New and Noteworthy

Thank You for Participating in the National Capital Needs Assessment for Health Centers!

Capital Link closed our national capital needs assessment and is currently analyzing the data provided by over 300 health centers across the nation. We extend our thanks to all who participated in this important project, which will help assess the extent of existing and future health center capital requirements. The results of this study will provide an estimate of the need for additional capital investment to enable health centers to achieve their growth goals. The data also helps us identify strategies for securing capital funding for health centers. Release of the report is expected this spring.

Health Centers: Building a Bridge between Primary Care and Mental Health Care

Health centers are known to eliminate barriers to health care for medically underserved populations and are continually seeking to expand service offerings to meet patient requirements. There is a current focus on the need to increase behavioral and mental health services, including  federal commitment to provide grant and loan programs for the expansion of facilities and programs supporting  the integration of behavioral health services into health centers. See below for resources and recent information available to assist health centers:

NACHC Resources for Behavioral Health and Primary Care Integration
Beginning in 2010, NACHC sought to understand how health centers were responding to the need for behavioral health services and provided recommendations for improving quality of care and increasing capacity. See the 2010 Assessment of Behavioral Health Services in FQHCs and the 2011 Assessment of FQHCs’ Integrated Behavioral Health Services for details.

In July 2013, NACHC issued a press release describing the results of a study with the Robert Graham Center for Policy Studies, noting that “all health centers that receive section 330 grant funding from HRSA are required to provide referrals to substance abuse and mental health providers, but most grantees by far exceed this standard. Nearly three-quarters of health centers had onsite mental health or substance abuse staff as of 2010.” Despite health center efforts to improve access to necessary behavioral health services, the study estimates that in order to meet the expected demand resulting from the Affordable Care Act, behavioral health staff will need to increase more than four-fold.

NACHC also partnered with the SAMHSA-HRSA Center for Integrated Health Solutions (CIHS) in 2012 and 2013 to implement the Behavioral Health Integration Learning Community, addressing the needs of health centers that had little or no behavioral health capacity. Thirteen health center teams participated in the Learning Community to accelerate the integration of behavioral health into their primary care settings. Key teachings and resources from the Learning Community include The Business Case for the Integration of Behavioral Health and Primary Care and companion Worksheet, and sample screening tools (PHQ-9, PHQ-2, AUDIT, AUDIT-C, and DAST-10). For more information about the Learning Community, visit the CIHS Website.

Patient-Centered Medical Home Accreditation and Recognition
With the enactment of the Affordable Care Act, Federal-level expectations for health centers to accomplish Patient-Centered Medical Home (PCMH) certification has significantly increased, and with it the requirement for health centers and behavioral health systems to collaborate strategically. For example, the Joint Commission developed a new Behavioral Health Home Certification product designed to recognize health care organizations that have successfully integrated primary physical and behavioral health care. The Joint Commission began offering this new certification option for organizations accredited under its Behavioral Health Care Accreditation program beginning January 1, 2014. Also, The National Committee for Quality Assurance recently proposed changes to its 2011 PCMH product, which, if approved, potentially require practices to have agreements, co-location, and direct integration with behavioral health providers. 

Substance Abuse and Mental Health Services Administration (SAMHSA) Programs
SAMHSA has initiated several programs and changes supportive of behavioral health and primary care integration, including Primary Care and Behavioral Health Integration (PBHCI), Wellness Initiative, and the SAMHSA/ HRSA Center for Integrated Health Solutions (CIHS). SAMHSA has also revised its Federal Block Grant program to encourage a broader approach in reaching beyond the populations that have historically been served through the program. According to the 2015 SAMHSA Federal Block Grant application, State Mental Health Authorities are expected to discuss their efforts related to coordination with State Primary Care Associations to enhance relationships between health centers, other primary care practices, and publicly funded behavioral health providers.

Upcoming Funding Opportunities
In mid-December, the White House announced the availability of $100 million to increase access to mental health services and improve facilities. Health centers seeking to expand or add mental or behavioral health services may soon be eligible for $50 million in grant funding from the Department of Health and Human Services (HHS). In addition, the U.S. Department of Agriculture (USDA) has set a goal of investing up to $50 million to increase access to mental health care in rural areas over the next three years. The funding will be used for the construction, expansion, or equipping of rural mental health facilities and will be provided through the Community Facilities direct loan program. For more information about the grant program, access the press release from the White House here. For more information about the loan program in rural areas, access the press release from the USDA here.