Every year or two a new description of an entire integrated primary care program is published that becomes an exemplar of the next step for many of the developing programs around the country. The latest example is Auxier, Farley and Seifert, (2011). Establishing an Integrated Care Practice in a Community Health Center. Professional Psychology: Research and Practice. Vol 42(5), Oct 2011, 391-397 describing the Salud Health Center in Colorado.
The Salud Family Health Centers is a federally qualified community health center consisting of 9 clinics covering 8 counties in North Central Colorado. The behavioral health team at Salud targets population based rather than disease specific approaches to care. Because each patient has their own list of co-morbidities, treatment approaches must be geared toward the whole person rather than the illness. At the Salud Center, their BHPs have a strong generalist training and are ready to provide on call services to physicians and patients. As a result of this on demand model, BHPs need be able to make connections with patients quickly, to formulate assessments after a relatively brief encounter and to communicate this effectively to the PCP in real time. In order to facilitate care within and across healthcare settings, the team at the Salud Centers developed a staged system wherein patients are identified for treatment in primary care or in specialty settings based on the acuity of need as well as the severity of illness.
No one model is a fit for every setting. Each setting needs to develop its own strategies to addressing the needs of its patients, but seeing a whole program described can be helpful for sites seeking to develop a program-wide rather than disease specific approach to integrated care.