Integrated Care
MAHEC has received a
two year grant from Kate B. Reynolds to integrate mental health services for children and families
in non-profit primary care practices in an 8 county region. It is estimated that this project can reach 7500 underserved
children and families in this area.
Grant Application
Grant Goals
- To assist 6 non profit primary care practices to hire mental health providers by August 31st, 2005
- To assist 6 more non-profit primary care sites by August 31st 2006,expanding into four new counties
The grant has three major components
- Support the identified sites with start up monies to hire a behavioral health clinician to provide mental health services in the practice.
- Provide training opportunities to all office staff (includes physicians, mid-levels, RN’s and mental health clinicians) that will insure success in sustaining and maintaining the services. Identify and develop best practices/treatment protocols to be shared and used by grant sites and any other practices that would like to participate.
- Provide psychiatric consultation dollars to the sites to be utilized as sites need examples of such consultation are site or telephone case consultation, telemedicine, and development of best practice models)
What sites are being supported by the grant for the second year?
- Health Plus- McDowell County
- Saluda Family Practice- Polk County
- Eastern Band of the Cherokee Indians- Swain County
- Blue Ride Health Center- Henderson, Transylvania, Polk Counties
History of AD/HD Algorithm Development
- As part of the Kate B. Reynolds’ Charitable Trust grant initiative to establish integrated care
services in non-profit primary care settings, a regional group of clinical experts met and discussed
the components of an AD/HD algorithm that will be used in this region in primary care practices.
The following group of people should be recognized for the work they did to make this become a
reality for Western North Carolina: Steve Baker, MD; Kelly Burgin, PhD; Jim Horwitz, MD; Paul
Iacono, MD; Harald Kowa, MD ; Adrian Sandler, MD; Louis Stein, MD; Paul Trani.
History of CCNC’s Depression Algorithm Development
- Access II Care of WNC (Medicaid managed care) has been reviewing the regions utilization data since 1998.
As far back as the first 1999 CODMAN network profiles, mental health diagnoses has been a contributing factor.
Major Depression Recurrent listed 5th for inpatient admissions. Both the dollar amount and the bed days were
the highest of the top 10 (significant in light of the fact Mental Health diagnosis is often under reported)
Over the years it repeatedly appears: in prescribing costs and patterns, in the profiles of children with
special health care needs, as a complicating factor in the treatment of chronic disease and through our
case management activities.
- Access II Care of WNC was delighted to partner with Western Highlands Network
in response to a plea from primary care physicians in our region for increased
resources to diagnose a nd treat mental health problems in the primary care
setting. Based in part on the MacArthur Initiative on Depression in Primary
Care at Dartmouth and Duke, BCHC Cures and MAHEC PrimeCare program an evidenced
based algorithm for the treatment of Depression in primary care was developed
as the standard for the region. The algorithm has been reviewed and approved
by both primary care and psychiatric physicians within the western region.
Access II Care’s primary care network providers, together with the Western
Highlands Network medical director and local psychiatrists participated in
the development of the algorithm and in the roll out across Access II Care’s
regional Medical Management Committee meetings.
- The algorithm was produced as part of a manual that includes screening tools,
critical decision making points, medication guidelines, patient education and self
management tools. During the first 6 months over 200 manuals have been produced and
the majority has been placed in patient exam rooms in primary care practices.
Committee Members
- Chip Baggett, Buncombe County Medical Society
- Susan Mims, MD, Buncombe County Health Center
- Ben Bailey, MD, Mountain Area Pediatric Associates
- Julie Montanaea, HealthPartners
- Karen Blicher, MAHEC
- Linda Poss, RN, Mission Hospitals
- Theresa Emmanuel, LPC, Mission Hospitals
- Sally Smith, RN, LCSW, MAHEC
- Dan Gerber, PhD, Western Highlands LME
- Jennifer Wehe, MSW, Access II Care