Whole Person Care

Committee Sponsor - Eaton Community Health
 
Nationally and in Michigan, innovative projects are utilizing models that incorporate Whole Person Care or its elements. These projects embrace the fundamental concept that there is a shared responsibility for the health of a community or patient population across sectors.

CAHA’s focus on Whole Person Care focus builds on successful initiatives in the tri-county region to integrate physical and behavioral health services. Whole Person Care benefits individuals and the community in which they reside. CAHA has developed a definition and vision for Whole Person Care in the tri-county community:
 
Definition
Whole person care is the coordination of health, behavioral health, and support to address social determinants of health in a person-centered and relationship based manner, taking into account all that is important to the person, as well as what is important for the person, with goals of improved health outcomes and efficient and effective use of resources.
 
Vision
CAHA is working with a group of community stakeholders to support Whole Person Care that is:
  • Equitably accessed and delivered
  • Person-centered
  • Inclusive of cultural backgrounds, needs and values
  • Provided by an educated, prepared, and diverse workforce
  • Committed to providing resources and support for each person’s health, wellness and self-management goals
  • Committed to valuing and hearing each individual
  • Valued as a means of improving health outcomes and using resources efficiently and effectively


Resources on Whole Person Care

Advancing the Quadruple Aim and Community Wellness is a community health model developed by Partners Behavioral Health Management:  https://www.partnersbhm.org/whole-person-integrated-care-model/

Community-based Whole Person Care Initiatives:
Social Determinants of Health:               Healthy! Capital Counties 2018 Community Needs Assessment: https://www.capitalareahealthalliance.org/docs/Barna.pdf
               Michigan State Innovation Model: https://www.capitalareahealthalliance.org/docs/Peacock.pdf
               Addressing Social Determinants of Health in Federally Qualified Health Centers:  https://www.capitalareahealthalliance.org/docs/Scott_1.pdf

Clinical-Community Partnerships to Address Social Determinants of Health:
An Educated and Prepared Workforce to Support Whole Person Care:

Education and Networking Events

Integrating Primary Care and Behavioral Health Services:  A Community Conversation
November 18, 2021


CAHA hosted community leaders from multiple sectors for a virtual community conversation about integration of primary care services with mental health, behavioral health, and substance use services. The purpose of this conversation was to explore collaborative efforts to support development of sustainable models of integration that will improve health and bring value to the community. The program featured presentations and opportunities for discussion.

Presentations included:
  • Thinking about the Business of Behavioral Health in Primary Care: Virna Little, PsyD, LCSW-r, SAP, CCM, Co-founder and Chief Operating Officer, Concert Health. Dr. Little shared insights on factors that support successful integration of behavioral health in primary care settings, the Collaborative Care Model and understanding the coding options that are available to support a sustainable practice. Download her slides here.
  • Implementing and Sustaining an Integrated Primary Care and Behavioral Health Model: Andrew R. Champine, PsyD, LP, MSHM, McLaren Health Care Corporation: Director of Behavioral Medicine Education, Chief Psychologist MICAPT; MSU College of Human Medicine: Assistant Professor Departments of Psychiatry, Family Medicine, and Internal Medicine. Dr. Champine discussed how McLaren Flint is utilizing the Health Behavior and Intervention approach in their integrated primary care – behavioral health settings.
  • Michigan Initiatives for Healthcare Integration and Coordination, 2020-21: Robert Sheehan LMSW, MBA, Chief Executive Officer, Community Mental Health Association of Michigan. Mr. Sheehan shared observations on the progress of integrated care in Michigan and findings from the 2020-21 survey of integration initiatives.
  • Health Plan Role in Behavioral Health Integration: William Beecroft M.D., D.L.F.A.P.A., Medical Director Behavioral Health BCBSM/BCN. Doctor Beecroft described the Collaborative Care Models and the steps that Blue Cross Blue Shield of Michigan have taken to promote the model and support practitioners’ adoption of the model. Download his slides here
Attendees participated in the breakout groups following the presentations and were asked to discuss the questions:  Several factors impact the sustainability of models that promote the integration of primary care and behavioral health service – billing and reimbursement, health workforce shortages and resources for practice transformation, to name a few. Which factor is most important now to your organization’s integration efforts?  What other issues come to mind when you think about expansion and sustainability of primary care/behavioral health models?

Each of the discussion groups highlighted issues related to the behavioral health workforce, including shortages, the need for a diverse, culturally aware workforce to address racial and ethnic disparities in access to services and outcomes, accessibility, and new models of care. View the event summary and follow-up materials here.

 

Whole Person Care and Social Determinants of Health 
July 23, 2019


CAHA held the second in a series of education and networking events on July 23, 2019, to promote whole person care in the Greater Lansing Area. The series is intended to increase awareness and understanding of concepts and strategies that support whole person care. 

Whole person care recognizes that many factors impact the health of an individual and the population, and that health and healthcare outcomes are greatly influenced by factors related to an individual’s social environment, physical environment and economic opportunity. Three presenters shared perspectives about these social determinants of health: Anne Barna, MA, Planning, Promotion and Evaluation Manager of the Barry Eaton District Health Department; Lisa Peacock, MSN, RN, WHNP-BC, Health Officer for the Health Department of Northwest Michigan and the Benzie-Leelanau District Health Department; and Anne Scott, MPH, Executive Director of Ingham Community Health Centers and Deputy Health Officer for the Ingham County Health Department. 
 
Ms. Barna shared findings from the 2018 Community Needs Assessment, a triennial assessment conducted by the health departments for Clinton, Eaton and Ingham Counties. The assessment is used by the health departments, health systems and community organizations to identify priorities for community health improvement. The priorities emerging from the 2018 assessment are: Behavioral Health, Health Care Access and Quality, Obesity, Financial Stability and Economic Mobility, and Chronic Disease. In discussing findings related to social determinants of health, Ms. Barna indicated that while chronic disease is the main killer throughout the tri-county area, social conditions that promote health vary across the region. Because of that disparity, minorities, people of low income and other vulnerable populations are often less healthy. She also encouraged participants to use the assessment to learn more about the community’s health status and priorities. It can be accessed at: https://www.healthycapitalcounties.org/
 
Ms. Peacock discussed a regional program in northwest Michigan, which was one of five regions selected as a Community Health Innovation Region for Michigan’s State Innovation Model project. The region is utilizing data from social determinants of health screenings and other sources to identify social conditions affecting health. Through partnerships with community organizations, businesses and healthcare providers, they are working to improve policies and practices to increase the availability of accessible transportation options; affordable and healthy housing; communities that promote active living; and healthy food access. 
 
Ms. Scott described how the Ingham Community Health Centers collect and use social determinants of health data to direct people to community resources, advocate and invest in strategies to improve the health outcomes of their patients and identify potential risks in their patient population. Focusing on several patient populations served by the Community Health Centers – homeless people, refugees and people identifying as lesbian, gay, bisexual or transgender – she described the different approaches utilized by the Community Health Centers in addressing the social determinants affecting the health of these populations.
 
Both Ms. Peacock and Ms. Scott commented on the value of Community Health Workers in their strategies and the need for policies that recognize their contribution to health and health outcomes.

 
The Whole Person Care Team
April 24, 2019


The Whole Person Care Team was held on April 24, 2019, and was presented by Christopher G. Wise, MHSA, PhD. The attendees represented health systems, community mental health, local public health, physician groups, education, health plans and community organizations. 

Dr. Wise has extensive experience in employing the principles of Lean thinking to the redesign of clinical practice processes. He discussed contexts in which practices have undergone redesign, including transformation to PCMH models, and alternative model testing for the Michigan State Innovation Model. A high level overview of the Lean process was shared and discussed: defining the scope of the problem to be addressed, creating visual maps of the current state process and the future state process, developing goals and action plans, implementation, checking and adjusting. Dr. Wise emphasized that process redesign needs to be done by the people doing the work and that the creation of visual maps is important to identifying steps that do not add value to meeting patient needs. He shared examples of current state and future state maps done in redesign processes and discussed the impact of redesign on cost and quality outcomes.

A lively discussion with attendees followed the presentation, addressing challenges and opportunities related to redesign, internal culture, the adaptive reserve for change, and other issues. View the slides from the session here.