Integrated Health Care Expansion Program

Central to its mission to enhance the mental health of children and adolescents, in early 2018, The Children's Service Center has expanded its integrated programming services to provide a "medical home" for some of the neediest children in this area. Programmatic services have been added to CSC's current complement of on-site mental health services including primary medical care, The Wright Center and pharmacy services, Genoa Pharmacy. Clients now have access to medical, psychiatric and pharmaceutical treatment in one location.

In the United States, poverty is one of the most widespread and persistent health risks facing children. Of the 5,800 children and adolescents served by the CSC, 85% are currently receiving some form of medical assistance. The connection between better outcomes for those children who receive integrated care (physical and mental) is well documented and has support on the federal level and in the medical community. The primary goal of CSC's Integrated Care Expansion program is to assure better health outcomes by advancing a one-stop location for low-income children to receive behavioral, physical, and pharmaceutical services.

The reasons for CSC's Integrated Care Expansion Program in Luzerne County and surrounding areas are simple and a wealth of research supports the importance of and need for the program.

Specifically:

  • Children with mental and emotional health disorders often improve when their physical health is treated. Findings from the 2009 "Healthy Development: A Summit on Young Children's Mental Health" (Society for Research in Child Development) found that a challenge to parents ability to provide for the mental health needs of their children is lack of "one-stop facilities that provide integrated health care and human services.
  • Behavioral health conditions among children and youth today are occurring at an alarming rate and impact their overall growth and development as well as lead to early morbidity. "Integrated care systems…are critical…and represent an approach to delivering care that comprehensively address the primary care, specialty care, and social support needs of children and youth in a continuous and family-centered manner." (Source: SAMHSA-HRSA, Center For Integrated Health Solutions 2013)
  • Mental and physical disorders are often co-occurring. Integrated health care provides early intervention and continuity of care. Integrated care prevents the risk for long term health problems leading into adulthood. The economic benefit of integrated care is the reduction of cost of long-term health care. (Sources: Integrated Behavioral Health Project; American Psychological Association 2015; Bazelon Center for Mental Health Law 2004; McKinsey & Company 2010)
  • Poverty is one of the most widespread and persistent health risks facing children. In Luzerne County alone, 28.8% of those under 18 live in poverty. (Since 2000, the poverty rate for all children living in Luzerne County has doubled.) Research links child poverty with toxic stress that can "alter gene expression and brain function and contributes to chronic cardiovascular, immune, and psychiatric disorders, as well as behavioral difficulties." Based on these findings, the American Academy of Pediatrics recommends all physicians screen patients for poverty. (Source: American Academy of Pediatrics 2016)

Outcomes

Improvements to clients overall physical and mental health

  • The Integrated Health Care Program will provide: proximity to physician, an element crucial to mental/behavioral patient success; effective medication management and, access to evidenced-based mental health treatment.

Improved management of chronic illness

  • Chronic health issues (e.g., diabetes, obesity, gastroenterology disease) and mental health issues are often co-occurring. Key to improvement is the ability of medical personnel to make referrals to associated professionals. Research supports improved patient success of 40 to 60 percent when coordinated care is the basis of referrals for co-occurring conditions.

Improved school attendance

  • A wealth of research supports the fact that access to health care and improvements to overall health greatly improves school attendance.

Coordinated care that results in prevention of medical emergencies and/or hospitalizations

  • With access to simultaneous medical and mental health intervention, the Integrated Health Care Program will permit CSC's professionals to intervene before issues develop or worsen.

Ability to share data between physician and mental health professionals

  • Perhaps, the single greatest outcome for CSC clients improved health will be the ability to co-locate medical, mental health, and pharmaceutical professionals and improve outcomes through the successful development and integration of a shared electronic medical record for each client receiving integrated services.