The purpose of the “Circles of Care – Certified Community Behavioral Health Clinic” (“CoC–CCBHC”) project is to expand access to and improve the quality of evidence-based community behavioral health and to integrate primary care services for Brevard County, Florida. The CoC-CCBHC and its Designated Collaborating Organizations (DCO) will provide comprehensive 24/7 access to these services as well as the treatment of co-occurring disorders and provision of physical healthcare in one location. The program will serve adults with serious mental illness (SMI), children and adolescents with serious emotional disturbances (SED), substance use disorders (SUD) including opiate disorders, and co-occurring disorders (COD).
Brevard County is home to 600,000 residents: 51% female, 49% male; 74% Caucasian, 11% African American, and 11% Hispanic or Latino. Within this population 9% live in poverty; 11% under age 65 are disabled; and 13% under age 65 have no health insurance. Approximately 13% of adults are veterans.
An estimated 19,000 Brevard adults could be diagnosed with an SMI and as many as 28,250 with an SUD. Among children and adolescents, the estimated number of SED students between the ages of 12 and 17 is 5,100 individuals. More than 1,500 could be diagnosed with an SUD.
The CoC-CCBHC proposes to serve 850 target population individuals in year 1 and 1250 in year 2. To meet the goals of the CCBHC CoC, a large comprehensive Community Mental Health Center that serves the residents of Brevard County, will continue to employ its current array of programs and services to supplement the CCBHC that include: 24/7 crisis and screening services; adult inpatient psychiatric hospitalization; adult and children’s crisis stabilization units; inpatient detoxification; a continuum of adult residential beds for SUD and SMI, as well as a facility specifically designated for pregnant women or women with young children; an SMI Drop-In center; an SMI psychiatric rehabilitation program; mental health and substance use care coordination and targeted case management, child and adult outpatient therapies and psychiatric medication management; ambulatory Medication Assisted Treatment; and school-based Prevention programs. CoC-CCBHC will additionally expand the trauma-informed, evidence-based ambulatory services and additionally provide outpatient screening, monitoring, and treatment of key primary health indicators. An ambulatory detox will be added to the array of services as well as court-ordered Assertive Community Treatment services. 24/7 county-wide mobile crisis response services will be provided by a local DOC as designated by the state.
The primary goals and year 1 objectives of the project include: (1) expand behavioral health services, integrate primary care and increase access to care with objectives that include (i) enrollment of 600 SMI consumers, (ii) 35 MAT consumers, (iii) case management to 122 consumers, and (iv) open a primary care clinic 20 hours / week; (2) implement new CCBHC required services with objectives that include (i) ambulatory detoxification to enroll 15 consumers; (ii) enroll 40 consumers in an expanded psychiatric rehabilitation services, (iii) provide HIV and HEP A-C testing as part of primary care to 40 consumers, (iv) expand medication management and therapy services to 30 SED youth; (3) demonstrate improved consumer outcomes with the following objectives (i) 65% of MAT consumers remain in treatment for at least 90 days, (ii) 90% of primary medical consumers will report being capable of managing their health care needs at 180 day reassessment, (iii) 85% of medication management consumers will be assessed by their primary care provider as either stable or improved at each visit, (iv) 65% of ambulatory detoxification will successfully complete detoxification, and (v) 90% of targeted case management recipients will function remain in the community as measured every 30 days.