Project Grant H79SM087003

CT ESSENTIAL - NEW FUNDING FROM THE U.S. SUBSTANCE ABUSE AND MENTAL HEALTH SERVICES ADMINISTRATION WILL HELP THE NONPROFIT BEHAVIORAL HEALTHCARE PROVIDER COMMUNITY HEALTH RESOURCES (CHR) EXPAND RECOVERY-ORIENTED SERVICES FOR PEOPLE OF ALL AGES IN A 21-TOWN CATCHMENT OF NORTHCENTRAL CT. TITLED CT ESSENTIAL, THIS PROPOSAL AIMS TO IMPROVE AND ADVANCE COMPLETE CARE FOR INDIVIDUALS OF ALL AGES. THE POPULATION TO BE SERVED INCLUDES ADULTS WITH SERIOUS MENTAL ILLNESS (SMI), SUBSTANCE USE DISORDERS (SUD), AND OPIOID USE DISORDERS (OUD) AND CHILDREN WITH SERIOUS EMOTIONAL DISORDERS (SED). SERVICES WILL BE PROVIDED THROUGH CHR LOCATIONS IN THE CATCHMENT AREA INCLUDING OUTPATIENT SITES IN ENFIELD, BLOOMFIELD AND MANCHESTER. POPULATION AND DEMOGRAPHICS OF THE CATCHMENT AREA SHOW A TOTAL POPULATION OF 356,856 (CENSUSDATA.GOV). PER CENSUS DATA, 66% OF THE AREA IS WHITE ALONE, 15.3% IS BLACK OR AFRICAN AMERICAN ALONE, 5.2% ASIAN ALONE, AND 8% IS TWO OR MORE RACES. ON AVERAGE, 17.6% OF HOUSEHOLDS IN THE CATCHMENT AREA SPEAK A PRIMARY LANGUAGE OTHER THAN ENGLISH. THE AREA AVERAGES 58.9% FEMALE AND THE AVERAGE AGE IS 43.3, WITH 5.5% OF THE POPULATION RESIDING UNDER THE POVERTY LINE, (OUTLIERS BEING EAST HARTFORD WITH 13.7% POVERTY, AND MANCHESTER AT 10.4%). 38% OF HOUSEHOLDS IN THE REGION HAVE INCOME WHICH FALLS BELOW WHAT IS NEEDED TO PAY FOR BASIC NECESSITIES SUCH AS HOUSING, FOOD, CHILDCARE, HEALTHCARE, TECHNOLOGY, AND TRANSPORTATION (CTUNITEDWAY.ORG). CHR DATA SHOWS THAT NEARLY 25% OF ALL CLIENTS FROM THE CATCHMENT AREA EXPERIENCED HOMELESSNESS IN 2021. NSDUH CITES THAT LGBT+ INDIVIDUALS ARE AT LEAST 2X MORE LIKELY TO USE SUBSTANCES, AND LGBTMAP.ORG REPORTS THAT 3.9% OF CT RESIDENTS IDENTIFY AS LBGT+. IT REMAINS UNCLEAR HOW MANY ARE PART OF OUR POF. CLINICAL CHARACTERISTICS OF THE POPULATION DEMONSTRATE A CONTINUED NEED FOR INCREASED CARE FOR INDIVIDUALS OF ALL AGES WITH SMI, SUD, OUD, COD, AND SED. STRATEGIES AND INTERVENTIONS INCLUDE INCREASING THE AVAILABILITY OF SERVICES TO ALL WITHIN THE POF. PROJECT GOALS AND MEASURABLE OBJECTIVES INCLUDE: IMPROVING THE QUALITY OF LIFE AND LIFESPAN OF INDIVIDUALS WITH SMI/SUD/COD AND CO-MORBID DISEASES BY ADVANCING EVIDENCE-BASED INTEGRATED BH AND PRIMARY CARE WITH THE FOLLOWING OBJECTIVES: 1) PROVIDE TRAUMA-SENSITIVE, RECOVERY-ORIENTED PRIMARY CARE SERVICES TO EXPAND THE NUMBER OF PEOPLE ENGAGED IN INTEGRATED BH AND MEDICAL CARE, 2) STABILIZE CHRONIC DISEASE SYMPTOMS AMONG INDIVIDUALS WITH SMI/SUD/COD ADMITTED TO FAMILY MEDICINE BY ENHANCING TECHNOLOGY NECESSARY TO MONITOR TARGET SYMPTOMS SUCH AS WEIGHT, BMI, BP AND LABORATORY RESULTS FOR METABOLIC SYNDROME AT REGULAR INTERVALS OVER TIME, 3) USE TEAM-BASED CARE INTEGRATED BH/PC WITH FQHC PARTNERS IN BLOOMFIELD AND MANCHESTER TO IMPROVE HEALTH OUTCOMES FOR PEOPLE WITH SMI/SUD/COD AEB IMPROVED TARGET SYMPTOMS (E.G., BP, BMI, A1C), AND 4) EXPAND ACCESS TO SPECIALTY INTEGRATED CARE BY STARTING A NEW FAMILY MEDICINE PROGRAM IN CHR'S LARGEST OUTPATIENT BEHAVIORAL HEALTH CLINIC. GOAL 2: PROVIDE THE RIGHT CARE, AT THE RIGHT TIME, FOR THE RIGHT PERSON TO DECREASE BH CRISIS EVENTS AND IMPROVE BH AMONG PEOPLE WITH SMI/SUD/COD/SED WITH THE FOLLOWING OBJECTIVES: 1) IMPROVE ACCESS TO INITIAL PSYCHIATRIC EVALUATION BASED ON ASSESSED NEED AT TIME OF REFERRAL, INCLUDING ACCESS TO MAT FOR OUD/AUD SO THAT ROUTINE REFERRALS ARE SEEN WITHIN TWO WEEKS, URGENT WITHIN TWO BUSINESS DAYS, AND EMERGENCY PES ARE SAME-DAY, 2) PROVIDE ENGAGEMENT AND RECOVERY SUPPORT SERVICES TO IMPROVE PARTICIPATION IN RECOMMENDED EBP BH CARE, AEB IMPROVED ATTENDANCE AND CLIENT OUTCOMES ON STANDARDIZED MEASURES (E.G. PHQ-9, GAD-7, BAM), AND 3) USING EVIDENCED-BASED PRACTICES AND MEASUREMENT-BASED CARE TO PROVIDE EFFECTIVE, EPISODIC CARE AEB CLIENT OUTCOMES AND IMPROVED ACCESS TO CLINIC-BASED SERVICES AND BY TREATING 100 MORE PEOPLE EACH YEAR USING THE SAME LIMITED RESOURCES. IN ALL, WE EXPECT TO SERVE 700 PEOPLE THROUGH THE DURATION OF THE PROJECT AND 175 UNDUPLICATED INDIVIDUALS IN EACH YEAR OF