Project Grant H79SM086867

SPECIALIZED TREATMENT AND RECOVERY TEAM (START) - YORK ENHANCEMENTS - WELLSPAN'S SPECIALIZED TREATMENT AND RECOVERY TEAM (START) - YORK ENHANCEMENTS EXPANDS ITS CERTIFIED COMMUNITY BEHAVIORAL HEALTH CLINIC TO SERVE 500+/YEAR, 2,150 IN 4 YEARS. ENHANCEMENTS ARE SUPPORT GROUPS AND EDUCATION IN COMMUNITY SETTINGS, EXPANDING WALK-IN HOURS, ADDING EVIDENCE-BASED PRACTICES SPECIFIC TO PERSONS EXPERIENCING HOMELESSNESS, FORMERLY INCARCERATED, SPANISH-SPEAKING AND LGBTQI+; TRAINING FOR LGBTAIA+ AFFIRMING STAFF, ON-SITE TOBACCO CESSATION, AND EXPANDING COLLABORATION WITH PRISON DIVERSION/RE-ENTRY. THE POPULATION OF FOCUS FOR START IS INDIVIDUALS WITH COMPLEX BEHAVIORAL AND PHYSICAL HEALTH NEEDS, WHO ALSO HAVE PSYCHOSOCIAL AND CULTURAL FACTORS AND/OR COMPLEXITIES PRECIPITATING, AND PROPAGATING HEALTH, MENTAL HEALTH, AND SUBSTANCE USE CONCERNS. MOST PARTICIPANTS ARE FROM YORK CITY, WHERE 44% ARE NON-WHITE, 33% HISPANIC, AND 27.7% LIVING BELOW POVERTY LEVEL. LOCATION IS YORK CITY, ALTHOUGH PARTICIPANTS ARE ACCEPTED FROM ANY GEOGRAPHIC AREA. GOAL 1: TO IMPROVE AND EXPAND THE CARE PROVIDED BY START OBJ 1A: BY INCREASING PEER AND RECOVERY SUPPORT SERVICES AND ADDING COMMUNITY PARTNERS THAT ADDRESS SDOH, START PARTICIPANTS SCORES ON THE DLA20 (IMPLEMENTATION BY MARCH 2023) WILL IMPROVE BY AT LEAST 10% FROM INTAKE TO DISCHARGE BY 9/29/24 AND ANNUALLY THEREAFTER. OBJ 1B: BY OFFERING ON-SITE FREEDOM FROM SMOKING GROUPS AND INDIVIDUAL COUNSELING AT START, THE # OF REFERRALS TO TOBACCO CESSATION WILL INCREASE BY 20% BY 9/29/24 AND ANNUALLY THEREAFTER. OBJ 1C: AS A RESULT OF SEEKING CONSUMER INPUT THROUGH PATIENT ROUNDING AND ENGAGING START COMMUNITY OVERSIGHT/GOVERNANCE GROUPS (CONSUMER ADVISORY BOARD AND CONSUMER ADVISORY COUNCIL) AND CONSIDERING THAT FEEDBACK TO IMPROVE SERVICES AT START, BY 9/1/23 AND ANNUALLY THEREAFTER 85% OF CONSUMERS WILL INDICATE THEY WOULD RECOMMEND THE PROGRAM TO OTHERS AS MEASURED ON MCCLEAN PERCEPTIONS OF CARE EBASIS PATIENT EXPERIENCE SURVEY. GOAL 2: TO INCREASE ACCESS TO AND AVAILABILITY OF HIGH-QUALITY SERVICES TO MEET IDENTIFIED COMMUNITY NEEDS OBJ 2A: AS A RESULT OF OFFERING AT LEAST 15 HOURS/WEEK OF OPEN SLOT (WALK-IN) APPOINTMENTS, BY 9/29/23 AND THEREAFTER, THE AVERAGE TIME BETWEEN REQUESTING AN APPOINTMENT AND HAVING A SCHEDULED APPOINTMENT WILL DECREASE TO AN AVERAGE OF 3 DAYS (CURRENTLY AT 3.4-DAY AVERAGE). OBJ 2B: AS A RESULT OF PROVIDING PEER AND RECOVERY SUPPORT AND SUPPORT GROUPS IN COMMUNITY LOCATIONS AND INCREASING START'S NUMBER OF LGBTQIA+-AFFIRMING TEAM MEMBERS, THERE WILL BE A 10% OVERALL INCREASE IN UNDUPLICATED INDIVIDUALS SERVED BY 9/29/24 AND MAINTAINED THEREAFTER, AND AT LEAST A 5% INCREASE IN NUMBER OF LGBTQIA+ INDIVIDUALS SERVED BY 9/29/24 AND ANNUALLY THEREAFTER. GOAL 3: TO PROVIDE CARE IN A COMMUNITY-BASED SETTING TO REDUCE OVERALL COST OF CARE OBJ 3.A: AS A RESULT OF INTEGRATION OF CRISIS STAFF WITH START STAFF AND INCREASED COMMUNITY OUTREACH, THE NUMBER OF ED DIVERSIONS WILL INCREASE BY 10% EACH YEAR TO AT LEAST 70/MONTH BY 9/29/23, 77/MONTH BY 9/29/24, 85/MONTH BY 9/29/25, 94/MONTH BY 9/29/26. OBJ 3B: UPON DISCHARGE FROM START TO PRIMARY CARE OR OTHER OUTPATIENT SERVICES, START PARTICIPANTS WILL HAVE A 20% REDUCTION IN ED VISITS FOR MH OR MH/SUD COMPARED TO THE 12 MONTHS PRIOR TO RECEIVING SERVICES AT START BY 9/29/25. OBJ 3C: AS A RESULT OF COLLABORATIVE EFFORTS BETWEEN THE START, COMMUNITY ACTION FOR RECOVERY AND DIVERSION (CARD), YORK COUNTY RE-ENTRY COALITION AND THE COUNTY PRISON SYSTEM, DIVERSIONS FROM THE JUSTICE SYSTEM INTO TREATMENT FOR THOSE WITH MH AND SUD DISORDERS WILL INCREASE BY 20% OVER FOUR YEARS (5% PER YEAR) BY 9/29/26 FROM A 2022 BASELINE OF 27.