​Implementation Resources from the National Center for Medical Home Implementation

Additional Implementation Resources

  • Best Practice Models: Integrated Behavioral Health and Primary Care
    The Substance Abuse and Mental Health Services Administration (SAMSHA), Health Resources and Services Administration (HRSA) Center for Integrated Health Solution archives examples of
    best practices in the integration of behavioral health and primary care in the United States. The archives include recorded webinars, videos, and economic advantages of behavioral health integration.
  • Promoting Physical and Behavioral Health Integration: Considerations for Aligning Federal and State Policy
    Published by the National Academy for State Health Policy, this
    brief summarizes key lessons and opportunities for federal and state alignment in promoting integration of behavioral and physical health. Case studies from Arizona, Missouri, and Tennessee are presented. Title V agency staff can find strategies related to payment models, data sharing approaches, and operational strategies to achieve integration.
  • Behavioral Health Integration in Pediatric Primary Care: Considerations and Opportunities for Policymakers, Planners, and Providers
    This report presented by the Milbank Memorial Fund discusses the prevalence of childhood behavioral health problems, describes the need for and barriers to behavioral health integration, and provides models of behavioral health integration in pediatrics. Policy implementation considerations are provided. The report is intended for pediatric clinicians, Title V agency staff, family/caregivers, and other child health stakeholders.

Training, Events, and Conferences

  • Association of Maternal and Child Health Programs (AMCHP) Annual Meeting
    February 10–13, 2018, Arlington, VA
    The 2018 AMCHP annual conference provides Title V leaders and staff, pediatricians, family partners and others an opportunity to present ideas, research, and programming for the maternal and child health population, including children and youth with special health care needs. The theme for the annual conference is Staying Focused: The Enduring Commitment of Maternal and Child Health to Families and Outcomes. Attendees are from multiple disciplines and include representation from government, physicians, family leaders, research, and advocates. 
  • Introducing the Title V Data Integration Toolkit
    November 30, 2017 at 1-2pm Central
    This webinarhosted by the Association of Maternal and Child Health Programs—discusses the newly released Title V Data Integration toolkit. This toolkit is a collection of resources that aim to assist states in integrating Title V data into Early Childhood Integrated Data Systems. Title V leaders will also share perspectives on their role in the development of this toolkit and experiences with data integration in their state.

Partners and National Initiatives

Interview with a Healthy Tomorrows Partnership for Children Program Grantee

The Building Resilience in Children (BRIC) program, located in one of three pediatric clinics within the Maimonides Medical Center, is a Healthy Tomorrows Partnership for Children Program grantee in Brooklyn, New York. The program focuses on providing mental health services within a pediatric primary care setting.

The BRIC program takes an integrated approach to behavioral health by co-locating a child psychologist in pediatric primary care; this individual sees patients with mild to moderate mental health issues. Children and adolescents are referred to the BRIC psychologist if they are identified as having a mental health problem through routine screening. The pediatrician conducts a warm hand-off to the psychologist for patients and families interested in receiving mental health services.

The BRIC program utilizes practical strategies and tips to ensure program success. The following integration strategies are core components of the program:

      • To promote buy-in from staff, all clinicians and clinic staff receive training about the importance of behavioral health integration and their role in the integration process. Residents and attending physicians also receive further training on mental health screening, identification, and management in primary care settings.
      • The clinic uses the Pediatric Symptom Checklist-17 (PSC-17), an evidence-based, validated, multilingual behavioral health screening instrument available via the clinic's electronic medical record (EMR) system.
      • Each staff member plays a role in the behavioral health integration process, including the following:
            • Clinic receptionists distribute paper versions of the PSC-17 to patients or caregivers of school-aged children ages ten years or older upon registration. 
            • Nurses/medical assistants input patient/caregiver responses from the paper version of the PSC -17 into the EMR.
            • Physicians review and calculate scores from the PSC-17 within the EMR, and refer patients to the BRIC child psychologist, if applicable.
            • The child psychologist participates in a "warm handoff" with the pediatrician through an introduction to the child/youth and family/caregiver during the appointment.
            • If the child and family are interested in participating, an intake appointment is made with the BRIC psychologist. The child/youth begins working individually with the BRIC psychologist, typically for six to eight sessions. Monthly group therapy sessions with peers are also available to interested participants.
            • During visits, clinic staff also help families enhance their self-efficacy skills to better manage their child's mental health problems. In addition, they identify other psychosocial stressors that need to be addressed.
      • To assess child mental health outcomes, caregivers complete another validated mental health assessment tool called the Child Behavior Checklist (CBCL), at the beginning of treatment and following completion of treatment.

To ensure sustainability and spread of the project, the BRIC program will receive funding from a New-York state program to expand to other Maimonides pediatric primary care sites. The BRIC child psychologist bills insurance providers for services to ensure sustainability of the program. The BRIC plans to develop an Integrated Care psychology training program that would enable psychology interns and externs who are completing postdoctoral psychology training to see patients under the supervision of the child psychologist.

For more information, visit the Healthy Tomorrows Partnership for Children Web site.