WellSpan’s Specialized Treatment and Recovery Team (START) – York Enhancements expands its Certified Community Behavioral Health Clinic to serve 500+/year, 2,150 in 4 years. Enhancements are support groups and education in community settings, expanding walk-in hours, adding evidence-based practices specific to persons experiencing homelessness, formerly incarcerated, Spanish-speaking and LGBTQI+; training for LGBTAIA+ affirming staff, on-site tobacco cessation, and expanding collaboration with prison diversion/re-entry. The population of focus for START is individuals with complex behavioral and physical health needs, who also have psychosocial and cultural factors and/or complexities precipitating, and propagating health, mental health, and substance use concerns. Most participants are from York City, where 44% are non-White, 33% Hispanic, and 27.7% living below poverty level. Location is York City, although participants are accepted from any geographic area.
Goal 1: To improve and expand the care provided by START
Obj 1a: By increasing peer and recovery support services and adding community partners that address SDoH, START participants scores on the DLA20 (implementation by March 2023) will improve by at least 10% from intake to discharge by 9/29/24 and annually thereafter.
Obj 1b: By offering on-site Freedom from Smoking groups and individual counseling at START, the # of referrals to tobacco cessation will increase by 20% by 9/29/24 and annually thereafter.
Obj 1c: As a result of seeking consumer input through patient rounding and engaging START community oversight/governance groups (Consumer Advisory Board and Consumer Advisory Council) and considering that feedback to improve services at START, by 9/1/23 and annually thereafter 85% of consumers will indicate they would recommend the program to others as measured on McClean Perceptions of Care eBasis patient experience survey.
Goal 2: To increase access to and availability of high-quality services to meet identified community needs
Obj 2a: As a result of offering at least 15 hours/week of open slot (walk-in) appointments, by 9/29/23 and thereafter, the average time between requesting an appointment and having a scheduled appointment will decrease to an average of 3 days (currently at 3.4-day average).
Obj 2b: As a result of providing peer and recovery support and support groups in community locations and increasing START’s number of LGBTQIA+-affirming team members, there will be a 10% overall increase in unduplicated individuals served by 9/29/24 and maintained thereafter, and at least a 5% increase in number of LGBTQIA+ individuals served by 9/29/24 and annually thereafter.
Goal 3: To provide care in a community-based setting to reduce overall cost of care
Obj 3.a: As a result of integration of crisis staff with START staff and increased community outreach, the number of ED diversions will increase by 10% each year to at least 70/month by 9/29/23, 77/month by 9/29/24, 85/month by 9/29/25, 94/month by 9/29/26.
Obj 3b: Upon discharge from START to primary care or other outpatient services, START participants will have a 20% reduction in ED visits for MH or MH/SUD compared to the 12 months prior to receiving services at START by 9/29/25.
Obj 3c: As a result of collaborative efforts between the START, Community Action for Recovery and Diversion (CARD), York County Re-entry Coalition and the county prison system, diversions from the justice system into treatment for those with MH and SUD disorders will increase by 20% over four years (5% per year) by 9/29/26 from a 2022 baseline of 27.