Welcoming Remarks and Keynote Presentation
On the Forefront of Colorado’s Youth Mental Health Crisis: The Promise of Primary Care.
Location: Mount Harvard
Welcoming Remarks: Dr. Ron-Li Liaw MD, Mental Health In-Chief, CHCO
Keynote Presenter: Dr. Lalit Bajaj, MD, Chief Quality Officer, CHCO

This keynote presentation will highlight the possibility and promise of addressing behavioral health in pediatric primary care.  While the process of treating behavioral health in primary care can be challenging from cultural, financial, and operational standpoints, the promise of broad-based prevention makes it worthwhile.  Dr. Bajaj, who has dedicated his career to helping bridge gaps between primary care and emergency medicine, will launch the conference by addressing not only the “why” of treating behavioral health in primary care but also inspiring participants of its possibility.   

Integration as Both/ And: The Array of Practice Options  
Location: Mount Harvard
Presenters:  Dr. Bruno Anthony, Professor, CU Anschutz and Anneka Quinn, FNP-C, Pediatrics West 

All too often practices are asked to choose between several options of behavioral health integration – co-location, referral or integration are frequently positioned as separate choices.  But increasingly this choice is a false one– using a mix of models is often preferred for staff, clinicians, and patients. This session will explore the continuum of options and suggest ways in which practices can select and grow into models that work best for their circumstances.

Breakout Sessions:
Roles and Scopes of Team Members  
Location: Mount Harvard
Presenter: Dr. Bethany Ashby, PsyD, Associate Professor, CU Anschutz and Allyson Gottsman, Research Instructor, Family Medicine, CU Anschutz 

Effectively treating and managing behavioral health issues in primary care settings requires a team efforts. From reception to clinical care to administrative office support, effective practices include all team members in their approach. This session focuses on how to involve and delineate roles and scopes across the practice and how to lead through cultural change.

Meeting the Challenge of Financial Sustainability
Location: Mount Snowmass
Presenters: Meadows Mental Health Policy Institute
A primary concern involving behavioral health treatment in primary care is creating a viable business case and financial model. Behavioral health visits require more time in consult rooms, and coding can be elusive, often resulting in reimbursements that do not cover costs. This session explores how practices can implement processes and pathways that result in a better bottom line.

Breakout Sessions:
Beyond the questionnaire: The ART of Screening and Assessment  
Location: Mount Harvard
Presenters: Dr. Brian Pitts, Assistant Professor, CU Anschutz and Erica Gleason, PhD
The availability of screening tools for behavioral health conditions suggests that there is a science to screening. This workshop will overview the evidence-based screening tools for depression, anxiety, suicide, and other conditions. We will weave in the art to this practice.  How practitioners (clinicians and others) enter into conversations, ensure candid answers from patients and actionable next steps. 

Supporting a Practice through a Behavioral Healthcare Model Change
Location: Mount Snowmass
Presenter: Dr. Melissa Buchholz, PsyD, Associate Professor, CU Anschutz  

Integrating behavioral health in pediatric primary care required more than simply embedding a mental health provider into your practice. Operationalizing interdisciplinary, integrated, team-based care approaches is challenging and requires planning, patience, and persistence. This session will focus on strategies that promote practice transformation at every stage of implementation. 

Breakout Sessions:
Brief Behavioral Health Interventions for Anxiety 
Location: Mount Harvard
Presenters: Dr. Ben Mullin, PhD, Associate Professor, CU Anschutz, Dr. Jooyoung Lee, MD, Sr. Instructor, CU Anschutz, Dr. Sarah Humphreys, Sapphire Pediatrics                                                                                                                         

Primary care providers have a range of choices in the direct and immediate treatment of mild and moderate anxiety. Today, many providers are trying “single session” or brief interventions for lower levels of acuity. Expanding on generations of infant weight management expertise we will explore what pediatricians can do to manage patients with a specified behavioral health diagnosis, this session will highlight ways to incorporate behavioral health interventions into current practice. The session will also include medication management, DBT tools and ongoing PCP (primary care providers) follow-up guidance.
 

Lessons from Primary Care: Strategies for Behavioral Health Clinic Culture Shift 

Location: Mount Snowmass 

Presenter: Dr. Cecile Fraley, MD, CEO Pediatric Partners of the Southwest 

Introducing new elements to current workflows – anything from depression screening to bringing in a licensed therapist for an immediate consult– requires both operational and cultural shifts for any practice.  When behavioral health elements fail in a practice setting, practice culture and norms are often to blame. This panel discussion with local practitioners will share triumphs, failures and “lessons learned” from their work in treating behavioral health in their clinics. 

Front Office Operations Logistics & other Facility Challenges – Panel Discussion
Location: Mount Snowmass
Presenters: Kelly Galloway, VP, Associate Chief Nursing Officer, Community Health, CHCO, Dr. Maya Bunik, MD, Professor, Pediatrics, CU Anschutz and Associate Chief Medical Office, Ambulatory, CHCO, and Dr. Ayelet Talmi, PhD, Professor, Psychiatry – Harris Program and Director, Section of Integrated Behavioral Health, CHCO

A partnership between patient care and administrative tasks for the front office. Creating efficiencies and involving vital staff members in the process of adapting to many behavioral health changes of content and confidentiality added to the practice. (behavioral health screeners, visit type, patient confidentiality, length of visits etc.) Optimizing your schedule and room assignments to account for the added time that behavioral health concerns add to all visit times like well child checks. Discussing the challenges that may occur and solutions to these challenges.

Primary Care Crisis Services and Escalation Pathways  
Location: Mount Harvard
Presenter: Dr. Beau Carubia, MD, Assistant Professor, CU Anschutz
This session will provide a comprehensive review of treating imminent risk behavioral health patients and will review common diagnoses that can readily escalate including aggression, bipolar, conduct disorder and suicidality.  Dr. Carubia will discuss approaches providers can take and decrease utilization of escalation pathway and community resources available for those in need.

Breakout Sessions:
High Impact Brief Behavioral Health Interventions for ADHD
Location: Mount Harvard
Presenters: Dr. Jessica Hawks, PhD, Associate Professor, CU Anschutz and Anne Penner, MD, Assistant Professor, CU Anschutz

ADHD and disruptive behaviors are some of the most common childhood mental health concerns seen by primary care providers. Fortunately, there are brief and effective interventions for this patient population that can be implemented in a primary care setting. This session will highlight screening tools used to accurately identify ADHD and/or behavioral concerns, as well as describe evidence-based brief behavioral interventions and pharmacological treatments that can be used to treat these youth. Common questions and concerns raised by parents will be discussed and suggestions will be provided regarding how to best respond. This presentation will end with a description of resources and referral information that can be accessed to provide ongoing support to these patients, including effective partnership with schools. 
 

Behavioral Health and the EHR Workflow Optimization 
Location:  Mount Snowmass
Presenters: Michael Ripperton, PedsConnect Manager, CHCO and Dr. Marissa Schiel, MD, Associate Professor, CU Anschutz

This session will explore how to add in behavioral health EHR Workflows to create a better tracking system for behavioral health patients. In addition to creating long-term management to help with care coordination, EHR workflows allow less room to fall through the cracks and track additional visits needed for follow-up to help increase financial gains for the practice. In addition, allowing the collection of data to improve practice workflows.

Breakout Sessions:

Brief Behavioral Health Interventions for Depression 
Location: Mount Harvard
Presenters: Dr. Marissa Nunez Moreno, PhD, Assistant Professor, CU Anschutz, and Dr. Melissa Batt, MD, MPH, Assistant Professor, CU Anschutz

Pediatric primary care providers are often at the forefront of identifying mood-related challenges in children and adolescents. Our session will equip you with practical techniques for assessing depression and other mood disorders, identifying when to refer for behavioral healthcare services, and recommend when to initiate medication during the critical bridge period between services. We will also provide you with actionable behavioral health strategies to integrate into your practice designed to boost patient motivation and start alleviating depressive symptoms. 
 

Schools: A Connection with Primary Care
Location: Mount Snowmass
Presenters: Lauren Henry, Psychologist, PMHI, and Lauren Eckhart, PsyD, Clinical Director of Colorado Springs Division 

This session will explore best practices in collaborating effectively with families and schools. Topics include the types of behavioral health providers in schools, the role of pediatrics in support plans (504s, IEPs), psychiatric medications, and behavioral health services delivered in schools. 

Looking Up and Looking Out: The Need for Advocacy and System Change 
Location: Mount Harvard 
Presenter: Dr. Ron-Li Liaw MD, Mental Health In-Chief, CHCO, and Dannette Smith, Commissioner, Behavioral Health Administration
While changes can be made at the individual practice level, policy decisions system transformation dictate both the promise and possibility of improving our children’s mental health. The collective voice of pediatric primary care providers can be an effective lever in changes we all need to do our jobs more effectively. This session will give an overview of Colorado's current policy and legislative context – and suggest meaningful changes that we can work together to make a reality.