North Carolina Medicaid Uses Task Force Recommendations to Merge Physical and Mental Health Care

Community Care of North Carolina, a Medicaid quality improvement program of the State's Office of Rural Health, is using U.S. Preventive Services Task Force recommendations in a pilot program. The program is using integrated models of care in which physical and mental health care are being merged in primary care settings.

The State used the Task Force recommendations to develop its database and outcome measures for the project, which is being piloted in several North Carolina communities.

According to Susan Davis, RN, CCM, Network Coordinator, Community Care of Wake and Johnston Counties, "One of the program's requirements was that any tools or outcomes measured must be evidence-based. Therefore, we used the recommendations specified in AHRQ's Guide to Clinical Preventive Services."

Elizabeth Tilson, MD, MPH, Medical Director, Community Care of Wake and Johnson Counties, explains, "As some of our data collection points, we are using the Task Force recommendations to follow the activities of the physical health provider integrated into mental health settings."

The State developed an Access database, using the Task Force recommendations, to collect data on health screenings for each practice. "This also creates a common database and set of expectations across the State," notes Davis.

Some of the data collected includes the following:

• Blood pressure.
• Cholesterol.
• Health risk counseling.
• Screenings for colorectal, cervical, and breast cancer, HIV, and other conditions.
• Three-, six-, and nine-month follow-up screenings and action plans.

The pilot program began in the fall of 2007. Health practitioners received copies of the Guide to Clinical Preventive Services at the start of the study.