Integrated primary and mental health care: Evaluating a nurse-managed center for clients with serious and persistent mental illness
- Judith McDevitt,
- Susan Braun(corresponding author),
- Margaret Noyes,
- Marsha Snyder,
- Lucy Marion
- University of Illinois at Chicago,
- Medical College of Georgia
Scholary Output:
Contribution to journal
Review article
Peer-reviewSustainable Development Goals
SDG 3 Good Health and Well
Abstract
Nurse-managed centers have been at the forefront of providing ambulatory care alternatives for underserved populations lacking access to care. Following this model, the Center for Integrated Health Care of the College of Nursing at the University of Illinois in Chicago delivers primary and mental health care services to a population of people with serious and persistent mental illness. The authors' experience illustrates the many rewards and challenges that nurse-managed centers face. This article describes their center's model of integrated care, examines selected performance indicators, and discusses the implications, opportunities, and challenges ahead.
Publication Information
Output type
Scholary Output:
Contribution to journal
Review article
Peer-reviewOriginal language
English (US)Pages from-to (Number of pages)
Pages 779-790 (12 pages)Journal (Volume, Issue Number)
Nursing Clinics of North America (Volume 40, Issue 4)Publication milestones
- Published - 12/2005
Publication status
Published - 12/2005
ISSN
0029-6465Publication IDs
- Scopus: 28444431562
- PubMed: 16324951
Publication metrics
Metrics
SciVal
FWCI
0.92
SciVal
Author count
5
SciVal
citations
11
SciVal
Paper percentile
62
Fractional count
1
Fractional count
0.20
Fractional count
4
Fractional count
0.80
Fractional count
1
Fractional count
1
PlumX, opens in new tab
Captures
43
Citation count
15
Funding Details
This work was supported by the Division of Nursing, Bureau of Health Professions, Health Resources and Services Administration, US Department of Health and Human Services, Grant #D11HP00152-05-00, and The Robert Wood Johnson Foundation, Local Initiative Funding Partners Program.
Although the IHC is too small and would face obstacles as an academic entity in becoming an FQHC itself, partnering with an FQHC could be a viable means to provide for future sustainability. In 2004, IHC partnered with a CHC affiliated with the University of Illinois at Chicago. This is the first step toward fully realizing the potential of FQHC partnership to enable most if not all of encounters to be reimbursed at FQHC rates. As was shown in the Table 3 projections, FQHC reimbursement mechanisms could provide greater than 70% of funding by fiscal year 2006 to 2007 if the necessary partnerships can be made. If successful, IHC would be on its way to financial security. Significant, positive factors operating are that Thresholds is supporting and assisting the IHC in these efforts. The center's unique mission of serving people with SPMI has attracted substantial funding over the years, including the current funding from The Robert Wood Johnson Foundation's Local Initiative Funding Partners Program. This award was made possible because Thresholds raised the required matching funds. It includes FQHC partnership among its goals.
The growth of the client base also warrants attention. Trends in the total number of clients, the number of new clients, the total number of visits, and visits per clinic day may indicate that the IHC clinic sites were reaching capacity by 2003 to 2004 given staffing levels, practice efficiencies, patient use patterns, and marketing outreach. As Table 1 indicates, volume was stabilizing at about 4500 visits, 600 clients, and a declining percentage of new clients each year. A significant expansion is underway with the “Doorway to Integrated Health Care” initiative funded by The Robert Wood Johnson Foundation's Local Initiative Funding Partners Program. The main goal of this award is to offer services to all clients of Thresholds from 2004 to 2007, thus expanding IHC's client base and generating more visits.