Behavioral health goal: Bridge gaps

A woman with complex health needs from Washington state who moved to the Boise area was already connected with a housing coordinator and care management, and was ready to start counseling a week after her arrival.

This is the vision of Certified Community Behavioral Health Clinics put into practice. Idaho has four organizations that received federal and state funds to establish the state’s first CCBHCs, which are designed to provide a comprehensive range of mental health and substance use services to anyone, regardless of their ability to pay. Services through these systems also can include primary care, dental care and other social services as needed.

The health systems are “bridging gaps” in services for those with serious and persistent mental illness and substance use disorders, said Kristen Heller, associate director of behavioral health at Terry Reilly Health Services.

The three other organizations that received grants to create CCBHCs are Heritage Health near Coeur d’Alene, Community Health Association (CHAS) of Spokane — which operates in the Lewiston area — and Family Health Services in Twin Falls.

For the Terry Reilly facility, the grants have allowed the community health clinic to expand its behavioral health capacity. The organization in April opened its new Dearborn clinic in Caldwell that offers counseling in addition to medical, dental, pharmacy, housing and substance use services, and it’s located next to the Treasure Valley 24-hour Crisis Center.

Terry Reilly partners with Pathways, which operates the crisis centers locally, to coordinate admissions and discharges.

“We can walk over there and interact with the patients, and they can walk the patient over after discharge to our Dearborn clinic so we can assist with that referral placed and getting them started with services,” Heller said.

People who may have been experiencing a mental health crisis can also be connected to a primary care doctor or dentist, depending on their need.

A new Trauma and Resilience Center is slated to open soon on McClure Avenue in Nampa. This center will provide counseling, with spaces group therapy and play therapy for children as well as outdoor spaces.

With the grants, the organization also hired more substance use disorder specialists and increased staffing in its medication-assisted treatment program. Medication-assisted treatment, known as MAT, is used to treat opioid use disorder. Those in the program also have the option to enroll in counseling to help them maintain sobriety, Heller said.

At a recent event to commemorate International Overdose Awareness Day, two Idaho women spoke of their experiences with addiction and both credited medication-assisted treatment with their ability to enter recovery.

“It allowed me to get my life back in order,” Shantel Stone said of the program. “I don’t have any cravings, I can focus on my goals. It gave me my life back.”

The CCBHCs are required to provide nine services: crisis services, treatment planning; screening, assessment, diagnosis and risk assessment; outpatient mental health and substance use services, targeted case management, outpatient primary care screening and monitoring, community-based mental health care for veterans; peer, family support and counselor services; and psychiatric rehabilitation services.

This model of care was originally implemented in 2017 in an eight-state “demonstration program,” according to the National Council for Mental Wellbeing. Two more states were added to the demonstration in 2020.

In October 2022, the Biden administration announced the program would be implemented nationwide and made planning grants available.

These CCBHCs are serving an estimated 2.1 million people in the U.S., the National Council for Mental Wellbeing said. The council reports that those who receive care at CCBHCs experience a 72% reduction in hospitalization, 40.7% reduction in homelessness and 60% less time in jail.

Leaders of the four CCBHCs in Idaho meet monthly to discuss how care is being delivered, how to collaborate, and ensure everyone is “on the same page” when it comes to building up services, Heller said.

In August, Division of Behavioral Health Administrator Ross Edmunds told the Idaho Board of Health and Welfare that these CCBHCs are “taking away the fracture that exists and creating some stability in a network of those.”

The clinics are aimed at providing care in underserved communities. Terry Reilly’s grant was to expand its offerings in Canyon County, but it has expanded its services at all of its locations, Heller said.

Anyone, regardless of residence, insurance status or ability to pay, may access these services at any of the clinics around the state.

At Terry Reilly, Heller said, front desk staff and medical providers are all trained to be able to refer patients to any of the services offered by the organization.

“Really, if somebody’s like, ‘I need help and I don’t know where to start,’ your first step is in our front doors,” Heller said.

Guido covers Idaho politics for the Lewiston Tribune, Moscow-Pullman Daily News and Idaho Press of Nampa. She may be contacted at lguido@idahopress.com and can be found on Twitter @EyeOnBoiseGuido.