Access to timely behavioral health services remains a pressing public health concern. In the last reporting year, there have been over 100,000 overdose deaths, including those related to fentanyl and other opioids and 50,000 suicides. Additionally, emergency departments have seen over 200,000 non-fatal overdose-related visits. These figures underscore the critical need for interventions that can make a difference for individuals at risk.
In Aug. 2024, Bamboo Health took part in the Medicaid Enterprise Systems Conference (MESC) 2024 conference in Louisville, KY, which centered on Medicaid systems and related health policy. Experts from the Delaware Division of Substance Abuse and Mental Health (DSAMH) and Bamboo Health led an educational panel at MESC to discuss how to improve access to behavioral health crisis support services.
The panel featured Michelle Singletary-Twyman, Deputy Director at DSAMH; Sean Miller, State Account Director at Bamboo Health; and Vatsala Kapur, Vice President of External Affairs at Bamboo Health.
We sat down with the MESC panelists to learn more about their key takeaways from presentations, conversations and more.
Q: What is the current state of patients’ behavioral health needs? What policies or actions are in place to address crises?
A: States have an important opportunity to leverage Section 1115 Waivers to implement innovative strategies that address behavioral health crises more effectively. These waivers allow states like Delaware, California, Oklahoma, Montana and others to develop and test new approaches to care that could significantly enhance the support provided to at-risk individuals. While many innovative strategies are in place to expand behavioral healthcare access, here are some of the ways states utilize funding from Section 1115 Waivers:
- Track behavioral health facility bed availability to streamline 988 Lifeline response
- Reimburse services for serious mental illness
- Provide housing assistance and re-entry services for justice-involved populations
- Break down data silos to gain better insight into patient context across state lines
Q: Let’s take a deeper look at how Delaware approaches this challenge. How can other states improve crisis management?
A: Delaware has made significant strides in improving its crisis management program, offering a model that other states can emulate. The state has developed a comprehensive crisis care continuum bolstered by the implementation of modernized data tracking and referral systems. We call this the Bamboo Intelligence Hub™, or in Delaware, DTRN360. A core element of this solution suite is transforming behavioral health referrals, allowing state providers to seamlessly manage treatment referrals, track controlled substance information and gain insight into a patient’s entire care history, including admissions with other healthcare providers. A critical step in making this transformation has entailed the shift from outdated paper and Excel chart documentation to an advanced crisis management system integrated through Bamboo. This system allows for real-time tracking of client encounters, ensuring that all interactions with individuals seeking crisis services are documented. This documentation is vital as it supports the building of a robust crisis care continuum and enables the effective management of data points that can influence client care.
Q: How can digital crisis management systems be used to better serve vulnerable populations, such as the uninsured, Medicaid patients or those who are justice-involved?
A: Alert features in crisis management software can help ensure no one falls through the cracks, providing greater visibility into patients’ needs and histories that historically may have been siloed. An example of this is the crisis system’s ability to support justice-involved individuals through their care journey. The system can alert care managers when a client has been arrested or released, providing critical information to maintain continuity of care. The system can also help bring in and support more uninsured individuals, a population that often goes unnoticed . With features like a referral network that spans from emergency departments to psychiatric hospitals and recovery housing, the system helps streamline the continuum of care, reducing delays and improving access to necessary services for individuals experiencing a physical or behavioral health disorder.
Q: How do data silos impact care delivery, and what role does collaboration with stakeholders nationwide play in overcoming these challenges?
A: Data silos are a significant challenge in the healthcare industry, particularly in behavioral health, where many systems still rely heavily on paper records or lack fully integrated electronic health records. This fragmentation hinders the ability to share critical information across providers, which in turn impacts care delivery. State health departments, behavioral and physical health providers and health plans need timelier patient context to make decisions and leverage a more cohesive and effective care delivery system, not just in Delaware but across other states as well.
The goal is to ensure that providers have the information they need to deliver the best possible care to their patients during pivotal care moments, no matter where they are in their treatment journey.
For Delaware, we discovered that many of our clients were receiving care outside of Delaware, in states like California and Texas—information we previously had no way of knowing. This data sharing is made possible through our collaboration with the Bamboo network, which connects us to hospitals and providers across the country. This nationwide data exchange ensures that we’re always aware of our clients’ whereabouts and care needs, no matter where they are. It’s a powerful tool for improving continuity of care and ensuring that our clients receive the support they need, wherever they may be.
Q: Recognizing behavioral health staff often face risk of burnout due to the nature of their caseloads, how can we better address administrative burden?
A: To alleviate this burden, it’s essential to streamline access to patient information and reduce the time spent on manual processes. One of the primary challenges in behavioral health is that staff frequently do not have the necessary information about patients readily available when they seek treatment. This lack of easy access to critical data can significantly slow down the process of connecting patients with the best possible care. Our goal is to address this by integrating more efficient data-sharing mechanisms so that staff can quickly access patient information and focus on delivering care at the top of their license rather than chasing down records.
We’ve found that having champions both at the state level and within the community is crucial to the success of technology implementations. These champions help drive the adoption of new systems by demonstrating their value to others. Early on, we organized user group sessions where different teams could share their experiences and learn from each other. This community-driven approach ensures that the tools we implement have buy-in and engagement from providers.
If you missed us at MESC this year, contact us to continue this discussion or meet us at an upcoming event.
