Collaborative Care for Perinatal Mental Health in Obstetrics, Gynecology, and Family Medicine Practices

The New York State (NYS) Office of Mental Health (OMH) announces the availability of funds to support the expanded implementation of the Psychiatric Collaborative Care Model (CoCM) in obstetrics, gynecology (OBGYN), and family medicine practices across New York State.

CoCM is the most evidence-based model for integrating behavioral health into physical health care with over 100 randomized control trials from the last two (2) decades of implementation. ¹ CoCM builds behavioral health capacity in primary care by enhancing the team with support from a Psychiatric Consultant and a Behavioral Health Care Manager (BHCM) to coordinate and provide evidence-based, treatment-to-target care to patients. It leads to significantly better clinical outcomes, greater patient and provider satisfaction and improved functioning for patients with behavioral health needs.

In the perinatal population, implementation of CoCM is associated with increased perinatal depression screening and treatment from obstetric clinicians and ultimately reducing depression in this population. ² Implementation of CoCM is also associated with reduction in racial disparities in perinatal depression care, with significant differences in antenatal depression screen and treatment recommendations for those who screened positive by race after CoCM. ³

NYS OMH currently provides comprehensive training and technical assistance to practices implementing CoCM. In 2015, NYS became the first state to provide Medicaid reimbursement for CoCM. Since then, comprehensive behavioral health services have been provided to tens of thousands of Medicaid patients across NYS. There are now more than 380 physical health practices providing CoCM, eligible for Medicaid reimbursement. Data from these practices is congruent with the RCT outcomes, with a consistent programmatic average of about 50 percent improvement after 70 days in treatment.

Real-time data from OBGYN practices in NYS that provide CoCM report an average of 78 percent of patients receiving an annual depression screen with a standardized tool, significantly more consistent than the usual care data from the Medicaid Perinatal Care study that showed while 63 percent of birthing persons were assessed for depression at an initial visit, just seven (7) percent of those were documented using a standardized screening tool, and 51 percent of postpartum birthing persons were assessed for depression. ⁴  

This Request for Applications (RFA) will provide the opportunity to expand CoCM reach to perinatal birthing persons in NYS as the state continues to prioritize access for birthing persons and infants in at-risk communities. Mental health conditions are attributed to 23 percent of maternal deaths nationally, and there is a growing body of evidence that demonstrates increased risk for new and concurrent psychiatric disorders during the peripartum period. ⁵ This demands OBGYN and family practices supporting perinatal birthing persons prioritize screening and behavioral health treatment, and CoCM provides the infrastructure needed to provide this care in the physical healthcare space. 

It is anticipated that OMH will make up to 17 awards across the state, contingent upon funding availability. This funding is specifically designated for new CoCM sites, with the goal to expand the capacity of OBGYN and family medicine practices to support perinatal birthing persons with behavioral health needs. Priority will be given to applicants in counties with no current CoCM presence, as well as at-risk areas, determined by counties with higher-than-average maternal mortality rates and higher percent of births covered by Medicaid or self-pay. Applicants should not be receiving duplicative financial support for the initial COCM implementation and start up from other sources, including public or private funding. Applicants are expected to support the ongoing program with revenue received from claims. The combined total of these awards will be up to $850,000 distributed in one-time upfront payments to all awardees. (See Section 1.F Operating Funds.)

The Local Governmental Unit (LGU), Director of Community Service (DCS)/Mental Health Commissioner has a statutory authority and responsibility for oversight and cross-system management of the local mental hygiene system to meet the needs of individuals and families affected by mental illness, substance use disorder and/or intellectual/ developmental disability in their communities. Collaboration is a vital component of the Collaborative Care Model for Maternal Mental Health. Applicants should notify their Local Government Unit (LGU) of their intent to apply. An email would be sufficient. LGU approval is not needed. 

The full RFP can be found at: https://omh.ny.gov/omhweb/rfp/

All applicants must be Prequalified by the due date/time of the RFP.

All applications/proposals must be submitted through the Statewide Financial System.