Cincinnati restoration initiative (CRI) - greater cincinnati behavioral health services (GCB) will restore services impacted by the covid-19 pandemic (c-19P) to address needs of persons with serious…

Cincinnati restoration initiative (CRI) - greater cincinnati behavioral health services (GCB) will restore services impacted by the covid-19 pandemic (c-19P) to address needs of persons with serious mental illness (SMI) and those with CO-occurring substance use disorders (COD). CRI will address gaps in services and infrastructure to minimize c-19P's impact in hamilton county, OH (HC). Behavioral health disorders are the most common pandemic health effect. C-19P's sweeping impacts will have significant health implications in a state with the highest SMI prevalence in the U.S. To address current and emerging needs, GCB seeks funds to address 3 gaps related to access, crisis services, and telehealth. C-19P amplified treatment demand. GCB admissions increased 40% while its workforce shrank 12.4% during c-19P. The service impact was immediate. Admission teams could not provide same day treatment access. Hospital and jail intakes declined 31%. Psychiatric and care management services each fell 26%. Average care manager (CM) caseloads ballooned from 34 clients to 44. 81% of clients experienced a service decrease resulting in unmet needs. Staff stress and burnout were directly related to staff shortages and higher caseloads. Access to crisis services was also an issue. GCB relied on HC's crisis continuum to address psychiatric crises, but these services were limited during c-19P. GCB's crisis response fell to CMS who were already overwhelmed. C-19P's impacts are only beginning to surface. GCB saw a 30% increase in psychiatric emergencies and 92% increase in overdose deaths since c-19P underscoring the need to build internal crisis capacity. To provide some service, GCB adopted basic telehealth since its EHR did not have a telehealth platform shifting services from face-to-face (95%) to telehealth (77%). This shift, alongside workforce reductions, resulted in a $3.9 million revenue reduction in the 12 months after c-19P. GCB will restore clinical services and bolster telehealth to minimize c-19P's impact on clients, staff, and GCB. CRI will serve 1,000 clients over 2 years - 500/year. Project goals/objectives focus on intake capacity, care management access, crisis services, and telehealth. CRI will achieve 4 goals: 1) expand intake capacity to meet treatment demand via a rapid engagement to care team to manage hospital and jail admissions. 2) expand care management access to reduce average CM caseload through 4 new care management teams. 3) increase crisis services to reduce psychiatric emergencies through a crisis support team and 2 additional crisis beds. 4) expand telehealth through a new EHR with a telehealth platform. Key interventions include cognitive behavioral therapy, critical time intervention, integrated dual disorder treatment, and motivational interviewing. CRI's population will include new clients with SMI or SMI+COD assigned to psychiatric, and care management services. 40% have psychotic disorders; 50% a COD, 55% are black; 42% white. 52% are male. Average age is 44. 86% are below 100% of the federal poverty level. GCB has the leadership and experience to restore and bolster services with samhsa support.