FY 2024 Behavioral Health Service Expansion - Project Abstract Summary Applicant: Horizon Health Care, Inc. Project Director Name: Wade Erickson, CEO Address: 109 N Main Street Howard, SD 57349 Phone: (605) 772-4525 Email: werickson@horizonhealthcare.org Website: http://horizonhealthcare.org Requested funding: $600,000 Program Grant Number: H80CS00135 Project Abstract Summary: Horizon Health Care (Horizon), is a private, non-profit 501c(3) Federally Qualified Health Center with 31 clinical sites across 22 South Dakota (SD) communities. With a network spanning over 28,000 square miles of rural and frontier regions, Horizon addresses the unique health challenges of rural populations through community-driven, equitable, and culturally sensitive care. Horizon provides 95,000 medical, dental, and behavioral health visits to 27,000 patients annually. Nearly 4,300 behavioral health visits are conducted each year, primarily via telehealth technology. Comprehensive, affordable healthcare is provided to geographically unique and culturally diverse populations, including six of the nine Native American reservations in the state. Horizon outreach efforts focus on individuals with incomes below 200% of the Federal Poverty Level (FPL), minorities, elderly, and the uninsured/underinsured. Individuals living at or below the 200% FPL comprise approximately 33% of Horizon’s patients. Horizon has a network of interpreter services and telemedicine technology to support nearly 3,000 non-English speaking patients. Horizon is community-driven and upholds the mission of meeting the most pertinent health needs of rural communities. Across SD, mental/behavioral health disorders disproportionately impact rural populations. Adults across all age groups had higher rates of mental illness, and major depressive episodes compared to the US population. The rate of 3-17 year olds with anxiety or depression has more than doubled since 2016 while the number of high school students who reported feeling sad/hopeless increased from 22% in 2013 to 36% in 2019. With the fifth highest suicide rate in the nation, suicide deaths increased by 31% over the last decade and are the leading cause of death for 10-29 year olds in the state. The suicide rate for the Native American population is 2.7 times higher than the White population. Alcohol is the most common substance use disorder in SD and is the fifth highest rate in the nation. SD mothers reporting the use of illicit drugs the month before becoming pregnant is rising, and 7% of all mothers used during pregnancy. Over the past decade, opioid related deaths in SD have nearly doubled and overdose deaths from all drugs increased by 78%. Native American overdose rates were 3 times higher than White rates. Horizon provides clinical services in 8 of the 12 counties with the highest suicide rates and in all 8 counties with the highest alcohol-related death rates. 100% of counties within the Horizon service area are professional mental health shortage areas, meeting only 28% of the overall need. More than half of adults with mental illness received no treatment, while 60% of youth with a major depressive episode did not receive treatment. With the Behavioral Health Service Expansion project, Horizon proposes to expand mental and behavioral health services, including substance use treatment, to increase the number of patients receiving care and decrease the racial and ethnic disparities across rural communities. Through increased public awareness and expanded telehealth capabilities, Horizon will ensure patients in rural areas have equitable access to mental health care and substance use treatment. Utilizing Horizon’s footprint, case management framework, and telehealth network, holistic care management will be reinforced through the utilization of community health workers, behavioral health technicians, and licensed behavioral health professionals. Expanded patient education and enhanced provider training will ensure significant improvements in access to care.
