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California Behavioral Health and Addiction Treatment News for December 2019

Across the nation, many states and communities are working to address a variety of behavioral health challenges. Here is some of the behavioral health and addiction treatment news making headlines in California.

Controversial California Law Could Force Conservatorship for Severe Behavioral Health and Substance Abuse

Under a law passed last year, the counties of San Francisco, Los Angeles, and San Diego can create conservatorships for a person with serious behavioral health or substance use disorders who cannot care for themselves. Los Angeles County is currently considering a plan to take guardianship over some homeless individuals and place them in mandatory treatment.

Earlier this year, San Francisco passed an ordinance to implement a similar program, although no individuals have yet been sent to treatment. The ACLU of Southern California has argued that this plan will not resolve the state’s homelessness problems. However, some community members support mandatory rehab for individuals with severe needs amid California’s increasing homelessness crisis.

Statewide “Warmline” May Help Prevent Mental Health Crises

The San Francisco Peer-Run Warm Line, first launched in 2014, has expanded throughout California. This expansion comes with a state budget allocation of $10.8 million for 3 years.

Compared to a crisis hotline, a warmline is intended to help individuals who need mental-health support but who are not in immediate crisis. By providing earlier intervention and emotional support, such as connecting individuals to behavioral health services, a warmline could help reduce the risk of an emergency hospital visit or ER call. However, they are a recent invention and their impact has not been thoroughly studied.

Southern California Opioid Fatalities Highest in Orange County

While the total number of opioid-related deaths has declined since 2016, Orange County still has the highest rate of opioid-related deaths in California. The county is also seeing an increase in heroin and fentanyl overdoses.

A county report, “Addressing the Opioid Crisis in Orange County,” found that overdose deaths are more common in areas with some of the highest concentrations of treatment centers. Additionally, many county addiction treatment centers do not offer medication-assisted treatment (MAT). While there is evidence for its effectiveness, MAT continues to face stigma and uncertainty among community members.

Despite Parity Laws, Mental Health Coverage Remains Limited

Consulting company Milliman recently issued a report that patients are much more likely to use out-of-network providers for behavioral health and addiction or substance abuse treatment than for other conditions. This disparity has increased since a previous study that Milliman published in 2017. For example, inpatient behavioral health care in California was 7.8 times more likely to be out-of-network.

Many Americans find it more difficult to find affordable behavioral health treatment, despite a 2008 law requiring insurers to provide equal access for mental and physical health care. The lack of affordability has become a nationwide concern amid rising rates of addiction, suicide, depression, and anxiety.

BestNotes Serves Behavioral Health and Addiction Treatment Providers in California

If you are a behavioral health and addiction treatment provider in California, you have a range of unique client and regulatory needs. BestNotes EHR and CRM solutions were designed with you in mind, offering customized options that help you improve care and streamline operations while staying up-to-date with regulatory changes. Contact us today to learn more or schedule a free demo.

date:  Dec 10, 2019
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Recent Studies Make New Connections Between Burnout and EHR Dissatisfaction

If you’re a behavioral health or addiction treatment professional who’s frustrated with your electronic health record (EHR) software, you’re definitely not alone. While EHR use has expanded nationwide, many clinicians continue to find them frustrating to use.

Provider complaints about many EHR systems include a lack of interoperability, limited functionality, poor usability, and low personalization. Add in the frustrations of meeting regulatory requirements, and many behavioral health providers are saying goodbye to their job satisfaction.

Research Into Provider Burnout

According to this study, 21-67% of mental health workers will at one time experience high levels of burnout. The reasons for burnout include: too many patients at a time, insurance regulations and guidelines to comply with their company or government.

In addition, government rules and regulations continually change. All of these regulations can leave clinicians unable to give patients the best care possible. As a result, they may feel powerless and stop trying.

Frustration and Burnout Has Extensive Effects

Research has already shown that the effects of burnout can impact patients, as well. A 2018 study published in the Journal of the American Medical Informatics Association found that patient satisfaction declines when providers are dissatisfied with their EHR and struggle to incorporate it into their patient care.

Besides that, provider burnout in general can be harmful for organizations and patients, as well as the individual provider. Burnout has been shown to increase the risk of:

Medical errors that could harm patients
Addiction, suicidal ideation, and other mental health symptoms caused by stress in providers
Staff turnover and low productivity, which increase costs

At BestNotes, we can’t control all the factors that contribute to clinician and administrative burnout. But we can put our resources into developing an EHR system that helps reduce the reasons for burnout. As a result, we offer benefits like:

Time-saving customization options that also protect patient safety by improving clinical workflows to reduce medical errors and support clinical decision-making

Keeping track of CARF, Joint Commission, federal, and state documentation requirements and updating BestNotes according to the most recent regulatory changes—so you don’t have to

Smoother, faster admissions by including a patient portal that allows clients to quickly and efficiently submit information for automatic uploading to your system

Easier outcomes tracking that helps you meet value-based care initiatives

The goal of any EHR solution is to help providers serve their patients and make processes more efficient. If your organization is struggling with an inefficient workflow, your EHR may have a built-in solution. Providers and behavioral health executives should contact their vendors to discuss a better solution.

Looking to implement a new EHR solution in your behavioral health or addiction treatment facility? Contact BestNotes today to learn more or schedule a demo.

date:  Dec 10, 2019
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Unpacking the New NAATP Guidebook for Addiction Treatment Providers and Consumers

Since 1978, the National Association of Addiction Treatment Providers (NAATP) has been working to advance addiction services and support its membership of service providers. To that end, NAATP has launched The Addiction Treatment Provider Quality Assurance Guidebook: A Guide to the Core Competencies for the Delivery of Addiction Treatment Services.

Where did the NAATP Guidebook come from?

This new Guidebook was created under the NAATP’s Quality Assurance Initiative, which was created in 2018 to create high standards for addiction treatment providers and services. The Initiative aims to promote best business practices, prevent unethical and substandard practices, help payers assess addiction treatment services, and educate both consumers and providers.

How should you use the NAATP Guidebook?

NAATP created the Guidebook as part of its efforts to improve addiction treatment quality and help protect consumers. This document includes directions for addiction treatment providers seeking to apply best practices, measure patient outcomes, and operate their practices ethically.

NAATP membership also requires adherence to its Guidelines, in addition to other licensing, accreditation, and Ethics Code compliance. Therefore, it’s recommended that all NAATP members familiarize themselves with the contents of the Guidebook.

NAATP also aims for the Guidebook to help inform members of Congress as they debate solutions to the U.S. addiction crisis. This crisis includes not only the opioid epidemic, but unscrupulous organizations or providers who would seek to take advantage of vulnerable individuals and families families. NAATP has delivered its Guidebook to all members of Congress with an explanatory letter.

What information does the NAATP Guidebook contain?

In its efforts to improve the quality and ethics of addiction treatment providers and organizations, the Guidebook identifies core competencies for all addiction treatment providers in nine categories. These include:
Operations, which covers organizational culture, licensing, and the physical facilities
Admissions and Patient Screening, which addresses appropriate screening throughout treatment, monitoring progress, and prevention of both over- and under-providing
Employment, Training, and Credentialing, which includes issues such as staff salaries, hiring former patients, and training for non-clinical staff
Billing, which includes calculating the cost of service, billing for toxicology, and collecting copays
Discharge and Continuing Care, including discharge planning and appropriately placing patients within the continuum of care
Outcomes Measures, including how to collect and analyze patient outcomes to improve program efficacy and inform the public
Community Engagement, Public Relations, and Public Policy, which addresses how to establish relationships with other medical community members, destigmatize addiction, and advocate for patients and the organization
Marketing, Advertising, and Visibility, which focuses on avoiding misleading marketing practices, promoting transparency, preserving brand integrity, working with third-party marketers, and avoiding any form of remuneration for patient referrals
Ethics, which covers adherence to the NAATP Code of Ethics

All of these categories include 32 specific Guidelines, as well as a list of resources for providers that seek to understand the Guidebook and follow its contents.

The full text of the Guidebook is available online through the NAATP website.

Does your practice follow NAATP standards?

BestNotes is proud to be a member of NAATP, which means that our EHR and CRM solutions are built to adhere to the association’s rigorous standards in support of addiction treatment providers. Contact us today to learn more about our solutions or schedule a free demo.

date:  Nov 26, 2019
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The Use of Motivational Interviewing in Behavioral Health

The BestNotes blog has been exploring different types of therapy used by addiction treatment and behavioral health providers. This time, we’re looking at motivational interviewing (MI).

Motivational Interviewing Overview
MI is a type of counseling that helps individuals resolve conflicting beliefs or feelings that have prevented healthy behavioral changes. It can be applied to individuals who are unmotivated, unwilling, or unprepared to make necessary changes in their lives.

Rather than trying to compel or direct clients toward changing their behavior, a therapist or counselor uses MI to guide a patient or client through their feelings and help them examine the need for change. Clinical psychologists William R. Miller and Stephen Rollnick are often credited for helping to develop this approach.

Who Motivational Interviewing Is For
According to some sources, MI was originally developed to address people struggling with alcohol problems. However, MI can help many other individuals who struggle to make necessary changes in their lives, including those with:

Addiction and substance abuse
Behavioral and mental health concerns
Chronic physical conditions, such as diabetes or asthma, that often require lifestyle changes

What Motivational Interviewing Involves
MI counseling involves a few basic ideas and assumptions:

Ambivalence toward one’s substance use, or changing substance use, is normal and common
Counselors can help individuals resolve their ambivalence by exploring and addressing their individual, inner motivations and values
The counselor and the patient are allies and equal collaborators in the counseling process
Change is most likely when the counselor is empathic, supportive, and yet directive, without arguing or confronting aggressively, which may make patients defensive and so hinder their progress

In their book, Motivational Interviewing: Preparing People To Change Addictive Behavior, Miller and Rollnick note that MI should involve persuasion and support, not coercion and arguments. They write, “The motivational interviewer must proceed with a strong sense of purpose, clear strategies and skills for pursuing that purpose, and a sense of timing to intervene in particular ways at incisive moments.”

During MI sessions, the counselor or motivational interviewer will encourage the patient to talk about their need to change their behavior and why they want to change. An MI clinician should take care to use reflective listening and empathy to help the patient see the discrepancy between their goals or values and their current behavior.

How Motivational Interviewing Works

MI aims to help increase a person’s motivation to change, and then encourage them to commit to change. By helping a patient explore their conflicting feelings and the necessity for change, MI can help encourage self-efficacy and optimism.

While the effectiveness of MI therapy needs more research, existing studies have shown positive results. One study of MI found that it “outperforms traditional advice giving” for several diseases and behavioral health issues.

While it can be combined with other types of therapies, including cognitive therapy and support groups, MI is usually short-term. In many cases, only one or two sessions may be needed.

Does Your EHR Work With Your Treatment Approach?

No two patients, clinicians, or treatment approaches are exactly alike. That’s why BestNotes EHR solutions offer many customization options to help you work more effectively and improve profitability. Contact us today to learn more or schedule a d

date:  Nov 19, 2019
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