Integrating Behavioral Health & Primary Care in New Hampshire: A Path Forward to Sustainable Practice & Payment Transformation

New Hampshire residents face challenges with behavioral and physical health conditions and the interplay between them. National studies show the costs and the burden of illness from behavioral health conditions and co-occurring chronic health conditions that are not adequately treated in either primary care or behavioral health settings. Bringing primary health and behavioral health care together in integrated care settings can improve outcomes for both behavioral and physical health conditions. Primary care integrated behavioral health works in conjunction with specialty behavioral health providers, expanding capacity, improving access, and jointly managing the care of patients with higher levels of acuity In its work to improve the health of NH residents and create effective and cost-effective systems of care, the NH Citizens Health Initiative (Initiative) created the NH Behavioral Health Integration Learning Collaborative (BHI Learning Collaborative) in November of 2015, as a project of its Accountable Care Learning Network (NHACLN). Bringing together more than 60 organizations, including providers of all types and sizes, all of the state’s community mental health centers, all of the major private and public insurers, and government and other stakeholders, the BHI Learning Collaborative built on earlier work of a NHACLN Workgroup focused on improving care for depression and co-occurring chronic illness. The BHI Learning Collaborative design is based on the core NHACLN philosophy of “shared data and shared learning” and the importance of transparency and open conversation across all stakeholder groups. The first year of the BHI Learning Collaborative programming included shared learning on evidence-based practice for integrated behavioral health in primary care, shared data from the NH Comprehensive Healthcare Information System (NHCHIS), and work to develop sustainable payment models to replace inadequate Fee-for-Service (FFS) revenues. Provider members joined either a Project Implementation Track working on quality improvement projects to improve their levels of integration or a Listen and Learn Track for those just learning about Behavioral Health Integration (BHI). Providers in the Project Implementation Track completed a self-assessment of levels of BHI in their practice settings and committed to submit EHR-based clinical process and outcomes data to track performance on specified measures. All providers received access to unblinded NHACLN Primary Care and Behavioral Health attributed claims data from the NHCHIS for provider organizations in the NH BHI Learning Collaborative. Following up on prior work focused on developing a sustainable model for integrating care for depression and co-occurring chronic illness in primary care settings, the BHI Learning Collaborative engaged consulting experts and participants in understanding challenges in Health Information Technology and Exchange (HIT/HIE), privacy and confidentiality, and workforce adequacy. The BHI Learning Collaborative identified a sustainable payment model for integrated care of depression in primary care. In the process of vetting the payment model, the BHI Learning Collaborative also identified and explored challenges in payment for Substance Use Disorder Screening, Brief Intervention and Referral to Treatment (SBIRT). New Hampshire’s residents will benefit from a health care system where primary care and behavioral health are integrated to support the care of the whole person. New Hampshire’s current opiate epidemic accentuates the need for better screening for behavioral health issues, prevention, and treatment referral integrated into primary care. New Hampshire providers and payers are poised to move towards greater integration of behavioral health and primary care and the Initiative looks forward to continuing to support progress in supporting a path to sustainable integrated behavioral and primary care

Opportunity-Rich Schools and Sustainable Communities: Seven Steps to Align High-Quality Education With Innovations in City and Metropolitan Planning and Development

Details challenges and steps for linking quality education and community and economic vitality, including establishing a shared vision and metrics, aligning investments for prosperity, and expanding access via transportation. Lists promising practices

Musselman Library Strategic Plan 2013-2016

Musselman Library Strategic Plan 2013-2016 reflects the evolution of libraries and higher education since the 2007 adoption of Crossroads, Connections, and Creativity: Musselman Library Strategic Plan. The 2013-2016 strategic plan challenges Musselman Library to think about ways in which the library can further support its community of learners. This plan builds upon the core issues of services, collections, learning, and access that were identified in 2007 and recognizes the growth accomplished in these areas. In early 2013, Robin Wagner, Director of Library Services, formed the Strategic Planning Steering Committee in order to develop a plan to guide Musselman Library’s priorities for the next three years. Following an environmental scan, focus groups, and dialogue with library staff, the committee identified five issues confronting libraries: lifelong learning, leadership, sustainability, continual assessment, and partnerships. Working groups were formed and charged to create goals and objectives inspired by these five issues. From the work completed by the groups, the Strategic Planning Steering Committee distilled these issues and articulated goals that advance the library within four strategic directions: lifelong learning, leadership, sustainability, and continual assessment. Recognizing the foundational role of collaboration in a liberal arts environment, partnerships is integrated across the four strategic directions, goals, and objectives. The 2013-2016 plan demonstrates Musselman Library’s commitment to contribute to Gettysburg College’s mission and addresses challenges presented to a new generation of learners and scholars in an age of information abundance. [excerpt

Universities as Living Labs for sustainable development : a global perspective

Walter Leal Filho, Baltazar Andrade Guerra, Mark Mifsud and Rudi Pretorius use case studies from Brazil, Malta and South Africa to reflect on how the Living Labs approach can contribute towards a more sustainable futurepeer-reviewe

Resilient livelihoods and food security in coastal aquatic agricultural systems: Investing in transformational change

Aquatic agricultural systems (AAS) are diverse production and livelihood systems where families cultivate a range of crops, raise livestock, farm or catch fish, gather fruits and other tree crops, and harness natural resources such as timber, reeds, and wildlife. Aquatic agricultural systems occur along freshwater floodplains, coastal deltas, and inshore marine waters, and are characterized by dependence on seasonal changes in productivity, driven by seasonal variation in rainfall, river flow, and/or coastal and marine processes. Despite this natural productivity, the farming, fishing, and herding communities who live in these systems are among the poorest and most vulnerable in their countries and regions. This report provides an overview of the scale and scope of development challenges in coastal aquatic agricultural systems, their significance for poor and vulnerable communities, and the opportunities for partnership and investment that support efforts of these communities to secure resilient livelihoods in the face of multiple risks

Friendship Village : Exploring the Critical Economic Development and Urban Design Link for Sustainable Development

Presented on December 3, 2008 from 6:30 to 8:30 pm in the Center for Quality Growth and Regional Development 2nd floor classroom.Full report: Friendship Village Exploring the Critical Economic Development and Urban Design Link for Sustainable Development, January 2009Runtime: 77:11 minutes (Presentation)Runtime: 23:27 minutes (Q & A)The Friendship Village group had the charge of advising a large-scale land developer on directions for promoting sustainability in the plans for a 210 acre multi-use project in south Fulton County, Georgia. Their work included site design recommendations modeled after traditional town centers in ten case studies but also included innovative open space and stormwater management proposals and ideas about educational and health care facilities. The diverse professional audience expressed admiration and the developer’s lead representative indicated that results exceeded her expectations.Faculty Advisors: Nancey Green Leigh, Professor of City and Regional Planning ; Richard Dagenhart, Associate Professor of Architecture ; John Skach, Adjunct Professor; Senior Associate, Urban Collag

The Economic Development and Workforce Development Systems

Provides an overview of current U.S. strategies for and challenges in ensuring economic growth with adequate employment opportunities and preparing disadvantaged people for careers. Also summarizes goals, key stakeholders, and the policy environment

Biodiversity Loss and the Taxonomic Bottleneck: Emerging Biodiversity Science

Human domination of the Earth has resulted in dramatic changes to global and local patterns of biodiversity. Biodiversity is critical to human sustainability because it drives the ecosystem services that provide the core of our life-support system. As we, the human species, are the primary factor leading to the decline in biodiversity, we need detailed information about the biodiversity and species composition of specific locations in order to understand how different species contribute to ecosystem services and how humans can sustainably conserve and manage biodiversity. Taxonomy and ecology, two fundamental sciences that generate the knowledge about biodiversity, are associated with a number of limitations that prevent them from providing the information needed to fully understand the relevance of biodiversity in its entirety for human sustainability: (1) biodiversity conservation strategies that tend to be overly focused on research and policy on a global scale with little impact on local biodiversity; (2) the small knowledge base of extant global biodiversity; (3) a lack of much-needed site-specific data on the species composition of communities in human-dominated landscapes, which hinders ecosystem management and biodiversity conservation; (4) biodiversity studies with a lack of taxonomic precision; (5) a lack of taxonomic expertise and trained taxonomists; (6) a taxonomic bottleneck in biodiversity inventory and assessment; and (7) neglect of taxonomic resources and a lack of taxonomic service infrastructure for biodiversity science. These limitations are directly related to contemporary trends in research, conservation strategies, environmental stewardship, environmental education, sustainable development, and local site-specific conservation. Today’s biological knowledge is built on the known global biodiversity, which represents barely 20% of what is currently extant (commonly accepted estimate of 10 million species) on planet Earth. Much remains unexplored and unknown, particularly in hotspots regions of Africa, South Eastern Asia, and South and Central America, including many developing or underdeveloped countries, where localized biodiversity is scarcely studied or described. ‘‘Backyard biodiversity’’, defined as local biodiversity near human habitation, refers to the natural resources and capital for ecosystem services at the grassroots level, which urgently needs to be explored, documented, and conserved as it is the backbone of sustainable economic development in these countries. Beginning with early identification and documentation of local flora and fauna, taxonomy has documented global biodiversity and natural history based on the collection of ‘‘backyard biodiversity’’ specimens worldwide. However, this branch of science suffered a continuous decline in the latter half of the twentieth century, and has now reached a point of potential demise. At present there are very few professional taxonomists and trained local parataxonomists worldwide, while the need for, and demands on, taxonomic services by conservation and resource management communities are rapidly increasing. Systematic collections, the material basis of biodiversity information, have been neglected and abandoned, particularly at institutions of higher learning. Considering the rapid increase in the human population and urbanization, human sustainability requires new conceptual and practical approaches to refocusing and energizing the study of the biodiversity that is the core of natural resources for sustainable development and biotic capital for sustaining our life-support system. In this paper we aim to document and extrapolate the essence of biodiversity, discuss the state and nature of taxonomic demise, the trends of recent biodiversity studies, and suggest reasonable approaches to a biodiversity science to facilitate the expansion of global biodiversity knowledge and to create useful data on backyard biodiversity worldwide towards human sustainability

Main Street Revitalization: Woonsocket, RI

A healthy environment that utilizes local urban ecologies will positively impact the health and well being of the community. It is important to create an environment that will foster understanding and inspire learning about native plants and animals, how to care for them, and how to protect them