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10/25/2016
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Philadelphia’s Population Health Approach
Dr. Arthur C. Evans, Commissioner
Kimberly Torguson, Director of Communications
BackgroundPhiladelphia’s Department of Behavioral Health and Intellectual disAbility Services
• Administrator for public mental health and addiction service system• Safety Net for 1.5 Million people (capitated for 600K Medicaid recipients)
• Substance use, mental health and intellectual disability services• Children, adult and family services• 200+ providers, full continuum of services• Medicaid managed by the city
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Current Challenges
Clinical Fiscal System
Traditional Treatment Model
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CommunityLife
In this model, clinical care is viewed as one of many resources needed for successful integration into the community.
Recovery Oriented System of Care
Severe Mental Illness
Diagnosable Mental Disorder
Everyone Else
5%
20%
75%
Current Treatment Approach
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Factors that Influence Health Status
HEALTHCARE
LIFESTYLE• Smoking• Obesity• Stress• Nutrition• Blood Pressure• Alcohol• Drug Use
ENVIRONMENT
HUMAN BIOLOGY
10%
19%
20%
51%
Diagnosed
At Risk
Healthy
Population Health Approach
Effective & Efficient Clinical Care
Mitigate Risk &Early Intervention
Keeping People Healthy
PeopleGoal
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Evolution of a SystemEvolution of a System
1st Wave2nd Wave
3rd WaveGetting people into the
community
Helping people to be part of the community
Promoting healthy communities
• De‐institutionalization• Expanding Network of
Providers• Creating Medicaid
managed care entity (CBH)• Creating the Dept. & a
single payor system
• Systematic implementation of a recovery‐oriented system of care
• Promoting recovery, resilience, and self‐determination as a framework for the system
• Creating Learning Organization
• Promoting health & wellness for the population
• Single unifying framework for all services and populations
• Reaching everyone• Efficiency and
effectiveness• Addressing social
determinants
System Evolution
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1. Working upstream (Earlier Intervention)
2. Broad set of strategies
3. Working with at risk & healthy populations
4. Deliver health promotion interventions
5. Working in non‐treatment settings
6. Health activation approaches
and empowering others
7. Working at the community level of analysis
7 Conceptual Shifts We needed for a Population Health Approach
Our Population Health Approaches Aim to:
Focus on Prevention and Early
Intervention
Reduce Stigma
Increase Community
Inclusion
Reduce Health Disparities
Boost Mental Health Literacy
Improve Outcomes
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Example: Evidence‐based Practices
• Trauma Initiative – Prolonged Exposure (PE)
• Philadelphia Alliance for Child Trauma Services (PACTS) – Trauma Focused CBT (TF‐CBT) and Child Family Traumatic Stress Intervention (CFTSI)
• Dialectical Behavior Therapy (DBT)
• Ecosystemic Structural Family Therapy (ESFT)
• Partners for Change Outcomes Management System (PCOMS)
• Beating the Blues
Our EBP Initiatives
500+ THERAPISTS at 60+ PROGRAMS
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Free, Supportive, Comprehensive and Not diagnostic –‘Check‐up from the Neck Up’
Example: In‐person Community Screening Events
Example: Healthy Minds Philly
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• BEyond Expectation Series• Building Brotherhood Mural•Workshops• Town halls
Example: Engaging Males of Color Initiative
First Aiders Trained
Example: Mental Health First Aid
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Example: Porch Light Program
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Example: Porch Light Program
Arthur C. Evans J
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“It gave addiction
and recovery a real voice.”
– Michael
Coming Together…
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Thank you!
DBHIDS.org ●Healthymindsphilly.org
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