Sunday, November 24, 2024
11/24/2024
The District of Columbia (DC or the District) Department of Behavioral Health (DBH or the Department) intends to use the Promoting Integration of Primary and Behavioral Health Care (PIPBHC) grant to expand services for Medicaid-eligible and uninsured adults with serious mental illness (SMI) and significant co-occurring physical health conditions, particularly focusing on older adults (aged 55 or older). In Fiscal Year (FY) 2023, DBH served 43,427 individuals. Of these individuals, 11,882 (31%) were adults aged 55 or older, 67% African American, 3 percent Hispanic, 2% white, and 48% male. According to the 2021-2022 SMASHA National Survey on Drug Use and Health (NSDUH), approximately 26.6 percent of adults have any mental illness and 6.4 percent have an SMI in DC. DC also has the second-highest overdose death rate in the country. Between 2016 and 2020, 76 percent of fatal opioid overdoses occurring in adults aged 40-69, and 84 percent of these deaths were African Americans and 72 percent were males. DBH serves approximately 2,000 adults annually in its Assertive Community Treatment (ACT) program, with 100 percent of enrollees living with an SMI and approximately 80 percent also living with at least one co-occurring physical disorder. Additionally, 75 percent of the 531 individuals currently served in our Mental Health Community Residence Facilities are over the age of 55, and 80 percent of them have serious co-morbid medical conditions and DBH receives at least three requests per week for increases in bed capacity. In this project, DBH intends to partner with at least two community agencies who serve these underserved and historically marginalized populations, one of which will be a primary care provider using the Collaborative Care Model and the other will be a Community Behavioral Health Clinic (CCBHC) such as: (1) Freedman's Medicine, a primary care center currently using the Collaborative Care Model and focuses on low-income older adults and individuals with disabilities and behavioral health conditions. Freedman's Medicine indicates that the 500 people they serve reflect resource constraints and they estimate with additional funding they could increase their service population to 2,000 people per year and could more effectively address the unmet needs of the community; and (2) Hillcrest Children and Family Center (Hillcrest), a DBH-certified behavioral health provider that served 1,131 Medicaid recipients including 831 adults in FY23. In 2023, Hillcrest became a CCBHC after receiving a SAMSHA Expansion grant to build up the infrastructure needed to deliver fully integrated behavioral health and primary care services to its patients. The Department will use the funding support from this grant to support Freedman's Medicine and Hillcrest to expand their existing integrated care efforts and reach more patients in need. In the implementation of this project, DBH plans to use a minimum of three Evidence-Based Practices (EBPs): the Collaborative Care Model, ACT, and Mental Health First Aid (MHFA). Collaborative Care is a proven strategy to reduce mental health inequities and improve outcomes for racial/ethnic minority groups and older adults. The PIPBHC grant aligns well with the ACT model as ACT program participants have SMI and often have one or multiple co-occurring chronic medical conditions. Finally, this grant complements the District’s use of MHFA, which trains primary care providers and clinics on behavioral health screening, in particular for those who have older adult patients.
HHS’ Tracking Accountability in Government Grants System (TAGGS) website provides access to detailed descriptions of grants, loans, aggregated direct payments and other types of financial assistance awarded by the HHS Operating Divisions (OPDIVs) and the Office of the Secretary Staff Divisions (STAFFDIVs).
