Integrated Health Care: Connecting Body & Mind

INTEGRATED HEALTH CARE QUICK FACTS:

Texans with serious mental illness such as bipolar disorder or schizophrenia die nearly 30 years earlier than the general population. (The national average is 25 years.)

Almost two-thirds of these deaths are caused by a treatable physical illness, but health care is beyond the reach of many people with debilitating mental health conditions.

People with serious physical illnesses such as diabetes and heart disease are more prone to depression and anxiety, which can impair their ability to follow doctors’ instructions, take medications and make positive life changes such as quitting smoking, eating healthier and exercising.

People's minds and bodies are inseparable -- except when it comes to health care. All too often, physical and mental health conditions are treated apart from one another. Different insurance plans cover physical and mental health care. Providers in unrelated offices or clinics treat physical and mental health conditions. Medical records with important details about test results, diagnoses and medications, are scattered and incomplete.

A growing body of research and experience shows that integrating, or systematically coordinating, physical and behavioral health care to treat the whole person can improve health. Read more about the Hogg Foundation's work with mental health service providers, public and private stakeholders, and policy makers to expand integrated health care in Texas below.

Integrated Health Care Planning and Implementation Grants

In August 2012, the Hogg Foundation awarded $720,950 to support the planning and implementation of integrated behavioral and physical health care programs at 10 organizations across Texas. Five organizations in the early stages of adopting an integrated health care program received up to $25,000 each to support their planning process. After one year, these grantees will be eligible for a second year upon successful completion of the one-year planning activities. Five additional organizations that have completed the planning phase were awarded up to $100,000 each over a two-year period to implement their integrated health care plan. One organization, will receive both types of grants. Read the news release about the grant awards.

Partnership with the Federal Office of Minority Health
On February 7, 2012, the Hogg Foundation in partnership with the federal Office of Minority Health hosted a one-day conference to promote integrated health care as a means of eliminating health disparities in racial and ethnic minority populations and persons with limited English proficiency. Conference attendees learned about integrated health care service models and practices, key components of cultural and linguistic competency, and recommendations developed by a national consensus panel of experts on how to bring these together to achieve quality health care for all. Participants also learned how these recommendations can be effectively implemented.

In June 2012, the Hogg Foundation and the Office of Minority Health released "Enhancing the Delivery of Health Care: Eliminating Health Disparities through a Culturally & Linguistically Centered Integrated Health Care Approach." The report is based on research conducted by the Hogg Foundation and proceedings from the 2011 national consensus meeting titled: "Eliminating Behavioral Health Disparities through the Integration of Behavioral Health and Primary Care Services for Racial and Ethnic Minority Populations and Those with Limited English Proficiency (LEP)." The literature review report, which examines reports and articles from peer and non-peer reviewed publications, compiles the available evidence from practice, and summarizes the knowledge base on cultural and linguistic competence in health care delivery, served to inform the national consensus meeting.

The report shares best practices, insights and strategies to create a framework for integrated health care, placing focus on racial and ethnic minorities, and people with LEP.

Collaborative Care Grant Initiative

The Hogg Foundation's work in this area began in 2006 with the award of $2.6 million in three-year grants to bring the “collaborative care” model of integrated health care to several clinics in Texas. Several models to integrate physical and mental health care are in use in the U.S. The collaborative care model places a primary care physician and a mental health professional at the same site to improve access to both types of care. The model proved so successful that most of the grantees continued using it after the grant ended.

Related links:

Feature story about an El Paso grantee's experience with integrated health care
Third-year update about the collaborative care initiative
Questions and answers about the collaborative care model

Integrated Health Care Financing Webinar
On July 26, 2011, the Hogg Foundation teamed up with national expert Kathleen Reynolds, LMSW, ACSW to host a free webinar on how to finance integrated health care, both nationally and in Texas. The webinar presented several ways to fund collaborative care and integrated health care initiatives today. Attendees also learned about a free new financing worksheet developed for Texas that can serve as an example for other states. View the webinar recording and the worksheet here.

Policy Workgroup

The Hogg Foundation's staff was appointed as a member to the Texas Integration of Health and Behavioral Health Workgroup. The workgroup was created by House Bill 2196 in 2009 to recommend best practices in policy, training and service delivery to promote the integration of health and behavioral health services in Texas. Members were appointed by the Texas Health and Human Services' executive commissioner and represent stakeholders such as consumers, family members, advocacy groups, providers, health care workers and state agencies. The Hogg Foundation hosted meetings and provided administrative support to the workgroup. The workgroup published its report on Integration of Health and Behavioral Health Workgroup before the 82nd Legislature convened in 2011.

Statewide Learning Community

In 2009, the Hogg Foundation awarded a one-year grant to Mental Health America of Greater Houston to create a statewide learning community on integrated health care. Members are collaborating in person and online to share information and experiences with implementing different integrated health care models, components and strategies. Learning community members are in Dallas, El Paso, Georgetown, Houston, Lubbock, Plainview, Round Rock, San Antonio and Tyler. In 2010, the grant was extended for an additional year and expanded to eighteen learning community participant organizations throughout Texas. MHA of Greater Houston contracted with two local firms, Sage Associates, Inc. in the first year and Working Partner, LLC in the second year, to conduct an assessment of the learning community. The foundation has aggregated findings from the assessments. Click here to read the executive summary.

Other Past Integrated Health Care Initiatives:

2008 Statewide Conference on Integrated Health