2023 Fall Newsletter : simplebooklet.com

LETTER FROM OHIOPHP LEADERSHIPOhioPHP has continued to grow in new and exciting ways throughout 2023 with theexpansion of our services to more of Ohio’s healthcare providers. Since the beginning ofthis year, we have established confidential safe haven programs with the Ohio VeterinaryMedical Licensing Board, Ohio Vision Professionals Board, Ohio Occupational Therapy,Physical Therapy, and Athletic Trainers Board, Ohio State Board of Psychology, and theOhio Chemical Dependency Professionals Board. Approximately 280,900 healthcareprofessionals in Ohio now have access to OhioPHP's range of services! We are happy to announce significant improvements have been made to the StateMedical Board of Ohio’s (SMBO) “One-Bite Program.” The enhancements and expansionof this program took effect in October 2023. These changes include the addition ofconfidential services for mental health and physical health conditions. OhioPHP will vetfacilities providing evaluations and treatment, when necessary, through our newtreatment provider network. The name of the new program is the “ConfidentialMonitoring Program.” These changes allow more licensees to take advantage ofconfidential assessments, referrals, and treatment without the fear of disciplinary actionagainst their license. We continued our partnership with the Ohio State Medical Association and theAmerican Foundation for Suicide Prevention to administer the statewide “Well-BeingCheckup and Referral Engagement Services (CARES), which connects healthcareprofessionals with mental health resources anonymously. Many of Ohio’s healthcareworkers have accessed this free anonymous screening tool and were connected withresources.We completed a record number of education programs to help educate healthcareprofessionals on substance use disorders, mental health disorders, burnout, and muchmore! For the first time ever, OhioPHP is now able to provide FREE continuing educationopportunities to many of Ohio’s healthcare professionals. Since the beginning of 2023,5,600 people have attended these education programs! As always, we wish to thank all of those individuals, healthcare facilities, medicalassociations, hospital administrations, and the many other stakeholders who generouslyprovide financial assistance to support OhioPHP's mission. Your support helps make ourwork possible. We continue to believe that keeping our healthcare professionals healthy and practicingin their chosen field ultimately impacts the quality of care for all patients. OhioPHPPage 2RICHARD N WHTINEY, MDMEDICAL DIRECTORKELLEY M. LONG, MBAEXECUTIVE DIRECTOR

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(continued) Tell us whatit means to you to“preserve the healers” inOhio. No one should rely onthemselves only for health(physical, mental, social).In order to preservehealers in Ohio, we haveto remove the stigmaassociated with mentalhealth disorders so peoplecan ask for help whenthey need it most.What first drew you todonating to OhioPHP?My wife’s personalexperience in deliveringsupport to a colleagueenrolled with OhioPHP.Why is donating toOhioPHP a priority foryou?The mission of OhioPHPaligns to our desire toprotect and heal ourcolleagues. It has been over 3 yearssince the start of theCOVID-19 pandemic,what do you see as thebiggest opportunity overthe next 3 years tosupport the mentalhealth and well-being ofhealthcare workers inOhio?Tell us a about yourself.I am a Family MedicinePhysician (and OBtrained). Over my career Ihave worked in theEmergency Room andhospitalist settings. I amcurrently the CountyCoroner for both Ottawaand Union counties. I have been married 37years and have 3wonderful kids. I love tofly and also have my pilotslicense and I love to travelthe world.Share with us anythingyou want about yourselfor your work.I am incredibly proud ofmy family. My wife’scareer and my kidssuccesses. I have asignificant drive toimprove the Ohio Coronersystem and support thework of coroners . I amalso finding newfulfilment in servingOhio’s most vulnerablepatients.The main focus ofOhioPHP is providingservices to healthcareprofessionals so they cantake care of their ownmental health and well-being. OhioPHPPage 4The biggest opportunity Isee is recognizing there isnot one cause for themental health crisis in ourhealthcare system and wecan develop a variety ofstrategies to meet thepsychological, societal,and cultural needs ofOhio’s professionals.As the spotlightcontinues to shine onthe importance of ourhealthcare professionalstaking care of their ownwell-being, what do youthink is the mostpromising aspect of thiscrucial conversation?OhioPHP is stimulatingthe conversation aroundhealthcare provider well-being. We have to talkabout the problem andprioritize and normalizethese issues so we cannormalize healing andpreventing injury fromhappening in the firstplace.Dr. Applegatehas donatedto OhioPHPsince 2015!

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DONOR SPOTLIGHTAETNAIn June of 2023, Aetna Better Health ofOhio donated $25,000 to the OhioProfessionals Health Program (OhioPHP)to support our expansion initiative withSafe Haven Programs to Ohio’s healthcareprofessionals. This is an interview with the ExecutiveDirector of the Children’s System of Carewith OhioRise and Aetna.Tell us more about Aetna and theOhioRISE Initiative.Aetna Better Health has contracts in 16states, including Ohio, managing distinctpopulations and regions within each state.We have more than 30 years’ experienceacross all populations, includingmanaging complex, high-risk populations.We are proud to work with child specialtyand child welfare contracts, as we focus onnearly 200,000 children across all of ourspecialty plans across the country.OhioRISE (Resilience through IntegratedSystems and Excellence) is a specializedMedicaid managed care program thatfocuses on children and youth who havecomplex behavioral health andmultisystem needs. Young people withmultisystem needs often need supportfrom multiple community systems such asschools, developmental disabilities, childprotection, juvenile justice, and mentalhealth and addiction. OhioPHPPage 7The OhioRISE program’s child and family-centric delivery system recognizes theneed to specialize services and supportfor this unique group of children, youth,families, and caregivers. As of September2023, more than 25,000 children andyouth are enrolled in the OhioRISE plan.As OhioRISE grows in the coming years,we aim to better serve children and youthwith behavioral health challenges.The main focus for Ohio ProfessionalsHealth Program (OhioPHP) is providingservices to healthcare professionals sothey can take care of their own mentalhealth and well-being. Tell us what itmeans to Aetna to preserve the healersin Ohio.I am one of the healers, so I understandwhat our healthcare providers are goingthrough. My background is a clinicalsocial worker with more than 30 yearsworking with children and familiesproviding special care. The health ofcaregivers is critical. If we are not takingcare of ourselves, we can’t take care ofothers. It has been over 3 years since the startof the COVID-19 pandemic, what do yousee as the biggest opportunity over thenext 3 years to support the mentalhealth and well-being of healthcareworkers in Ohio?As someone who works in the behavioralhealth field, it is evident the affect COVID-19 had on everyone. Those in care-providing professions, were hit especiallyhard because they were on the frontlinecaring for patients and showing up forwork, putting themselves at risk. Thestress was immense, we all experienced atraumatic event. Continued on next page.

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The pandemic may be over, but the trauma isn’t over;there’s a lasting effect. We must be purposeful inunderstanding and acknowledging that. Suicide,depression and anxiety are higher across allpopulations. Our children were isolated, and it takesyears to get their development back on track. Weneed to be purposeful ensuring that we haveprograms in place for the people doing work, peoplewe serve to get back to normal that will take time todo. As a spotlight continues to shine on the importanceof our healthcare professionals taking care of theirown well-being, what does Aetna think are themost promising aspects of this crucialconversation?The crucial aspect is that we are having it to beginwith. As a society, we work first and we take care ofself when we get sick. Before COVID-19, peopleworked while sick. The fact that we can have theconversation about life balance and burnout is vital.Raising awareness allows us to think about how tosupport and manage others. It’s crucial that wecontinue the conversation on what needs to happento support workforce. Having these conversations,especially through programs like Safe Haven, opensthe door to future initiatives that ensure our level ofcare is as quality as it can possibly be. WHY WASDONATING TOOHIOPHP APRIORITY FORAETNA?At Aetna BetterHealth, we employ alot of caregivers, andpeople with livedexperiences whohave becomecaregivers. It takes alot of heart and careto work directly withproviders andmembers throughthe lens of living inthe trenches. Withinour organization, wehave programs tohelp with ouremployees with theirwell being, onecalled Resources forLiving, because weknow how importantit is taking care of ourworkforce. OhioPHPPage 8

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OHIOPHP TAKES ACTION TO PRESERVEAND PROTECT OHIO’S HEALERSOn a sunny day in May almost 30years ago, I took an oath as aphysician to practice medicine inthe best interest of my patients, torespect my teachers andcolleagues, and to “understand thatpreserving health is as important astreating disease.”* Ironically,nothing in the Hippocratic Oathmentions self-preservation orprotecting the health of the healersthemselves. As burnout amonghealthcare workers continues toclimb**, the Ohio ProfessionalsHealth Program (OhioPHP) remainssteadfast in its mission to facilitatethe health and wellness ofhealthcare professionals in order toenhance patient care and safety. Inshort, healthy healers = healthierpatients and safer care. OhioPHP’s work impacts the healthof healthcare workers on a variety oflevels—including the statewidelegislative and regulatory level, thehospital and regional practice level,and the individual practitioner level.The interactions between andamong these different levels havehad a synergistic positive effect onOhio’s healthcare workforce. OhioPHPPage 9By Christina Delos Reyes, MD, FASAM OhioPHP Associate Medical DirectorOhioPHP’s Impact on the Statewide Legislativeand Regulatory Environment On October 3, 2023, major changes wereimplemented in the monitoring and regulationof licensees and applicants of the State MedicalBoard of Ohio (SMBO), who have substance usedisorders or mental illness. The SMBO currentlylicensees the following practitioners;acupuncturists, anesthesiologist assistants,dieticians, genetic counselors, messagetherapists, physicians (MD/DO/DPM), residentphysicians, physician assistants, and respiratorycare professionals.New laws and rules will allow a practitioner orapplicant who has been diagnosed with asubstance use disorder, mental health disorder,physical health condition, or another potentiallyimpairing condition(s) to seek helpconfidentially.*** OhioPHP has been instrumentalover the last decade in making these long-awaited changes a reality for State Medical Boardlicensees. In partnership with OhioPHP, theSMBO has: Replaced the former “One-Bite Program” withan expanded Confidential MonitoringProgram (CMP) for all impaired licensees andapplicants, not just those who have presentedto the Medical Board for the first time. Transitioned aspects of Medical-Board-ordered impairment monitoring from theSMBO to OhioPHP for comprehensivetherapeutic monitoring. Transferred the management of the MedicalBoard’s treatment provider network toOhioPHP. Updated both the initial and renewalapplication questions to adopt the languagerecommended by the Federation of StateMedical Board, the American MedicalAssociation, and the Dr. Lorna Breen Heroes'FoundationThe questions now focus on only disclosingcurrent mental and physical healthconditions impairing their ability to practice.There is also a safe haven, non-reportingoption for those who are under treatmentand in good standing with the OhioPHP tonot disclose this information.

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Additionally, since 2021, OhioPHP has taken the lead in establishing Safe Havenprograms with other Ohio licensing boards, including those that license OccupationalTherapists, Athletic Trainers, Physical Therapists, Psychologists, Vision Professionals,Chemical Dependency Professionals, Veterinarians, and Veterinary Technicians. A SafeHaven program provides a confidential path for individuals to seek help for burnout,mental health disorders, or substance use disorders, and is a therapeutic alternative toregulatory action for chronic illnesses. OhioPHP has committed to partnering with all other healthcare licensing boards toestablish Safe Haven programs for all of Ohio’s healthcare workers.Safe Haven Programs in ProgressOhio Board of NursingOhio Dental BoardOhio State Chiropractic BoardOhioPHP’s Impact on Hospital and Regional Practice Systems OhioPHP has been actively involved in improving the well-being of healthcareprofessionals in large hospital systems and regional practices. In 2017, OhioPHP broughttogether medical associations and other stakeholders to launch the Ohio PhysicianWellness Coalition, a group dedicated to addressing physician burnout by providingwellness initiatives.**** OhioPHP hired its first Wellness Director, Dr. Colleen Opremcak,in 2018; this position is currently held by Dr. Phuong Huynh. The OhioPHP Well-beingDirector is responsible for the development and delivery of educational outreachpresentations on well-being topics, including burnout, oversight of the wellnesscollaborations between OhioPHP and other organizations in the state, such asColumbus Medical Association Doc-to-Doc and Ohio State Medical Association (OSMA)Well-Being CARES, and maintenance of relationships with well-being leadersthroughout the state, such as with the Ohio Physician Wellness Coalition.In addition, OhioPHP’s clinical team has presented numerous educational programs tothousands of healthcare professionals during hospital medical staff meetings and GrandRounds, resident, and fellow didactic sessions, and at local and regional healthcareconferences. Educational program topics include physician impairment and recovery,substance use disorders in healthcare professionals, suicide prevention, decreasingburnout, and improving work-life balance. OhioPHP’s Impact on the Individual Practitioner OhioPHP impacts individual practitioners through two main services: Well-BeingScreenings and chronic illness management or therapeutic monitoring. Since 2021,OhioPHP has offered Well-Being Screenings at no charge to healthcare professionalsseeking recommendations related to burnout, mental health disorders, and substanceuse disorders. The Well-Being Screenings utilize a multidisciplinary approach andinclude clinical interviews, computer-based screening tools, urine drug screening, andinterviews with collateral sources.***** Currently, OhioPHP supports and monitors several hundred healthcare practitionerswith substance use disorders, mental illnesses, and physical conditions. OhioPHPPage 10No Safe Haven ProgramOhio Counselor, Social Worker, andMarriage and Family Therapist BoardOhio Speech and Hearing ProfessionalsBoardOhio Board of Pharmacy

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The clinical staff at OhioPHP includes two addiction medicine physicians, one addictionpsychiatrist, and seven clinicians trained as chemical dependency and/or mental healthclinicians, the majority of whom have Master’s degrees. The typical length of anOhioPHP monitoring agreement is 1 – 5 years. Each OhioPHP participant is assigned toan individual Case Manager, who conducts several “field visits” per year. Moreimportantly, the ongoing support and compassion from the clinical staff leads to highsuccess rates among the participants—over 90% of participants who complete a five-year agreement are in recovery from substance use disorders. OhioPHP has recently leveraged its partnerships with local and national organizations toprovide two other resources to individual healthcare workers. The first resource is calledthe Well-Being Checkup and Referral Engagement Service (Well-Being CARE Service) –a free, voluntary, and anonymous online questionnaire that quickly screens for ahealthcare professional’s current mental health and well-being. A licensed mental healthprofessional reviews the answers and will reply with personalized recommendations. Thehealthcare worker can decide whether to contact the licensed mental healthprofessional for additional services. The Well-Being CARE Service is a partnershipbetween OhioPHP, the Ohio State Medical Association (OSMA), and the AmericanFoundation for Suicide Prevention (AFSP).***** The second resource is called “Doc-to-Doc” and is a Peer Support program designed toprovide access to an empathetic network of physician peers who have beenprofessionally trained to support colleagues in need. The program is free and 100%confidential. Peer support will occur over one to two sessions and if more robust servicesare needed, referrals can be coordinated. The goal of the Doc-to-Doc program is toensure that Central Ohio physicians feel emotional and psychological support fromthose who have walked in their shoes. OhioPHP helps to administer this program inpartnership with the Columbus Medical Association (CMA).******Including Ourselves in the Equation As a physician and healthcare worker for almost three decades, I have been conditionedover many years to respond efficiently and effectively to healthcare crises and to providelong-term treatment for chronic conditions— in other people. I received very little formaltraining in self-preservation—that is, how to protect myself and maintain my personalhealth and well-being. In fact, I was informally praised and formally rewarded forconsistently putting patients’ needs above my own. Ironically, our own expectations andsociety’s pressure for healthcare workers to be superhuman—to maintain roboticprecision and perfection in a chaotic and traumatic environment—denies each of us theopportunity to be nothing more and nothing less than what our patients are: imperfect,limited, broken—and yes, HUMAN. As I have aged and become a patient (whilesimultaneously still being a healthcare worker), I can more fully appreciate how my lackof self-preservation skills has exacted a high price in terms of my own health and well-being. Can I give myself the same compassion and grace that I so easily extend to mypatients? Can I afford not to? As I recalled how my journey as a physician began with an oath, I wondered if today’sgraduating medical students found themselves in a similar place—promising to care forthe health of others at the cost of their own well-being. OhioPHPPage 11

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Fortunately for them—and I daresay, their future patients! —modern-day Hippocraticoaths have begun to include the healers in the equation. Below is an example from theUniversity of Pittsburgh School of Medicine Class of 2024 Oath: “I will honor my physical,mental and emotional health so as to not lessen the quality of care I provide.”******* Andfrom the Class of 2024 at Washington University of School of Medicine: “To myself I pledge, in deference to my humanity, to recognize my limitations andconsciously pursue my own wellness so that I can best care for others. I promise tocontinually engage in self-reflection and cultivate my own growth and passion formedicine. I will confront challenges that may seem insurmountable and not hesitate toask for help. Likewise, when others need support, I will offer my hand. I will embrace myunique professional path and welcome the responsibilities, joy, and fulfillment thisjourney brings.”********These and similar sentiments from medical schools across the country left me inspiredand hopeful. May all healthcare professionals make a daily promise to preserve andprotect their health—to include their own well-being in the healthcare equation. REFERENCES *https://www.aapsonline.org/ethics/oaths.htm (accessed by CDR on 9.21.23) **McCloskey RJ, Hammond GC, Gallant K, et al. Ohio Physicians’ Retrospective Pre-Post COVID-19Pandemic Reports of Burnout and Well-Being. Journal of Medical Regulation 1 October 2022; 108(3): 8–17. https://doi.org/10.30770/2572-1852-108.3.8 ***https://med.ohio.gov/about-the-board/communications/news/medical-board-expands-programming-for-wellness-of-providers (accessed by CDR on 9.21.23) ****https://www.ohiophysicianwellness.org/about (accessed by CDR on 9.25.23) *****https://www.ohiophp.org/about-us (2019-2022 Impact Report accessed by CDR on 9.26.23) ******https://www.columbusmedicalassociation.org/doctodoc (accessed by CDR on 9.26.23) *******https://www.pitt.edu/pittwire/features-articles/modern-day-hippocrates-incoming-school-medicine-students-write-their-own-oath (accessed by CDR on 9.25.23) ********Med Students, Schools Put Modern Spin on Age-Old Hippocratic Oath - Medscape - Nov 22,2022. https://www.medscape.com/viewarticle/984492#vp_1 (accessed by CDR on 9.25.23) OhioPHPPage 12To learn more aboutthe new ConfidentialMonitoring Programwith the StateMedical Board ofOhio, you can attendone of our upcomingtrainings. Scan theQR code to register!

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010302Well-beingScreeningsAdvocacyChronic IllnessManagementWhen you donate to OhioPHP,you are supporting yourcolleagues in need. A gift toOhioPHP can help fund a freewell-being screening for one ofOhio’s healthcare workers.Everyday, OhioPHP is working toadvocate for confidential servicesfor healthcare professionals. A giftto OhioPHP can support this workand ensure that Ohio’s healthcareworkers have access to safe andconfidential pathways to get well,without fear of disciplinary action.A gift to OhioPHP can also helpsupport the costs of providingconfidential chronic illnessmanagement to a healthcareprofessional struggling with amental health or substance usedisorder.DONATINGTO OHIOPHPSUPPORTING OHIO’SHEALTHCARE WORKERSOhioPHPPage 13

2023 Fall Newsletter

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