Project Grant H79SM083249

BOSTON CERTIFIED COMMUNITY BEHAVIORAL HEALTH CENTER - THE BOSTON CERTIFIED COMMUNITY BEHAVIORAL HEALTH CLINIC (CCBHC) WILL INCREASE ACCESS TO ROBUST CONTINUUM OF INTEGRATED BEHAVIORAL AND PHYSICAL HEALTH SERVICES FOR VULNERABLE POPULATIONS RESIDING IN BOSTON, MA. OUR POPULATION OF FOCUS WILL BE LOW-INCOME, UNINSURED AND UNDER-INSURED ADULTS WITH SERIOUS MENTAL ILLNESS (SMI), SUBSTANCE USE DISORDERS (SUDS), AND CO-OCCURRING DISORDERS (CODS), AND CHILDREN AND ADOLESCENTS WITH SERIOUS EMOTIONAL DISTURBANCE (SED). BOSTON'S CURRENT COMMUNITY-BASED BEHAVIORAL HEALTH (BH) CARE SYSTEM DOES NOT WORK WELL FOR THE CITY'S MOST VULNERABLE RESIDENTS, WHO FREQUENTLY CONTEND WITH THE OVERWHELMING CIRCUMSTANCES OF LIVING IN POVERTY AND THE INSIDIOUS IMPACTS OF SOCIAL DETERMINANTS OF HEALTH. AS SUCH, THERE REMAIN SEVERAL GAPS IN CARE, SUCH AS A LACK OF 24/7 ACCESS TO URGENT BEHAVIORAL HEALTH SERVICES, INCLUDING PSYCHOPHARMACOLOGY; INSUFFICIENT PRIMARY CARE INTEGRATION; AND A LACK OF ON-SITE SERVICES FOR YOUTH WITH SED AND THEIR FAMILIES. BAY COVE HUMAN SERVICES, INC., IN PARTNERSHIP WITH BOSTON MEDICAL CENTER (BMC) AND BOSTON HEALTH CARE FOR THE HOMELESS PROGRAM (BHCHP), SEEKS TO FILL THOSE GAPS BY IMPLEMENTING AN ACCESSIBLE SYSTEM OF BH CARE PROVIDING CRISIS SERVICES, SAME-DAY TREATMENT, NAVIGATION, CARE COORDINATION, PSYCHOPHARMACOLOGY TREATMENT, INTEGRATED PRIMARY CARE, AND RECOVERY SUPPORTS. THIS SYSTEM WILL PROVIDE "TREATMENT ON DEMAND" FOR THOSE READY TO ENGAGE IN CARE THROUGH A "NO WRONG DOOR APPROACH" FACILITATED BY ENHANCED CARE NAVIGATION AND COORDINATION, AND INCREASE OUTREACH EFFORTS AND SUPPORTS FOR THOSE NOT YET READY TO ENGAGE IN CARE. THE GOALS OF THE PROJECT ARE: 1) TO EXPAND THE CAPACITY OF BAY COVE'S EXISTING BEHAVIORAL HEALTH URGENT CARE CENTER (BHUCC) TO PROVIDE 24/7 SCREENING, INITIAL ASSESSMENT, AND FACILITATED REFERRALS TO THE BOSTON CCBHC'S MULTIDISCIPLINARY TEAM; 2) TO DEVELOP AND IMPLEMENT THE INFRASTRUCTURE NECESSARY FOR BAY COVE TO BECOME A CCBHC; AND 3) TO EVALUATE THE BOSTON CCBHC ON SAMHSA AND OTHER QUALITY MEASURES WITH A VIEW TO SUSTAINABILITY. OUR MEASURABLE OBJECTIVES INCLUDE: ESTABLISHING PROTOCOLS AND DATA SHARING AGREEMENTS FOR COLLABORATION WITH BMC AND BHCHP; HIRING NEW BEHAVIORAL HEALTH PROFESSIONALS, INCLUDING CLINICIANS, PSYCHIATRISTS, AND COMMUNITY HEALTH WORKERS; IMPLEMENTING AN ON-SITE PRIMARY CARE CLINIC; INITIATING BASELINE AND FOLLOW-UP ADMINISTRATION OF NOMS TOOL AND STANDARDIZED MEASURES OF PSYCHIATRIC SYMPTOMS; AND COMPLETING QUARTERLY REPORTS AND ANNUAL OUTCOME EVALUATIONS. WE WILL ENROLL A MINIMUM OF 400 PARTICIPANTS A YEAR, FOR A TOTAL OF 800 CLIENTS THROUGHOUT THE LIFE OF THE PROJECT. THE PROCESS EVALUATION WILL ASSESS PROJECT IMPLEMENTATION IN RELATION TO TIMELINES ON STANDARDIZED MEASURES OF MENTAL HEALTH SYMPTOMS AND QUALITY OF LIFE, AS WELL AS ON NOMS MEASURES AND UTILIZATION OF ACUTE CARE SERVICES. ANNUALLY, THE EVALUATOR WILL INTERVIEW CCBHC STAFF AND ADVISORY BOARD MEMBERS TO YIELD QUALITATIVE DATA ON BARRIERS AND FACILITATORS AND PERCEIVED CHALLENGES, SUCCESSES, AND EFFECTIVENESS.