COMMUNITY PROJECT FUNDING/CONGRESSIONALLY DIRECTED SPENDING - CONSTRUCTION - PROJECT ABSTRACT ORGANIZATION: CATHOLIC MEDICAL CENTER (CMC) UIE #: NE8YG9EKJWF6 ADDRESS: 100 MCGREGOR STREET, MANCHESTER, NH 03102-3730 PROJECT DIRECTOR: KERI DEGEN PHONE: 603.663.6056, FAX: 603.663.6067 EMAIL: KERI.DEGEN@CMC-NH.ORG WEBSITE: CATHOLICMEDICALCENTER.ORG AMOUNT REQUESTED IN FIRST BUDGET PERIOD: $500,000 ACCORDING TO HEALTHCARE COST AND UTILIZATION PROJECT STATISTICAL BRIEF #227, "INDIVIDUALS WITH MENTAL HEALTH ISSUES AND SUBSTANCE USE DISORDER (SUD) ARE AMONG THE FASTEST GROWING PATIENT POPULATIONS IN U.S. HOSPITAL EMERGENCY DEPARTMENTS (ED'S). BETWEEN 2006 AND 2014, THIS POPULATION EXPERIENCED A 44% INCREASE IN ED VISITS." THIS TREND HAS CONTINUED TO CREATE A CRISIS FOR MANY NH HOSPITALS ED'S, INCLUDING CMC. WITHOUT ADEQUATE ACCESS TO PSYCHIATRIC BEDS FOR ADMISSION, THESE PATIENTS OFTEN "BOARD" FOR HOURS, DAYS AND EVEN LONGER. THE CMC EMERGENCY DEPARTMENT (CMC ED) PROVIDES CARE TO INVOLUNTARILY ADMITTED PATIENTS IN A DESIGNATED AREA IN THE ED CALLED THE BEHAVIORAL HEALTH ANNEX. OFTEN TIMES PATIENTS WILL "BOARD" THERE FOR DAYS, WEEKS OR MONTHS UNTIL PROPER BED PLACEMENT IS AVAILABLE. THE ENVIRONMENT OF CARE IN THE ANNEX IS NOT SUFFICIENT TO MEET THE RECOVERY SUPPORT NEEDS OF THESE PATIENTS. OVER THE PAST TWO YEARS, THIS HAS RESULTED IN 10 CMC EMPLOYEES BEING PHYSICALLY ASSAULTED DURING A PATIENT OUTBURST OR ALTERCATION. CMC RECOGNIZES THE NEED TO EXPAND AND RENOVATE ITS ED BEHAVIORAL HEALTH ANNEX TO MEET THE GROWING BEHAVIORAL HEALTH AND/OR SUD TREATMENT NEEDS OF THE COMMUNITY. THE HOSPITAL IS IN THE PLANNING AND DESIGN PHASE OF AN EXPANSION AND RECONSTRUCTION PROJECT SET TO BREAK GROUND IN 2023, WHICH WILL INCLUDE THE CONSTRUCTION AND IMPROVEMENT BEHAVIORAL HEALTH/SUD BOARDING SPACE IN THE CMC ED. BEHAVIORAL HEALTH PATIENTS THAT USE THE CMC ED FOR THEIR CARE ROUTINELY HAVE DELUSIONS, HALLUCINATIONS AND HAVE A HIGH RATE OF CHEMICAL DEPENDENCY. THIS MAKES THEIR NEEDS VERY COMPLEX AND THEIR CAPABILITY TO FOLLOW TREATMENT RECOMM ENDATIONS IS OFTEN VERY POOR. THEY ARE FREQUENTLY UNEMPLOYED OR UNDEREMPLOYED AT BEST. THIS OFTEN LEADS TO POOR OR NO INSURANCE COVERAGE FOR BASIC TREATMENT LET ALONE MORE INTENSIVE INPATIENT TREATMENT. HIGH COMPLEXITY PLUS POOR TREATMENT ADHERENCE AND VERY LIMITED TREATMENT OPTIONS EXACERBATES THE CURRENT CRISIS. IT IS WELL KNOWN THAT THE STATE OF NH AND THE CITY OF MANCHESTER ARE WORKING TOGETHER TO SUPPORT THIS POPULATION AND CREATE WAYS TO INCREASE ACCESS TO INPATIENTS TREATMENT BUT THIS REMAINS A COMPLEX PROBLEM WITH NO QUICK FIX. THE CONSTRUCTION OF THE CMC ED BEHAVIORAL HEALTH ANNEX WILL PROVIDE A TEMPORARY RECOVERY ENVIRONMENT FOR PATIENTS WHERE THEY WILL BE TREATED WITH DIGNITY AND RESPECT WHILE THEY AWAIT INPATIENT TREATMENT. THIS WILL BENEFIT THE COMMUNITY BECAUSE IT WILL HELP TO REDUCE THE NUMBER OF PATIENTS IN CRISIS WHO LEAVE THE HOSPITAL AGAINST MEDICAL ADVICE PRIOR TO GETTING THE SUPPORT THEY NEED. AS A RESULT, THIS WILL SUPPORT A DECREASED NEED FOR LAW ENFORCEMENT INTERACTIONS AND/OR VIOLENCE IN THE CITY OF MANCHESTER.