Prairie Ridge Integrated Behavioral Healthcare

DEPARTMENT OF HEALTH AND HUMAN SERVICES SUBSTANCE ABUSE AND MENTAL HEALTH SERVICES ADMINISTRATION COMMUNITY MENTAL HEALTH CENTERS GRANT PROGRAM - THE PRAIRIE RIDGE COMMUNITY MENTAL HEALTH CENTERS GRANT PROGRAM WILL FOCUS ON RESTORING AND SUPPORTING DELIVERY OF CLINICAL SERVICES THAT WERE IMPACTED BY THE COVID-19 PANDEMIC AND WILL WORK TO ADDRESS THE NEEDS OF INDIVIDUALS WITH SEVERE EMOTIONAL DISTURBANCE (SED), SERIOUS MENTAL ILLNESS (SMI) AND INDIVIDUALS WITH SMI OR SED AND SUBSTANCE USE DISORDERS, REFERRED TO AS CO-OCCURRING DISORDER (COD). INDIVIDUALS SERVED WILL INCLUDE ADULTS WITH SEVERE MENTAL HEALTH DISORDERS, CHILDREN WHO HAVE A DIAGNOSABLE MENTAL , BEHAVIORAL, OR EMOTIONAL DISORDER, AND/OR INDIVIDUALS EXPERIENCING A MENTAL HEALTH CONDITION WITH A CO-OCCURRING SUBSTANCE USE DISORDER. THE GEOGRAPHIC FOCUS OF THE PROJECT INCLUDES AN 8-COUNTY AREA IN NORTHERN IOWA, INCLUDING THE COUNTIES OF CERRO GORDO, FLOYD, MICHELL, WORTH, WINNEBAGO, KOSSUTH, HANCOCK AND FRANKLIN. THE TOTAL POPULATION OF THE 8-COUNTY AREA, AS DOCUMENTED BY THE U.S. CENSUS 2018 AMERICAN COMMUNITY 5 YEAR SURVEY, IS 123, 149. OUR COMMUNITY HEALTH NEEDS ASSESSMENT SHOWS INDIVIDUALS IN OUR AREA CONTINUE TO FACE MANY UNMET NEEDS DUE TO THE LACK OF COMPREHENSIVE AND INTEGRATED SERVICES SYSTEMS, INCONSISTENT USE OF EVIDENCE-BASED PRACTICES, A LACK OF INSURANCE, POVERTY (WITH 10.46% OF THE POPULATION LIVING BELOW THE POVERTY LEVEL), AND A LACK OF AFFORDABLE TRANSPORTATION. THESE CHALLENGES ARE EXACERBATED BY A PERSISTENT SHORTAGE OF PROVIDERS IN THE AREA, INCLUDING PHYSICIANS AND PSYCHIATRISTS. THE LACK OF PSYCHIATRISTS IS PARTICULARLY ACUTE AND INTENSIFIED BY A STATEWIDE DECLINE IN PSYCHIATRIC BEDS FOR EMERGENT AND CRISIS SERVICES. ALL COUNTIES WITHIN OUR CATCHMENT AREA A PRIMARY CARE AND BEHAVIORAL HEALTH CARE SHORTAGE AREAS (HPSAS) FOR MEDICAID POPULATIONS. A CHNA BY A LOCAL HEALTH SYSTEM ALSO IDENTIFIES A LACK OF MENTAL HEALTH PROVIDERS/SUPPORT SERVICES AS THE MOST SIGNIFICANT NEED IN NORTH CENTRAL IOWA. THE LACK OF BEHAVIORAL HEALTH SERVICES IS LINKED TO A CRITICALLY HIGH SUICIDE RATE WHICH, EVEN BEFORE THE COVID-19 PANDEMIC, WAS THE NINTH LEADING CAUSE OF DEATH IN IOWA AND THE SECOND LEADING CAUSE OF DEATH FOR IOWANS BETWEEN THE AGES OF 10 AND 34. SINCE 2000, SUICIDES HAVE GROWN FROM 288 TO 521 IN 2019, AND ARE GROWING STILL FURTHER DURING THE COVID-19 PANDEMIC. FROM MARCH TO AUGUST 2020 ALONE, 267 SUICIDE DEATHS WERE REPORTED IN IOWA. CONCURRENTLY, ALCOHOL AND DRUG-RELATED HOSPITALIZATION RATES CONTINUE TO GROW. WHILE DATA ON THE IMPACT OF THE PANDEMIC IS STILL BEING GATHERED, THE U.S. CENSUS BUREAU ESTIMATES THAT ROUGHLY 100,000 MORE IOWANS IN DECEMBER 2020 REPORTED FEELING DEPRESSED NEARLY EVERY DAY COMPARED TO WHAT WAS SURVEYED IN MAY OR OCTOBER. THE CENTERS OF DISEASE CONTROL FOUND THAT IN THE FALL 2020, MENTAL HEALTH EMERGENCY VISITS ROSE BY 24% FOR CHILDREN AND 31% FOR TEENS. PRAIRIE RIDGE HAS DESIGNATED FIVE GOALS WITH MEASURABLE OBJECTIVES TO MEET THE NEEDS OF THE PEOPLE IN OUR CATCHMENT AREA AND OUR FOCUS POPULATIONS. THESE GOALS INCLUDE EXPANDING AVAILABILITY AND EASE OF ACCESS TO COMMUNITY-BASED PEER SUPPORT AND CRISIS RESPONSE SERVICES BY ESTABLISHING COMMUNITY DROP-IN CENTERS, ENHANCING PARTNERSHIPS BETWEEN PRAIRIE RIDGE'S BEHAVIORAL HEALTH TEAM AND THE CRIMINAL JUSTICE SYSTEM, EXPANDING ACCESS TO INTEGRATED HEALTH HOME SERVICES TO NON-MEDICAID FUNDED PATIENTS, ADDRESSING BEHAVIORAL HEALTH ISSUES OF SCHOOL-AGED CHILDREN AT RISK FOR SED THROUGH PROVISION OF "RECONNECTING YOUTH" CURRICULUM WITHIN THE SCHOOLS, AND INCREASING OUTREACH ABILITY BY TRAINING AND SUPPORTING PEERS TO ASSIST INDIVIDUALS WITH ADDRESSING BEHAVIORAL HEALTH NEEDS THAT MAY HAVE ARISEN OR WORSENED AS A RESULT OF THE PANDEMIC.

DEPARTMENT OF HEALTH AND HUMAN SERVICES SUBSTANCE ABUSE AND MENTAL HEALTH SERVICES ADMINISTRATION: FY 2020 CERTIFIED COMMUNITY BEHAVIORAL HEALTH CLINIC EXPANSION GRANTS - THE PRAIRIE RIDGE INTEGRATED BEHAVIORAL HEALTHCARE CCBHC INITIATIVE WILL FOCUS ON INCREASING ACCESS TO HIGH-QUALITY, EVIDENCE-BASED COMMUNITY BEHAVIORAL HEALTH AND SUBSTANCE USE DISORDER SERVICES. THE FOCUS OF SERVICES WILL BE TO PROVIDE COMPREHENSIVE, INTEGRATED CARE THAT DIRECTLY ADDRESSES BEHAVIORAL HEALTH ISSUES, CHRONIC HEALTH CONDITIONS AND ADVERSE SOCIAL DETERMINANTS TO HEALTH LIKE HUNGER, POVERTY, LACK OF TRANSPORTATION AND HOMELESSNESS. INDIVIDUALS SERVED WILL INCLUDE ADULTS WITH SEVERE MENTAL HEALTH DISORDERS, CHILDREN WHO HAVE A DIAGNOSABLE MENTAL, BEHAVIORAL, OR EMOTIONAL DISORDER, INDIVIDUALS WITH SUBSTANCE USE DISORDERS, INDIVIDUALS SUFFERING WITH A CHRONIC MEDICAL CONDITION THAT OCCURS WITH ONE OF THE PREVIOUS THREE CONDITIONS AND/OR INDIVIDUALS WITH CO-OCCURRING CONDITIONS THAT INCLUDE 2 OR MORE OF ANY OF THE CRITERIA LISTED ABOVE. THE GEOGRAPHIC FOCUS OF THE PROJECT INCLUDES AN 8-COUNTY AREA IN NORTHERN IOWA, INCLUDING THE COUNTIES OF CERRO GORDO, FLOYD, MITCHELL, WORTH, WINNEBAGO, KOSSUTH, HANCOCK AND FRANKLIN. THIS AREA HAS NO EXISTING CCBHC. THE TOTAL POPULATION OF THE 8-COUNTY AREA, AS DOCUMENTED BY THE U.S. CENSUS 2018 AMERICAN COMMUNITY 5-YEAR SURVEY, IS 123,149. OUR COMMUNITY HEALTH NEEDS ASSESSMENT SHOWS INDIVIDUALS IN OUR AREA CONTINUE TO FACE MANY UNMET NEEDS DUE TO THE LACK OF A COMPREHENSIVE AND INTEGRATED SERVICES SYSTEM, INCONSISTENT USE OF EVIDENCE-BASED PRACTICES, A LACK OF INSURANCE, POVERTY (WITH 10.46% OF THE POPULATION LIVING BELOW THE POVERTY LEVEL), AND A LACK OF AFFORDABLE TRANSPORTATION. THESE CHALLENGES ARE EXACERBATED BY A PERSISTENT SHORTAGE OF PROVIDERS IN THE AREA, INCLUDING PHYSICIANS AND PSYCHIATRISTS. THE LACK OF PSYCHIATRISTS IS PARTICULARLY ACUTE AND INTENSIFIED BY A STATEWIDE DECLINE IN PSYCHIATRIC BEDS FOR EMERGENT AND CRISIS SERVICES. ALL COUNTIES WITHIN OUR CATCHMENT AREA ARE PRIMARY CARE AND BEHAVIORAL HEALTHCARE SHORTAGE AREAS (HPSAS) FOR MEDICAID POPULATIONS. A CHNA BY A LOCAL HEALTH SYSTEM ALSO IDENTIFIES A LACK OF MENTAL HEALTH PROVIDERS/SUPPORT SERVICES AS THE MOST SIGNIFICANT NEED IN NORTH CENTRAL IOWA. THE LACK OF BEHAVIORAL HEALTH SERVICES IS LINKED TO A CRITICALLY HIGH SUICIDE RATE WHICH IS THE NINTH LEADING CAUSE OF DEATH IN IOWA AND THE SECOND LEADING CAUSE OF DEATH FOR IOWANS BETWEEN THE AGES OF 10 AND 34. FURTHER, THERE HAS BEEN A MARKED INCREASE IN THE NUMBER OF SUICIDE DEATHS SINCE 2000, GROWING FROM 288 TO 521 IN 2019, AND GROWING STILL FURTHER DURING THE COVID-19 PANDEMIC. FROM MARCH TO AUGUST 2020 ALONE, 267 SUICIDE DEATHS WERE REPORTED IN IOWA. CONCURRENTLY, ALCOHOL-AND DRUG-RELATED HOSPITALIZATION RATES CONTINUE TO GROW. ISSUES ARE PARTICULARLY ACUTE AMONG OUR VETERANS, WHO MAKE UP NEARLY 7.6% OF THE STATE'S POPULATION. PRAIRIE RIDGE HAS DESIGNATED FOUR GOALS WITH MEASURABLE OBJECTIVES TO MEET THE NEEDS OF THE PEOPLE OF OUR CATCHMENT AREA AND OUR FOCUS POPULATIONS. THESE GOALS INCLUDE PROVIDING IMMEDIATE ACCESS TO COMPREHENSIVE SUICIDE PREVENTION SERVICES, DEVELOPING AN ASSERTIVE COMMUNITY TREATMENT PROGRAM, EXPANDING ACCESS TO A COMPREHENSIVE RANGE OF COMMUNITY-BASED MENTAL HEALTH AND SUBSTANCE USE DISORDERS SERVICES (INCLUDING THE EXPANSION OF CRISIS SERVICES AND MEDICATION ASSISTED TREATMENT SERVICES), AND EXPANDING ACCESS TO VETERAN-FOCUSED MENTAL HEALTH AND SUBSTANCE USE DISORDERED SERVICES. OUR GOAL IS TO SERVE 1,000 UNDUPLICATED INDIVIDUALS IN THE FIRST TWO YEARS.

FY 2023 ASSERTIVE COMMUNITY TREATMENT - THE PRAIRIE RIDGE INTEGRATED BEHAVIORAL HEALTHCARE ASSERTIVE COMMUNITY TREATMENT (ACT) GRANT WILL FOCUS ON EXPANDING THE REACH OF OUR EXISTING ACT TEAM. PRAIRIE RIDGE INTEGRATED BEHAVIORAL HEALTHCARE (PRAIRIE RIDGE) IS A NONPROFIT COMMUNITY-BASED PROVIDER OF INTEGRATED BEHAVIORAL HEALTHCARE IN NORTH CENTRAL IOWA. OUR CATCHMENT AREA CONSISTS OF EIGHT, LARGELY RURAL COUNTIES (CERRO GORDO, FLOYD, MITCHELL, WORTH, WINNEBAGO, KOSSUTH, HANCOCK, AND FRANKLIN) THAT ARE SIGNIFICANTLY UNDERSERVED. ALL EIGHT COUNTIES ARE DESIGNATED BY HRSA AS MEDICAID MENTAL HEALTH PROFESSIONAL SHORTAGE AREAS (HPSAS). IN 2020, PRAIRIE RIDGE INITIATED OUR MEDICAID-ONLY ASSERTIVE COMMUNITY TREATMENT (ACT) PROGRAM TO PROVIDE INTENSIVE SUPPORT AND TREATMENT SERVICES TO INDIVIDUALS WITH SERIOUS MENTAL ILLNESS (SMI) LIVING WITHIN A 25-MILE RADIUS OF MASON CITY. HOWEVER, THAT 250-MILE RADIUS ONLY COVERS A SMALL PORTION OF OUR GEOGRAPHICALLY EXPANSIVE SERVICE AREA. A SIGNIFICANT PORTION OF RESIDENTS LIVING IN THE EIGHT COUNTIES WE SERVE HAVE NO ACCESS TO AN ACT TEAM. WHEN INDIVIDUALS WITH SMI CANNOT ACCESS ACT, THEY ARE OFTEN MORE EASILY LOST TO BEHAVIORAL HEALTH CARE AND HAVE MORE FREQUENT HOSPITALIZATIONS. BASED ON THESE SIGNIFICANT GAPS, WE ARE PROPOSING TO EXPAND OUR ACT PROGRAM'S RADIUS TO THE ENTIRETY OF THE EIGHT COUNTIES IN OUR CATCHMENT AREA. OUR POPULATION OF FOCUS IS ADULTS AND TRANSITION-AGED CONSUMERS 18 AND OVER WITH SMI OR SERIOUS EMOTIONAL DISTURBANCE (SED) WHO LIVE WITHIN THE ENTIRETY OF OUR EIGHT-COUNTY SERVICE AREA. IN ALIGNMENT WITH THOSE NEEDS, PRAIRIE RIDGE'S GOALS AND MEASURABLE OBJECTIVES INCLUDE: 1) EXPAND OUR CURRENT ACT PROGRAM TO SERVE INDIVIDUALS IN A LARGER GEOGRAPHIC AREA; 2) SUPPORT ACT CONSUMERS TO BUILD RECOVERY CAPITAL AND ADDRESS THEIR WHOLE PERSON NEEDS TO HELP THEM LIVE SAFELY AND WITH STABILITY IN THEIR COMMUNITIES OF CHOICE; AND 3) IMPROVE HEALTH AND FUNCTIONING OF ACT CONSUMERS TO DECREASE THEIR MORTALITY RATES. NUMBER TO BE SERVED: THROUGH THIS EXPANSION OF OUR ACT TEAM, WE WILL INCREASE ACCESS TO 24/7, EVIDENCE-BASED, MULTIDISCIPLINARY TEAM-BASED SERVICES FOR ADULTS AND TRANSITION-AGED CONSUMERS 18 AND OVER WITH SMI AND SED INCLUDING THE FOLLOWING NUMBERS OF CLIENTS SERVED EACH YEAR: 40 UNDUPLICATED INDIVIDUALS BY THE END OF YEAR1; 15 ADDITIONAL UNDUPLICATED INDIVIDUALS BY THE END OF YEAR 2 (FOR A TOTAL OF 55 INDIVIDUALS BEING SERVED); 7 ADDITIONAL UNDUPLICATED INDIVIDUALS IN YEAR 3 (FOR A TOTAL OF 62 INDIVIDUALS SERVED); AND 6 ADDITIONAL UNDUPLICATED INDIVIDUALS IN YEARS 4 AND 5 (FOR A TOTAL OF 74 INDIVIDUALS SERVED).