Project Grant H79TI083593

OPEN DOOR'S YOUTH AND FAMILY TREE - BRIEF SUMMARY: OPEN DOOR FAMILY MEDICAL CENTER (OPEN DOOR) WILL ENHANCE COMPREHENSIVE BILINGUAL TREATMENT AND RECOVERY SERVICES FOR VULNERABLE ADOLESCENTS AND TRANSITIONAL YOUTH WITH SUD AND/OR COD AND THUS REDUCE DIFFERENCES IN ACCESS, USE, AND OUTCOMES OF TREATMENT AND RECOVERY SERVICES AMONG MINORITY POPULATIONS, AS WELL S GIRLS AND WOMEN. "OPEN DOOR'S YOUTH AND FAMILY TREE" PROJECT WILL ENSURE YOUTH ARE SUPPORTED AS THEY MOVE THROUGH RECOVERY, INCLUDING ENGAGING THEIR FAMILIES, AND PROVIDING AGE-APPROPRIATE, TECHNOLOGY-BASED SUPPORTS THAT THEY CAN ACCESS AT WILL, ALL UNDER A COMPREHENSIVE PATIENT CENTERED MEDICAL HOME MODEL. POPULATION TO BE SERVED: OPEN DOOR WILL SERVE VULNERABLE ADOLESCENTS AND TRANSITIONAL YOUTH AGES 12-25 AND THEIR FAMILIES/CAREGIVERS, TARGETED AMONG THE ORGANIZATION'S 60,000 PATIENTS. THESE PATIENTS EXHIBIT SIGNIFICANT NEGATIVE SOCIAL DETERMINANTS OF HEALTH: NINE IN TEN LIVE BELOW 200% FPL WHILE A MAJORITY LIVE IN OUTRIGHT POVERTY IN A HIGH-COST OF LIVING AREA; 43% ARE UNINSURED, MORE THAN TWICE THE NEW YORK STATE AVERAGE FOR FEDERALLY QUALIFIED HEALTH CENTERS; A MAJORITY IDENTIFY AS RACIAL/ETHNIC MINORITIES (82% AS LATINX/HISPANIC WITHIN THE YOUTH COHORT); AND 71% ARE BEST SERVED IN A LANGUAGE OTHER THAN ENGLISH. USING INTERNAL DATA, WE ESTIMATE THAT A MAJORITY OF PATIENTS 12-25 REPORT POLY-SUBSTANCE USE, INCLUDING CANNABIS, ALCOHOL, OPIOIDS, AND OTHERS; AMONG YOUNG PATIENTS WITH SUD, 50% HAVE A CO-OCCURRING MENTAL HEALTH DIAGNOSIS. STRATEGIES/INTERVENTIONS: OPEN DOOR WILL LEVERAGE INTEGRATED MENTAL HEALTH, MEDICAL, AND WRAPAROUND SERVICES WITHIN SIX SITES TO OFFER AN "ALL UNDER ONE ROOF" APPROACH USING FAMILY-CENTERED COMPREHENSIVE OUTPATIENT CARE, EARLY INTERVENTION, SCREENING AND COUNSELING, MEDICATION ASSISTED TREATMENT, RECOVERY SUPPORT, AND EDUCATION ON HEALTHY CHOICES. EVIDENCE-BASED PRACTICES WILL INCLUDE: COGNITIVE BEHAVIORAL THERAPY AND TRAUMA-FOCUSED CBT; DIALECTICAL BEHAVIORAL THERAPY GROUPS FOR SUD; MOTIVATIONAL INTERVIEWING; SEEKING SAFETY; MATRIX MODEL FOR TEENS & YOUNG ADULTS; BRIEF STRATEGIC AND MULTIDIMENSIONAL FAMILY THERAPY; AND NURTURING PARENTING. GOALS & OBJECTIVES: THE PROPOSED PROJECT WILL SERVE 450 YOUTH OVER THE PROJECT LIFETIME, BROKEN OUT AS 50 SERVED IN YEAR ONE AND 100 PER YEAR FOR PROJECT YEARS 2-5, AND THEIR FAMILIES. PROJECT GOALS ARE AS FOLLOWS: GOAL 1 - INCREASE ACCESS TO HIGH QUALITY, PATIENT CENTERED SUD AND COD SERVICES; GOAL 2 - MAXIMIZE RETENTION IN CARE; GOAL 3 - IDENTIFY AND ADDRESS ELEVATED HEALTH RISKS BY PROVIDING SPECIALIZED CARE AND SUPPORTS; GOAL 4 - IMPROVE SELF-REPORTED ASSESSMENT OF WELLNESS AND FUNCTIONING AMONG ADOLESCENTS AND TRANSITIONAL YOUTH WITH SUD, MH, AND/OR CO-OCCURRING DISORDERS. MEASURABLE OBJECTIVES INCLUDE 90%-PLUS SCREENING AND DOCUMENTED TREATMENT PLAN RATES; 100% ASSESSMENT AND OFFERING FOR MAT; 80% RETENTION AND DIGITAL RECOVERY APP ENROLLMENT RATES; 100% SCREENING FOR ADVERSE CHILDHOOD EVENTS, ASSESSMENT FOR THOSE AT RISK FOR STI, PREGNANCY, AND GENDER SPECIFIC RISKS; 70% SERVED WITH MAJOR DEPRESSIVE DISORDER SHOWING REDUCTION IN PHQ-9 SCORES; 80% ACHIEVEMENT OF PATIENT-ARTICULATED 6-MONTH TREATMENT GOALS AND 80% OF PATIENTS "FEELING BETTER" AFTER SIX MONTHS IN THE PROGRAM.