Central Kansas Foundation: The value of integrating SUD services

December 9, 2014
Maureen Fitzgerald
Communications Coordinator, ATTC Network Coordinating Office
Editor, NIATx

Some might not expect to find one of the country’s most advanced examples of integrated care in a small Midwestern town. But in Salina, Kansas (population 47,846) the Central Kansas Foundation has been integrating its services with other health care providers in the area since 2009. Today, CKF has integrated recovery services into acute and primary care settings at two local hospitals and collaborates with a health network of 15 critical access hospitals. Les Sperling, CEO of CKF, shared some insights on what he’s learned about integrating SUD services in a panel presentation and in one of the Ignite Talks at the recent ATTC Forum on Advancing the Integration of SUD Services and Health Care.

CKF began its integration efforts shortly after Sperling returned from a SAAS convention in 2009 where Dr. H. Westley Clark challenged SUD providers to pursue integration with primary and acute care organizations. “Since our philosophy was that addiction is treated best when the medical illness component is included, it made great sense to seek out the assistance of medical practitioners to help us with diagnosis, medication-assisted treatment, and engagement strategies,” says Sperling. “We also benefitted from a visionary governing board and a staff comprised of early adopters.” Another advantage came from being involved with the work of SAAS and NIATx, Sperling adds.

Relationships, relationships, relationships

In addition, CKF was fortunate to be connected with a medical community that understood the value of behavioral health and its impact on costs and patient outcomes.

 “Building collaborative relationships with the medical community has been a very rewarding and challenging experience,” says Sperling. “Understanding the differences between delivery systems and also the external and internal constraints faced by medical practitioners each day is crucial,” he adds.

“Medical practitioners are very busy and SUD providers need to realize that,” says Sperling. “We very quickly learned that developing the skill to tailor your time with medical professionals to focus on the economical and efficient delivery of information was the key to a successful meeting. “

(In other words, have your elevator speech handy!) 

Another key to building relationships with the medical community, says Sperling, is having committed staff who excel at their jobs. He credits the Mid-America ATTC with helping his counselors (and peer recovery specialists) build and upgrade their skill sets, particularly in the use of Motivational Interviewing.

When SUD folks do their jobs in medical settings, patients get better and practitioners notice.

CKF’s initial strategy for integrating was to place SUD staff directly in emergency rooms and medical, surgical, and primary care settings to do screenings and brief interventions. In 2014, CFK’s contract with Salina Regional health Center included 24/7 coverage of the Emergency Department.

“A significant problem facing every Emergency Department is the increase in patients who present under the influence of alcohol and/or drugs. Placing SUD care managers into the ED creates an effective way to engage patients in real time, provide appropriate placement and intervention, and reduce some of the workload on ED staff so that they can focus on other emerging medical situations.”

With this approach, CKF offers busy medical settings a solution to caring for patients with substance use disorders who often require lots of time and attention, tend to reappear frequently, and don’t seem to get better. 

(And a recent news story on a study conducted by Rutgers University adds to the research supporting integrated care: “Forty percent of preventable hospitalizations indicated a diagnosis of a behavioral health condition.” )

 “We believed that the appropriate SUD identification and intervention substance use in medical settings has great value to the medical providers and the patients,” says Sperling. “That value includes improved clinical integration, better patient outcomes, and lower costs related to return to acute care settings.” 

Note that emphasis on value. It’s embedded in CKF’s Three Guiding Principles for Integration: How’s that for a set of empowering guiding principles?

What’s next?

CKF is adapting its strategies continuously to keep up with the rate of change in health care. “The emerging utilization of Big Data, predictive analytics, biometric monitoring, and smart phone technology to improve outcomes and early intervention made it necessary for us to question our “traditional” models of care delivery and move toward new models of population health management.”

Looking ahead, Sperling says CKF will continue to expand its partnerships with acute and primary care and also integrate promising technological and medication supports (such as A-CHESS) into its continuum of services. “We continue to ask the question:  10 years from now, will anyone “need” to see a clinician face-to-face every time to receive the care and support they need?” 

What do you think? 

"Will we really need this in 10 years?" asks Les Sperling, CEO of CKF