Integrating Behavioral Health into Primary Care through Telehealth Evidence-Based Telehealth Network - a. Title: WellSpan Behavioral Health Referral Network (WBHRN) b. Applicant: WellSpan Health (WSH) c. Address: 45 Monument Rd Ste 200 York, PA 17403-5071 d. Website: https://www.wellspan.org e. Requested award amount: $1,260,553 f. Facility type: From NOFO Section III. 1. B. - c, e, i, j, m g. Project Director: Dr. Shannon Terrell Gordon, LCSW, CFRE, Vice President - WellSpan Behavioral Health Network h. Project Director contact information: 478-954-6802 | sgordon7@wellspan.org i. Funding Preferences: (B) SERVICES -The WBHRN project aims to provide mental health care through telebehavioral health services (tbhs) . j. Service Area: Adams (A), Franklin (F), Lancaster (La), Lebanon (Le), and York (Y) Counties in south-central PA (3,501 sq miles, 1,412,463 residents). MUA-A, Le, MUP-F,La,Y, Le-Den HPSA, Y-MH HPSA. Population is primarily white, 10% Hispanic/Latino, 20% elderly (65+), and 10% disabled with 9% living in poverty, 8% uninsured, and 17% needing assistance with health materials. Average mental health provider ratio is 652:1 (PA-400:1). Surveyed behavioral health (bh) factors report an average of ~20% who smoke, drink excessively, use marijuana, report trauma symptoms. 8% have a PHQ-8 depression indicator, 40% report mental health negatively impacted by COVID, and 64% report experiencing > 1 days with depressive symptoms in a 2-week period. k. Needs, Objectives, and Projected Outcomes: Of 436,805 patients served by WSH in FY23 (7/1/22 – 6/30/23), 49% had bh symptoms and 1,330 adult and 520 youth patients are on the wait list for specialized ambulatory bh services. The objectives of the WBHRN project are: 1) contract with a nationally recognized virtualist provider and implement virtualist bh collaborative care model (CoCM) in 2 rural and underserved originating sites alongside a broader 64-site network; 3) Serve at least 6,012 rural or underserved patients with tbh CoCM (Year 1: 668, Year 2: 1,336 patients, Year 3: 1,336 patients, Year 4: 1,336 patients, Year 5: 1,336 patients); 4) Develop an evidence-based psychoeducation library for each served condition; 5) Teach Family Practice Residents regarding collaborative care. Projected outcomes include: 1) 6,012 rural or underserved patients served and 2) at 120 days post CoCM admission, patients will see an 8-point reduction in PHQ-9 or GAD-7 scores and 40% of patients will achieve PHQ-9 or GAD-7 score of less than 5 prior to CoCM discharge. l. Two rural and/or underserved originating sites will be supported m. Total patients served: CY23-Fairfield (4745), Penn National (6263), Years 1-5-Fairfield (24, 48, 48, 48, 48), Penn National (48, 96, 96, 96, 96) n. Self-Assessment: Progress will be measured through the use of WSH's electronic health record, Epic, which, alongside WSH internal tracking of incurred costs and data submitted by payors, will provide various patient data related to engagement in CoCM, PHQ-9 and GAD-7 scoring, participation of practices and providers as well as the # of referrals, active episodes of collaborative care, average patient engagement duration, overall healthcare costs of patients, and wait times to appointments. Provider experience surveys will ensure continued provider education, satisfaction, and engagement. o. Outcomes: WBHRN will evaluate the overall effectiveness of integrating tbhs into the primary care setting. Evaluation of project-related data will inform if tbhs can be made more accessible to underserved and rural patients through collaboration between a virtualist provider and regional healthcare system. p. Additional Activities: None q. Sustainability: Fees billed for services will sustain the network. r. WSH is not a current EB-TNP awardee s. WSH has not applied for EB-TNP funding or served as an originating site t. Grants.gov alerted WSH to the opportunity u. State Consultation: WSH submitted its project abstract to the PA State Office of Rural Health on 3/20/24. The PASORH has provided a letter of support.