Provider-Led Innovation in Health and Health Equity
Crisis Intervention Therapy and Education (CITE) Pilot
Fully funded by Carolina Complete Health Network, the 2025 CITE Pilot aimed to address North Carolina’s pediatric behavioral health ED boarding crisis, where youth often waited weeks for placement due to limited options. Carolina Complete Health Network, Novant Presbyterian Pediatric ED, and SPARC’s MORES program partnered to test whether a dedicated ED behavioral health clinician, supported by MORES community services, could reduce boarding times.
Given strong outcomes, Novant Health is maintaining the dedicated clinician and exploring expansion, while Carolina Complete Health Network is launching Phase 2 at an additional ED and community site.
Pilot Model
- Behavioral health clinician embedded in the ED
- MORES mobile crisis team providing home, community, and ED response plus up to 8 weeks of stabilization services
- Education and training for families, providers, and community partners
Key Results
- Pediatric “social hold” occupancy dropped from 50–70% to <10%
- Average length of stay fell from 4–6 weeks to 3–4 days (2.11 days for pilot-identified patients)
- A typical cohort (115 patients) previously used nearly one year of ED bed capacity—equivalent to nine beds daily
- “Left without being seen” rates improved from >2% to <1% (53% reduction)
- Improved patient flow, community coordination, and staff experience
Continuous Glucose Monitoring for Children/Adolescents with Obesity and Asthma
Salisbury Pediatrics leveraged data to identify at-risk patients with a diagnosis of obesity and asthma. By incorporating the use of continuous glucose monitors, the goal for this pilot is for patients and families to get valuable education on their chronic disease, understand how weight and obesity impacts multiple areas and disease processes of their life. This will equip individuals to make meaningful changes that will positively impact their health. Intended outcomes include reduced asthma medicine need, reduced emergency room visits, reduced unscheduled asthma visits, reduced weight, and improved metabolic metrics. Carolina Complete Health Network will be providing continuous glucose monitors to the identified cohort along with other incentives to increase patient and family engagement in the pilot. This pilot will be payer blind and will
provide funding to all individuals identified as part of the pilot.
Archived Pilots
| Region and Practice Type | Pilot Aim |
|---|---|
| Region 3 Multi-Specialty Practice | Introduce LCSW into Care Management program |
| Region 4 Multi-Specialty Practice | Integrating LCSW with Pediatric Practice for Behavioral Health Integration |
| Region 5 Family Medicine Practice | Best Practices in Health Equity |
| Region 5/6 Child and Multi-Specialty Clinic | AMH Tier 3 Readiness Support: Read the full case study (PDF). |
- “Having access to someone who can help our patients quicker than we have ever had before. My patients and their parents are truly benefiting from working with the LCSW.”
- “Its really nice to have an LCSW just right there in the office and that helps to give early assistance to needy patients.”
- “She is available in office and can see patients after their appt with provider (convenient for the parent). She can assess the severity for further referral. She can follow-up if they need more frequent counseling.”
- “Has been easier to get help for these patients in a timely manner as there are not too many resources out there in our community and the wait has been long.”
- Carolina Complete Health Network partnered with Neighbor Health Center Inc. to serve the needs of the underserved in the Raleigh area. The pilot set out to integrate behavioral health services in the office. Throughout the pilot, Neighbor Health has been able to successfully reach level 4 on the SAMSHA scale of Collaboration/Integration (PDF) which states close collaboration onsite with some system integration and serve an outstanding 472 individuals! Read more about this case study here (PDF).