Banyan Community Health Center Inc

HEALTH CENTER PROGRAM

THE PURPOSE OF THIS PROGRAM IS TO ENABLE COMMUNITY MENTAL HEALTH CENTERS TO SUPPORT AND RESTORE THE DELIVERY OF CLINICAL SERVICES THAT WERE IMPACTED BY THE COVID-19 PANDEMIC. - THE BANYAN HEALTH SYSTEMS D/B/A BANYAN COMMUNITY HEALTH CENTER, INC. (BANYAN) PROPOSES THE BANYAN COMMUNITY MENTAL HEALTH CENTER (CMHC) RESTORATION PROJECT (CRP), WHICH RESPONDS TO SAMHSA FOA NO. SM-14-021: FY2021 COMMUNITY MENTAL HEALTH CENTERS (CMHC) GRANT PROGRAM. THE POPULATION OF FOCUS (POF) FOR THE CRP IS THE MAJORITY MINORITY (BLACK AND LATINX) POPULATION OF THE BROWARD AND MIAMI-DADE COUNTIES (MDC), WHO RESIDE PRIMARILY IN THE LITTLE HAVANA, CUTLER BAY AND LAUDERDALE HILLS, THE SITE OF BANYAN’S NEW STATE-OF-THE-ART INTEGRATED BEHAVIORAL HEALTH AND PRIMARY CARE CENTER, WHOSE SERVICES WILL CENTER ON WESTERN BROWARD IN WHICH INTEGRATED SERVICES ARE LARGELY UNAVAILABLE. SOUTH FLORIDA IS WELL-KNOWN FOR ITS DIVERSE POPULATION, BUT IN BANYAN’S PRIMARY SERVICE AREA, THE POPULATION IS AS MUCH AS 79.4% LATINX AND 16.3% BLACK. THE COMMUNITIES SERVED BY BANYAN STRUGGLE WITH OVERWHELMING POVERTY (54.5% HAVE INCOMES BELOW THE FEDERAL POVERTY LEVEL); UNEMPLOYMENT IS RAMPANT; 74.9% OF ADULTS HAVE LIMITED ENGLISH PROFICIENCY; AND 82.7% OF LOW-INCOME FAMILIES ARE EITHER UNSERVED BY A HEALTHCARE PROVIDER OR DECLINED CARE IN THE PAST YEAR BECAUSE THEY COULD NOT AFFORD IT. ENVIRONMENTAL FACTORS (I.E., CROWDED LIVING CONDITIONS AND SUBSTANDARD HOUSING) COMBINED WITH LIMITED ACCESS TO HEALTH AND BEHAVIORAL HEALTH CARE HAVE CREATED CONDITIONS IN WHICH SERIOUS EMOTIONAL DISTURBANCE (SED) AMONG CHILDREN IS RISING AND GREATER NUMBERS OF ADULTS WITH SMI ARE GOING UNTREATED. THE COVID-19 PANDEMIC HAS ALSO INCREASED THE NEED FOR SERVICES TO ADDRESS THE OPIOID EPIDEMIC, WHICH BARELY SLOWED DOWN IN BROWARD AND MDC--MORE INDIVIDUALS REQUIRING TREATMENT FOR CO-OCCURRING MENTAL AND SUBSTANCE USE DISORDER (COD), BUT NO INCREASE IN AVAILABILITY OR ACCESS TO THESE CRITICAL SERVICES. IT WILL ENABLE BANYAN TO REBALANCE/REALIGN IN-PERSON VS. TELEHEALTH VISITS FOR PATIENTS WITH COD RECEIVING RESIDENTIAL DRUG-FREE TREATMENT OR OUTPATIENT MAT OR LONG-ACTING INJECTABLE PSYCHOTROPIC MEDICATION, WHO REQUIRE FREQUENT MONITORING. THE PROPOSED CRP WILL SUPPORT AND RESTORE CLINICAL SERVICES FOR MORE THAN 4000 INDIVIDUALS AND FAMILIES WITH SED, SMI AND COD (2500 IN Y1 AND 1500 IN Y2) WHO ARE BEST SERVED IN A CMHC SETTING. IT WILL ENABLE BANYAN TO DEVOTE CLINICAL SERVICES (E.G., PSYCHIATRY) TO THOSE IN GREATEST NEED, AND EXTEND SUPPORTIVE SERVICES (E.G., DROP-IN CENTER) TO SEVEN DAYS/WEEK. IT WILL ALSO PROVIDE SUPPORT AND TRAINING TO REDUCE BURN-OUT, IMPROVE JOB SATISFACTION AND EMPLOYEE RETENTION WITHIN BANYAN. BANYAN SUFFERED THE CATACLYSMIC LOSS OF MORE THAN $4 MILLION IN THE PAST 15 MONTHS—NEARLY 12% OF ITS $35 MILLION TOTAL BUDGET, LESS THAN HALF OF WHICH WAS RECOVERED THROUGH THE CARES ACT AND THE AMERICAN RESCUE PLAN—BUT WILL STILL FACE PAINFUL CUTS IN STAFF AND SERVICES WITHOUT SAMHSA FUNDING. BANYAN—WHICH RECEIVED HRSA’S GOLD STAR FOR INTEGRATED BEHAVIORAL HEALTH SERVICES IN PRIMARY CARE IN 2020—WOULD ALSO BE FORCED TO ABANDON MUCH OF THE PROGRESS MADE ON BUILDING INTEGRATED SERVICES OVER THE PAST HALF DECADE. THOUGH THESE GRANT FUNDS WILL SUPPORT ONLY BANYAN’S CMHC PROGRAM, IT WILL ENABLE BANYAN TO RESTORE THE HIGH-QUALITY, COMPREHENSIVE, FULLY-INTEGRATED BEHAVIORAL HEALTH SERVICES FOR INDIVIDUALS WITH SED, SMI AND COD IN BROWARD AND MDC.

THE PURPOSE OF THIS PROGRAM IS TO IMPROVE AND ADVANCE THE COMMUNITY HEALTH CENTER WITH THE DELIVERY OF CLINICAL AND BEHAVIORAL HEALTH SERVICES USING AN INTEGRATED CARE MODEL. - THE BANYAN HEALTH SYSTEMS D/B/A BANYAN COMMUNITY HEALTH CENTER, INC. (BANYAN) PROPOSES THE BANYAN CERTIFIED COMMUNITY BEHAVIORAL HEALTH CLINIC—IMPROVEMENT AND ADVANCEMENT, WHICH RESPONDS TO SAMHSA FOA NO. SM-22-012: THE BANYAN CCBHC-2 (BCCBHC-2), IN ORDER TO DISTINGUISH IT FROM THE ORIGINAL BCCBHC PROJECT. THE POPULATION OF FOCUS (POF) FOR BCCBHC-2 IS THE MAJORITY MINORITY (BLACK AND LATINX) POPULATION OF THE BROWARD AND MIAMI-DADE COUNTIES (MDC), WHO RESIDE PRIMARILY IN THE LITTLE HAVANA, CUTLER BAY AND LAUDERDALE HILLS, THE SITE OF BANYAN’S NEW STATE-OF-THE-ART INTEGRATED BEHAVIORAL HEALTH AND PRIMARY CARE CENTER, WHOSE SERVICES WILL CENTER ON WESTERN BROWARD, WHICH REMAINS A SERVICES DESERT OVERALL, WITH INTEGRATED SERVICES ARE LARGELY UNAVAILABLE. SOUTH FLORIDA IS WELL-KNOWN FOR ITS DIVERSE POPULATION, BUT IN BANYAN’S PRIMARY SERVICE AREA, THE POPULATION IS AS MUCH AS 79.4% LATINX AND 16.3% BLACK. THE POF ALSO ENCOMPASSES DISPROPORTIONATE NUMBERS OF LGBTQ+ ADULTS AND OTHER SEXUAL AND GENDER MINORITIES. IN ADDITION TO STRUGGLING WITH SERIOUS EMOTIONAL DISTURBANCE (SED), SMI, SUD AND/OR (COD), BANYAN WHO PRESENT WITH ONE OF MORE OF THE FOLLOWING CONDITIONS: PTSD, TOBACCO/VAPING USE OR DEPENDENCE, OBESITY AND/OR POOR NUTRITION WILL PARTICIPATE IN AN IMPLEMENTATION SCIENCE PILOT STUDY TO SEARCH FOR WAYS TO BETTER PROVIDE NEEDED TREATMENT FOR CLIENTS. THE COMMUNITIES SERVED BY BANYAN STRUGGLE WITH OVERWHELMING POVERTY (54.5% HAVE INCOMES BELOW THE FEDERAL POVERTY LEVEL); UNEMPLOYMENT IS RAMPANT; 74.9% OF ADULTS HAVE LIMITED ENGLISH PROFICIENCY; AND 82.7% OF LOW-INCOME FAMILIES ARE EITHER UNSERVED BY A PRIMARY CARE PROVIDER OR DECLINED CARE IN THE PAST YEAR BECAUSE THEY COULD NOT AFFORD IT. ENVIRONMENTAL FACTORS (I.E., CROWDED LIVING CONDITIONS AND SUBSTANDARD HOUSING) COMBINED WITH LIMITED ACCESS TO HEALTH AND BEHAVIORAL HEALTH CARE HAVE CREATED CONDITIONS IN WHICH SED AMONG CHILDREN IS RISING AND GREATER NUMBERS OF ADULTS WITH SMI ARE GOING UNTREATED. THE COVID-19 PANDEMIC FURTHER INCREASED THE DEMAND FOR HEALTH/BEHAVIORAL HEALTH SERVICES. THE PROPOSED BCCBHC-2 PROGRAM WILL PROVIDE CLINICAL SERVICES FOR MORE THAN 1300 INDIVIDUALS AND FAMILIES WITH SED, SMI AND COD (220 IN Y1; 360 IN Y2-Y4, FOR A TOTAL OF 1300 OVER THE 4-YEAR PROJECT PERIOD), WHO CAN BE EFFECTIVELY SERVED IN AN OUTPATIENT SETTING WITH THE RIGHT SUPPORT. THE PROJECT’S KEY INNOVATION IS THE APPLICATION OF THE CRITICAL TIME INTERVENTION (CTI) TO HOMELESS INDIVIDUALS WHO HAVE BEEN DIAGNOSED WITH SED/SMI/SUD/COD AND ARE HIGH UTILIZERS OF INPATIENT HOSPITAL AND ED SERVICES. OTHER EBPS WILL INCLUDE COGNITIVE BEHAVIOR THERAPY, MEDICATION ASSISTED TREATMENT, WELLNESS RECOVERY ACTION PLANNING, MOTIVATIONAL INTERVIEWING, SEEKING SAFETY, TRAUMA-FOCUSED CBT, NUTRITION/EXERCISE COACHING, PEER-BASED RECOVERY SUPPORT SERVICES AND TOOLS TO QUIT AND QUIT SMOKING NOW. BANYAN WILL COMBINE CTI WITH THE EXTENSIVE USE OF STANDARD SCREENING INSTRUMENTS (PHQ-9/9A, PHQ-9/9A; GAD7; CAGE; PSC; MDQ ALONG WITH URINE SCREENING FOR SUBSTANCE USE. WHERE INDICATED, BANYAN WILL ALSO USE SCARED, PSC, M-CHAT & CRAFFT. BANYAN’S FQHC USES A DIABETES SCREEN, BP SCREEN, HIV, HCV A/B/C/ AND STI TESTING ADMINISTERED ACCORDING TO AAFP PERIODICITY SCHEDULES. BANYAN HAS EMBEDDED MOST OF THESE IN ITS EMRS (INTERGY AND CREDIBLE) TO FACILITATE ASSESSMENT BUT WILL MOVE TO THE EPIC EHR IN YEAR 2.

BANYAN COMMUNITY HEALTH CENTER: INCREASING ACCESS TO INTEGRATED CARE FOR WOMEN AND THEIR CHILDREN, PREGNANT WOMEN AND WOCBP. - BANYAN HEALTH SYSTEMS, DBA BANYAN COMMUNITY HEALTH CENTER, INC. (BANYAN OR BCHC) AND ITS DESIGNATED COLLABORATING ORGANIZATION (DCO) FELLOWSHIP HOUSE (FH), PROPOSE THE BANYAN CERTIFIED COMMUNITY BEHAVIORAL HEALTH CLINIC (BCCBHC) WHICH WILL EXPAND ACCESS TO TREATMENT, IMPROVE ADHERENCE TO, AND QUALITY OF LICENSED TREATMENT FOR SUBSTANCE USE DISORDERS (SUD), SUD PREVENTION, SERIOUS MENTAL ILLNESS (SMI), AND CO-OCCURRING MENTAL AND SUBSTANCE USE DISORDERS (COD) IN BROWARD AND MIAMI-DADE COUNTIES IN FLORIDA. FURTHER, BANYAN'S EFFORTS WILL FOCUS ON LITTLE HAVANA AND CUTLER BAY NEIGHBORHOODS AND NORTHEASTER BROWARD COUNTY AREAS IN WHICH BANYAN HAS BEEN A MAJOR PRESENCE FOR 50 YEARS. THE BANYAN CCBHC WILL DELIVER ITS SERVICES TO WOMEN OF CHILDBEARING POTENTIAL AND THEIR CHILDREN WHO HAVE BEEN DIAGNOSED WITH SUD, SMI, COD (OR CHILDREN DIAGNOSED WITH TRAUMA, COGNITIVE OR DEVELOPMENTAL DELAYS). BANYAN'S INNOVATION WILL BE THE CREATION OF COMPREHENSIVE AND FULLY INTEGRATED PRIMARY CARE SUD, SMI, AND COD, PREVENTION AND TREATMENT SERVICES THAT BY USING ARTIFICIAL INTELLIGENCE TO FACILITATE POPULATION HEALTH MANAGEMENT, EFFECTIVELY ENABLING BANYAN CCBHC TO ACCESS THE DATABASE INFORMATION OF BOTH PARTNERS. COMBINED WITH BANYAN'S EXISTING TELE-HEALTH CAPACITY, BANYAN AND ITS PARTNERS WILL BE ABLE TO MORE EFFECTIVELY COLLABORATE ON TREATMENT PLANNING AND ADDRESS CRISES AND OTHER UNTOWARD EVENTS TOGETHER WITH ALL THE PRACTITIONERS INVOLVED IN A POF MEMBERS TREATMENT. SPECIFICALLY, THE BANYAN CCBHC WILL BRING THESE SERVICES TO 350 POF MEMBERS IN YEAR 1 AND 450 IN YEAR 2 (800 TOTAL). TO REACH THAT TOTAL, BANYAN AND FH ANTICIPATE SCREENING 500 INDIVIDUALS EACH YEAR WHO ARE NOT CURRENTLY CONNECTED TO TREATMENT. THE GOALS OF THE PROPOSED PROJECT INCLUDE: EXPANDING THE NUMBER OF POF MEMBERS THAT RECEIVE COMPREHENSIVE SUD/SMI/COD TREATMENT BY 800 OVER THE TWO-YEAR PROJECT PERIOD, IMPROVING TREATMENT AND PREVENTION SERVICES EFFECTIVENESS, REDUCING SUBSTANCE ABUSE AMONG THE POF, REDUCING THE SEVERITY OF SYMPTOMS AND IMPROVING TREATMENT ADHERENCE, REDUCING RELAPSES REQUIRING HOSPITALIZATION, INCREASING THE SUBJECTIVE SENSE OF PARTICIPANTS WELL-BEING, AND IMPROVING THEIR QUALITY OF LIFE. BANYAN'S CCBHC WILL FOCUS OUTREACH AND ENGAGEMENT EFFORTS ON MEMBERS OF THE POF THAT APPEAR TO HAVE THE MOST SERIOUS NEEDS OR HAVE REACHED THE POINT WHERE THEY ARE READY TO MAKE POSITIVE CHANGES IN THEIR LIVES, BUT DO NOT KNOW WHERE TO TURN. THE PROPOSED PROJECT WILL SIGNIFICANTLY REDUCE HOSPITAL ADMISSIONS, LENGTH OF STAY, AND EMERGENCY DEPARTMENT (ED) VISITS BY POF MEMBERS OVER THEIR USE OF INPATIENT AND ED SERVICES IN THE PRIOR YEAR. THE BANYAN CCBHC ALSO ANTICIPATES WORKING WITH CHILD WELFARE TO REDUCE OUT-OF-HOME PLACEMENTS BY HELPING POF MOTHERS TO BE BETTER PARENTS. IN ADDITION, THE PROJECT WILL RESULT IN FEWER BABIES BORN WITH NEONATAL ABSTINENCE SYNDROME AND/OR LOW BIRTH WEIGHT. FINALLY, BANYAN ANTICIPATES YEAR-OVER-YEAR IMPROVEMENTS IN THESE STATISTICS WITHIN THE TWO-YEAR PROJECT PERIOD AS WELL AS WHEN MEASURED AGAINST PRIOR YEARS. THESE OUTCOME ARE MADE POSSIBLE BY USING THE PREDICTIVE POWER OF THE PROJECT'S SOFTWARE TO PLAN INTERVENTIONS THAT ARE BOTH TIMELY AND EFFECTIVE WITH THE POF.

HEALTH CENTER PROGRAM

AMERICAN RESCUE PLAN ACT FUNDING FOR HEALTH CENTERS

CONGRESSIONALLY DIRECTED SPENDING FOR CONSTRUCTION PROJECTS

BANYAN WORKS: COMBINING STATE-OF-THE-ART RESIDENTIAL SUBSTANCE USE DISORDER TREATMENT, WORKFORCE DEVELOPMENT, JOB PLACEMENT AND SOBER HOUSING TO IMPROVE HEALTH OUTCOMES IN SOUTH FLORIDA.

HEALTH CENTER CLUSTER

TEACHING HEALTH CENTER (THC) GRADUATE MEDICAL EDUCATION (GME) PAYMENT PROGRAM

PREVENTION CAPACITY BUILDING FOR MIAMI-DADE ETHNIC MINORITIES MSM

FY 2021 ENDING THE HIV EPIDEMIC - PRIMARY CARE HIV PREVENTION

BANYAN COMMUNITY HEALTH CENTER COMPREHENSIVE OPIOID RECOVERY CENTERS - BANYAN COMMUNITY HEALTH CENTER, INC. PROPOSES THE BANYAN COMPREHENSIVE OPIOID RECOVERY CENTER, A THREE-YEAR INITIATIVE SERVING APPROXIMATELY 1,000 UNIQUE INDIVIDUALS ACROSS MIAMI-DADE AND BROWARD COUNTIES, FLORIDA, A SERVICE AREA OF APPROXIMATELY 4.7 MILLION RESIDENTS, WITH OPIOID USE DISORDER (OUD), ALCOHOL USE DISORDER (AUD), OR OTHER SUBSTANCE USE DISORDERS (SUDS). BANYAN WILL SERVE 500 UNDUPLICATED INDIVIDUALS IN YEAR 1, 525 IN YEAR 2, AND 550 IN YEAR 3, WITH PARTICIPANTS OFTEN FACING PRIOR OVERDOSE, CO-OCCURRING MENTAL OR CHRONIC MEDICAL CONDITIONS, INFECTIOUS-DISEASE RISKS, AND HOUSING OR EMPLOYMENT INSTABILITY. BANYAN WILL SERVE AS THE PRIMARY DIRECT-SERVICE PROVIDER, BUILDING UPON ITS INTEGRATED PRIMARY CARE, BEHAVIORAL HEALTH, PSYCHIATRY, AND DETOXIFICATION SERVICES, WITH FDA-APPROVED MEDICATIONS FOR OUD AND AUD, MOTIVATIONAL INTERVIEWING, AND COGNITIVE BEHAVIORAL THERAPY. OBJECTIVES INCLUDE ENSURING 100% OF PARTICIPANTS RECEIVE INDIVIDUALIZED ASSESSMENTS AND TREATMENT PLANS, OFFERING APPROPRIATE MOUD OR MAUD TO 100% OF CLINICALLY ELIGIBLE PARTICIPANTS, PROVIDING OVERDOSE EDUCATION AND DIRECT OORM ACCESS TO AT LEAST 90%, AND ACHIEVING TREATMENT INITIATION OR A COMPLETED WARM HANDOFF FOR AT LEAST 80% OF PARTICIPANTS.

HEALTH CENTER CORONAVIRUS AID, RELIEF, AND ECONOMIC SECURITY (CARES) ACT FUNDING

HEALTH CENTER INFRASTRUCTURE SUPPORT

FISCAL YEAR 2023 CAPITAL ASSISTANCE FOR HURRICANE RESPONSE AND RECOVERY EFFORTS (CARE)

TEACHING HEALTH CENTER PLANNING AND DEVELOPMENT PROGRAM

FY 2018 CAPITAL ASSISTANCE FOR HURRICANE RESPONSE AND RECOVERY EFFORTS

FY 2020 EXPANDING CAPACITY FOR CORONAVIRUS TESTING (ECT)

BANYAN COMMUNITY HEALTH CENTER MENTAL HEALTH AWARENESS TRAINING PROGRAM - BANYAN COMMUNITY HEALTH CENTER, INC. WILL IMPLEMENT THE MENTAL HEALTH AWARENESS TRAINING PROGRAM ACROSS MIAMI-DADE AND BROWARD COUNTIES, FLORIDA, TO STRENGTHEN CRISIS-RESPONSE CAPACITY AMONG LAW ENFORCEMENT AND OTHER FIRST RESPONDERS. THE PROJECT WILL TRAIN LOCAL, STATE, AND FEDERAL LAW ENFORCEMENT OFFICERS; 911 PUBLIC SAFETY TELECOMMUNICATORS; FIREFIGHTERS; PARAMEDICS; EMERGENCY MEDICAL TECHNICIANS; AND OTHER FIRST RESPONDERS USING ADULT, YOUTH, TEEN, AND PUBLIC SAFETY MENTAL HEALTH FIRST AID AND QPR SUICIDE-PREVENTION TRAINING. BANYAN WILL ALSO PROVIDE WRITTEN AND ELECTRONIC COMMUNITY RESOURCES, CONDUCT YEAR-ROUND OUTREACH, AND MAINTAIN PARTNERSHIPS WITH WESTCARE AND BANYAN’S CRISIS STABILIZATION UNIT AND CENTRALIZED RECEIVING FACILITY TO SUPPORT WARM HANDOFFS TO SCREENING, ASSESSMENT, AND SERVICES. THE PROJECT WILL TRAIN AT LEAST 400 INDIVIDUALS IN YEAR 1 AND 1,200 CUMULATIVELY BY YEAR 3, WITH AT LEAST 85% OF TRAINEES ACHIEVING A 20% OR GREATER KNOWLEDGE GAIN. BANYAN WILL ESTABLISH A BASELINE AND STANDARDIZED PROCESS FOR LAW-ENFORCEMENT REFERRALS TO ITS CRISIS RESPONSE TEAM, INCREASE DOCUMENTED REFERRALS TO ITS CRISIS UNIT BY AT LEAST 20% ABOVE BASELINE AND MAINTAIN OR IMPROVE THAT LEVEL ANNUALLY, AND REACH AT LEAST 10,000 RESIDENTS ANNUALLY WITH RESOURCE MATERIALS THROUGH AT LEAST 24 OUTREACH EVENTS PER YEAR.

FY 2023 EXPANDING COVID-19 VACCINATION

FY 2020 CORONAVIRUS SUPPLEMENTAL FUNDING FOR HEALTH CENTERS

FY 2023 BRIDGE ACCESS PROGRAM

FY 2018 CAPITAL ASSISTANCE FOR HURRICANE RESPONSE AND RECOVERY EFFORTS