Title: Implementation lessons: Integrating care from the prospective of primary care providers

Seriously mentally ill individuals have significant barriers to accessing primary health care, resulting in poor health status, increased morbidity and mortality, and overuse of emergency resources. PRICARe (Promoting Resources for Integrated Care and Recovery) is a collaborative project between three organizations which is designed to create a model for co-located, integrated primary care services for consumers currently receiving mental health services through a community mental health organization.

This paper addresses the implementation of primary care services into a community mental health facility from the perspective of the primary care providers. Challenges have included information management, obtaining medical history information, assessing the appropriate scope of practice for available resources, developing mechanisms for accessing supportive services such as specialty care, and resolving billing and coding issues in a non-primary care facility. Strengths of the implementation have been the positive reception of clients to co-located primary care, the ease of establishing medical practitioner-patient relationships, and the support and collaboration between case managers and the medical staff. Collaboration with case managers and mental health teams with whom individuals are already engaged has facilitated meeting individual patients' medical needs and follow-through on treatment plans. Examples of consultations between case managers and the PRICARe medical providers that have enhanced the medical providers' ability to best serve this population will be presented. The lessons learned in this innovative project are useful for future planning of co-located, integrated primary care and mental health services.