Tuesday, April 29, 2025
4/29/2025
Primary and Behavioral Health Care Integration - The Integrated Care Program is a collaborative effort between Aspen Pointe Health Services, a community behavioral health provider, and Peak Vista, a Federally Qualified Health Center. This grant will expand the breadth and depth of the organizations' current integrated program operating in the behavioral health setting. Participants in the expanded program will receive comprehensive physical healthcare services and management; intensive care coordination; health promotion and disease management services, including telephonic disease management; transitional care from inpatient to other settings; individual and family support; and linkages with specialty healthcare and support services. Efficient, comprehensive Electronic Health Record communication will facilitate the integration of care. Program goals and objectives are: Goal 1. SMI clients will engage in integrated care. Objective: For grant years 1-4, the program intends to engage 250, 375, 475, and 600 clients, respectively. A client will be considered to have engaged in integrated care if he/she undergoes physical health care assessment with the integrated care physical health provider and has at least two follow-up visits. The program is expected to serve approximately 750 unduplicated clients over the four years, assuming a 25% annual dropout rate with client replacement. Goal 2. Integrated care clients will engage in wellness and disease management activities. Objective: Within three months of entering the program, .50% of integrated care clients will participate in at least one wellness or disease management activity. Goal 3. Integrated care clients will attain improved physical health status. Objective: At least 50% of SMI clients enrolled in integrated care for six months or longer will have an improvement in one or more indicators of physical health status (blood pressure, BMI, waist circumference, breath CO, fasting glucose or HbA1C, lipid profile).
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).