Project Grant H79SM083335

SSTAR CCBHC INITIATIVE - THE SSTAR CCBHC EXPANSION PROJECT 2020 WILL ADDRESS THE MOST URGENT HEALTH NEEDS OF THE FALL RIVER, MASSACHUSETTS COMMUNITY WHICH INCLUDE LACK OF ACCESS TO MENTAL HEALTH SERVICES - ESPECIALLY PSYCHIATRY- OPIOID AND POLYSUBSTANCE OVERDOSE, AND SMOKING. THE CITY HAS ONLY RECENTLY BEGUN TO RECOVER FROM A SUSTAINED PERIOD OF ECONOMIC DEPRESSION WHICH BEGAN WITH THE EXODUS OF TEXTILE/MANUFACTURING JOBS TO THE SOUTH AND OVERSEAS. IN PERCENTAGE TERMS FALL RIVER HAS THE LARGEST PORTUGUESE AMERICAN POPULATION IN THE UNITED STATES. HRSA DESIGNATED FALL RIVER A HEALTH PROFESSIONAL SHORTAGE AREA (HPSA) FOR MENTAL HEALTH WITH A SCORE OF 16. THE POPULATION OF FOCUS WILL BE OPIOID ADDICTED ADULTS WITH CO-OCCURRING MENTAL ILLNESS. SSTAR CURRENTLY MEETS THE CRITERIA FOR CCBHC WITH THE EXCEPTION OF ACCESS STANDARDS FOR ADULT AND CHILD PSYCHIATRIC SERVICES. SSTAR HAS BEEN PROVIDING BEHAVIORAL HEALTH SERVICES SINCE 1977 AND HAS LONG BEEN A LEADER IN INTEGRATED PRIMARY AND BEHAVIORAL HEALTH CARE, PROVIDING PRIMARY CARE THROUGH OUR FQHC LOCATED IN THE SAME BUILDING AS OUR OUTPATIENT BEHAVIORAL HEALTH CLINIC AND OPIOID TRIAGE CENTER. THIS CCBHC EXPANSION WOULD REDUCE OVERDOSE DEATHS, INCREASE POST-OVERDOSE ENGAGEMENT IN MAT AND OTHER BEHAVIORAL HEALTH TREATMENT, AND REDUCE HOSPITAL EMERGENCY DEPARTMENT UTILIZATION FOR OVERDOSE-RELATED VISITS BY ESTABLISHING A NEW MEDICAL MONITORING AND OBSERVATION SERVICE (MMOS) EMBEDDED IN OUR CCBHC/OPIOID TRIAGE CENTER/MAT BRIDGE CLINIC. THIS PROJECT WILL INCREASE ACCESS TO PSYCHIATRIC SERVICES BY BOTH RECRUITING ADDITIONAL PSYCHIATRIC PROVIDERS AND BY MAXIMIZING NEW AND EXISTING PSYCHIATRIC RESOURCES BY DEVELOPING AND IMPLEMENTING NEW DIGITAL TECHNOLOGY TO REDUCE WASTED APPOINTMENTS DUE TO NO-SHOWS AND CANCELLATIONS. WE EXPECT TO REDUCE THE WAIT FOR PSYCHIATRIC EVALUATIONS FOR NEW PATIENTS FROM SIX MONTHS TO THREE DAYS BY THE END OF YEAR II, AND INCREASE THE NUMBER OF UNIQUE PSYCHIATRIC PATIENTS SEEN BY 225 IN YEAR I. TO REDUCE RISK OF OVERDOSE BY POLYSUBSTANCE USE, THE PROJECT WILL DEVELOP NEW FOR BENZODIAZEPINES AND STIMULANTS PRESCRIBING PROTOCOLS FOR SSTAR PRIMARY CARE AND PSYCHIATRIC PRESCRIBERS. TO ASSIST WITH THE CHANGED PRESCRIBING PRACTICES, SSTAR CCBHC 2020 WILL DEVELOP AND IMPLEMENT A NEW OUTPATIENT GROUP CURRICULUM TO HELP PATIENTS TAPER OR WITHDRAW FROM MEDICATIONS THAT ARE CONTRAINDICATE BY BEST MEDICAL PRACTICE. THE OUTPATIENT CURRICULUM WILL BE BASED ON DBT AND WILL INCORPORATE PEER RECOVERY COACHES, ACUPUNCTURE TREATMENT, AND FAMILY ENGAGEMENT. AT LEAST 40 CCBHC CLIENTS WILL PARTICIPATE IN SMOKING CESSATION INDIVIDUAL AND/OR GROUP SESSIONS. THE PROJECT WILL ENHANCE SSTAR'S CAPABILITY TO PROVIDE CARE THROUGH TELEHEALTH, BOTH TO EXPAND TREATMENT RESOURCES, BUT ALSO TO BETTER PREPARE US TO CONTINUE CARING FOR OUR PATIENTS DURING A PUBLIC EMERGENCY SUCH AS PANDEMIC. EXPANDED USE OF A DIGITAL HEALTH AND WELLNESS SOLUTION - THE MYSTRENGTH MOBILE PHONE APP- THAT INCLUDES MODULES FOR SMOKING CESSATION, RECOVERY SUPPORT, AND MINDFULNESS WILL CONTRIBUTE TO OVERALL IMPROVED HEALTH STATUS OF OUR POPULATION.