Citizen advocates ccbhc expansion - massena clinic - as an essential safety-net provider of services, successfully coordinating and delivering mental health (MH) and substance use disorder (SUD)…

Citizen advocates ccbhc expansion - massena clinic - as an essential safety-net provider of services, successfully coordinating and delivering mental health (MH) and substance use disorder (SUD) services since 1988, citizen advocates (CA) seeks to leverage our success as an existing ccbhc to solidify sustainability and expand services to the population of ST. Lawrence county, NY. The largest county geographically in NYS, the population of 107,740 finds greater than 1 in 5 living in poverty, 2X the national average, levels which escalate in children to nearly 1 in 3. While the population is primarily caucasian at 92%, there is a large reservation community regionally with approximately 3,500 residents CA seeks to ensure are supported. Approximately 1% of NYS' veterans are residents of SLC, or 7,739 individuals. Residents experience high rates of adult obesity, tobacco use, diabetes well above the state average, coupled with a high rate of self-inflicted hospitalizations at 5.6 per 10K, and 17.6 per 1,000 among teens. The opioid epidemic has severely impacted this community as well, with ED visits and hospital discharges related to non-fatal opioid use per 1,000 significantly higher in SLC than rest of state, at 393.3 compared to 303.6, respectively. Admissions to SUD treatment for ages 12 and up were 764.4 in SLC compared to NYS. CA is poised to support this population in need, as demonstrated by our provision of evidence-based, trauma-informed services to 1563 people over the course of the ccbhc to date. This grant is critical to solidify sustainability and enable US to serve a total of 2000+ consumers, adding an average of 170 unduplicated new consumers year over year during the 4-year grant cycle. To accomplish this, our goals and strategies include increasing the access and awareness of medication assisted treatment (mat), with associated benchmark goals such as increasing the number of unique individuals served by mat by at least 50 year over year, providing at minimum 2 education sessions to pcps on mat a year, and 4 community forum trainings on narcan, capturing at least 50 people. Age-adjusted mat prescribing rates had increased by 200% during the first grant cycle and expect continued increase by at least 50% each year. Another goal is to increase the use and access to preventative BH and wellness treatments, where during this grant cycle CA will work to additionally partner with local tribal leaders to ensure access to crisis services are met, and increase native american consumers by 10% in year one. Trauma informed care staff training program will be implemented, with key principles employed throughout CA's service approach, and at minimum 2 staff trainings will be hosted. These trained staff will inform outreach to marginalized populations, with the goal to mitigate rates of suicidality, especially among teens, and launch a veterans-focused group. Within this framework, an additional 2 staff persons at minimum will be trained on emdr, an EBP proven to mitigate the response to trauma. Other key program strategies include increasing the provision of crisis services by 20% in year one, launching signs of suicide, EBP prevention program for school-aged children, and providing special training to the crisis team on suicide prevention.