Press Release – July 2021

July 30, 2021

JULY 30, 2021

The Foundation for Health Leadership & Innovation Secures Funding to Improve and Advocate for Behavioral Health Needs of North Carolina’s Children and Adolescents

The new program, funded by The Duke Endowment, will be led by FHLI’s
Center for Excellence for Integrated Care team

CARY— The Center of Excellence for Integrated Care (COE) — a program of the Foundation for Health Leadership & Innovation (FHLI) — has received a grant from The Duke Endowment to lead a three-year program focused on child and adolescent behavioral health. The emphasis of the project is on advocacy for mental health check-ups for children, as well as on training for behavioral health professionals to provide pediatric and family assessments and interventions.

“North Carolina’s health care workforce is doing amazing work every day with well-child exams and preventative services for children and adolescents,” said Dr. Amelia Muse, COE’s Program Director. “However, after the hardships of the past year, it’s time to answer the call for more support for providers, families, and communities on preventative and interventive behavioral health care.”

With a dual emphasis on advocacy and workforce development, The Duke Endowment has provided support for this program that will include partners from the i2i Center for Integrative Health and the North Carolina Area Health Education Center (AHEC) Program.

The COE team will partner with i2i to convene a workgroup of family members, advocates in children’s welfare, and representatives of practitioners to develop a sustainability plan to embed annual behavioral health well-child checks into medical protocols and practices, with a focus on the need for insurance coverage. This additional focus on behavioral health during or in conjunction with the well-child check will bring North Carolina alongside other leadership states, who have worked to support pediatricians, children, and families with additional behavioral health emphasis.

“With our more than 34 years of collaboration and advocacy experience addressing behavioral, I-DD, SUD, and primary healthcare, i2i is well-suited to lead this advocacy effort,” said i2i Executive Director Ann Rodriguez. “We are thrilled to partner with FHLI, COE, and NC AHEC on this critical initiative. The pandemic and North Carolina’s Medicaid transformation efforts have created an opportunity to ramp up integrated, preventative care practices across the state and strengthen whole-child care.”

Simultaneously, the COE team will partner with North Carolina AHEC to address workforce development issues by offering a continuing education opportunity for a cohort of 45 licensed behavioral health providers and ten graduate student interns currently working with youth and families. The one-year specialized training program will focus on mental health and substance use prevention, assessment, and intervention for children and adolescents and their families.

The second year of the program will train a second cohort of behavioral health professionals, with the first cohort of graduates acting as peer supervisors to assist with oversight and case consultation. The training curriculum will be informed by evidence-based literature, as well as by information collected from regularly held workgroup meetings of child and family advocates, youth, family members and providers advising on policy to support child and adolescent behavioral health wellness.

“At the Foundation for Health Leadership & Innovation, we are committed to cultivating a culture of innovation, experimentation, and risk-taking,” said Kelly Calabria, FHLI’s President and Chief Executive Officer. “Given how COVID-19 has exacerbated an already-dire need for behavioral health services for all North Carolinians, we believe this work — led by our team behavioral health experts — is the type of innovative thinking that is needed. We thank the Duke Endowment for recognizing this need and for trusting FHLI to drive a solution.”

About FHLI’s Center of Excellence for Integrated Care
The Center of Excellence for Integrated Care (COE) — a program of the Foundation for Health Leadership & Innovation — supports the clinical, operational, and financial transformation of health systems to provide whole-person care. COE’s integrated care experts support communities in providing whole-person care and reducing the stigma of behavioral health for patients and providers. Learn more at

About the Foundation for Health Leadership & Innovation
The Foundation for Health Leadership & Innovation (FHLI) is a nonprofit organization that envisions healthy communities across North Carolina where everyone can flourish. FHLI develops and supports innovative partnerships that build a healthier North Carolina through collaboration and respect. With a long history in the state — and a deep understanding of its health care needs — FHLI scales solutions that benefit the entire state. FHLI staff are thought leaders and experts who bring communities together for a better, healthier North Carolina. Learn more at

About i2i Center for Integrative Health
The i2i Center for Integrative Health is a non-profit 501(c)3 organization whose mission it is to foster collaborative and evidence-based initiatives for improving the quality and efficacy of the behavioral health, intellectual and developmental disabilities, and substance use care and support service systems within a comprehensive system of whole-person care. Learn more at

About North Carolina AHEC
The North Carolina AHEC Program provides and supports educational activities and services with a focus on primary care in rural communities and those with less access to resources to recruit, train, and retain the workforce needed to create a healthy North Carolina. Learn more at

About The Duke Endowment
Based in Charlotte and established in 1924 by industrialist and philanthropist James B. Duke, The Duke Endowment is a private foundation that strengthens communities in North Carolina and South Carolina by nurturing children, promoting health, educating minds and enriching spirits. Since its founding, it has distributed more than $4 billion in grants. The Endowment shares a name with Duke University and Duke Energy, but all are separate organizations.


For more information, contact:
Marni Schribman, Director of Communications & Public Relations
Foundation for Health Leadership & Innovation (FHLI)

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Implementation in a Flash

July 14, 2020

This edition of the COE blog is co-authored by Julie Austen, PhD, and Lisa Tyndall, PhD, LMFT. Dr. Austen is an Implementation Specialist at the Frank Porter Graham Child Development Institute at the University of North Carolina at Chapel Hill. Dr. Tyndall is a Senior Integration Specialist at the Center of Excellence for Integrated Care at the Foundation for Health Leadership & Innovation. Julie is healer who works at the systems level. With expertise and lived experience at the intersections of health psychology, integrated care, community capacity building, knowledge transfer, and minority wellness, she serves as an implementation specialist with UNC’s Frank Porter Graham Child Development Institute.

Colleagues for a decade, Julie and Lisa’s “forward together” paths crossed when they realized that integrated care cannot move forward without an intentional focus on the “how.” Now, the COE team and Julie partner together to strengthen access to evidence-based practices related to healthcare systems reform.

Implementation in a Flash

Long ago, Plato declared, “Necessity is the mother of invention.” The recent COVID-19 pandemic has birthed many new and necessary elements in America’s healthcare system. Clinics large and small have re-tooled themselves and have had to work with patients to get their needs met in new and creative ways. As the country’s experience of the pandemic has progressed, we have learned that this process was both a sprint and a marathon. While systems became creative quickly in how to do their work safely for all, now many of them have a chance to come up for air and take a look around to better understand how to sustain that work. And in fact, many are asking themselves, if this isn’t over, how do we handle a second potentially steeper wave? Where are we in this process of developing our protocols, new programs, or new workflows?

Now is the time for clinics to prepare themselves for this second potential wave by pausing to reflect on their progress, timelines, needs, and capacities. The good news is, this timeout to evaluate is actually built into the implementation science framework.

Implementation science provides a framework for best practice in how to implement an evidence-based practice, program or policy, for example implementing telehealth like so many clinics did in rapid time these past few months. Focusing on an implementation science framework can help us find our way through the complexity of change, identify where we are, and plan for what we still need to do. Researchers have identified four stages of implementation when systems are making changes: exploration, installation, initial implementation, and full implementation. Keep in mind, to arrive at full implementation of an effort, where the new initiative is fully folded into the clinic, typically takes up to 3 – 5 years! So, considering the typical timeframe for implementing changes, it would be completely understandable for clinics to feel a need to re-orient themselves for the long haul at this point in time just a few months in to any new initiatives brought on by this pandemic. It is for this reason that we turn to the implementation science to help us organize, co-create, optimize, and innovate.

Let’s look at a stage-based framework as a way of thinking about where your clinic is in a particular process. As your clinic comes up for air, we recommend identifying the stage of implementation by asking a few questions associated with each stage and then using that information to guide your next steps (Metz, Naoom, Halle, & Bartley, 2015).

Adapted from Metz, Naoom, Halle, & Bartley, 2015

Examine the table above that highlights the three core implementation elements as identified by Metz, Naoom, Halle, and Bartley (2015): implementation teams, data and feedback loops, and implementation infrastructure. Think about an initiative you may have just started or will start soon. What processes or pieces have you completed so far? What pieces do you need to circle back to? Who needs to help?

For example, if a clinic has never implemented telehealth for any of its providers, that effort likely became a necessity due to the pandemic. Now, thinking about the creation of that workflow and those clinic processes, who developed or thought through those new processes of telehealth check-in, billing for telehealth, or best practices for telehealth? Was there a team of people? Did that team represent all of the parts of the clinic that it needed to represent? Has that team continued to meet, or did the meetings get disregarded once things picked up speed? Thinking through these questions can help you see where you are and where the clinic needs to go next. Once a new initiative begins we often underestimate the amount of time it takes to successfully implement to the full implementation, this is a good time to reflect on what has already been accomplished and what steps to take next to make it “stick.” (See Metz et al. 2015).

If you look the table above and are still wondering where to begin, a great place to start is identifying needs at the community, organization, clinic, and individual patient level. From there, you’ll be able to identify what your next goals could be to help guide you towards the next activities of implementation. Interested in obtaining assistance in helping making your implementation of integrated care stick? Feel free to reach out for a consultation with our team.


Bertram, Rosalyn & Blase, Karen & Fixsen, Dean. (2015). Improving Programs and Outcomes: Implementation Frameworks and Organization Change. Research on Social Work Practice. 25. 477-487. 10.1177/1049731514537687.

Metz, A., Naoom, S.F., Halle, T., & Bartley, L. (2015). An integrated stage-based framework for implementation of early childhood programs and systems (OPRE Research Brief OPRE 201548). Washington, DC: Office of Planning, Research and Evaluation, Administration for Children and Families, U.S. Department of Health and Human Services.

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North Carolina Integrated Care Symposium 2019

June 15, 2020

Center of Excellence for Integrated Care Symposium logo

In the fall of 2019, the Foundation for Health Leadership and Innovation’s Center of Excellence for Integrated Care, in partnership with Wake AHEC, hosted the North Carolina Integrated Care Symposium 2019: Inspire, Educate, and Connect. Aiming to bring together healthcare professionals from multiple disciplines, this symposium focused on educating the over 130 attendees on clinical innovation, operational/implementation necessities, and financial shifts in the healthcare system. In addition to this focus on the three-world view (Peek, 2008), attendees were treated to a morning plenary on team-based care by Dr. Eduardo Salas of Rice University as well as a lunchtime plenary on provider burnout and self-care by Dr. Clark Gaither. Continuing education events such as this, where whole systems are brought together, are necessary to continuing shifting the paradigm to true whole person care being delivered in North Carolina.

The 2019 Symposium was made possible in part with funding provided by:

  • Community Care of Western North Carolina
  • Foundation for Health Leadership and Innovation
  • Kate B. Reynolds Charitable Trust
  • Wake AHEC

Peek, C. J. (2008). Planning care in the clinical, operational, and financial worlds. In Collaborative Medicine Case Studies (pp. 25-38). Spring New York.

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