Saturday, April 26, 2025
4/26/2025
FY 2024 Behavioral Health Service Expansion - An enormous need exists to increase access to behavioral health services in the Mississippi Delta, a region characterized by multi-generational poverty, racism, political disenfranchisement, and a poor economy offering few opportunities. Herein, Delta Health Center (DHC), the only federally qualified health center (FQHC) serving a rural six-county region in the Delta, proposes to expand the availability, accessibility, and utilization of mental health and substance use treatment services in its network of 11 primary care access points. DHC serves more than 14,000 patients, most of whom are Black (91.4%) and four-fifths of whom (81.0%) have incomes at or below 100% of poverty. Many of the individuals and families we serve are negatively affected by poverty, housing and/or food insecurity, a lack of transportation, a lack of childcare, involvement in the criminal justice system, and other social determinants of health. Seventeen percent self-report mental health disorders—likely a low estimate, given the widespread stigma surrounding these disorders in marginalized populations and rural communities. The ratio of behavioral health providers to patients in the DHC service area is 1,113:1, compared to 540:1 and 350:1 for Mississippi and the US, respectively. Workforce shortages, lengthy waiting times, lack of transportation, and longstanding issues of medical mistrust and community-level stigma discourage many people from accessing the few providers available. Further discouraging access, these services are available only in standalone facilities in small towns where patients may have trouble remaining anonymous. Recognizing the urgent need to expand behavioral health services, in 2018 and 2019 DHC applied for and received two grant awards from the Health Resources and Services Administration (HRSA) to integrate behavioral health into primary care. Subsequently, in 2021 and 2022, we received grants from the US Department of Agriculture to equip our primary care sites with telehealth carts, now used in part to deliver behavioral health services. Our current behavioral health staffing consists of a clinical psychologist and a psychiatric nurse practitioner (PNP) who provide psychotherapy and psychopharmacology, respectively, to adult patients. The proposed project will increase DHC’s capacity to provide medication for opioid use disorder (MOUD) and pediatric mental health services. Patients in need of these services must be referred outside our system, often to standalone facilities requiring transportation. Thus, the first goal of the proposed Behavioral Health Services Expansion (BHSE) project is to integrate addiction treatment services, including a substance abuse counselor and MOUD, into our primary care practices, thereby completing the behavioral health care continuum for adults. The second goal is to initiate mental health services for pediatric patients by hiring a full-time mental health professional with experience in child and adolescent counseling. Faced with many adverse childhood experiences (ACEs), many of the children we serve exhibit signs and symptoms of autism, anxiety, and/or attention deficit /hyperactivity disorder that can benefit from early intervention, potentially preventing the escalation of behavioral issues to full-blown mental disorders in adulthood. To achieve the first goal, we plan to implement universal screening, brief intervention and referral to treatment of substance misuse; to expand our capacity to provide substance treatment services, including addiction counseling and MOUD; and to implement the Massachusetts Nurse Care Management Model of office-based addiction treatment. To achieve the second goal, we will increase our capacity to provide child and adolescent psychology, including the administration of standardized tests, family therapy, and other therapies. Project evaluation will measure increases in the number of patients receiving behavioral health services.
HHS’ Tracking Accountability in Government Grants System (TAGGS) website provides access to detailed descriptions of grants, loans, aggregated direct payments and other types of financial assistance awarded by the HHS Operating Divisions (OPDIVs) and the Office of the Secretary Staff Divisions (STAFFDIVs).