How CSBMG Supports Rural Hospitals in Advancing Integrated Behavioral Health Care

Written by: CSB of Middle Georgia

Across rural communities, hospitals are often the first point of contact for individuals experiencing behavioral health crises, substance use concerns, or co-occurring conditions. In Middle Georgia, the Community Service Board of Middle Georgia (CSBMG) plays a crucial role in supporting our hospitals partners. Through strong coordination, peer linkage efforts, crisis stabilization pathways, and participation in statewide behavioral health integration initiatives.

Collaborative Relationships with Rural Hospitals

CSBMG maintains positive working relationships with multiple rural and critical access hospitals throughout its 16-county service area. While no CSBMG staff are currently embedded in emergency departments, collaboration occurs consistently through referral coordination, case management follow-up, and transitional support services.

Staff from intensive service programs such as ICM (Intensive Case Management), CST (Community Support Team), and residential programs regularly accompany or support individuals presenting to hospitals when medical clearance is required prior to local hospital admission and/or behavioral health admission to higher levels of care, such as crisis stabilization units. CSBMG’s Child/Adolescent/Emerging Adult services also maintain a strong referral and communication network with pediatric and youth-serving hospital departments.

CSU-to-BHCC: A Central Link for Crisis and Medical Clearance

CSBMG’s Crisis Stabilization Unit (CSU), which is soon to transition into a state-designated Behavioral Health Crisis Center (BHCC), functions as a core access point for individuals referred by local emergency departments. The leadership team overseeing this program consists of former ER charge nurses, which has helped establish communication and mutual trust between hospital ER teams and CSBMG clinicians.

Hospital partners frequently coordinate with the CSU/BHCC for individuals requiring psychiatric stabilization or detoxification from substances such as alcohol and opioids. Medical clearance remains an essential step in the admission process, requiring regular collaboration between hospital medical staff and CSBMG intake teams.

Integrated Care as a Foundational Practice

CSBMG’s delivery approach is grounded in whole-person care, with integrated behavioral and physical health coordination embedded into service planning. Integrated care expectations are reinforced through state and national accreditation and certification frameworks, including CARF, NADD, DCH, and DBHDD surveys and site reviews. As CSBMG advances toward full Certified Community Behavioral Health Clinic (CCBHC) certification, physical-behavioral health coordination and linkage with medical providers—including hospitals—remain central to service delivery.

Hospital Collaboration Through Statewide Grant Initiatives

Several grants strengthen CSBMG’s hospital partnerships and support behavioral health integration in emergency care settings.

1. REALTTIME (Rural Expanded Access to OUD Care and Linkage Using Toxicologists for Telehealth-Initiated Treatment)
   Funded through Emory University and the Georgia Poison Center, this initiative equips rural emergency departments to identify and treat opioid use disorder (OUD). CSBMG’s RISEUP recovery team partners with Taylor Regional and Bleckley Memorial Hospitals, providing peer linkage immediately following overdose or withdrawal-related hospital visits. Through telehealth-supported medical guidance, hospital providers can initiate buprenorphine treatment while peers connect individuals with outpatient recovery supports and behavioral health services.
2. GPCA HRSA RCORP-BH Grant (Georgia Primary Care Association—Rural Communities Opioid Response Program – Behavioral Health)
   As part of a four-CSB collaboration with two Federally Qualified Health Centers (FQHCs), CSBMG contributes to bi-directional referrals, case management coordination, and integrated care protocols across 19 rural counties. This initiative addresses barriers to behavioral health access for both general and justice-involved populations, strengthening care continuity between medical and behavioral health systems, including hospitals.
3. SAMHSA CCBHC Certification Development and Implementation Grant
   As a current SAMHSA CCBHC grantee, CSBMG is building a service model where integrated care, rapid access, and coordinated crisis response support hospital engagement. Care Coordinators are strategically positioned to ensure individuals transitioning from emergency departments receive timely follow-up and connection to outpatient behavioral health services.

Looking Ahead: Expanding Integration Opportunities

As CSBMG progresses toward full BHCC designation and CCBHC certification, opportunities exist for deeper hospital-based collaboration, including behavioral health navigators, care coordinators, or peer recovery support specialists being more engaged across outpatient and hospital settings. Future innovations may include enhanced data-sharing frameworks, co-trained crisis response teams, and expanded rural hospital partnerships supported by state and federal funding models.

Conclusion

While CSBMG does not currently embed clinical staff directly in rural emergency departments, meaningful and effective integration with hospitals is already occurring through referral networks, crisis pathways, peer recovery linkages, and grant-funded partnerships. As behavioral health integration becomes increasingly critical in rural health systems, CSBMG remains committed to advancing collaborative, community-based solutions that support individuals at every point of care—including the emergency room door.