Most Answered Questions

• We are finally going to be a smoke-free campus, and we're giving clients and employees a few months to start addressing their smoking problems. The serious question that I have is regarding enforcing this policy with groups that utilize our Cultural Community Center after hours (mostly 12-step groups) who smoke in our parking lot and leave cigarette butts all over the place. Has anyone else had to confront this? And if so what was your plan and how well has it worked for you? Asked by: Andrea Washington
  • In Sarasota we have partnered with an agency that has helped us with your question. They are called GULFCOAST SOUTH AREA HEALTH EDUCATION CENTER, INC. I wonder if you may have an AHEC near you as well. They provide free smoking cessation services. They have provided free classes to our staff (case managers, therapists, nurses, receptionists etc.) that has taught them to know how to interact and encourage our clients to begin the process of smoking cessation. They will also come in and provide smoking cessation classes and support to your clients on a monthly basis. I think all staff who interact in any way with the clients have to be taught first how to encourage clients to want to quit smoking or using tobacco products. Once they have the training we can have a universal approach to our clients. So far it seems to be working…….it’s a new approach for but so far it is very encouraging. I hope this helps. Find out if there is an AHEC near you: http://www.nationalahec.org/Directory/AHECDirectory.asp --Trina Dutta Answered by: Leslie Stratford
• What tools are you using to track improvement of health/behavioral health indicators? Asked by: Cheryl Holt
  • Currently we use a 15-item "Healthy Living Questionnaire" that includes the SF-8 Health Outcomes Questionnaire items to look at self-reported changes in both physical and mental health status and behaviors over time. This has been administered quarterly in our 50+ residential, clinic, outreach and shelter programs over the past two years. We have seen change primarily in consumers' access to primary care services. We also track weight and waist circumference for participants in our physical activity program. Clinic consumers are also supposed to have quarterly weight and BP measurements and yearly glucose and lipid monitoring, but we have not yet been able to obtain reliable aggregate data from clinic charts. We are hoping to capture in the near future whether consumers have documented health goals in treatment/service plans. We introduced an EMR in our primary/specialty care clinic over a year ago and are working on ways to monitor health indicators using this platform. Answered by: Jeanie Tse,MD
• What are typical staffing ratios and caseloads for case managers in community behavioral health centers providing integrated primary care? Asked by: Nancy S. Halloran, MPH
  • Case load for our case manager is optimal at about 60 active individuals. She has carried up to 80 but with impact on documentation time and some negative impact on overall decrease in symptoms (still better than we were doing without a case manager). Some other pilots have limited caseload to 30 for clients with more complicated symptoms with good outcomes. Answered by: Bill Schlesinger
• I would like advice regarding patient flow (for instance, if the behavioral health provider is seeing a patient and a primary care provider wants to do a warm handoff, how is that done? Asked by: Nancy S. Halloran, MPH
  • That's where the care manager comes in for us. The care manager provides 'brief therapy,' not longer sessions, and can be available within about 10-20 minutes if not immediately That wait time is (regretfully) in line with the wait time for other services during a visit. If the provider is sufficiently concerned, they may opt to wait (significant emotional distress emerging in the encounter). Usually the patient will wait in the exam room. CBT therapy sessions are scheduled after an interview with the care manager, if that's appropriate in the diagnosis. Most 'easy diagnoses' are initially flagged at intake with the PHQ-9, so there's some ability to alert the care manager if needed. Answered by: Bill Schlesinger
• We are doing a search for 2 new Behaviorist positions to work within a primary care setting. I am interested in hearing from the medical community, what your salary range is for Licensed Psychologists who serve as Behaviorists in primary care settings. Asked by: Mary Monnat
  • My organization has been running an integrated care collaborative with an FQHC in our community for four years. We hired a licensed clinical social worker and pay $42,500 per year. For our master's degreed therapists in the traditional mental health setting, we pay around $33,000-$35,000. In our setting, LCSW's make more than LPC's. Have you thought about using masters level licensed clinicians? Answered by: Kristina Hannon