We at Div. 31 understand that innovative integrated care work goes on at the state level, but often this work is unknown outside of the state. Instead of reinventing the wheel, we invite states to take advantage of these resources as part of our Division 31 State Toolkit for Integrated Care. This toolkit serves as a resource to members seeking to develop integrated care practices in their state. It will be updated on a semiannual basis.
State Toolkit for Integrated Care
Outcome Measurement and Demonstrating Value
- The Advantages of Providing Psychological Services in Primary Care Pediatrics: a two-page handout useful for pediatrician offices or advocacy (PDF)
- Added Value: Psychological Services in Pediatrics: a four-page handout useful for pediatrician referrals or advocacy (PDF)
- Adding Value in Pediatric Health Care: PowerPoint by Doug Tynan, PhD (PDF, 678KB)
- Behavioral Health Services in Primary Care: a four-page handout from APA describing integrated care and collaborative care models (PDF)
- CPC+ Behavioral Health Menu of Options from CMS (2017) (PDF)
Specific State Legislative Language and Strategies
COVID-19 Resources and State Responses
- American Psychological Association COVID-19 resources
- Maintaining integration in a COVID-19 world: blogpost by Paul T. Korte, PhD, April 22, 2020.
- SPTAs responses to the COVID-19 pandemic: blogpost by Kathleen Ashton, PhD, ABPP, June 15, 2020.
- Telehealth guidance by state during COVID-19
State Legislative Language for Integrated Care
- APA Division 31 Best Practices for States: Integrated Care and Psychology Advocacy: describes integrated care victories and strategies for state psychological associations.
- Missouri: Legislative Language Supporting Use of Health and Behavior Codes for State Medicaid Patients: 208.152 subsection 14:
Beginning July 1, 2016, and subject to appropriations, providers of behavioral, social and psychophysiological services for the prevention, treatment or management of physical health problems shall be reimbursed utilizing the behavior assessment and intervention reimbursement codes 96150 to 96154 or their successor codes under the Current Procedural Terminology (CPT) coding system. Providers eligible for such reimbursement shall include psychologists. Missouri H & B Code language.
- Delaware has a current bill to implement annual mental health wellness visits
- Health and Behavior CPT Codes: A Model of Legislative Advocacy: PowerPoint by Paul Korte, PhD, 2019 (PDF, 56KB)
- Minnesota: Extending collaborative care codes to psychologists
- Minnesota: Overview of a State Statute That Extends the Collaborative Care Codes Beyond MDs and Prescribing APPs to Include Psychologists, LICSWs, LMFTs as well
- Minnesota legislative language on collaborative care codes including psychologists
Subd. 48. Psychiatric consultation to primary care practitioners. Medical assistance covers consultation provided by a psychiatrist, a psychologist, an advanced practice registered nurse certified in psychiatric mental health, a licensed independent clinical social worker, as defined in section 245.462, subdivision 18, clause (2), or a licensed marriage and family therapist, as defined in section 245.462, subdivision 18, clause (5), via telephone, e-mail, facsimile, or other means of communication to primary care practitioners, including pediatricians. The need for consultation and the receipt of the consultation must be documented in the patient record maintained by the primary care practitioner. If the patient consents, and subject to federal limitations and data privacy provisions, the consultation may be provided without the patient present.
- Brief diagnostic assessment from Minnesota statute
- Brief Diagnostic Assessment-DHS manual
The Minnesota Psychological Association to change the requirements for a diagnostic assessment (90791). The Minn. state law was changed to reduce the requirements for a “brief” diagnostic assessment in order to be more applicable to primary care. The “brief” is now much briefer and able to be completed in a 30-minute PCBH visit.
- Oregon: Comprehensive Integrated Care Legislation/Behavioral Health Home Senate Bill 832
- Vermont: state blueprint for integrated care
- Integrated care model in Vermont
- OneCare Vermont selected for national multisite demonstration for advancing integrated care models for people with complex needs. Newspaper article describing integrated care model in Vermont.
- Statewide Approach to Behavioral Health Integration — Delaware's Perspective: Powerpoint by Traci Bolander PsyD 2019 (PDF, 701KB)
- Medicaid Workshop Convention 2019 (PDF, 740KB)
Innovative pilot project launched in 2018 by APA and the D.C. Psychological Association. Placed supervised psychology trainees in two primary care offices serving the D.C. Medicaid population (Summer 2018). Supervised services provided by interns and a postdoctoral fellow were reimbursed by a Medicaid managed care organization (MMCO).
Racism Pandemic and State Responses
Resources for graduate students and early career psychologists
- The Society for Health Psychology is pleased to offer an introductory primary care psychology curriculum for use in educating psychology graduate students, interns and postdoctoral fellows. The course is free for use by training programs.
- Developing a Competent Integrated Care Workforce. Training Partnerships in Oregon: PowerPoint by Roseann Fish Getchell, PsyD (PDF, 1.2MB)
- Securing a Job in Integrated Primary Care: Tips, Tricks, and Other Helpful Info (PDF, 410KB)
Resources for post graduate training in integrated care/mid-career psychologists
- APA’s Pain Management and Opioid Crisis Initiative By Kathleen Ashton, PhD, ABPP
- Progress Notes Podcast: Integrated Care: Benefits for Patients and Practitioners. Psychologists immersed in integrated health care describe the benefits and challenges to seeing patients in a primary care setting.
- OPA / APA Ohio Summit on Psychological Pain Management Services - CE Event
- University of Massachusetts Center for Integrated Primary Care. Offers online training and certificate in primary care behavioral health.
- Cherokee Health Integrated Care Training Academy. Offers six trainings per year on integrated care model in Knoxville, Tenn.
- Introduction to Integrated Primary Care CE Course
- SAMHSA Center for Integrated Health Solutions
- Farleigh Dickinson certificate program for integrated primary care (PDF)
Links to telehealth trainings
Getting Paid: Insurance Advocacy, CPT, RVUs
Health and behavior codes
- Health and Behavior Assessment and Intervention CPT Codes Crosswalk (PDF)
- 2020 Health Behavior Assessment and Intervention Services CPT Code Descriptions (PDF)
- 2020 Health Behavior Assessment and Intervention Services Proposed Relative Value Units (RVU) (PDF)
- Health Behavior Assessment and Intervention Website
- Mini Webinars on using 2020 HB Codes
- States that Accept Medicaid for H & B Codes (2017).
Productivity standards for integrated care psychologists working in systems
- Psychological Services Mental Health Productivity Monitoring in the Veterans Health Administration: Challenges and Lessons Learned, Lisa K. Kearney, Clifford Smith, Daniel R. Kivlahan, Robert C. Gresen, Eileen Moran, Mary Schohn, Jodie Trafton and Antonette M. Zeiss
- Letter from American Academy of Pediatrics: regarding reimbursement of CPT 96127 Brief assessment (PDF)
Blog posts on integrated care and value
Innovative practice models — enhanced co-location
- Enchanced Co-location Model: PowerPoint presented at APA convention, August 2019 by Kevin Arnold, PhD (PDF, 67KB)
- The Role of SPTAs in Dissemination and Training for Co-Located Care: PowerPoint by Kathleen Ashton, PhD, APA convention 2019 (PDF, 303KB)
- APA and LRA's Work Around Innovative Practice Models: PowerPoint by Shirley Higuchi, JD, at APA convention 2019 (PDF, 74KB)
Ethics and Integrated Care
- Integrated Care: Ethics for Psychologists in Hospital Settings: blogpost by Kathleen Ashton, PhD, August 2016
- Summary of Considerations for APA Ethical Standards Revision by Integrated Care Ethics Workgroup 2019 (PDF)
- Ethics and confidentiality for psychologists in academic health centers (Ashton & Sullivan 2018)
- Special ethical considerations for behavioral health consultants in the primary care setting. (Fivecoat eet al 2017)
- Patient and provider relationships: Consent, confidentiality, and managing mistakes in integrated primary care settings. (Hodgson et al., 2013)
- Ethical challenges unique to the primary care behavioral health model (PCBH). Runyan et al., 2018)
- Navigating the legal and ethical foundations of informed consent and confidentiality in integrated primary care. (Hudgins 2013)
- Ethical matters in rural integrated primary care settings. (Mullin & Stenger 2013)
- American Psychological Association Ethics Code
Integrated Care Policies
Practical Tools (Brief Blog Posts and Videos)
- VA Psychologist Experience in Integrated Care: blog post by Paul Korte, PhD, 2019.
- Behavioral Health Consultation vs. Traditional Psychotherapy: What's the Difference?: blog post by Natalie Pileplenko, PhD.
- Blog post: Professional Etiquette for the Integrated Care Psychologist by Kathleen Ashton, PhD.
- Supervision in Integrated care: blog post, Kathleen Ashton, PhD (PDF, 68KB).
- Integrated Care Lessons for Those Starting Out: blog post by Kathleen Ashton, PhD (PDF, 94KB).
- Top 10 Ways the Integrated Care Psychologist Can Combat Provider Burnout: blog post by Kathleen Ashton, PhD.
- Integrated Care and Social Media: blog post by Kathleen Ashton, PhD.
- How to Take a Vacation as an Integrated Care Psychologist: blog post by Kathleen Ashton, PhD (PDF, 104KB).
- Work Life Balance in Integrated Care: blog post by Kathleen Ashton, PhD (PDF, 142KB).
- Incorporating Work Life Balance Into the Workplace: blog post by Kathleen Ashton, PhD (PDF, 139KB).
- Advantage and Challenges of Working in Institutions (such as hospital setting): blog post by Kathleen Ashton, PhD (PDF, 27KB).
- Integrated Care Resources and Videos from APA Practice