The ICARE Kids program provides integrated primary and behavioral health care services to children ages 5-17 in seven cities across six rural counties in Southeastern Illinois. It operates within Federally Qualified Health Care Clinics and aims to address issues like high unemployment, child abuse and neglect, lack of mental health services, and transportation barriers. The program screens all children for social and emotional issues, coordinates their care between primary care doctors and behavioral health clinicians, and measures outcomes using standardized tools. While it faced challenges with staff turnover, lower enrollment than expected, and retaining counselors in rural areas, ICARE Kids has become self-sustaining through Medicaid billing and its successful model led to additional grant funding to expand integrated care services

1. ICARE Kids
(Innovative, Coordinated, Accessible, Research Based, and Efficient)
Integrated Primary and Behavioral Health Care for Children
Callie Livingston, MS, LCPC Integrated Care Coordinator, LifeLinks

2. ICARE Kids
 Focused on Federally Qualified Health Care Clinics operated by SIHF Healthcare in
Rural Communities:
 7 cities (Mattoon, Charleston, Greenup, Effingham, Olney, Salem and Vandalia)
 In 6 counties (Coles, Cumberland, Effingham, Fayette, Richland and Marion)
 Served children ages 5-17 years
 LifeLinks and our Primary Care Partner, SIHF Healthcare identified issues in several
rural communities in Southeastern Illinois:
 High unemployment
 Rates of child abuse and neglect above the state average
 Many low income families with few options for care
 Transportation issues making it difficult for them to travel to other providers
 Limited or no mental health services for children in many rural communities
 No integrated care model in the region where children could receive primary and
behavioral health care in one location

3. ICARE Kids
 Projected to serve 5,670 children
 Universal Screening of children and adolescents ages 5-18 for social emotional
issues within the primary care office setting
 Consumer centered communication and coordination with primary health care
team (doctors, nurse practitioners, support team), behavioral health
clinicians, and families working together to meet the child’s needs
 All treatment interventions are evidence based or evidence informed
 Use of standardized tools at regular intervals to measure the child’s
functional improvement as well as any decrease in the severity of the issue

4. ICARE Kids
 Primary Care staff turnover
 Fewer number of children presenting for primary care services than
anticipated
 Front desk support team members did not all buy in to the value and process
of universal screening
 Recruiting and retaining ICARE Kids counselors in these very rural areas
 Some families/parents dropped out of treatment before it was completed
 Creativity was required to achieve warm hand offs as clinicians became busier
 Space issues – Rural FQHCs do not have room to house additional personnel-
funding for remodeling to accommodate integrated care is needed

5. ICARE Kids
 ICARE Kids continues – Billing for services to Medicaid & Medicaid Management
Care has made it a self-sustaining program.
 The success of ICARE Kids led LifeLinks to be one of only 3 agencies in the
State selected to participate in a SAMHSA funded grant – PIPBHC
 Universal screening and outcome based measurement experience gained from
ICARE Kids will be continued in PIPBHC!

6. ICARE Kids
 Early identification and treatment is effective!
 The integrated care model with Behavioral Health Clinicians embedded in the
Primary Care office setting reduces some barriers to treatment.
 Outcome measurements used to measure progress can be motivators for
consumers, families, staff and primary care personnel.
 Planning is important – a good timeline helps keep implementation on track
 Universal staff training ensures the program is replicated in each site in the
same way.
 Flexibility and openness to change must be embraced for a new program like
this to work.

7. ICARE Kids
Questions?