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Innovations : carrollcountyintegration-behavioral

Clinical Innovations

Title: Carroll County Integration of Behavioral Health and Primary Health Care


Organization: Carroll County Health Department, Bureau of Addiction Treatment and Access Carroll  Inc. 

Innovation Type: Integrated Mental and Behavioral Health  

What They’re Doing: Integrating Mental and Behavioral Health with Primary Care    

Clinical Innovation: Patients receiving  recovery health treatment at Carroll County Health Department, Bureau of Addiction Treatment Services have had difficulty accessing primary care services on a timely basis. In order to increase access, the Bureau of Addiction Treatment Services hired a part-time nurse practitioner to see patients 8-12 hours a week at Access Carroll, a free primary care clinic. The nurse practitioner and  recovery health staff talk regularly about their shared patients’ needs and concerns to provide seamless care for the population. The patients seen by the Bureau of Addiction Treatment Services’ nurse practitioner are also able to utilize Access Carroll’s patient-centered clinical and non-clinical support services. The Nurse Practitioner gives scheduling priority to patients served by the Bureau of Addiction Treatment but also sees patients from the Access Carroll population when appointments are available.

Evaluation Type: Non-Experimental/ Qualitative Support 

Evaluation Plan: Tracking patient outcomes, patient access, and patient satisfaction.

At this time patient outcomes are largely anecdotal. Full integration is in the planning process with hopeful implementation by mid-2012, at which point the organization plans to evaluate on the basis of shared statistics and patient care outcomes gathered through the  electronic health record. Currently patients are surveyed annually through a Likert Scale Patient Satisfaction Survey in each core area of service. 

Patient Health and Cost Outcomes: The overall outcomes include improved recovery plan compliance, reduced recidivism, continuity of care in a patient-centered environment, and reduction of chronic disease exacerbations. Goals of the integration also include improved access to services at one central location and reduction in over utilization of costly acute care and emergency department services.  In large part, cost outcomes are yet to be determined in the areas of primary and chronic disease care, but directly indicate at least marginal if not significant reductions in cost due to reductions in utilization of high-cost and episodic care services. Cost outcomes for recovery services and recidivism are improved as a result of timely care access, medication and disease maintenance, and compliance with program requirements, that reduce the higher cost of initial intake services, parole violations, incarcerations, etc.  

Other Outcomes of Interest:  

  • Patients report improved access to care, greater satisfaction with coordinated care efforts, improved compliance with necessary program requirements or mandates (i.e. courts, parole, recovery plans, chronic disease care plans, etc.). Access to treatment is provided to substance abuse patients within 7 days of need with providers who are specially trained to offer addictions treatment.  

  • Providers report improved satisfaction for team-coordinated efforts of recovery services with primary care services. Providers have greater and improved access to collaborative care plans including medication and chronic disease management.    

Publications: None  

Date of Implementation: January 2009

Contact: Susan M. Doyle, RN, Director, Bureau of Addiction Treatment Services, 410-876-4800,

Tammy Black, RN, Executive Director, Access Carroll, 410-871-1478,

Multimedia: Pending

Where to learn more: Call or email the contacts listed above.


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