FY 2024 Behavioral Health Service Expansion - Project Abstract Health Center Program grant number: H80CS00688 Keystone Rural Health Consortia, Inc. (KRHC), a Federally Qualified Health Center (FQHC) since 1976, serves a remote, rugged, and mountainous area representing three Pennsylvania Counties (Cameron, Elk, McKean). The service area is in the north-central region of Pennsylvania, measuring approximately 3,327 square miles, and is comprised of 134,142 residents. The area is predominantly rural and isolated; 100% of the population in Cameron, 55.9% in Elk, and 72.4% in McKean live in low-population density areas. The terrain is mountainous, with elevations up to 2,550 feet, and the system of roads is winding, narrow, steep, and often poorly maintained. The area transportation network comprises secondary, state roads and, in some cases, township dirt roads. Fog, ice, and snow are regular impediments to travel for residents. This geography represents the most significant barrier to care. Residents in KRHC’s service area experience high substance use disorders and mental health conditions while also struggling with unemployment, low income, and transportation and food insecurity. Rates for suicide death, opioid dispensing, and overdoses are significantly higher in portions of the service area compared to the state. Residents who identify as Black, Latino/a, and multi-racial experience disproportionally higher depression rates as their White counterparts. As the only FQHC in this multi-County service area, KRHC offers three primary care centers and four dental clinics. However, primary medical, dental, and behavioral/mental health provider shortages are significant challenges for the service area. Travel to the closest FQHC outside of the service area requires a drive of at least 40 minutes. To counteract these challenges, KRHC proposes the implementation of a holistic patient-centered approach by: 1) enhancing the mental health workforce capacity by increasing the full-time equivalence of clinical and support staff and expanding patient capacity for current mental health staff 2) initiating SUD services, including MOUD prescribers, and supporting ongoing professional development in evidence-based practices; 3) increasing community outreach efforts to connect residents to services and reduce stigma and discrimination related to seeking care and treatment; and 4) providing targeted SUD services, including MOUD treatment, to special populations. The short-term impact is that KRHC patients will be able to access behavioral health services, including MOUD, in the primary care setting. As a result of BHSE funding, KRHC will serve an additional 886 mental health patients, 110 SUD patients, and 110 MOUD patients, resulting in a total of 996 new, unduplicated patients.