Abstract
Southern California Health and Rehabilitation Program (SCHARP) proposes to seamlessly integrate primary care and behavioral health and improve overall quality to serve 600 individuals in South Central Los Angeles, an underserved community. The focus populations are homeless (adults including veterans, and children) with SMI or SUD, children and adolescents with SED, and individuals with COD; and a general SMI, SUD, SED, and COD population. Project strategies include infrastructure development to support data driven decision making, targeted staff expansion to address gaps in service, and training for all staff on EBPs and protocols for integrated care delivery and consumer support. The project has three goals: Goal 1- improve overall service quality, and enhance the agency ability to ensure that data drives all agency policies through CCBHC certification, the use of dashboards, a written protocol manual, and initiating Joint Commission accreditation Goal 2 -expand staff training as a primary strategy to ensure service quality including in EBPs and health navigation and Goal 3 -through targeted enhanced staffing, expand the delivery of timely services to the focus populations including case managers, employment specialists, and clinical staff. The catchment area is the Los Angeles County Public Health Department (LACDPH) Service Planning Area 6 (SPA 6). Portions are designated as Mental Health and Primary Care Health Professional Shortage Areas (HPSAs). The total population is 1,030,078. About 68% of residents are Latino, 22% African-American, 2% White, 2% Asian, with less than1% other. Almost half speak Spanish at home (48.8%). About 33.6% live at or below 100% FPL the highest rate in LAC. About 30.6% of residents report their health is fair or poor, the highest rate in LAC (LACDPH, 2017). SCHARP reports that 24% of clients who are homeless are diagnosed with Schizophrenia, 28% with Schizoaffective Disorder, 21% with Bipolar Disorder, 15% with Major Depression, 16% with PTSD and 25% with COD. The prevalence of SED SMI among those at or below 138% FPL in SPA 6 is 27.8% for children 0 to18. EBPs to be utilized include many cited in SAMHSA CCBHC Report to Congress (2017). These include Housing First, Motivational Interviewing, Seeking Safety, CBT and Trauma Informed CBT, and ACT. A wide range of other EBPs are used. SCHARP has been a continuous provider of BH and related services including housing since 1995. It serves the chronically, severely mentally ill and homeless from diverse populations, many of whom have co-occurring SU and health disorders. SCHARP focuses on Permanent Supportive Housing (PSH), ACT and Housing First. SCHARP has already met the majority of the CCBHC compliance criteria and will complete remaining compliance criteria within 4 months of notice of award. California is a planning grant state.
