Promoting Sustainable Integration of Primary and Behavioral Health Care Services in East Texas - In Texas, behavioral health services - which encompass both mental health and substance use disorders (SUD) - have evolved over the last decade. Statewide implementation of the Certified Community Behavioral Health Clinic (CCBHC) model in conjunction with a movement toward managed care, and improved psychiatric crisis system, as well as enhanced community collaboration, have all contributed to significant advancement in behavioral health care in Texas. As a current SAMHSA Promoting Integration of Primary and Behavioral Health Care (PIPBHC) grantee, Texas Health and Human Services Commission (HHSC) has identified key elements essential to providing integrated care with meaningful outcomes. This grant opportunity allows Texas HHSC to continue building a sustainable model for promoting integration of primary care and behavioral health services in an underserved part of the state. Through a two-part approach - enhancing service delivery through care coordination between services and increasing access points through co-location and innovative partnerships - Texas plans to continue building systems capacity related to integrated health. Texas HHSC will work with four provider sites to improve access to behavioral health, primary care, and specialty care thereby improving health outcomes. The four community health centers participating in this project cover 26 counties in East Texas, which include some of the most rural and urban counties in the state and border three states (Oklahoma, Arkansas, and Louisiana) and the Gulf of Mexico. The region has been designated as medically underserved, with some counties having this designation as far back as 1978. Given the variation between population, resources, and geographic area, Texas' healthcare system must function differently in each community. To best serve East Texans with mental health, substance use, and physical health needs, Texas HHSC will work with the four selected providers across 25 rural counties and one urban county to identify integrated care models that work in each community. Behavioral health providers will collaborate with primary care providers in a variety of ways to identify best practices for the people in their counties. Through the project, Texas will focus on four key populations who would benefit from the PIPBHC model: 1) adults with serious mental illness (SMI), 2) individuals with co-occurring mental illness and physical health conditions and chronic diseases, 3) children and adolescents with serious emotional disturbances (SED) who have co-occurring physical health and chronic conditions, and 4) individuals with substance use disorders. The Texas strategy for success will focus on building capacity of targeted clinic partnerships in select service ares to provide effective, evidence-based integrated healthcare. The partnerships will be supported at the state level through learning collaboratives, partnerships with managed care and integration experts, and community network building. Through these partnerships Texas HHSC will also examine the elements required to implement true bi-directional integration and collaborative care models. Texas is ideally positioned to leverage this grant to transform service delivery and align incentives to improve the lives and health outcomes of vulnerable populations by creating a more efficient and coordinated system.
