FY 2024 behavioral health service expansion - squirrel hill health center ("shhc") provides high quality, culturally competent, primary and preventive health care to an urban population of underserved…

FY 2024 behavioral health service expansion - squirrel hill health center ("shhc") provides high quality, culturally competent, primary and preventive health care to an urban population of underserved and vulnerable people of all ages, regardless of their backgrounds, insurance status, or ability to pay. Shhc has two fqhc funded sites, one within the city of pittsburgh and the second in nearby brentwood, PA. In recent years, shhc has added several small satellite locations within an addiction recovery program in wilkinsburg, PA, a latino community organization in mooncrest, PA, and a community center in turtle creek, PA. Shhc's mobile medical unit also brings primary care to some of the region's most isolated residents, including clients of various social service agencies and mental health providers. Shhc's newest site is within the former suburban general hospital building in the low-income community of bellevue, PA, where a regional healthcare system is creating an incubator focused on addressing the social determinants of health. Shhc's target populations include low income, uninsured, and underinsured individuals, and patients with barriers to care due to age, religion, ethnicity, culture, language, and/or disability. 69% of shhc patients have limited english proficiency. Through a contract with the PA department of health, shhc provides mandatory health services for all newly arriving refugees in southwestern PA, many of whom remain health center patients. Other target populations include prenatal patients and people living with behavioral health challenges, including opioid addiction. Shhc's sites are accessible by public transportation, on foot. And have free parking. In 2007, shortly after opening, shhc created a fully integrated behavioral health care program, a novelty at the time. Funded initially through a private foundation grant, shhc hired a part time psychiatrist and an lcsw therapist to provide behavioral health assessments and treatment for shhc's primary medical c are patients. In 2014, shhc was awarded a hrsa behavioral health integration grant, to support expanding services as shhc continued to grow significantly. A 2017 innovation grant from the PA department of health supported our integration of medication assisted treatment for opioid addiction into existing services. Shhc has been a recognized center of excellence in this work since 2021. Going into the pandemic, shhc had a steadily increasing number of new patients with comparable growth in behavioral health services. In march 2020, we pivoted to telehealth for the first time. Despite a temporary 35% drop in unique patients in 2020, BH services increased 31%. Shhc's overall patient numbers have since rebounded and grown, up 12% in 2022 and another 15% in 2023. But the behavioral health care practice has not been able to keep up with demand. A combination of provider burnout and turnover, the challenges of paying increasingly high salaries to remain competitive while dealing with stagnant reimbursement rates, and the lack of space needed for a successful transition back to in person care as patients' interest in telehealth has declined, have combined to stymie our ability to sustain this critical part of our practice even as need increases. With our new site, we now have sufficient space to operate a more effective behavioral health hybrid telehealth/in-person model. We are rebuilding the BH team with a new director and are poised to expand a pilot to develop our own therapists by employing msws as they get their clinical training. To meet demand, we also need to recruit staff with additional language proficiency, continue to focus on trauma informed care, and develop a pediatric BH practice that meets our patients' needs. But we cannot accomplish these goals without additional financial resources to support the practice during yet another period of transition, so that shhc can remain, as IT has been for 17 years, a leader in integrated, holistic, patient CE ntered care.