Helio Health CCBHC-PDI - Helio Health CCBHC: Providing Integrated Community-Based BH and Health Services to Mohawk Valley Residents Across the Life Course. Helio Health (Helio) proposes to implement a new CCBHC at our Insights of Helio Health site in Utica, New York to address mental, behavioral, and physical needs in an integrated, geographically accessible, culturally appropriate, and community-based setting. Helio is a not-for-profit regional health care leader offering a full continuum of behavioral and social services throughout Central Upstate NY. We will increase the number of unduplicated clients served by 400 in Y1, 500 in Y2, 600 in Y3, and 750 in Y4, totaling 2,250. The geographic area includes six counties in the Mohawk Valley: Fulton, Herkimer, Montgomery, Oneida, Otsego and Schoharie with an estimated population of 485,000. Our Population of Focus is children and adults living with serious mental illness (SMI), substance use disorders (SUD), co-occurring mental health (MH) and substance use disorders (COD), serious emotional disturbance (SED), and co-occurring physical conditions, MH, and SUD needs.70% of our patients have COD. Oneida County (Utica) has elevated rates of SMI in the past year (4.7%), thoughts of suicide (4.5%), heroin use (4.2%), and underage alcohol use (22.2%). We serve a low-income population. 72% of our clients have Medicaid, 65.5% are unemployed, and 68% have a high school degree or less. 31,215 residents are veterans, of whom an estimated 48% likely have MH/SUD needs. While Oneida County is 85.3% White, our client population is 27% Black, Indigenous, and People of Color (BIPOC) of whom 19% are Black. The CCBHC model is an opportunity to address disparities in access to services and health outcomes for low-income children and families, residents of rural areas who face barriers to accessing services and strengthen services to better meet the needs of existing patients, who are disproportionately BIPOC. Goals and objectives: (1) Increase access to integrated MH, SUD and COD services for young people and veterans by providing MH and SUD services for children and adolescents, contracting with a child psychiatrist 8 hours per week, training at least 5 staff in EBPs specific to children and adolescents and 2 staff in Cognitive Processing Therapy to support veterans; implementing crisis mental health services, including hiring or training 2 counselors, implementing Zero Suicide screening and assessment protocols, and improving outcomes for CCBHC clients of all ages with depression, with at least 50% having at least a 25% decrease in their PHQ-9 score after 6 months; (2) Increase access to MH and SUD recovery services and supports, including addressing social needs by providing targeted case management services through 4 new case managers; providing psychiatric rehabilitation through 2 new staff trained in appropriate EBPs; increasing peer supports by training existing CRPAs as family support peers and hiring and training 4 new MH peer specialists; and improving staff capability to work with veterans by training 2 staff as certified military counselors. We will improve CCBHC participants’ self-reported functioning in everyday life and social connectedness by 10%, based on NOMS data. And we will (3) fully comply with CCBHC requirements in Y1, providing 5 of 9 required services in April 2023 (Screening, Assessment, and Diagnosis; Patient-Centered Treatment Planning; Peer Support, Counselor Services and Family Supports; Outpatient MH and SUD Services; and Outpatient Clinic Primary Care Screening and Monitoring of Key Health Indicators and Health Risks) and the rest by end of Y1. We will increase clients under age 18 served by at least 100, ensure that new intakes receive physical health screening, complete a needs assessment and a plan for staffing, training and delivery of services, and comply with CCBHC reporting requirements for all measures by April 2023.
