Primary Care Association (PCA) Initiative


The goal of APA’s primary care association initiative is to develop psychologist positions and psychology training programs in Federally Qualified Health Centers (FQHCs) around the country, particularly community health centers and rural health clinics. These health centers are organized in states and regions of the country as Primary Care Associations (PCA) under the oversight of the HRSA’s Bureau of Primary Health Care (BPHC) and its national organization, the National Association of Community Health Centers (NACHC).

The Primary Care Association Initiative was launched on September 19, 2008, in Washington, D.C., when the APA Education Government Relations Office and the APA Committee on Rural Health (CRH; under the authority of the APA Committee for the Advancement of Professional Practice) hosted an all-day meeting. Our goal was to work with BPHC, NACHC and the PCAs to increase the demand for psychologists and psychology trainees for delivering integrated health care at the health centers throughout the nation. This initiative grew out of the longstanding awareness of the lack of access to behavioral health and psychological and integrated health care services in rural areas.


The goals of the meeting were to

  • Learn what has worked to create positions for psychologists and psychology trainees in FQHCs;

  • Create an action plan to work with state Primary Care Associations to promote integrated care and new positions for psychologists and psychology trainees; and

  • Build the foundation for a partnership among state, provincial and territorial psychological associations (SPTAs), state primary care associations, relevant federal agencies and national organizations, and the American Psychological Association to further the initiative.

CRH has taken a strong interest in integrated care because it seems likely to be a part of healthcare reform and it seems to be a great model for rural psychology practice. An integrated care model brings psychologists into primary care and attempts to seamlessly provide both mental/behavioral health services along with traditional primary care medicine. At its most basic, integrated care can involve the co-location of mental health services in a primary care physician’s office; in models with a higher degree of collaboration, the psychologist works as part of the team with the physician, nurses, and other staff, providing brief behavioral health interventions and consulting directly with the team on treatment plans. It has been stated that the primary care system in America is the de facto mental health system. In rural areas where psychologists and other mental health professionals are less densely located, it is even more important to provide services where most people will be willing, able, and likely to receive them.

Key Recommendations

The meeting concluded with a number of key recommendations, including:

  • Drafting talking points for use by psychologists willing to reach out to their state Primary Care Association.

  • Facilitate discussions among key stakeholders, including state, provincial, and territorial psychological associations, primary care associations, psychologists, payers, etc.

  • Developing materials to educate FQHC administrators on the positive health outcomes of employing psychologists.

  • Sharing publications with key players in the FQHC program at the federal, state & local levels.