Tropical Texas Behavioral Health CCBHC Expansion Program - Tropical Texas Behavioral Health (TTBH) CCBHC Expansion Program proposes to expand and enhance through process improvement, health outcome improvement and expanded policies and procedures of its behavioral health services to treat adult and youth with Substance Use Disorder (SUD), Primary Care and Co-Occurring Disorders (COD) through the implementation of the Care Coordination model via the CCBHC Expansion grant.
TTBH has over 50 years of operations as the Local Mental Health Authority (LMHA) for the region in south Texas known as the Rio Grande Valley (RGV) serving residents of area of Hidalgo, Cameron and Willacy Counties. The target population are individuals identified with Severe and Persistent Mental Illness (SPMI) with major depressive disorder, bipolar disorder, schizophrenia, and other related disorders. The RGV is composed of 1.3 million residents with about 90% Hispanic population. Percentage of resident without health insurance coverage are 31.2%, 29% and 22.3% for Hidalgo, Cameron and Willacy counties, respectively, which is about three times higher than the average resident of the U.S. at 10% (based on the U.S. Census Bureau, Quick Facts for Hidalgo, Cameron and Willacy counties in Texas, population estimates, July 1, 2018, V2018).
TTBH's Care Coordination team will provide services to address behavioral health issues as well as referral to internal clinical services to primary care, substance use disorders, veteran services, assisted outpatient treatment (AOT) and crisis services. External referral may include HIV, Hepatitis A, B, and C testing at the Valley AIDS Council. TTBH consistently employs evidence-based practices to assess client's needs to determine the most appropriate type of care. Additionally, TTBH provides clients with support services such as a drop-in center and assistance with employment and housing. TTBH clients have the advantage of receiving integrated services in each of our four clinics throughout the RGV.
The TTBH CCHBC Expansion program will focus on adults and youth with serious mental illness, SUD, COD and chronic medical conditions. Based on research, these conditions are often linked with one another. According to "Improving the Quality of Health Care for Mental and SUD Conditions", 2006, Among those seeking treatment for drug-use disorder, 60.3% had at least one independent mood disorder, 42.6% at least one independent anxiety disorder, and 55.2% a comorbid alcohol-use disorder (Grant et.al., 2004). Also, specific mental or substance-use diagnoses place individuals at higher risk for certain general medical conditions. For example, person with anxiety disorders have higher rates of cardia problems, hypertension, gastrointestinal problems, genitourinary disorders, and migraine (Harter et.al, 2003). Given these statistics, the following intervention services have been identified to expand existing services via the CCBHC model for this program: 1) Improved coordination and access to SUD and COD treatment services for adults and youth; 2) Improved access to routine whole-person integrated care with Primary Care services, and 3) Implementation of Care Coordination services to improve continuity of care.
The program plans to employ fifteen Care Coordinators, a Program Director, Program Evaluator, Supervisor, Fiscal person, System support analyst, and a clerk. The program goals include: 1) will expand access to care coordination activity with integrated behavioral health, primary care, and substance use disorder services; 2) will improve preventative care and screening outcomes related to Body Mass Index (BMI); 3) will improve screening outcomes related to depression for clients; 4) will improve screening outcomes related to substance use for clients. At least 700 unduplicated clients will be assessed for services and enrolled annually and at least 1400 unduplicated clients will be screened and enrolled over the two-year life of the grant.
