Sidebar: Challenges to Providing Services to North Carolina Veterans Who Have Traumatic Brain Injury

Abstract

ncmedicaljournal.com NCMJ vol. 72, no. 1 ncmedicaljournal.com 51 CareLine and with the North Carolina National Guard. The goal of promoting the behavioral and physical health of military families will be addressed with programs and evidence-based practices that support the families’ resilience and emotional health. The DMHDDSAS Practice Improvement Collaborative, managed by the Governor’s Institute on Alcohol and Drug Abuse, reviews and catalogues evidence-based practices designed to address the health care needs of this special group. The historic collaboration between LMEs and state hospitals has been expanded to include the VA, the University of North Carolina system, Area Health Education Centers and Community Care of North Carolina (CCNC), and the Center of Excellence for Integrated Care (CEIC). The DMHDDSAS will continue to work with SAMHSA’s national technical-assistance center to improve the quality of service delivered in North Carolina. CCNC provides managed primary care for Medicaideligible patients, under the guidance of the North Carolina Division of Medical Assistance. According to Michael Lancaster, director of behavioral health at CCNC, care managers help coordinate health care for military members, veterans, or family members who have Medicaid coverage. The CCNC case manager works cooperatively with the LME care coordinator to ensure that appropriate services are secured. North Carolina has worked to improve care for all of its citizens, including those who served the nation as a member of the military. One avenue of improvement is being investigated by the CEIC, whose work addresses the disconnection between mental health and physical health, a by-product of the US health-care system’s payment system. This disconnection has made access to timely mental health services and coordinated care difficult for residents in North Carolina and the United States and has exacerbated the stigma many patients may feel about seeking mental health services. While the VA has led the way in integrating mental health care and physical health care at VA facilities, the public and private health systems have lagged in efforts to help patients who have mental and physical conditions. In 2006, professional organizations, state agencies, consumer groups, and others joined together to create the training program, clinical tools, and practice-based demonstration projects to enable primary care practices to integrate a mental health or substance abuse provider into the practice. This integration could be as minimal as an agreement to share patient care between a primary care practice and a mental health or substance abuse provider in the same region, or it could be as complex as the full integration of the behavioral health or primary care provider into the practice’s teams of Challenges to Providing Services to North Carolina Veterans Who Have Traumatic Brain Injury