ABSTRACT: Promoting Integrated Care in Connecticut
The Connecticut Department of Mental Health & Addiction Services (DMHAS), in partnership with primary care and behavioral health treatment providers in three CT communities with large populations of underserved adults with co-morbid behavioral health and medical conditions, proposes to launch Promoting Integrated Care in Connecticut (PIC-CT) to fill major gaps both in the integration of behavioral health into primary care as well as the integration of primary care into behavioral health. We would engage 2,250 individuals over the course of the grant period into primary care, behavioral health care including medication assisted treatment, care coordination including nurse care management, and peer health navigation services for health promotion, referrals, and support.
Connecticut has considerable momentum to implement this project. We have recently implemented a Behavioral Health Home, authorized under Section 2703 of the Patient Protection and Affordable Care Act. This model serves individuals with serious mental illness (SMI) and co-occurring disorders who have Medicaid spend in excess of $10,000 in a calendar year, typically as a result of chronic co-morbid medical conditions. The core services articulated in SAMHSA’s FOA perfectly align with Connecticut’s CMS-approved State Plan Amendment for Health Homes. Primary providers identified to partner under this opportunity are not currently BHH providers and were targeted to expand the reach of integrated care in those communities. Lessons learned from BHH implementation will frame out best practices for this project. Three urban areas have been identified that have high rates of individuals who have high Medicaid spend, a behavioral health diagnosis, and are currently not being served by an integrated model of care: Hartford, Bridgeport, and Waterbury.
The overarching goal of the project is to increase access to integrated care for individuals with substance use, mental health, and/or co-occurring disorders with a special focus on increasing health literacy, promoting health behavior change, and increasing access to medication-assisted treatment. We will accomplish these goals by: (1) implementing integrated care; (2) implementing evidence-based practices in the context of integrated primary and behavioral health care; and (3) improving overall wellness and physical health status for individuals.
Through this project, we anticipate incremental improvement in health outcome indicators, co-occurring mental health and substance use disorders, including tobacco use. This measurement will contribute to an improvement in the overall health of people with SMIs and substance use disorders by addressing the basic risk factors related to high morbidity and mortality rates of individuals with SMIs and substance use disorders. In addition, patients will have increased immediate access to care; reduction of health disparities; and increased service linkage through care coordination.