Enhancing Skills in Behavioral Health Management

With the Affordable Care Act (ACA), Medicaid has become the largest insurer in the U.S. Annual NYS Medicaid funding is approximately $50 billion. In NYS in 2013 there were 5.79 million Medicaid recipients. In 2014, the Centers for Medicare and Medicaid Services (CMS) approved New York’s $8.25 billion Medicaid Redesign Team (MRT) waiver amendment. The goal of New York’s federal waiver, the Delivery System Reform Incentive Payment (DSRIP) program, is to reduce avoidable hospital use by 25% through transforming the healthcare delivery system and also the way that health care is paid for. To receive funding NYS DSRIP required Medicaid providers and community-based organizations to form integrated delivery networks called Performing Provider Systems (PPSs). Behavioral Health (BH) is at the core of health care reform in NYS. In DSRIP, BH encompasses both mental health and substance use disorders. Medicaid members diagnosed with BH conditions account for 21% of Medicaid members but 60% of the total cost of care.

Integrating BH into primary care involves transforming the healthcare delivery system and will also require transforming the healthcare workforce. Yet access to care for patients with behavioral health issues has become more limited due to safety concerns especially for students in Nursing Programs.

One approach that can expose healthcare professionals to management of patients with behavioral health issues is Simulation. The NCSBN National Simulation Study: A Longitudinal, Randomized, Controlled Study Replacing Clinical Hours with Simulation in Pre-licensure Nursing Education (2014) noted that there were no differences between the use of 10%, 25%, and 50% of simulation and clinical experiences. Transforming the healthcare delivery system to address the growing need for behavioral health services requires new approaches to workforce development. One approach that can expose students and healthcare professionals to management of patients with behavioral health issues is Simulation. This project describes one innovative teaching approach utilizing a collaborative effort in Simulation with Nursing and Applied Theater programs to develop an educational strategy to promote development of knowledge, skills and attitudes in management of behavioral health issues.