The Collaborative Care model (CoCM) adds two additional clinical staff members to the traditional primary care treatment team. In executing Collaborative Care, the CoCM treatment team must be staffed and trained in CoCM practices. It is also important that these team members are committed to providing team-based care.
The size of the CoCM caseload and characteristics of the patient population will determine the amount of dedicated behavioral health care manager (BHCM) and psychiatric consultant time that is necessary for CoCM implementation. As patients are enrolled in CoCM, the BHCM and psychiatric consultant will need to dedicate additional time to managing their caseload. The caseload size may also vary depending on the characteristics of the population. Vulnerable populations and those with low social support may require additional care management time. It is also possible that the clinic may need to limit the caseload size to ensure all patients can be proactively managed.
Who are the New Members of the Treatment Team?
Behavioral Health Care Manager
The BHCM plays a unique role in the CoCM treatment team. These responsibilities include liaising with the primary care provider and psychiatric consultant and proactively following up with the patient. The BHCM should have an educational background in nursing, social work, or equivalent behavioral health training and licensure, and should be enthusiastic about practicing team-based care.
The CHC may need to reassign a current staff member or hire a new staff member to this role. In determining potential candidates, the implementation team should consider the characteristics outlined in the job descriptions. While the educational background is important, many clinical skills can be learned. Therefore, the CHC should also consider the soft-skills of each candidate. The document below includes a brief job description, a comprehensive job description, and a job description developed by the University of Washington Advancing Integrated Mental Health Solutions (UW-AIMS) Center. These resources may be adapted to the specific needs of each CHC.
The psychiatric consultant will initially dedicate 1-2 hours per week to perform panel review(s) with the BHCM. Dedicated psychiatrist time is dependent on the acuity of the patient population, clinic and patient panel size, and BHCM FTE. As more patients are enrolled in CoCM, the psychiatrist may need to dedicate additional time for panel reviews and curbside consultations.
If the CHC is not associated with a psychiatrist, a psychiatric consultant will need to be identified, contracted to provide services, credentialed to practice in the clinic, and licensed to use the electronic health record (EHR) and/or patient registry. The resources below will support this process.
What Training is Recommended to Practice CoCM?
All CoCM treatment team members and clinic support staff should receive training in the clinical model and be advised on new clinical workflows. Training will vary by the role of the staff and involvement in the model.