Developing a CCBHC to Address Mental Health Disparities in Crawford County, Kansas
Crawford County Mental Health Center (CCMHC) seeks grant funding to become a Certified Community Behavioral Health Clinic and expand integrated behavioral health care by enhancing care coordination, improving consumer experience by improving wait times, and providing culturally-competent care. Our CCBHC will address health disparities in the county, which has one of the highest poverty rates in the U.S. and marked disparities in behavioral health outcomes.
Crawford County is a county of 38,972 (2020 census) in southeast Kansas. The collapse of mining in the area saw employment and population dwindling, leaving the county the state’s poorest, with 23% of households below the poverty line. Psychological conditions are more prevalent in low-income individuals, and for many behavioral health indicators (including percentages of individuals with frequent mental distress, percentages of adults who binge drink, and age-adjusted suicide mortality rates), Crawford County data are worse than the state and the U.S. County demographics are reflected in CCMHC’s consumers, with 87% living in poverty. CCMHC serves over 800 adults and 360 children each year, of which 60% have Medicaid. Almost 90% of these consumers have been diagnosed with SED, 18% with SPMI. Given known health disparities in low-income and minority populations, CCMHC efforts will focus efforts on those Medicaid individuals living in poverty, people of color, and veterans by enhancing services to the target population of 700 clients annually, with a total of 2,927 over 4 years. African Americans represent 2.3% of county residents but 8.8% of current CCMHC clients. Conversely, the largest ethnic minority Hispanic/Latinos are 5.1% and veterans are 5.8% of the local population but only 2.5% of patients.
CCMHC will apply for CCBHC certification under the state of Kansas, in accordance with state law by 2024, changing to a prospective payment system (PPS) with these four goals and their supporting measurable objectives:
1. Increase care coordination within CCMHC and with our community partners to reduce drop outs, increase engagement, and follow through with plans of treatment. We will measure the number of patients served with an increased number of Medicaid patients by 25% in year 1 with an annual increase of 3%, provide services to all African Americans, Hispanic/Latino, and veterans by year 2 and sustain that percentage throughout the grant, provide targeted case management services to 75% of incarcerated individuals with mental illness and 75% of patients seeking behavioral health services in hospital ER in the first year, with an annual increases of 3%, and through annual culturally competent staff training.
2. Reduce wait times for individuals seeking treatment for routine initial evaluations through implementation of a same day access model in year 1. CCMHC will reduce wait times from initial contact to initial evaluation to an average of 10 days within Year 1 and within 3 days by the end of the grant project in year 2.
3. Reduce the number of patients who attempt suicide and the suicide mortality rate through comprehensive treatment plans using targeted evidence-based practices by providing Zero Suicide Model services to 100% of population receiving crisis services within year 2.
4. Enhance treatment effectiveness through evidence-based practices for target population groups. Measures will include: providing DBT to 100% of SUD patients, providing ART to 75 patients, IPS to 25 patients, providing PCIT to 10 families, and providing RAISE to 100% of patients with schizophrenia under age 35, all within year 1. This goal is also measured through providing TLC to 125 patients annually by year 2 and MI to 100% of SUD patients in year 3, and providing TF-CBT to 25 patients in year 4.