Project Grant H79SM086628

CAPE COD CCBHC - THE CAPE COD CERTIFIED COMMUNITY BEHAVIORAL HEALTH CLINIC (CCBHC) WILL SERVE AS A MUCH NEEDED SUPPLEMENT TO EXISTING SERVICES BY CREATING A ROBUST CONTINUUM OF INTEGRATED BEHAVIORAL AND PHYSICAL HEALTH SERVICES FOR VULNERABLE POPULATIONS RESIDING IN CAPE COD, MA. OUR TARGET POPULATION WILL BE LOW-INCOME, UNINSURED AND UNDER-INSURED ADULTS WITH SERIOUS MENTAL ILLNESS , SUBSTANCE USE DISORDERS, AND CO-OCCURRING DISORDERS, AND CHILDREN AND ADOLESCENTS WITH SERIOUS EMOTIONAL DISTURBANCE. WE WILL ADDRESS THE IMPACT OF CHALLENGES RELATED TO ACCESS TO CARE FELT BY THE REGION'S MOST VULNERABLE RESIDENTS, WHO FREQUENTLY CONTEND WITH THE OVERWHELMING CIRCUMSTANCES OF LIVING IN POVERTY AND THE INSIDIOUS IMPACTS OF SOCIAL DETERMINANTS OF HEALTH(SDOH). IN MANY WAYS, THERE ARE TWO CAPE CODS - ONE A POPULAR TOURIST DESTINATION THAT SEES UPWARDS OF 5 MILLION VISITORS ANNUALLY AND CATERS TO WEALTHY SEASONAL RESIDENTS AND VISITORS AND THE OTHER A RURAL, INSULAR COMMUNITY OF 228,996 YEAR ROUND RESIDENTS, WITH 14,176 PEOPLE LIVING BELOW THE POVERTY LEVEL. WITH THE WEALTH OF THE REGION HIDING THE PROBLEM, ACCESS TO SERVICES CAN BE MORE CHALLENGING THAN IN PLACES WITH HIGHER POVERTY. BAY COVE HAS BEEN PROVIDING FOR THE URGENT BEHAVIORAL HEALTH (BH) NEEDS FOR CAPE COD AS THE STATE CONTRACTED EMERGENCY SERVICE PROVIDER (ESP) FOR FIVE YEARS WHERE WE PERFORM AN AVERAGE OF 3,000 CRISIS EVALUATIONS ANNUALLY. SINCE 2019, OUR ESP HAS OPERATED A FOLLOW UP PROGRAM FOR INDIVIDUALS WHO HAD SOUGHT CRISIS SERVICES. ENGAGING IN THIS FOLLOW-UP WORK HAS GIVEN US AN IN-DEPTH UNDERSTANDING OF THE DEMAND FOR SERVICES, THE COMMUNITY BH PROVIDER LANDSCAPE AND THE MOST PRESSING SDOH NEEDS OF THE PEOPLE WE SERVE IN THIS COMMUNITY. WHAT WE HAVE SEEN FIRST HAND IS THE LACK OF OPTIONS FOR ONGOING CARE ON CAPE COD DESPITE THE SIGNIFICANT NEED FOR BH SERVICES. GIVEN OUR EXPERIENCE ON THE CAPE, BAY COVE IS WELL POSITIONED TO BE THE IDEAL AGENCY TO SUCCESSFULLY BRING CCBHC SERVICES TO CAPE COD. IN BECOMING A CCBHC, BAY COVE SEEKS TO ADDRESS GAPS BY PROVIDING OPEN ACCESS TO CULTURALLY RESPONSIVE, INTEGRATED BEHAVIORAL HEALTHCARE REGARDLESS OF INSURANCE STATUS. THE CCBHC WILL PROVIDE CRISIS SERVICES, SAME-DAY TREATMENT, PSYCHOPHARMACOLOGY TREATMENT, INTEGRATED PRIMARY CARE, ENHANCED CARE NAVIGATION AND COORDINATION, AND INCREASED OUTREACH EFFORTS AND SUPPORT SERVICES FOR THOSE NOT YET READY TO ENGAGE IN CARE. THE GOALS OF THE PROJECT ARE: 1) TO ADDRESS THE UNDER RESOURCED AND OVERLY IMPACTED CONTINUUM OF CARE FOR CAPE COD RESIDENTS BY BUILDING A BH OUTPATIENT SERVICE LOCATION AT OUR HYANNIS SITE TO BE WOVEN INTO THE EXISTING OVER BURDENED CARE SYSTEM; 2) TO BUILD A ROBUST CCBHC CONTINUUM OF CARE TO FURTHER DEVELOP BAY COVE'S CAPACITY TO RAPIDLY TRIAGE, ASSESS, PRIORITIZE AND ADDRESS THE MOST PRESSING BH NEEDS FOR SERVICES ON THE CAPE; 3) TO DEVELOP AND IMPLEMENT THE INFRASTRUCTURE NECESSARY FOR BAY COVE TO BECOME A CCBHC ON CAPE COD; AND 4) TO EVALUATE THE CAPE COD 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 OUR DCOS, CHILD AND FAMILY SERVICES AND DUFFY HEALTH CARE AND OUR COMMUNITY SUPPORTERS CAPE COD VET CENTER AND THE NATIONAL ALLIANCE FOR MENTAL ILLNESS; HIRING NEW BH PROFESSIONALS, INCLUDING CLINICIANS, PSYCHIATRISTS, AND COMMUNITY WORKERS; IMPLEMENTING A CO-LOCATED 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 100 PARTICIPANTS A YEAR, FOR A TOTAL OF A OF 400 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.