Modification published on 01/26/2016
Extending Deadline for those with a previously approved waiver from HRSA's Division of Grants Policy
This announcement solicits applications for a two-year FY 2016 Nurse Education, Practice, Quality, and Retention-Interprofessional Collaborative Practice: Behavioral Health Integration (NEPQR-IPCP:BHI) program to integrate interprofessional and collaborative models of behavioral health services into routine nurse-led primary care delivered in vulnerable and/or underserved/rural populations.
In 2003, the New Freedom Commission on Mental Health report cited primary care as an area where patients need to receive more effective mental health assessment and treatment. Further, Healthy People 2020 recommends that early interventions, including behavioral health screenings, become an essential component of primary care visits. The Affordable Care Act created a federal infrastructure to integrate primary care and behavioral health services through increased access to mental health and substance abuse prevention and treatment benefits. This increase in coverage also increases the demand for a competent health workforce, capable of working in an integrated setting.
The NEPQR-IPCP:BHI program aims to expand the evidence-based practice of integrating behavioral health providers into nurse-led primary care teams in order to increase access to care, enhance care coordination and improve patient outcomes in vulnerable and/or underserved community- based settings.
Program Requirements
NEPQR-IPCP:BHI recipients will increase access to quality behavioral health care by delivering team-based, integrated primary care and behavioral health services in community-based settings.
All applicants are required to:
· Practice interprofessional, integrated care in a primary care setting. The primary care provider must be an advanced practice registered nurse (APRN);
· Expand an existing nurse-led primary care team with the addition of at least one onsite full-time equivalent (FTE) licensed behavioral health provider. The integrated team must include a primary care provider (APRN), behavioral health provider, care coordinator, and consulting psychiatric provider;
· Describe their current level of behavioral health integration (using the SAMHSA-HRSA Center for Integrated Health Solutions six-level framework; http://www.integration.samhsa.gov/integrated-care-models/A_Standard_Framework_for_Levels_of_Integrated_Healthcare.pdf) and forecast how they will progress to higher levels of health care integration;
· Propose an efficient plan to identify and treat behavioral health problems in the primary care setting. Use of the following evidence-based tools are required:
o Screening, Brief Intervention, and Referral to Treatment (SBIRT) approach – to identify patients for unhealthy alcohol and substance use; and
o Improving Mood-Promoting Access to Collaborative Treatment (IMPACT) approach – to identify patients for depression;
· Propose an innovative plan for achieving increased access to behavioral health services including a detailed description of how SBIRT and IMPACT will be implemented into the primary care setting;
· Utilize an interoperative health IT system that enables the exchange of primary care and behavioral health clinical data to assess patient and project outcomes and ensure accountable care, and allows practitioners to utilize a common set of patient records that are constantly updated and available to each member of the provider team in real time; and
· Describe a rapid cycle quality improvement (RCQI) method that identifies, implements, and measures changes made to improve the project’s performance.
Successful applicants will:
Demonstrate a high level of need for behavioral health services within the target community/population;
Implement an interprofessional collaborative practice model to deliver comprehensive, culturally competent, and integrated behavioral health services;
Systematically identify and treat individuals in need of behavioral health services; and
Explain how they will leverage existing behavioral health resources in and around the community to address service delivery gaps.
To meet the goal of the program, award recipients are expected to use funds for the following activities:
· Create more efficient and integrated practices that lead to high quality patient- and population-centered outcomes that can subsequently inform interprofessional education models;
· Expand a nurse-led primary care team consisting of, at a minimum, a primary care provider (APRN), behavioral health provider, care coordinator, and consulting psychiatric provider (options include telebehavioral health);
· Serve as a primary care/behavioral health integrated practicum site for interprofessional training for nursing and other health professions students;
· Provide universal screening for depression and unhealthy alcohol and other drug use using SBIRT and IMPACT tools and provide necessary education and support, intervention, monitoring and follow-up;
· Develop an effective referral arrangement for more intensive and/or any continuous treatment needs;
· Implement rapid cycle quality improvement (RCQI) to identify, implement and measure changes made to improve the project’s performance;
· Evaluate the program, collect needed program information, and disseminate findings to appropriate audiences;
· Develop a sustainable business model; and
· Establish a formal arrangement for technical assistance to increase the level of behavioral health integration and enhance patient care delivery, allocated at no less than $25,000 per year.
Applicants should be committed to increasing diversity in health professions programs and the health workforce. This commitment helps ensure, to the extent possible, that the workforce reflects the diversity of the nation. Programs should develop the competencies and skills needed for cross-cultural understanding and expand cultural fluency, recognizing that bringing people of diverse backgrounds and experiences together facilitates innovative and strategic practices that enhance the health of all people.
Diversity refers to the multiplicity of human differences among groups of people or individuals. Increasing diversity means enhancing an individual’s, group’s, or organization’s cultural competence; in other words, the ability to recognize, understand, and respect the differences that may exist between groups and individuals. Increasing diversity in the health care workforce requires recognition of many other dimensions including, but not limited to, sex, sexual orientation and gender identity, race, ethnicity, nationality, religion, age, cultural background, socio-economic status, disability, and language.”
