FY 2024 Behavioral Health Service Expansion - Morovis Community Health Center (MCHC) is an experienced FQHC serving Morovis, Toa Baja and Vega Alta, PR, service area classified as Medically Underserved and Health Professional Service Areas (MUA/HPSA), with extensive rural areas. In 2023, as per UDS Report of MCHC, 2,685 mental health patients and 217 patients with Substance Use Disorder (SUD) were provided treatment only in the main Morovis clinic, but with referrals from the other two clinics. Puerto Rico, as per the most recent prevalence studies (Canino, Glorisa, 2018 and Colon, Hector, 2016) show 7.3% of adults of 18 to 64 years of age with Severe Mental Illness and 2.5% of the population with a substance use disorder (SUD). While the central eastern region served by the MCHC is the 4th highest prevalence region, it has a higher percent of rural populations with access barriers that include lack of public transportation, low income due to unemployment, housing insecurity, especially after the natural disasters of the past 7 years. The target population for the proposed project will include, in the MCHC main center in Morovis, adults with opioid addiction since, under a contractual agreement with the PR Mental Health and Anti-Addiction Services Administration (MHAASA), MCHC is providing SUD treatment to 72 adolescents active currently. The BHE would permit expansion of SUD treatment to 50 adults and treatment with buprenorphine medication at the main site to 10 opioid addicted adults, where there is an ER for attention to any overdose event. At the Toa Baja clinic of the MCHC, the BHE will target 75 adults or adolescents with a substance abuse disorder (SUD) and 150 adults or adolescents with a mental health disorder (MHD) by recruiting an interdisciplinary team of professionals that includes psychologist, social worker, GP, nurse and Addiction Counselor, with hours of a psychiatrist in this clinic which only has one psychologist and one SW currently for a population of over 72,000, where there is about a 2.1% incidence of interpersonal violence, and housing insecurity in 1.7% of the population as per a recent community needs assessment of the MCHC. An outreach worker will be recruited to identify and enroll patients with collaborative partners in the BHE Project. MCHC will expand collaborative agreements it currently has with the MHAASA, Capestrano and Pan American clinics for MH and SU, the PR Departments of the Family for attention to foster care children, and Education for referrals of adolescents with at risk behaviors for diagnosis and treatment through the proposed project in the Morovis and Toa Baja clinics, and establish new agreements with the Continuum of Care (CoCs) of PR for attention to housing insecurity and other social determinants. The EBPs to be used will include SBIRT, CBT, MI, Crisis Intervention, Transtheoretical Model of Change, on which staff will be trained. The QI/QA program of MCHC will monitor project achievements and patient outcomes. The total number of additional MH patients under the proposed project in the 2-year period is 150, with 130 SU patients. A total of $600,000 is requested for YR 01 and $500,000 for YR 02, with about $21,000 in Program Income estimated for this number of patients.
