The purpose of the Kalamazoo Community Mental Health and Substance Abuse Services’ CCBHC project is to improve the health of individuals in Kalamazoo county while advancing integration of behavioral health and physical health care, increasing use of evidence-based practices and expanding capacity, access and availability to high quality care.
Target Population: KCMHSAS’ CCBHC population of focus is Adults with Serious Mental Illness (SMI), Adults with Substance Use Disorders (SUD), Children/Adolescents with Serious Emotional Disturbance (SED), and Youth and Adults with co-occurring Substance Use Disorders (COD). Adults with SMI and co-occurring opioid and other substance use are identified as a sub-population of focus. Kalamazoo County’s population is 261,659 with 56,962 youth under the age of 18 and 14,625 veterans. The County, including the target population, has a diverse population with 81.7% White, 11.6% Black/African American, 0.5% American Indian and 4.8% Hispanic/Latino. Gender makeup is 50.9% male and 49.1% female; 3.8% LGBTQ.
Strategies/Interventions: KCMHAS will provide: crisis mental health services, screening, assessment and diagnosis, patient centered treatment planning, risk assessment and crisis planning, outpatient behavioral health services, outpatient primary care screening and monitoring of health indicators and risks, clinical monitoring for adverse effects of medications, targeted case management, psychiatric rehabilitation services, clubhouse programming, peer recovery supports, veterans’ behavioral health services, and assertive community treatment. Evidence based practices include: SBIRT, Motivational Interviewing, Matrix Model of treatment.
Goal 1. Increase access to behavioral health services for population of focus. Objective 1a) Outreach staff will provide individual contacts to 1,200 people in the community by end of year 2. Objective 1b) Additional staff will be hired/trained to provide services to 1000 individuals.
Goal 2. Deliver comprehensive and coordinated care that provides access to effective evidence based interventions for individuals with complex needs. Objective 2a) Provide evidence based treatment for 100% CCBHC enrolled individuals. Objective 2b) Provide care coordination for 100% CCBHC enrolled individuals. Objective 2c) Increase number of individuals receiving SUD services from implementation baseline by 100% by end of year 2.
Goal 3. Deliver integrated care for behavioral health and physical health risks and needs. Objective 3a) All CCBHC enrolled individuals will receive primary care screening and monitoring of health indicators and risks identified in CCBHC Quality Measures.
Objective 3b) Individuals identified with high behavioral and physical health risks will be assigned to a Nurse Care Coordinator for monitoring and follow up care.
This project will serve 500 individuals Year 1 and 500 individuals Year 2 for a total of 1000 unduplicated individuals by end of Year 2.