The Banyan Health Systems d/b/a Banyan Community Health Center, Inc. (Banyan) proposes the Banyan Certified Community Behavioral Health Clinic—Improvement and Advancement, which responds to SAMHSA FOA No. SM-22-012: The Banyan CCBHC-2 (BCCBHC-2), in order to distinguish it from the original BCCBHC Project. The population of focus (POF) for BCCBHC-2 is the majority minority (Black and Latinx) population of the Broward and Miami-Dade Counties (MDC), who reside primarily in the Little Havana, Cutler Bay and Lauderdale Hills, the site of Banyan’s new state-of-the-art integrated behavioral health and primary care center, whose services will center on western Broward, which remains a services desert overall, with integrated services are largely unavailable. South Florida is well-known for its diverse population, but in Banyan’s primary service area, the population is as much as 79.4% Latinx and 16.3% Black. The POF also encompasses disproportionate numbers of LGBTQ+ adults and other sexual and gender minorities. In addition to struggling with serious emotional disturbance (SED), SMI, SUD and/or (COD), Banyan who present with one of more of the following conditions: PTSD, tobacco/vaping use or dependence, obesity and/or poor nutrition will participate in an implementation science pilot study to search for ways to better provide needed treatment for clients.
The communities served by Banyan struggle with overwhelming poverty (54.5% have incomes below the Federal Poverty Level); unemployment is rampant; 74.9% of adults have limited English proficiency; and 82.7% of low-income families are either unserved by a primary care provider or declined care in the past year because they could not afford it. Environmental factors (i.e., crowded living conditions and substandard housing) combined with limited access to health and behavioral health care have created conditions in which SED among children is rising and greater numbers of adults with SMI are going untreated. The Covid-19 pandemic further increased the demand for health/behavioral health services.
The proposed BCCBHC-2 Program will provide clinical services for more than 1300 individuals and families with SED, SMI and COD (220 in Y1; 360 in Y2-Y4, for a total of 1300 over the 4-year project period), who can be effectively served in an outpatient setting with the right support. The Project’s key innovation is the application of the Critical Time Intervention (CTI) to homeless individuals who have been diagnosed with SED/SMI/SUD/COD and are high utilizers of inpatient hospital and ED services. Other EBPs will include Cognitive Behavior Therapy, Medication Assisted Treatment, Wellness Recovery Action Planning, Motivational Interviewing, Seeking Safety, Trauma-Focused CBT, Nutrition/Exercise coaching, peer-based Recovery Support Services and Tools to Quit and Quit Smoking Now. Banyan will combine CTI with the extensive use of standard screening instruments (PHQ-9/9A, PHQ-9/9A; GAD7; CAGE; PSC; MDQ along with urine screening for substance use. Where indicated, Banyan will also use SCARED, PSC, M-CHAT & CRAFFT. Banyan’s FQHC uses a diabetes screen, BP screen, HIV, HCV A/B/C/ and STI testing administered according to AAFP periodicity schedules. Banyan has embedded most of these in its EMRs (Intergy and Credible) to facilitate assessment but will move to the EPIC EHR in Year 2.
