Horizon Health Services Inc

HEALTH CENTER CLUSTER

HEALTH CENTER CLUSTER

EXPANSION AND CONTINUATION OF CERTIFIED COMMUNITY BEHAVIORAL HEALTH CLINIC (CCBHC) SERVICES

ESTABLISHMENT OF CCBHC SERVICES

CCBHC I&A GRANT - AS A CCBHC-IA GRANT AWARDEE, HORIZON HEALTH SERVICES (HHS) WILL EXPAND AND ENHANCE OUR CCBHC SERVICES TO SERVE ALL INDIVIDUALS ACROSS THE LIFESPAN IN NEED OF BEHAVIORAL HEALTHCARE IN THE EAST SIDE OF BUFFALO CITY (EAST BUFFALO), ERIE COUNTY, NEW YORK (NY), WITH A PARTICULAR FOCUS ON ADDRESSING BH DISPARITIES FOR BLACK INDIVIDUALS WITH CRIMINAL JUSTICE (CJ) INVOLVEMENT AND/OR TRANSITIONING FROM INPATIENT, EMERGENCY DEPARTMENT (ED), OR RESIDENTIAL TREATMENT. HHS' PROJECT GOALS ARE TO: (1) IMPROVE TARGETED CASE MANAGEMENT (TCM) FOR THOSE WHO ARE NON-HEALTH HOME (HH) ELIGIBLE OR REFUSE TO PARTICIPATE IN HH; (2) INCREASE THE CAPACITY OF THE CLINIC TO MEET THE MEDICAL AND MEDICATION NEEDS OF OUR PATIENTS; AND (3) REDUCE THE RATE OF NEVER EVENTS (OVERDOSE/SUICIDE ATTEMPT/PATIENT DEATH). WE WILL ADDRESS THESE GOALS BY STRATEGICALLY AND PROACTIVELY OUTREACHING AND ENGAGING PATIENTS, ESPECIALLY THOSE COMING FROM A HIGHER LEVEL OF CARE OR THE CJ SYSTEM. SPECIFICALLY, WE WILL: (1) HIRE 1 FTE TARGETED CASE MANAGER; (2) OFFER TCM TO 90% OF ELIGIBLE PATIENTS; (3) PROVIDE TARGETED OUTREACH TO 90% PATIENTS COMING FROM A HIGHER LEVEL OF CARE; AND (4) SCREEN 90% OF NEW PATIENTS FOR HEALTH-RELATED SOCIAL NEEDS (HRSN). WE EXPECT THAT 50% OF ELIGIBLE PATIENTS WILL RECEIVE TCM IN EACH YEAR OF THE GRANT PERIOD. TO IMPROVE PATIENT ACCESS TO MEDICATION AND MEDICAL MONITORING, WE WILL HIRE 1 FTE NURSE, 1 FTE POPULATION HEALTH SPECIALIST, AND 1.3 FTE PSYCHIATRIC NURSE PRACTITIONER (PNP) TO PROVIDE MEDICATION CONSULTATION/EDUCATION TO 75% OF PATIENTS PRESCRIBED BH RX AND PRIMARY CARE SCREENING AND MONITORING, INCLUDING REFERRAL TO ONGOING PRIMARY CARE, TO 75% OF PATIENTS WHO ARE NOT CONSISTENTLY CONNECTED TO PRIMARY CARE. THROUGH IMPROVED MONITORING AND TCM, HHS AIMS TO REDUCE THE RATE OF NEVER EVENTS BY 20% AS WELL AS IMPROVE HEDIS RATES FOR FOLLOW-UP AFTER HOSPITALIZATION FOR MENTAL ILLNESS (FUH), HIGH-INTENSITY CARE FOR SUD (FUI), ED VISIT FOR MENTAL ILLNESS (FUM), AND ED VISIT FOR ALCOHOL AND OTHER DRUG ABUSE OR DEPENDENCE (FUA) RATES BY 25% OVER THE GRANT PERIOD. WE WILL COLLABORATE WITH TWO FQHCS, EVERGREEN HEALTH AND COMMUNITY HEALTH CENTER OF BUFFALO (CHCB), TO PROVIDE PRIMARY CARE SERVICES TO HHS PATIENTS IN NEED OF FURTHER TREATMENT FOR MEDICAL CONDITIONS, INCLUDING ONGOING MONITORING OF HEALTH NEEDS AND HIV AND HEP SCREENINGS AND CARE. WE WILL ALSO PARTNER WITH THE CRISIS SERVICES OF ERIE COUNTY (CSE) TO OFFER THE FULL RANGE OF 24/7 CRISIS SERVICES; RESTORATION SOCIETY TO PROVIDE PSYCHOSOCIAL REHABILITATION (PSR) AND OTHER PEER-SUPPORTED SERVICES; HORIZON VILLAGE'S TERRACE HOUSE TO PROVIDE SUD CRISIS STABILIZATION; AND ENDEAVOR HEALTH SERVICES TO PROVIDE CLUBHOUSES AND PERSONALIZED RECOVERY ORIENTED SERVICES (PROS) TO HHS PATIENTS. THE PROJECT WILL SERVE 300 UNDUPLICATED INDIVIDUALS IN THE FIRST YEAR OF THE PROJECT AND 450 INDIVIDUALS FOR EACH YEAR THEREAFTER, FOR A TOTAL OF 1,650 INDIVIDUALS OVER THE COURSE OF THE PROJECT.

MATCONNECT - THROUGH HORIZON HEALTH SERVICES' (HHS') MATCONNECT PROGRAM, WE WILL EXPAND AND ENHANCE ACCESS TO MEDICATIONS FOR OPIOID USE DISORDER (MOUD) TREATMENT AND RECOVERY SUPPORT SERVICES (RSS) FOR INDIVIDUALS WITH OPIOID USE DISORDER (OUD) WHO ARE LIVING IN NIAGARA AND GENESEE COUNTIES, NY, WHERE - ACCORDING TO THE NEW YORK STATE DEPARTMENT OF HEALTH - OPIOID BURDEN IS AMONG THE HIGHEST IN THE STATE. WE WILL PRIORITIZE ENGAGEMENT OF INDIVIDUALS LIVING IN RURAL AREAS IN THE TWO COUNTIES, AS WELL AS THOSE WITH A HISTORY OF CRIMINAL JUSTICE SYSTEM INVOLVEMENT. OUR FOCUS POPULATION INCLUDES PEOPLE LIVING WITH OUD FROM DIVERSE BACKGROUNDS. WE ANTICIPATE THAT 81% OF OUR MATCONNECT PATIENTS WILL BE WHITE, 7% BLACK, AND THE REMAINDER EITHER BIRACIAL OR OF OTHER RACES. WE ANTICIPATE 4% OF PATIENTS WILL BE HISPANIC. WE HAVE INITIATED OUTREACH TO THE TONAWANDA INDIAN RESERVATION OF THE TONAWANDA SENECA NATION, AND ARE CAREFULLY ASSESSING HOW WE CAN WORK TOGETHER TO SUPPORT THEIR OUD NEEDS IN A CULTURALLY SENSITIVE AND APPROPRIATE WAY. AS SUCH, WE EXPECT A SMALL PERCENTAGE OF OUR PATIENTS WILL BE FROM THIS COMMUNITY. THROUGH OUR MATCONNECT PROGRAM, HHS WILL HIRE THREE PRESCRIBERS WHO WILL PROVIDE MOUD, INCLUDING BUPRENORPHINE, SUBOXONE, AND VIVITROL. WE WILL OFFER SAME-DAY INDUCTION ASSESSMENTS, MOUD PRESCRIPTIONS, AND INSTRUCTIONS FOR A HOME INDUCTION, AS WELL AS SERVE AS A RESOURCE FOR ONGOING MOUD TREATMENT. OUR PRESCRIBERS WILL WORK COLLABORATIVELY WITH EACH PATIENT, ALONG WITH HHS' COUNSELING STAFF AND STATE-CERTIFIED PEER SPECIALIST TO INTEGRATE MOUD WITH COMPREHENSIVE PSYCHOSOCIAL SERVICES, COUNSELING, BEHAVIORAL THERAPIES, RSS, AND OTHER CLINICALLY APPROPRIATE SERVICES THAT ARE PROVIDED IN ALIGNMENT WITH EACH PATIENT'S NEEDS AND RECOVERY GOALS. OVERALL, OUR PROGRAM WILL OFFER MOUD AND INDIVIDUALIZED RSS TO 950 INDIVIDUALS LIVING WITH OUD IN OUR TWO-COUNTY REGION, INCLUDING 100 IN YEAR 1, 175 IN YEAR 2, 200 IN YEAR 3, 225 IN YEAR 4, AND 250 IN YEAR 5. OUR GOALS AND MEASURABLE OBJECTIVES INCLUDE: (1) INCREASE ACCESS TO MOUD AND RSS FOR INDIVIDUALS IN NIAGARA AND GENESEE COUNTIES VIA THE FOLLOWING OBJECTIVES: 1.1: ENGAGE 950 INDIVIDUALS IN OUR PROGRAM OVER THE FIVE YEAR GRANT PERIOD; 1.2: 80% OF INDIVIDUALS WILL RECEIVE MOUD SERVICES WITHIN FIVE BUSINESS DAYS AFTER REFERRAL; 1.3: 80% OF INDIVIDUALS SERVED WILL MEET WITH THE PEER SPECIALIST WITHIN 48 BUSINESS HOURS OF MATCONNECT ENGAGEMENT; AND 1.4: 75% OF PATIENTS WHO ENGAGE IN MOUD WILL ALSO BE ENGAGED IN HHS' INDIVIDUAL, GROUP, AND/OR FAMILY COUNSELING SERVICES WITHIN TWO WEEKS OF ENROLLMENT. (2) DECREASE ILLICIT OPIOID USE AND PRESCRIPTION OPIOID MISUSE AMONG INDIVIDUALS WE SERVE THROUGH THE PROVISION OF EVIDENCE-BASED, FDA-APPROVED MOUD VIA THE FOLLOWING: 2.1: 80% OF INDIVIDUALS SERVED WILL IMPROVE THEIR QUALITY OF LIFE AND RECOVERY CAPITAL AFTER 3 MONTHS OF ENGAGEMENT; AND 2.2: 75% OF PEOPLE SERVED WILL REDUCE THEIR MISUSE OF OPIOIDS AFTER SIX MONTHS. (3) REDUCE ACCIDENTAL OVERDOSE EVENTS FROM ILLICIT OPIOID USE AND PRESCRIPTION OPIOID MISUSE AMONG PATIENTS THROUGH THE FOLLOWING OBJECTIVES: 3.1: 100% OF PATIENTS SERVED WILL BE OFFERED TRAINING IN OVERDOSE RESPONSE, ALONG WITH NALOXONE AND FENTANYL TEST STRIPS, WITHIN 2 WEEKS OF ENGAGEMENT; 3.2: WHEN AN ACCIDENTAL OVERDOSE OCCURS, HHS WILL ENGAGE OUR INCIDENT RESPONSE POLICY 100% OF THE TIME; AND 3.3: 65% OF PATIENTS WHO INDICATE IN THEIR BASELINE GPRA INTERVIEW THAT THEY EXPERIENCED AN OVERDOSE IN THE PAST 30 DAYS WILL NOT REPORT EXPERIENCING AN OVERDOSE IN THE LAST 30 DAYS AT THEIR 6-MONTH OR DISCHARGE GPRA INTERVIEW, WHICHEVER COMES FIRST. DATA COLLECTION AND MEASUREMENT PROCEDURES WILL BE DELINEATED IN A COMPREHENSIVE CQI PLAN, INCLUDING THE USE OF STANDARDIZED INSTRUMENTS PER AN ESTABLISHED TIMELINE.

CONGRESSIONALLY DIRECTED SPENDING FOR CONSTRUCTION PROJECTS - HORIZON HEALTH SERVICES, INC. (HHS) IS A FEDERALLY QUALIFIED HEALTH CENTER THAT HAS BEEN PROVIDING ESSENTIAL HEALTHCARE SAFETY NET SERVICES IN A RURAL SETTING FOR THE PAST 45 YEARS. HHS PROVIDES PRIMARY MEDICAL, DENTAL, BEHAVIORAL HEALTH, AND PHARMACY SERVICES TO UNINSURED, UNDERINSURED, AND OTHER VULNERABLE PATIENTS. THE CURRENT SERVICE AREA IS DEFINED PREDOMINANTLY AS ISLE OF WIGHT, SOUTHAMPTON, SUSSEX, AND SURRY COUNTIES IN VIRGINIA. HHS CURRENTLY OPERATES THREE MEDICAL CENTERS (IVOR, SURRY, WAVERLY), ONE DENTAL CENTER (IVOR), AND ONE OPEN-DOOR RETAIL PHARMACY (WAVERLY). LIMITED BEHAVIORAL HEALTH SERVICES ARE CURRENTLY PROVIDED BY ONE LICENSED CLINICAL SOCIAL WORKER, SHARED ACROSS ALL SERVICE LOCATIONS. IN 2023, HHS RENDERED CARE TO 5,188 PATIENTS ACROSS 16,370 VISITS. HHS IS SEEKING TO ENHANCE AND EXPAND THE SERVICES THAT IT CURRENTLY PROVIDES AT ITS WAVERLY MEDICAL CENTER LOCATION IN SUSSEX COUNTY. THE CURRENT BUILDING IS IN DIRE NEED OF REPLACEMENT. THE AGING BUILDING, CONSTRUCTED IN THE 1960’S, IS IN NEED OF MAJOR REPAIRS/RENOVATION. THE INTERIOR IS OUTDATED, AND THE POOR PHYSICAL CONDITION OF THE FACILITY DETERS NOT ONLY SOME PATIENTS BUT HINDERS RECRUITMENT/RETENTION OF QUALIFIED HEALTHCARE PROFESSIONALS AS WELL. THE CURRENT APPROXIMATE 3,000 SQ. FT. BUILDING IS TOO SMALL TO MEET THE GROWING PATIENT DEMAND AND ACCOMMODATING THE INCREASING NUMBER OF PATIENTS/VISITS HAS BECOME CHALLENGING. WAVERLY MEDICAL CENTER HAS SEEN A 13% INCREASE IN PATIENT VISITS OVER THE PAST FIVE YEARS. IN ADDITION, MORE STAFFING HAS BEEN ADDED TO SERVE THE GROWING NUMBER OF PATIENTS. THE ORGANIZATION LOOKED INTO THE POSSIBILITY OF ADDING ON TO THE EXISTING BUILDING BUT FOUND THAT THE CURRENT STRUCTURE COULD NOT SUPPORT A SECOND STORY AND THE SMALL FOOTPRINT OF THE PROPERTY DID NOT ALLOW FOR SINGLE-STORY EXPANSION. CURRENTLY, THIS LOCATION PROVIDES ONLY PRIMARY CARE SERVICES BUT THERE IS A SIGNIFICANT NEED FOR DENTAL AND BEHAVIORAL HEALTH SERVICES IN SUSSEX CO UNTY. THERE ARE CURRENTLY NO OTHER PROVIDERS OF THESE SERVICES WITHIN THE COUNTY. THERE ARE 10,763 PEOPLE IN SUSSEX COUNTY (2021 CENSUS BUREAU) WITHOUT READILY ACCESSIBLE DENTAL OR MENTAL HEALTH SERVICES. 1,875 OF THEM LIVE IN WAVERLY ALONE. THE LACK OF SPACE IN THE CURRENT BUILDING PROHIBITS THE ORGANIZATION FROM ADDING THESE MUCH-NEEDED SERVICES IN THE CURRENT FACILITY. TO ADDRESS THESE GROWING CONCERNS, HORIZON PLANS TO CONSTRUCT A NEW, LARGER WAVERLY HEALTH CENTER THAT WILL PROVIDE MORE SPACE TO ENHANCE ACCESS TO THE EXISTING PRIMARY CARE PRACTICE AND ALLOW THE ADDITION OF DENTAL AND BEHAVIORAL HEALTH SERVICES (TO INCLUDE SUBSTANCE ABUSE SERVICES), ALL UNDER ONE ROOF. HORIZON SERVES A POPULATION ADVERSELY AFFECTED BY POVERTY, UNEMPLOYMENT, LOW EDUCATION/LITERACY LEVELS, GEOGRAPHIC/TRANSPORTATION BARRIERS, AND SOCIAL ISOLATION. IT HAS A HIGH MINORITY POPULATION. ACCORDING TO THE U.S. CENSUS BUREAU, 56.1% OF THE POPULATION IN SUSSEX COUNTY IS BLACK, COMPARED TO THE STATE AVERAGE OF 19.9%. THE RATE OF PERSONS LIVING IN POVERTY IN SUSSEX COUNTY IS SUBSTANTIALLY HIGHER THAN STATE AND NATIONAL AVERAGES. SIMILARLY, SUSSEX COUNTY EXCEEDS BOTH STATE AND NATIONAL UNEMPLOYMENT AND NON-INSURED RATES AND HAS A HIGHER THAN STATE AVERAGE ELDERLY POPULATION. SIMPLY STATED, HHS’ WAVERLY MEDICAL CENTER PROVIDES CARE TO SOME OF THE MOST VULNERABLE PATIENTS IN THE COMMONWEALTH OF VIRGINIA. SUSSEX AND SURROUNDING COMMUNITIES HAVE LONG BEEN FEDERALLY DESIGNATED MEDICALLY UNDERSERVED AREAS AND HEALTH PROFESSIONAL SHORTAGE AREAS. THIS PROJECT WOULD ALLOW HHS THE SPACE NEEDED TO ADD MORE HEALTHCARE PROFESSIONALS AND ADD ADDITIONAL SERVICES… TO REACH MORE PEOPLE AND AFFECT MORE LIVES. CPF/CDS FUNDING WILL BE USED TOWARDS THE SITE WORK AND BUILDING CONSTRUCTION COSTS OF THE NEW WAVERLY HEALTH CENTER. PRELIMINARY DISCUSSIONS WITH ARCHITECTS AND CONCEPTUAL PLANS INDICATE AN IDEAL BUILDING SIZE OF APPROXIMATELY 29,000 SQ. FT. WITH AN ESTIMATED PROJECT COST OF $17,421,322.

CHILDHOOD TRAUMA AND RESILIENCY (CTR) PROGRAM - THROUGH HORIZON HEALTH SERVICES' (HHS') PROPOSED CHILDHOOD TRAUMA AND RESILIENCY (CTR) PROGRAM, HHS WILL INCREASE ACCESS TO EFFECTIVE, EVIDENCE-BASED TRAUMA- AND GRIEF-FOCUSED TREATMENT FOR CHILDREN, ADOLESCENTS, AND THEIR FAMILIES WHO EXPERIENCE TRAUMATIC EVENTS. OUR TARGET POPULATION IS CHILDREN AND ADOLESCENTS AGES 8-17 IN ERIE AND NIAGARA COUNTIES, NY WHO SCREEN POSITIVELY FOR TRAUMA USING THE ADVERSE CHILDHOOD EXPERIENCES QUESTIONNAIRE, ALONG WITH THEIR CAREGIVERS. TO REDUCE DISPARITIES IN TREATMENT ACCESS/OUTCOMES, WE WILL ACTIVELY SEEK TO ENGAGE CHILDREN AND ADOLESCENTS WHO ARE LIVING IN UNDERSERVED AND/OR UNDER-RESOURCED COMMUNITIES WITHIN THE TWO COUNTIES, AND LGBTQI+ ADOLESCENTS. A RECENT SURVEY OF BUFFALO PUBLIC SCHOOL (ERIE COUNTY) STUDENTS REVEALED THAT 1/3 HAVE WITNESSED A VIOLENT CATASTROPHIC EVENT. THROUGH OUR CTR PROGRAM, HHS WILL EXPAND OUR LICENSED CLINICIAN AND PSYCHIATRY CAPACITY, WHILE PROVIDING STAFF EXTENSIVE ADVANCED TRAININGS TO SUPPORT THE DELIVERY OF HIGH QUALITY, EFFECTIVE SERVICES TO MEET OUR COMMUNITIES' GROWING TRAUMA-RELATED NEEDS. WE WILL OFFER 465 CHILDREN AND THEIR FAMILIES A COMPREHENSIVE ARRAY OF EVIDENCE-BASED PRACTICES, PROVIDING DIRECT MENTAL HEALTH AND TRAUMA-RELATED TREATMENT AND SUPPORT SERVICES, OVER THE 5-YEAR GRANT PROGRAM. THIS INCLUDES 65 CHILDREN AND ADOLESCENTS IN YEAR 1, ALONG WITH 100 UNDUPLICATED CHILDREN AND ADOLESCENTS IN YEARS 2-5. OUR GOALS AND OBJECTIVES INCLUDE: (1) IMPROVE ACCESS TO EVIDENCE-BASED TRAUMA TREATMENT FOR CHILDREN AND ADOLESCENTS IN ERIE AND NIAGARA COUNTIES VIA THE FOLLOWING OBJECTIVES: 1.1: BY THE END OF MONTH 4, HIRE 3 CLINICIAN FTES AND A PART TIME (0.6 FTE) CHILD PSYCHIATRIST; 1.2: 100% OF CHILDREN AND ADOLESCENTS SERVED AT OUR THREE CTR CLINIC SITES WILL BE OFFERED A TRAUMA SCREENING USING THE ACE QUESTIONNAIRE WITHIN THREE VISITS; 1.3: REDUCE THE WAIT TIME FOR A CHILD/ADOLESCENT'S FIRST VISIT WITH A CLINICIAN AT EACH CTR SERVICE SITE BY 30% BY THE END OF YEAR 1, BY 50% BY THE END OF YEAR 2, AND BY 75% BY THE END OF YEAR 3; AND 1.4: 100% OF CHILDREN, ADOLESCENTS, AND FAMILIES SERVED WILL BE OFFERED A CONNECTION TO HHS' FAMILY PEER ADVOCATE WITHIN 30 DAYS TO ADDRESS THEIR WRAPAROUND SERVICE NEEDS. (2) RAISE THE STANDARD OF CARE FOR CHILDREN AND ADOLESCENTS EXPERIENCING TRAUMA IN ERIE AND NIAGARA COUNTIES VIA THE FOLLOWING: 2.1: 100% OF CLINICAL STAFF WORKING AT OUR THREE CTR SITE LOCATIONS WILL RECEIVE ADVANCED TRAINING TO DELIVER TWO OR MORE OF OUR SELECTED EBPS BY THE END OF THE FIVE-YEAR GRANT PERIOD; 2.2: AT THE END OF EACH YEAR OF THE GRANT, THE PROJECT DIRECTOR WILL IMPLEMENT AN ASSESSMENT OF FIDELITY FOR EACH OF OUR SELECTED EBPS; 2.3: 100% OF CHILDREN, ADOLESCENTS, AND FAMILIES ENROLLED IN CTR WILL BE SERVED USING ONE OR MORE OF OUR SELECTED EBPS; AND 2.4: PROVIDE FOUR EDUCATIONAL SESSIONS TO EXTERNAL PARTNERS DURING EACH YEAR OF THE GRANT PROGRAM ON THE IMPACT OF TRAUMA AND HOW TO IDENTIFY/REFER CHILDREN AND ADOLESCENTS IN NEED OF SUPPORT. (3) REDUCE THE IMPACT OF TRAUMA ON THE WELLBEING OF CHILDREN AND ADOLESCENTS SERVED BY OUR CTR PROGRAM BY ACCOMPLISHING THE FOLLOWING OBJECTIVES: 3.1: AFTER 6 MONTHS OF CTR ENGAGEMENT, 60% OF CHILDREN AND ADOLESCENTS WHO SCREEN POSITIVELY ON THE SCREEN FOR CHILD ANXIETY RELATED DISORDERS WILL HAVE A DECREASE IN THEIR ANXIETY-BASED SYMPTOMS AND BEHAVIORS ASSOCIATED WITH TRAUMA; 3.2: 60% OF CHILDREN AND ADOLESCENTS SERVED (AGES 11+) WHO SCREEN POSITIVELY ON THE PATIENT HEALTH QUESTIONNAIRE FOR ADOLESCENTS WILL HAVE A DECREASE IN THEIR DEPRESSION-RELATED SYMPTOMS AFTER 6 MONTHS OF ENGAGEMENT WITH CTR; 3.3: 100% OF THE FAMILIES OF CHILDREN AND ADOLESCENTS WHO WE SERVE THROUGH CTR WILL BE OFFERED FAMILY THERAPY USING ONE OF OUR EBPS WITHIN ONE MONTH; AND 3.4: 80% OF CHILDREN/ADOLESCENTS ENROLLED WITH CTR WILL RETURN TO STABLE/BASELINE RISK BY THE TIME OF THEIR PLANNED DISCHARGE. DATA COLLECTION AND MEASUREMENT PROCEDURES WILL BE DELINEATED IN A COMPREHENSIVE CQI PLAN, INCLUDING THE USE OF STANDARDIZED TOOLS.

SUBSTANCE ABUSE-FREE EDUCATION/INTERVENTION & REFERRAL (SAFER) PROGRAM - THROUGH HORIZON HEALTH SERVICES' (HHS) PROPOSED SUBSTANCE ABUSE-FREE EDUCATION/INTERVENTION & REFERRAL (SAFER) PROGRAM, HHS WILL EXPAND AND ENHANCE ACCESS TO THE EVIDENCE-BASED SBIRT PUBLIC HEALTH MODEL FOR ADOLESCENTS AND YOUNG ADULTS IN MIDDLE AND HIGH SCHOOLS AS WELL AS COLLEGE TO REDUCE UNDERAGE DRINKING, OPIOID, AND OTHER SUBSTANCE USE AND THE CONSEQUENT NEGATIVE HEALTH IMPACTS. OUR FOCUS POPULATION IS WESTERN NEW YORK ADOLESCENTS AND YOUNG ADULTS AGED 10-25 - WITH THE MAJORITY FALLING BETWEEN AGES 12-21 - IN THE ERIE, GENESEE, AND NIAGARA COUNTIES CATCHMENT AREA WHO ARE PROVIDED SERVICES AT OUR NEW YORK STATE (NYS) OFFICE OF MENTAL HEALTH-LICENSED SCHOOL-BASED CLINICS. TO REDUCE DISPARITIES IN TREATMENT ACCESS AND OUTCOMES, WE WILL ACTIVELY SEEK TO ENGAGE ADOLESCENTS AND YOUNG ADULTS FROM UNDERSERVED AND MARGINALIZED POPULATIONS INCLUDING LGBTQ+. RECENT DATA FROM THE NYS YOUTH RISK BEHAVIORAL SURVEILLANCE SYSTEM SHOWS 23% OF HIGH SCHOOLERS REPORTED DRINKING ALCOHOL IN THE PAST MONTH AND IN ERIE COUNTY, ONE DISTRICT RELATES THAT >10% OF THEIR HIGH SCHOOLERS REPORT REGULARLY VAPING. HHS RECOGNIZES THREE MAJOR PROBLEMS/AREAS OF NEED AMONG THE FOCUS POPULATION IN OUR CATCHMENT AREA: 1) RATES OF ALCOHOL AND OTHER DRUG USE (AOD) AMONG ADOLESCENTS AND YOUNG ADULTS ARE RISING; 2) THERE IS A LACK OF ACCESS TO TIMELY AOD INTERVENTION AND TREATMENT BY AN ADEQUATE AND CULTURALLY-AWARE BEHAVIORAL HEALTH WORKFORCE; AND 3) RATES OF POOR OUTCOMES ASSOCIATED WITH ADOLESCENT AND YOUNG ADULT AOD ARE INCREASING SUCH AS PERSISTENT ALCOHOL AND SUBSTANCE USE DISORDERS IN ADULTHOOD. OUR GOALS AND OBJECTIVES - ALIGNED WITH THE AFOREMENTIONED AREAS OF NEED - INCLUDE: 1) INCREASE THE NUMBER OF ADOLESCENTS AND YOUNG ADULTS WHO ARE SCREENED WITH AN EVIDENCE-BASED TOOL FOR UNDERAGE DRINKING, OPIOID USE, AND OTHER SUBSTANCE USE + TOBACCO. 2) IMPROVE TIMELY ACCESS TO AND AVAILABILITY OF EVIDENCE-BASED, CULTURALLY APPROPRIATE AOD INTERVENTION AND TREATMENT SERVICES FOR SAFER PARTICIPANTS. 3) REDUCE NON-DEPENDENT ALCOHOL AND SUBSTANCE USE BEFORE IT RESULTS IN AOD DISORDERS THAT CONTINUE INTO ADULTHOOD, POTENTIALLY CAUSING A MULTITUDE OF HEALTH AND SOCIAL PROBLEMS. THROUGH OUR SAFER PROGRAM, HHS WILL AUGMENT OUR LICENSED SCHOOL-BASED CLINICIAN CAPACITY AND PROVIDE EVIDENCE-BASED TRAINING TO SUPPORT THE DELIVERY OF SBIRT SCREENINGS AND SERVICES TO MEET OUR CATCHMENT AREA'S GROWING AOD NEEDS. WE WILL OFFER 900 ADOLESCENTS AND YOUNG ADULTS OVER 5 YEARS SCREENING FOR AOD, AND POSSIBLE CO-OCCURRING MENTAL HEALTH CONDITIONS, UTILIZING VALIDATED SCREENING TOOLS. FOR ADOLESCENTS AND YOUNG ADULTS WHO SCREEN POSITIVE, BRIEF INTERVENTION WILL BE PROVIDED WHICH EMPLOYS MOTIVATIONAL INTERVIEWING TECHNIQUES TO INCREASE INSIGHT AND AWARENESS ABOUT SUBSTANCE USE TO INSPIRE BEHAVIOR CHANGE. REFERRAL TO TREATMENT MAY BE INDICATED FOR INDIVIDUALS PRESENTING WITH AOD BEYOND WHAT THE SCHOOL-BASED CLINIC CAN SUPPORT. FOR ADOLESCENTS AND YOUNG ADULTS REFERRED TO TREATMENT, MULTIPLE EVIDENCE-BASED PRACTICES MAY BE APPLIED GIVEN EACH INDIVIDUAL'S UNIQUE DIAGNOSIS(ES) AND TREATMENT PLAN. IN ADDITION TO SBIRT SERVICES PROVIDED BY CLINICIANS, ADOLESCENTS AND YOUNG ADULTS WILL HAVE ACCESS TO A CASE MANAGER TO COORDINATE WRAPAROUND SUPPORTIVE SERVICES, A FAMILY LIAISON TO ASSIST FAMILIES AS THEY CONTEMPLATE AND APPROACH TREATMENT AS WELL AS WITH THEIR CULTURAL/LINGUISTIC NEEDS, AND YOUTH PEER SUPPORT THROUGH A COMMUNITY-BASED PARTNERSHIP. THE SAFER PROGRAM WILL PLACE SIGNIFICANT EMPHASIS ON OUTREACHING TO UNDERSERVED/MINORITY SEGMENTS OF OUR CATCHMENT AREA TO OFFER SBIRT SERVICES IN ADDITIONAL ADOLESCENT- AND YOUNG ADULT-SERVING SETTINGS OVER THE COURSE OF THE PROGRAM TO MAXIMIZE HEALTH EQUITY. BY THE END OF SAFER, WE AIM TO EXPAND THE UPTAKE OF SBIRT INTO ROUTINE HEALTHCARE ENCOUNTERS AT OUR PARTICIPATING SITES. DATA COLLECTION/MEASUREMENT PROCEDURES WILL BE DELINEATED IN A COMPREHENSIVE CQI PLAN, INCLUDING THE USE OF STANDARDIZED INSTRUMENTS PER AN ESTABLISHED TIMELINE.

AMERICAN RESCUE PLAN ACT FUNDING FOR HEALTH CENTERS

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

HEALTH CENTER INFRASTRUCTURE SUPPORT

MH ALERT - THROUGH OUR PROPOSED MH ALERT PROGRAM, HORIZON HEALTH SERVICES (HHS) WILL TRAIN ADULT INDIVIDUALS TO: 1) RECOGNIZE MENTAL HEALTH (MH)/SUICIDAL SIGNS/SYMPTOMS; 2) SAFELY DE-ESCALATE CRISIS SITUATIONS; AND, 3) REFER PERSONS-IN-NEED TO COMMUNITY-BASED MH SERVICES AND TREATMENT. OUR POPULATION OF FOCUS TO BE TRAINED (TRAINEES) INCLUDES FACULTY, STAFF, COACHES, AND PARENTS/GUARDIANS AT THREE (3) SCHOOLS; AND, EMPLOYEES AND ADULT PROGRAM PARTICIPANTS AT SIX (6) WORKPLACES. OUR POPULATION BEING IMPACTED BY THE TRAININGS INCLUDES STUDENTS AGED 10-19 AT THE SCHOOLS; AND, EMPLOYEES AND ADULTS/YOUTH WITH WHOM TRAINEES INTERACT AT THE WORKPLACES. OUR CATCHMENT AREA IS ERIE AND NIAGARA COUNTIES AND WE WILL ACTIVELY SEEK TO ENGAGE ADDITIONAL, DIVERSE SCHOOL, WORKPLACE, AND COMMUNITY-ORGANIZATION PARTNERS THROUGHOUT THE 3-YEAR PROGRAM. A RECENT, MASS SHOOTING INCIDENT WITHIN OUR CATCHMENT AREA HAS INCREASED WHAT WERE ALREADY-ELEVATED RATES OF ANXIETY AND OTHER MH SYMPTOMS/INCIDENTS OBSERVED OVER THE LAST SEVERAL YEARS. CONCURRENTLY, THERE IS A SHORTAGE OF RESOURCES IN ENVIRONMENTS WHERE NEED IS THE GREATEST WITH 62% OF SCHOOLS IN ERIE COUNTY REPORTING NO PREVENTION PROGRAMMING AND AN UPTICK IN REQUESTS RECEIVED BY HHS FOR WORKPLACE PROGRAMS. TO ADDRESS THE NEED, HHS WILL OFFER 1,000 ADULTS MH AWARENESS TRAINING USING THE FOLLOWING UN-MODIFIED EVIDENCE-BASED PRACTICES (EBP): QUESTION, PERSUADE, REFER (QPR), AN EBP TO REDUCE SUICIDAL BEHAVIORS AND SAVE LIVES BY PROVIDING PROVEN SUICIDE PREVENTION TRAINING, AND MENTAL HEALTH FIRST AID (MHFA), AN EBP TRAINING COURSE THAT TEACHES PARTICIPANTS ABOUT MH/SUD AND HOW TO INTERVENE. OUR GOALS AND OBJECTIVES INCLUDE: (1) INCREASE ACCESS TO INFORMATION/EDUCATION ABOUT MH DISORDERS AND SUICIDE PREVENTION THROUGH EVIDENCE-BASED TRAININGS: 1.1. IDENTIFY FOUR QUALIFIED STAFF TO CONDUCT TRAININGS; 1.2-1.3. FOUR QUALIFIED STAFF BECOME CERTIFIED QPR GATEKEEPER INSTRUCTORS, AND CERTIFIED MHFA INSTRUCTORS; 1.4. ALL ENTITIES SUBMITTING LETTERS OF COMMITMENT WILL HOST QPR TRAININGS BY OUR CERTIFIED INSTRUCTORS RESULTING IN APPROXIMATELY 18 GROUPS OF 20 TRAINEES FOR AN APPROXIMATE TOTAL OF 365 INDIVIDUALS TRAINED ANNUALLY (PRORATED TO 270 FOR YEAR 1); 1.5 ALL PARTNERS SUBMITTING LETTERS OF COMMITMENT WILL BE OFFERED FULL-DAY MHFA TRAINING FOLLOWING COMPLETION OF QPR TRAINING; 1.6. FOLLOWING TRAININGS, 100% OF EXIT SURVEYS RECEIVED BACK WILL REPORT INCREASED KNOWLEDGE OF SUBJECT MATTER. (2) IMPROVE LINKAGE/CONNECTION TO MH TREATMENT/SERVICES/RESOURCES FOR POPULATIONS IMPACTED BY TRAININGS: 2.1. DURING QPR TRAININGS, 100% OF TRAINEES WILL BE GIVEN CONTACT INFORMATION FOR COMMUNITY-BASED TREATMENT/SERVICES/RESOURCES TO DISCUSS WITH AND DISTRIBUTE TO THE POPULATION IMPACTED AS THEY OBSERVE MH SIGNS/SYMPTOMS. 2.2. CULTIVATE AND ACTIVELY MAINTAIN RELATIONSHIPS/COMMUNICATION WITH CURRENT/NEW SCHOOLS, WORKPLACES, AND COMMUNITY-BASED ORGANIZATIONS TO OPTIMIZE USE OF TREATMENT REFERRAL MECHANISMS. DATA COLLECTION AND MEASUREMENT PROCEDURES WILL BE CONDUCTED ON A QUALITY-TESTED, SECURE DATA MANAGEMENT SYSTEM WITH REPORTING OCCURRING COMMENSURATE WITH THE INDICATED TIMELINE.

ARRA - CAPITAL IMPROVEMENT PROGRAM

FY 2020 EXPANDING CAPACITY FOR CORONAVIRUS TESTING (ECT)

ARRA - INCREASE SERVICES TO HEALTH CENTERS

FY 2023 EXPANDING COVID-19 VACCINATION

FY 2020 CORONAVIRUS SUPPLEMENTAL FUNDING FOR HEALTH CENTERS

FY 2023 BRIDGE ACCESS PROGRAM

ESTABLISHMENT OF CCBHC SERVICES