FY 2024 Behavioral Health Service Expansion - Project Title: LCH Behavioral Health Service Expansion Applicant Name: Livingston Community Health (LCH) HRSA Number: H80CS02588 LCH is a Federally Qualified Health Center established in 1970 as one of California’s first licensed non-profit community clinics and has since has grown to a multi-site primary health care network serving low-income patients throughout California’s Merced and Stanislaus counties. LCH is recognized as a Patient Centered Medical Home by the National Committee on Quality Assurance; a certification that recognizes the organization’s patient care teams work in partnership with patients to provide care that’s coordinated, effective, and timely, and is a widely recognized symbol of quality. Needs to be addressed: Lack of access to mental health care and treatment for substance abuse continues to be a significant problem in the service area. According to data from the Centers for Medicare and Medicaid Services (CMS), the service area counties had a combined rate of just 126.1 mental health care providers for every 100,000 residents compared to 194.4 statewide and 176.3 nationwide. Both service area counties are designated as Health Professional Shortage Areas for Mental Health. This shortage is clearly felt by service area residents. A recent 2023 Community Health Needs Assessment conducted by the County of Merced identified mental health and substance use as one of the top three most important health problems in the county. A similar 2022 Kaiser Permanente CHNA conducted for Stanislaus County identified mental and behavioral health as the second leading health priority. According to the California Dept. of Public Health, both counties have seen sharp increases in the rates emergency department (ED) visits resulting from opioid-related overdoses of since 2019. The surge in opioid-related ED visits is having dire consequences. Since 2018, mortality rates for drug-related overdose deaths in both counties have increased dramatically from a rate of 14.57 deaths per 100,000 residents in Merced and 14.1 in Stanislaus, to 24.96 and 33.77 (respectively) in 2022. Proposed services: Over the past decade LCH has greatly expanded access to mental health (MH) care in the service area through the integration of behavioral health services with their existing primary care clinics. LCH currently operates 9 service delivery sites throughout Merced and Stanislaus counties, all of which offer integrated behavioral health care services. However, the need for services continues to outpace organizational capacity. BHSE funds will allow LCH to develop a specialized SUD treatment program to increase the organization’s ability to deal with the growing opioid crisis and build LCH’s capacity to meet the MH and SUD needs of their patient and target populations. BHSE funds will be used to expand behavioral health care capacity through additional providers with specialized SUD training who will be equipped to provide both MH and SUD services, including MOUD, and through the addition of dedicated support staff including community health workers/case managers, who will provide patient care coordination and navigation services. This will help ensure patients are connected to the resources they need, while freeing up BH clinicians treat more patients with MH and/or SUD needs, including those who would benefit from MOUD. The new SUD treatment program will be coordinated by a new SUD Program Manager, who will provide program oversight and supervision/support for staff and providers. Population groups served: This project will target LCH’s current primary care patients who are in need of MH care or SUD treatment, but who are not currently accessing BH services. In 2023, LCH served 25,160 patients providing 107,270 visits: 96% of patients lived at 200% of the FPL, 73% were of Hispanic descent, 16% were uninsured, 63% were covered by Medi-Cal, 15% were dependent on the agricultural workforce and 45% were best served in a non-English language.