A Health Home for Individuals with Serious and Persistent Mental Illnesses and Addictions
Many of Meridian’s patients face considerable challenges addressing their complex health needs. Individuals with severe mental illnesses and substance use disorders are particularly likely to have co-morbid illnesses that are also chronic in nature. Successful management requires that both sets of problems get equal and coordinated attention if the current trend for premature death and disability for those with mental illnesses and substance use disorders is to bend. Part of the challenge is that the very nature of brain disorders makes disease self-management and accessing appropriate and timely care more difficult for the patients Meridian treats. Of patients currently engaged in treatment, only 40% indicate they have a primary care relationship. The reasons
involve ability to pay, access and transportation problems, difficulties with communication and follow-through related to their mental illness or addiction, and the impact of stigma; many of our patients feel unwelcome or feel their problems are not properly addressed in traditional primary care. Many over-utilize the emergency room for their care, adding cost and providing no continuity of care for chronic conditions. They are likely to have a readmission for failure to adhere to needed post –discharge instructions. These patients average nearly 300 days since their last primary care visit, meaning many have not received physical health services in well over a year.
Meridian proposes and alternate care model wherein Meridian would serve as the Health Home for our patients who currently do not have primary care relationships, whether they are insured or indigent. Being a Health Home allows Meridian to provide both behavioral and physical health care to patients in one location in order to improve their access to care and decrease the negative impact and cost for this high medical risk population. Meridian has not been able to attract federal dollars to our rural (low population) area to support this initiative, but believe an Integrated Health Home Pilot serving both Medicaid and indigent uninsured patients with serious mental illness could be a benefit to these patients and decrease overall State expenditures for their care in this area. At present, the only Medicaid plan addressing the needs of this population is unavailable in Area 3.
The funding requested would support:
- Creation of a primary care clinic at two Meridian locations (including renovation needed)
- Meridian staff would: