Through the CCBHC PDI Grant, CCAOH seeks transform its New Haven Family Service Center, a community-based behavioral health clinic, into a CCBHC. The CCBHC will increase access to and availability of high quality behavioral health services for low income individuals in New Haven CT.
CCBHC will target individuals across the lifespan with Any Mental Illness (AMI), Serious Mental Illness (SMI), Substance Use Disorder (SUD) and Co-Occurring Disorders (COD) in New Haven, CT. 2021 Census data show that the target population ages 5 and up is 128,598; 47% are male and 53% are female; 32% are Caucasian; 33% are Black, 31% are Hispanic of any race, 5% are Asian. Approximately 22% (28,079) are ages 5-19, 11% (14,486) are ages 20-24, 49% (63,046) are ages 25-59 and 18% (22,987) are age 60+. Some 23.3% of the city’s population lives below poverty, with the highest poverty among Hispanics at 33%, 22% among African Americans, 28.5% among some other race, 33.2% among people of 2+ races and 17.6% among whites. 3.6% of people identify as LGB (4,692) and .03% (386) as transgender.
GOAL 1: To create the infrastructure, staffing and management capacity for full implementation of the CCBHC. Objectives: By 10/15/23, the PI/PD will convene a 7 member Project Management Team (PMT). By 1/31/24, DataHaven will conduct a community needs assessment. 2) By 2/28/24, the PMT will develop a plan for staffing, service delivery and staff training. GOAL 2: To implement the operational and infrastructure changes needed to meet CCBHC certification criteria and improve the quality care. Objectives: By 11/15/23, the PMT will adapt its existing CCBHC processes and procedures for collecting, reporting and tracking encounter, outcome and quality data. By 11/30/23, the PI/PD will develop formal care coordination partnerships with 3 Mobile Crisis DCOs and 1 Psychosocial Rehabilitation DCO. By 1/31/24 obtain an outpatient psychiatric clinic license. By 5/4/24, connect the agency EHR with CT’s Health Information Exchange. By 1/31/24, integrate the CCBHC into existing CQI systems. By 1/31/24 convene a 6-8 member project advisory board, composed of 51% of persons receiving services. By 9/29/24, complete a CCBHC certification attestation. GOAL 3: To improve behavioral health functioning, decrease mental health symptoms and reduce risk of self/other harm among adults and children with MI, SMI, COD. Objectives: Beginning 10/1/23, improve mental health symptoms/ functioning among at least 60% of 120 adults (10-15 who are veterans/military) in year 1 and 240 (20-30 who are veterans/military) annually, clinic staff will provide outpatient behavioral health services. Beginning 12/15/23, prevent unnecessary hospitalization/ER visits among 1,200 adults and 1,200 children annually, CCBHC clinicians and supervisors and DCO Emergency Mobile Crisis clinical staff will work collaboratively. Beginning 2/2824, a peer recovery specialist will provide individual and group support services for 75 participants and their families (35 in year one). Beginning 2/28/24, to reduce drug use and overdose risk among 50% of 64 adults with SA/COD annually (32 in year 1) by providing an IOP. Beginning 3/15/24, to improve behavioral health symptoms and functioning among a minimum of 60% of 70 children annually, (30 in year one), by providing children’s outpatient care. Beginning March 3/1/24, 60% of 35 participants will show increases in daily living skills through psychosocial rehabilitation services offered by Fellowship Place (DCO). Beginning 5/1/24, to promote a tobacco use quit rate of 30%, offer tobacco cessation and MAT, respectively, to 20 persons in year 1 and 30 annually thereafter. Beginning 4/15/24, to increase daily living skills and reduce the impact of SDHs among 60% of 20 adults with SMI/COD (30 annually) through TCM services. The project will serve 180 adults/children in year 1 and 375 adults/children in years 2-4, for a total of 1,305.