ICL Hub CCBHC - As a CCBHC-IA awardee, ICL (Institute for Community Living, Inc.) will improve and advance outreach, engagement, and integrated behavioral health treatment for 1,000 at-risk residents of Brooklyn, NY across the lifespan. i.e., children, youth, adults and their families through a Whole Family Health Model (WFHM), with a focus on Spanish-speaking populations, recent immigrants and asylum seekers, and veteran families. The Health Hub CCBHC serves the geographic catchment area of Bedford-Stuyvesant, East New York/Starrett City/Cypress Hills, and Brownsville/Ocean Hill in Brooklyn, New York. These neighborhoods are among the most at-risk, high-need areas in NYC, with disproportionately poor health outcomes. They are home to primarily communities of color, including a large number of immigrants. ICL’s Health Hub, located in East New York, Brooklyn, delivers integrated, holistic care in a single site in partnership with our co-located FQHC partner, Community Healthcare Network, Inc. (CHN); services include primary care, family support, MH/SUD outpatient programs, recovery programs, and care coordination to address behavioral and physical health concerns of the highly diverse, underserved local population. CCBHC funding will enable us to continue to address significant health disparities experienced by Latino families with children, who lack health insurance, and experience other barriers to quality care. We will extend our outreach efforts to new immigrants and asylum seekers, who have come to NYC in great numbers over the past few months. The project’s goals are to: (1) Increase access to comprehensive BH services for individuals and families, with limited resources, language, and other barriers to care; (2) Improve BH and other outcomes for individuals and families, with limited resources, language, and other barriers to care; and (3) Enhance CCBHC Infrastructure to promote care coordination, monitoring, and advancement. To encourage outreach and engagement, we will utilize a comprehensive Spanish outreach initiative, engage community partners, such as shelters, and conduct bi-weekly presentations to local providers and agencies to streamline referrals into the CCBHC. We will enhance our capacity to serve our Spanish-speaking clients by adding bilingual case management staff. In addition, we will continue to intensify services for veteran families. We will collaborate with CHN to provide primary care screening, monitoring, and services to our clients. As a part of our WFHM, we will continue to develop a Family Care Plan in our EHR and improve care coordination with other providers via electronic data sharing. To ensure services are responsive to community needs, we will convene a bilingual Advisory Work Group and conduct comprehensive needs assessments that will inform our staffing, training, and service activities. The project will serve 250 unduplicated individuals in each year of the project and 1,000 individuals over the course of the 4-year grant.
