FY 2024 behavioral health service expansion - EL dorado county community health center (EDCCHC) is a non-profit fqhc providing primary care, behavioral health (BH), medication assisted treatment (mat)…

FY 2024 behavioral health service expansion - EL dorado county community health center (EDCCHC) is a non-profit fqhc providing primary care, behavioral health (BH), medication assisted treatment (mat) for substance use disorders (SUD), dental, vision, pharmacy, podiatry, women's health, and telemedicine specialty services. EDCCHC opened in 2003 and operates a new comprehensive site in placerville and two sites in cameron park. EDCCHC's service area is EL dorado county (EDC) california. EDC is designated by hrsa as a high needs geographic hpsa for mental health with a shortage of 9.19 providers and a mental health hpsa score of 22. EDCCHC is the largest provider for the low-income, uninsured, and underinsured patient population. In 2016, EDCCHC received hrsa substance abuse service expansion funding to expand mat services beyond one provider who prescribed suboxone. With this funding, EDCCHC developed an integrated behavioral health service model to support patients receiving SUD services with BH. Since this time, EDCCHC has significantly increased mental health services staffing (14.48 FTE,1,709 patients,14,695 visits), which has increased the number of patients identified as needing SUD/moud services. UDS data (line 21) identifies 77 SUD/moud patients. EDCCHC data identified 540 SUD/moud patients in 2023. There is a significant need to increase BH staffing capacity to expand the number of patients who can access BH and SUD/moud services with CO-occurring BH. EDCCHC is the largest and primary SUD/moud provider in the county. Evidence of the need to increase EDCCHC's capacity is: 1) with more BH services, the number of patients referred for SUD/moud services has increased significantly. EDCCHC's data identifies that 37% of BH patients need SUD/moud services. SUD/moud/BH services are needed for an estimated 115 more EDCCHC patients. 2) marshall hospital/ medical informed EDCCHC that IT would be closing down psychiatric services at the beginning of 2024 and would refer approximately 3 00 psychiatric patients to EDCCHC for BH. Using EDCCHC's ratio of 37% of BH patients needing SUD/moud services, EDCCHC has a need to provide BH for up to 300 patients and BH/moud services to 111 more patients. 3) in 2023, EDCCHC provided medical care to 612 homeless patients. In january 2024, EDC increased centralized services for the homeless population. EDC now has a new temporary navigation center to provide temporary housing for up to 60 homeless people and is providing a safe nearby parking area for people living in their cars. EDCCHC's mobile medical unit is now providing health services at the navigation center for one day a week. There is a BH therapist for the mobile medical unit, who is identifying homeless patients in need of BH/SUD/moud services. The american addiction centers website identifies that around 1/3 of people who are homeless have problems with alcohol and/or drugs, and around 2/3 of these people have lifetime histories of drug or alcohol use disorders. With 612 homeless patients, IT can be assumed that 1/3RD or 184 homeless individuals are in need of SUD/moud/BH services and a higher number need BH. The california overdose surveillance dashboard identified that in EDC in 2022, there were 36 opioid overdose deaths (20.1/100K, higher than the state rate of 18.66), 66 (40.3/100K) emergency department visits related to opioid overdose, and 16 (9.2/100K) hospitalizations. The EL dorado community health needs assessment & community improvement plan 2023-2028 identifies "mental health / substance abuse" as the top health priority in the county. EDCCHC proposes to add BH staff to increase capacity to provide BH access for patients identified as needing BH and patients identified as needing SUD/moud with CO-occurring BH services including psychiatry as needed. The goal is to increase capacity and access for existing EDCCHC patients, for former marshall patients who can no longer access a psychiatrist, and for the homeless population.