Project Grant H79SM087164

INTERBOROUGH CCBHC CONEY ISLAND - THE IMPROVED AND ADVANCED INTERBOROUGH DEVELOPMENT AND CONSULTATION CENTER CERTIFIED COMMUNITY BEHAVIORAL HEALTH CLINIC IDCCCCBHCIA WILL PROVIDE MORE EFFICIENT AND TARGETED CCBHC SERVICES TO ALL CCBHC CLIENTS, WITH AN EMPHASIS ON TWO HIGH-NEED POPULATIONS: 1 ADOLESCENTS AND YOUNG ADULTS AT HIGH RISK OF SUICIDE, AND 2 CLIENTS WITH COMORBID MULTIPLE CHRONIC MEDICAL CONDITIONS AND SERIOUS MENTAL ILLNESS. WE WILL DO THIS BY CREATING SPECIALIZED CARE PATHWAYS FOR EACH OF THESE POPULATIONS. CARE PATHWAYS ARE CLINICAL TOOLS FOR ASSESSING, TRIAGING, AND DIRECTING CLIENTS TO CARE, WHICH WILL BE BASED ON EACH CLIENTS COMPREHENSIVE INTAKE ASSESSMENT AND INCORPORATED INTO CARELOGIC, OUR ELECTRONIC MEDICAL RECORD. IDCC CURRENTLY OPERATES A CCBHC IN CONEY ISLAND, BROOKLYN, NY CI, IN WHICH THE CARE PATHWAYS WILL BE DEVELOPED AND IMPLEMENTED. WE WILL SERVE 200 TO 300 CLIENTS ANNUALLY, ALL OF WHOM FALL UNDER ONE OF THE FOLLOWING CATEGORIES SERIOUS MENTAL ILLNESS SMI; SUBSTANCE USE DISORDERS SUD, INCLUDING OPIOID USE DISORDERS; COOCCURRING MENTAL HEALTH AND SUBSTANCE USE DISORDERS COD; AND CHILDREN AND ADOLESCENTS WITH SERIOUS EMOTIONAL DISTURBANCE SED. SERVICES WILL BE AVAILABLE TO ANY INDIVIDUAL WITH A MENTAL HEALTH AND/OR SUBSTANCE USE DISORDER, INCLUDING INDIVIDUALS EXPERIENCING A MENTAL HEALTH OR SUBSTANCE USE-RELATED CRISIS. THE IDCCCCBHC IA WILL SERVE ADOLESCENTS AND ADULTS ACROSS THE LIFESPAN, INCLUDING PREGNANT WOMEN AND THEIR CHILDREN; VETERANS AND THEIR FAMILIES; AND THE UNDERSERVED RACIAL, ETHNIC AND CULTURAL COMMUNITIES THAT RESIDE IN BROOKLYN, NY. THE CONEY ISLAND COMMUNITY HAS A TOTAL POPULATION OF 106,459. FIFTY-THREE PERCENT OF RESIDENTS ARE FOREIGN-BORN, COMPARED WITH A NYC RATE OF 37%, AND 43% REPORT LIMITED ENGLISH PROFICIENCY 23% NYC RATE. CI DEMOGRAPHICS INCLUDE 56% WHITE, 16% LATINO, 14% ASIAN, AND 12% BLACK. THE POVERTY RATE IS 24%, WITH UNEMPLOYMENT OF 11% IN 2018. VETERANS MAKE UP 2.1% OF THE POPULATION. 5.1% OF NEW YORK CITYS POPULATION IS LGBTQIA. RATES OF OBESITY, DIABETES, AND HYPERTENSION ARE HIGHER IN CONEY ISLAND THAN THE REST OF BROOKLYN OR IN NYC. THE RATE OF AVOIDABLE HOSPITALIZATIONS IS 47.5% HIGHER THAN THE OVERALL NYC RATE, AND THE RATE OF PSYCHIATRIC HOSPITALIZATIONS IS 13.2% HIGHER THAN THE OVERALL NYC RATE. NYC COMMUNITY HEALTH PROFILE, 2018, CD13. COMPARED TO THE NYC RATE, DRUG RELATED DEATHS ARE 45% HIGHER, AND THE SUICIDE RATE IS 35% HIGHER, FOR ADULTS UNDER 65 IN CONEY ISLAND. THE NUMBER OF YOUTH AND YOUNG ADULTS WHO ARE AT HIGH RISK FOR SUICIDE INCREASED GREATLY DURING THE RECENT PANDEMIC, BOTH NATIONALLY AND IN OUR OWN SERVICE AREA. IN MAY 2020, DURING THE COVID19 PANDEMIC, EMERGENCY DEPARTMENT ED VISITS FOR SUSPECTED SUICIDE ATTEMPTS BEGAN TO INCREASE AMONG ADOLESCENTS AGED 12 TO 17 YEARS, ESPECIALLY GIRLS. DURING FEBRUARY 21 THROUGH MARCH 20, 2021, SUSPECTED SUICIDE ATTEMPT ED VISITS WERE 50.6% HIGHER AMONG GIRLS AGED 12 TO 17 YEARS THAN DURING THE SAME PERIOD IN 2019; AMONG BOYS AGED 12 TO17 YEARS, SUSPECTED SUICIDE ATTEMPT ED VISITS INCREASED 3.7%. THE IDCC CCBHCIA HAS THE FOLLOWING GOALS AND MEASURABLE OBJECTIVES: 1, CLIENTS ASSIGNED TO THE HIGH RISK SUICIDE CARE PATHWAY WILL SHOW A REDUCTION IN DEPRESSION, ANXIETY, SUICIDALITY AND TRAUMA-RELATED SYMPTOMS; AND 2, CLIENTS ASSIGNED TO THE HIGH MEDICAL NEED CARE PATHWAY WILL SHOW SIGNIFICANT IMPROVEMENTS IN BMI, A1C AND IN KEEPING MEDICAL APPOINTMENTS. THESE GOALS WILL BE ACHIEVED BY IMPROVING OUR SCREENING, ASSESSMENT, AND DIAGNOSIS, INCLUDING RISK ASSESSMENT; OUR PATIENT-CENTERED APPROACH TO TREATMENT PLANNING; OUR OUTPATIENT PRIMARY CARE SCREENING AND MONITORING OF KEY HEALTH INDICATORS AND HEALTH RISKS; OUR TARGETED CASE MANAGEMENT; AND OUR PSYCHIATRIC REHABILITATION SERVICES. ALL NINE REQUIRED CCBHC SERVICES WILL BE AVAILABLE TO ALL IDCC CCBHC IA CLIENTS.