Primary and Behavioral Health Care Integration Initiative

About the Program

Category: Health (Best in Category)

Year: 2014

A 2006 National Association of State Mental Health Program Directors study shows people with mental illness die, on average, 25 years earlier than the rest of the population. Most deaths are due to chronic health conditions associated with some psychiatric medications and a sedentary lifestyle. These outcomes, coupled with the reality that people served by the CSB often have low health literacy, poor access, lower socioeconomic levels, and disabilities that can interfere with seeking care, led the Fairfax-Falls Church Community Services Board (CSB) to make the integration of primary and behavioral health care a top priority. The CSB provides a continuum of services for people with mental illness, substance use disorder, intellectual and developmental disabilities and is an agency of Fairfax County government. By partnering with health care providers to explore approaches to build health care access, CSB created the County’s first integrated primary and behavioral health care programs without special funds or policy changes. Programs are providing better care and health outcomes for some of our most vulnerable community members. Key design features include: • Services are available to anyone served by the CSB (instead of a single population) in an effort to offer fully integrated care. • No grant funding or other source was used to make this happen. Strong partnerships and leveraging of resources made this possible. • Focus on health promotion and wellness as well as treatment of diseases is critical. Staff positions have been retooled to focus on health integration and wellness services, including smoking cessation, disease self-management, and other wellness activities. • Health services are located at CSB sites and behavioral health services are located at primary care sites. • On-site enrollment is available to facilitate access to health care providers. Entitlement staff also help individuals “mine” for benefits for which people may be eligible but do not know. • A strong payor mix makes this a sustainable model. CSB staff strives to ensure there is a healthy balance between insured and uninsured referrals. • Culture change among staff has been vital to making health care integration a reality. Rather than seeing health care services as an “add on,” the culture is shifting to a “whole health” focus with health care being a key feature.