It is widely recognized that unaddressed Behavioral Health (BH) conditions increase suffering and total cost of care and that BH drives 60-80% of all visits to Primary Care (PC). Building and supporting the delivery of integrated behavioral health care at PCP sites is fundamental and necessary to improve quality of life and to decrease inefficient utilization of health care services and dollars.
The Care Transformation Collaborative of Rhode Island (CTC-RI) has designed, implemented and evaluated IBH models and provides workforce and practice development programs.
|Associates in Primary Care*|
|East Bay Community Action Program (E. Providence & Newport)|
|Providence Community Health Centers – Chafee|
|Tri-County Community Action*|
|Women’s Medicine Collaborative*|
|Brown University – Governor Street|
|Coastal Medical – Hillside Family Medicine|
|Providence Community Health Centers – Capitol Hill|
|Providence Community Health Centers – Prairie Avenue|
|Wood River Health Services|
*Participated in the Major Depressive Disorder Learning Collaborative
|Infrastructure Payment||1st payment: month 1||2nd payment: month 5|
|$15,000 prorated per 5000 attributed lives||$10,000||$5,000|
|Incentive Payment||Year 1: month 12||Year 2: month 24|
|$10,000 each year for meeting screening targets||Depression: 70%
Substance Use Disorder: 50%
Substance Use Disorder: 70%
CTC conducted a qualitative research evaluation study which included interviews with the practice staff and key stakeholders with the following barriers and recommendations identified:
Providers love it: “When I say how much I love having integrated behavioral health, it is that I can’t imagine primary care without it. It just makes so much sense to me to have those resources all in the same place because it is so important.” Provider indicated in the qualitative research study
Value of deliberate screening: “I’m surprised especially with the anxiety screener that there’s more out there than I knew about. I was talking to somebody yesterday. I know the patient pretty well, and the patients, if they had an issue, would tell me. But it comes up in a screener”. Provider indicated in the qualitative research study
Impact on ED use: “One of the things we identified through the program was somebody was going to the ER almost every other day and it was due to anxiety. So, he was giving tools to control that and it actually empowered him. He felt like he had taken control of the issue. And his ER visits dropped right off. He was being seen here (at the primary care practice) more frequently, but that’s OK. We’d rather he come here than go to the ER”. Practice Manager indicated in the qualitative research study
Total cost of care data from the All Payer Claims Database show significantly lower cost of care in practices that have integrated behavioral health program than the comparison groups. A more robust quantitative analysis from Brown University is due in 2020.
A presentation on the overall IBH Pilot Program can be found here (link master IBH deck).
Having worked with over 100 pediatric, family medicine, and adult primary care practices, the Care Transformation Collaborative of Rhode Island (CTC-RI) has a proven track record for assisting primary care practices to better support the successful integration of behavioral health and primary care.
CTC-RI has received national and regional recognition and awards for our innovation and leadership. Using a personal hands-on approach, we can assist you with developing a customized action plan designed to meet your strategic objectives by offering the following integrated behavioral health services.
Practices and systems of care interested in implementing integrated behavioral health, with Dr. Nelly Burdette serving as CTC's Senior IBH leader, should contact firstname.lastname@example.org.
The purpose of this training is to provide foundational knowledge and professional skills practice as preparation for individuals delivering integrated behavioral health (IBH) practice facilitation at primary care sites in Rhode Island.
"The course really solidifies and celebrates the role of the practice facilitator. The resources are current and dedicated to the adult learner. You will find the experience engaging and it will expand your professional base."
Jayne Daylor RN MS.
Senior Integrated Behavioral Health Program Leader, Care Transformation Collaborative-Rhode Island (CTC-RI). Dr. Nelly Burdette has more than 10 years’ experience within integrated behavioral health clinical and leadership positions. She has created Integrated care programs at federally-qualified health centers, community mental health centers, and the Veteran’s Administration for pediatric, family medicine and adult populations. From positions in senior leadership to providing clinical services embedded within medical practices, she has provided integrated behavioral health training and supervision to interdisciplinary medical teams. In her current roles, Dr. Burdette is the Associate Vice President of Integrated Behavioral Health at Providence Community Health Centers, the largest federally qualified health center in Rhode Island and serves in both a leadership and clinical role. She has also been serving as a senior content expert and integrated behavioral health practice facilitator for CTC-RI for the past 4 years. Dr. Nelly Burdette received her doctorate degree in Health Psychology from Spalding University and completed her internship at Cherokee Health Systems, focusing on behavioral health services within a primary care safety net population. Her post-doctorate was completed at University of Massachusetts Medical School in Primary Care Psychology.
Course Participants: Behavioral health clinicians (PhD, PsyD, LICSW, LMFT, LMHC).
Next Course Start Date: September 14, 2020
Estimated time commitment is ~24 hours.
Cost for Foundational Course: $750 for CTC members; $1000 for out of state
Advanced: Onsite IBH Shadowing (Optional) Highly recommended and unique add-on to the course includes a live shadowing component in which Dr. Burdette schedules your organization for an initial practice facilitation session with the course participant observing and then a follow-up practice facilitation session with Dr. Burdette shadowing the course participant. Shadowing rate is currently available to Rhode Island only, but please inquire if interested in out-of-state shadowing. Schedule to be arranged with Dr. Burdette.
Additional Cost for Onsite IBH Shadowing: $750
Interested course participants should submit their application and CV or resume to CTCIBH@ctc-ri.org by Feb 24, 2020. You will be notified of your acceptance and provided further instructions within 7 days of receipt.
Another Training program will be offered in the Fall of 2020.
Please note, this training program is not for learning how to do integrated behavioral health. There are other courses that cover this topic, such as this one.
2nd Thursday Monthly
Topic focus on Pediatric IBH (Jan, Apr, Jul, Oct)
Topic focus on Adult IBH Pilot (Feb)
Committee Meeting (Mar, Jun, Sept, Dec)
50 Holden Street 3rd floor
Click here for parking and directions.
To be announced
The Integrated Behavioral Health (IBH) Committee is charged with supporting the development of, and ongoing learning around, sustainable approaches to integrating behavioral health in a wide variety of primary care practices. The IBH committee acts as content experts for informing the implementation of CTC IBH pilot projects and work in partnership with the health plans, systems of care, Office of Health Insurance Commission and other partners in testing and evaluating new models/programs of care. The committee acts as an advisory group to: a) inform Patient Centered Medical Home (PCMH) adult and pediatric practices and community health teams as they develop programs to meet the behavioral health needs of patient and families in primary care b) strengthen workforce development by coordinating efforts with academic programs c) inform public policy. The IBH Committee Charter can be found here (link to charter).
PCMH Kids is a state-wide collaborative covering 110,000 children from 37 practice sites representing ½ the children in RI and 80% of the Medicaid population. This PCMH Kids IBH initiative consists of 8 pediatric practice sites serving approximately 40,000 children and represents both independent practice sites and practices that are part of systems of care. Priority was given to practices that serve vulnerable populations. This initiative recognizes and capitalizes on the fact that primary care is the logical center piece for providing effective mental health promotion and prevention because the pediatrician is the most likely medical professional that children and adolescents come in contact with during their early and adolescent years.
Through this pediatric IBH initiative, CTC-RI and PCMH Kids is building on its success in implementing integrated behavioral health in adult primary care practices as well as leveraging the behavioral health work done in pediatrics through our PCMH-Kids program over the past 3 years. The 8 pediatric practices enrolled in this program are:
|Comprehensive Community Action Program (CCAP)|
|Hasbro Pediatric Primary Care|
|Tri-County Community Action Agency|
|Coastal Medical – Bald Hill|
|Coastal Medical - Waterman|
|Hasbro Medicine Pediatric Primary Care|
|Northern RI Pediatrics|
CTC provided IBH practice facilitation to 9 primary care practices, 2 of which had to drop out of the program, over a one year time period to assist them with implementing an IBH program geared towards providing holistic patient centered primary care services. The 7 primary care practices enrolled in the program are: