FY 2024 behavioral health service expansion - ST

Joseph's mercy care services, INC. (mercy care), award #H80CS00022, is a federally qualified health center (fqhc) serving over 17,000 homeless and economically or socially disenfranchised individuals and families annually in georgia's fulton and dekalb counties, including the city of atlanta, and is the only healthcare for the homeless fqhc in the city. Fulton and dekalb are sprawling counties covering over 800 square miles and 1.8 million people, with drastically disparate rates of poverty and disease across neighborhoods and racial/ethnic groups and significant unmet healthcare needs. Mercy care's patient population reflects the most vulnerable segments of our service area: 54% of our clients are experiencing homelessness, 53% are uninsured, and of those for whom we have income data, 80% live at or below 100% of the federal poverty level. Behavioral health (BH) and substance use disorders (SUD) are common, with 5,845 (33%) of current patients having a BH or SUD diagnosis. Despite the high prevalence of these diagnoses, only 3,737 patients received BH services, 542 received SUD services, and 19 received medication for opioid use disorder (moud) at mercy care in 2023. The objective of BH service expansion is to close the GAP between those diagnosed and those who receive treatment. Mercy care will increase the number of patients receiving mental health and SUD services, including moud, as well as increase the number of BH and SUD visits by improving access to services within our existing integrated behavioral health (IBH) program model. The IBH model offers BH services in the same setting as primary care services. The juxtaposition of primary care exam rooms with BH consult rooms ensures a no-wrong-door approach to accessing BH and SUD services, enabling trusted primary care physicians to do warm hand-offs to BH staff before a patient leaves the clinic. Activities will include improving efficiencies in the electronic health records system a ND delivery of care to create more appointment slots and reduce or eliminate barriers to accessing BH services. Mercy care also will expand pharmacy and primary care providers' role in the use of FDA-approved moud. In addition, mercy care will help clients address social determinants of health that impact recovery from BH and SUD conditions, such as food insecurity, homelessness, and lack of transportation. All services will be recovery-oriented, trauma-informed, and equity-based.