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$5 Million Investment to Expand Access to Behavioral Health Care in Primary Care Offices
Raleigh -- October 30, 2024: North Carolina Press Release: 5 Million Investment to Expand Access to Behavioral Health Care
in Primary Care Offices.
The North Carolina Department of Health and Human Services announces $5 million to help providers build capacity and implement the Collaborative Care Model in primary care offices across the state. Through the Collaborative Care Model, primary care providers work with an integrated behavioral health case manager and a psychiatric consultant to monitor and treat patients for mild to moderate behavioral health conditions. The need for integrated medical and behavioral health care is greater than ever as rates of anxiety and depression have substantially increased following the COVID-19 pandemic.
The North Carolina Department of Health and Human Services announces $5 million to help providers build capacity and implement the Collaborative Care Model in primary care offices across the state. Through the Collaborative Care Model, primary care providers work with an integrated behavioral health case manager and a psychiatric consultant to monitor and treat patients for mild to moderate behavioral health conditions. The need for integrated medical and behavioral health care is greater than ever as rates of anxiety and depression have substantially increased following the COVID-19 pandemic.
"Too many individuals with mental health and substance use disorders delay the care they need because they struggle finding a provider," said NC Health and Human Services Secretary Kody H. Kinsley. "Collaborative Care can serve more people earlier by supporting primary care providers in reaching people at the onset of behavioral health symptoms."
Collaborative Care is covered by NC Medicaid, Medicare and most commercial insurance plans in North Carolina, helping to break down barriers that separate how physical and behavioral health services are delivered and paid for. Patients are able to receive services through a provider, and in a setting, they already know and trust, which gives them easier access to the care they need. Collaborative Care improves patient outcomes, reduces health care costs and reduces stigma related to mental health and substance use disorders.
NCDHHS' investment is designed to help with the startup costs of implementing Collaborative Care, particularly for primary care providers in rural or high-need areas that have limited access to behavioral health services. The department is partnering with Community Care of North Carolina (CCNC) to select eligible provider applications and distribute funding to approximately 100 providers across the state.
As of Oct. 10, providers can apply for up to $50,000 per site to help with hiring and start up costs. Primary care practices are encouraged to apply and can find more information through CCNC's dedicated Collaborative Care website . Efforts will be made to ensure primary care practices in western North Carolina impacted by Hurricane Helene will have an opportunity to apply for inclusion in the program, even if they are unable to apply for funds at this time.
"The need is greater than ever before," said Dr. Carrie Brown, Chief Psychiatrist for NCDHHS. "From 2019 to 2021, the percentage of Americans reporting symptoms of anxiety and depression nearly quadrupled, from 11% to 41%. The Collaborative Care partnership between primary care and psychiatrists is one example of the department's efforts to increase access to behavioral health care for those who need it as we focus on whole-person health."
Nationally, the Collaborative Care Model is a strategic response to the shortage of mental health care professionals across the country. Recent data show more than 123 million people in the US live in a Federally Designated Mental Health Professional shortage area, including one in four North Carolina counties. In North Carolina, a recent study finds there are 28 counties without a practicing psychiatrist, and it can take weeks or even months to get an appointment with a mental health provider.
With the Collaborative Care Model, a behavioral health care manager is embedded within a primary care office and, through consultation with a psychiatrist, helps the primary care physician implement evidence-based interventions for patients who screen positive for targeted behavioral health conditions. In this model, one psychiatrist can reach far more North Carolinians with mild to moderate behavioral health needs than they could directly provide care for through traditional behavioral health services.
"Through this partnership with primary care professionals, we are working to create a more accessible mental healthcare system," said Kelly Crosbie, MSW, LCSW, Director of the NCDHHS Division of Mental Health, Developmental Disabilities, and Substance Use Services. "This ensures our community receives the mental health care they need and deserve, in a setting where they are most comfortable."
The $5 million investment in capacity building is made possible by the NC General Assembly through the signing bonus North Carolina received from the federal government when it approved Medicaid Expansion. The investment builds on the department's strategic work to enhance access to the Collaborative Care Model, which has already resulted in a nearly 100% increase in utilization among NC Medicaid primary care providers between April 2023 and May 2024.
NC Medicaid, in coordination with key stakeholders, has led a statewide effort over the past two years to align requirements and reimbursement for Collaborative Care across payors, increase NC Medicaid reimbursement for behavioral health services to 120% of Medicare rates and remove copays for Medicaid beneficiaries . Additionally, NC Medicaid has provided training and technical assistance to support model implementation through Area Health Education Centers, connected interested primary care practices with psychiatric consultants, and created a customized Collaborative Care registry for providers through CCNC. These efforts are outlined in detail in a white paper published by NC Medicaid in December 2023.
NCDHHS' investment in the Collaborative Care Model is part of a broader commitment to build an integrated behavioral health system in North Carolina. The NC General Assembly last year allocated a historic $835 million to strengthen the behavioral health system, and millions of North Carolinians are already benefiting from the sweeping, systemic improvements these funds are making for their health, well-being and day-to-day lives . More information is available in the NCDHHS Transforming North Carolina's Behavioral Health System white paper.