Project Name: The Jewish Board Staten Island CCBHC
Overview: The Jewish Board (JB) requests a CCBHC PDI grant to expand substance use (SU) treatment, crisis care, rehabilitation, health, peer support, assessment and care planning services to address critical pandemic-exacerbated needs in Staten Island (SI), New York. These improvements will enable JB to assess and treat 5,000 primarily low-income SI residents of all ages with over the 4-year grant period with comprehensive behavioral health (BH) services.
Targeted Needs: (1) SI residents have multiple access barriers to engaging with services, especially scarcity of behavioral health (BH) care on the Island. (2) The pandemic has exacerbated substance use, suicidal behaviors, trauma, depression, anxiety, tobacco use and social determinants of health. Children/youth have experienced unprecedented life disruptions. (3) Historical health disparities for Black, Latinx and low-income SI residents have resulted in higher prevalence of chronic health conditions (CHC). Disparities to be addressed are access to care barriers, higher risks to children/youth negatively impacted by the pandemic, increased substance abuse and suicide, and historic racial/economic disparities in prevalence of CHC.
Strategies and Interventions: In order to increase service capacity, JB will (1) expand SU treatment by adding clinicians and peers, as well as an additional clinical program; (2) shorten time for assessment and care planning by adding a Facilitated Intake Team that will also provide targeted outreach to underserved populations of focus; (3) enhance crisis care by adding a Bridges to Care Team that is available 24/7 for crisis management, short-term crisis/urgent care and transition from inpatient to community care; (4) add a Health Team including a registered nurse and patient navigator to screen, monitor, educate and manage health conditions while linking consumers to nearby primary care providers; (5) add adult rehabilitation and peer support with new NYS-certified CORE services; (6) enhance children's rehabilitation resources in its NYS-certified CFTSS program; and (7) formalizing a partnership with the local Veteran's Administration health services network to provide collaborative care for active military and veterans who may need CCBHC services. With these additions and enhancements, JB will fully meet the CCBHC criteria within 12 months of award, with many improved/enhance services available within 6 months.
Population Served: In 2021, the SI Hub served 2,100 unduplicated individuals (65% female) with 90% having a mental health (MH) condition, 10% with a serious mental illness (SMI) and 6% a co-occurring substance use disorder (SUD). JB currently offers comprehensive children's BH care, resulting in 41% of consumers being children ages 5-17 (59% are adults ages 18+). In 2021, 76% are low-income on Medicaid or Medicare/Medicaid and reflect the racial/ethnic diversity of SI. With a CCBHC PDI grant, consumers serviced annually will increase to 3,074 in Year 4, with consumers overall receiving a broader array of services to address their needs. With targeted outreach, JB will serve more individuals who have heretofore experienced barriers to accessing care, including SI residents who are Black, Hispanic, Asian, low-income and veterans.
Goals/Objectives: (1) Improve timely access to outpatient BH care (Reduce wait time for initial routine intake appointments to 10 business days and urgent intake appointments to 1 day (2) Improve BMI Screening/Follow-Up ages 18+ (60% Screening/Follow-Up) (3) Improve Tobacco Use Screening/Cessation Intervention: 18+ (Increase tobacco use cessation interventions to 60%) (4) Improve SUD Diagnosis and Follow-Up (Increase to 80% Screening/ 75% Follow-Up) (5) Improve Suicide Risk Assessment Follow-Up ages 10+ ( 90% Follow-Up).