Letter of Intent Instructions
Collaborative Care Model (CoCM) Pilot Program Funding Opportunity
Introduction
The Maryland Department of Health (“MDH”) Medical Assistance Program is offering primary care
provider sites the opportunity to apply for the Collaborative Care Model (CoCM) Pilot Program. The CoCM
Pilot Program is established pursuant to HB 1682/SB 835—Maryland Medical Assistance Program –
Collaborative Care Pilot Program (Chapters 683 and 684 of the Acts of 2018).
The CoCM Pilot Program will be effective from July 1, 2019, through June 30, 2023. MDH will select up to
three sites to participate in the CoCM Pilot Program. Total annual funding across all selected CoCM Pilot
Sites will be $550,000. Funding awards will consist of two parts:
Year One infrastructure funding available between July 1, 2019 and June 30, 2020 up to $225,000
across all selected CoCM Pilot Sites; and
Funding available to support delivery of collaborative care services from January 1, 2020, through
June 30, 2023, up to $225,000 in FY20 and $550,000 annually in FY21, FY22, and FY23.
Payments are for services not otherwise covered or directly reimbursed by Medicaid. Payment for services
will be made only for care delivered to Medicaid participants enrolled in HealthChoice.
CoCM Pilot Sites will be required to report on performance measures and share data for evaluation purposes
in order to receive funding. Information and updates about the CoCM Pilot Program opportunity may be
found on the MDH website, https://mmcp.health.maryland.gov/Pages/Collaborative-Care.aspx. MDH has
provided the following template and application timeline for you to help you frame your Letter of Intent
(LOI).
Purpose of the Letter of Intent (LOI)
The purpose of this LOI is to assess prospective statewide interest in the CoCM Pilot Program, obtain
preliminary pilot design proposals, and provide an opportunity for potential applicants to submit questions.
Submission of this LOI is voluntary and non-binding. Thus, failure to submit a LOI will not preclude an
applicant from applying to participate in the CoCM Pilot Program, and submission of an LOI does not
require an applicant’s future participation in the CoCM Pilot Program. MDH anticipates releasing the
Request for Applications (RFA) for the CoCM Pilot on April 10, 2019, with applications being due on May
22, 2019.
Eligibility for Funding
To participate in the CoCM Pilot Sites must deliver primary care services and include individual providers,
group practices, or primary care offices within a larger health system. CoCM Pilot Sites must deliver services
to Medical Assistance participants enrolled in HealthChoice. Behavioral health providers are not eligible to
serve as CoCM Pilot Sites. CoCM Pilot Sites must have the capacity to provide services through the CoCM.
Background on the Collaborative Care Model (CoCM)
The CoCM is an evidence-based approach for integrating physical and behavioral health services in primary
care settings that includes: (1) care coordination and management; (2) regular, systematic monitoring and
treatment using a validated clinical rating scale; and (3) regular, systematic psychiatric caseload reviews and
consultation for patients who do not show clinical improvement. Proponents of the model suggest that
merging behavioral health with primary care normalizes and de-stigmatizes treatment for behavioral health
disorders. This in turn encourages patients to seek access to the evidence-based behavioral health services
available in their regular primary care clinics.
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The CoCM incorporates a team of three providers: (1) a Primary Care Provider (PCP), (2) a behavioral
health (BH) care manager, and (3) a psychiatric consultant. The PCP’s main role within the model is to
provide primary care services, coordinate care, and help a patient access a range of health care services. Soon
thereafter, the individual is introduced to the BH care manager, who works closely with the PCP. The BH
care manager is primarily responsible for supporting and implementing treatment initiated by the PCP, such
as the monitoring of medication. The primary care team in consultation with the psychiatric consultant
determines the course of treatment and sets measurable benchmarks that they expect the individual to reach
in the future. Once the treatment plan is implemented, the individual’s progress is tracked at regular
intervals using validated clinical rating scales (e.g., Patient Health Questionnaire-9 (PHQ-9)). If a patient is
not improving as expected, the treatment plan and goals are systematically adjusted. In addition to working
closely with the primary care team, the psychiatric consultant may also meet directly with patients that
present significant diagnostic challenges or who are not showing clinical improvements. Interactions with the
primary care team and patients may be conducted in-person or via telehealth from the PCP’s office to the
psychiatric consultant.
CoCM Pilot Sites must indicate their target population, including how individuals will be identified for
participation in the CoCM Pilot. CoCM Pilot Sites may target individuals diagnosed with mild to moderate
depression using the PHQ-9 screening tool or may specify a different target population with a behavioral
health need (either substance use disorder or mental health). CoCM Pilot sites should specify the validated
clinical tool(s) they intend to use. For purposes of the CoCM Pilot, an addiction medicine specialist or any
other behavioral health medicine specialist as allowed under federal regulations governing the model may
also serve as a consultant.
Letter of Intent Submission Instructions
Provider sites that are interested in applying for funding for the CoCM Pilot are strongly encouraged to
submit a LOI to MDH by April 19, 2019, at 5PM. The letter should be submitted via e-mail or e-mail
attachment to MDH.healthchoicerenewal@maryland.gov. The Letter of Intent should be no more than
three pages long.
Letter of Intent Template
In order to help you prepare your LOI and aid our assessment, MDH requests that the Letter of Intent from
applicants address the following elements:
1. Primary Applicant Contact Information
Provide the primary applicant’s name, mailing address, point of contact name, e-mail
address, and telephone number. Please also provide (as applicable): Individual Provider
National Provider Identification Number(s) (NPI), Group Practice Name, and Group
National Provider Identification Number (NPI).
2. Primary Applicant Eligibility for Funding
Affirm that the primary applicant is a provider site that delivers primary care services to
Medicaid participants enrolled in HealthChoice.
3. Project Goal and Synopsis
Provide a brief description of the CoCM Pilot Program’s goals that your organization is
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attempting to meet, as well as a high-level synopsis of your proposed plan.
4. Target Population and Geographic Area
Describe the geographic area in which the CoCM Pilot would operate, the target
population(s), and the number of Medicaid participants that you expect to serve.
5. Project Plan
Provide a project narrative of your proposal describing your intervention plans, including
workflow.
6. Care Coordination
Describe how you coordinate delivery of care with Maryland’s Managed Care Organizations
and refer participants for specialty behavioral health services to Beacon Health Options, the
Behavioral Health ASO.
7. Budget
Please briefly describe your Year One infrastructure development needs and anticipated
related costs. Types of infrastructure costs eligible for funding include:
• Development of a patient registry and/or integration of a patient registry into an
electronic health record (EHR) system that includes the delivery of services; patient
responses through routine use of the relevant screening tool; and ongoing performance
improvement.
• Development of other monitoring, reporting, and billing tools required to implement
CoCM;
• Training staff in order to implement; and other developments as needed by the CoCM
Pilot Site;
• Other infrastructure needs as specified by the interested site.
6. Questions (not included in the three page limit)
Please include any questions you may have for MDH about the CoCM Pilot Program.
Responses to select questions will be added to the CoCM Pilot Program Frequently Asked
Questions (FAQ) document and posted on the MDH website.
CoCM PILOT PROGRAM TIMELINE
DATES
Letter of Intent (LOI) Instructions and Request for Applications (RFA)
for CoCM Pilot Program released to public
April 10, 2019
Letters of Intent due to MDH
April 19, 2019
CoCM Pilot Applications due to MDH
May 22, 2019
CoCM Application Review Process
May 23 – June 7, 2019
CoCM Pilot Award Notifications (Infrastructure funding awards will
begin July 1; funding for delivery of services expected start date is
January 1, 2020)
June 14, 2019
CoCM Pilots Begin (Based upon approved Pilot implementation plans)
July 1, 2019
