The Stepping In It Podcast with Renee Schulte & Jason Haglund

In this episode we embark on an exploration of Certified Community Behavioral Health Centers (CCBHCs), uncovering their pivotal role in revolutionizing mental health care accessibility. From crisis services available 24/7 to comprehensive behavioral health support, we delve into the nine essential services these centers provide and their critical connection to bridging gaps within the behavioral health system. Through a data-driven analysis, we unravel the profound impact of CCBHCs nationwide, shedding light on their ability to serve over 2.1 million individuals, significantly reduce wait times for care, and expand access to substance use disorder treatment, including Medication-Assisted Treatment (MAT). Finally, we journey to Iowa to witness the real-life application of CCBHCs, recognizing both their promise and the challenges faced, particularly in rural areas where enhanced funding is paramount. Join us as we assess the progress and envision the future of CCBHCs in transforming mental health care delivery.

In this episode, you will be able to:

• Discover strategies to enhance access to comprehensive behavioral health services in rural areas.
• Uncover the benefits of Certified Community Behavioral Health Centers for rural communities.
• Explore the unique challenges faced in providing behavioral health services in rural areas.
• Learn effective ways to integrate substance use and mental health treatment for holistic care.
• Understand the role of technology in revolutionizing and improving behavioral health care in rural settings.

The key moments in this episode are:
00:00:02 - Introduction to CCBHCs

 00:03:16 - Core Services of CCBHCs

 00:07:05 - Required Services and Care Coordination

 00:10:00 - Funding and Safety Net

 00:12:12 - Integration of Primary Health Care

 00:13:01 - Sustainable Healthcare Services in Rural Communities

 00:14:45 - Comprehensive Care Beyond CCBHCs

 00:19:22 - Impact of CCBHCs

 00:23:29 - Challenges of Setting Up CCBHCs

 00:25:49 - Challenges of Providing Services in Rural Areas

 00:26:59 - CCBHCs Serving the Community

 00:27:57 - Innovations in Rural Healthcare

 00:30:35 - The Importance of Setting Boundaries

 00:34:28 - Conclusion and Call to Action 

Links:

• https://www.samhsa.gov/certified-community-behavioral-health-clinics 
• https://www.thenationalcouncil.org/resources/2022-ccbhc-impact-report/ 

Connect with us: 

https://ruralpolicypartners.com/ 

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https://www.youtube.com/@ruralpolicypartners

 
Watch this episode on Youtube: https://youtu.be/MfbSnCgI9Z8 

In this episode, we delve into the crucial topic of crisis services and the importance of knowing where to turn when inpatient isn't an option. Join us as we explore various levels of care available during crises, including crisis residential, subacute, and access centers. First, we break down the differences between crisis residential and community-based crisis stabilization, and shed light on the purpose of access centers. Next, we focus on the data surrounding substance use treatment facilities and the intricacies of subacute care, clarifying its definition and scope. Lastly, we tackle the challenges faced by access centers in Iowa and discuss legislative efforts to expand the definition of subacute care. Tune in for a comprehensive discussion on navigating crises with patience and understanding.

In this episode, you will be able to:

• Understand the roadmap for navigating behavioral health systems.
• Discover the options available for crisis residential treatment.
• Gain insights into the role and benefits of subacute care in mental health.
• Learn about the importance of integrating behavioral and physical health care.
• Explore the significance of secure residential facilities in behavioral health care.

The key moments in this episode are:
00:00:02 - Introduction to the Podcast

 00:02:34 - Understanding Crisis Residential and Subacute

 00:07:24 - Defining Subacute Care

 00:10:44 - Access Centers and their Role

 00:11:58 - The History of Access Centers

 00:12:50 - The Purpose of Access Centers and Subacute Care

 00:13:21 - Confusion and Misunderstanding

 00:13:52 - Role of Crisis Residential and Stabilization Units

 00:14:13 - Towards a Collaborative Care Model

 00:15:24 - Challenges of Subacute Care

 00:25:53 - The Shift Towards Whole-Person Healthcare Integration

 00:27:01 - Secure Residential Facilities and Medicaid Funding

 00:28:32 - Exploring Locked Residential Care

 00:32:23 - Self-Care and Personal Boundaries

 00:35:17 - Navigating Levels of Care in Behavioral Health 

Links:

• https://www.politico.com/news/2024/01/01/mental-hospitals-drug-users-congress-00132671
• https://bhbusiness.com/2024/02/05/cms-new-behavioral-health-model-illustrates-ongoing-effort-to-push-value-based-care-integration-forward/?euid=ffe4958e2b&utm_source=bhb-newsletter&utm_medium=email&utm_campaign=324bfbf3de&mc_cid=324bfbf3de&mc_eid=ffe4958e2b
• https://www.cms.gov/files/document/ibh-fact-sheet.pdf

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https://ruralpolicypartners.com/ 

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https://www.youtube.com/@ruralpolicypartners

Watch this episode on Youtube: https://youtu.be/gZdWLc0KL5I 

In this episode, we explore crisis services, covering everything from hotlines to mobile response units and access centers. We delve into the interconnectedness of these services, their alignment with the 988 suicide and crisis lifeline, and the importance of person-centered care. Additionally, we analyze performance data, offering insights into the ideal crisis response model and providing tools for communities to optimize their services. Through real stories, we highlight challenges faced in rural areas and emphasize the necessity of collaboration for effective crisis intervention. Join us as we navigate the landscape of crisis services, striving towards a future where support is readily available, regardless of the door through which it's sought.

In this episode, you will be able to:

• Mastering the complexities of navigating behavioral health systems can revolutionize crisis service accessibility.
• Implementing the 988 crisis hotline opens up a world of benefits for crisis intervention and support.
• Enhancing crisis services in rural communities is crucial for ensuring mental health support reaches all individuals.
• Understanding the pivotal role of access centers in mental health can transform crisis service provision.
• Unveiling effective strategies for mobile crisis response teams can elevate crisis intervention to new heights.

The key moments in this episode are:
00:00:02 - Introduction to the Podcast

 00:03:03 - Components of an Ideal Crisis System

 00:07:31 - Evolution of Crisis Call Centers

 00:10:19 - Importance of Warm Lines

 00:12:07 - Differentiating 911 and 988

 00:12:36 - Evolution of the Crisis Response System

 00:15:14 - 23 Hours Observation and Crisis Stabilization

 00:18:13 - Levels of Care in Crisis Response

 00:20:28 - Utilizing Data for Policy Decisions

 00:23:20 - Impact of 988 and Call Center Connectivity

 00:25:18 - The Importance of Location in Crisis Response

 00:26:15 - Challenges with Mobile Crisis Response

 00:28:37 - Partnership between Law Enforcement and Behavioral Health

 00:33:56 - Understanding Access Centers

 00:37:07 - The Future of Access Centers

 00:37:40 - Excitement for Summer Activities

 00:38:59 - Jason's Concert Plans

 00:40:09 - The Importance of Crisis Services

 00:40:30 - Accessing Crisis Services

 00:41:35 - Conclusion and Call to Action 

Links:

• https://hhs.iowa.gov/programs/mental-health/crisis-services 
• https://www.samhsa.gov/find-help/988/performance-metrics
• https://crisisnow.com/
• https://calculator.crisisnow.com/#/data-insights?chart=SC&geo=State&lob=All&location_key=19169&metric1=bh_high_needs&tab=Map

Connect with us: 

https://ruralpolicypartners.com/ 

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https://www.youtube.com/@ruralpolicypartners

Watch this episode on Youtube: https://youtu.be/Yj0xtXMeC2s  

Discover the intricacies of outpatient care in our latest episode, where we delve into best practices and challenges within this vital segment of the behavioral health continuum. From examining policy nuances and evidence-based practices to confronting data revealing concerning wait times for psychotherapy intake, we explore the complexities of outpatient utilization and mental health professional shortages. We also address critical issues such as insurance-driven client selection, the burden of waitlists, and the alarming trend of providing outpatient aftercare in emergency department settings. Join us as we advocate for systemic improvements to enhance access and quality within outpatient care delivery.

In this episode, you will be able to:

• Overcoming Behavioral Health System Challenges in Rural Areas: Learn how to navigate and improve mental health services in underserved rural communities.
• Accessing Outpatient Mental Health Services: Discover strategies to easily access and utilize crucial outpatient mental health services.
• Provider Shortages in Mental Health Care: Explore innovative solutions to address the shortage of mental health providers and ensure comprehensive care for all.
• Improving Outpatient Care Accessibility: Gain insights on enhancing the accessibility and quality of outpatient mental health care for better patient outcomes.
• Crisis Intervention and Self-Care Tips: Acquire essential tips for effective crisis intervention and valuable self-care practices to support mental health.

The key moments in this episode are:
00:00:02 - Introducing the Podcast

 00:02:50 - Utilization of Outpatient Care

 00:07:30 - Understanding Intensive Outpatient Treatment

 00:10:21 - Challenges with Implementing Evidence-Based Practices

 00:11:38 - The Impact of ACT Teams

 00:12:52 - the challenge of funding ACT teams in rural areas

 00:13:47 - adapting evidence-based practices for rural communities

 00:15:54 - different levels of outpatient care

 00:17:32 - barriers to accessing outpatient care

 00:24:05 - forever caseloads and provider shortages

 00:26:20 - Provider Shortages and Workforce Challenges

 00:27:38 - Self-Imposed Rules and Regulations

 00:30:35 - No Reject, No Reject

 00:32:29 - Stabilizing Patients in a Home Structure

 00:34:14 - Outpatient vs. Crisis Services

 00:38:18 - Engaging with the Audience

 00:38:51 - Working Together for Better Behavioral Health

 00:38:18 - Invitation for Engagement

 00:38:51 - Collaborative Efforts for Change

Links:

• https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9815605/#:~:text=Data%20from%20July%202021%20indicated,access%20to%20needed%20psychological%20care
• https://www.ruralhealthinfo.org/rural-maps/mapfiles/hpsa-mental-health.jpg?v=16
• https://www.kff.org/other/state-indicator/mental-health-care-health-professional-shortage-areas-hpsas/?currentTimeframe=0&selectedRows=%7B%22states%22:%7B%22iowa%22:%7B%7D%7D%7D&sortModel=%7B%22colId%22:%22Location%22,%22sort%22:%22asc%22%7D

Connect with us: 

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Welcome to our podcast series where we embark on a journey to unravel the intricacies of the mental health system from a 30,000-foot view. In this inaugural episode, we set the stage for a multi-part exploration into the various components that constitute a robust mental health system.

Drawing upon decades of collective experience, our hosts, Renee and Jason, provide invaluable insights into the design and evolution of mental health systems. Renee's role in crafting Iowa's adult mental health system underscores the ongoing quest for equitable access to services, while Jason's expertise in behavioral health levels of care offers a nuanced understanding of service delivery across different settings.

In this episode, you will be able to:

• Discover the intricacies of the behavioral health system and navigate its complexities with confidence.
• Uncover the critical importance of ASAM placement criteria in effective addiction treatment for better patient outcomes.
• Explore the gaps in the mental health system structure and learn how to address them for improved care delivery.
• Master the art of seamless care transitions to enhance patient experience and outcomes.
• Embrace a holistic approach for co-occurring disorders and revolutionize your care delivery for better patient well-being.

The key moments in this episode are:
00:00:02 - Introduction to Behavioral Health Systems

 00:01:59 - Personal Background and Experience

 00:07:05 - Update on ASAM Placement Criteria

 00:10:45 - Dismantling Silos in Behavioral Health

 00:12:18 - Overview of Behavioral Health System Levels

 00:12:51 - Understanding Asam Criteria and Levels of Care

 00:15:32 - Mental Health System and Crisis Services

 00:18:01 - Reevaluation of Mental Health Institutions

 00:22:44 - Challenges in Iowa's Mental Health System

 00:25:40 - Hope for the Future

 00:26:12 - Restructuring the System for Whole-Person Treatment

 00:27:37 - Structural Divides in Treatment

 00:29:09 - Treatment Barriers and Revocation

 00:30:38 - Implementation Challenges and System Gaps

 00:34:04 - Looking Ahead and Call to Action 

Links:

• Mental Health System Outline
• Mental Health System Locus
• https://www.asam.org/asam-criteria/about-the-asam-criteria
• https://discover.hazeldenbettyford.org/

Connect with us: 

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https://www.youtube.com/@ruralpolicypartners

Watch this episode on Youtube: https://youtu.be/WG0nQv3-n1w 

In this episode of our "Missing Link" series, we spotlight the damaging effects of lacking cooperation within systems. From identifying the signs of dysfunction to offering actionable solutions, we explore the journey towards restoring harmony. Join us as we dissect real-world examples, including insights from a Minnesota hospital's fundraising department. Discover the keys to fostering cooperation and overcoming resistance to change.

In this episode, you will be able to:

• Discover the impact of cooperation on teamwork and productivity in organizations.
• Learn effective conflict resolution strategies to foster a harmonious team environment.
• Unlock the key to enhancing workplace communication for improved cooperation and collaboration.
• Address practical needs in the workplace to encourage a culture of cooperation and support.
• Gain insight into the essential components of mental health systems for a cooperative and supportive work environment.

The key moments in this episode are:
00:00:02 - Introducing Cooperation

 00:05:25 - Challenges of Uncooperative Individuals

 00:09:20 - Building Cooperation on Communication and Collaboration

 00:10:43 - Avoiding Duplication and Inefficiency

 00:12:35 - Frustrations with Wasted Resources

 00:13:32 - Building Communication and Cooperation in the Workplace

 00:14:53 - Ego and Resistance to Collaboration

 00:16:59 - Encouraging Ongoing Learning and Collaboration

 00:19:46 - Uncooperative Behavior or Lack of Resources

 00:21:59 - Focusing on Cooperation and Addressing Resistance

 00:25:25 - The Importance of Cooperation in Organizations

 00:27:11 - Self-Care Tip: Turn Off the News

 00:28:25 - Self-Care Ideas

 00:29:44 - Preview of Next Topic: Mental Health System Overview

 00:30:35 - Conclusion and Call to Action 

Links:

• https://www.teambonding.com/improve-cooperation-amongst-co-workers/

Connect with us: 

https://ruralpolicypartners.com/ 

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https://www.youtube.com/@ruralpolicypartners

 
Watch this episode on Youtube: https://youtu.be/HAHJUw__5cY  

If you're feeling frustrated by the lack of collaboration in your workplace and the resulting duplication and competition, then you are not alone! The challenges of individual tasks, missed opportunities, and system structures designed against collaboration are likely causing your pain. It's time to find effective strategies to enhance teamwork and problem-solving. Let's shake things up and find new ways to achieve successful workplace collaboration.

In this episode, you will be able to:

• Discover the impact of workplace collaboration on productivity and innovation.
• Explore the power of psychological safety for fostering open and effective communication.
• Overcome the challenges of ineffective collaboration and enhance team performance.
• Learn actionable strategies for successful workplace collaboration and team synergy.
• Uncover the benefits of seeking strategic partnerships for business growth and success.

The key moments in this episode are:
00:00:02 - Introduction to Collaboration

 00:03:13 - Challenges of Collaboration

 00:07:26 - Benefits of Collaboration

 00:08:52 - Business Perspective on Collaboration

 00:12:31 - Importance of Adaptability and Creativity

 00:13:03 - Embracing Collaboration in Creative Projects

 00:14:31 - Dealing with Conflict in the Workplace

 00:16:21 - Recognizing Strengths and Involving Others

 00:19:37 - Impact of Duplication and Lack of Collaboration

 00:25:55 - Initiating Collaborative Conversations

 00:26:53 - The Importance of Not Quitting on Self Care

 00:27:35 - Adapting Self Care Strategies

 00:28:23 - Finding New Self Care Activities

 00:29:01 - The Importance of Collaboration

 00:29:57 - Conclusion and Call to Action

Links:

• https://www.researchgate.net/profile/Stephanie-Meeuwissen/publication/375793878_Understanding_and_strengthening_collaboration_in_the_workplace_How_to_work_towards_constructive_conflicts/links/6564ac05ce88b87031196e7a/Understanding-and-strengthening-collaboration-in-the-workplace-How-to-work-towards-constructive-conflicts.pdf
• https://www.mural.co/blog/collaboration-skills

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https://www.youtube.com/@ruralpolicypartners

Watch this episode on Youtube: https://youtu.be/0nKASdfl4YY 

If you're feeling frustrated and overwhelmed by the lack of clarity in your team's communication, then you are not alone! Despite countless meetings and emails, confusion still reigns and important messages are getting lost in the shuffle. Instead of the seamless collaboration and alignment you're striving for, misunderstandings and miscommunication seem to be the norm. It's time to change the approach and prioritize clear and effective communication to achieve the results you're aiming for.

In this episode, you will be able to:

• Mastering clear and effective communication can transform your leadership skills.
• Avoid communication breakdowns by implementing proactive strategies in your organization.
• Overcome the challenges of bedtracking systems with innovative solutions.
• Use after action reviews to evaluate progress and drive continuous improvement.
• Discover the importance of celebrating success and leveraging strengths for business growth.

The key moments in this episode are:
00:00:12 - Winter Meetings and Legislative Updates

 00:01:43 - Missing Links in Communication

 00:04:38 - Real-life Examples of Miscommunication

 00:09:16 - Importance of In-person Communication

 00:11:23 - The Power of Nonverbal Communication

 00:13:06 - Importance of Clear Communication

 00:15:00 - Impact of Poor Communication

 00:18:13 - Flaws in Bedtracking Systems

 00:22:55 - Listening as a Communication Skill

 00:26:51 - Importance of Reviewing and Evaluating

 00:27:13 - After Action Review Process

 00:27:42 - Celebrating Strengths and Making Changes

 00:28:36 - Importance of Communication

 00:29:03 - Next Week's Topic: Collaboration

Links:

• https://www.forbes.com/sites/forbescoachescouncil/2020/08/24/strong-nonverbal-skills-matter-now-more-than-ever-in-this-new-normal/?sh=352752fc5c61 
• https://professional.dce.harvard.edu/blog/8-ways-you-can-improve-your-communication-skills/ 

Connect with us: 

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Watch this episode on YouTube: https://youtu.be/RTAlWp1Puvc 

Embark on a journey of discovery as we unravel the unexpected complexities of mental health beds. Join us as we navigate through the convoluted landscape, unveiling the truth behind the numbers and definitions. Get ready to be astonished by the lack of clarity and consistency in defining and counting beds. Stay tuned as we shed light on this critical issue and drive positive change in mental health care.

In this episode, you will be able to:

• Understand the Challenges of Mental Health Beds to improve patient care and access.
• Define Mental Health Beds to ensure proper understanding and utilization.
• Explore the Levels of Care in Mental Health Beds for comprehensive treatment options.
• Address Inconsistencies in Bed Counting for accurate resource allocation and planning.
• Enhance Communication in Mental Health Care for better collaboration and patient outcomes.

The key moments in this episode are:
00:00:00 - "Introduction: County Beds"

 00:03:42 - "Legislative Confusion"

 00:07:17 - "Complexity of Inpatient Beds"

 00:11:12 - "Challenges with Bed Trackers"

 00:12:35 - "Ineffectiveness of Bed Trackers"

 00:13:29 - Limitations of Bed Tracking System

 00:14:58 - Staffed Beds and Open Bed Times

 00:16:45 - Inefficiencies in Bed Utilization

 00:19:47 - Importance of Communication and Collaboration

 00:24:18 - No Eject, No Reject Policy

 00:26:05 - Collective Problem-Solving

 00:27:28 - Implementation Challenges

 00:29:51 - Lack of Transparency

 00:32:35 - Medicaid System Variability

 00:37:32 - Self-Care Challenge

 00:38:57 - Creating New Habits

 00:39:21 - Frustrations and Definitions

 00:39:47 - Finding Alternatives

 00:40:05 - Getting People Unstuck

 00:40:47 - Conclusion and Next Episode 

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Watch this episode on YouTube: https://youtu.be/HYHGF92I5YE 

In this episode of The Stepping In It Podcast, we dive deep into the fundamental question that often arises in the realm of mental health and healthcare: What do we do, and perhaps more importantly, why do we do it? Join us as we explore the intersection between mental health and healthcare.

In this episode, you will be able to:

• Discover practical ways to access affordable mental health care.
• Understand the impact of insurance coverage disparities on mental health support.
• Overcome the challenges of accessing effective mental health treatment.
• Explore the benefits of integrating behavioral health services into your wellness routine.
• Learn effective strategies for tracking habits to foster positive mental health changes.

The key moments in this episode are:
00:00:00 - Introduction

 00:02:45 - Lack of Parity in Mental Health Care

 00:06:32 - Challenges with Insurance

 00:09:32 - Prior Authorization Challenges

 00:12:48 - Need for Overhaul

 00:13:39 - Barriers and Bias in Access to Mental Health Care

 00:15:10 - Shift in Concerns in Rural Areas

 00:16:30 - Changes in Federal Policies

 00:18:38 - Barriers to Accessing Mental Health Care

 00:24:07 - Positive Programs and Support

 00:27:16 - Importance of Small Habits for Better Health

 00:27:39 - Don't Give Up on Your Goals

 00:27:51 - Equity and Parity in Behavioral Health Care

 00:28:14 - Positive Shifts in Mental Health Awareness

 00:28:36 - Conclusion and Call to Action

Links:

• https://www.psychiatry.org/psychiatrists/advocacy/federal-affairs/health-insurance-coverage-access-to-care/mental-health-parity
• https://www.kff.org/private-insurance/poll-finding/kff-survey-of-consumer-experiences-with-health-insurance/ 
• https://www.kff.org/mental-health/issue-brief/proposed-mental-health-parity-rule-signals-new-focus-on-outcome-data-as-tool-to-assess-compliance/
• https://www.kff.org/health-costs/issue-brief/privately-insured-people-with-depression-and-anxiety-face-high-out-of-pocket-costs/ 

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