaching the Unreachable: Engaging People with SUTS in Pre-Contemplation Phase,” and their ingredients for success below.

Download a PDF of the Presentation

Click the image above to download a pdf of our suts presentation

Click the image above to download a pdf of our suts presentation

Reaching the Unreachable: Engaging People with SUTS in Pre-Contemplation Phase

So how do we help people who not yet ready for change? How can improve health and wellness — when a person does not recognize the impact of substance use in their life?

We begin from a place of curiosity, conversation, information, and engagement — for staff and clients — and we cultivate an environment where change might be possible.

As part of Telecare’s Whole Person Care initiative, we developed and launched a curriculum called Co-Occurring Education Groups (COEG). The 16-week curriculum is intended to address the shared challenges providers and systems face: reaching the “unreachable” through respect, engagement, education, and ongoing support.

COEG Basic Framework

Each session in the 16-week curriculum covers a different topic of discussion: from understanding addiction, to recognizing triggers, to reflecting on one's hopes and goals. In some of Telecare’s programs, groups are offered weekly; in others, groups are offered several times a week. Each group is moderated by a trained staff member and takes 60 to 90 minutes to complete. Due to Telecare’s many types of programs, the curriculum was designed to supplement — not replace — the regular clinical services that a program already delivers. Likewise, the curriculum does not contain service-line specific information, therefore, almost any program can use the materials. The groups are open, so new participants can join a group at any time. This flexible drop-in format gives individuals ownership over their future.

Ingredients for Success

  • Keep on going

  • Teach it all

  • Share the facilitation

  • Stick to the script

  • Be prepared

  • Include everyone

  • Educate and explore

  • Show respect and non-judgment

  • Keep groups open

  • Schedule groups regularly

More Information

Brochures & Information

COEG Resources

Links we Love: September 2018

/
Telecare_Links+We+Love.png

September is National Recovery Month. This month, we’re featuring inspiring stories, news, and information to continue to support and spread a stigma-free environment.

From Member to Employee: Christina’s Journey Through Telecare's WIT Program

/
Christina Roberts, driver at Telecare steps orange county and former WIT member

Christina Roberts, driver at Telecare steps orange county and former WIT member

September is National Recovery month. It is a time dedicated toward educating Americans that substance use treatment and mental health services can enable those with symptoms of a mental health diagnosis and/or substance use to live healthy, rewarding lives.

At Telecare, we not only treat those with co-occurring disorders, but also take pride in employing former clients who have lived experienced and continue in their recovery journey. Christina Roberts, a driver at Telecare STEPS Orange County, shares her inspiring example. By harnessing life’s setbacks, Christina has shown that it’s possible to navigate to destinations the previously may have seemed impossible.

“When I come into work now, I'm giving back. I can relate. I had a drug and alcohol problem. I now have two years clean. I struggled with homelessness, drug addiction, and mental illness. I hope that I can just take one member and lead them in the right direction and help change their life like it's changed my life,” said Christina.

 
Telecare STEPS Orange County_Christine_Peer.png
 

After getting into trouble and ending up in front of a judge for sentencing, Roberts was given two choices: serve jail time or participate in the Orange County Collaborative Court (WIT) program. WIT, which stands for “Whatever It Takes,” began in 2012 as a collaboration between Telecare and the mental health courts of Orange County. It’s a four-phase, voluntary program where members who have a demonstrated history of mental illness are put on conditional release from prison.

While in WIT, they are required to be sober, transition up to new phases, and ultimately graduate from the program. The goal is to equip those in recovery with new skills and resources—things they might not receive through incarceration.

“To be honest, I had a relapse. It was too much. It was overwhelming. I was scared. I didn't want to follow directions. I wouldn't submit to the program,” she admitted. “I got arrested. When I got arrested, I had to serve some time, but then Telecare took me back. They gave me a second chance. WIT stands for ‘Whatever It Takes,’ and they stood by what that means.”

Christina then fully embraced WIT, the support groups, and most importantly, her peers. Actively participating in the programs is also what helped her find her true calling—wanting to go from Telecare member to Telecare employee.

“When I came back from my relapse, I told my probation officer and the staff at Telecare that I was going to work for Telecare. I didn't know how it was going to happen. A few months later, I spoke at an FSP luncheon and I got three job offers,” Christina said.

She chose to accept the offer as a driver at STEPS and hasn't looked back.

Christina credits Telecare for being the driving force in her personal recovery—a force that stood with her and believed in her when no one else did.

“Telecare saved my life,” said Christina. “It provided stability, and it's shown me how to become a productive member of society. It taught me that I can make it in this world and have a mental illness.”

Program Spotlight: Summer Openings at Telecare

/

Summer is one of the busiest times at Telecare. Our Start-Up Team is currently deployed across California to support the launch of programs designed in partnership with new and existing customers. From May through July, Telecare opened the following programs, and more are coming soon. To explore Telecare’s full list of locations, click here.

Southern California

Treehouse North in Anaheim, ca

Treehouse North in Anaheim, ca

  • Now Open: TREEhouse North (Anaheim, CA)
    • In May, Telecare's newest crisis residential program, TREEhouse North, opened as part of Orange County Health Care Agency's efforts to expand its network of crisis care. Similar to TREEhouse South, which opened in Mission Viejo in July 2017, TreeHouse North provides voluntary, short-term services, typically lasting 7 to 14 days. The team of peer counselors and licensed professionals provides co-occurring capable services for people who are experiencing a behavioral health crisis and may also have substance use issues.
Stanislaus County's TRAC/TMRS

Stanislaus County's TRAC/TMRS

Central California

San Joaquin County's TEIR

San Joaquin County's TEIR

  • Now Open: TRAC/TMRS Expansion (Modesto, CA)
    • In June, one of Telecare's oldest Stanislaus County programs expanded its services to join the Stanislaus CARE team, a multi-agency team providing services to people experiencing homelessness and co-occurring mental illness. 
  • Now Open: TEIR Expansion (Stockton, CA)
    • In July, Telecare's early intervention program serving San Joaquin County's youth expanded from 25 to 50 slots to meet the growing community needs. Telecare is pleased to support efforts to address mental health issues at the earliest stages to help people prevent or minimize the negative effects of untreated symptoms of mental illness. 

Northern California

Alameda County's Sausal Creek

Alameda County's Sausal Creek

  • Now Open: Sausal Creek Redesign (Oakland, CA)
    • In July, Telecare's crisis walk-in clinic completed the redesign of its services to meet the evolving needs of their community by adding a medication clinic and case management. Over the years, Sausal Creek has served Alameda County as a 24/7 crisis walk-in.

Links we Love: June 2018

/
Links We Love.png
 

In recent months, many public figures came forward and discussed their experience with mental health in major news outlets across the country. Here are some resources we found inspiring:

NatCon2018 Presentation: An Organization’s Incremental Journey Toward Whole Person Care: Practice Improvement in Real Life

/
telecare-journey-toward-whole-person-care.png

In 2010, Telecare began a journey to Whole Person Care, bringing greater focus on healthcare and substance use services into our behavioral health programs. 

With limited resources to draw upon, we needed to be cost-conscious and choose approaches that offered the greatest impact and leverage.

In April 2018, we shared our journey and lessons learned in an iPoster session at NatCon18.

View a PDF of the Presentation

Download our natcon iposter session by clicking the image above.

Download our natcon iposter session by clicking the image above.

Workforce Development

As we began to develop our Whole Person Care plan, we found that we needed to address the training challenges of our geographically diverse and multidisciplinary workforce. Telecare has nearly 3,500 staff spread over seven states and a very diverse workforce of behavioral health providers and nursing staff. The entire range of our staff needed to understand the importance of whole health as well as have knowledge of co-occurring substance use and chronic health conditions, and be able to use tools to engage clients and enhance motivation through stage-matched conversations. To address this, we developed an 18-hour Whole Person Care eLearning program that covers stages of change, substance use and addiction education, as well as significant facts on chronic health conditions, culminating in an earned certificate. 

Clinical Practice Improvement

We needed to update and enhance our current clinical practices to include whole health education and lifestyle modifications, as well as explore clinical models for coordinated care that improve outcomes and reduce costs for customers. 

Our Co-Occurring Education Groups (COEG) were developed to reach people in pre-contemplation and contemplation stages of change around substance use. We also created “Smart Sets”: Decision trees that enforce key elements of health integration and identify touchpoints for motivational enhancement. We also partnered with customers to build new coordinated care clinical models that improve outcomes while reducing costs. We tested and refined new processes and then disseminate them broadly to the rest of our programs. Finally, we identified several interdependent evidence-based practices and developed a clinical framework to bring them to staff, matching the critical skills to staff roles and client acuity levels. 

Client Education

The people we serve often do not understand their high-risk physical health conditions, nor do they have fact-based information on the effects of substance use on their health. To assist our mental health providers in regularly educating and engaging clients in conversations around their health conditions, Telecare created easy-to-read, visually-engaging handouts that present a range of whole health topics, including blood pressure, body weight, diabetes, and asthma. The handouts provide education on facts and effects about each condition and offer suggestions for how to manage or prevent the condition. They also inform and empower clients by suggesting lifestyle changes that can directly improve their health and wellness. 

Staff have reported increased confidence initiating conversations by using these handouts, and clients report that they are learning information about their conditions for the first time. We have translated these handouts into six threshold languages to increase accessibility. Our workforce benefits from the handouts as well: staff report that they are using the handouts to learn about and manage their own chronic health conditions. 

Initial Outcomes

Telecare’s Partners in Wellness, the first mental health Pay for Success program in the nation that incorporates our Whole Health tools, is surpassing its success targets, with excess savings of more than $500,000 in the first year. Another program, Inland Empire Health Plan (IEHP), a population management program for high utilizers, has shown statistically significant reductions in psych inpatient, psych ER, medical ER, and IOP utilization, as well as increased contacts with their primary care physicians. (See poster for more details.)

Lessons Learned

We have learned that the following practices greatly enhance our ability to integrate Whole Person Health into our programs:

  • Educating our senior leadership team first. Senior leaders must fully understand and be "on board" with new practices and clinical models before roll-out to the company at large.

  • Engaging all staff to see health equity as a social justice issue, which helps us advocate for the people we serve.

  • Communicating clearly and consistently to ensure comprehension and buy-in from staff.

  • Adapting plans as funding appears and disappears; being nimble allows us to keep up with changes in the healthcare environment.

  • And finally, remembering that small steps matter! Sustaining momentum is important when introducing and learning from new models of care.

More Information

Download our natcon iposter session by clicking the image above

Download our natcon iposter session by clicking the image above

Telecare Whole Person Care Brochures and Information

COEG Resources

NatCon 2018 Presentation: Pay for Success

/

In 2017, Telecare opened the nation's first mental health Pay for Success (PFS) program in Santa Clara County, California, called Partners in Wellness.

At NatCon2018, Telecare hosted a lunch and learn presentation sharing initial results from our PFS program, an overview of the PFS model, a clinical overview of the program, and learnings for other systems interested in possible implementation. We are pleased to share the presentation and findings below.

Alternative Payment Models:
Pay for Success

Initial Results

telecare-pay-for-success-savings.png

In the first year of operation, Partners in Wellness saved more than $508,482 above the target savings. The program reduced usage well over the target rate for all services, including 81% over the target of psychiatric emergency services visits and 100% over the target for state hospital days. Significant clinical results were also shown: after a year, people with higher depression, psychosis, and drug and alcohol use scores showed significant improvement over time. Anxiety levels (measured through screenings) also improved, as well as physical health measurements such as HDL-C scores. 

PFS Model Overview

Telecare's Partners in Wellness program is an innovative six-year, performance-based contract to deliver publicly-funded services. Telecare is at risk to deliver the savings targets outlined in the contract by reducing clients' use of psychiatric hospitals, psychiatric emergency services, state hospitals, and other mental health services while also ensuring each client’s whole-person wellness. The performance targets are set to fully pay for the program (in savings) and return additional savings at the end of the six years. Dr. Keith Humphreys of Stanford University objectively evaluates the program results. From the RFP process beginning in December 2014 through the January 2017 official launch of the program, more than two years of work went into the development of this program. 

What's Different About Pay for Success?

Pay for Success programs, including Partners in Wellness, include several areas of additional measures and tools, and a higher degree of data analytics, than other programs typically provide. (Click on the chart to the right to see an outline of some of these differences.)

PFS Clinical Model Overview

The clinical care model for Partners in Wellness uses several tools to engage with consumers, also known as partners, on multiple fronts. Physical and mental health are measured through screenings and assessments, and a "whole health" care plan is created in partnership with the persons served. From there, the multidisciplinary team — including several peer specialists — works with the partner to ensure they have adequate housing, medications, physical health supports, care coordination, and assistance in developing recovery tools as they work toward their wellness and recovery goals. Data from health measures and a daily "Wellness Snapshot" are entered and used to produce a Huddle Report that prioritizes the team's treatment and intervention planning in their morning huddle. A monthly report tracks partners' progress over time. Treatments are adjusted as needs change. 

Lessons Learned

One of the most important lessons we have learned in our first year of operations is how crucial it is to have a firm understanding of the community in which we are working, as well as strong relationships within that community. Factors such as other community resources, housing costs, and Conservator or Public Guardian Policies can all make a big difference in the outcomes of Pay for Success programs like Partners in Wellness. 

More Information

 

Visit Us at NATCON 2018!

/

Telecare is excited to attend National Council's NATCON2018 in Washington, D.C., April 23 - 25. We are presenting at two forums during the conference. Dr. Kent Eller, SVP and Chief Medical Officer, and Shannon Mong, Director of Innovation Initiatives, will be presenting a Whole Person Care poster session. Shannon will also be presenting a Pay for Success Model Lunch-n-Learn with Faith Richie, SVP of Development. 

Join us for Breakfast

In addition to our regular booth, we will be hosting an informal breakfast at the Gaylord National Resort & Convention Center, Magnolia 2 Conference Room, on April 24.

RSVP

Let us know if you'd like to join us! Send your RSVP to Cynde Burgstahler at cburgstahler@telecarecorp.com. 

Links We Love: April 2018

/
Links We Love.png

Get ready! May is Mental Health Month, and to celebrate, we've found some excellent resources you can share in your communities.

  • The wait is over! Mental Health America creates a fabulous toolkit every year filled with fact sheets, infographics, template social media posts, press releases, and more! Download your copy here.
  • NAMI also creates an excellent resource page with talking points, infographics, social media suggestions, and more. Check out the NAMI Mental Health Month resource page for more information.
  • The National Council for Behavioral Health created resources to make outreach efforts even easier. Download infographics on women's mental health, how to help a friend in need, and identifying behaviors in teens that might be warning signs. Check out their resource page here.

Links We Love: March 2018

/
Links We Love.png

Welcome New Telecare Leaders!

/

Telecare has made recent improvements to our operational structure to provide better leadership for our programs and better service to our customers. To read more about our leadership changes, click here. 

This month, we are pleased to introduce our newest Vice President of Operations, Michael Sherbun, as well as welcome our other newest leadership staff below!

Michael Sherbun, VP of Operations

Michael Sherbun, Vice President of Operations at Telecare

Michael Sherbun, Vice President of Operations at Telecare

"I am passionate about this field and assuring treatment is available for all those who are in need," said Michael. "I look forward to continuing the rich culture that Telecare has created and expanding our service wherever needed to enhance access to mental health treatment. I truly love what I do, and am fortunate to be with a company as great as Telecare."

Michael will oversee three of our Psychiatric Health Facilities—Heritage, Willow Rock Center, and Santa Cruz—as well as Santa Cruz CSP, Gladman MHRC, Sausal Creek, and our two contract service hospitals, Ohio Valley General and Providence Milwaukee.