FY 2024 Behavioral Health Service Expansion - Catahoula Parish Hospital District No. 2 (CPHD) is a JCAHO-accredited section 330(e) Federally Qualified Health Center (FQHC) grantee (H80CS00206). CPHD’s mission is to provide accessible and affordable, high quality, comprehensive preventive, and primary healthcare services to the medically underserved (MUA, Primary Care and Mental Health HPSA’s) and poor highly rural populations predominantly from Catahoula, Franklin, Tensas, and Concordia Parishes (Counties) in the Northeast Louisiana (LA) Delta region west of the Mississippi River. Sixty miles from the nearest MSA, the area is characterized by poverty, unemployment, lack of adequate healthcare and lack of reliable transportation, declining populations, and farming/aquaculture (catfish and turtle farming), logging and gravel pit mines are major area employers. On average, 8.8% of service area residents are uninsured, 35% are Medicaid insured, over 54% have incomes <200% and 30% < 100% of Federal Poverty Level, 40% are minorities, predominantly Black/African Americans, 25% are 65+, 3.9% are LGBTQ, and 2,200 are Veterans. CPHD’s target low-income population has high rates of Substance Use Disorder (SUD) (drinking 17%, smoking 28%, 20% increase in opioid and heroin substance use and deaths due to overdose since 2020), 14% report frequent mental distress and mood disorders, 39% experience anxiety or depression disorders, 19% experience behavior disorders (hyperactivity/attention deficit, other conduct disorders). Depression and serious mental illness have increased significantly - since COVID-19 began, the number of annual self-harm and suicide hospitalizations has doubled and is an additional 10% higher in rural areas, and LA’s drug overdose death rate has increased to more than 55/100,000 annually (300% growth over 10 years), 54% of which are due to opioids. There is a significant lack of access to Mental Health (MH) and SUD, including Medication for Opioid Use Disorder (MOUD), counseling, and treatment services in our area. Approximately 20-22% (10,450 people) need MH care, and 17.5% (7,142) of adults need SUD services, but do not receive care due to lack of access. Primary barriers are low-income/inability to afford care, lack of public transportation and geographic barriers, lack of insurance coverage, and lack of providers for the uninsured and Medicaid insured populations – MH patient-provider ratio as high as 4,283:1. MH and SUD cultural beliefs also deter patients from seeking help. CPHD sites (all rural) are staffed by 61.7 FTE’s of medical/behavioral health/dental providers, ancillary staff, and administration. In 2023, CPHD saw 7,803 patients, providing 27,154 encounters. With BHSE grant funding, CPHD will increase access to 322 new patients for MH (205), SUD (100, currently 0), and MOUD (17) and 4,995 encounters annually, directly and through telehealth. We plan to hire 1 FTE Certified Addictions Counselor and 1 FTE Medical Social Worker (Yr 1), and 1 FTE Licensed Clinical Social Worker to provide counseling and treatment services for MH, SUD and MOUD, and 1 FTE Receptionist (Yr 2) for enabling assistance, and support .33 FTE Addictionist MD and .72 FTE Psychiatric NP to provide psychotropic medication management and monitoring, using BHSE grant funding. Increased social worker/counselor staffing will provide consultations to patients screening positive for depression, anxiety and/or substance use. Grant funds and Program Income generated will be used to support additional providers, staff, and patient transportation assistance to scheduled appointments for counseling and treatment, purchase of supplies (SUD medications, testing, patient educational materials), and to help bring awareness to our patient and community populations regarding opioid and other substance use disorders. CPHD is requesting Yr 1 HRSA BHSE grant funding in the amount of $600,000 to support expansion of its MH, SUD and MOUD program to increase patient access and utilization.
