Foundation Program Sites
JOIN US  

Behavioral Health

Addiction and Dependence Treatment

Guideline Information

Guideline title: Addiction and Dependence Treatment Report and Guidelines

Publication Status: Needs minor revisions- to be scheduled

Date of publication: 2014

Date of last evidence search: 2014

Scope: stigma and bias reduction, screening, referrals, treatment

Methods: Current guidelines and literature review and expert consensus

Description: The number of people in Washington with addiction and substance use disorders, variation in screening protocols, and lack of access to treatment were identified by the Bree Collaborative as a priority area for improvement and the Collaborative elected to form a work group to address these issues.

Supporting Materials

Letter from Health Care Authority Accepting Addiction and Dependence Treatment Report and Recommendations
Addiction and Dependence Treatment Public Comment Summary
Workgroup Charter

Resources and Tools

Resources and Tools

SAMSHA The ASAM Clinical Practice Guideline on Alcohol Withdrawal Management: Pocket Guide

HCA Alcohol Use Treatment 

National Institute on Alcohol, Abuse, and Alcoholism 

Reduce Stigma

Words Matter: A Stigma Fighting Cheat Sheet

Central East Addiction Technology Transfer Center Network Anti-Stigma Toolkit

The Effectiveness of Interventions for Reducing Stigma Related to Substances Use Disorders: A systematic Review

NIAAA Alcohol Treatment Navigator 

Increase Appropriate Screening

Alcohol Use Disorder Identification Test – Concise (AUDIT-C)

CAGE Questionnaire for Alcohol Dependence

CRAFFT Screening Tool for Adolescents

Drug Abuse Screening Test (DAST-10)

General Anxiety Disorder Tool (GAD-7)

Increase Capacity for Brief Intervention and Treatment

SAMHSA Screening, Brief Intervention, and Referral to Treatment (SBIRT)

ATTC Motivational Interviewing Resources

CMS Medicare Learning Network SBIRT

Addiction and Dependence Treatment

Motivational Interviewing in the SBIRT Model

Metrics and Evaluation Tools

To support health system improvement the Bree Collaborative has created operational measures that are designed to help measure progress on the implementation of our guidelines.These measures were developed in collaboration with subject matter experts and are aligned across audience types (such as state agencies, health plans, providers, community organizations, employers, etc.)

To use our operational measures, find the audience type, or types, that is closest to your organization and download the measures document. There may be more than one audience type that is relevant. For example, large health systems may want to track progress at both the organizational level and the individual practitioner level.

Operational measures are also aligned with the Bree Collaboratives’ self-report data collection efforts. Organizations are not required to report on operational measures, however organizations can submit data to help track system wide progress, measure their progress against others, and to be eligible for implementation awards. Instructions for the self-report submission can be found in the section below.

Delivery Site and Health Systems

Health System Evaluation Score Card Health System Score Card _ ADT

Health Plans

Health Plan Evaluation Score Card Health Plan Score Card _ ADT

Guideline Metrics

For more generic tools for planing, data collection and data management, please visit our Tool Depot

Jump to Evaluation Tool Depot

Workgroup Members

Member Title Organization
Charissa Fotinos, MD Deputy Chief Medical Officer Health Care Authority
Tom Fritz (Chair) Chief Executive Officer Inland Northwest Health Services
Linda Grant Chief Executive Officer Evergreen Manor
Tim Holmes Vice President of Outreach Services and Behavioral Health Administration MultiCare Health System
Ray Hsiao, MD Co-Director, Adolescent Substance Abuse Program Seattle Children’s Hospital
Scott Munson Executive Director Sundown M Ranch
Rick Ries, MD Associate Director Addiction Psychiatry Residency Program, University of Washington
Terry Rogers, MD Chief Executive Officer Foundation for Health Care Quality
Ken Stark Director Snohomish County Human Services Department
Jim Walsh, MD Physician Swedish Medical Center

Behavioral Health: Early Intervention for Youth - NEW!

Guideline Information

Guideline title: Behavioral Health: Early Intervention for Youth

Publication Status: Active

Date of publication: 2025

Date of last evidence search: 2024

Date for review: TBD

Scope: This report and guidelines focus on strategies in primary care and school settings for advancing the early identification and connection of youth to services and interventions for the most common youth behavioral health needs for which training for effective treatments are most reasonable accessible in Washington state. For this report, “early” refers to the stage of progress of a behavioral health concern, not chronological age. Focus areas include: Patient, Caregiver and Provider Education and Capacity Building;  Screening, Brief Intervention & Referral to Treatment; Coordinated Management of Behavioral Health; Monitoring & Data Sharing; and Incentives & Investments.

Methods: Current guidelines and literature review and expert consensus

Description: This report and set of guidelines build on the Bree Collaborative 2017 Behavioral Health Integration
report. While not all systems will be able to provide fully integrated behavioral health currently, progress toward full integration should be prioritized. Integrated behavioral health is the most effective mechanism to increase access. The guideline also calls for appropriate funding for the components of integrated care and for State agencies to invest in infrastructure to assess impact of policy and systems changes, training and supervision efforts, and clinical and functional outcomes for prevention and intervention activities. These guidelines also build on a public health framework of universal identification with targeted support and interventions, blending primary (preventing disease), secondary (early disease identification), and tertiary (reducing disease severity) prevention with the socio-ecological model.

Implementation Checklists by Audience

Generic Audience

COMING SOON!

Metrics and Evaluation Tools

Introduction to Evaluation Tools

The Bree has developed multiple tools specific to Youth Behavioral Health to support the evaluation projects implemented based on our guidelines.

Evaluation Matrix

The Bree has developed an evaluation matrix to help clarify measurable objectives, goals, and metrics that are relevant to the recommendations made by the work group. The matrix can be use during planning of your implementation project to help identify long-term outcomes or impacts of your project(s). The matrix provides a broad summary of the recommendations by audience for each component or focus area the guideline addresses (for example: education, access, treatment, etc.).

Youth Behavioral Health Evaluation Matrix

Evaluation Framework

The Evaluation Framework provides further guidance on how organizations can conduct and align their work with other audience actors (example: all health plans in Washington state) or other audience types (example: health plans and providers). It provides specific details for measurement, provides strong and soft recommendations for the types of evaluations each organization may consider conducting, expands on alignment with other initiatives in Washington State, and makes recommendations for ethical and equity considerations.

EVALUATION FRAMEWORK

Data Matrix

An example of how to fill out this form is available in Appendix B of the Evaluation Framework. The Data Matrix tool can be used in planning your data collection effort for your implementation and evaluation.

Data Matrix Template– fillable form

Theory of Change

The theory of change illustrates how the work group conceptualized changes that would occur throughout the health care ecosystem as a result of their recommendations.

Youth Behavioral Health Theory of Change

Score cards

To support health system improvement the Bree Collaborative has created evaluation score cards that are designed to help measure progress on the implementation of our guidelines.These measures were developed in collaboration with subject matter experts and are aligned across audience types (such as state agencies, health plans, providers, community organizations, employers, etc.)

To use our score cards, find the audience type, or types, that is closest to your organization and download the excel document. There may be more than one audience type that is relevant. For example, large health systems may want to track progress at both the organizational level and the individual practitioner level.

Score cards are also aligned with the Bree Collaborative’s self-report data collection efforts. Organizations are not required to report, however organizations can submit data to help track system wide progress, measure their progress against others, and to be eligible for implementation awards.

Completed score cards can be sent to knicholas@qualityhealth.org

Score cards can be found in the tabs below:

Delivery Site and Health Systems

Health clinic and health system score card YBH_care clinic_score card

Schools

School and school based health center score card YBH_school_score card

State Agencies

Washington State Health Care Authority score card YBH_HCA_score card

Washington State Department of Heath score care YBH_DOH_score card

Employers and purchasers

Employers or employers as purchasers score card YBH_employer_score card

Health Plans

Health plan score card YBH_health plan_score card

For more generic tools for planing, data collection and data management, please visit our Tool Depot

Jump to Evaluation Tool Depot

Workgroup Members

Name Title Organization
Terry Lee, MD (Chair) Senior Behavioral Health Medical Director Community Health Plan of Washington
Linda Coombs, MSW, LCIS Behavioral Health Clinical Director United Health Community
Delaney Knottnerus, LICSW, MSW School-based SBIRT Manager King County
Brittany Weiner, MS, LMFT, CPPS Senior Behavioral Health Medical Director Community Health Plan of Washington
Libby Hein, LMHC Director of Behavioral Health Molina Healthcare
Santi Wibawantini, MA, LMFT, CMHS Child Therapist Kaiser Permanente
Sarah Rafton, MSW Executive Director Washington Chapter of American Academy of Pediatrics
Kevin Mangat, LMHC, MHA Manager, Child & Family Team Navos
Sally McDaniel, LMFT, LMHC, SUDP, CMHS Clinical Manager, Child and Family Services Greater Lakes Mental Healthcare
Thatcher Felt, DO Pediatrician Yakima Valley Farm Workers Clinic
Jeffery Greene, MD Pediatrician Seattle Children’s
Erin Wick, MBA, SUDP Executive Director, Integrated Student Supports Educational Service District 113
Katie Eilers, MPH, MSN, RN Director of Office of Family and Community Health Improvement Department of Health
McKenna Parnes, PhD Postdoctoral Research Fellow University of Washington CoLab
Diana Cockrell, MA, SUDP Section Manager Prenatal to 25 Lifespan; Mental Health and Substance Use Disorders Washington HCA

Behavioral Health Integration

Guideline Information

Guideline title: Behavioral Health Integration Report and Guidelines

Publication Status: Needs minor revisions – to be scheduled

Date of publication: 2016

Date of last evidence search: 2016

Date for review: TBD

Scope: Integrated Care, Patient Access, information sharing, population health, treatment, patient communication, data and metrics.

Methods: Current guidelines and literature review and expert consensus

Description: This Report and Guidelines are focused on integrating behavioral health care services into primary care for those with behavioral health concerns and diagnoses for whom accessing services through primary care would be appropriate.

Supporting Materials

Letter from Health Care Authority Accepting Behavioral Health Integration Recommendations
Behavioral Health Charter and Roster
Behavioral Health Integration Core Process Measures
Behavioral Health Integration Guideline Checklist

Resources and Tools

Resources and Tools (General)

WA DOH Behavioral Health Integration 

WA State Integrated Care Assessment 

UW Training, Workforce, and Policy Innovation Center

CDC Behavioral Health Integration 

AHRQ What is Integrated Behavioral Health?

SAMSHA Integrated Models for Behavioral Health and Primary Care 

Integrated Care Teams

Common Barriers and Strategies to Support Effective Health Care Teams for Integrated Behavioral Health

Making the Case for Change and Overcoming Barriers

AHRQ Provider and Practice Level Competencies for Integrated Behavioral Health in Primary Care: A Literature Review

Preparing the Workforce for Behavioral Health and Primary Care Integration

AHRQ Conducting a Morning Briefing 

AMA Ed Hub: Daily Team Huddles Learning Module

Patient Access to Behavioral Health as a Routine Part of Care

Enhanced Access Implementation Guide

AHRQ Warm Handoff Resources

Integrated Behavioral Health Partners:  Warm Handoff Practice Scripts

Accessibility and Sharing of Patient Information

IBHP Data Sharing Toolkit

Electronic Health Record Challenges, Workarounds and Solutions Observed in Practices Integrating Behavioral Health and Primary Care

Collective Medical Care Coordination (EDIE or PreManage ED) 

Practice Access to Psychiatric Services

WA Partnership Access Lines (PAL)

Washington Partnership Access Line

Operational Systems and Workflows to Support Population Health

NCQA Population Health Management Resource Guide for Behavioral Health

AMA Ed hub: Identifying the Optimal Panel Sizes for Primary Care Physicians

Empanelment Implementation Guide

Clinical Standards for Empanelment

Empanelment: Four-Cut Methodology 

AIMS Center Care Management Tracking System (CMTS)

Evidence-Based Treatment

Alcohol Use Disorder Identification Test – Concise (AUDIT-C)

General Anxiety Disorder Tool (GAD-7)

Patient Health Questionnaire – 9 (PHQ-9)

NCQA Patient Centered Medical Home (PCMH)

AHRQ Health Literacy Universal Precautions Toolkit

Patient Involvement in Care

ATTC Motivational Interviewing (MI) Resources

Data for Quality Improvement

SAMHSA Business Case for Behavioral Health Care

Primary Care Workforce Study Cost Tool 

General Integration Resources

AHRQ Lexicon for Behavioral Health and Primary Care Integration

University of Washington AIMS Center

Oregon Health Authority Patient-Centered Primary Care Home Program

BHI Implementation Guides

Collaborative Care Implementation Guide

SAMHSA-HRSA Center for Integrated Health Solutions Quick Start Guide to Behavioral Health Integration for Safety-Net Primary Care Providers

Qualis Health Implementation Guide to Behavioral Health Integration

Assessments

AHRQ Self-Assessment Checklist for Integrating Behavioral Health and Ambulatory Care

Maine Health Access Foundation (MeHAF) Site Self-Assessment

Patient-Centered Medical Home Assessment (PCMH-A)

Related Bree Webinars Link

Related Bree Webinars Link

Metrics and Evaluation Tools

To support health system improvement the Bree Collaborative has created operational measures that are designed to help measure progress on the implementation of our guidelines.These measures were developed in collaboration with subject matter experts and are aligned across audience types (such as state agencies, health plans, providers, community organizations, employers, etc.)

To use our operational measures, find the audience type, or types, that is closest to your organization and download the measures document. There may be more than one audience type that is relevant. For example, large health systems may want to track progress at both the organizational level and the individual practitioner level.

Operational measures are also aligned with the Bree Collaborative’s self-report data collection efforts. Organizations are not required to report on operational measures, however organizations can submit data to help track system wide progress, measure their progress against others, and to be eligible for implementation awards. Instructions for the self-report submission can be found in the section below.

Delivery Site and Health Systems

Health System Evaluation Score Card Health System Score Card _ Behavioral Health

Health Plans

Health Plan Evaluation Score Card Health Plan Score Card _ Behavioral Health

Guideline Metrics

The Bree work group recommends several standard measures to support Behavioral Health Integration with Primary Care.

HEDIS 2017 includes two depression-specific measures:

  • Utilization of the PHQ-9 to Monitor Depression Symptoms for Adolescents and Adults
    Depression Remission or Response for Adolescents and Adults
    The HEDIS measure, Depression Remission or Response for Adolescents and Adults, allows health plans to assess and report the percentage of health plan members 12 years and older with a
    diagnosis of depression who had evidence of response or remission within 5 to 7 months of their initial diagnosis. Remission is documented by a PHQ-9 score less than 5 points and response is indicated by a 50% decrease over the initial PHQ-9 score.

This is one of only two measures for which health plans have the option of using an Electronic Clinical Data System (ECDS) such as a registry or other clinical management tracking system in addition to their EHR to capture reporting data. More information can be found here.

National Quality Forum measure 0418 (NQF 0418) Screening for clinical depression and follow-up plan (NEEDS  LINK)

  • “Percentage of patients aged 12 years and older screened for clinical depression on the date of the encounter using an age appropriate standardized depression screening tool AND if positive, a follow-up plan is documented on the date of the positive screen.” This measure is consistent with the need to impact and measure the impact of access to mental health treatment in Washington State.

The Healthier Washington Common Measure Set on Health Care Quality and Cost includes six behavioral health-focused measures including:

  • Adult Mental Health Status. Measured by the Department of Health through Washington State the Behavioral Risk Factor Surveillance System survey.
    • The percentage of adults ages 18 and older who answer “14 or more days” in response to the question, “Now thinking about your mental health, which includes stress, depression and problems with emotions, for how many days during the past 30 days was your mental health not good?” on the Behavioral Risk Factor Surveillance System.
  • Mental Health Service Penetration (Broad Version). Measured by health plans and Washington State Department of Social and Health Services (DSHS) from claims data.
    • The percentage of members with a mental health service need who received mental health services in the measurement year. Separate reporting for age groups: 6-17 years and 18-64 years.
  • Substance Use Disorder Service Penetration. Measured by DSHS from claims data.
    • The percentage of members with a substance use disorder treatment need who received a substance use disorder treatment in the measurement year. Reported for Medicaid only. Separate reporting for age groups: 6-17 years and 18-64 years.
    • This measure is reported for Medicaid only.
  • Antidepressant Medication Management. Measured by the Washington Health Alliance from Claims data.
    • The percentage of members 18 years and older who were treated with antidepressant medication, had a diagnosis of major depression and who remained on an antidepressant medication treatment.
    • Two rates will be reported: Effective Acute Phase Treatment and Effective Continuation Phase Treatment.
  • Follow-up After Hospitalization for Mental Illness. Measured by health plans from claims data.
    • The percentage of discharges for members 6 years of age and older who were hospitalized for treatment of selected mental illness diagnoses and who had a follow-up visit with a mental health practitioner within 30 days of discharge.
  • 30-day Psychiatric Inpatient Readmissions. Measured by DSHS from claims data.
    • For members 18 years of age and older, the number of acute inpatient psychiatric stays that were followed by an acute readmission for a psychiatric diagnosis within 30 days.
    • This measure is reported for Medicaid only.

NCQA HEDIS Measures

AHRQ Atlas of Integrated Behavioral Health Care Quality Measures

Washington State Common Measure Set

For more generic tools for planing, data collection and data management, please visit our Tool Depot

Jump to Evaluation Tool Depot

Workgroup Members

Member Title Organization
Brad Berry Executive Director Consumer Voices Are Born
Regina Bonnevie, MD Medical Director Peninsula Community Health Services
Michelle Guerra, MD Senior Clinician Premera
Larry Marx, MD Medical Director, Behavioral Health Support Services Kaiser Permanente
Rose Ness, MA, LMHC, CDP Behavioral Health Expert Sound Integration for Behavioral Healthcare
Kim McDermott, MD Physician NeighborCare
Mary Kay O’Neill MD, MBA Partner Mercer
Joe Roszak  CEO Kitsap Mental Health Services
Anna Ratzliff, MD, PhD/
Anne Shields, MHA, RN		 Director of the UW Integrated Care Training Program, Associate Director for Education/Associate Director AIMS Center, University of Washington
Jeff Reiter,  PhD Lead Psychologist Swedish Medical Services
Julie Rickard, PhD Program Director of Integrated Behavioral Services Confluence Health
Brian Sandoval, PsyD Behavioral Health Manager, Oregon and Washington Services Yakima Valley Farmworkers Clinics
Lani Spencer, RN, MHA Vice President Health Care Management Services, Amerigroup –Washington
Emily Transue, MD, MHA  Senior Medical Director Coordinated Care
Melet Whinston, MD Medical Director United Health Care

Award Winners

Award winners for Best Practices in Behavioral Health Integration into Primary Care:

Perinatal Behavioral Health

Guideline Information

Guideline title: Perinatal Behavioral Health Report and Guidelines

Publication Status: Active

Date of publication: January 2024

Date of last evidence search: 2023

Scope: education and communication; integrated behavioral health; care coordination; community linkage to social programs; expanded team roles.

Methods: Current guidelines and literature review and expert consensus

Description: The Perinatal Behavioral Health topic was selected by Bree Collaborative members in September 2022 and a workgroup of clinical and community experts met from January 2022 to January 2023. The Bree guidelines focus areas are organized around identifying a person with or at risk for perinatal behavioral health needs and ensuring they receive appropriate treatment and follow-up care.

Implementation Checklists by Audience

The checklist tool translates the Bree guidelines into action steps for that sector. The action items have been arranged into levels 1, 2, and 3 to correspond to the difficulty level of implementing the action into the sectors’ setting. Bree staff co-created the checklists with report workgroup members and topic experts.

Delivery Site and Health System Checklists (Birthing Hospitals)

Level 1

Level 2

Level 3

Delivery Site and Health System Checklists (Outpatient Care Clinics)

Level 1

Level 2

Level 3

Health Care Professional Checklists

Level 1

Level 2

Level 3

Metrics and Evaluation Tools

To support health system improvement the Bree Collaborative has created  process measures that are designed to help measure progress on the implementation of our guidelines. In 2023 the Bree Collaborative introduced a new process of metrics and measures identification that has been embedded into the guideline development work. These “score card” workbooks include four tab. The first is designed to measure an organizations fidelity with the Bree recommend activities.  The “Equity” tab measures progress on capturing and using demographic and SDOH data in related to the topic. The “barriers and enablers” tab captures information about challenges and supports that an organization has encountered in the process of adopting the guidelines. The “survey” tab asks qualitative questions about the usefulness of the Bree Guidelines.

To use our score cards, find the audience type, or types, that is closest to your organization and download the workbook. There may be more than one audience type that is relevant. For example, large health systems may want to track progress at both the organizational level and the individual practitioner level.

Respondents or those using the score cards may add columns to compare sites, programs, providers, health insurance plans to evaluate the fidelity of their implementation work across their organizations.

These process measures are also aligned with the Bree Collaborative’s self-report data collection efforts. Organizations are not required to report if they chose to use these resources, however organizations can submit data to help track state- wide progress, measure their progress against others, and to be eligible for implementation awards.

Completed score cards can be submitted to knicholas@qualityhealth.org

Perinatal Care Providers

Perinatal Care Provider Evaluation Score Card Perinatal Providers_Final

Metric 1 – HEDIS Perinatal/postnatal Depression Screening and Follow-up, by race, ethnicity/language, SOGI, disability, age

Metric 2 – SUD rate among pregnant patients, by race, ethnicity/language, SOGI, disability, age

Metric 3 – SUD Treatment rate among pregnant patients, by race, ethnicity/language, SOGI, disability, age

Metric 4 – PROM/PREMs on perceived discrimination and mistreatment during pregnancy

Metric 5 – Screening for Social Drivers of Health screening rate among pregnant patients, by race, ethnicity/language, SOGI, disability, age

Metric 6 – Prenatal Care: Timeliness of Prenatal Care: The percentage of deliveries in which women had a prenatal care visit in the first trimester, on or before the enrollment start date or within 42 days of enrollment in the organization

Metric 7 – Postpartum Care: Timeliness of Prenatal Care: The percentage of deliveries in which women had a prenatal care visit in the first trimester, on or before the enrollment start date or within 42 days of enrollment in the organization

Metric 8 – Screening, Brief Intervention, and Referral to Treatment (SBIRT) CPT-4: 99408, 99409, HCPCS: G0396, G0397, G0443, H0050

Pediatricians

Pediatrician Evaluation Score Card Pediatrician_final

This metric is meant to be a repeat measure on the same patients however, for quality improvement purposes, organizations may want to track individuals that do not meet each sub-item in order to identify the biggest gaps in screening.

(AAP) Percent of postpartum people who are screened for mental health concerns at 1-, 2-, 4-, and 6-month well-child visit; continue screening through 1-year well-child visits

Metric 1a – Percent of postpartum people who are screened for mental health concerns at 1 month visit

Metric 1b – Percent of postpartum people who are screened for mental health concerns at 1 and 2 month visits

Metric 1c – Percent of postpartum people who are screened for mental health concerns at 1, 2 and 4 month visit

Metric 1d – Percent of postpartum people who are screened for mental health concerns at 1,2, 4 and 6 month visit

Metric 1e – Percent of postpartum people who are screened for mental health concerns at 1, 2, 4 6 months visist and at 1 year visit

Outpatient Perinatal Clinics

Outpatient Perinatal Clinics Evaluation Score Card Outpatient_Final

Hospitals

Hospital Evaluation Score Card Hospitals_Final

The following metrics are aligned with SBIRT measures in outpatient settings. Metrics for referrals are still under consideration,

Metric 1 – SUB-2 Alcohol Use Brief Intervention Provided or Offered, SUB-2a Alcohol Use Brief Intervention, by pregnancy status

Metric 2 – SUB-3 Alcohol and Drug Use Disorder Treatment Provided or Offered at Discharge, SUB-3a Alcohol and Drug Use Disorder Treatment at Discharge, by pregnancy status

Metric 3 – TOB-2 Tobacco Use Treatment Provided or Offered, TOB-2a Tobacco Use Treatment, by pregnancy status

Metric 4 – TOB-3 Tobacco Treatment Provided or Offered at Discharge, TOB-3a Tobacco Treatment at Discharge, by pregnancy status

Health Plans

Health Plan Evaluation Score Card Health plans_Final

Metric 1 – Social Needs Screening and Intervention (SNS-E), stratified by pregnancy status

Metric 2 – PROM/PREMs on perceived discrimination and mistreatment during pregnancy

Metric 3 – HEDIS Perinatal/postnatal Depression Screening and Follow-up, by race, ethnicity/language, SOGI, disability, age

Metric 4 – Percent of postpartum members who are screened for mental health concerns at 1-, 2-, 4-, and 6-month well-child visit; continue screening through 1-year

Metric 5 – Prenatal Care: Timeliness of Prenatal Care: The percentage of deliveries in which women had a prenatal care visit in the first trimester, on or before the enrollment start date or within 42 days of enrollment in the organization, by race and ethnicity

Metric 6 – Postpartum Care: Timeliness of Prenatal Care: The percentage of deliveries in which women had a prenatal care visit in the first trimester, on or before the enrollment start date or within 42 days of enrollment in the organization, by race and ethnicity

Metric 7 – Screening, Brief Intervention, and Referral to Treatment (SBIRT) CPT-4: 99408, 99409, HCPCS: G0396, G0397, G0443, H0050

Washington State Health Care Authority

Washington State Health Care Authority Evaluation Score Card

Metric 1 – Percent of pregnant patients or those who delivered within 12 months with a diagnosis of, 1) depression, 2) OUD, 3) anxiety, 4) SUD, 5) suicidality, 6) other mental health concerns

Metric 2 – HEDIS Perinatal/postnatal Depression Screening and Follow-up, by race, ethnicity/language, SOGI, disability, age

Metric 3 – Prenatal and Postpartum Care (PPC): Timeliness of Prenatal Care: The percentage of deliveries in which women had a prenatal care visit in the first trimester, on or before the enrollment start date or within 42 days of enrollment in the organization.

Metric 4 – Prenatal and Postpartum Care (PPC): Postpartum Care: The percentage of deliveries in which women had a postpartum visit on or between 7 and 84 days after delivery

Metric 5 – Social Needs Screening and Intervention (SNS-E) (Uses Electronic Data System (ECDS) reporting)

Metric 6 – Screening, Brief Intervention, and Referral to Treatment (SBIRT) CPT-4: 99408, 99409, HCPCS: G0396, G0397, G0443, H0050

Washington State Department of Health

Washington State Department of Health Evaluation Score Card DOH_score card_final

Metric 1 – Perinatal Mental Health Provider-to-Patient Ratio

Metric 2 – Maternal Mental Health Prescriber-to-Patient Ration

For more generic tools for planing, data collection and data management, please visit our Tool Depot

Jump to Evaluation Tool Depot

Workgroup Members

Member Title Organization
Colleen Daly, PhD (Chair) Director, Global Occupational Health, Safety and Research Microsoft
Trish Anderson, MBA, BSN Senior Director, Safety and Quality Washington State Hospital Association
Aphrodyi Antoine, MPH, MBA Deputy Regional Administrator Health Resources and Services Administration
Christine Cole, LICSW Infant and Early Childhood Mental Health Program Manager Washington Health Care Authority
Melissa Covarrubias Community Health Plan of Washington
Billie Dickson Associate Director, Policy Washington State Medical Association
Andrea Estes, MBA Sexual and Reproductive Health Programs Innovation Manager Washington Health Care Authority
Cindy Gamble, MPH  Tribal Public Health Consultant American Indian Health Commission
Kristin Hayes, MSW Perinatal Mental Health Counselor Evergreen Health
Libby Hein, LMHC Director of Behavioral Health Molina Healthcare
Mandy Lee, MSN, RN, CCM Healthy First Steps Program Manager United Healthcare
Kay Jackson, CNM, ARNP Midwife Off the Grid Midwifery and Health
Ellen Kauffman, MD, FACOG Obstetrician
Jillian King, DNPC Doctorate of Nursing Practice Candidate University of Washington
Gina Legaz, MPH National Director, Prematurity Collaborative March of Dimes
Jennifer Linstad, MSM, LM, CPM Licensed Midwife, Co-owner Out Place Birth Center Our Place Birth Center, LLC
Maryellen Maccio, MD Family Medicine Valley Medical Center
Patricia Morgan, ARNP Psychiatric Nurse Practitioner Evergreen Health
Sheryl Pickering Health Services Consultant/WIC Tribal Liaison Washington Department of Health, WIC
Ashley Pina Pregnant and Parenting Family Substance Use Disorder Policy Administrator Washington Health Care Authority
Sarah Pine Behavioral Health Program Manager Washington Health Care Authority
Katie Price, LICSW Clinical Social Worker Katie Price Therapy
Brianne Probasco Reproductive Health Coordinator Washington Association for Community Health
Monica Salgaonkar, MHA Program Manager, Continuing Medical Education Washington State Medical Association
Nicole Saint Clair, MD Executive Medical Director Regence
Caroline Sedano, MPH Perinatal Unit Supervisor Washington Department of Health
Beth Tinker, PhD, MPH, MN, RN Nursing Consultation Advisor, Clinical Quality Care Transformation Washington Health Care Authority
Janmarie Ward, MPA Private Consultant American Indian Health Commission
Josephine Young, MD, MPH, MBA Medical Director Commerical Markets Premera
Gloria Andia, MSC Public Health Analyst Health Resources and Services Administration
Cheryl Altice, MPH Public Health Analyst Health Resources and Services Administration

Prescribing Antipsychotics to Children and Adolescents

Guideline Information

Guideline title: Prescribing Antipsychotics to Children and Adolescents Report and Guidelines

Publication status: Needs minor revisions – to be scheduled

Date of publication: 2016

Date of last evidence search: 2016

Scope: Medication evaluation, prescribing, medication management, psychosocial interventions, provider communication

Methods: Current guidelines and literature review and expert consensus

Description: Evidence shows that atypical anti-psychotic use is associated with patient harms including obesity, cardiovascular effects including hypertension, the possibility of tics, and other effects on the developing brain. Additionally, long-term research on the effects of atypical anti-psychotic use in youth is lacking. Evidence-based first line treatments for aggressive, impulsive, and disruptive behaviors in the absence of psychosis include psychosocial therapies. However, there is a lack of accessible and cost-effective behavioral therapy options, especially outside of urban areas and few effective alternative pharmacotherapy options available. Many patients do not receive an appropriate mental health assessment and if anti-psychotics are prescribed, receive monitoring of side effects.

Supporting Materials

Letter from Health Care Authority Accepting Pediatric Psychotropic Use Report and Recommendations
Pediatric
Psychotropic Use Charter

Metrics and Evaluation Tools

To support health system improvement the Bree Collaborative has created operational measures that are designed to help measure progress on the implementation of our guidelines.These measures were developed in collaboration with subject matter experts and are aligned across audience types (such as state agencies, health plans, providers, community organizations, employers, etc.)

To use our operational measures, find the audience type, or types, that is closest to your organization and download the measures document. There may be more than one audience type that is relevant. For example, large health systems may want to track progress at both the organizational level and the individual practitioner level.

Operational measures are also aligned with the Bree Collaborative’s self-report data collection efforts. Organizations are not required to report on operational measures, however organizations can submit data to help track system wide progress, measure their progress against others, and to be eligible for implementation awards. Instructions for the self-report submission can be found in the section below.

Health Care Professionals

Primary Care Providers Evaluation Score Card PCP Score Card _ Psychotropics

Behavioral Health Provider Evaluation Score Card BH Provider Score Card _ Psychotropics

Health Plans

Health Plan Evaluation Score Card Health Plan Score Card _ Psychotropics

Washington State Agencies

Washington State Health Care Authority Evaluation Score Card WA HCA Score Card _ Psychotropics

Guideline Metrics

For more generic tools for planing, data collection and data management, please visit our Tool Depot

Jump to Evaluation Tool Depot

Workgroup Members

Name Title Organization
Shelley Dooley Parent Advocate
Nalini Gupta, MD Pediatrician Developmental and Behavioral Pediatrics Providence Health and Services
Robert Hilt, MD Director, Community Leadership; Director of Partnership Access Line Seattle’s Children’s
Paula Lozano, MD MPH (Chair) Medical Director, Research and Translation Group Health Cooperative
Liz Pechous. PhD Clinical Director ICARD, PLLC
Robert Penfold, PhD Co-investigator, Medical Health Research Network Group Health Research Institute
James Polo, MD, MBA Chief Medical Officer Western State Hospital
David Testerman, PharmD Pharmacy Director Amerigroup
Mark Stein, PhD, ABPP Director of ADHD and Related Disorders Seattle Children’s
Donna Sullivan, PharmD, MS Chief Pharmacy Officer Washington Health Care Authority

Risk of Violence to Others

Guideline Information

Guideline title: Risk of Violence to Others Report and Guidelines

Publication Status: Active

Date of publication: 2019

Date of last evidence search: 2019

Scope: Identification of increased risk for violence, assessment of violence risk, violence risk management, protection of third parties

Methods: Current guidelines and literature review and expert consensus

Description: In 2018, the Washington State Legislature included a budget proviso for the Bree Collaborative to address the clinical uncertainty resulting from the Volk decision, directing the Collaborative “to identify best practices for mental health services regarding patient mental health treatment and patient management. The work group shall identify best practices on patient confidentiality, discharging patients, treating patients with homicide ideation and suicide ideation, record keeping to decrease variation in practice patterns in these areas, and other areas as defined by the work group.”12 This work builds upon the 2017 Collaborative guidelines on behavioral health integration into primary care and the 2018 guidelines on suicide care. 

Metrics and Evaluation Tools

Behavioral Health Care

Behavioral Health  Evaluation Score Card BH care Score Card _ ROV

Health Plans

Health Plan Evaluation Score Card Health Plan Score Card _ ROV

ER Departments

Emergency Departments Evaluation Score Card ER department Score Card _ ROV

Washington State Health Care Authority

WA HCA Score Card WA HCA Score Card _ ROV

Private and Public Purchasers and Employers

Employer/Purchaser Score Card Employer_purchaser Score Card _ ROV

Guideline Metrics

The Collaborative supports an expectation of depression remission and/or response within five to seven months. To that end they recommended the following metrics:

  • HEDIS 2017 includes two depression-specific measures:
    • Utilization of the PHQ-9 to Monitor Depression Symptoms for Adolescents and Adults
    • Depression Remission or Response for Adolescents and Adults
      The HEDIS measure, Depression Remission or Response for Adolescents and Adults, allows health plans to assess and report the percentage of health plan members 12 years and older with a diagnosis of depression who had evidence of response or remission within 5 to 7 months of their initial diagnosis. Remission is documented by a PHQ-9 score less than 5 points and response is indicated by a 50% decrease over the initial PHQ-9 score. This is one of only two measures for which health plans have the option of using an Electronic Clinical Data System (ECDS) such as a registry or other clinical management tracking system in addition to their EHR to capture reporting data. More information can be found here: www.ncqa.org/hedis-quality-measurement/hedis-measures/hedis-2017
  • Healthy People 2020 includes metrics on the suicide rate for the population at large and for adolescents,on major depressive episodes, on integrated behavioral health, and on access to mental health care. 55
    • MHMD-1: Reduce the suicide rate
      • Baseline: 11.3 suicides per 100,000 population occurred in 2007 (age adjusted to theyear 2000 standard population)
      • Target: 10.2 suicides per 100,000 population
      • Target-Setting Method: 10 percent improvemet
    • MHMD-2: Reduce suicide attempts by adolescents
    • Baseline: 1.9 suicide attempts per 100 population occurred in 2009
      • Target: 1.7 suicide attempts per 100 population
      • Target-Setting Method: 10 percent improvement
    • MHMD-4: Reduce the proportion of persons who experience major depressive episodes(MDEs)
    • MHMD-4.1: Reduce the proportion of adolescents aged 12 to 17 years who experiencemajor depressive episodes (MDEs)
      • Baseline: 8.3 percent of adolescents aged 12 to 17 years experienced a majordepressive episode in 2008
      • Target: 7.5 percent
      • Target-Setting Method: 10 percent improvement
    • MHMD-4.2: Reduce the proportion of adults aged 18 years and older who experience major depressive episodes (MDEs)
      • Baseline: 6.5 percent of adults aged 18 years and over experienced a major depressive episode in 2008
      • Target: 5.8 percent
      • Target-Setting Method: 10 percent improvement
    • MHMD-5: Increase the proportion of primary care facilities that provide mental health treatment onsite or by paid referral
      • Baseline: 79.0 percent of primary care facilities provided mental health treatment on site or by paid referral in 2006
      • Target: 87.0 percent
      • Target-Setting Method: 10 percent improvement
    • MHMD-6: Increase the proportion of children with mental health problems who receive treatment
      • Baseline: 68.9 percent of children with mental health problems received treatment in 2008
      • Target: 75.8 percent
      • Target-Setting Method: 10 percent improvement

Workgroup Members

Member Title Organization
 Kim Moore, MD (chair)  Associate Chief Medical Director CHI Franciscan
G. Andrew Benjamin, JD, PhD, ABPP Clinical Psychologist, Affiliate Professor of Law University of Washington
Kate Comtois, PhD, MPH Professor Department of Psychiatry and Behavioral Sciences Harborview Medical Center
Jaclyn Greenberg, JD, LLM Policy Director, Legal Affairs Washington State Hospital Association
Laura Groshong, LICSW Private Practitioner Washington State Society for Clinical Social Work
Ian Harrel, MSW  Chief Operating Officer  Behavioral Health Resources
Marianne Marlow, MA, LMHC Member Washington Mental Health Counseling Association
Neetha Mony State Suicide Prevention Plan Program Manager, Injury & Violence Prevention, Prevention and Community Health Washington State Department of Health
Kelli Nomura, MBA Behavioral Health Administrator King County
Mary Ellen O’Keefe, ARNP, MN, MBA Clinical Nurse Specialist – Adult Psychiatric/Mental Health Nursing; President Elect Association of Advanced Psychiatric Nurse Practitioners
Jennifer Piel, MD, JD Psychiatrist Department of Psychiatry, University of Washington
Jeffrey Sung, MD Member Washington State Psychiatric Association
Samantha Slaughter, PsyD Member WA State Psychological Association
 Adrian Tillery Harborview Mental Health and Addiction Services
Amanda Ibaraki Stine, LMFTA Member Washington Association for Marriage and Family Therapists

Award Winners

Award winners for Best Practices in Risk of Violence Toward Others:

Suicide Care

Guideline Information

Guideline title: Suicide Care Report and Guidelines

Publication Status: Active

Date of publication: 2018

Date of last evidence search: 2018

Scope: screening and assessment, treatments, follow up, patient/family communication, care pathways

Methods: Current guidelines and literature review and expert consensus

Description: The work group worked closely with and built from the Washington Suicide Prevention Plan released in January 2016 and the previous Bree Collaborative guidelines on integrating behavioral health into primary care released in March 2017. Guidelines are applicable to in- and out-patient care settings including for care transitions, behavioral health providers and clinics, and for specialty care (e.g., oncology) around the focus areas/scope (above). The work group’s goal is integration of implementable standards for suicide care, assessment, management, treatment, and supporting suicide loss survivors into clinical care pathways. These guidelines are focused on a clinical setting, but the work group recognizes need for visibility and education in a variety of community settings, and that limited access to behavioral health is an issue.

Supporting Materials

Letter from the HCA accepting Suicide Care Recommendations
Suicide Care Charter and Roster

Metrics and Evaluation Tools

Delivery Site and Health Systems

Health System Evaluation Score Card Health System Score Card _ Suicide care

Health Care Professionals

Primary Care and Behavioral Health Provider Score Card PC_BH Providers Score Card _ Suicide Care

Health Plans

Health Plan Evaluation Score Card Health Plan Score Card _ Suicide Care

Speciality Care (e.g oncology, etc.)

Specialty Care Evaluation Score Card – Speciality Care Score Card _ Suicide Care

Washington State Health Care Authority

Washington State Health Care Authority Score Card WA HCA Score Card _ Suicide Care

Private and Public Purchasers

Purchaser/employer Score Card Employer Score Card _ Suicide Care

Guideline Metrics

The Collaborative supports an expectation of depression remission and/or response within five to seven months. To that end they recommended the following metrics:

  • HEDIS 2017 includes two depression-specific measures:
    • Utilization of the PHQ-9 to Monitor Depression Symptoms for Adolescents and Adults
    • Depression Remission or Response for Adolescents and Adults
      The HEDIS measure, Depression Remission or Response for Adolescents and Adults, allows health plans to assess and report the percentage of health plan members 12 years and older with a diagnosis of depression who had evidence of response or remission within 5 to 7 months of their initial diagnosis. Remission is documented by a PHQ-9 score less than 5 points and response is indicated by a 50% decrease over the initial PHQ-9 score. This is one of only two measures for which health plans have the option of using an Electronic Clinical Data System (ECDS) such as a registry or other clinical management tracking system in addition to their EHR to capture reporting data. More information can be found here: www.ncqa.org/hedis-quality-measurement/hedis-measures/hedis-2017
  • Healthy People 2020 includes metrics on the suicide rate for the population at large and for adolescents,on major depressive episodes, on integrated behavioral health, and on access to mental health care. 55
    • MHMD-1: Reduce the suicide rate
      • Baseline: 11.3 suicides per 100,000 population occurred in 2007 (age adjusted to theyear 2000 standard population)
      • Target: 10.2 suicides per 100,000 population
      • Target-Setting Method: 10 percent improvemet
    • MHMD-2: Reduce suicide attempts by adolescents
    • Baseline: 1.9 suicide attempts per 100 population occurred in 2009
      • Target: 1.7 suicide attempts per 100 population
      • Target-Setting Method: 10 percent improvement
    • MHMD-4: Reduce the proportion of persons who experience major depressive episodes(MDEs)
    • MHMD-4.1: Reduce the proportion of adolescents aged 12 to 17 years who experiencemajor depressive episodes (MDEs)
      • Baseline: 8.3 percent of adolescents aged 12 to 17 years experienced a majordepressive episode in 2008
      • Target: 7.5 percent
      • Target-Setting Method: 10 percent improvement
    • MHMD-4.2: Reduce the proportion of adults aged 18 years and older who experience major depressive episodes (MDEs)
      • Baseline: 6.5 percent of adults aged 18 years and over experienced a major depressive episode in 2008
      • Target: 5.8 percent
      • Target-Setting Method: 10 percent improvement
    • MHMD-5: Increase the proportion of primary care facilities that provide mental health treatment onsite or by paid referral
      • Baseline: 79.0 percent of primary care facilities provided mental health treatment on site or by paid referral in 2006
      • Target: 87.0 percent
      • Target-Setting Method: 10 percent improvement
    • MHMD-6: Increase the proportion of children with mental health problems who receive treatment
      • Baseline: 68.9 percent of children with mental health problems received treatment in 2008
      • Target: 75.8 percent
      • Target-Setting Method: 10 percent improvement

Workgroup Members

Member Title Organization
Kate Comtois, PhD, MSW Psychologist Harborview Medical Center
Karen Hye, PsyD Clinical Psychologist CHI Franciscan Health
Matthew Layton, MD, PhD, FACP, DFAPA Clinical Professor, Department of Medical Education and Clinical Sciences Elson S. Floyd College of Medicine, Washington State University
Neetha Mony, MSW Statewide Suicide Prevention Plan Program Manager Washington State Department of Health
Julie Rickard, PhD Physician & Healthcare Consultant Confluence Health
Julie Richards, MPH Research Associate Kaiser Permanente Washington Health Research Institute
Hugh Straley, MD (chair) Chair Bree Collaborative
Jennifer Stuber, PhD Associate Professor University of Washington School of Social Work
Jeffrey Sung, MD Member Washington State Psychiatric Association

Treatment for Opioid Use Disorder-NEW!

Guideline Information

Guideline title:  Treatment for Opioid Use Disorder Report and Guidelines

Publication Status: Revised 2024

Date of publication: 2024

Date of last evidence search: 2024

Scope: Education, access, screening and diagnosis, treatment, recovery support and coordination

Methods: Current guidelines and literature review and expert consensus

Description:

This guideline outlines a multisector approach to coordinate low-barrier medication for Opioid Use Disorder (MOUD) around individual patient need across a variety of care settings. Non-traditional access points for MOUD are essential for the most underserved. Recovery support services, including care coordination, peer support, and if a site is unable to offer MOUD, warm handoffs during transitions of care are vital to quality care for people who use opioids. The following focus areas are used to structure and guide necessary changes.

2017 Supporting Materials

Letter from the Health Care Authority Accepting the Total Knee and Total Hip Replacement Bundle and Warranty and the Opioid Use Disorder Treatment and Alzheimer’s Disease and Other Dementias Report and Recommendations

Implementation Checklists by Audience

The checklist tool translates the Bree guidelines into action steps for that sector. The action items have been arranged into levels 1, 2, and 3 to correspond to the difficulty level of implementing the action into the sectors’ setting. Bree staff co-created the checklists with report workgroup members and topic experts.

Delivery Site and Health System Checklists

Level 1

Level 2

 Level 3

Health Care Professional Checklists

Level 1

Level 2

Level 3

Health Plan Checklists

Level 1

Level 2

Level 3

Metrics and Evaluation Tools

Introduction to Evaluation Tools

The Bree has developed multiple tools specific to OUD Treatment to support the evaluation projects implemented based on our guidelines.

Evaluation Matrix

The Bree has developed an evaluation matrix to help clarify measurable objectives, goals, and metrics that are relevant to the recommendations made by the work group. The matrix can be use during planning of your implementation project to help identify long-term outcomes or impacts of your project(s). The matrix provides a broad summary of the recommendations by audience for each component or focus area the guideline addresses (for example: education, access, treatment, etc.).

OUD TREATMENT EVALUATION MATRIX

Evaluation Framework

The Evaluation Framework provides further guidance on how organizations can conduct and align their work with other audience actors (example: all health plans in Washington state) or other audience types (example: health plans and providers). It provides specific details for measurement, provides strong and soft recommendations for the types of evaluations each organization may consider conducting, expands on alignment with other initiatives in Washington State, and makes recommendations for ethical and equity considerations.

OUD Treatment Evaluation Framework

Data Matrix

An example of how to fill out this form is available in Appendix B of the Evaluation Framework. The Data Matrix tool can be used in planning your data collection effort for your implementation and evaluation.

Bree Collaborative Data Matrix template – fillable form

Theory of Change

The theory of change illustrates how the work group conceptualized changes that would occur throughout the health care ecosystem as a result of their recommendations.

OUD Treatment Theory of Change

Link to our Evaluation Framework COMING SOON!

Score cards

To support health system improvement the Bree Collaborative has created evaluation score cards that are designed to help measure progress on the implementation of our guidelines.These measures were developed in collaboration with subject matter experts and are aligned across audience types (such as state agencies, health plans, providers, community organizations, employers, etc.)

To use our score cards, find the audience type, or types, that is closest to your organization and download the excel document. There may be more than one audience type that is relevant. For example, large health systems may want to track progress at both the organizational level and the individual practitioner level.

Score cards are also aligned with the Bree Collaborative’s self-report data collection efforts. Organizations are not required to report, however organizations can submit data to help track system wide progress, measure their progress against others, and to be eligible for implementation awards.

Completed score cards can be submitted to knicholas@qualityhealth.org

Score cards can be found in the tabs below:

Delivery Site and Health Systems

The Bree Collaborative has developed score cards to help organizations assess their current state and progress on implementing best practices. Score cards can be used for internal quality improvement programs or submitted to the Bree Collaborative as part of the criteria for awards eligibility.

Health system score card

OUD Treatment Program score card

Providers score card

Provider Training and Academics

The Bree Collaborative has developed score cards to help organizations assess their current state and progress on implementing best practices. Score cards can be used for internal quality improvement programs or submitted to the Bree Collaborative as part of the criteria for awards eligibility.

Academic Training Program score card

Health Plans

The Bree Collaborative has developed score cards to help organizations assess their current state and progress on implementing best practices. Score cards can be used for internal quality improvement programs or submitted to the Bree Collaborative as part of the criteria for awards eligibility.

Health plan score card

Washington State Agencies

The Bree Collaborative has developed score cards to help organizations assess their current state and progress on implementing best practices. Score cards can be used for internal quality improvement programs. State agencies may also use score cards for their partner organizations to align work.

Washington State Health Care Authority score card

Washington State Department of Health score card

Washington State Division of Behavioral and Health Resources score card

Private and Public Purchasers

The Bree Collaborative has developed score cards to help organizations assess their current state and progress on implementing best practices. Score cards can be used for internal quality improvement programs or submitted to the Bree Collaborative as part of the criteria for awards eligibility.

Employer Purchasers score card

Correctional Facilities

The Bree Collaborative has developed score cards to help organizations assess their current state and progress on implementing best practices. Score cards can be used for internal quality improvement programs or submitted to the Bree Collaborative as part of the criteria for awards eligibility.

Correctional Facilities Score Card

Guideline Metrics

Three composite metrics were identified by the work group subcommittee to measure changes to identification and treatment for individuals with OUD.

OUD identification/diagnosis
1a. OUD diagnosis (cascade measure) Percentage of individuals who had documented OUD diagnosis (e.g., on an insurance claim).
1b. Assessed for SUD using a standardized screening tool (supporting measure) Percentage of individuals who were screened/assessed for SUD
using a standardized screening tool.

Initiation of OUD treatment (NFQ 3400)
2a. Use of pharmacotherapy for OUD (cascade measure) Percentage of individuals with an OUD diagnosis who filled a prescription for or were administered or dispensed an MOUD, overall and by type of MOUD (methadone, buprenorphine, naltrexone).
2b. OUD provider availability (supporting measure) Number of providers who can prescribe buprenorphine, number of providers who do prescribe buprenorphine, number of opioid treatment programs that dispense methadone and/or buprenorphine.

Retention in OUD treatment – NQF #3175/HEDIS® † Initiation
and Engagement of Substance Use Treatment (NQF #0004), stratified forOUD/(NQF #3488)
3a. Continuity of pharmacotherapy for OUD (cascade measure) Percentage of individuals who filled a prescription or were dispensed an MOUD who received the MOUD for at least six months, overall and by type of MOUD (methadone, buprenorphine, naltrexone).
3b. Initiation of OUD treatment and engagement in OUD treatment (supporting measure) Percentage of individuals who initiate SUD treatment within 14 days of an OUD diagnosis.
Percentage of individuals who had two or more additional SUD services within 30 days of the initiation SUD treatment encounter.
3c. Follow-up after an emergency department visit for substance use (supporting measure)Percentage of emergency department visits for individuals with a principal SUD or overdose diagnosis who had a follow-up visit for SUD within seven days of the visit and within 30 days of the visit

For more generic tools for planing, data collection and data management, please visit our Tool Depot

Jump to Evaluation Tool Depot

Examples of Implementation - IN DEVELOPMENT

The Bree Collaborative is actively soliciting evaluations from organizations that use our guidelines if whole or part to inform a quality improvement project. If you are interested in submitting the results of your evaluation please contact our Evaluation and Measurement Manager, Karie Nicholas at knicholas@qualityhealth.org.

Workgroup Members

2024 Workgroup Members

Name Title Organization
Charissa Fotinos, MD (Chair) Deputy Chief Medical Officer Washington HealthCare Authority
Nikki Jones, LCISW, SUDP, CMHS, DDMHS, GMGS Behavioral Health Addictions Administrator United Health Community
Michael Sayre, MD Medical Director Medic One
Brad Finegood, MA, LMHC Strategic Advisor Opioids and Health King County
Everett Maroon, MPH Executive Director Blue Mountain Heart 2 Heart
Tina Seery, RN, MHA, CPHQ, CPPS, CLSSBB Senior Director, Quality and Rural Programs Washington State Hospital Association
Tawnya Christiansen, MD Behavioral Health Medical Director Community Health Plan of Washington
Sue Petersohn, EN, MBA, CARN Program Manager, Multicare SUD Task Force MultiCare
Mark Murphy, MD Medical Director Addiction Services MultiCare
Libby Hein, LMHC Director of Behavioral Health Molina Healthcare
Ryan Caldeiro, MD Chief Chemical Dependency Services
and Consultative Psychiatry		 Kaiser Permanente
Herbie Duber, MD Regional Medical Officer – Northwest WA Department of Health
Bob Lutz, MD, MPH CHAS Health
Amanda McPeak, PharmD Pharmacist and Director of Long-term Care Kelley-Ross/Harborview
Jason Fodeman, MD Associate Medical Director of Innovation and Outreach L&I
Maureen Oscadal, RN, CARN Registered Nurse Harborview Medical Center/Addiction Drugs and Alcohol Institute
John Olson, MD, MHA Addiction Medicine Physician Sound Health
Daniel Floyd Care Coordination and Recovery Section Manager King County Behavioral Health and Recovery Division
Kelly Youngberg, MHA Assistant Director for Health Care Implementation and Strategy Addictions, Drug and Alcohol Institute
Cris DuVall, PharmD, SUDP, WSPA Clinical Pharmacist Counselor Compass Health, Island Drug
Tom Hutch, MD, FASAM Medical Director We Care Daily Clinic
Liz Wolkin, MSN, RN, NPD-BC CEN Emergency Department Support Program Administrator Washington HealthCare Authority
David Sapienza, MD Lead Physician Pathways, Public Health Seattle & King County – Community Health Services Division

2017 Workgroup Members

Member Title Organization
Charissa Fotinos, MD (Co-Chair) Deputy Medical Officer Health Care Authority
Andrew Saxon, MD (Co-Chair) Director, Center of Excellence in Substance Abuse Treatment and Education (CESATE) VA Puget Sound Health Care System
Jane Ballantyne, MD, FRCA Professor, Department of Anesthesiology and Pain Medicine University of Washington School of Medicine
Caleb Banta-Green, PhD, MPH, MSW Senior Scientist Alcohol and Drug Abuse Institute, University of Washington
David Beck, MD Immediate Past President Washington Society of Addiction Medicine
Ryan Caldeiro, MD Chief Chemical Dependency Services and Consultative Psychiatry Kaiser Permanente
Mary Catlin, BSN, MPH Institutional Nurse Consultant Department of Health
Nancy Lawton, MN, ARNP, FNP President ARNPs United of Washington State
Darin Neven, MD, MS President and Founder Consistent Care
Richard Ries, MD Director, Addiction Psychiatry Residency Program University of Washington
John Robinson, MD, SM Chief Medical Officer First Choice Health
John Roll, PhD Professor & Vice Dean for Research, Elson S. Floyd College of Medicine Washington State University
Terry Rogers, MD Medical Director Lakeside Milam Recovery
Vania Rudolf, MD, MPH Addiction Recovery Services Swedish Medical Center
Mark Stephens President Change Management Consulting
Milena Stott, LICSW, CDP Chief Of Inpatient Services Valley Cities Counseling

Award Winners

Award winners for Best Practices in Opioid Use Disorder Treatment (2017 Report):

© 2025 Foundation for Health Care Quality | Privacy Statement | Disclaimer