FY 2024 Behavioral Health Service Expansion - Mosaic Community Health (Mosaic) is a section 330 funded (H80CS00270) Community Health Center located in Central Oregon that provides trusted quality care, with compassion and support for all. In 2002, the rural community of Prineville opened the region's first Federally Qualified Health Center and from those roots, Mosaic today operates more than a dozen clinics, including seven School-Based Health Centers and a Mobile Clinic, serving over 30,000 patients across the region. The Central Oregon area, including Deschutes, Crook and Jefferson counties, is one of the fastest growing regions in the country with nearly all the communities designated as rural. Over the past several years, the mental health needs of our region have grown significantly. All three counties have more residents reporting higher numbers of poor mental health days than the state average and Mosaic patients’ mental health and substance use disorder diagnoses have been growing year-over-year. In addition, the three counties in our service area all face significantly higher than average rates of mental health provider ratios than the state average, with rural Jefferson and Crook counties experiencing extremely difficult mental health provider recruiting challenges. Compounding this all, behavioral health needs in all three Central Oregon counties are not being met due to the reality of the stigma of accessing services. In a recent Mosaic Community Stakeholder Survey, over eighty percent of our regional community partners called on Mosaic to increase mental health and SUD services over anything else we offer. Mosaic was an early adopter of the integrated behavioral health model in primary care over ten years ago. However, we have largely focused on short-term behavioral changes for chronic conditions with only a small amount of capacity to help more long-term MH conditions. Mosaic was also an early adopter of integrated Medication-Assisted Treatment (MAT) because of the high rates of opioid-use disorder in our region. Although we have led the region in the largest number of PCPs conducting MAT, we have struggled with meeting the SUD counseling needs that go conjointly with MAT medication management and supports because of the regional and state competition for hiring SUD clinicians. On the front lines, our PCP Teams are seeing an extremely heightened need for expanded mental health services and are spending increased time managing mental health medications and SUD patients due to increased acuity. They have specifically asked for an expanded model of behavioral health care to include more support and training for our BH teams to incorporate longer-term MH interventions. In addition, they have expressed a critical need for more mental health medication management supports which can be met with a Clinical Pharmacist specialized in Psychiatry and Addiction who can consult with not only PCPs but also provide training for all pharmacists on MH medications. Additionally, all staff will begin receiving MH and SUD de-stigmatization training which will foster an overall heightened awareness and understanding of MH and SUD throughout the organization. Funding from this grant will specifically be used to provide expanded Behavioral Health services including resources to recruit additional staff needed to serve more patients with mental health and SUD services while also providing additional specialized trainings to our current BHC, SUD, and PCP teams to increase skills and supports. While we see the need for expanded behavioral health supports in our entire low-income patient population, we especially will focus on the challenges of our rural, isolated communities with limited access to BH and SUD services. With the proposed additional staff, aided by recruitment supports, and various expanded training opportunities, Mosaic will be able to significantly increase patient numbers accessing mental health and SUD services.
