FY 2024 behavioral health service expansion - project synopsis: with these funds, santa rosa community health (srch) will increase the number of patients receiving mental/behavioral health services…

FY 2024 behavioral health service expansion - project synopsis: with these funds, santa rosa community health (srch) will increase the number of patients receiving mental/behavioral health services and increase the number of patients receiving SUD services by expanding a fully integrated primary care behavioral health (pcbh) model at srch's dutton, lombardi, and vista campuses. Populations served: srch patients navigate numerous barriers to health and access to care, including poverty, food insecurity, lack of transportation, disproportionate rates of chronic disease, addiction, and housing insecurity or homelessness. Of the 40,105 patients we served in 2023, 97% live at or below 200% of the federal poverty level. 74.5% identified as racial or ethnic minorities, 64.5% of which as hispanic/latinx. 50% were best served in a language other than english, predominantly spanish. 33% of srch patients were under the age of 18. 5853 (14.5%) were uninsured. 2,823 patients identified that they are experiencing homelessness. Patients who reported being unhoused included 420 latino/a/x individuals, 816 women, and 434 elders (ages 60+). 3,592 (8%) received mental health services and 596 (1.7%) received substance use services, the latter primarily for opioid use. Patient & community need: since 2017, a series of natural disasters pummeled sonoma county even before and as the covid pandemic struck. The 2017 sonoma complex wildfires destroyed over 5,300 homes and killed twenty-four people. The 2019 kincade fire forced almost 200,000 people to evacuate and caused significant stress and disruption of daily life. The covid pandemic disrupted employment and schooling, infected nearly 40,000 county residents as of september 2021, and killed nearly 400 loved ones and friends. The 2020 glass fire and LNU lightning complex fire compounded problems of an already disastrous year. Living through any one of these disasters is a traumatic experience. The combination of all of them - in conjunction with a severe shortage of easily accessible mental health providers - has created an extreme mental health crisis in sonoma county. In 2022, nearly 50% of srch patients carried a mental health diagnosis with 30% of patients with a MH diagnosis having three or more MH diagnoses. Of all patients with a MH diagnosis > 30% scored within the moderate-severe to severe range for depression, > 50% scored within the moderate-severe to severe range for anxiety, and almost 50% had a CO-morbid substance use disorder (SUD). Our aces scores also follow a similar pattern of high risk, or acuity, with nearly 1 in 5 patients having an aces score of 4 or more. A particular area of extreme concern is our youth mental health status. The proportion of srch patients aged 12-18 with anxiety increased 26% compared to pre-covid. Sonoma county also has the second-highest youth suicide rate in the nine-county SAN francisco BAY area. Tragically, sonoma county has seen an unfortunate rebound in opioid-fentanyl related deaths in 2023. In 2022, countywide efforts led to a 20% drop in opioid-related deaths from the year prior, however, 51 deaths were reported from january-april 2023, compared to 98 for all of 2022. Proposed services: building on a successful pcbh pilot at our dutton campus, srch will use this funding to hire three primary care behavioral health providers, one at each of our largest clinics: dutton, lombardi, and vista. Funds will also support training for primary care teams at the three clinics in the pcbh model; training in and expansion of utilization of standardized screening tools, in particular for alcohol use; and development of a refreshed model for mental health therapy services that aligns with the proposed expansion of pcbh interventions.