Administrator Group-Behavioral Health Preventive Care

FORM APPROVED

OMB Approval No. 0917-New

Exp. Date XX/XX/XX11

PART I – ADMINISTRATOR/SUPERVISOR FOCUS GROUP

Behavioral Health Overview (30 minutes)

First, I’d like to ask you some general questions about Behavioral Health screenings in the primary care setting. These screenings include Domestic/Intimate Partner Violence Screening for women ages 15-40, Alcohol Screening for women of childbearing age (15-44), and Depression screening for adults over age 18.

#	Question	Answer
1	Do you use CRS (Clinical Reporting System) and GPRA to track your facility’s screening rates for behavioral health GPRA measures? (Does the site use the tools within CRS to run reports, patient lists, etc.?)
2	Why or Why not?
3	Are behavioral health services coordinated with primary care at your facility? If so, how? (Prompt respondents to discuss overall coordination as well as specific services such as DV counseling, etc.)
4	What role do funding levels play in your ability to screen for behavioral health conditions?
5	Are there any funding resources that have been allocated specifically for behavioral health screening (e.g. gaming revenues, grants, IHS program grants)?	Circle one: Yes or No If no, skip to question 7.
6	Please describe those resources for me.
7	Have vacancies, staffing levels and turnover rates affected your facility’s ability to perform behavioral health screenings?	Circle one: Yes or No If no, skip to question #9.
8	In what way?
9	Has your facility started any initiatives to improve screening rates for any of the behavioral health measures?	Circle one: Yes or No If no, skip to question #11.
10	Would you describe those initiatives for me?
11	Are there any service unit policies in place with respect to these behavioral health screenings?	Circle one: Yes or No If no, skip to next section.
12	Would you describe those policies for me?

Public Burden Statement: In accordance with Paperwork Reduction Act (5 CFR 1320.8 (b)(3), a Federal agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid OMB control number. Respondents must be informed (on the reporting instrument, in instructions, or in a cover letter) the reasons for which the information will be collected; the way the information will be used to further the proper performance of the functions of the agency; whether responses to the collection of the information are voluntary, required to obtain a benefit (citing authority), or mandatory (citing authority); and the nature and extent of confidentiality to be provided, if any (citing authority). Public reporting burden for this collection of information is estimated to average 2 hours per response, including time for reviewing instructions, searching existing data sources, gathering and maintaining the necessary data, and completing and reviewing the collection information. Send comments regarding the burden estimate or any other aspect of this collection of information to the IHS PRA Information Collection Clearance Staff, 801 Thompson Ave., Suite 450, Rockville, MD 20852.

DOMESTIC VIOLENCE INTRODUCTION (2 MINUTES)

Now, we’d like to talk specifically about Domestic Violence. Before we start, I’d like to define exactly what I mean by Domestic Violence:

Domestic Violence is a pattern of assaultive and coercive behaviors that may include inflicted physical injury, psychological abuse, sexual assault, progressive social isolation, stalking, deprivations, intimidations, and threats. These behaviors are perpetrated by someone who is, was, or wishes to be involved in an intimate or dating relationship with an adult or adolescent, and are aimed at establishing control by one partner over the other. For this discussion we are going to talk about how your facility screens for domestic violence among women ages 15-40 years. Do you have any questions before we move on?

Section A: Screening Process and Service Coordination (6 minutes)

First, I’d like to ask you a few questions about your programs and staff.

#	Question	Answer
1	What is your facility’s usual screening process for DV? Try to guide the discussion to encompass the beginning and end of the process or processes they perform, from initial identification to data entry.
2	Optional: If they reported having DV staff: Has having DV staff affected your screening rates in the primary care setting?

Section B: Community (12 minutes)

Next, I’d like to ask you a few questions about the communities you serve.

#	Question	Answer
1	Do attitudes or perceptions about DV in the community present any barriers to screening?
2	What role do other factors, such as transportation, communication, or referral resources play in your ability to screen for DV?
3	What role do community organizations play in your site’s approach to DV screening, prevention, and treatment?
4	Are tribal or community DV organizations a part of your response team?
5	Are your providers aware of existing tribal or community DV organizations?

Section C: Other Factors (10 minutes)

Next, I’d like to ask you a few questions about other factors that may affect your screening rates:

#	Question	Answer
1	Are there any factors we haven’t covered that you think contribute to your facility’s success in screening for DV?
2	Are there any factors we haven’t covered that might limit your facility’s ability to screen for DV?
3	What would you recommend to improve DV screening rates?
4	What would you recommend as DV screening “best practices” for other facilities?

ALCOHOL SCREENING TO PREVENT FAS INTRODUCTION (2 MINUTES)

Next, we’d like to talk about alcohol screenings to prevent Fetal Alcohol Syndrome. For this discussion we are going to talk about how your facility screens for alcohol use among women of childbearing age (15-44). Do you have any questions before we move on?

Section A: Screening Process and Service Coordination (6 minutes)

First, I’d like to ask you a few questions about your programs and staff.

#	Question	Answer
1	What is your facility’s usual screening process for alcohol use among women ages 15-44? Try to guide the discussion to encompass the beginning and end of the process, from initial identification to data entry.
2	Optional: if they reported having mental health and/or substance abuse staff: Has having behavioral health staff affected your screening rates in the primary care setting?

Section B: Community (12 minutes)

Next, I’d like to ask you a few questions about the communities you serve.

#	Question	Answer
1	Do attitudes or perceptions about alcohol use in the community present any barriers to screening?
2	What role do factors such as transportation, communication, or referral resources play in your ability to screen women for alcohol use?
3	What role do community organizations play in your site’s approach to alcohol screening and FAS prevention?
4	Are tribal or community organizations part of your response team? This could include substance abuse, mental health, etc.
5	Are your providers aware of existing tribal or community substance abuse organizations?

Section C: Other Factors (10 minutes)

Next, I’d like to ask you a few questions about other factors that may affect your screening rates:

#	Question	Answer
1	Are there any factors we haven’t covered that you think contribute to your facility’s success in screening for alcohol use among female patients?
2	Are there any factors we haven’t covered that might limit your facility’s ability to screen for alcohol use among female patients?
3	What would you recommend to improve alcohol screening rates?
4	What would you recommend as alcohol screening “best practices” for other facilities?

DEPRESSION SCREENING INTRODUCTION (1 MINUTE)

Finally, I’d like to talk about depression screenings. We will be discussing how your facility screens patients over the age of 18 for depression. Do you have any questions before we move on?

Section A: Screening Process and Service Coordination (9 minutes)

First, I’d like to ask you a few questions about your programs and staff.

#	Question	Answer
1	What is the usual screening process for depression? Try to guide the discussion to encompass the beginning and end of the process, from initial identification to data entry.
2	Optional: if they reported having mental health staff: Has having behavioral health staff affected your screening rates in the primary care setting?

Section B: Communities (12 minutes)

Next, I’d like to ask you a few questions about the communities you serve.

#	Question	Answer
1	Do attitudes or perceptions in the community about depression present any barriers to screening?
2	What role do other factors, such as transportation, communication, or referral resources play in your ability to screen for depression?
3	What role do community organizations play in your site’s approach to depression screenings?
4	Are tribal or community organizations part of your depression response team?
5	Are your providers aware of existing tribal or community organizations?

Section C: Other Factors (10 minutes)

Finally, I’d like to ask you a few questions about other factors that may affect your screening rates:

#	Question	Answer
1	Are there any factors we haven’t covered that you think contribute to your facility’s success in screening for depression?
2	Are there any factors we haven’t covered that might limit your facility’s ability to screen for depression
3	What would you recommend to improve depression screening rates?
4	What would you recommend as depression screening “best practices” for other facilities?

CONCLUSION (2 minutes)

1.

Do you have any other comments about behavioral health screening in the primary care setting that you would like to add?

10