The Centers for Youth and Families (CFYF) will improve and enhance its current slate of CCBHC services to 530 new clients in the target population - children (0+) with SED and persons of all ages who are at risk of: 1) SMI 2) SUD, 3) COD and 4) individuals with mental health issues also at risk for chronic health conditions in Little Rock, Arkansas - Pulaski County. The geographic region is primarily designated urban and is the most populous county in Arkansas (Pop 397,931; US Census). Pulaski County is HRSA-designated both Medically Underserved and a Health Professional Shortage Area in the primary and behavioral health domain. Despite its urban setting, the county ranks low on many Health Behaviors, Clinical Care, Social & Economic Factors, and Physical Environment (County Rankings, 2022). The population of the catchment area is 54% NH White, 6% Hispanic, 37% NH Black / African American, 2% Asian, <1% Native American, and 4% Multiracial and 8.5% are veterans. Across the county, about 16% of people are in poverty, 17% are experiencing severe housing problems, 25% of children are in poverty and nearly 75% are eligible for free/reduced lunch. Further, 17% drink alcohol excessively, 15% are food insecure, 18% are in poor to fair health, 11% experience frequent physical duress, 16% experience frequent mental duress, and 10% are uninsured. The county has an Index of Dissimilarity (Black / White) score of .49, suggesting nearly half of the residents would need to relocate with in the county to create a uniform distribution of the population. Minorities living in segregated and isolated neighborhoods have lower housing quality, higher poverty, less access to education and employment, nutritional deficiencies, and less access to health care. Addressing inequity in access to quality healthcare is a pathway to reducing racial inequalities in health outcomes.
CFYF is uniquely situated to address persistent integrated behavioral health inequalities as they are in southern Pulaski County, a predominantly minority area, with a client composition that is 56% Black and 9% Hispanic (CFYF, 2022). To meet the continued needs of the clients of the CCBHC and individuals in Pulaski County we have identified 4 main goals. Goal 1: Improve and enhance the current slate of services for the target population in the catchment area through targeted behavioral health equity activities including the retention of PCC staff (Y1-4) and the mobile mental health unit (Y1-4). We will increase the provision and scope of services offered by CFYF through Management Based Care and other EBPs (Y1-4). Increase general wellness exams through the PCC to include treatment and care for chronic conditions as well as screen for SED, SMI, SUD, and COD (Y1-4). Provide additional and on-going EBP training, including trauma informed care, recovery care, targeted case management, SUD treatment to all clinical staff involved in the care of the target population (Y1-4). Provide workforce development that specifically addresses Diversity, Equity, Inclusion and Accessibility, Cultural Competency, and Implicit Bias Reduction Training (Y1-4). Ensure EBPs are appropriate for specific populations for use in their care (Y1-4).Goal 2: Expand telehealth services to the target populations. Specifically, telehealth will be expanded at the outpatient west facility to include telehealth capable rooms and additional telehealth therapists. Goal 3: Increase accessibility for historically underrepresented and under resourced communities through mobile mental health services (Y1-4) in targeted areas of Pulaski County to create a continuum of care. Goal 4: Identify and improve underlying social determinants of health (SDOH) for target population through the implementation of assessment of SDOH (Y1-4) and Measurement Based Care (Y2-4).