Audience: Administrator

Collaborative Care Workflow Guide

Successful Collaborative Care (CoCM) programs have a defined, detailed workflow that maps the patient journey from screening to the end of an episode of care. These workflows detail the five phases of an episode of CoCM. Each phase has a unique set of tasks tailored to the resources available at the site. These workflows should be accessible to those who use them and describe steps with sufficient detail.

Need help building your workflow?

Behavioral Health Care Manager Role and Job Description

The Behavioral Health Care Manager is responsible for coordinating and supporting mental health care within the clinic and for coordinating referrals to clinically indicated services outside the clinic. The Behavioral Health Care Manager may provide evidence-based treatments or work with other mental health providers when such treatment is indicated.

The job description below provides a comprehensive list of the duties and responsibilities required of a Behavioral Health Care Manager.

Psychiatric Consultant Role and Job Description

The Psychiatric Consultant supports the prescribing medical provider and Behavioral Health Care Manager in treating patients with behavioral health problems. They will typically consult with the Behavioral Health Care Manager on a weekly basis to review the treatment plan and provide treatment suggestions for patients who are new or not improving as expected.

The resource below includes a PDF of a comprehensive description of the duties, responsibilities, resource requirements and typical workload of a Psychiatric Consultant.

Create a Shared Vision for Collaborative Care

A shared organizational vision is a concrete way for team members within an organization to understand the purpose of a program. A powerful vision statement will stretch expectations and professional aspirations while helping staff step outside of their comfort zone. Visioning is an important process that provides focus and enables Collaborative Care (CoCM) teams to build a shared understanding of their common purpose and future goals.

Use the following guide (below) to facilitate the development of a shared vision of CoCM that maps onto existing behavioral health services. The document goes over why a shared vision is important and the steps that are required to create a shared vision within a CoCM framework.

Help Clinic Staff Talk with Patients About the PHQ-9

This tool is designed to help clinic support staff with answers to frequent questions they may hear from patients about the PHQ-9.

It’s best for support staff to have the opportunity to role play and practice before using the PHQ-9 with patients. It can also be helpful for support staff to keep this someplace where they can refer to it, as needed, when they get questions from patients.

Comparing Collaborative Care to Usual Care

Compared to usual care, Collaborative Care is shown to increase the effectiveness of depression treatment and lower total healthcare costs. This handout outlines those differences using data from the IMPACT trial.

Quick Guide on Bundled Payments for Behavioral Health Integration Services

The Centers for Medicare & Medicaid Services (CMS) announced Medicare payments for services provided by primary care providers for patients participating in a Collaborative Care program or receiving other behavioral health integration services. This handout summarizes the four AMA CPT® codes that can be used to bill for these services.

The payment structure may be used to treat patients with any behavioral health condition that is being treated by the billing practitioner, including substance use disorders.

Example Psychiatric Consultant Services Contract

An example of a Psychiatric Consultant services agreement between a Community Mental Health Center and a Federally Qualified Health Center for organizations that may be interested in contracting for Psychiatric Consult services.

Please note: Contract language and template example is provided with permission from Valley Cities Behavioral Health Care.

Behavioral Health Integration Services Fact Sheet

The Centers for Medicare and Medicaid Services have an updated fact sheet detailing codes that can be used to bill for behavioral health integration (BHI) and Collaborative Care Model (CoCM) services.