1 Training 15 Performance Measure with Proposed Revisions

Training 15 PERFORMANCE MEASURE Goal: Consultation and Training for Mental and Behavioral Health Level: Grantee Domain: MCH Workforce Development
GOAL	Increase the availability and accessibility of consultation services to providers caring for individuals with behavioral or mental health conditions.
MEASURE	Number of providers participating in consultation and care coordination support services.
DEFINITION	Total number of providers participating in consultation (teleconsultation and in-person) and care coordination support services provided by the Pediatric Mental Health Care Access (PMHCA) program and the Screening for Maternal Depression and Related Behavioral Disorders (MDRBD) program.
BENCHMARK DATA SOURCES
GRANTEE DATA SOURCES	PMHCA and MDRBD awardees report using the data collection form.
SIGNIFICANCE	Mental and behavioral health issues are prevalent among children and adolescents, and pregnant and postpartum women in the United States. However, due to shortages in the number of psychiatrists, developmental-behavioral providers, and other behavioral health clinicians, access to mental and behavioral health services is lacking. Research indicates that telehealth can improve access to care, reduce health care costs, improve health outcomes, and address workforce shortages in underserved areas. Telehealth strategies that connect primary care providers with specialty mental and behavioral health care providers can be an effective means of increasing access to mental and behavioral health services for children and pregnant and postpartum women, especially those living in rural and other underserved areas.

Training 15 Data Collection Form

1. Provider Consultation and Training

   1. Consultation:

      Provider Type		Number enrolled (if applicable)1	Number participating2	Number enrolled AND participating (if applicable)3
      Primary Care Providers (non-specialty)	Pediatrician
      	Family Medicine
      	OB/GYN
      	Internal Medicine
      	Advanced Practice Nurse/Nurse Practitioner
      	Certified Nurse Midwife
      	Physician Assistant
      Others	Psychiatrist
      	Developmental-Behavioral Pediatrician
      	Nurse
      	Behavioral Health Clinician (e.g. psychologist, therapist, counselor)
      	Care Coordinator/ Patient Navigator
      	Other Specialist Physician, APN/NP, PA (specify type):
      	Other (specify type):
      Unknown Provider type
      Total (will auto-populate)
      Total Primary Care (will auto-populate)

      1. Number and types of providers enrolled for and participating in program consultation (teleconsultation or in-person) and care coordination support services⁴.

2. Use of program consultation and care coordination support services.

   1. Number of provider contacts with the program for consultation (teleconsultation or in-person), care coordination support, or both.

Type of contact	Number of provider contacts with the program for services
Consultation Only
Care Coordination Support Only
Both

2. Number of consultations and referrals⁵ given to providers.

Consultation or referral	Number of consultations or referrals given
Consultations via telehealth
Consultations in-person
Referrals

3. Please indicate the condition(s) about which providers contacted the program for consultation (teleconsultation or in-person) or care coordination support services. Select all conditions that apply. Specify the number of contacts for each condition. Each contact can involve more than one condition⁶.

• Anxiety disorders

  • Number of contacts for this reason _________

• Depressive disorders(excluding postpartum depression)

  • Number of contacts for this reason _________

• Postpartum depression

  • Number of contacts for this reason _________

• Bipolar and related disorders

  • Number of contacts for this reason _________

• Attention-Deficit/ Hyperactivity Disorder (ADHD)

  • Number of contacts for this reason _________

• Autism Spectrum Disorder

  • Number of contacts for this reason _________

• Disruptive, impulse-control, and conduct disorders

  • Number of contacts for this reason _________

• Feeding and eating disorders

  • Number of contacts for this reason _________

• Obsessive-compulsive and related disorders

  • Number of contacts for this reason _________

• Trauma and stressor-related disorders

  • Number of contacts for this reason _________

• Schizophrenia spectrum and other psychotic disorders

  • Number of contacts for this reason _________

• Substance-related disorders

  • Number of contacts for alcohol _________

  • Number of contacts for marijuana _________

  • Number of contacts for nicotine _________

  • Number of contacts for opioids _________

  • Number of contacts for other substance-related disorders _______

• Suicidality or self-harm

  • Number of contacts for this reason _________

• Other (please specify)___________

  • Number of contacts for this reason _________

3. Number of consultations (teleconsultations and in-person) and referrals provided by each member of the mental health team. [Measures applies only to PMHCA awardees]

Member of mental health team	Number of consultations provided	Number of referrals provided
Psychiatrist
Psychologist
Social Worker
Counselor
Care Coordinator
Other behavioral clinicians
Other (specify type):
Total (will auto-populate)

2. Training:

   1. Number and types of providers trained.

Provider Type		Number Trained
Primary Care Providers (non-specialty)	Pediatrician
	Family Medicine
	OB/GYN
	Internal Medicine
	Advanced Practice Nurse/Nurse Practitioner
	Certified Nurse Midwife
	Physician Assistant
Others	Psychiatrist
	Developmental-Behavioral Pediatrician
	Nurse
	Behavioral Health Clinician (e.g. psychologist, therapist, counselor)
	Care Coordinator/ Patient Navigator
	Other Specialist Physician, APN/NP, PA (specify type):
	Other (specify type):
Unknown Provider type
Total Primary Care (will auto-populate)
Total (will auto-populate)

2. Total number of trainings held ____

   1. Topics covered by trainings and number of trainings per topic. Select all that apply:

 Mental or behavioral health conditions-related trainings (e.g., anxiety, depression, substance use disorder, ADHD, OCD, eating disorders, tics, Autism, developmental delay, behavioral dysregulation, etc.) Please include comprehensive trainings that cover medications, screenings, treatments, etc. for specific conditions in this category.

Number of trainings covering topic _____

 Medication-focused trainings

Number of trainings covering topic _____

 Screening and assessment/testing-focused trainings

Number of trainings covering topic _____

 Treatment modality-focused trainings

Number of trainings covering topic _____

 Trauma focused trainings

Number of trainings covering topic _____

 Parent and family-focused trainings

Number of trainings covering topic _____

 Practice Improvement/Systems Change/Quality Improvement (e.g., practice workflows, integrating protocols into the EHR, integrating behavioral health into primary care, expanding community referrals, ensuring culturally and linguistically appropriate services)

Number of trainings covering topic _____

 COVID-19-focused trainings

Number of trainings covering topic _____

 Other (please specify) ________________

Number of trainings covering topic _____

2. Training mechanisms used. Select all that apply:

   • In-person

Number of trainings using this mechanism _____

• Project ECHO® (distance learning cohort)

Number of trainings using this mechanism _____

• ECHO-like (distance learning cohort)

Number of trainings using this mechanism _____

• Web-based

Number of trainings using this mechanism _____

• Other (please specify)

Number of trainings using this mechanism _____

2. Individuals Served

   1. Number of individuals for whom a provider contacted the program for consultation (teleconsultation or in-person) or care coordination support services

	Total	Rural/underserved7
Children 0-11
Adolescents 12-21
Women (pregnant or postpartum)

2. Number of individuals recommended for referral and/or treatment, among those for whom a provider contacted the program for consultation (teleconsultation or in-person) or care coordination support services.

	Referral only	Treatment only	Both referral and treatment
Children 0-11
Adolescents 12-21
Women (pregnant or postpartum)

3. Percent of individuals screened for behavioral or mental health condition [Optional]

	Numerator8	Denominator9	% (auto-populated)
Children 0-11 screened for behavioral or mental health condition
Adolescents 12-21 screened for behavioral or mental health condition
Women (pregnant or postpartum) screened for behavioral or mental health condition
Women (pregnant or postpartum) screened for depression
Women (pregnant or postpartum) screened for anxiety
Women (pregnant or postpartum) screened for substance use

1 Enrolled provider: a provider who has formally registered with the program to facilitate use of consultation (teleconsultation or in-person) or care coordination support services, at the time of reporting. An enrolled provider is currently enrolled with the program even if initial enrollment occurred prior to current reporting period. An enrolled provider may or may not be a participating provider.

2 Participating provider: a provider who has contacted the program for consultation (teleconsultation or in-person) or care coordination support services, and who may or may not be an enrolled provider.

3 This column refers to the number of enrolled providers (registered) who are participating in the program (contacting the program for consultation or care coordination support services).

4 Care Coordination Support: In context of MDRBD/PMHCA, care coordination support means, at minimum, that the program provides resources and referrals to a provider when they contact the program, or to the patient/family when the program works with patients/families directly. In these programs, “care coordination support” is synonymous with “providing resources and referrals”.

5 Referrals are given to providers (or directly to the patients/families) by the program to introduce specific health providers or services. Referrals are typically provided using the referral database. More than one referral can be provided at a time.

6 If the patient has a diagnosed condition, but the provider is calling about another condition, a different presenting concern, or another reason, please count the reason(s) the provider is calling the program. If the patient does not have a diagnosis, the reason for contact can be a suspected diagnosis, diagnostic impression, presenting concerns/symptoms, suspected problem, or another reason. The condition(s) selected should be the reason(s) the provider is calling for consultation (teleconsultation or in-person) or care coordination support services.

7 For this measure, you may use provider zip codes to identify rural or underserved counties if the patient zip code is unavailable. The use of patient zip codes is not required. HRSA defines rural areas as all counties that are not designated as parts of metropolitan areas (MAs) by the Office of Management and Budget. In addition, HRSA uses Rural Urban Commuting Area Codes to designate rural areas within MAs. This rural definition can be accessed at https://datawarehouse.hrsa.gov/tools/analyzers/geo/Rural.aspx. If the county is not entirely rural or urban, follow the link for “Check Rural Health Grants Eligibility by Address” to determine if a specific site qualifies as rural based on its specific census tract within an otherwise urban county. Underserved areas are defined by the following terms: Any Medically Underserved Area/Population (MUA/P); or a Partially MUA/P. MUA/Ps are accessible through https://data.hrsa.gov/tools/shortage-area/mua-find

8 For PMHCA: Number of children and adolescents, 0-21 years of age, for whom a provider contacted the mental health team for consultation or referral, who received at least one screening for a behavioral health condition using a standardized validated tool.

For MDRBD: Number of pregnant and postpartum women (PPW) for whom a provider contacted the program for consultation or referral during the reporting period, who received at least one screening for [depression, anxiety, or substance use] using a standardized validated tool.

9 For PMHCA: Number of children and adolescents, 0-21 years of age, for whom a provider contacted the mental health team for consultation or referral.

For MDRBD: Number of pregnant and postpartum women (PPW) for whom a provider contacted the program for consultation or referral during the reporting period.