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FY 2024 BEHAVIORAL HEALTH SERVICE EXPANSION - VALLEY HEALTH TEAM (VHT) (HRSA NUMBER: H80CS00525) IS A FEDERALLY QUALIFIED HEALTH CENTER ESTABLISHED IN 1973 AS ONE OF CALIFORNIA'S FIRST LICENSED NON-PROFIT COMMUNITY CLINICS AND HAS SINCE GROWN TO A MULTI-SITE PRIMARY HEALTH CARE NETWORK SERVING LOW-INCOME PATIENTS THROUGHOUT CALIFORNIA'S FRESNO, TULARE AND INYO COUNTIES. VHT IS ACCREDITED BY THE JOINT COMMISSION AND RECOGNIZED BY THE NATIONAL COMMITTEE FOR QUALITY ASSURANCE (NCQA) AS A PATIENT-CENTERED MEDICAL HOME (PCMH), WIDELY RECOGNIZED INDICATORS THAT THE MEDICAL PRACTICE IS WELL-MANAGED AND DELIVERS HIGH QUALITY CARE. NEEDS TO BE ADDRESSED: LACK OF ACCESS TO MENTAL HEALTH CARE AND TREATMENT FOR SUBSTANCE ABUSE CONTINUES TO BE A SIGNIFICANT PROBLEM IN THE SERVICE AREA. ACCORDING TO DATA FROM THE CENTERS FOR MEDICARE AND MEDICAID SERVICES (CMS), THE SERVICE AREA COUNTIES HAD A COMBINED RATE OF JUST 191.3 MENTAL HEALTH CARE PROVIDERS FOR EVERY 100,000 RESIDENTS COMPARED TO194.4 STATEWIDE. TULARE COUNTY SAW THE WORST SHORTAGE WITH A RATE OF JUST 141.8 MENTAL HEALTH PROVIDERS PER 100,000 RESIDENTS. BOTH TULARE AND INYO COUNTIES HAVE BEEN DESIGNATED AS HEALTH PROFESSIONAL SHORTAGE AREAS FOR MENTAL HEALTH, ALONG WITH MOST OF FRESNO COUNTY. THIS SHORTAGE IS CLEARLY FELT BY SERVICE AREA RESIDENTS. A 2022 COMMUNITY HEALTH NEEDS ASSESSMENT CONDUCTED BY A GROUP OF HOSPITALS IDENTIFIED MENTAL HEALTH AS THE MOST IMPORTANT HEALTH NEED IN BOTH FRESNO AND TULARE COUNTIES, WHILE SUBSTANCE ABUSE WAS RANKED 8TH. A SIMILAR 2022 CHNA CONDUCTED IN INYO COUNTY IDENTIFIED MENTAL HEALTH AS THE LEADING HEALTH PRIORITY, WHILE SUBSTANCE ABUSE WAS RANKED 3RD. ACCORDING TO THE CALIFORNIA DEPARTMENT OF PUBLIC HEALTH, ALL THREE COUNTIES HAVE SEEN INCREASES IN THE RATES EMERGENCY DEPARTMENT (ED) VISITS RESULTING FROM OPIOID-RELATED OVERDOSES SINCE 2018. THE SURGE IN OPIOID-RELATED ED VISITS IS HAVING DIRE CONSEQUENCES. SINCE 2018, MORTALITY RATES FOR DRUG-RELATED OVERDOSE DEATHS IN BOTH COUNTIES HAVE INCREASED DRAMATI CALLY FROM A RATE OF 11.6 DEATHS PER 100,000 RESIDENTS IN FRESNO, 38.3 IN INYO, AND 11.96 IN TULARE, TO 22.1, 40.5 AND 23.4 (RESPECTIVELY) IN 2022. PROPOSED SERVICES: OVER THE PAST DECADE VHT HAS GREATLY EXPANDED ACCESS TO MENTAL HEALTH (MH) CARE IN THE SERVICE AREA THROUGH THE INTEGRATION OF BEHAVIORAL HEALTH SERVICES WITHIN THEIR EXISTING PRIMARY CARE CLINICS. VHT CURRENTLY OPERATES 16 SERVICE DELIVERY SITES THROUGHOUT FRESNO, TULARE AND INYO COUNTIES, MOST OF WHICH OFFER ON-SITE BEHAVIORAL HEALTH CARE SERVICES. HOWEVER, THE NEED FOR SERVICES CONTINUES TO OUTPACE ORGANIZATIONAL CAPACITY. BHSE FUNDS WILL ALLOW VHT TO INCREASE ITS ABILITY TO DEAL WITH THE GROWING OPIOID CRISIS AND BUILD CAPACITY TO MEET THE MH AND SUD NEEDS OF ITS PATIENT AND TARGET POPULATIONS. BHSE FUNDS WILL BE USED TO EXPAND BEHAVIORAL HEALTH CARE CAPACITY THROUGH ADDITIONAL PROVIDERS WITH SPECIALIZED SUD TRAINING WHO WILL BE EQUIPPED TO PROVIDE BOTH MH AND SUD SERVICES, INCLUDING MOUD, AND THROUGH THE ADDITION OF DEDICATED SUPPORT STAFF INCLUDING BEHAVIORAL HEALTH CASE MANAGERS, WHO PROVIDE PATIENT CARE COORDINATION AND NAVIGATION SERVICES. THIS WILL HELP ENSURE PATIENTS ARE CONNECTED TO THE RESOURCES THEY NEED, WHILE FREEING UP BH CLINICIANS TO TREAT MORE PATIENTS WITH MH AND/OR SUD NEEDS, INCLUDING THOSE WHO WOULD BENEFIT FROM MOUD. ADDITIONAL PROVIDERS AND SUPPORT STAFF WILL ALLOW VHT TO MEET THE NEEDS OF A GREATER NUMBER OF MH AND SUD PATIENTS, INCLUDING THOSE IN NEED OF MOUD. POPULATION GROUPS SERVED: THIS PROJECT WILL TARGET VHT'S CURRENT PRIMARY CARE PATIENTS WHO ARE IN NEED OF MH CARE OR SUD TREATMENT, BUT WHO ARE NOT CURRENTLY ACCESSING BH SERVICES. IN 2023, VHT SERVED 36,116 PATIENTS, PROVIDING 161,472 VISITS: 90% OF PATIENTS LIVED AT 200% OF THE FPL, 68% WERE OF HISPANIC DESCENT, 15% WERE UNINSURED, 64% WERE COVERED BY MEDI-CAL, 56% WERE DEPENDENT ON THE AGRICULTURAL WORKFORCE AND 23% WERE BEST SERVED IN A NON-ENGLISH LANGUAGE.
$600.0k 9/19/24