WIXLIB

6Community College health CenterAssociationOMPD, DOC, IJDHColts player for addictionpreventionMedicaid and other state agenciesAnthem etc., Indiana PhilanthropicAlliance, United Way Indiana,Indiana Healthcare Foundation(Heather Reed)Floyd Memorial Hospital, RonaldKronNFL, MLB, NBA, NCCA, etc.State AgenciesAthletic TeamsState Insurance AgenciesHealth/Family FoundationsHospitalsAthletic Associations (college andprofessional)Next Steps to Implement in Your StateNext stepChoose date for a 15-20 personsummitHave a planning meeting todebrief and set priorities. Meetingcan be in person at IndianaAddictions Coalition Office and viaphoneCreate timelineID additional 2-3 members whocan help move from talk to actionto join a steering committee(prioritize members based onstrategy buckets)Invite steering committeeHost first steering committeeBy when?Spring 2016Contact/Lead/WhoAll of the planning teamJuly 31, 2015Miranda/Kim to coordinate –current planning team toparticipateJuly 31, 2015July 31, 2015All of planning teamAll of planning teamAugust 31, 2015September 30, 2015All of planning teamAll of planning teamIndiana’s ReflectionsWhat is an overnight reflection you had?Goal orientedConnectedThink outside of the soft packFeeling supportedTipping pointEncouraging and inspiringI have hopeIntegration6

7KentuckyWhat Other Data Points Might Your State Need for Tobacco Use byBehavioral Health Populations?Type of dataDisparate populations: Appalachian population (viacounty level data)Low SESWhy people smokeTobacco use and mental illness by county% of Medicaid members using tobacco cessationbenefitsImpact of health department cuts on cessation servicesBH/Quitline dataPossible data sourcesUniversity of Kentucky GIS dept.KY MedicaidNational Jewish HealthWhere are we now?Proposed Baseline (Mental Health)Data Source42.6%(Poor Mental Health)BRFSSProposed Baseline (Substance Abuse)Data Source45.1%(Binge Drinking)BRFSSWhere do we want to be?Proposed Target (Mental Health)Reduce smoking rates by 20% in the MH population by 2020 (42.6% to 34.0%).Proposed Target (Substance Abuse)Reduce smoking rates by 20% in the SA population by 2020 (45.1% to 36.0%).7

8How will we get there?If you are to achieve your target, how can your planning team members work together to impact the system?Prioritize smoking cessation among Medicaid/Mental Health and Substance Use departmentsCraft position statement supporting tobacco-free policies; signed by BH, SA, Medicaid departments, and others;Secretary Audrey Tayse Haines; Commissioner BegleyData collection – conduct focus groups on why people smoke; women and substance abuseContract with quitline to educate MCOsNAMI conference in LouisvilleRegional Prevention Centers/BH directors educationComp care contracts – include incentives for smoking cessation services (or language supporting services)Collect smoking status of Comp Care patientsGet smoking on the agenda in other public agencies(Bring information from Tobacco Cessation Affinity Group to this group)Establish direct referrals to quitline from EHRNRT on Rx pads for providersPromote cessation within CMHC staff “Quit and Win”; motivator for consumersMCO incentives for patients with SPMIMobilizing Your State – Who Can Make This Happen?Comprehensive list of potential partnersSector / Agency / DepartmentMedicaidSmoke-free KYPathways/CMHCsDBHDIDPublic HealthAmerican Lung/Cancer/Heart – reps on Smoke-free coalitionsFoundation for Healthy KentuckyCampaign for TFK- Amy BarkleyState Insurance - KEAPNAMI - KYState HospitalsNurses/Medical AssociationKentucky Public Health AssociationKCC – Kentucky Cancer ConsortiumKCP – Kentucky Cancer ProgramCenter for Rural HealthPrivate Hospitals – The RidgeKentucky Behavioral Health AssociationKARP – Kentucky association for Regional Programs (CMHCS)EQRO – external quality review organization (for Medicaid)PAR – People advocating for Recovery- Mike BerryDept. of EducationDept. of Health Policy- Emily ParentoOmbudsmen OfficeProtection PermancyAnthem8

9Coal Industry/Unions – who influences in Eastern KY?Mental Health AmericaUnited Steel Workers of AmericaOSHAUKY researchersP & A – Protection and AdvocacyKY QuitlineFamily Resource CentersComp CareKY partnership for families and childrenState recovery centersFaith-basedHomeless shelters and soup kitchensUniv. of LoiusvilleNext Steps to Implement in Your StateNext stepCollect and share dataSend data requests to Judy andBobbyEngage leadership; commissionersfrom DBHDID/DPH/DMSPlanning Team Conf. Call / DebriefPrioritize List of Invitees andIdentify contact personDevelop fact sheets and messagingBy when?August 2015July 2015July 2015First week of July 2015Contact/LeadJudy and BobbyeAmy, Ron, WendyWendy and Judy (Medicaid/DMS),Bobbye (DPH-Mayfield)WendyAmandaKentucky’s ReflectionsWhat is an overnight reflection you had?Amicable to my workReal vable9

10MontanaWhere are we now?Proposed Baseline (Mental Health)Data Source48.0%(People with serious psychological distress who useany form of tobacco)State Adult Tobacco SurveyProposed Baseline (Substance Abuse)Data Source31.0%(Addictions/Binge Drinking)BRFSSWhere do we want to be?Proposed Target (Mental Health)Reduce smoking rates by 15% in the MH population by 2020 (48.0% to 41.0%).Proposed Target (Substance Abuse)Reduce smoking rates by 15% in the SA population by 2020 (31.0%-27.0%).How will we get there?If you are to achieve your target, how can your planning team members work together to impact the system?Create interdepartmental workgroupAnalysis of survey dataProvider educationDevelopment of talking points with signatures with endorsements (from leaders to providers)Influence DPHHS DirectorMessagingGood valueWho are we “selling” and what are we saying, making the case, ROIWhat will promote the change? Going from knowledge to action (what are the barriers)?More carrotsDefine obstacles and develop broad planUse the word “workgroup”Planning team to reach out to contacts/network, e.g. Greg to MT medical society – informal outreach, identifypartnershipsTailor surveyInfluence attitudes and knowledgeWhat NRT is covered?Identify barriersPharmacy (pilot) with quitlines10

11Mobilizing Your State – Who Can Make This Happen?Comprehensive list of potential partnersSector / Agency / DepartmentMedical providers – public and private sectors, MDs, NPs, PAs , whole office, administrators, etc.Medical support, ancillary – public and private sectors, RNs, CTTs, MAs, CNAsInpatient and outpatient BH providers – LACs, LCSWs, LCPC, SW, case managers, psychiatrists, psychologists,IHSHospital associationMH adminAddictions adminMT primary care associations to outreach to FQHCsMedicaidMT medical associationNAMI MT, peers, peer support networkCorrectionsWICVAFort HarrisonState psych hospitalsUniversities – MSU U of MT – campus MHAmerican IndiansPrivate insurance – BC/BSOPIDisability servicesBrain injury allianceAmerican Cancer Society/ALA/ etc.Shodair HospitalNext Steps to Implement in Your StateNext stepCreate one pager for potentialstakeholdersBy when?In 2 weeks by end of June 2015Create cheat sheet for planningcommittee (Qs for stakeholders)By Friday June 26, 2015Set up conference call to discussone pager and cheat sheet andmake assignment of who eachplanning team member will talk toSchedule stakeholders meetingsSet in person team meeting datepost stakeholders meetingsSet up invitees listPrioritize next 3 months’actionsJuly 15, 2015, 3 pm MTUp to each team memberAug 27, 1-3 pmContact/LeadClarePlanning team to give input toClare to add to one pagerClare,Planning team/Bobbi to give inputto ClareCarrie to set up conference line anddial linePlanning teamPlanning team11

12-Create full timelineAdd members to planningteamMT leadership academyApril 2016Planning teamMontana’s ReflectionsWhat is an overnight reflection you had?EnlighteningCollaborativeEnergeticReminded me that I love public healthI have a visual picture in mindIt was empowering to start a planRefreshing12

13OhioWhat Other Data Points Might Your State Need for Tobacco Use byBehavioral Health Populations?Where are we now?Proposed Baseline (Mental Health)Data Source44.2%(Adults with poor mental health)BRFSS 2013Proposed Baseline (Substance Abuse)Data Source80.0%*(Adults with psychotherapeutic drug abuse ordependence)*the team is going to research a better data point;don’t want to use binge drinking/heavy drinkingNSDUH 2002-2011**** NSDUH data is a range of 10 years; can’t use on ayearly basisWhere do we want to be?Proposed Target (Mental Health)Reduce smoking rates by 10% in the MH population by 2020 (44.2% to 39.8).Proposed Target (Substance Abuse)Reduce smoking rates by 10% in the SA population by 2020 (80.0% to 72.0%).How will we get there?If you are to achieve your target, how can your planning team members work together to impact the system ?Fonda – Disseminating informationTracy/ Fonda - Working with youth led movement – peer to peer youth advocacy programTed – Disseminating information to providers – FQHCs, professional associations; getting data on providers andpatientsMandy – Working on survey data, for smoking prevalence in the SA population? Offering to do policy work –adopting smoke free policiesHeather - Encourage local public health dept. to work with boardsFonda – Smoke free buildings on her campusesTFOA state tobacco coalition – encourage them to take this issue on and use their resourcesACS, ALA partnershipsIdea - Ohio partners for cancer control – add someone from MHA with tobacco experience to that groupShare cessation info as a part of recovery messagingIncorporate this issue into youth led strategiesShare consistent messaging via professional associations13

14Encourage local health depts. to work with ADAMH on this issueTraining for providers and a survey to measure # of providers already trainedStaff cessation as well as patientsInsure that all of psychiatric state hospitals are tobacco free inside and campusTobacco free hiringWorking Partners - Drug free workplace initiative, include tobacco cessationState employees already offered cessation treatment encouraged through wellness environmentsPeer centers going tobacco free?Insurance policies with this population not all Medicaid coverageEncourage expansion of NRTQuitline – improving coverage - some services included but not allPrisons, MH and SA treatment centers all be tobacco freeSmoke-free multi-housingWellness approach – adding tobacco-free signage, etc.ACA compliant- tobacco coverageDiscussion with Department of InsuranceDAS-state employment tobacco freeNRT expansionAdoption and compliance smoke free environmentsPCMH initiativeEngage Medicaid and the 5 MCPsGeographic focus areasEducation to these groups on referral strategies, info dissemination, etc.Develop Quit protocols specific to each of these organizations’ areas of focus for MH/SUD clientsMobilizing Your State – Who Can Make This Happen?Comprehensive list of potential partnersName and/or positionJason WilsonSector / Agency / DepartmentGovernor’s office of AppalachiaAppalachian Regional CommissionProvider Associations:- Hugh Wirtz – Ohio Council- Brent Mulgrew - OSMA– Anne Spicer- OAFP- Melissa Arnold – Ohio AAP- Janet Shaw - OPPA- Larry Moliterno - OARP- John Wills- OOA– Bobbi Celeste - OPAPerson who will make initialinviteTracy PlouckTracy PlouckTed WymysloCommission on Minority HealthMembership Associations:- OACBHA – Fonda Freeman- OACHC – Ted Wymyslo- Health licensing boards – (HeatherReed has list of contacts)- Beth Bickford- AOHC- Chad Brown - OEHA- Lois Hall - OPHA14

15Shannon JonesConsumer Family Groups:- NAMI- OEC- OCCARMCP and other payersAdvocacy orgs: ACS, AHA, ALACancer Action NetworkState agencies: ODH, MHAS, ODM,Insurance, JFS, DVS, DRC, DASDevelopmental DisabilitiesCoalitions: Youth led, TFOA, OPCC, ReentryUHCANFed. Partners: SAMHSA, CMS, CDCHRSA, National Council & NBHNLegislatures-Government office – Faith based orgs.Housing AssociationsAcademic Institutions: OSU, CASETracyNext Steps to Implement in Your StateNext stepInvite these folks to the planningteam:- ODM-Ohio Council-OEC-OCCAR-ALA- Shelly KiserConvene the new planning teamfor an in-person meeting.By when?By July 2015By mid-Aug 2015Contact/Lead-Tracy invite all of themDeeper Data DiveBy mid-July 2015Look into finding a consumer whosuccessfully quit to attend themeeting.Include evaluation componentsBy mid-Aug 2015Tracy Tracy’s assistant may be able tohelpAngie will send her data personcontact to MandyTracy/ AngieBy mid-Aug 2015AngieOhio’s ReflectionsWhat is an overnight reflection you had?ActionOpportunitiesRelevant data gapsHopeChallengingTeam workConcrete progressSaving lives15

16WyomingWhat Other Data Points Might Your State Need for Tobacco Use byBehavioral Health Populations?Type of data% BH providers offering cessationservices% prevalence by socioeconomiclevel% tobacco use prevalence by type% prevalence in Native American% smoking BH diagnosis% smoke-free policyimplementationNational ranking in smokingrelated chronic diseasePossible data sourcesState survey; NSSATContact/LeadKelly BuckinghamStephanie PyleYRBS, WCISStefanWCIS, MedicaidBrenda Stout, StefanStephanie PyleAmerica’s Health Ranking, RWJFCounty Health RankingsChris NewmanWhere are we now?Proposed Baseline (Mental Health)Data Source38.2%(Frequent mental distress among current cigarettesmokers)BRFSSProposed Baseline (Substance Abuse)Data Source29.5%(Cigarette smoking rate among adult binge drinkers)BRFSSWhere do we want to be?Proposed Target (Mental Health)Reduce smoking rates by 10% in the SA population by 2020 (38.2% to 28.2%).Proposed Target (Substance Abuse)Reduce smoking rates by 10% in the MH population by 2020 (29.5% to 19.5%).16

17How will we get there?If you are to achieve your target, how can your planning team members work together to impact the system?Modeling at state levels, work with other state-level providers, share information, resources (top-bottom approach)Brenda Stout (Medicaid education) at other sitesEmphasis on communicationCreate team charter to push forward strategiesChris Newman and all team members to have regular meetings, decide who to pull in, etc (monthly at first)Chris Newman will work with Stephanie Pyle (quitline education), Brenda Stout (Medicaid benefits), Stefan (datacollection, survey), and Kelly (providers)Make sure each team member is updated regularly on each other’s progressBrenda Stout work with Kelly Buckingham to educate providers on Medicaid benefitsBring together Medicaid data, WCIS data, quitline data and provider data to educate each other in order to findinadequaciesState-funded providers: requirement of smoking cessation treatment integration, nicotine dependence as diagnosis– add specific requirements to contract (see if already existing)“Talk to your doctor” media campaign directed to providers, increase quitline referrals – provide materials to othergroups (Board of Pharmacy, Medicaid channels, etc) – low/no costMobilizing Your State – Who Can Make This Happen?Comprehensive list of potential partnersName and/or positionWY Health, Volunteers of America,WAMHSAS,WIC Providers, StacySBIRTDD/ABI (DevelopmentalDisability/Acquired Brain Injury)Wyoming Medical SocietyNAMIPMO (Prevention Manag. Org)American Psychological AssociationAmerican Psychiatric AssociationDental Hygienists – April Burton(State), Cassie (Internal), DentistAssociationNursing AssociationMary WalkerSBIRTWYSABehavioral Health Advisory CouncilChampions of MHMH Licensing BoardMedicaid, KidCare, Blue Cross/BlueShieldTribal Health, Medicaid (Lindsey)WDE (WY Dept. of Education)Dept. of Family Services (MedicaidSector / Agency / DepartmentProvider GroupsPerson who will make initialinviteKelly BuckinghamChris Newman (WAMHSAS)Stephanie Pyle (WIC)Brenda Stout (SBIRT)Medical AdvocacySheila BushChris NewmanStephanie PyleDental GroupsBrenda StoutNursingPharmacyPublicYouthBehavioral HealthStephanie PyleBrenda StoutBrenda StoutChris Newman, Kelly BuckinghamChris NewmanInsuranceBrenda StoutTribalEducationChris NewmanJoe S.Brenda Stout17

18eligibility)American Cancer SocietyCancer Prevention GroupSteve L.Larry B.CancerChris NewmanDepartment of CorrectionsVeteransChris NewmanChris NewmanNext Steps to Implement in Your StateNext step-Review all data sources-Initial meeting to map out priorities, solidify objective to makeour case.-Send “save-the-date” notifications to stakeholdersCreate 1-pager on purpose of summit, importance of certainsectorsMeeting with director(s) for buy-in, lay out goalsBy when?July 2015 (before August1)Contact/LeadPolicy Team (ChrisNewman)July 2015Meet with senior management, lay out plansReach out to sector representatives, establish buy-inSet summit date goal for October (expectation) in Casper orRiverton. Alternative: early December.August 2015Jessica andKatherineChris Newman,Stefan JohanssonChris NewmanAugust 2015Wyoming’s ReflectionsWhat is an overnight reflection you had?Don’t let perfect be the enemy of goodInsightfulEngagingInformativeMotivating18

19Policy Academy Concluding Thoughts“Ready to get started”“Move forward and keep the momentum going”“Connected to each �Informed”“I didn’t know most of people before, they are a special group of people and fortunate to have met them and knowthem”“Time for us to start strategizing”“The conversations we had are really sincere commitments among our team members”“Eagerness to go back”By the end of the Policy Academy, state representatives learned what works, made commitments to change, anddeveloped strategies to help individuals with mental illness and addictions live longer, healthier lives. The Academyhelped catalyze communication between state departments and advocates and each learned to be successful inthe implementation of organizing local efforts. In assuring success in the implementation of organizing local effortsit is important to remember these key points, have a catalytic leader to keep the momentum, perform proposalbased decision making (PBDM), manage and move through conflict, and remembering why you came together inthe first place.In conclusion, as mentioned by Acting Assistant Secretary for Health in the Department of Health and HumanServices, Dr. Karen DeSalvo, “It is alarming that, despite declining tobacco use in the overall U.S population,smoking prevalence for adults with mental illness or substance use disorders has not changed significantly over thelast couple of decades. We cannot be complacent when we hear that nearly three out of four people ages 12 andolder who received substance abuse treatment at a specialty facility in the past year reported smoking cigarettes inthe past month. We can change this.” Amongst creating new relationships and coalitions, states that attended leftwith an action plan and potential tools for implementation to create or build upon existing tobacco control andbehavioral health initiatives within their state

5 5 problem. Tobacco Control and DMH can promote NA as a peer recovery resource statewide - Miranda, Dennis Mental health provider training - Miranda and Joan explore how to work with Dennis Ailes Work with local pharmacy chain to include NRT voucher if they call the quitline - Miranda Methadone Clinics - recommend SAMHSA include tobacco as part of existing policy to offer smoking cessation