CHD ccbhc PCP expansion project - severe mental illness (SMI) and substance use disorder (SUD) "is the most urgent health need impacting [western massachusetts]," according to baystate health's 2022…

CHD ccbhc PCP expansion project - severe mental illness (SMI) and substance use disorder (SUD) "is the most urgent health need impacting [western massachusetts]," according to baystate health's 2022 community health needs assessment (CHNA). Substance use disorders, including opioid use, were of "particular concern." the intersection of physical and mental health care has become a place of great need following the covid-19 pandemic. In hampden county, "one in seven adults (15%) reported their mental health was not good for 14 days or more within the prior 30 days... This exceeded the statewide rate of 13%." the CHNA also reports "between 2016-2020, deaths of despair [in hampden county] were ... 29% higher than the state rate." the four cities our ccbhcs serve LIE in the pioneer valley catchment area - primarily west springfield, with springfield, chicopee, and holyoke as satellite locations. The merrick and memorial neighborhood census tracts, encompassing the park street ccbhc in west springfield, have an average poverty level of 13.5%, nearly 1.5X the rate of west springfield at large. This neighborhood has a significant population of refugee families with unique cultural and linguistic needs, with 26% being foreign-born - approximately three times the rate in hampden county. The satellite springfield and holyoke clinics are located in neighborhoods with poverty rates of 27.7% and 30.9%, respectively. The population served is especially vulnerable because they are often under- or UN-insured and experiencing housing insecurity or homelessness. The western MA network to end homelessness reports that individual homelessness has worsened since the covid-19 pandemic began, with just over 2,800 people in hampden county without homes in 2022. Approximately 3% of the population is uninsured in the four census tracts where these ccbhcs are located. Due to high poverty and low employment numbers, we can assume that even those insured likely have fraught access to affordable, adequate health care in these areas federally designated as medically underserved. All four clinics are in health professional shortage areas (HSPA). The present project will utilize resources to support expanding the number of referrals to and availability of primary care at these ccbhcs alongside continuing the nine core ccbhc services. We will provide enhanced primary care screening and monitoring of key health indicators and health risks to people with SMI and SUD/OUD in neighborhoods where vulnerable populations live - especially under and uninsured people and individuals experiencing housing insecurity or homelessness. These are areas of need identified in CHD's needs assessment. This integration of care will improve care delivery, client experience, and outcomes. The project will serve a total of 600 individuals over the course of the 4-year project.