FY 2024 Behavioral Health Service Expansion - DESCRIPTION OF ORGANIZATION: Marillac Clinic opened in 1988 as an indigent care clinic providing integrated medical, dental and behavioral healthcare to the underserved. In May 2015 Marillac was awarded Federally Qualified Community Health Center status (Grant #H80CS28356). Since then, the organization has expanded integrated primary care services from 5,546 patients to 12,074 patients (2023). Starting in 2019 and annually thereafter, Marillac has been recognized as a Patient Centered Medical Home with Behavioral Health Distinction by the National Council on Quality Assurance. Our service area in western Colorado consists of desert, agricultural and mountain areas. It includes Mesa County, (where most patients reside) and the contiguous rural counties of Delta, Montrose, San Miguel, Ouray, Hinsdale and Gunnison. The uninsured rate for our area is approximately 8-10%, and one-quarter of our residents on Medicaid. NEEDS TO BE ADDRESSED & POPULATION TO BE SERVED: Mesa County is designated as a Health Provider Shortage Area for primary care, dental and behavioral health services. The 2021-2023 Mesa County Community Health Needs Assessment (MCCHNA) emphasized a staggering fact: the top three causes of early death result from intentional self-harm, non-vehicle accidents and drug overdose. The MCCHNA also reflects substantial mental health concerns: 14% of local adults have received treatment for a mental health condition or emotional problem; 21% of adults have been diagnosed with a depressive disorder. Within our patient population, the percentages are more than double that. The coroner’s office in Mesa County reported this solemn data for 2022: 57 persons took their own lives; fatal vehicle collisions involved drugs and/or alcohol 52% of the time; and drug intoxication was the third leading cause of accidental deaths. An assessment of local youth revealed these topmost concerns: feeling worried/stressed, feeling sad, eating and weight issues, suicide/wanting to hurt oneself and alcohol/drug use. Mesa County’s suicide rate of 37/100,000 remains in the top quartile for Colorado. In fact, it is more than double the nation’s rate of 14.4/100,000 (CO Department of Public Health & Environment). Unmet medical and mental health needs (including substance use disorder), persist throughout the lower income households of Mesa County and the surrounding region. PROPOSED PROJECT: From 9/1/24-8/31/26, Marillac will utilize $600,000 in year 1 and $500,000 in year 2 to dramatically expand behavioral healthcare capacity, resulting in service to 450 new MH patients and 200 new SUD/OUD patients through 7 clinic sites, including two School Based Health Centers on high school campuses. Throughout this behavioral health service expansion, Marillac will provide patient-centered, culturally humble care that is appropriate for persons of all ages, cultures, and lifestyles. Marillac’s project will 1) expand our clinical workforce; 2) increase in-house psychiatric expertise and availability; 3) provide specialized training and establish new clinical job competencies; 4) establish efficient team-based care protocols, workflows, tools and systems for screening, tracking and treating SUD/OUD; 5) increase SUD/OUD awareness and destigmatize addiction across the entire organization; 6) robustly encompass Social Determinants of Health throughout the screening, treatment and recovery we provide for patients; 7) create sustainable clinical services that strengthen our organization, addiction medicine partnerships and collaborations to serve hard to reach populations; and 8) further develop our in-house pharmacy resources, including a secure drop box for medication surrender, the pharmaceuticals needed for MAT, and a stockpile of Naloxone for distribution throughout our workforce and the populations we are privileged to serve.
