The NC Center of Excellence for Integrated Care

The NC Center of Excellence for Integrated Care has been charged with integrating care in multiple health care settings. Our goal is to integrate patients' physical and behavioral health care, whether the care is delivered in an office or clinic, a hospital or mental health agency.

Deploying a small interdisciplinary team, the Center is a resource for assessment, training, and technical assistance to health care professionals and organizations. To assure that standards of care applied by the Center are broadly agreed upon and evidence-based, the Center works with stakeholders across North Carolina to assess evidence and ascertain best practice in clinical assessment, clinical tools, and techniques.

We offer:

  • Customized training based on the needs of providers after listening closely to their concerns;
  • Collaborative learning for groups of providers to allow them to test integrated care tools and techniques within their own quality assurance programs;
  • Technical assistance to providers to help them implement integrated care techniques and troubleshooting as providers initiate integrated service;
  • A resource for providers to investigate evidence-based tools and techniques in integrated care.

The Center continues to support the goals expressed by Governor Purdue: to “establish the national model for an integrated approach to behavioral and primary health services for patients with mental health, developmental disability and substance abuse problems.”

 
Foundation Work in Integrated Care, 2006-2009

Many North Carolinians have inadequate access to mental health, developmental disability, and substance abuse services (MH/DD/SAS), and their services for physical and behavioral health are poorly coordinated. Primary care providers (PCPs) often must try to address unmet behavioral health needs with insufficient specialty back-up and information. The ICARE Partnership, a demonstration project that was largely concerned with educating providers on integrated care, was a project that operated from 2006 through 2009 to begin addressing these problems. Project goals were to increase collaboration and communication between primary care and MH/DD/SAS providers and to increase the capacity of PCPs to provide appropriate, evidence-based behavioral health services to their patients and the capacity of MH/DD/SAS providers to screen and refer for physical illness. The work included:

Education and Assistance

  • Statewide Education and Assistance
  • Needs assessment to determine educational and technical assistance needs.
  • Provider training and technical assistance to develop a range of provider training opportunities to encourage capacity and relationship building. Modalities included centralized and regional workshops; web-based conferences and resources; and practice-based trainings and technical assistance.
  • Development and implementation of a clinical consultation service.

Local Model Development

  • Community Systems - Development of integrated and coordinated local systems around the "Four Quadrant Model" to include improved care planning, communication, support (resource directories and consultation) and the development of evidenced-based programs to care for patients with targeted behavioral health problems.
  • Practice Implementation – Providing practice-based technical assistance to local providers to assure implementation of best practices.

Process and Policy Change

  • Reporting practice-based, community, regional and statewide changes recommended or implemented.

This demonstration project was successful in establishing practice approaches and procedures to increase collaboration and integrated care for behavioral health practitioners in a variety of medical practice settings. Overall, practitioners and patients reported improved access to care, perceived improvements in communications among community providers, and increased awareness of the role of the LMEs in coordinating screening, triage and referral to treatment.

For a complete description of project outcomes, click here.

Click here for the Final Evaluation Report on the ICARE Integration Pilot Sites by the Cecil G. Sheps Center for Health Services Research at UNC Chapel Hill.

Access the full History of the ICARE PARTNERSHIP.