Behavioral Health Services North Inc

BEHAVIORAL HEALTH SERVICES NORTH IS SEEKING A CCBHC IMPROVEMENT AND ADVANCEMENT GRANT TO IMPROVE AND BUILD UPON CCBHC EXPANSION GRANT OF 2020. - BEHAVIORAL HEALTH SERVICES NORTH (BHSN) IS A NON-PROFIT CORPORATION AND EXISTING CCBHC EXPANSION GRANTEE IN NY THAT WILL CONTINUE TO SERVE ALL ADULTS AND CHILDREN WITHIN CLINTON, FRANKLIN AND ESSEX COUNTIES, WHO EXPERIENCE MH AND/OR SUD ISSUES. THE CCBHC-IA AWARD WILL ALLOW THE BHSN CCBHC TO CONTINUE ADVANCING ITS CCBHC SERVICES IN WHOLE-PERSON INTEGRATED CARE, WITH A STRENGTHENED POPULATION HEALTH/EQUITY FOUNDATION. THE PREDOMINANTLY RURAL SERVICE AREA, WHICH IS WITHIN A REGION CALLED "NORTH COUNTRY," IS OLDER, LESS DIVERSE, AND MORE MALE THAN NY AS A WHOLE, WITH A CONCENTRATION OF NATIVE AMERICANS IN FRANKLIN COUNTY. COMPARED TO NY STATE, CLINTON AND FRANKLIN COUNTY HAVE HIGHER RATES OF THOSE LIVING BELOW THE FEDERAL POVERTY LINE(FPL); CLIENTS IN OUR CATCHMENT ARE SICKER, WITH A HIGHER PERCENTAGE DIAGNOSED WITH 2 OR MORE CHRONIC MEDICAL CONDITIONS AND HIGHER RATES OF INPATIENT HOSPITALIZATION. DISPARITIES IN THE IMPACT OF MH/SUD IN THE REGION COMPARED WITH NY AND THE US INCLUDE HIGHER RATES OF POOR MH DAYS, FREQUENT MENTAL DISTRESS, EXCESSIVE DRINKING, DRIVING DEATHS RELATED TO ALCOHOL, DRUG OVERDOSES AND SUICIDE MORTALITY. ALL 3 COUNTIES HAVE BEEN DESIGNATED AS RURAL HEALTH PROFESSIONAL SHORTAGE AREAS FOR PRIMARY CARE AND MH PROVIDERS. OUR GOALS AND OBJECTIVES WILL BE FULFILLED THROUGH ENHANCEMENTS IN OUR CARE COORDINATION SERVICES WITH HEALTH INFORMATION SYSTEM IMPROVEMENTS THAT ENABLE RISK STRATIFICATION AND A DATA-INFORMED POPULATION HEALTH APPROACH TOWARD ADDRESSING DISPARITIES IN UTILIZATION, SERVICE GAPS AND NEEDS TO TARGET APPROPRIATE CARE. WE PLAN TO SERVE 3,400 UNIQUE CLIENTS IN YEAR 1, WITH AN ADDITIONAL 200 OVER THE NEXT 3 YEARS, TOTALING 4,000 BY END OF THE GRANT PERIOD. OUR GOALS AND OBJECTIVES ARE: *GOAL 1. ENHANCE CARE COORDINATION SERVICES TO TARGET THE RIGHT CARE AT THE RIGHT TIME FOR CCBHC CLIENTS -OBJECTIVE 1.1. ESTABLISH DEFINITIONS OF RISK TIERS WITHIN 12 MONTHS OF GRANT AWARD USING A COMBINATION OF CLINICAL ASSESSMENT TOOLS, CLIENT DEMOGRAPHICS, UTILIZATION, SDOH SCREENING RESULTS, SYMPTOM RATING SCALES AS PER MEASUREMENT-BASED CARE, OUTCOMES AND CLIENT NEEDS. OBJ 1.2. USING COMPLETED EHR ENHANCEMENTS, APPLY TIERING PROTOCOLS TO CURRENT AND NEW CCBHC CLIENTS AND ESTABLISH A PLAN TO FOCUS ON HIGH RISK AND RISING RISK CLIENTS-WITHIN 18 MONTHS OF GRANT AWARD. *GOAL 2. IMPROVE HEALTH OUTCOMES -OBJECTIVE 2.1. ADVANCE OUTCOMES SPECIFIED IN YEAR 2 RISK BEARING VBP CONTRACT WITH NORTHWINDS IPA MEASURED BY THE FOLLOWING HEDIS MEASURES: 2.1A. INCREASE THE PERCENTAGE OF CLIENTS WHO HAVE HEALTH SCREENINGS BY 25 % 2.1B. INCREASE THE PERCENTAGE OF CLIENTS WITH FOLLOW-UP AFTER HOSPITALIZATION BY 20 % 2.1C. INCREASE THE PERCENTAGE OF CLIENT FOLLOW-UP AFTER CRISIS CARE BY 25 % 2.1D. REDUCE INPATIENT UTILIZATION BY 5 % *GOAL 3. ENHANCE ACCESS TO MH/SUD CARE -OBJ 3.1. IMPLEMENT PATIENT PORTAL BY 12 MONTHS OF AWARD THAT ENABLES CLIENTS' MEANINGFUL INVOLVEMENT IN THEIR OWN CARE, INCLUDING APPOINTMENT SCHEDULING, ACCESS TO CARE PLAN, CRISIS SUPPORT; SELF-ASSESSMENTS, AND DAILY JOURNALING. OBJ 3.2. IMPLEMENT THE 4M MODEL OF CARE FOR OLDER ADULTS BY TRAINING STAFF AND IDENTIFYING ELIGIBLE CLIENTS BY END OF YEAR 2. OBJ 3.3. ON AN ANNUAL BASIS 90 % OF CCBHC CLIENTS WITH A HISTORY OF SUBSTANCE USE WILL RECEIVE SBIRT

BEHAVIORAL HEALTH SERVICES NORTH (BHSN) INC IS SEEKING TO BECOMING A CERTIFIED COMMUNITY BEHAVIORAL HEALTH CLINIC THROUGH THE CCBHC EXPANSION GRANT APPLICATION.

COMMUNITY CRISIS RESPONSE - THE MOBILE CRISIS EXPANSION PROJECT WILL ENABLE BEHAVIORAL HEALTH SERVICES NORTH ( BHSN ) TO LEVERAGE ITS CRISIS RESPONSE FOUNDATION TO BUILD CAPACITY OF THE EXISTING MOBILE CRISIS SERVICES TO SERVE MORE CLIENTS AND SUPPORT MORE ER AND LAW ENFORCEMENT DIVERSIONS ACROSS CLINTON, WARREN, AND WASHINGTON COUNTIES IN THE " NORTH COUNTRY " OF NY. OUR POPULATION OF FOCUS INCLUDES ALL ADULTS AND CHILDREN WITHIN 3 COUNTIES WHO EXPERIENCE BEHAVIORAL HEALTH ( BH ) CRISES. THESE COUNTIES ARE PART OF THE ADIRONDACK REGION, WHICH COMPARED TO NY STATE AS A WHOLE, HAVE SIGNIFICANT ISSUES WITH MH AND SUD, AFFECTING 1/3 OF THE MEDICAID POPULATION. CLIENTS IN OUR 3 COUNTIES EXPERIENCE FREQUENT MENTAL DISTRESS, RATES OF CHILDHOOD ABUSE/MALTREATMENT AND SUICIDE MORTALITY RATES HIGHER THAN NY STATE AS A WHOLE. ALL COUNTIES HAVE RURAL DESIGNATION AS MH HEALTH PROFESSIONAL SHORTAGE AREAS (HPSAS). THE HPSAS AND RURAL GEOGRAPHY POINT TO A LACK OF ACCESS TO BH. BHSN IS THE SOLE LICENSED CRISIS RESPONSE AND 24/7 MOBILE CRISIS RESPONDER IN CLINTON AND 1 OF 5 OTHER ORGANIZATIONS OFFERING OUTPATIENT MH/SUD SERVICES IN OUR CATCHMENT. WHILE WARREN AND WASHINGTON COUNTIES HAVE MOBILE CRISIS PROVIDER, IT ONLY OPERATES DURING DAYTIME HOURS, WITH LIMITED EVENING / AFTER HOUR CAPACITY. IN 2020, OUR CRISIS CALLS INCREASED BY 189 % OVER OUR 2019 VOLUME AND CALLS FROM JANUARY TO JUNE OF 2022 INCREASED BY 48 % OVER THE COMPARATIVE 2021 TIME FRAME, INDICATING A CONTINUED UPWARD TREND. WHILE BHSN HAS EXTENSIVE CAPACITY TO HANDLE CRISIS CALLS THROUGH OUR EXISTING CRISIS HOTLINE AND PROVIDE COMMUNITY BASED BH SERVICES, WE HAVE LIMITED CAPACITY TO RESPOND WITH MOBILE TEAMS. THE NUMBER OF BH - RELATED CRISIS CALLED HANDLED BY LOCAL AND STATE LAW ENFORCEMENT FAR OUTWEIGH THE NUMBER HANDLED BY OUR EXISTING CRISIS TEAM IN CLINTON COUNTY. OUR TEAM HAS BEEN HANDLING AN AVERAGE OF 4 MOBILE RESPONSES A WEEK, WHILE THE COMBINED LAW ENFORCEMENT/EMS PICKUPS AND ER VISITS ACROSS THE COUNTIES FOR ADULTS AND CHILDREN HAVE AVERAGED OVER 10 - 15 TIMES THIS AMOUNT, INDICATING A DIRE NEED FOR ADDED INFRASTRUCTURE FOR MOBILE CRISIS RESPONSE. THE PREDOMINANTLY RURAL NATURE OF OUR GEOGRAPHY FURTHER HINDERS OUR ABILITY TO HANDLE MORE CLIENT VOLUME DUE TO TRAVEL TIME. WE HAVE PARTNERED WITH THE FOLLOWING ORGANIZATIONS TO HELP ACHIEVE OR PROJECTS GOALS AND OBJECTIVES : CHAMPLAIN VALLEY FAMILY CENTER ( CVFC ) - A LOCAL INTENSIVE CRISIS STABILIZATION CENTER, PLATTSBURGH CITY POLICE ( CLINTON COUNTY ), AND MORRISONVILLE - SCHUYLER FALLS VOLUNTEER AMBULANCE SERVICE ( MORRISONVILLE EMS ) GOAL 1 ENHANCE CAPACITY FOR CRISIS SERVICES OBJ 1 A ADD 2 MOBILE CRISIS TEAMS - INCREASE VOLUME OF CLIENTS SERVED BY 250 % OBJ 1 D CREATE WORKFLOW THAT SUPPORT A DIRECT REFERRAL STREAM BHSN MOBILE CRISIS RESPONSE TO NEW REGIONAL INTENSIVE CRISIS STABILIZATION CENTER, CHAMPLAIN VALLEY FAMILY CENTER GOAL 2 DIVERT CLIENTS AWAY FROM LAW ENFORCEMENT RESPONSES TOWARDS APPROPRIATE BH SERVICES OBJ 2 A REDUCE INVOLUNTARY PICK UPS BY CITY POLICE DEPARTMENT BY 25 % OBJ 2 B REDUCE 911 LAW ENFORCEMENT ONLY RESPONSES BY PLATTSBURGH CITY POLICE DEPARTMENT BY 30 % OBJ 2 C PROVIDE 3 CRISIS INTERVENTION TRAININGS AND EVIDENCE BASED SUICIDE ASSESSMENT TRAINING PER YEAR TO STATE / LOCAL LAW ENFORCEMENT AND EMS STAFF TO SUPPORT DIVERSION PRACTICES

BHSN CRISIS RESPONSE - BEHAVIORAL HEALTH SERVICES NORTH (BHSN) IS A NOT-FOR-PROFIT, REGIONAL LEADER IN NORTHEASTERN NEW YORK STATE (NYS) THAT OFFERS COMPREHENSIVE MH, SUD, AND SOCIAL SERVICES TO CLIENTS OF ALL AGES. OUR PROGRAMS SPAN MORE THAN 20 LICENSED OUTPATIENT AND RESIDENTIAL PROGRAMS DELIVERED FROM 15 FACILITIES LOCATED IN THE LARGEST POPULATION HUBS (PLATTSBURGH AND GLENS FALLS) NORTH OF NYS'S CAPITAL DISTRICT, ACROSS OVER 6,000 SQUARE MILES OF PREDOMINANTLY RURAL AREAS ABUTTING CANADA IN CLINTON, FRANKLIN, ESSEX, WARREN AND WASHINGTON COUNTIES. OUR POPULATION OF FOCUS INCLUDES ALL ADULTS AND CHILDREN WITHIN THE 5 COUNTIES WHO EXPERIENCE MH OR SUD ISSUES. DESPITE SIGNIFICANT INVESTMENTS IN SERVICES OVER THE LAST SEVERAL YEARS, NORTHEASTERN NYS CONTINUES TO HAVE UNMET NEED FOR SMI, SED, AND SUD SERVICES. THERE ARE NO CRISIS RESIDENTIAL PROVIDERS IN CLINTON, ESSEX, WARREN, OR WASHINGTON COUNTIES AND ONLY ONE IN FRANKLIN COUNTY WITH 13 BEDS, WHICH IS OVER 50 MILES AWAY FROM THE LARGEST POPULATION CENTER IN PLATTSBURGH. ALL COUNTIES HAVE RURAL DESIGNATIONS AS MENTAL HEALTH HPSAS. ACCORDING TO NYS 2021 COUNTY HEALTH RANKINGS, THESE COUNTIES HAD SIGNIFICANT EXISTING BH NEEDS PRIOR TO THE PANDEMIC INCLUDING RATES OF SUICIDE, POOR MENTAL HEALTH, NEEDING BUT NOT RECEIVING SU TREATMENT, EXCESSIVE DRINKING, SUBSTANCE USE DISORDER, AND ALCOHOL USE THAT WERE HIGHER THAN NYS. THE ISSUES OF LIMITED PROVIDER AVAILABILITY AND INCREASING NEED FOR SERVICE WERE EXACERBATED BY THE COVID-19 PANDEMIC, SOCIAL ISOLATION, AND ANXIETY AS EVIDENCED BY A 734% INCREASE IN OUR REGION'S HOT-LINE CALLS/MONTH FROM 30 BEFORE THE PUBLIC HEALTH EMERGENCY (PHE), TO AN AVERAGE OF 250 IN THE FIRST QUARTER OF 2021. BHSN ALSO EXPERIENCED AN EXPONENTIAL INCREASE IN WAITLISTS ACROSS ALL SERVICE PROGRAMS. BHSN IS ALSO THE SOLE 24/7 MOBILE CRISIS PROVIDER ACROSS CLINTON AND ESSEX COUNTIES AND THE OFF-HOURS PROVIDER OF THESE SERVICES IN WARREN AND WASHINGTON COUNTIES. INCREASED DEMAND FOR SERVICES WAS FURTHER IMPACTED BY STAFFING CHALLENGES EXPERIENCED DURING THE PHE, THREATENING THE ABILITY TO SUSTAIN EXISTING OPERATIONS AND CLINICIAN CASELOADS REACHED THEIR MAXIMUMS. BHSN AIMS TO TARGET THIS ROUND OF CMHC FUNDING TOWARD BUILDING THE BHSN CRISIS RESPONSE PROGRAM, WHICH WILL CONSIST OF ENHANCING INFRASTRUCTURE FOR CRISIS SERVICES BY ADDING A MOBILE CRISIS TEAM AND A CRISIS RESIDENCE PROGRAM TO THE REGION; ENHANCING OPEN ACCESS CLINICAL STAFF CAPACITY; AND AN EXPANSION OF TELEHEALTH TECHNOLOGY TO INCREASE BH SERVICE ACCESS FOR POPULATIONS WITH MH/SUD NEEDS WITHIN THE 5-COUNTY CATCHMENT. BHSN ALSO SEES THE IMPERATIVE TO SEED THIS INFRASTRUCTURE TO BE ABLE TO MEET THE PROJECTED 14% GROWTH (PROJECTED BY VIBRANT EMOTIONAL HEALTH) IN CALL VOLUME AS A RESULT OF THE 988 LAUNCH PLANNED FOR OCTOBER 2021. IN YEAR 1, BHSN PLANS TO SERVE 1,500 UNDUPLICATED INDIVIDUALS AND YEAR 2, 1,500, TOTALING 3,000 TO BE SERVED. OUR GOALS ARE TWO-FOLD: (1) ENHANCE ACCESS TO MH/SUD CARE FOR CHILDREN AND ADULTS; (2) ENHANCE CAPACITY FOR CRISIS SERVICES.

PURPOSE: THE CONTINUUM OF CARE (COC) PROGRAM IS DESIGNED TO PROMOTE COMMUNITY-WIDE COMMITMENT TO THE GOAL OF ENDING HOMELESSNESS; PROVIDE FUNDING FOR EFFORTS BY NONPROFIT PROVIDERS, STATES, AND LOCAL GOVERNMENTS TO QUICKLY HOUSE HOMELESS INDIVIDUALS AND FAMILIES WHILE MINIMIZING THE TRAUMA AND DISLOCATION CAUSED TO HOMELESS INDIVIDUALS, FAMILIES, AND COMMUNITIES BY HOMELESSNESS; PROMOTE ACCESS TO AND EFFECTIVE UTILIZATION OF MAINSTREAM PROGRAMS BY HOMELESS INDIVIDUALS AND FAMILIES; AND OPTIMIZE SELF-SUFFICIENCY AMONG INDIVIDUALS AND FAMILIES EXPERIENCING HOMELESSNESS. THE MOST RECENT COC AWARD ANNOUNCEMENT LISTING AWARDS BY STATE AND COC IS ACCESSIBLE AT HTTPS://WWW.HUD.GOV/PROGRAM_OFFICES/COMM_PLANNING/COC/AWARDS. SELECT THE LINK UNDER THE FUNDING AND AWARD INFORMATION SECTION FOR THE APPROPRIATE FISCAL YEAR.; ACTIVITIES TO BE PERFORMED: CONTINUUM OF CARE PROGRAM FUNDS MAY BE USED TO PAY FOR THE ELIGIBLE COSTS USED TO ESTABLISH AND OPERATE PROJECTS UNDER FIVE PROGRAM COMPONENTS: (1) PERMANENT HOUSING, WHICH INCLUDES PERMANENT SUPPORTIVE HOUSING FOR PERSONS WITH DISABILITIES, AND RAPID REHOUSING; (2) TRANSITIONAL HOUSING; (3) SUPPORTIVE SERVICES ONLY; (4) HOMELESS MANAGEMENT INFORMATION SYSTEMS (HMIS), AND (5) IN SOME CASES, HOMELESSNESS PREVENTION. THIRTEEN TYPES OF ASSISTANCE MAY BE PROVIDED THROUGH THE CONTINUUM OF CARE (COC) PROGRAM: (1) COC PLANNING ACTIVITIES/COSTS FOR DESIGNING AND CARRYING OUT A COLLABORATIVE PROCESS FOR THE DEVELOPMENT OF AN APPLICATION TO HUD; (2) UNITED FUNDING AGENCY (UFA) COSTS FOR FISCAL CONTROL AND ACCOUNTING NECESSARY TO ASSURE THE PROPER DISBURSAL OF, AND ACCOUNTING FOR, FEDERAL FUNDS AWARDED TO SUBRECIPIENTS UNDER THE CONTINUUM OF CARE PROGRAM, (3) ACQUISITION OF REAL PROPERTY (INCLUDING STRUCTURES) FOR USE IN THE PROVISION OF HOUSING OR SUPPORTIVE SERVICES; (4) REHABILITATION OF STRUCTURES TO PROVIDE HOUSING OR SUPPORTIVE SERVICES; (5) NEW CONSTRUCTION, INCLUDING THE BUILDING OF A NEW STRUCTURE OR BUILDING AN ADDITION TO AN EXISTING STRUCTURE FOR USE AS SUPPORTIVE HOUSING; (6) LEASING OF A STRUCTURE OR STRUCTURES, OR PORTIONS THEREOF, TO PROVIDE HOUSING OR SUPPORTIVE SERVICES; (7) RENTAL ASSISTANCE, WHICH MAY BE SHORT-TERM, MEDIUM-TERM, OR LONG-TERM, AS WELL AS TENANT-BASED, PROJECT-BASED, OR SPONSOR-BASED, FOR TRANSITIONAL OR PERMANENT HOUSING; (8) SUPPORTIVE SERVICES TO ASSIST PROGRAM PARTICIPANTS OBTAIN AND MAINTAIN HOUSING; (9) OPERATING COSTS OF SUPPORTIVE HOUSING; (10) COSTS OF IMPLEMENTING AND OPERATING HMIS; (11) PROJECT ADMINISTRATIVE COSTS; (12) RELOCATION COSTS; AND (13) INDIRECT COSTS IN ACCORDANCE WITH 2 CFR PARTS 200, AS APPLICABLE. IN ADDITION TO USING GRANT FUNDS FOR THE ELIGIBLE COSTS DESCRIBED ABOVE, RECIPIENTS AND SUBRECIPIENTS IN CONTINUUMS OF CARE DESIGNATED AS HIGH PERFORMING COMMUNITIES MAY ALSO USE GRANT FUNDS TO PROVIDE HOUSING RELOCATION AND STABILIZATION SERVICES AND SHORT- AND/OR MEDIUM-TERM RENTAL ASSISTANCE TO INDIVIDUALS AND FAMILIES AT RISK OF HOMELESSNESS AS SET FORTH IN 24 CFR 576.103 AND 24 CFR 576.104, IF NECESSARY TO PREVENT THE INDIVIDUAL OR FAMILY FROM BECOMING HOMELESS. LIMITATION ON USE OF FUNDS: NO ASSISTANCE PROVIDED UNDER PROGRAM (OR ANY STATE OR LOCAL GOVERNMENT FUNDS USED TO SUPPLEMENT THIS ASSISTANCE) MAY BE USED TO REPLACE STATE OR LOCAL FUNDS PREVIOUSLY USED, OR DESIGNATED FOR USE, TO ASSIST HOMELESS PERSONS OR PERSONS AT-RISK OF HOMELESSNESS.; EXPECTED OUTCOMES: DECREASE IN THE NUMBER INDIVIDUALS AND FAMILIES EXPERIENCING HOMELESSNESS, MORE SPECIFICALLY USING PERFORMANCE INDICATORS SUCH AS THE LENGTH OF TIME HOMELESS, RETURNS TO HOMELESSNESS OVER TIME, AND EXITS TO PERMANENT HOUSING. COC PERFORMANCE PROFILE REPORTS CAN BE FOUND AT HTTPS://WWW.HUDEXCHANGE.INFO/PROGRAMS/COC/COC-PERFORMANCE-PROFILE-REPORTS/.; INTENDED BENEFICIARIES: INDIVIDUALS AND FAMILIES EXPERIENCING HOMELESSNESS.; SUBRECIPIENT ACTIVITIES: THE SUBRECIPIENT ACTIVITIES ARE UNKNOWN AT THE TIME OF AWARD.

HOMELESS ASSISTANCE

CONTINUUM OF CARE PROGRAM

CONTINUUM OF CARE PROGRAM

CONTINUUM OF CARE PROGRAM

HOMELESS ASSISTANCE

HOMELESS ASSISTANCE

HOMELESS ASSISTANCE

SUPPORTIVE HOUSING PROGRAM

SUPPORTIVE HOUSING PROGRAM