Table 2. Characteristics and Descriptions of Advancing Care Together (ACT) Innovations
IDPatient Screening TypeDirect Staff FTENew Hires for InterventionLarge-Asset Investment (IT/Space Build-Out)
Description: CMHC developed a new integrated care clinic; this included building a new facility and bringing on a primary care team. Systematic screening is accomplished via a Web tablet at check-in. The practice developed a Health Tracker that extracts selected information from two separate behavioral health and medical EHRs to provide information about patients' behavioral and physical health needs at the point of care.
16Systematic20 to 50NoNo/no
Description: A research team is working with an FQHC with an onsite behavioral health provider and patient navigators to develop a screening tool that assesses patients' behavioral health needs and treatment preferences. Clinic and research staff implemented this tool with the goal of establish consistent screening and referral of patients to their preferred treatment.
18Clinician discretion>50YesNo/yes
Description: This was a partnership between a FQHC system, a substance abuse treatment center and a CMHC. The CMHC was the site of the intervention. A team that included a physician's assistant, medical assist, care coordinator, and substance abuse counselor moved among three CMHCs to make primary care and substance use services available to patients at each site.
14Clinician discretion20 to 50NoNo/no
Description: This system colocated behavioral health providers in primary care clinics to provide patients with solution-focused interventions and to facilitate referral to other organizational resources (eg, long-term therapy, case management). Behavioral health providers also provided some consultations to medical clinicians upon request.
Description: Privately owned primary care practice partnered with a CMHC to hire, train, and supervise a colocated behavioral health provider. Practice also expanded its health coach services. Practice systematically screened patients at check-in using paper based tool with follow-up screening administered by Medical Assistant during intake, as needed. Patients connected with behavioral health provider or health coach, as needed.
Description: Privately owned primary care practice automated behavioral health screening by implementing web-tablets at check-in. The practice worked with information technology partners to develop coding necessary to integrate data into their EHR, and hired and colocated a psychologist to address patients' needs. They continue to expand their behavioral health staff.
12Clinician discretion<20NoNo/no
Description: FQHC increased screening and behavioral health services for newly identified pregnant women by adding a psychology fellow who screened patients, offered brief therapy, and followed up with patients as needed. All eligible patients received a followup screen at 6 weeks postpartum.
4Systematic20 to 50YesNo/no
Description: A postdoctoral psychology training program partnered with an FQHC serving seniors to implement an enhanced, computerized cognitive and psychological screening. The team implemented and tracked clinical use of the screening, provided a summary report to clinicians, and followup treatment to patients as requested
Description: Solo, privately owned primary care practice partnered with CMHC to embed a behavioral health provider into the practice. The practice systematic screened patients at check-in and intake. Behavioral health provider delivered therapy to patients most with poorly controlled chronic diseases, and most in need of services.
13Clinician discretion20 to 50NoNo/no
Description: Privately owned family practice collaborated with a privately owned behavioral health center to integrate care. A behavioral health provider was colocated in the primary care practice. The behavioral health center expanded services into the family practice by delivering trainings on integration, colocating a behavioral health provider to increase consultations and warm handoffs, and implementing systematic screening.
  • CMHC, community mental health center; EHR, electronic health record; FTE, full-time equivalent; IT, information technology.