CARF standards address integrated primary care

CARF International convened an International Standards Advisory Committee (ISAC) to develop and release interdisciplinary, field-driven accreditation standards for the Integrated Primary Care Specialty Program. A specialty designation requires a program seeking accreditation to meet an additional set of standards that reflects its expertise in a specific type of service delivery.

Integrating primary care into a mental health or substance use disorder program allows the program to holistically address the behavioral health, physical health, and social needs of the persons served, enhance the level of care provided, and improve outcomes for the persons served. CARF has three service areas where accreditation for this specialty program can be achieved and found in the 2026 standards manuals for Behavioral Health, Child and Youth Services, and Opioid Treatment Program.

“Healthcare has been artificially partitioned into distinct fragments,” said Michael Connolly, D.O., Chief Medical and Quality Officer, CARF International and ISAC participant. “It is proper to consider a person’s health to include all factors that impact their health and well-being. Integrative care standards begin to move us in the right direction. Even though I helped put the standards together, I would like nothing more than to see these standards become obsolete and we routinely care for people holistically, as individuals who are all special and complex.”

Standards rationale

A needs assessment of the population served, including behavioral health, physical health, and social needs, guides the development of services, including screening practices and protocols to optimize health outcomes for the persons served. In addition to the person served, the interdisciplinary team includes providers who can address needs in each of these areas through an integrated approach. The program, either directly or through collaboration and linkages, provides care coordination, care management, individual and family support services, and referral to community and social services.

In addition to monitoring and measuring the progress of individual persons served, the program collects and analyzes data to manage and improve behavioral health, physical health, social, and functional outcomes for the population served.

Integrated behavioral health/primary care programs seek to educate the persons served on strategies for wellness and self-management. Cross-training for personnel addresses common conditions in the population served and how behavioral health, physical health, and social needs may impact each other, models of integrated care, and collaborative person-centered planning practices.

Leadership at both the program and organizational levels engage in efforts to continually improve collaborative care and champion integrated care.

“These new standards help healthcare organizations ensure their integrated primary care/behavioral health teams are delivering excellent, measurable care. The designation provides a clear way for organizations to demonstrate their successful integration efforts and commitment to high-quality patient care,” said Michael Johnson, Senior Managing Director of Behavioral Health, CARF International and ISAC participant.

Standards created

The standards address the essential components of an Integrated Primary Care Specialty Program, which include:

• Leadership support of integrated care
• Needs assessment of the population served
• Scope of integrated care
• Integrated interdisciplinary team and planning
• Education and training for persons served and direct-service personnel
• Performance measurement and management specific to integrated care

CARF standards process

CARF’s process for creating new standards includes convening an ISAC to develop the standards, then a review of the proposed standards and gaining expert insight from the CARF International Advisory Council before conducting a public field review. The Integrated Primary Care Specialty Program ISAC and public field review involved 85 stakeholders, including individuals with lived experience and their family members.

CARF staff and the ISAC members used input from the reviews and a consensus-driven process to finalize the standards published in the 2026 Behavioral Health, Child and Youth Services, and Opioid Treatment Program Standards Manuals, which go into effect July 1, 2026.