1. Clarify Overlapping and Distinct Goals

• PCBH is designed for population-based, real-time behavioral health integration within primary care, emphasizing immediate access and brief interventions.
• CCBHCs focus on comprehensive behavioral health services, ensuring 24/7 crisis care, care coordination, and a broader continuum of behavioral health treatment.
• Aligning these frameworks means recognizing where each excels—PCBH for integrated, stepped-care inside primary care and CCBHCs for more structured mental health and substance use disorder treatment.

2. Leverage the CCBHC Funding to Enhance PCBH Capacity

• Many FQHCs implementing CCBHC find that the funding supports hiring additional behavioral health staff, expanding crisis services, and improving data tracking—all of which can also reinforce the PCBH model.
• Use CCBHC grant resources to embed BHCs more effectively in primary care, ensuring a seamless bridge to specialty services when needed.

3. Enhance Care Coordination Across Both Models

• Establish workflows that integrate care coordination efforts between PCBH teams and CCBHC case managers to ensure smooth transitions between brief interventions in primary care and longer-term behavioral health services when necessary.
• Develop shared documentation and communication practices that support continuity of care without creating duplicative efforts.

4. Address Workforce Challenges

• Given that both models require skilled behavioral health professionals, focus on cross-training clinicians in both brief interventions (PCBH) and more intensive services (CCBHC).
• Consider a tiered approach where generalist BHCs work within primary care while specialists manage higher-acuity cases through the CCBHC framework.

5. Leverage Technology and Data

• Implement measurement-based care tools that work across both systems to track patient outcomes and demonstrate effectiveness.
• Use shared electronic health record (EHR) features to enable smooth referrals and tracking of patient progress between primary care and specialty behavioral health services.

6. Communicate a Unified Vision to Staff and Leadership

• Staff may perceive PCBH and CCBHC as competing priorities; leadership should clarify that they are complementary strategies that enhance patient access to the right level of care at the right time.
• Regular training and team huddles can reinforce collaboration and clarify roles.

7. Culture, culture, culture!

• Most importantly, do not create multiple sub-cultures in the same organization. Ensure that you engage in culture-building across the FQHC to maintain the primary care focus. Even the CCBHC work should be seen through the lens of supporting the population-based work of the primary care teams.

References

Reiter, J. T., Dobmeyer, A. C., & Hunter, C. L. (2018). The Primary Care Behavioral Health (PCBH) Model: An Overview and Operational Definition. Journal of clinical psychology in medical settings, 25(2), 109–126. https://doi.org/10.1007/s10880-017-9531-x