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Implementation of a Reverse Colocation Model: Lessons from Two Community Behavioral Health Agencies in Rural Pennsylvania

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Abstract

This qualitative study examined the implementation of a reverse colocation pilot program that sought to integrate medical care in two community behavioral health agencies. To accomplish this, each agency hired a registered nurse, provided training for its staff to function as wellness coaches, and implemented a web-based tool for tracking consumer outcomes. The findings from two rounds of stakeholder discussions and consumer focus groups suggested that agencies successfully trained their staffs in wellness coaching, integrated nurses into agency functions, developed integrated care planning processes, and increased awareness of wellness among staff and consumers. Similar to other complex interventions, the agencies experienced challenges including difficulty establishing new procedures and communication protocols, discomfort among staff in addressing physical health concerns, difficulty building collaborative relationships with primary care providers, and modest uptake of the web-based tool. The study offers insights into the practical aspects of integrating care and makes recommendations for future efforts.

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Acknowledgments

This work was funded by the U.S. Department of Health and Human Services Office of the Assistant Secretary for Planning and Evaluation. The authors acknowledge the efforts of the project officers: Hakan Aykan and David DeVoursney. They also thank the staff and consumers at the behavioral health agencies for sharing their experiences and colleagues Randall Brown and Crystal Blyler who reviewed drafts and provided thoughtful comments.

Conflict of interest

The authors report no competing interests.

Author information

Authors and Affiliations

  1. Mathematica Policy Research, P.O. Box 2393, Princeton, NJ, 08543-2393, USA

    Angela M. Gerolamo PhD, APRN, BC & Jung Y. Kim MPH

  2. Mathematica Policy Research, 1100 1st Street NE, 12th Floor, Washington, DC, 20002-4221, USA

    Jonathan D. Brown PhD

  3. Thomas Jefferson University School of Nursing, 130 South 9th Street, Philadelphia, PA, USA

    Angela M. Gerolamo PhD, APRN, BC

  4. Community Care Behavioral Health Organization, University of Pittsburgh Medical Center Insurance Division, Pittsburgh, PA, USA

    James Schuster MD, MBA

  5. Center for High-Value Health Care, University of Pittsburgh Medical Center, Pittsburgh, PA, USA

    Jane Kogan PhD

Authors
  1. Angela M. Gerolamo PhD, APRN, BC
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  2. Jung Y. Kim MPH
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  3. Jonathan D. Brown PhD
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  4. James Schuster MD, MBA
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Corresponding author

Correspondence to Angela M. Gerolamo PhD, APRN, BC.

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Gerolamo, A.M., Kim, J.Y., Brown, J.D. et al. Implementation of a Reverse Colocation Model: Lessons from Two Community Behavioral Health Agencies in Rural Pennsylvania. J Behav Health Serv Res 43, 443–458 (2016). https://doi.org/10.1007/s11414-014-9423-x

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  • DOI: https://doi.org/10.1007/s11414-014-9423-x

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