Since 1983, United Community Health Center Maria Auxiliadora, Inc. (UCHC) has been committed to the delivery of quality, accessible, and comprehensive primary healthcare to all patients in our communities regardless of insurance status and/or ability to pay. Our clinics serve rural locations in southern Pima County and southern Arizona. UCHC’s Designated Service Area (DSA) spans 3,000 square miles, with a population of over 111,000 with just over 25,000 of the population considered low income per the GeoNavigator mapping tool. In our smaller outlying communities, our clinic is the first point of access for populations seeking health care, so we positioned to provide a continuum of care including primary care, dental, pediatric, and behavioral health services. In 2018, UCHC started its Behavioral Health program. Since then, we have expanded to 3.5 psychiatric nurse practitioners and a licensed clinical social worker and per our 2023 UDS report, have 840 mental health patients and over 4,000 visits annually. Per our 2023 UDS report, we have 242 patients with alcohol related disorders; 222 with substance use disorders; 691 with tobacco use disorder; 2,235 with depression and other mood disorders; 2,922 with anxiety disorders, including PTSD; 640 with attention deficit and disruptive behavior disorders; and 2,016 with other mental conditions. With our current staffing capacity, we are unable to provide care or treatment that addresses all our patient’s needs, especially when it comes to alcohol and substance use disorder diagnoses. Patients are told of other treatment programs both in and outside of our service area. We are working on formal referral contracts to include our self-pay and sliding fee patients in these programs since financial strain can be a barrier to care. We realize transportation can be barrier to those that need to seek treatment further from home. By not being able to treat these patients in our health centers, we lose the o
pportunity for coordinated integrative care. For this reason, we are applying for the Behavior Health Services Expansion grant to increase the number of patients receiving mental health services and to begin a program to increase the number of patients receiving substance use disorder (SUD) services including treatment, recovery, and support and with medications for opioid use disorder (MOUD). The result will be more providers trained in these services which will increase access for our patients, remove financial and transportation barriers, and provide coordinated and integrated care within our clinics. We would begin with training. We need funding to train our primary care and behavioral health staff in the best evidence-based practices for treating substance use disorders. Secondly, we would expand our staff to include a clinical oversight position, licensed clinical social workers, and counselors; behavioral health technicians, and referral sources in Pima County to provide severe MOUD services, such as those requiring inpatient care. We would hire a case manager to address underlying patient needs for housing, food insecurity, financial strain, transportation, language barriers and discrimination and expand transportation services by adding another vehicle and driver. We are once again a Patient Centered Medical Home (PCMH)! We are meeting the requirements of the five functions of medical home that include Comprehensive Care, Patient Centered, Coordinated Care, Accessible Services, Quality and Safety. We are ready to provide more behavioral health services using these foundational principles. We would measure this program through our Quality Committee and through use of Plan Do, Study Act (PDSA’) initiatives. We would utilize data provided by our Health Information Systems department. UCHC currently uses E clinical works and Azara to measure our progress. After 2 years of initial funding, we would sustain our program through program income, local grants and
HRSA grant funding.