FY 2024 Behavioral Health Service Expansion - Family Health Services, Health Center Program #H80CS00425. In an earnest effort to increase access to behavioral health services through the expansion of mental health and substance abuse services in primary care clinics, FHS proposes to use Behavioral Health Service Expansion funds for the addition of 3.0 FTE Counselors, 1.0 FTE Substance Use Disorder Counselor, 1.0 FTE Registered Nurse for the integrated medical services at our Twin Falls Behavioral Health clinic, and 1.0 FTE mid-level Medical Provider who will offer Medication Assisted Treatment – for a total of six new staff. As of April 2024, the entire state of Idaho is a Mental Health Professional Shortage Area. Our greatest challenge will be recruiting and hiring counselors, as there is a national shortage of mental health professionals. Rural areas have more difficulty courting staff with wages not as competitive and natural and built community environments not as inherently attractive. FHS will use BHSE funds in Year One to offer sign on bonuses to new counselors to mitigate this challenge as part of their contract. FHS projects 373 total new patients will have access to culturally sensitive mental health/behavioral health and/or substance abuse over an estimated 2,995 total new encounters through the BHSE funding. Approximately 252 new patients will receive mental health services over 1,758 encounters. Sixty-five new patients will access SUD over six-hundred encounters, and fifty-six new patients will receive treatment with MOUD over an estimated 637 encounters. FHS follows a Collaborative Care model of team-driven care with a focus on integrated care, population health management, outcome measures guiding clinical decision-making, and evidenced-based care to improve health outcomes. The proposed funding for staffing and recruitment bonuses will better prepare FHS to navigate the provision of comprehensive, whole-person care for a growing number of high-needs, high utilization patients living with mental health conditions and/or substance use disorders. Idaho and Utah are the only Intermountain West states to see more than 1% population growth between 2022 and 2023 and our communities are witness to the effects of that growth, both negative and positive. While Idaho is gaining needed diversity and growth, the rising cost of living, especially housing, is contributing to higher rates of stress and anxiety. FHS regularly screens patients for social drivers of health and more patients are indicating concern about access to housing, utility, transportation, and food that can contribute to depression and/or anxiety. In 2022, approximately 2,557 FHS patients had depression or other mood disorder diagnoses. Just over 3,100 had an anxiety diagnosis, including PTSD. In 2023, 3,140 patients had a depression or other mood disorder diagnosis, and 3,252 patients had an anxiety disorders diagnosis. Patients with alcohol disorders increased from 188 in 2022 to 277 in 2023 and patients with other substance-related disorders (excluding tobacco use disorder) increased from 411 in 2022 to 461 in 2023. Our proposal also directly responds to an increase in suicide rates for the state in recent years, with the age-adjusted death rate increasing from 20.5 (12th highest in US in 2020) to 22.2 in 2022 (sixth highest in the US). The staffing proposed in our BHSE application directly reflects the needs of our communities and our patients to better access mental health services and SUD services in a timely manner, including receiving treatment with MOUD in an affordable, non-discriminatory, and culturally appropriate manner. Our goal is to strengthen our capacity through integration of services, to promote equal access to care and reduce disparities in care, and ensure all patients, regardless of their need, receive the whole person, comprehensive care they deserve.