FY 2024 behavioral health service expansion - charles river community health (CRCH) seeks $545,838 in behavioral health service expansion (BHSE) funding in year 1 and $159,904 in year 2 to expand…

FY 2024 behavioral health service expansion - charles river community health (CRCH) seeks $545,838 in behavioral health service expansion (BHSE) funding in year 1 and $159,904 in year 2 to expand behavioral health (BH) and substance use disorder (SUD) services at our brighton and waltham, MA sites, including treatment with medications for opioid use disorder (MOUD). Per our CY2023 UDS data, CRCH serves the most underserved, at-risk populations in our community: 67% of patients are latinx, 81% are patients of color, and 75.8% need services in a language other than english, the third highest rate among massachusetts fqhcs. In addition, 31% of our patients are uninsured, due to immigration status or other barriers. We have also served nearly 150 unhoused families living in local shelters who have faced trauma, and continue to receive requests to serve more families as they arrive in our area. CRCH has an integrated approach to behavioral health, and provides care using two complementary models. First, we provide brief, targeted behavioral health treatment by a BH clinician trained in BH-primary care integration. If during a medical appointment a BH or SUD need is identified by the PCP, such as the patient reporting stress or anxiety, or substance use challenge, the PCP asks the BH clinician assigned to primary care that day to see the patient. The BH visit takes place in the medical exam room and is focused on addressing the short term BH needs of the patient. This model supports patients whose BH needs might stem from a specific recent event or goal that may be effectively addressed through a few concise, focused sessions following a medical appointment. IT also supports patients who need longer term BH counseling but are not yet ready to commit to therapy due to stigma or other barriers, but are willing to speak with a BH clinician as part of the primary care team to address some of their needs. CRCH continues to offer conventional therapy in our BH department, tailored to patients for whom this approach is most beneficial. With BHSE funding, CRCH plans to hire 4.0 ftes of BH clinicians to serve 1,000 BH mental health patients by 12/31/25. We will also serve 88 SUD patients and 40 MOUD patients through our BHSE work plan activities. We also plan to cross train existing and newly hired BH clinicians to build their clinical comfort level and competency with providing care using both the BH-primary care integration and long term therapy models, to maximize access to BH and SUD care for patients to meet the increased need. We will also hire a new 1.0 FTE integrated services director, reporting to our chief clinical officer, to be the program champion overseeing this BH expansion project. IT has been our experience that providing BH care integrated with primary care takes time for some pcps to adapt to, and they may be hesitant to call the BH clinician into the medical exam room and consider the BH clinician part of the primary care team. The integrated services director will be a BH clinician, likely psychiatric advance practice provider with BH-primary care integration experience to provide training, coaching and support to pcps to ensure the BH-primary care integration model is incorporated into how we provide primary care. CRCH also plans to expand and strengthen our BH-primary care integration model by having the BH clinician assigned to primary care each day proactively review PCP schedules and have a BH visit with any primary care patient with chronic conditions to discuss lifestyle changes and the BH support needed to get there. Finally, with BHSE funding, CRCH will hire 0.5 FTE interpreter to work across our 2 sites, who will also be trained in the basics of SUD to become an SUD health education specialist.