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Appalachia Health News tells the story of our health challenges and how we overcome them throughout the region. 

W.Va. Mental Health Providers Hopeful For New, Sustainable Funding Model

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June Leffler
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West Virginia Public Broadcasting
Southern Highlands Community Mental Health Center operates a "call center" for those needing immediate care.

A mental health clinic in Princeton stays busy year round, but staff have been gearing up for a summer season of selling plants.

“The green house is amazing,” said Crystal Breeden, chief of nursing at Southern Highlands Community Mental Health Center. Breeden said some patients with intellectual needs love to get their hands in the dirt and sell potted flowers to make an extra few bucks.

“You come back next month, you'll see all the hanging plants and the roses. It is a beautiful, beautiful business over here,” Breeden said.

The green house is synonymous with the mental health facility and offers a point of contact to southern West Virginia communities like Mercer, Wyoming and McDowell counties. The clinic offers therapy, crisis support and medication assistance for mental and substance use disorders. Before COVID, about 100 patients a day would visit the clinic.

Breeden said the clinic is meant to be a one stop shop. Patients shouldn't have to travel or wait for care. That's why there’s a primary care clinic next door and a pharmacy on site.

“As they're leaving the building, they can go ahead and pick up their scripts on the way out so that there's not that lull in services,” Breeden said.

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June Leffler
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West Virginia Public Broadcasting
Southern Highlands in Princeton, W.Va. runs a greenhouse known for its poinsettias during Christmas.
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June Leffler
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West Virginia Public Broadcasting
The greenhouse at Southern Highlands has provided flowers to the Princeton community for decades.

Southern Highlands has been able to offer more services to a wider range of clients thanks to millions of dollars in grants. However, grants come and go, said CEO Lisa Jones.

“It's often hard to get enough money into the service lines to be able to provide all of the services that are necessary,” Jones said.

Mental health providers like Jones are optimistic to take part in a more sustainable, federal funding model that will soon roll out in West Virginia due new state legislation.

The Certified Community Behavioral Health Clinic, or CCBHC, model certifies clinics that meet evidence-based, quality standards for a “patient centered” approach. The feds expect these clinics to provide the best care in a timely manner for even the most severe cases. In turn, the model offers better Medicaid reimbursement, so clinics can afford to reach those higher benchmarks.

“We have several vacant nurse positions. We have some vacant therapy positions, direct care, case management, there's hardly any areas that the vacancy problem doesn't touch,” Jones said. “We're so hopeful that this is gonna help, you know, put us back in the game and get our positions filled and to be able to serve even more people then we're able to serve now.”

CCBHC outcomes

The federal funding model is new to the Mountain State, but it first rolled out in a handful of states five years ago. Since then, the model’s been studied by federal agencies and the National Council on Mental Wellbeing.

States like Missouri, New York and Nevada report that these clinics have been able to expand services, serve more clients and hire dozens more workers.

These clinics are also offsetting burdens for hospitals and law enforcement agencies. States report these patients are less likely to have to go to the emergency room, and that clients with criminal records are less likely to be arrested.

Those are outcomes state lawmakers like. Sen. Ryan Weld, R-Brooke, sponsored the legislation that would get this model rolling in the Mountain State.

“In the northern panhandle we’ve had a loss of inpatient and intensive outpatient mental health treatment,” Weld said.

As a former prosecutor, Weld said too often cops and deputies are being called to respond to those in mental health crises. That’s not good for cops or residents.

“This model will help alleviate some of that burden from law enforcement from having to transport those individuals as well as get them the services they need,” Weld said.

CCBHC expectations

The CCBHC model can provide better outcomes because the model demands that clinics meet rigorous standards their counterparts don’t have to meet.

One thing clinics must provide, that Weld championed to fellow lawmakers, is same day care for people having a mental health crisis.

Back at Southern Highlands, the clinic already has a ten bed facility for this purpose.

“The one thing at the crisis unit is it's not a one size fits all approach, because just what works for one person doesn't work for everyone,” said Matt Huffman, the clinic’s substance use disorder officer. “So you can't really say what a crisis looks like, because it's going to look different for every single person.”

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June Leffler
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West Virginia Public Broadcasting
Dr. Alina Vrinceanu-Hamm is Southern Highlands' medical director.
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June Leffler
/
West Virginia Public Broadcasting
Matt Huffman runs substance use disorder services at Southern Highlands.

The standards clinics must meet are extensive. Equity and accessibility are key measures. Clinics can’t turn someone away who’s unable to pay. Clinics must also provide telehealth, at-home and non-traditional hours options.

Clinics must also abide by evidence-based practices. For instance, these clinics should offer medication-assisted treatment, which is effective in preventing overdose deaths, recidivism and infectious disease. Detox alone is not enough.

“It's been a lot more about the quantity, now it's going to be a little bit more about the quality and value based assessment,” said Tina Borich, Southern Highlands' chief clinical officer.

Borich said the clinic uses cognitive behavioral therapy and motivational interviewing to help mental health patients dealing with trauma. She only wants to implement the best practices in her clinic, and this new model will push her to do so.

“What I'm probably most excited about is to allow our staff the opportunity to have that training, and in the end to actually see how we have positive outcomes,” Borich said.

Appalachia Health News Reporter, jleffler@wvpublic.org, 502-377-0438, @june_leffler

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