Magazine article Behavioral Healthcare Executive

Building a New Future Together

Magazine article Behavioral Healthcare Executive

Building a New Future Together

Article excerpt

The afternoon meeting in July 2004 was an informal get-together between two executive directors, who orten met to discuss issues that aftected both of their organizations in Alaska's central Kenai Peninsula. No one would have predicted that a seed plained that day-to build a facility that houses both a community mental health center and a community health center-would become reality just three years later. Even more surprising has been the enthusiasm of both organizations' boards to consider an even more integrated approach to care.

Background

The community menial health organization is Central Peninsula Counseling Services (CPCS), which recently celebrated its 30th anniversary. With 100 employees and a $5 million annual budget, CPCS provides a comprehensive array of clinical and rehabilitation services for seriously emotionally disturbed children and severely mentally ill adults, operates an adult day center for the trail and elderly, and provides around-the-clock psychiatric emergency services.

Central Peninsula Health Centers (CPHC) is a five-year-old federally qualified health center with a $4 million budget and more than 50 employees. CPHC operates Cottonwood Health Center, a primary care clinic, and Aspen Dental Clinic, providing services regardless of patients' ability to pay. The organization particularly focuses on prevention and chronic disease management.

Both CPCS and CPHC serve vulnerable and economically disadvantaged residents of the central Kenai Peninsula in south-central Alaska, a popular tourist destination for outdoor enthusiasts. The central Kenai Peninsula is a large rural area with almost 33,000 residents. Much of the employment is seasonal, unemployment rates are relatively high, and roughly 20% of the population lacks health insurance of any kind. Health status statistics tor the area reveal relatively high rates of chronic health conditions including mental illness.

Historically the relationship between CPCS and CPHC was friendly but limited. In 2004, CPHC secured a grant to provide behavioral health screening and brief intervention services to its medical patients and subcontracted with CPCS to provide these services in the primary care setting. This initial integration of staff and services, albeit relatively modest in scope, served as the foundation for the colocation discussions that followed.

Rationale

For CPCS, colocating with a community health center will provide benefits for both consumers and the organization. With youth and adult mental health programs currently split between two communities 11 miles apart, it is challenging to manage and coordinate services. Families with both child and adult consumers must travel to two separate locations. Psychiatric services are offered primarily at one site, thus limiting access. Maintaining two facilities has increased operational expenses through use of courier services and duplication of support staff, utilities, transportation, and building maintenance costs, which are particularly challenging in the current funding environment.

For CPHC, the new building represents an opportunity to create a healthcare setting optimally responsive to providers' and patients'needs. CPHC currently operates in a rented facility with neither adequate space nor a functional design, and it cannot meet the growing organization's needs.

For both organizations allocation will provide economies of scale and operating efficiencies through shared maintenance, phone system, information technology, and utility costs. Wc also are considering sharing administrative functions, such as human resources or finance. Yet regardless ot the cost savings and increased efficiencies, the most compelling argument tor colocation is that it will create the opportunity for consumers to receive holistic, coordinated care.

A recent study revealed that persons with serious mental illnesses die 25 years younger than the general population, with much of the disparity attributed to inadequate medical care ot chronic physical and mental disabilities. …

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