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Integrated Health Care • Grant Program
The Hogg
Foundation for Mental Health launched its Integrated Health Care
Initiative grant program in April 2006 with the announcement of
the five organizations selected to spearhead the effort. The grantees
will receive more than $2.6 million over three years to promote
the effective identification and treatment of mental health problems
in primary care settings.
The five organizations
funded through this initiative will adopt the collaborative care
model and address barriers to implementation that they encounter.
Collaborative care is an integrated health care approach in which
primary care and mental health providers partner to manage the treatment
of persons with mental health problems in the primary care or pediatric
setting. Two decades of research have demonstrated that the collaborative
care model improves primary care patients' mental health outcomes
with a minimal investment of resources.
The five grantee
organizations will work closely with the Foundation and various
expert consultants throughout the three-year period as they implement
the collaborative care model and address the barriers that arise
along the way. The Foundation will provide grantees with a variety
of resources and technical assistance to help them achieve their
goals.
Integrated
Health Care Grantees
Parkland Health
and Hospital System
People's Community
Clinic
Project Vida Health
Center
Texas Children's Pediatric
Associates
Valley Primary Care
Network
Collaborative
Care Training
Program Evaluation
Learning Community
Kick-Off
Meeting
Integrated Health Care Grantees
The
five grantee organizations were selected through a competitive proposal
review process in which Foundation staff and a national panel of
collaborative care experts evaluated applicants' proposals for implementing
the collaborative care model and addressing barriers that arise
in the process. The awardees clearly demonstrated their commitment
and readiness to adopt the model, as well as their understanding
of the types of problems they are likely to encounter in the process.
The Foundation's
Integrated Health Care Initiative grantees are:
Parkland
Health and Hospital System
Parkland Health and Hospital System in Dallas received a grant
of $576,634 over three years to implement the collaborative care
model in two of its Community Oriented Primary Care (COPC) clinics
Bluitt-Flowers Health Center and East Dallas Health Center.
The clinics will use these funds to provide treatment to adults
with depression.
An internationally
recognized medical system, Parkland Health and Hospital System
was established in 1894 to meet the health care needs of poor
and medically indigent patients in Dallas County. In 1987, Parkland
launched COPC, a model designed to improve the health of underserved
individuals through accessible primary care and health promotion
programs.
The Bluitt-Flowers
COPC provides services to one of the poorest areas of the county,
and the East Dallas COPC is located in a federally designated
Medically Underserved Area. Both COPCs primarily serve Medicaid
and "charity" patients. Building on the COPCs' existing integrated
health care efforts, the IHC Initiative will enable the clinics
to expand the scope of mental health services offered and deepen
the collaboration between physical and mental health providers.
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People's
Community Clinic
A grant of $275,255 over three years was awarded to People's Community
Clinic (PCC) in Austin to treat adults with various mental health
problems in partnership with Austin Travis County Mental Health
Mental Retardation Center.
One of the
oldest, continuously running clinics in the country, PCC has never
wavered from its mission to improve the health of medically underserved
and uninsured Central Texans by providing high quality, affordable
health care.
At PCC, the
primary care team directly engages the patient, using a preventive
health care model. Through the IHC Initiative, PCC will expand
upon its extensive record of providing effective, comprehensive
primary care to interface mental health intervention with primary
care service delivery.
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Project
Vida Health Center
Project Vida Health Center (PVHC) received a grant of $373,104
over three years to treat mental health problems in adults and
children in its three El Paso clinics. This faith-based Federally
Qualified Health Center will partner with Family Services of El
Paso and El Paso Mental Health Retardation for the initiative.
PVHC serves
low-income families and is annually reviewed and evaluated by
a Community Congress of over 100 community residents. With clinic
sites in East Central and Northeast El Paso, PVHC provides a full
spectrum of primary care services. The area is a federally designated
Medically Underserved Area and Health Personnel Shortage Area.
Since its
founding, PVHC has been recognized with numerous awards from both
local and national organizations, including the Health Resources
and Services Administration and the Department of Health and Human
Services' Office of Minority Health.
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Texas
Children's Pediatric Associates
Through a partnership with Texas Children's Hospital, Texas Children's
Pediatric Associates (TCPA) will use its grant of $306,570 over
three years to treat children with attention-deficit hyperactivity
disorder in its Ripley clinic, located in Houston's East End.
TCPA, a non-profit
pediatric group practice, is a wholly owned subsidiary of Texas
Children's Hospital. It is the country's largest group of general
pediatricians, providing a medical home to approximately a quarter
of Houston's children.
Of all Houston's
neighborhoods, TCPA-Ripley's service area is home to the poorest
population with the lowest educational level. TCPA-Ripley will
use its IHC Initiative grant funding to provide care for the clinic's
growing population of pediatric patients diagnosed with attention-deficit
hyperactivity disorder who lack access to mental health services.
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Valley
Primary Care Network
Based in Harlingen, Valley Primary Care Network (VPCN) received
a grant of $1,138,184 over three years to bring the collaborative
care model to its four constituent community health centers
the Brownsville Community Health Center, Community Action Council
of South Texas, Nuestra Clinica del Valle, and Su Clinica Familiar.
The clinics will partner with Tropical Texas Center for Mental
Health and Mental Retardation to treat a range of mental health
problems in children and adults.
VPCN's mission
is to establish a health care delivery network that achieves a
seamless continuum of quality comprehensive health care, with
a focus on increasing access to health care and decreasing disparities
in health conditions.
VPCN's four
community health centers provide a spectrum of primary health
care services to the low-income, underserved people of the Rio
Grande Valley. The vast majority of residents are Latino with
varying degrees of acculturation and English proficiency. Although
the Valley comprises both urban and rural communities, much of
its population resides in the poor, rural settlements called colonias.
Through the IHC Initiative, VPCN's health centers will provide
mental health services to the Valley for the first time.
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Collaborative
Care Training
While
most of the grantee organizations have experience with integrated
health care in some form, none had experience with collaborative
care. To support their adoption of the model, the Foundation has
contracted with Dr. Jurgen Ünutzer, Vice-Chair of Psychiatry at
the University of Washington School of Medicine, and his University
of Washington colleagues to provide training and consultation throughout
the grant period.
Dr. Ünutzer
and his colleagues have over 20 years of experience with implementing
and researching collaborative care, including the highly successful
IMPACT (Improving Mood-Promoting Access to Collaborative Treatment)
Study. Dr. Ünutzer's group provides collaborative care training
to organizations around the country.
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Program
Evaluation
With
the grant program's focus on implementation issues, an evaluation
of the process that grantees go through in implementing collaborative
care and identifying and addressing barriers is essential to the
initiative's success. The evaluation's findings will also shed light
on patient outcomes, staff satisfaction with the model, and cost-effectiveness.
The Foundation
has contracted with Dr. Richard Frank, the Margaret T. Morris Professor
of Health Economics at Harvard University, to conduct the evaluation.
Dr. Frank will partner with Dr. Howard Goldman, Director of Mental
Health Policy Studies at the University of Maryland School of Medicine,
and Ms. Brenda Coleman-Beattie, a Texas behavioral healthcare management
consultant, for the program evaluation.
The evaluation
team has extensive experience in mental health services research.
The team will conduct a process and outcome evaluation of the grant
program. Taking a formative approach, the team will use the evaluation
results to provide feedback to both the grantees and the Foundation
throughout the grant period.
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Learning
Community
Foundation
staff and the grantees' project teams will come together regularly
throughout the grant period both in person and through teleconferences
to discuss success and challenges encountered. Through these regular
points of connection, the Foundation and grantees will create a
learning community.
The learning
community approach will maximize learning between grantees, while
helping the Foundation gather information for dissemination to other
foundations, primary care providers, mental health providers, and
other stakeholders in integrated health care.
Kick-Off
Meeting
A
meeting to kick off the Hogg Foundation for Mental Health's Integrated
Health Care Initiative grant program was held in Austin on June
28, 2006.
Thirty-seven
people attended the day-long kick-off meeting, including representatives
of the five grantee organizations, the evaluation team, the collaborative
care trainers, and Hogg Foundation staff.
The following
materials from the meeting are available:
Meeting
Agenda (PDF)
Presentation
on the IHC Training by Jurgen Unutzer and Richard Veith
PowerPoint
Presentation (PPT)
Presentation
on the IHC Evaluation by Richard Frank and Brenda Coleman-Beattie
PowerPoint
Presentation (PPT)
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