Co-occurring Center for Excellence

Co-occurring Center for Excellence
Name	Co-occurring Center for Excellence
Type	Nonprofit center
Founded	2000s
Location	United States
Focus	Integrated treatment for co-occurring disorders

Co-occurring Center for Excellence is a clinical and policy-focused organization dedicated to improving integrated care for individuals with co-occurring mental health and substance use disorders. The center collaborates with federal agencies, academic institutions, healthcare providers, and community organizations to translate evidence into practice and to support system-level change. It serves as a hub for training, technical assistance, research synthesis, and implementation support across multiple care settings.

Overview

The center operates at the intersection of clinical practice, public policy, and implementation science, engaging stakeholders such as the Substance Abuse and Mental Health Services Administration, National Institutes of Health, Centers for Disease Control and Prevention, Department of Veterans Affairs, and state behavioral health authorities. It partners with universities like Harvard University, Johns Hopkins University, University of California, Los Angeles, and University of Pennsylvania and with health systems including Kaiser Permanente, Mayo Clinic, and Massachusetts General Hospital to pilot integrated models. The organization synthesizes guidance from major guideline bodies such as the World Health Organization, American Psychiatric Association, American Society of Addiction Medicine, and National Institute for Health and Care Excellence to inform practice standards. It engages with advocacy groups including National Alliance on Mental Illness, Facing Addiction, and Alcoholics Anonymous-linked networks to align clinical aims with lived-experience perspectives.

Services and Programs

Programs include clinical consultation, site-based technical assistance, and implementation coaching modeled on frameworks from Institute for Healthcare Improvement, Agency for Healthcare Research and Quality, and The Cochrane Collaboration. Service delivery models promoted draw from evidence in integrated settings like community health centers, federally qualified health centers, correctional health services, and Veterans Health Administration clinics. The center offers online toolkits, decision aids, and fidelity measures adapted from Motivational Interviewing research, Cognitive Behavioral Therapy manuals, and Medication-Assisted Treatment protocols endorsed by U.S. Food and Drug Administration. It conducts programmatic work in collaboration with payers such as Centers for Medicare & Medicaid Services and private insurers exemplified by Blue Cross Blue Shield plans to explore payment models like bundled payments and value-based purchasing.

Research and Evidence Base

The center curates and translates literature from randomized controlled trials, meta-analyses, and implementation studies published in journals associated with The Lancet, JAMA, New England Journal of Medicine, and American Journal of Psychiatry. Its research synthesis highlights studies of integrated care models informed by authors and projects originating from institutions such as Columbia University, Yale University, Stanford University, and University of Washington. The evidence base encompasses pharmacotherapy trials involving medications reviewed by the U.S. Food and Drug Administration, psychosocial interventions rooted in Dialectical Behavior Therapy and Contingency Management, and system-change evaluations using frameworks from Consolidated Framework for Implementation Research and RE-AIM. The center disseminates findings through partnerships with conferences like American Public Health Association, Society for Implementation Research Collaboration, and American Society of Addiction Medicine meetings.

Training and Workforce Development

Workforce initiatives include competency-based curricula co-developed with professional bodies such as the American Psychological Association, American Medical Association, American Nurses Association, and National Association of Social Workers. Training modalities encompass in-person workshops, virtual learning collaboratives, and competency assessments aligned to licensure boards like state medical boards and accreditation organizations such as Joint Commission. The center has educational partnerships with training hospitals and residency programs affiliated with University of California, San Francisco, Duke University School of Medicine, and Mount Sinai Health System to integrate co-occurring disorder competencies into clinical training. It supports peer workforce development leveraging models from Peer Support Specialist programs and collaborates with organizations like SAMHSA’s technical assistance networks.

Governance and Funding

Governance structures typically include advisory boards composed of leaders from federal agencies such as SAMHSA, NIH, state health departments, and academic partners from Harvard Medical School and Johns Hopkins Bloomberg School of Public Health. Funding streams combine grants and contracts from federal agencies including SAMHSA, NIH, and Centers for Medicare & Medicaid Services with foundation support from entities like the Robert Wood Johnson Foundation, Kresge Foundation, and Gates Foundation, as well as fee-for-service agreements with healthcare systems. The center adheres to accountability standards promoted by funders and accreditation entities such as the National Committee for Quality Assurance and reports outcomes aligned with national reporting systems like the Uniform Data System.

Impact and Outcomes

Evaluations document improved screening rates, increased initiation of evidence-based pharmacotherapies reviewed by the FDA, enhanced linkage to community supports like Housing First programs, and reductions in emergency department utilization consistent with findings in implementation science literature. Outcome measures tracked include clinical symptom scales referenced in DSM-5, service utilization metrics used by Medicaid programs, and patient-reported outcomes aligned with instruments endorsed by the Patient-Reported Outcomes Measurement Information System. Policy influence is reflected in state-level adoption of integrated care standards and incorporation of co-occurring disorder guidance into programs run by agencies such as SAMHSA and CMS.

Category:Behavioral health organizations