Care Transformation Collaborative of –RI(CTC-RI) Awarded State Innovation Model (SIM) Grant to Support Integrated Behavioral Health in Primary Care and Practice Transformation for Pediatric Patient Centered Medical Home Practices (PCMH-Kids)

CTC-RI is pleased to announce the receipt of a three year $870,000 grant from the Rhode Island SIM to support the work of a) providing Integrated Behavioral Health (IBH) in primary care and b) practice transformation for pediatric patient centered medical home practices (PCMH-Kids Programs).  Program goals include testing how primary care interventions improve quality and efficiency through a two-pronged multi-payer practice transformation project. 

CTC-RI recently launched a project to integrate behavioral health (IBH) care into a total of 12 primary care practices.  The target population for the IBH project includes 58,000 adults who are patients of 12 primary care practices.  Practices are implementing universal screening for depression, anxiety and substance use disorders.  Patients with elevated screening rates will have a “warm hand-off” to a behavioral health clinician who is part of the primary care practice team.  Practices will additional work to improve care coordination for patients with behavioral health needs who frequently utilize the emergency department for care.  

In 2016, CTC-RI expanded its multi-payer initiative to include nine pediatric primary care practice sites including 30,000 children and families.  The overall goal of this initiative is to standardize and improve the patient and family-centered care delivered by pediatric practices and work toward improving patient/family satisfaction, lower health care costs and improve population health. 

Michele Brown MPA, Project Coordinator with the Office of Program Development has been appointed to provide project management support for these new initiatives.  Ms. Brown has worked for Umass Medical School for nine years in the Community Case Management and Disability and Community Services Divisions where she helped with the coordination of in-home nursing services for medically fragile children.  She is also a graduate of the Clark University MPA program.