Working with Primary Care / FQHCs

WEBINAR - Working Together: FQHCs and Community Behavioral Health Organizations 
Presentation materials and a recording of the National Council's webinar on working with FQHCs is available online.

The webinar generated over 261 questions from participants.  Since the webinar we have been organizing the questions into five categories:  General Administration; Financing; Partnership Creation, Information Technology and Clinical Issues.  Respondses to your questions are now available in a new Q&A Fact Sheet. Make sure to check back for updates to the fact sheet.

Scope of Project
HRSA Policy Information Notice (PIN) 2008-01on Defining Scope of Project and Policy for Requesting Changes. The PIN defines scope of project requirements for FQHC.

*Also see PIN 09-03 for an update to scope of practice requirements defined in PIN 2008-01.

Affiliation Agreements
HRSA Policy Information Notice (PIN)  97-27 on Affiliation Agreements of  Community and Migrant Health Centers. The PIN explains affiliation policy requirements for an FQHC to partner with a community behavioral health organization.

*Also see PIN 98-24 for an update to PIN 97-27 on the review process for determining whether affiliation arrangements are in compliance with PIN 97-27. 

Initial Lessons From the First National Demonstration Project on Practice Transformation to a Patient-Centered Medical Home
Nutting, Paul, et al. (2009). Ann Fam Med 2009; 7: 254-260.
The article describes six early lessons from the National Demonstration Project and offers four recommendations for assisting the transformation of primary care practices. 

County-Based PC/BH Collaboration Tool Kit

The Kit was developed by the Integrated Behavioral Health Project, an initiative of The California Endowment and the Tides Center, to help primary care clinics and government mental health agencies forge collaborative relationships.  Though the focus is on California counties, much of the 180-page Kit can be generalized to other locales.
 

Contracts and MOUs

Sample MOU between CMHC and Primary Care Clinics for Integrated projects.
Sample Partnership Agreement between CMHC and FQHC
Sample Affiliation Agreement between CMHC and FQHC

Enhancing the Continuum of Care: Integrating Behavioral Health and Primary Care through Affiliations with FQHCs 

A new National Council fact sheet provides important considerations to help guide the development of affiliation agreements among partnering Community Behavioral Health Providers and Federally Qualified Health Centers (FQHCs).  As community providers increasingly collaborate to provide clients with comprehensive and integrated primary and behavioral health services, written agreements can help to demonstrate compliance with various federal and state laws, regulations, and guidance that guide FQHCs.
 

The Do's and Don'ts of Contracting for Behavioral Health Services

This information bulletin from the National Association of Community Health Centers provides information for community health centers to procure behavioral health services for their patients from another community-based provider. This bulletin explores the definition and key elements of a procurement (or “purchase of services”) contract; addresses specific federal requirements and standards that must be observed when executing the procurement arrangement; and provides common contractual terms that should be included in all agreements.

Cultural Issues

"Resolving Differences Between Behavioral Health and Primary Care Cultures", Presentation by Beth Wrobel, and Bob Franko at the National Council's 2009 Conference. 

Training Community Mental Health Center Staff to Work in Primary Care

Access recordings and presentations from our recent webinar series on "Training CMHC Staff to Work in Primary Care." 

• Part 1: Getting Started-On-the-Job-Training and Preparing Behavioral Health Staff to Work in Primary Care,  
• Part 2: Relationships: The Behavioral Health Consultant, Primary Care Physician, and Psychiatrist
• Part 3: Warm Handoffs.   
   

Confidentiality

Organized Health Care Delivery System - HIPAA Reference
Behavioral health and primary care organizations can share information under this section of the HIPAA law.
OHDS HIPAA Reference

Confidentiality Diagram
This one-page document outlines four levels of HIPAA compliance and the tools necessary to protect your organization. **For a contextual description of the diagram, see "Raising the Bar" by Kathleen Reynolds. Diagram

42CFR and HIPAA
The Confidentiality of Alchohol and Drug Abuse Patient Records Regulations and the HIPAA Privacy Rule: Implications for Alcohol and Substance Abuse Programs, provides valuable information for behavioral health providers seeking guidance on patient confidentiality issues.

Sample: HIPAA Business Associates Agreement

Sample: Integrated Mental Health/Substance Abuse and Primary Care Confidentiality Policy. This policy designed for the state of Michigan addresses HIPAA, 42CFR and Michigan specific privacy policies. Individuals from other states need to edit in order to meet their state guidelines.

Sample: Legislation passed by Washington State to amend their state privacy laws in support of primary and behavioral health collaboration.

Job Descriptions

Sample Nurse Care Manager

Consulting Psychiatrist (Source: IMPACT)