--- title: Practice Support Services | mental health description: mental health | Health care practices in North Carolina face many challenges. Our quality improvement coaches (QICs) are trained to work with you to transform the way in which care is delivered in your practice. --- [![nwahec.png](https://go.northwestahec.wakehealth.edu/hs-fs/hubfs/WFUSM_NWAHEC%20Cobranding%20Logo_H_RGB.png?width=2025&height=300&name=WFUSM_NWAHEC%20Cobranding%20Logo_H_RGB.png "nwahec.png")](https://go.northwestahec.wakehealth.edu/) - [Home](https://go.northwestahec.wakehealth.edu) - [What's New at NWAHEC Blog](https://go.northwestahec.wakehealth.edu/blog) - [NWAHEC Staff](https://go.northwestahec.wakehealth.edu/staff) - [Practice Support Updates](https://go.northwestahec.wakehealth.edu/practicesupport) # Practice Support Update Blog ## [A Collaborative Path to Better Pediatric Behavioral Health: How Twin City Pediatrics Transformed Care with Support from Northwest AHEC](https://go.northwestahec.wakehealth.edu/practicesupport/twincitypeds) Aug 13, 2025, 3:00:00 PM / by [Brooke Kochanski](https://go.northwestahec.wakehealth.edu/practicesupport/author/brooke-kochanski) posted in [mental health](https://go.northwestahec.wakehealth.edu/practicesupport/topic/mental-health), [behavioral health](https://go.northwestahec.wakehealth.edu/practicesupport/topic/behavioral-health), [Pediatric](https://go.northwestahec.wakehealth.edu/practicesupport/topic/pediatric), [practice support](https://go.northwestahec.wakehealth.edu/practicesupport/topic/practice-support), [collaborative care](https://go.northwestahec.wakehealth.edu/practicesupport/topic/collaborative-care) [0 Comments](https://go.northwestahec.wakehealth.edu/practicesupport/twincitypeds#comments-listing) In the face of rising pediatric mental health needs, Novant Health Twin City Pediatrics found itself at a crossroads. As adolescent mental health concerns such as depression and anxiety became more prevalent, clinicians found themselves increasingly fielding complex and time-consuming questions. These mild to moderate conditions required consistent follow-up and oversight, yet the surge in demand for mental health services made it difficult for patients to access timely care, particularly from providers who accepted their insurance. Many adolescents went without necessary treatment.  Thanks to a powerful partnership with **Northwest AHEC** and the guidance of **Lara Dickerson, MHA,** Senior Quality Improvement Specialist, the practice chose a different path—one of innovation, collaboration, and compassion. | ![IMG\_2293](https://go.northwestahec.wakehealth.edu/hs-fs/hubfs/IMG_2293.jpeg?width=500&height=375&name=IMG_2293.jpeg) *Adair Stewart, Dr. Elizabeth Allen, Dr. Gretchen Hoyle, Lara Dickerson, Jennifer Cleland Green, Lauren Stokes* | | --- | ### **The Challenge** Primary care pediatricians face a dilemma. Mental health visits are longer, emotionally taxing, and historically under-reimbursed. Yet the need is undeniable. Twin City Pediatrics chose to lean in—embracing the challenge rather than deflecting it. The question became: *Can mental health care in pediatrics be both impactful and financially viable?* The answer, it turns out, is yes. ### **The Solution: Collaborative Care Model (CoCM)** With coaching from Lara Dickerson and guidance from AHEC Practice Support Services, Twin City Pediatrics implemented the Collaborative Care Model (CoCM).  A practice which emphasizes collaboration between primary care physicians, care managers, and psychiatric consultants to improve access, outcomes, and patient satisfaction within the pediatric medical home.  Key components of the model include: - A **Behavioral Health Care Manager (BHCM)** providing core services like parent coaching, brief therapeutic interventions, and referral coordination. - A **Psychiatric Consultant** offering oversight and subspecialty advice.. - A **Primary Care Provider** trained in pediatric physical health. - **Validated clinical tools** (PHQ-9, GAD-7, Vanderbilt, etc.) for measurement-based care. - Customized **EHR workflows** and a **patient registry** to track progress and enable billing for behavioral health services within the primary care practice. ### **Practice Support Team Impact** The journey began with a conversation at the 2023 NC Pediatric Society Meeting, leading to a partnership with Northwest AHEC. Practice coach Lara Dickerson became a key ally, meeting monthly with the team for two years. Her support included: - Coordinated with internal Novant departments (HR, billing, IT, compliance). - Billing guidance and documentation templates. - Consultation with NC Medicaid on psychiatric consultant roles. - Staff training modules. - Troubleshooting billing issues. - Setting BHCM workload benchmarks. - Secured a **$50,000 Capacity Building Fund grant** from [Community Care of NC](https://www.communitycarenc.org/newsroom/cocm-capacity-building-fund-application) to support BHCM staffing. Thanks to this comprehensive support, the program not only launched - it thrived. ### **The Results** By June 2025, the program became **revenue-positive**, six months ahead of schedule. With monthly BHCM costs of $5,400 and over $13,000 billed in June alone, the practice expects $6,500 in revenue—exceeding expenses by more than $1,100 per month. Today, the program includes a growing number of enrolled patients - many with complex needs - and is delivering tangible improvements in the lives of children and their families. > “The Psychiatric Collaborative Care Model has empowered our practice to provide meaningful, evidence-based mental health care for our pediatric patients. Our success is replicable, sustainable, and deeply impactful.” > — *Gretchen S. Hoyle, MD - Twin City Pediatrics* > “It was amazing to see how this model enables primary care practices to spend adequate time with each patient on physical and mental health concerns, developing treatment plans collaboratively with specialists and making a significant difference for kids in our community.” > — *Christopher Jones, DrPH, MHA - Northwest AHEC* ### **From Patients & Families** > “I’m so glad he’s finally going to get the help he needs.” > “I’ve felt so alone for so long. Having someone to talk to means everything.” > “She is so much better. I can’t thank you enough.” ### **[Read the full Report from Twin City Pediatrics & Gretchen S. Hoyle, MD](https://go.northwestahec.wakehealth.edu/hubfs/A%20Collaborative%20Path%20to%20Better%20Pediatric%20Behavioral%20Health%20-%20Twin%20City%20Peds.pdf)** [Read More](https://go.northwestahec.wakehealth.edu/practicesupport/twincitypeds) ## [Addressing Mental Health with the Collaborative Care Model (CoCM)](https://go.northwestahec.wakehealth.edu/practicesupport/addressing-mental-health-with-the-collaborative-care-model) Jun 11, 2025, 3:30:00 PM / by [Leslie D McDowell, DNP, ANP-BC, RN](https://go.northwestahec.wakehealth.edu/practicesupport/author/leslie-d-mcdowell-dnp-anp-bc-rn) posted in [mental health](https://go.northwestahec.wakehealth.edu/practicesupport/topic/mental-health), [behavioral health](https://go.northwestahec.wakehealth.edu/practicesupport/topic/behavioral-health), [Pediatrics](https://go.northwestahec.wakehealth.edu/practicesupport/topic/pediatrics), [podcast](https://go.northwestahec.wakehealth.edu/practicesupport/topic/podcast), [collaborative care](https://go.northwestahec.wakehealth.edu/practicesupport/topic/collaborative-care) [0 Comments](https://go.northwestahec.wakehealth.edu/practicesupport/addressing-mental-health-with-the-collaborative-care-model#comments-listing) On the most recent episode of the Northwest AHEC Healthcare Insights podcast, host Andrew Brewer speaks with Dr. Gretchen Hoyle. Dr. Hoyle returns to provide a post-launch update of implementing a collaborative care management model (CoCM) in primary care practice in a large health system. The model provides continuity of care for chronic conditions such as ADHD, anxiety, and depression. Learn how CoCM operates and insights on transforming care practices with a behavioral care manager, data registry, EHR workflows, and billing. According to Dr. Hoyle, "This model allows us as pediatricians to use a team based approach for pediatric patients with mental health issues." Members of the CoCM team include the primary care provider who makes a diagnosis and referral, a psychiatric consultant who provides subspecialist level expertise and advice, and the behavioral health care manager (BHCM) who interacts most closely with the patient and their family. Dr. Hoyle finds it is the BHCM that is the "hero" of the CoCM team! Check out the [latest episode of NW AHEC Healthcare Insights podcast](https://soundcloud.com/nwahecwebmaster/hi-ep-126-gretchen-hoyle-md)!   [Read More](https://go.northwestahec.wakehealth.edu/practicesupport/addressing-mental-health-with-the-collaborative-care-model) ## [Highlighted Resource: Mental Health Practice Readiness Inventory](https://go.northwestahec.wakehealth.edu/practicesupport/highlighted-resource-mental-health-practice-readiness-inventory) May 13, 2025, 12:15:00 PM / by [Janice Moore, MLS](https://go.northwestahec.wakehealth.edu/practicesupport/author/janice-moore) posted in [mental health](https://go.northwestahec.wakehealth.edu/practicesupport/topic/mental-health), [digital library](https://go.northwestahec.wakehealth.edu/practicesupport/topic/digital-library), [adl](https://go.northwestahec.wakehealth.edu/practicesupport/topic/adl) [0 Comments](https://go.northwestahec.wakehealth.edu/practicesupport/highlighted-resource-mental-health-practice-readiness-inventory#comments-listing) How can healthcare providers check whether they are prepared to support their patients' mental healthcare needs? [Read More](https://go.northwestahec.wakehealth.edu/practicesupport/highlighted-resource-mental-health-practice-readiness-inventory) ## [Behavioral Health Reverse Integration Online Modules available through September 2025](https://go.northwestahec.wakehealth.edu/practicesupport/behavioral-health-reverse-integration) Feb 13, 2025, 7:35:21 AM / by [Brooke Kochanski](https://go.northwestahec.wakehealth.edu/practicesupport/author/brooke-kochanski) posted in [mental health](https://go.northwestahec.wakehealth.edu/practicesupport/topic/mental-health), [behavioral health](https://go.northwestahec.wakehealth.edu/practicesupport/topic/behavioral-health), [online learning](https://go.northwestahec.wakehealth.edu/practicesupport/topic/online-learning), [integrated care](https://go.northwestahec.wakehealth.edu/practicesupport/topic/integrated-care) [0 Comments](https://go.northwestahec.wakehealth.edu/practicesupport/behavioral-health-reverse-integration#comments-listing) These online modules focus on the reverse integration process and provide details on how to implement this model of care. Credit is offered for FREE in these self-paced online modules (5 to choose from).    ![fabric-2642229\_1920](https://go.northwestahec.wakehealth.edu/hs-fs/hubfs/fabric-2642229_1920.jpg?width=300&name=fabric-2642229_1920.jpg)The integration of behavioral health care into primary care is now widely considered an effective strategy for improving outcomes for patients with physical and behavioral health conditions. Reverse integration of primary care into behavioral healthcare is another form of integration that produces improved quality of care and patient outcomes. Participants will learn the benefits of this model of care, the financial aspects of integrated care, as well as other clinical and operational aspects of providing this model of care. [Click here to view more information and to register today!](https://go.northwestahec.wakehealth.edu/bhreverseintegration)   **Cost and Registration** This series is offered free of charge through support from the NC AHEC Program. Instructions for accessing the online programs will be emailed to you with your registration confirmation letter. **Target Audience** This series will be beneficial to behavioral health and human service practitioners, including psychologists, social workers, counselors, marriage and family therapists, substance use and addictions professionals, clinicians and all others interested in this topic. **Credit** Credit types available include: - **1.0 Contact Hour from Northwest AHEC** - Northwest AHEC is recognized by the North Carolina Psychology Board as an approved provider of (Category A) Continuing Education for North Carolina Licensed Psychologists. Each program will provide 1.0 contact hour of (Category A) continuing education for North Carolina psychologists. No partial credit will be given. - **1.0 NBCC Contact Hour** Northwest AHEC has been approved by NBCC as an Approved Continuing Education Provider, ACEP No. 5465. Programs that do not qualify for NBCC credit are clearly identified. Northwest AHEC is solely responsible for all aspects of the program. - **1.0 NASW-NC Contact Hour** NC AHEC is a 2021 NASW-NC approved provider of distance continuing education. Each program has been approved for 1.0 contact hour**.** [Read More](https://go.northwestahec.wakehealth.edu/practicesupport/behavioral-health-reverse-integration) ## [The State of Adolescent Mental Health: Where we've been, where we are, and where we are going](https://go.northwestahec.wakehealth.edu/practicesupport/the-state-of-adolescent-mental-health-where-weve-been-where-we-are-and-where-we-are-going) Jun 19, 2024, 11:56:00 AM / by [Practice Support Team](https://go.northwestahec.wakehealth.edu/practicesupport/author/practice-support-team) posted in [Primary Care](https://go.northwestahec.wakehealth.edu/practicesupport/topic/primary-care), [mental health](https://go.northwestahec.wakehealth.edu/practicesupport/topic/mental-health), [behavioral health](https://go.northwestahec.wakehealth.edu/practicesupport/topic/behavioral-health), [adolescent](https://go.northwestahec.wakehealth.edu/practicesupport/topic/adolescent), [Pediatrics](https://go.northwestahec.wakehealth.edu/practicesupport/topic/pediatrics), [youth](https://go.northwestahec.wakehealth.edu/practicesupport/topic/youth) [0 Comments](https://go.northwestahec.wakehealth.edu/practicesupport/the-state-of-adolescent-mental-health-where-weve-been-where-we-are-and-where-we-are-going#comments-listing)   [Read More](https://go.northwestahec.wakehealth.edu/practicesupport/the-state-of-adolescent-mental-health-where-weve-been-where-we-are-and-where-we-are-going) ## [Interesting Topics to Start Your Summer: Free HRSA-Sponsored Webinars](https://go.northwestahec.wakehealth.edu/practicesupport/interesting-topics-to-start-your-summer-free-hrsa-sponsored-webinars) May 22, 2024, 9:00:00 AM / by [Leslie D McDowell, DNP, ANP-BC, RN](https://go.northwestahec.wakehealth.edu/practicesupport/author/leslie-d-mcdowell-dnp-anp-bc-rn) posted in [Primary Care](https://go.northwestahec.wakehealth.edu/practicesupport/topic/primary-care), [learning](https://go.northwestahec.wakehealth.edu/practicesupport/topic/learning), [mental health](https://go.northwestahec.wakehealth.edu/practicesupport/topic/mental-health), [Substance Use](https://go.northwestahec.wakehealth.edu/practicesupport/topic/substance-use), [aging](https://go.northwestahec.wakehealth.edu/practicesupport/topic/aging), [naloxone](https://go.northwestahec.wakehealth.edu/practicesupport/topic/naloxone) [0 Comments](https://go.northwestahec.wakehealth.edu/practicesupport/interesting-topics-to-start-your-summer-free-hrsa-sponsored-webinars#comments-listing) ![ocean.sunrise.sailboats.GG](https://go.northwestahec.wakehealth.edu/hs-fs/hubfs/ocean.sunrise.sailboats.GG.jpg?width=300&height=225&name=ocean.sunrise.sailboats.GG.jpg) Today we bring you news from the HRSA (Health Resources and Services Administration) Primary Health Care Digest, on a variety of topics we thought would be of interest to primary care practitioners in all settings. [Read More](https://go.northwestahec.wakehealth.edu/practicesupport/interesting-topics-to-start-your-summer-free-hrsa-sponsored-webinars) ## [New Podcast Learning Series](https://go.northwestahec.wakehealth.edu/practicesupport/new-podcast-learning-series) Mar 28, 2024, 8:23:46 AM / by [Andrew L. Brewer, MS, NBHWC](https://go.northwestahec.wakehealth.edu/practicesupport/author/andrew-brewer) posted in [Social Determinants of Health](https://go.northwestahec.wakehealth.edu/practicesupport/topic/social-determinants-of-health), [Healthcare Insights](https://go.northwestahec.wakehealth.edu/practicesupport/topic/healthcare-insights), [mental health](https://go.northwestahec.wakehealth.edu/practicesupport/topic/mental-health), [Substance Use](https://go.northwestahec.wakehealth.edu/practicesupport/topic/substance-use), [behavioral health](https://go.northwestahec.wakehealth.edu/practicesupport/topic/behavioral-health), [rural health centers](https://go.northwestahec.wakehealth.edu/practicesupport/topic/rural-health-centers), [housing](https://go.northwestahec.wakehealth.edu/practicesupport/topic/housing), [continuing education series](https://go.northwestahec.wakehealth.edu/practicesupport/topic/continuing-education-series), [online learning](https://go.northwestahec.wakehealth.edu/practicesupport/topic/online-learning), [population health](https://go.northwestahec.wakehealth.edu/practicesupport/topic/population-health), [alcohol use](https://go.northwestahec.wakehealth.edu/practicesupport/topic/alcohol-use), [winston-salem](https://go.northwestahec.wakehealth.edu/practicesupport/topic/winston-salem), [podcast](https://go.northwestahec.wakehealth.edu/practicesupport/topic/podcast), [harm reduction](https://go.northwestahec.wakehealth.edu/practicesupport/topic/harm-reduction), [resource](https://go.northwestahec.wakehealth.edu/practicesupport/topic/resource), [homeless](https://go.northwestahec.wakehealth.edu/practicesupport/topic/homeless), [shelter](https://go.northwestahec.wakehealth.edu/practicesupport/topic/shelter) [0 Comments](https://go.northwestahec.wakehealth.edu/practicesupport/new-podcast-learning-series#comments-listing) We have a new learning opportunity from Northwest AHEC called the Podcast Learning Series. Now you can listen to select episodes of our [Healthcare Insights in Northwest North Carolina podcast](https://soundcloud.com/nwahecwebmaster) and earn continuing education credits. And it’s free! The podcast format allows you to listen at your convenience and multitask while listening. I personally like to do my cardio workout or weight training while consuming podcast content, and sometimes find myself listening while cooking, cleaning, or doing yard work. It's a great way to optimize your learning and your life activities. This first episode in this Podcast Learning Series is on homelessness in Forsyth County. In this episode you will learn about the main causes of homelessness in our region, the services provided by service organizations in Forsyth County, and the challenges of serving the homeless population and finding permanent housing. Once you have finished the episode you can take the short post-test to receive 1 hour of CE credit. And another bonus is that this is offered to you at no cost aside from your time and attention. You can link directly to the course, register and listen here: [https://northwestahec.wakehealth.edu/courses-and-events/72832/podcast-ce-series-homelessness-in-forsyth-county ](https://northwestahec.wakehealth.edu/courses-and-events/72832/podcast-ce-series-homelessness-in-forsyth-county ) Alternatively, you can listen to Healthcare Insights in Northwest North Carolina wherever you get your podcast content (Spotify, Google, Apple, Soundcloud, etc.). Simply search for "Healthcare Insights in Northwest North Carolina" and look for [Episode 87 featuring William McDonald, Director of the Bethesda Center for the Homeless in Winston-Salem, NC](https://soundcloud.com/nwahecwebmaster/hi-ep-87-william-bo-mcdonald-homelessness-in-forsyth-county).  Once you have listened you can register for the course, take the post-test and claim your 1 hour CE credit. I hope you find our episodes timely and relevant to your practice. And finally, if you have a topic or know of a person that you think would be great to have on the podcast, please don’t hesitate to reach out and let me know. I am always looking for interesting topics and presenters to have on the podcast. [Read More](https://go.northwestahec.wakehealth.edu/practicesupport/new-podcast-learning-series) ## [Highlighted Resource: Problematic Gambling Risk Factors and Resources](https://go.northwestahec.wakehealth.edu/practicesupport/highlighted-resource-problematic-gambling-risk-factors-and-resources) Mar 7, 2024, 7:45:00 AM / by [Janice Moore, MLS](https://go.northwestahec.wakehealth.edu/practicesupport/author/janice-moore) posted in [mental health](https://go.northwestahec.wakehealth.edu/practicesupport/topic/mental-health) [0 Comments](https://go.northwestahec.wakehealth.edu/practicesupport/highlighted-resource-problematic-gambling-risk-factors-and-resources#comments-listing) North Carolina regulations around gambling will become more permissive in March 2024, making problematic gambling a greater public health concern. [Read More](https://go.northwestahec.wakehealth.edu/practicesupport/highlighted-resource-problematic-gambling-risk-factors-and-resources) ## [Unlocking the Signs: Mental Health Awareness for You and Your Loved Ones](https://go.northwestahec.wakehealth.edu/practicesupport/take-care-of-yourself-and-others) Dec 27, 2023, 12:46:00 PM / by [Leslie D McDowell, DNP, ANP-BC, RN](https://go.northwestahec.wakehealth.edu/practicesupport/author/leslie-d-mcdowell-dnp-anp-bc-rn) posted in [mental health](https://go.northwestahec.wakehealth.edu/practicesupport/topic/mental-health), [behavioral health](https://go.northwestahec.wakehealth.edu/practicesupport/topic/behavioral-health) [0 Comments](https://go.northwestahec.wakehealth.edu/practicesupport/take-care-of-yourself-and-others#comments-listing) ![side profile stressed young businessman sitting outside corporate office holding head with hands looking down. Negative human emotion facial expression feelings.-1](https://go.northwestahec.wakehealth.edu/hs-fs/hubfs/side%20profile%20stressed%20young%20businessman%20sitting%20outside%20corporate%20office%20holding%20head%20with%20hands%20looking%20down.%20Negative%20human%20emotion%20facial%20expression%20feelings.-1.jpeg?width=300&height=200&name=side%20profile%20stressed%20young%20businessman%20sitting%20outside%20corporate%20office%20holding%20head%20with%20hands%20looking%20down.%20Negative%20human%20emotion%20facial%20expression%20feelings.-1.jpeg) Not sure if you or someone you know is living with mental health problems?  Mental illnesses can affect a person's thinking, mood, or behavior. There are early warning signs and symptoms that can help determine if you or someone you know is experiencing a mental health condition.   [Read More](https://go.northwestahec.wakehealth.edu/practicesupport/take-care-of-yourself-and-others) ## [9 Simple Stress Busters to Sleigh Holiday Hassles and Jingle Away the Pressure!](https://go.northwestahec.wakehealth.edu/practicesupport/dont-let-gossip-undermine-your-clinic-site-0) Dec 14, 2023, 8:15:00 AM / by [Leslie D McDowell, DNP, ANP-BC, RN](https://go.northwestahec.wakehealth.edu/practicesupport/author/leslie-d-mcdowell-dnp-anp-bc-rn) posted in [mental health](https://go.northwestahec.wakehealth.edu/practicesupport/topic/mental-health), [stress](https://go.northwestahec.wakehealth.edu/practicesupport/topic/stress), [mindfulness](https://go.northwestahec.wakehealth.edu/practicesupport/topic/mindfulness) [0 Comments](https://go.northwestahec.wakehealth.edu/practicesupport/dont-let-gossip-undermine-your-clinic-site-0#comments-listing) Stress can really disrupt our lives and steal our joy. There are both healthy and unhealthy ways to cope with stress. [Read More](https://go.northwestahec.wakehealth.edu/practicesupport/dont-let-gossip-undermine-your-clinic-site-0) [All posts](https://go.northwestahec.wakehealth.edu/practicesupport/all) [Next](https://go.northwestahec.wakehealth.edu/practicesupport/tag/mental-health/page/2) This is a search field with an auto-suggest feature attached. - There are no suggestions because the search field is empty. ### Practice Support Services Health care practices in North Carolina face many challenges. Our team of quality improvement coaches (QICs) have skills and expertise to support you in your transformation efforts. 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