Conference Agenda

1. IMPACT Training Conference: September 22 & 23
2. Optional Post-Conference Workshops on Problem-Solving Treatment (PST) and Financing IMPACT Care: September 24

The two day IMPACT training conference provides:

• introduction to evidence-based team care for depression
• detailed exploration of team roles and how to build an effective integrated care team
• practical skills for all members of the integrated care team, especially the care manager
• implementation strategies from organizations that have successfully implemented IMPACT

The one day post-conference workshop on Problem-Solving Treatment (PST) provides:

• introduction to this brief and practical evidence-based psychotherapy
• detailed skills training in the technique

The one day post-conference workshop on Financing IMPACT Care provides:

• introduction to financing IMPACT care
• examples of financing IMPACT care in various settings

Conference attendees may participate in one or both of these training components, depending on their needs. A detailed agenda for each is provided below.

Wednesday, September 22

(Bay Auditorium)

8:00      Registration & Continental Breakfast

8:30      Welcome, Introductions (15 min)        

8:45      IMPACT:  A Practical Approach to Team-Based Depression Care (1 hr)

(Jürgen Unützer)

• What is depression and why treat it in primary care?
• Overview of the IMPACT model of depression care
• Summary of the evidence supporting IMPACT
• Description of the stepped-care treatment algorithm for depression                               
• The value of a team approach to depression

9:45      Key Components of Depression Care Management – Part 1 (45 min)

(Jürgen Unützer, Rita Haverkamp, Rachel Quintanilla)

• Key components of the IMPACT program as they are implemented by the care manager
• Methods for identifying depression

10:30    Break

10:45    Key Components of Depression Care Management – Part 2 (1 hr 15 min)

• Initial session / patient education / treatment options and planning
• Follow-up contacts / PHQ-9 / symptom tracking
• Relapse prevention
• Care manager role in supporting medication therapy  

12:00    Lunch

12:45     Antidepressant Medications  (1 hr 30 min)

(Jürgen Unützer)

• Key principles of antidepressant therapy and types of medications commonly used in primary care
• Patient education about antidepressants
• When to initiate, titrate, and switch antidepressants
• Combination therapy and drug interactions

2:15      Break

2:30      Challenging Cases  (1 hr)

(Jürgen Unützer)

• The role of the consulting psychiatrist and how it differs from traditional consultation
• Difficult cases that may benefit from psychiatric consultation: persistent depression, comorbid medical conditions or chronic pain, comorbid psychiatric conditions, comorbid alcohol/substance abuse
• Managing patients at risk for suicide

 3:30      Behavioral Activation and Brief Introduction to Problem-Solving Treatment  (1 hr)

(Rita Haverkamp)

• The role of behavioral activation in managing depression
• Ways to encourage behavioral activation
• Integrating behavioral activation into depression care management
• What is Problem-Solving Treatment and how does it fit with Behavioral Activation?

4:30      Homework Assignment (30 min)

5:00      Adjourn Day 1  

Thursday, September 23  

(Bay Auditorium, Sound Room)

8:00      Continental Breakfast

8:30      Review of Day One, Q&A  (1 hr)  

9:15      Concurrent Sessions (1 hr)

10:30     Break

10:45    Concurrent Sessions (1 hr)

12:00     Lunch

12:45     IMPACT Implementations – Part 1 (2 hr 15 min)

            (Jürgen Unützer, Rachel Quintanilla, Rita Haverkamp, Virna Little, Nancy Jaeckels, Diane Powers)

• Overview and goals of AIMS Center (Advancing Integrated Mental health Solutions)
• Adaptations of the IMPACT model for diverse practice settings and populations (e.g. HMO setting, FQHC  setting, low-income Latino population, state-wide implementation)

2:45      Break

3:00      IMPACT Implementations – Part 2 (30 min)

• More adaptations of the IMPACT model for diverse practice settings and populations

3:30      Implementation Planning and Team Building  (1 hr)

(Jürgen Unützer, Diane Powers)

• Implementation process and timeline
• Building the team
• Clinical tracking systems
• Action planning for implementing IMPACT in your setting

4:30      Panel Discussion with Presenters (30 min)   

• Questions and answers on all topics addressed in the training

5:00      Adjourn Day 2   

Friday, September 24, 2010

Optional Workshop Track I – Problem Solving Treatment (PST) 

PST Workshop Morning – Didactic
(Bay Auditorium)

 8:00      Continental Breakfast

8:30      Problem-Solving Treatment (PST): Introduction and Initial Session (1 hour 30 min)

(Patricia Areán, Rita Haverkamp)

• The theoretical model and evidence base for PST
• Key steps of problem-solving treatment
• Discuss key elements of initial PST session
• Observation of initial PST session

10:00    Break

10:15    Problem-Solving Treatment (PST): Follow-up Sessions (1 hour 15 min)

(Patricia Areán, Rita Haverkamp)

• Key elements of successful follow-up sessions
• Observation of follow-up PST session

11:30    Problem-Solving Treatment (PST): Group PST, Certification Process (30 min)

(Patricia Areán, Rita Haverkamp)

• Group PST
• Case supervision
• Certification process

12:00    Discussion (30 min)

12:30    Lunch

PST Workshop Afternoon – Role Playing
(Bay Auditorium, Cove Room) 

1:15      Problem-Solving Treatment (PST): Initial Session Role Play (1 hour)

(Patricia Areán, Rita Haverkamp)  

• Role playing to facilitate practice of core PST skills

2:15      Break

2:30      Problem-Solving Treatment (PST): Follow-up Session Role Play (1 hour)

(Patricia Areán, Rita Haverkamp)

• Role playing to facilitate practice of core PST skills

3:30      Discussion (30 min)

4:00      Adjourn

Optional Workshop Track II - Financing IMPACT Care

( Sound Room)

8:00      Continental Breakfast

8:30      Financing IMPACT Care: Overview (45 min)

(Jürgen Unützer)

• Cost of providing IMPACT care
• Cost effectiveness of IMPACT
• Developing a business case for IMPACT

9:15      Financing Integrated Mental Healthcare (50 min)

            (Barbara Mauer)

• Four Quadrant model
• Overview of healthcare reform and implications for financing integrated mental healthcare
• Examples of financing
• Primary care in mental health
• Mental health in primary care (CHPW GA-U program)

10:05    Break

10:20    Financing DIAMOND Care (50 min)

            (Nancy Jaeckels)

• Payment structure for state-wide DIAMOND Initiative in Minnesota
• Lessons about cost of care and payment from first two years of DIAMOND experience

11:10:   Billing and Reimbursement for IMPACT Care (1 hr)

            (Virna Little, Jürgen Unützer)

• Financing IMPACT care in various settings (e.g. FQHC, school health centers)
• State variations in funding structures and options
• Sustainability planning for implementation
• Resources for billing and reimbursement information
• Medicare hierarchical condition coding for care management

(Jürgen Unützer, Barbara Mauer, Nancy Jaeckels, Virna Little)

• Options for financing collaborative care for depression in specific practice settings

2:15      Break

2:30      Financing IMPACT Care: Case-based Discussion – Part 2 (1 hr 30 min)

(Jürgen Unützer, Barbara Mauer, Nancy Jaeckels, Virna Little)

• Options for financing collaborative care for depression in specific practice settings

4:00      Adjourn