FY 2024 behavioral health service expansion - appalachian mountain community health centers (amchc; health center program grant number 2 H80CS28348-08-00) will implement a hrsa behavioral health…

FY 2024 behavioral health service expansion - appalachian mountain community health centers (amchc; health center program grant number 2 H80CS28348-08-00) will implement a hrsa behavioral health services expansion (bhse) project focused on adding a specialty mental health (MH) and substance use disorder (SUD) treatment clinic, including an individualized outpatient program (IOP) and medication for opioid use disorder (moud), to its federally qualified health center programming. This expansion will be managed from amchc's administrative headquarters in the city of asheville, north carolina (NC), and will be implemented at an existing amchc clinic site in the rural western north carolina town of murphy (cherokee county), where vacant space is available. This expansion project will increase the number of patients receiving MH and SUD services through amchc by filling an urgent need across multiple rural appalachian counties in far western NC including cherokee, clay, graham, and macon. Amchc's primary care clinics in cherokee and graham counties provide integrated behavioral health (BH) care, but there are few options within a reasonable driving distance for out-referring patients in need of individualized MH or intensive SUD treatment. Amchc's service population for its primary care clinics and the BH expansion consists primarily of area residents living at or below 200% of the federal poverty level, a population that experiences elevated rates of suds and MH challenges including overdose, alcohol-related, and suicide death rates that exceed state rates. NC has one of the nation's most acute shortages of BH providers, and shortages in cherokee, clay, graham, and macon counties are among the state's most extreme. Additionally, residents of the proposed service area experience health-related social needs (hrsns) at higher rates than NC as a whole, including low rates of labor force participation and high rates of poverty, housing insecurity, and disability. Amchc's bhse project will include the hiring, onboarding, and training of a psychiatric provider to deliver services to adults and children while overseeing the management of moud treatment; three licensed clinical social workers to provide MH and SUD counseling including IOP services; two community health workers known as community resource advocates to provide wraparound services to patients addressing hrsns; a registered nurse for supporting the medical needs of BH patients and administering medications; a certified peer support specialist to provide additional treatment and recovery support; a care manager to coordinate care across settings and within amchc; and support staff including a medical assistant, two patient services representatives, a security guard, and an administrative assistant. Increases in patient numbers for MH and SUD services will be driven by referrals from amchc's integrated primary and BH care clinics in cherokee and graham counties, where unmet demand for referrals to specialty providers is high. Referral agreements will also be put in place with county social services agencies, law enforcement agencies, local hospital systems, and other primary care providers across this geographically isolated region of the state.