Greater Cincinnati Behavioral Health Services

CINCINNATI RESTORATION INITIATIVE (CRI) - GREATER CINCINNATI BEHAVIORAL HEALTH SERVICES (GCB) WILL RESTORE SERVICES IMPACTED BY THE COVID-19 PANDEMIC (C-19P) TO ADDRESS NEEDS OF PERSONS WITH SERIOUS MENTAL ILLNESS (SMI) AND THOSE WITH CO-OCCURRING SUBSTANCE USE DISORDERS (COD). CRI WILL ADDRESS GAPS IN SERVICES AND INFRASTRUCTURE TO MINIMIZE C-19P'S IMPACT IN HAMILTON COUNTY, OH (HC). BEHAVIORAL HEALTH DISORDERS ARE THE MOST COMMON PANDEMIC HEALTH EFFECT. C-19P'S SWEEPING IMPACTS WILL HAVE SIGNIFICANT HEALTH IMPLICATIONS IN A STATE WITH THE HIGHEST SMI PREVALENCE IN THE U.S. TO ADDRESS CURRENT AND EMERGING NEEDS, GCB SEEKS FUNDS TO ADDRESS 3 GAPS RELATED TO ACCESS, CRISIS SERVICES, AND TELEHEALTH. C-19P AMPLIFIED TREATMENT DEMAND. GCB ADMISSIONS INCREASED 40% WHILE ITS WORKFORCE SHRANK 12.4% DURING C-19P. THE SERVICE IMPACT WAS IMMEDIATE. ADMISSION TEAMS COULD NOT PROVIDE SAME DAY TREATMENT ACCESS. HOSPITAL AND JAIL INTAKES DECLINED 31%. PSYCHIATRIC AND CARE MANAGEMENT SERVICES EACH FELL 26%. AVERAGE CARE MANAGER (CM) CASELOADS BALLOONED FROM 34 CLIENTS TO 44. 81% OF CLIENTS EXPERIENCED A SERVICE DECREASE RESULTING IN UNMET NEEDS. STAFF STRESS AND BURNOUT WERE DIRECTLY RELATED TO STAFF SHORTAGES AND HIGHER CASELOADS. ACCESS TO CRISIS SERVICES WAS ALSO AN ISSUE. GCB RELIED ON HC'S CRISIS CONTINUUM TO ADDRESS PSYCHIATRIC CRISES, BUT THESE SERVICES WERE LIMITED DURING C-19P. GCB'S CRISIS RESPONSE FELL TO CMS WHO WERE ALREADY OVERWHELMED. C-19P'S IMPACTS ARE ONLY BEGINNING TO SURFACE. GCB SAW A 30% INCREASE IN PSYCHIATRIC EMERGENCIES AND 92% INCREASE IN OVERDOSE DEATHS SINCE C-19P UNDERSCORING THE NEED TO BUILD INTERNAL CRISIS CAPACITY. TO PROVIDE SOME SERVICE, GCB ADOPTED BASIC TELEHEALTH SINCE ITS EHR DID NOT HAVE A TELEHEALTH PLATFORM SHIFTING SERVICES FROM FACE-TO-FACE (95%) TO TELEHEALTH (77%). THIS SHIFT, ALONGSIDE WORKFORCE REDUCTIONS, RESULTED IN A $3.9 MILLION REVENUE REDUCTION IN THE 12 MONTHS AFTER C-19P. GCB WILL RESTORE CLINICAL SERVICES AND BOLSTER TELEHEALTH TO MINIMIZE C-19P'S IMPACT ON CLIENTS, STAFF, AND GCB. CRI WILL SERVE 1,000 CLIENTS OVER 2 YEARS - 500/YEAR. PROJECT GOALS/OBJECTIVES FOCUS ON INTAKE CAPACITY, CARE MANAGEMENT ACCESS, CRISIS SERVICES, AND TELEHEALTH. CRI WILL ACHIEVE 4 GOALS: 1) EXPAND INTAKE CAPACITY TO MEET TREATMENT DEMAND VIA A RAPID ENGAGEMENT TO CARE TEAM TO MANAGE HOSPITAL AND JAIL ADMISSIONS. 2) EXPAND CARE MANAGEMENT ACCESS TO REDUCE AVERAGE CM CASELOAD THROUGH 4 NEW CARE MANAGEMENT TEAMS. 3) INCREASE CRISIS SERVICES TO REDUCE PSYCHIATRIC EMERGENCIES THROUGH A CRISIS SUPPORT TEAM AND 2 ADDITIONAL CRISIS BEDS. 4) EXPAND TELEHEALTH THROUGH A NEW EHR WITH A TELEHEALTH PLATFORM. KEY INTERVENTIONS INCLUDE COGNITIVE BEHAVIORAL THERAPY, CRITICAL TIME INTERVENTION, INTEGRATED DUAL DISORDER TREATMENT, AND MOTIVATIONAL INTERVIEWING. CRI'S POPULATION WILL INCLUDE NEW CLIENTS WITH SMI OR SMI+COD ASSIGNED TO PSYCHIATRIC, AND CARE MANAGEMENT SERVICES. 40% HAVE PSYCHOTIC DISORDERS; 50% A COD, 55% ARE BLACK; 42% WHITE. 52% ARE MALE. AVERAGE AGE IS 44. 86% ARE BELOW 100% OF THE FEDERAL POVERTY LEVEL. GCB HAS THE LEADERSHIP AND EXPERIENCE TO RESTORE AND BOLSTER SERVICES WITH SAMHSA SUPPORT.

CCBHC - AMELIA

GCBHS-CCBHC IA - AMELIA - GREATER CINCINNATI BEHAVIORAL HEALTH SERVICES (GCB) WILL ENHANCE ITS CERTIFIED COMMUNITY BEHAVIORAL HEALTH CLINIC IN AMELIA, OHIO (CCBHC-A) TO EXPAND ACCESS TO BEHAVIORAL HEALTH TREATMENT TO SUPPORT RECOVERY IN CLERMONT COUNTY, OHIO. CCBHC-A WAS ESTABLISHED IN 2020 WITH SAMHSA FUNDS AND MEETS ATTESTATION REQUIREMENTS. IT IMPROVED SERVICE ACCESS AND QUALITY FOR A DISPARATE POPULATION IN THE APPALACHIAN REGION WHICH HAS THE HIGHEST RATES OF ECONOMIC, SOCIAL AND HEALTH DISPARITIES IN THE U.S. PRIMARY PROBLEMS GRANT FUNDS WILL ADDRESS INCLUDE PRESCRIBER WAITING TIMES THAT AVERAGE 16 DAYS WHICH INCREASE SUICIDE RISK, HOSPITALIZATION, AND DELAY MEDICATION ACCESS; LIMITED CRISIS RECEIVING AND STABILIZATION SERVICES THE DRIVE LOCAL INCARCERATION RATES AND EMERGENCY DEPARTMENT (ED) UTILIZATION; LIMITED USE OF PEERS IN THE CRISIS CONTINUUM,; LACK OF BRIEF INTERVENTIONS AND THERAPIES (BIT) TO OFFER IMMEDIATE, SHORT-TERM SERVICES FOR PEOPLE IN CRISIS; AND HEALTH INFORMATION TECHNOLOGY (HIT) INNOVATIONS NEEDED TO STRENGTHEN CARE MANAGEMENT AND POPULATION HEALTH MANAGEMENT. CCBHC-A WILL SERVE 1000 CLIENTS OVER FOUR YEARS - 250 CLIENTS PER YEAR IN YEARS 1-4. THE FOCUS POPULATION WILL BE YOUTH AND ADULTS, TO INCLUDE PERSONS WITH SERIOUS MENTAL ILLNESS, SUBSTANCE USE DISORDERS, SERIOUS EMOTIONAL DISTURBANCE, CO-OCCURRING DISORDERS, AND PEOPLE IN BEHAVIORAL HEALTH CRISIS. THE POPULATION IS 93% WHITE; 5% BLACK; 2% HISPANIC/LATINO. 50% ARE FEMALE; 49% MALE; 1% TRANSGENDER. 94% ARE HETEROSEXUAL. 7% ARE UNDER 18; 45% ARE BETWEEN 30-49 YEARS. 86% ARE BELOW 138% OF THE FEDERAL POVERTY LEVEL. 84% HAVE A SMI; 47% A COD. SAMHSA FUNDS WILL IMPROVE PSYCHIATRIC PRESCRIBER CAPACITY, ENHANCE CRISIS SERVICES AND ADVANCE HIT. GOALS AND OBJECTIVES INCLUDE: 1) IMPROVE PSYCHIATRIC PRESCRIBER CAPACITY TO INCREASE MEDICATION ACCESS BY HIRING AN ADDITIONAL PRESCRIBER; 2) ENHANCE CRISIS SERVICES TO REDUCE ED USE BY ESTABLISHING A BEHAVIORAL HEALTH URGENT CARE ALIGNED TO THE OHIO DEPARTMENT OF MENTAL HEALTH AND ADDICTION SERVICES STANDARDS; 3) IMPROVE PEER CRISIS SUPPORT TO REDUCE CLIENT DISTRESS BY ESTABLISHING A PEER RESPITE PROGRAM; 4) INCREASE THE AVAILABILITY OF BITS TO IMPROVE ACCESS TO SHORT-TERM INTERVENTIONS BY DEVELOPING SCREENING, BRIEF INTERVENTION, AND REFERRAL TO TREATMENT (SBIRT) PROTOCOLS AND TRAINING STAFF IN SOLUTION-FOCUSED BRIEF THERAPY (SFBT; AND 5) STRENGTHEN CARE COORDINATION AND POPULATION HEALTH MANAGEMENT VIA HIT INNOVATIONS AND ELECTRONIC HEALTH RECORD INTEGRATION TO INCLUDE A PATIENT PORTAL, HEALTH EVENT NOTIFICATION, AND POPULATION HEALTH MANAGEMENT DASHBOARDS AND REPORTS. KEY INTERVENTIONS INCLUDE CRITICAL TIME INTERVENTION, MOTIVATIONAL INTERVIEWING, SBIRT, AND SFBT. GCB HAS SUCCESSFULLY IMPLEMENTED AND SUSTAINED 8 SAMHSA-FUNDED PROJECTS, INCLUDING CCBHC-A. IT HAS THE CAPACITY, EXPERIENCE, AND PARTNERSHIPS TO ENHANCE CCBHC-A TO CONTINUE TO IMPROVE HEALTH AND PROMOTE RECOVERY FOR A DISPARATE POPULATION IN A DISPARATE REGION.

CLERMONT COUNTY - ACT

GCBHS INTENSIVE ENGAGEMENT-MAT PROJECT (IE-MAT) - GREATER CINCINNATI BEHAVIORAL HEALTH SERVICES (GCB) WILL PARTNER WITH SHELTERHOUSE (SH), THE LARGEST HOMELESS SHELTER IN CINCINNATI, AND CINCINNATI HEALTH NETWORK (CHN), A HEALTH CARE FOR THE HOMELESS PROGRAM, TO EXPAND ACCESS TO MEDICATION-ASSISTED TREATMENT (MAT) SERVICES FOR PERSONS WITH OPIOID USE DISORDER (OUD) IN HAMILTON COUNTY, OH. IE-MAT WILL EXPAND OUTREACH, MAT, BEHAVIORAL HEALTH TREATMENT (BHT) AND RECOVERY SUPPORT SERVICES (RSS) FOR COMPLEX, UN- AND UNDERINSURED CLIENTS WHO HAVE A CO-OCCURRING MENTAL HEALTH DISORDER (MHD) AND/OR ARE HOMELESS. RATES OF OUD AND RELATED HARMS ARE HIGHER IN VULNERABLE POPULATIONS. ADULTS WITH MHD HAVE A HIGH PREVALENCE OF OPIOID USE, FOUR TIMES THAT OF PEOPLE WITHOUT MHD. OUD, COUPLED WITH MHD, IS LINKED TO OVERDOSE (OD), AND INCREASES HIV AND HEPATITIS C INFECTION. THERE IS ALSO A HIGH PREVALENCE OF SUBSTANCE USE DISORDERS AMONG PERSONS EXPERIENCING HOMELESSNESS (PEH), INCLUDING HIGHER RATES OF OPIOID MISUSE. DRUG OD IS THE LEADING CAUSE OF DEATH AMONG PEH, WITH RATES 30 TIMES HIGHER THAN THE GENERAL POPULATION. DESPITE HIGH RATES OF OUD AND RELATED HARMS, TREATMENT INITIATION AND RETENTION ARE LOW. HC'S TREATMENT CONTINUUM LACKS THE CAPACITY TO PROVIDE OUD SERVICES TO CLINICALLY VULNERABLE POPULATIONS WHO ARE UN- AND UNDERINSURED. IT ONLY HAS 2 PUBLICLY FUNDED OPIOID TREATMENT PROGRAMS (OTP). OVERALL, THE PREVALENCE, MULTIPLICITY, AND SEVERITY OF BEHAVIORAL HEALTH ISSUES IN THE FOCUS POPULATION, COUPLED WITH LIMITED TREATMENT OPTIONS, DEMAND A RESPONSE TO MINIMIZE THE DISPARITIES PRESENT FOR PERSONS WITH OUD WHO HAVE A CO-OCCURRING MHD AND/OR ARE HOMELESS. IE-MAT WILL PROVIDE MAT, BHT, AND RSS TO 260 CLIENTS OVER THE 5 YEAR PROJECT (20 IN YEAR 1 AN 60/YEAR IN YEARS 2-5). IE-MAT WILL EXPAND ACCESS TO MAT VIA TARGETED OUTREACH TO PERSONS WITH OUD TO FACILITATE TREATMENT INITIATION AND ESTABLISH AN OTP AT SH THAT COMBINES MAT, BHT AND RSS. OUTREACH OBJECTIVES FOCUS ON HIRING AND TRAINING PEER RECOVERY COACHES TO CONDUCT OUTREACH AND FACILITATE TREATMENT ENTRY. OTP OBJECTIVES FOCUS ON COLLABORATING WITH SH AND CHN TO ESTABLISH A CERTIFIED AND ACCREDITED OTP IN A HOMELESS SHELTER. KEY EVIDENCE-BASED PRACTICES INCLUDE MAT, MOTIVATIONAL INTERVIEWING, COGNITIVE BEHAVIORAL THERAPY, INTEGRATED DUAL DISORDER TREATMENT, AND CONTINGENCY MANAGEMENT. IE-MAT CLIENTS WILL INCLUDE THOSE ENROLLED IN GCB'S MENTAL HEALTH PROGRAMS AND PERSONS SERVED THROUGH ITS PATH HOMELESS OUTREACH TEAM. MENTAL HEALTH CLIENTS ARE 78% WHITE AND 52% FEMALE. AVERAGE AGE IS 41. 22% ARE HOMELESS. 9% ARE UNINSURED. 77% HAVE A CO-OCCURRING SUBSTANCE USE DISORDER. MENTAL HEALTH DIAGNOSES INCLUDE MOOD DISORDERS, ANXIETY DISORDERS, AND SCHIZOPHRENIA/PSYCHOTIC DISORDERS. PATH CLIENTS ARE 73% MALE AND 57% WHITE. 25% ARE UNINSURED. 57% REPORT A CO-OCCURRING DISORDER. GCB HAS THE CAPACITY, EXPERIENCE, AND PARTNERSHIPS TO EXPAND MAT ACCESS TO VULNERABLE POPULATIONS IN DESPERATE NEED OF TREATMENT AND RSS TO REDUCE SUBSTANCE USE AND PROMOTE RECOVERY.

HOLISTIC HEALTH INTEGRATION PROJECT - CINCINNATI (HHIP-C HIT)

BREAK-FREE CINCINNATI

PATHS TO RECOVERY

HOLISTIC HEALTH INTEGRATION PROJECT - CLERMONT COUNTY

CLERMONT CO. DRUG FREE COALITIONCONTINUATION OF THE ENVIRONMENTAL PREVENTION STRATEGIES AND EVIDENCED BASED PREVENTION THAT HAS BEEN DONE IN YEAR 1-5 OF THE DRUG FREE COMMUNITY FUNDING.

HOLISTIC HEALTH INTEGRATION PROJECT - CLERMONT COUNTY