Oss: Is There A WHAM In Your Future?

NYAPRS Note: SAMHSA-HRSA's new Whole Health Action Management program's emphasis on 'consumer engagement and peer support' is being lauded by noted national BH expert Monica Oss, based on her sharing a panel with Larry Fricks at this past NYAPRS Executive Seminar. Is There A WHAM In Your Future? By Monica E. Oss Chief Executive Officer, OPEN MINDS May 5, 2013

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Where does consumer engagement and peer support fit into the integrated care management models of the future? I had a preview of this in a presentation of Whole Health Action Management (WHAM) by Larry Fricks, Deputy Director of the SAMHSA-HRSA Center for Integrated Health Solutions (CIHS) at last week's New York Association of Psychiatric Rehabilitation Services (NYAPRS) executive seminar in Albany.

If you're not familiar with WHAM, it is SAMHSA's new peer support curriculum. According to SAMHSA, WHAM is designed to train "peers teaching skills to better self-manage chronic physical health conditions and mental illnesses and addictions to achieve whole health and resiliency." If you aren't familiar with the program it is centered on 10 elements:

1. Stress Management 2. Healthy Eating 3. Physical Activity 4. Restful Sleep 5. Service to Others 6. Support Network 7. Optimism Based on Positive Expectations 8. Cognitive Skills to Avoid Negative Thinking 9. Spiritual Beliefs and Practices 10. A Sense of Meaning and Purpose

My question after the presentation of the WHAM model is whether WHAM could replace traditional targeted case management services in the emerging integrated care management models - and if there is a "financially sustainable" model for delivering the WHAM program. There are emerging data on the return-on-investment of peer support models. One study measured the potential use of peer specialists in place of day treatment, with an average cost of $997 per year versus $6,491 per day, respectively (see Cost Effectiveness of Using Peers as Providers<http://www.namigbcan.org/pdf/Cost%20Effectiveness%20of%20Using%20Peers%20as%20Providers.pdf>). But, there are many factors that will determine the future role of peer services in care coordination (see Reducing Staffing Costs: Three 'Must Consider' Options<http://r20.rs6.net/tn.jsp?e=001CthEI3jU93hhBNjkMNXwxf30gygUF6g2HYWcBm6JAa_aJMD5H4-6a08vZe6Iwqoeah-jNqyvuVxlwBaDroKBrafV485-wZLyZ2i5c942b3HeMyhfC8ZfLvVGkkW7nX9f4Tuiootm_6__jsU8kYog5wZi9bfhcDQQ8wHSjXoQOwzCRdCZESNRknndu-bVJsHGiqev3V3KqO4=> premium members).

In a webinar for the National Council (see WHAM: Eight Weeks to Whole Health through Self-Management Skills and Peer Support<http://r20.rs6.net/tn.jsp?e=001CthEI3jU93jXOGRsM-X4QAO8AuWhGFdbeXD4cSJW16EIyCXjO9Xo8b53m9l5mLQ_hxPH2LwA0EZugddmzTvLERdybdFl5pdjIV2a_WqYUKeo0iGR1tmMs10hUaIsS6nGCKKIOdNiTF1ZrjWKHpBYOpKmsfqbpQ1M0baHEF0ZkGm6LV9bLHseIYBbXQUa5mr7>), Mr. Fricks made two key points:

1. WHAM teaches skills for writing whole health goals that can go into treatment plans 2. WHAM is designed for the peer workforce going into new Medicaid billable service models like health homes

And the model is already used in Georgia (and billed to Medicaid) through that state's Certified Peer Specialists (CPS) working directly with peers in Peer Support and other community based services (see Georgia's Peer Support Expansion into Whole Health Coaches<http://r20.rs6.net/tn.jsp?e=001CthEI3jU93hqKTRNGSllbgNncvvk6Hhf6VZDrXTadKKe0QVI6dXOlsMFcrkYRvYB2ZdA2BFdjzGI2wmMHQDnFRTkolJ9DOWVXmqJiF7GdsRSP7ythRJOnTWeJQZzFw2OhKXVT_q_coKAYeHiUwxVWzWt1eEFbVWqZeGlQHQAp9YPn-UK5rr4KpWffBPS6zCk8R4ubv_3RSVO9psN6WlIoQQ4H_AShzWJ>).

WHAM is an example of the promise - and the challenges - that peer support services pose to emerging models of care coordination and service delivery.