FY 2024 Behavioral Health Service Expansion - Greater Sioux Community Health Center dba Promise Community Health Center (H80CS24171) Greater Sioux Community Health Center dba Promise Community Health Center opened in July 2008, became an FQHC Look Alike in late 2008, and has been a Health Center Program grantee since 2012. We provide primary and preventive medical, dental, and behavioral health services to more than 6,400 underserved individuals in rural Sioux County, Iowa, located in the far northwest corner of the state. The majority of our patients are low-income and are uninsured or Medicaid beneficiaries. More than half of our patients are Hispanic/Latino and are best provided care in a language other than English. We currently provide integrated medical and behavioral health services to help patients assess current coping skills, address emotional needs, and work through lifelong patterns. We employ a board certified psychiatric mental health nurse practitioner, who provides specialty care in the areas of psychiatric consultation, evaluation, and psychiatric medication management. We offer therapy for individuals, children, couples, and for women’s issues, as well as services to address trauma and post-traumatic stress disorder. We currently do not have the capacity to provide medications for opioid use disorder (MOUD) services. In 2023, we provided mental health services to 293 patients and SUD services to 0 patients, but demand for services exceeds our current capacity. The number of mental health therapy and medication management visits at Promise nearly doubled between 2022 and 2023. Due to limited staff capacity, our wait list for therapy services has been steadily rising and currently includes more than 50 patients. The lack of other providers in the county that are easily accessible and are able to accept referrals has increased the need for onsite services at our health center. Mental health issues and substance use disorders are an increasing concern among our patients and throughout Sioux County. Over the past several years, the county has experienced an increase in poor mental health days, frequent mental distress, and binge/heavy drinking among adults, as well as a rising suicide rate. An increasing number of middle and high school students are also reporting poor mental health and illicit substance use, which is higher among Hispanic/Latino students. An ongoing behavioral health workforce shortage at our health center and throughout Sioux County has made it challenging to meet these growing needs. The diverse populations we serve often face stigma associated with seeking out or even talking about mental health and substance use issues. These populations include Hispanic/Latino, recent immigrants, and victims of trauma, domestic violence, and/or sexual abuse. Even those who have lived their entire lives in our rural community, where everyone knows each other, are often reluctant to seek care for behavioral health concerns. Our patients face additional barriers to accessing services, including language/cultural differences, lack of transportation, and lower education and literacy levels. BHSE funding will allow us to provide access to mental health services for 155 additional patients, SUD services for 30 patients, and MOUD for 5 patients. A total of 45 new unduplicated patients will be served through this funding. This patient target will be achieved by: -hiring a licensed mental health counselor, social worker, and Spanish interpreter; -training current primary care staff and psychiatric nurse practitioner to provide SUD, MOUD; and -improving our behavioral health screening processes for patients age 12 and older.
