Family Connections Certified Community Behavioral Health Clinic - ABSTRACT: Family Connections Certified Community Behavioral Health Clinic: Family Connections (FC), a leading New Jersey non-profit since 1879, will integrate our mental health (MH) and substance use disorder (SUD) services with on-site primary care and socioeconomic supports to deliver client-centered, culturally competent, team-based care for underserved individuals, predominantly people of color, in Essex County, New Jersey. We will serve a total of 1,000 unduplicated clients over two years, 500 per year, including adults with and without serious persistent mental illness (SPMI), people with opioid use disorder (OUD) with need for Medication Assisted Treatment (MAT), veterans and their families, and children and adolescents with unmet need for culturally competent mental and behavioral healthcare (BH), including for serious emotional disturbance (SED). With nearly 800,000 residents, Essex County is the 14th most densely populated county in the nation and the third largest in New Jersey. The Urban Core of Essex has among the highest rates statewide of poverty, unemployment, crime, substance use disorders, and child abuse. The inequitable impact of COVID-19 on health and poverty has exacerbated existing need and gaps in services. Our approach will integrate proven delivery models, relying on evidence-based practices and strong linkages with community-based partners addressing primary care and socioeconomic needs. Goals and Objectives: (1) Improve BH outcomes by increasing timely access to and delivering the full range of CCBHC services to 500 more individuals in the first year, and an additional 500 in year two; demonstrating 25% improvement in achieving individual treatment goals; establishing co-located primary care; and accepting overflow clients when ordered by the court systems 100% of the time; (2) Increase access to services for BIPOC children and adolescents with a wide range of MH needs by serving 150 more children and teens in the first year and an additional 150 in year two; demonstrating 25% improvement in achieving individual treatment goals; completing a BH Disparities Impact Statement and Outreach Plan to identify and engage BIPOC parents, children, and teens in need; collecting and using ACEs data from all CCBHC clients to direct trauma-focused treatment planning; assessing 100% of clients, including children/teens, for suicidality and continuing to embed the Zero Suicide framework; (3) Increase access to and coordination of MAT by adding it in a geographically accessible location; providing MAT to 50 individuals in the first year and an additional 80 in year two; finalizing a specialty pharmacy agreement to ensure timely supply of MAT; and increasing the percent of clients maintaining sobriety from 50% to 75% after 90 days; (4) Expand services to active duty and military veterans and their families in our 5-year-old program delivered BY vets, FOR vets, to serve 30 additional veterans and family members in year one and an additional 60 in year two; and (5) Expand the range of services to address the target populations' socioeconomic needs through partnerships to support clients' need for legal services, affordable housing, and jobs.
