Terros Health, located in Maricopa County, Arizona, the nation’s third largest public health jurisdiction, has supported the needs of our diverse communities for over 50 years. We have grown adept in providing integrated trauma-informed care for individuals with serious mental illness (SMI) and co-occurring disorders(COD). Our proposed project, Terros Health CMHC,will expand services for non-Medicaid funded participants by offering housing support services, enhanced peer support, and greater outreach and engagement for this underfunded population.
Our intensive service project, located at our 51st Ave. Health Center at 4616 N. 51st Ave., #108, Phoenix, AZ, 85031, is focused on individuals with SMI or COD who are uninsured or underinsured and not receiving Medicaid, but currently receiving needed care from our CARF accredited CMHC. However, these individuals do not have adequate insurance coverage for the full range of necessary supports provided, such as crisis intervention, managing co-occurring physical health issues, sustaining employment, and maintaining stable housing in the community. From 2014 to 2021, the number of individuals with SMI presenting at our 51st Avenue clinic grew from 830 to more than 1700 currently.
In fiscal year 2021, our CMHC experienced a decrease of $1,193,953 (SAGB) and $450,410 (MHGB) in funding for vital services that are not supported by Medicaid or other third-party insurers. We are leveraging our experience and will continue to expand our services including recent innovations such as COVID-19 testing and vaccination, mobile screening and treatment, and provision of services through telehealth.
The COVID-19 pandemic has disrupted access to physical, behavioral, and social determinants of health (SDoH) services and supports, decreasing the health and safety of individuals with SMI in our service area. When telehealth platforms expanded in 2020, we saw our complex population having difficulty accessing care through this medium, justifying the need for additional face-to-face interactions with our clinical team as we continue to offer virtual options.
Resources for this project will fill underfunded/unfunded gaps for our target population: 1) Group and individual counseling services; 2) Outreach and engagement using peer supports; 3) Psychosocial and vocational rehabilitation; 4) Case management; 5) Housing support services; 6) Social services enrollment; 7) Primary care services; 8) Psychiatric services; 9) Benefits coordination; 10) Transportation; and 11) court ordered treatment services.
Project goals are 1) provide the full array of services to all individuals needing care including outpatient, telemedicine, and expanded clinical recovery support service and 2) reengage participants into care. Objectives include engaging 60% of participants in health promotion activities, engaging 75% of participants in a Behavioral Health Medical Provider visit at least once every three months, securing an 80% level of involvement in face-to-face or virtual telehealth visits and engaging 80% of participants with PCP coordination of care.
A minimum of 221 participants will be served for each of the two project years, with a total of at least 442 individuals served during the lifetime of the grant.