Care Transformation Collaborative of Rhode Island News & Updates | February 2022

As CTC-RI continues to strengthen integrated behavioral health (IBH) in primary care, we interviewed our CTC-RI IBH Committee co-chair, John Todaro, Ph.D., who serves as Clinical Psychologist and Director at Providence Behavioral Health Associates about IBH’s growing impact in Rhode Island. 

As the CTC-RI IBH Committee co-chair and director of Providence Behavioral Health, why is IBH important in Rhode Island?
The main objective of an integrated healthcare system is delivering the right care to the right patient at the right time. IBH allows us to achieve that objective since we are part of the healthcare team and our services are accessible in the primary care office. This level of integration can ensure that individuals who need behavioral health services can receive them when they are most needed, resulting in an overall better experience for the patient.

How has CTC-RI's work to expand IBH in primary care impacted the workforce?
CTC-RI has done an excellent job of facilitating and expanding IBH’s footprint in primary care. As a result, there are more clinicians working in primary care as a result of CTC-RI’s work than there were 10 years ago. Now that IBH services are regarded as an integral part of primary care, we need to address the workforce shortage of behavioral health clinicians who are trained to work in this area. CTC-RI is being proactive on this issue by offering high-quality training opportunities to expand the IBH workforce. 

In an effort to increase the number of IBH-trained behavioral health professionals working in RI primary care, CTC-RI recently announced we’re offering 10 enrollment slots at no cost, thanks to funding from UnitedHealthcare, to enrollees in the ‘Primary Care Behavioral Health’ course developed by the UMass Chan Medical School Center for Integrated Care. We recently interviewed a clinician, Jennifer Etue, LICSW, IBH Manager at Providence Community Health Centers, who previously went through the training.

How is IBH changing the way primary care is delivered in RI?
IBH expands the previous limitations of primary care. Primary care teams usually have to manage their medical scope of the social determinants, behavioral health and substance use components that show up in primary care. Alternatively, IBH teams offset those “out of scope” demands in conjunction with the patient’s medical needs to provide immediate support to care teams and patients in real time alleviating the tremendous demand of patient need. From micro to macro, IBH changes the lives of patients and care teams, but also offsets the costs associated with not addressing larger systematic issues (ER use as an example) that impact patient access and care.

What lessons learned from your UMass IBH training are you now using at your practice?
The UMass training provided a large framework and context for IBH dynamics in primary care. Not only does it ensure valuable education about how to engage care teams, but will train/support providers around the correlation of health, chronic health conditions, behavioral health struggles, and substance use/dependence in primary care. The UMass course provides a massive support/framework to practitioners which then trickles down to support of care teams and patients.
Last call! CTC-RI Offering Free Enrollment in UMass IBH Primary Care Training

In an effort to increase the number of IBH-trained behavioral health professionals in RI primary care, CTC-RI is offering 10 enrollment slots at no cost in the ‘Primary Care Behavioral Health’ course developed by the UMASS Chan Medical School Center for Integrated Care. Funding from UnitedHealthcare made this opportunity possible.

Application deadline is February 18! In addition to covering the training cost ($1,600 value), CTC-RI will provide $500 stipends to both the program participant and ​the primary care practice where they are employed, if applicable, to recognize the time commitment that this course represents. Questions? Email ssummers@ctc-ri.org.

Please join CTC–RI/PCMH Kids in congratulating the most recent group of 48 nurse care managers who completed the 12-week gLearn NCM Core Curriculum! Representing every system of care in the state, the learners prepared a capstone presentation and shared their work at our NCM/Care Coordinator Best Practice Sharing meetings. The group marks the 4th year that CTC-RI/PCMH Kids has offered this program through funding from UnitedHealthcare and the RIDOH. Read more here.

After a year of hard work, achievements and learning, the Telehealth Learning Collaborative 1st cohort practices celebrated at their January wrap-up meeting with PDSAs and lessons learned. Through funding by the CARES Act, UnitedHealthcare, and RIDOH, 13 practices spent the last year focusing on projects addressing a range of chronic conditions, and exploring the use of technology to better care for patients during and after the pandemic. Reid Plimpton, Northeast Telehealth Resource Center, presented on “Telehealth in 2022 and Beyond,” helping RI primary care practices understand the telehealth landscape in the new year. We look forward to hearing from the 2nd Cohort of 8 practices in April. Congratulations to:

The January Clinical Strategy Committee meeting featured presentations by two guests: Vicki Loner, MS, CEO of OneCare Vermont discussed the development of the single statewide accountable care organization in VT and related implications for RI. Katherine Howitt, MA, Director of MA Medicaid Policy Institute, BCBS of MA Foundation presented on developing primary care capitation for pediatric patients and on a recent report from the Center for Health Care Strategies and the BCBSMA Foundation.


Join us for the March 11 Breakfast of Champions, 7:30-9:00am! Register via Eventbrite to receive the Zoom link.

Mansi Kachalia James, DO, Board Certified Allergist, Immunologist, Providence Community Health Center will review updates on adult and pediatric asthma guidelines, and we'll feature a panel discussion on primary care and community-based efforts to improve asthma outcomes for children:

  • Moderator: Patricia Flanagan, MD, Hasbro Children’s Hospital, & Brown Univ. Pediatrics
  • Panelist: Lillian Nieves, PharmD, PCHC on a pharmacist-led effort to reduce ED visits in children with asthma
  • Panelist: Garry Bliss, Prospect CharterCARE, to discuss community-clinical partnerships in the Road to Equity project with the West Elmwood 02907 Health Equity Zone to improve outcomes in children with asthma
  • Panelist: Elizabeth McQuaid, PhD, Hasbro and Brown University to discuss school-based asthma education
Rhode Island COVID Updates

Governor McKee lifts mask or vax policy at businesses; School districts to decide on district mask policies beginning March 4
Gov. McKee announced he has lifted the state's mask or vax policy at businesses statewide (effective February 11). In addition, beginning March 4, mask policies in RI schools will be decided by individual school districts, not the state.

COVID Data
During his February 9 press conference, Gov. McKee noted the state is seeing "encouraging" movement, with the case average declining (down 71% from 2 weeks prior). This makes RI the 8th lowest percent positive rate in country.

Transmission
As of January 19, the state's COVID transmission rate is showing a 21.2% decline from last week, but still remains high, with an 18.7% test-positive rate, and hospitalization rates continuing to increase.

Vaccines
As of February 15, 94.6% of Rhode Islanders are partially vaccinated (99% for those 18+), 79.8% have completed their primary vaccine series (89.7% for those 18+), and 37.9% have received a booster dose (45.4% for those 18+).
In Case You Missed It: In the News
OHIC Newsletter
January 31, 2022
Reforming the health care delivery system can only be achieved through collaboration with our state and community partners. Rhode Island is lucky to have many strong advocates and innovators working to improve the quality of health care, while also making it more accessible. Our community partners at the Care Transformation Collaborative of Rhode Island (CTC-RI), the state’s multi-payer hub for new, innovative primary care pilot programs, initiatives, and transformation, has been introducing and expanding integrated behavioral health (IBH) into primary care, including adult and pediatric practices. By embedding a behavioral health specialist into the trusted primary care practice setting, patients seamlessly receive both primary care and behavioral health support under one roof. This work proved essential to Rhode Islanders during this pandemic. Read more here.
Practice Resources
PediPRN: Training for practitioners in child/adolescent mental health
The PediPRN Intensive Program by Bradley Hospital provides in-depth training for pediatric primary care practitioners in child/adolescent mental health. The course covers mental health areas that are commonly addressed in pediatric primary care settings such as: safety assessment and crisis management, psychiatric levels and systems of care, anxiety disorders, depressive disorders, ADHD, autism spectrum disorders, eating disorders, substance use disorders, gender identity, and collaboration with schools. The program kicks off on March 26. Learn more.

CMS Releases CY2022 Telehealth Update to Medicare Physician Fee Schedule
In mid-January, CMS sent out an article to providers regarding telehealth billing changes in the Medicare Physician Fee Schedule (PFS), including two new modifiers and a Telehealth Services List update. The update mostly covers recent expansions to mental health treatment via telehealth. Read more.

Please Share Research Survey: URI's Vaccine Hesitancy Project
The University of Rhode Island COVID-19 Vaccine Hesitancy Project is a research study sponsored by the CDC surveying those in Rhode Island communities to identify obstacles preventing them from receiving the COVID-19 vaccine. Flyers in English and Spanish are available for download and distribution.

Geriatric Education Series: Exercise for Cognitive and Physical Function in Older Adults with Cognitive Impairment 
The RI Geriatric Education Center is hosting this webinar on February 23 from 12-1pm.

Geriatric Education Series: A Strengths-Based Approach to Dementia Care
The RI Geriatric Education Center is hosting this webinar on March 15 from 8:05-9:05am.
Upcoming CTC-RI Committee Meetings and Workgroups
  • February 18, 07:30-09:00AM – Clinical Strategy Committee
  • February 23, 08:00-09:30AM – Practice Reporting/Practice Transformation Committee
  • February 25, 07:30-08:45AM – Board of Directors
  • March 10, 07:30-09:00AM – Quarterly Integrated Behavioral Health Committee
  • March 15, 08:00-09:30AM – Care Manager/Coordinator Best Practice Sharing
  • March 18, 07:30-09:00AM – Clinical Strategy Committee
  • March 25, 07:30-08:45AM – Board of Directors
Upcoming Learning Collaboratives and Professional Development
  • March 11, 07:30-08:00AM – Quarterly CTC-RI Breakfast of Champions
  • March 17, 10:30-12:00PM – Rhode to Equity Momentum Session
  • March 24, 07:30-09:00AM – Pharmacy Quarterly Learning Collaborative: Reducing Preventable Hospitalizations and ED Usage
Care Transformation Collaborative of RI | ctc-ri@ctc-ri.org | ctc-ri.org