Continuous Quality Improvement (CQI) Planning: Behavioral Health ...

Continuous Quality Improvement (CQI) Planning: Behavioral Health & Health Care Reform Update
OACBHA Quick Hit Team—INTEGRATION OF PHYSICAL AND BEHAVIORAL HEALTH
The Board system will be taking the lead in assisting local communities with implementation of three evidencebased
initiatives that will result in improved care for clients and significant savings in cost and time through
advancing the statewide implementation of:
1. ACE Screening (Adverse Childhood Experiences): the Adverse Childhood Experiences (ACE) Study is one of
the largest investigations ever conducted to assess associations between childhood maltreatment and later-life
health and well-being. The study is collaboration between the Centers for Disease Control and Prevention and
Kaiser Permanente's Health Appraisal Clinic in San Diego.
Childhood abuse, neglect, and exposure to other traumatic stressors [termed adverse childhood experiences
(ACE)] are common. Almost two-thirds of our study participants reported at least one ACE, and more than one of
five reported three or more ACE. The short- and long-term outcomes of these childhood exposures include a
multitude of health and social problems such as alcoholism and alcohol abuse, COPD, depression, smoking, STD’s,
and unintended pregnancies.
Family Health History and Health Appraisal questionnaires are used to collect information on childhood
maltreatment, household dysfunction, and other socio-behavioral factors. The ACE Score, a count of the total
number of ACE respondents reported, is then calculated; as the number of ACE increase, the risk for identified
health problems increases in a strong and graded fashion.
2. SBIRT (Screening, Brief Intervention and Referral to Treatment): comprehensive, integrated, public health
approach to the delivery of early intervention and treatment services for persons with substance use disorders, as
well as those who are at risk of developing these disorders. Primary care centers, hospital emergency rooms,
trauma centers, and other community settings provide opportunities for early intervention with at-risk substance
users before more severe consequences occur.
Screening quickly assesses the severity of substance use and identifies the appropriate level of treatment.
Brief intervention focuses on increasing insight and awareness regarding substance use and motivation
toward behavioral change.
Referral to treatment provides those identified as needing more extensive treatment with access to
specialty care.
Deborah Kelley, Deputy Director of Planning & Policy, December 2012 Board Meeting