Behavioral health in federally qualified health centers: What practitioners and researchers need to know.

Abstract

The Federally Qualified Health Centers (FQHCs) that provide the foundation for America's safety net system have developed inventive approaches toward patient care through the expanded services required to meet the demands of increasingly complex patient populations. In reaction to the evidence outlining the benefits of behavioral health integration, many FQHCs are including behavioral health providers on their treatment teams. This article provides background information about FQHCs, details the current presence of behavioral health within FQHCs, and describes how the Affordable Care Act (ACA) is supporting integration through initiatives such as Meaningful Use and Patient-Centered Medical Home. Psychologists can contribute to the patient-centered care philosophy that underlies the health center program by (a) helping practices implement the behavioral health components of medical home requirements, (b) establishing clinical workfiows for the management of complex patients, (c) expanding the workforce through clinical training programs, (d) strengthening the evidence base for the treatment of comorbid medical and behavioral conditions, and (e) designing evaluation protocols to illuminate the relative impact of different integrated primary care models.

Psychology in patient-centered medical homes: Reducing health disparities and promoting health equity.

“…The National Committee for Quality Assurance (NCQA, 2014), which offers the most commonly used mechanism nationally through which primary care practices can achieve PCMH recognition (Auxier, Hirsh, & Warman, 2013), specifies criteria that have explicit relevance for reducing health disparities in underserved populations. For example, evaluating disparities in care for vulnerable populations served by PCMHs is regarded as a routine component of practice assessment (NCQA, 2014).…”

“…The Health Resources Services Administration (HRSA) has supported NCQA PCMH recognition for community health centers, a principal vehicle for primary health service for millions of medically underserved and uninsured individuals and a key resource for expanding the reach of primary care services with appropriations provided through the ACA (Adashi, Geiger, & Fine, 2010; Auxier et al, 2013). With their focus on providing accessible, high-quality, whole person, and culturally informed care, community health centers are well positioned to implement a PCMH framework of care for individuals disproportionately affected by health disparities (Adashi et al, 2010; Anderson & Olayiwola, 2012).…”

“…Patient-Aligned Care Team programs have been associated with improved outcomes pertaining to patient satisfaction, quality of service delivery, hospitalizations, emergency department visits, and staff burnout (Nelson et al, 2014). PCMH implementation in community health centers and the Veterans Health Administration include behavioral health specialists as part of interprofessional teams, with significant employment opportunities for psychologists (Auxier et al, 2013; Kearney, Post, Pomerantz, & Zeiss, 2014).…”

An Evidence Roadmap for Implementation of Integrated Behavioral Health under the Affordable Care Act

“…The roles of behavioral health in ACA organizations, therefore, are focused on expanding traditional mental health skills and services. These models include implementing BH into the medical home through establishing workflows for complex patients, expanding the workforce through clinical training programs, strengthening evidence for IBHC and designing evaluation protocols to assess impact of IBHC [81] .…”

Ways that psychologists can contribute to tobacco cessation efforts in integrated primary care settings.

“…Although much of the extant research has focused on increasing tobacco cessation interventions delivered by PC medical providers, the results have been suboptimal, especially for intervention components such as assistance with strategies for quitting and arranging follow-up services (Kruger, O’Halloran, & Rosenthal, 2015). Psychologists are increasingly becoming part of the interdisciplinary team in patient-centered medical homes (Kaslow, Kapoor, Dunn, & Graves, 2015; Kessler et al, 2014), and there is a growing demand for psychologists in PC settings (Auxier, Hirsh, & Warman, 2013).…”