With SAMHSA CCBHC Expansion funds, Advocates proposes to create the Advocates Community Counseling (ACC) CCBHC to bolster its existing 24/7 behavioral health (BH) service continuum, targeting un/underinsured people of all ages with complex BH and physical health needs in 5 communities in the MetroWest (MW) region of Massachusetts (MA), (total pop. 166,183), an area not covered by any CCBHC in MA.
Population to be served: Framingham, our proposed CCBHC location, is the largest community in MW (pop 71,232) and the most diverse, with ~35% of its residents from communities of color and 38% speaking a language other than English. The city has the largest Portuguese-speaking Brazilian population in MA and a higher percentage of uninsured residents (7%) compared to the region/state (3%), many of whom are immigrants. MW has higher rates than state averages of hospitalizations related to mental health or heroin abuse. ACC will service those most at risk - people with serious mental illness (SMI), substance use disorders (SUD), co-occurring mental health and substance use disorders (COD), co-occurring complex medical conditions, and serious emotional disturbances (SED) - some of whom are uninsured and/or non-English speaking.
Strategies/interventions: We will improve the accessibility and quality of community BH services in the MW region through the creation of the ACC CCBHC, operating an integrated, team-based approach to providing comprehensive, accessible, and responsive “whole-person” care across a continuum of complexity and need, providing the right care, in the right place, at the right time. The proposed approach draws on proven delivery models and Evidence Based Practices (EBP) and creates strong linkages with strategic community partnerships, particularly primary care and SUD providers and those that address social determinants of health.
Goals and Objectives: ACC CCBHC will serve 400 people in year 1 and 400 in year 2, reaching an unduplicated total of 800 in 2 years. Goal 1- Decrease barriers to care by expanding access to 24/7 BH services for people with SMI/SUD/COD/SED who have experienced stigma, lack of insurance, or scarcity of culturally/linguistically appropriate services, by implementing a ‘no wrong door’ approach regardless of their ability to pay or place of residence; offering multilingual and culturally competent care to Portuguese and Spanish-speaking residents; and embedding peer support throughout our services. Goal 2- Improve efficiency and effectiveness of BH services by creating service delivery models to better assess needs, coordinate care, and integrate BH and physical healthcare through integrated treatment teams; conducting preventative primary care services; and implementing care coordination to provide continuity of care. Goal 3- Increase access to services that meet the unique BH needs of target populations by expanding EBPs through an addiction recovery and medication-assisted treatment (MAT) team; first-episode psychosis team based on Coordinated Specialty Care and Open Dialogue; and youth and family team using the Adolescent Community Reinforcement Approach (A-CRA).