Problem Addressed: Mental Health and Mental Disorders

Healthy People 2010 Objective: 18

Web Address: thomaselangleymedical.com

SNAPSHOT

The Behavioral Health Department at the Thomas E. Langley Medical Center (TELMC) is a recently created department within this Federally Qualified Health Center that focuses on the mental health needs of the people of rural Sumter County. The program’s mission is to serve all residents regardless of their ability to pay. This is accomplished through grant funding and some billing through Medicare, Medicaid, and private insurance.

THE MODEL

Blueprint: The Behavioral Health Department serves all residents of Sumter County, Florida, regardless of ability to pay. The staff for this department consists of a full-time psychologist, two full-time licensed clinical social workers, a part-time psychologist, a case manager, and an office manager. Behavioral Health receives referrals from many specialists ranging from pediatricians to gerontologists. The department addresses all mental/behavioral health issues of people in all age groups within the catchment area, including a large Hispanic population.

The services are delivered on-site at TELMC, in a building designated for Behavioral Health Services. The department provides psychological evaluation services, traditional therapeutic services, specialized programs, and services for attorneys and courts. The psychological evaluation services include psychological testing, intellectual testing, psycho-educational testing, and alcohol and drug addiction evaluations. The traditional therapeutic services include child, adolescent, and geriatric therapy; employee assistance programs; and coping/life management skill development. Specialized programs address attention deficit hyperactivity disorder (ADHD), pain management, loss and grief issues, stress management, domestic violence, and sexual abuse. It also provides social skills training, addictions education and counseling, cognitive assistance programs, random drug screening, and rapid saliva alcohol testing. Additionally, the program provides services for attorneys and courts including competency determinations, diversion programs, custody evaluations, identifying substance abuse, and making treatment recommendations. Group therapy, marital counseling, family therapy, conjoint therapy, pain management group, parenting and educational seminars, couples counseling, teen group, and children’s group round out the complement of behavioral health services offered by TELMC.

The department coordinates the center’s participation in the National Health Disparities Depression Collaborative. The Collaborative allows the center to share data and exchange best practices with other centers throughout the country. The Collaborative is an ongoing endeavor to ensure the highest quality of patient care.

Also, there are many outreach endeavors that are ongoing to serve the entire Sumter County population. Sumter County is approximately 546 square miles with a total population of just over 50,000. Many of the residents are seasonal¾from retired persons who live in the area from October to April to migrant workers who stay through the citrus harvest season. The median income falls within the lower middle class range.

Making a Difference: To measure the success of the program, the following indicators are monitored: psychologists’ productivity, decrease in the number of “no-shows” from baseline data, number of network panels in which staff are accepted for third-party payment, and patient satisfaction. Other quality-related indicators include quality assurance chart reviews, physician review for medical necessity as appropriate, and annual internal quality council review accessing progress on the above measures and developing new goals.

Beginnings: Behavioral Health began in August 2000 and was fully implemented in February 2001. It started in response to several primary care physicians’ recognition of mental health problems in many of their established patients. Before it was established, these mental health needs had to be addressed by outside referrals, which limited access to care and follow-up and resulted in inadequate treatment of behavioral health problems.

Challenges and Solutions: Behavioral Health has been successful in its endeavors to integrate primary health care and mental health, and to sustain itself financially. Lack of funds, however, has prevented expansion of the program to meet all of the needs of the community. Behavioral Health’s pursuit of increased access is complicated in part by the fact that Florida does not require insurance companies to include mental health coverage as part of their plans. Also, of the companies that do provide coverage, it is often difficult for new professionals and organizations to become a part of the panel of licensed professionals permitted to be reimbursed for services provided. During the initial year, TELMC made a commitment to absorb any losses. Behavioral Health is applying for a grant to provide services to children and families who are affected by domestic abuse. In addition, Behavioral Health is seeking funding through a hospital-based foundation for equipment and direct services for patients and their families who cannot afford care. Behavioral Health is marketed to new clients through newspapers, its web page, and community involvement.

PROGRAM CONTACT INFORMATION

William J. Kuzbyt, Psy.D.

Behavioral Health

1489 W. Hwy 301

Sumterville, FL 33585

Phone: (352) 793-5900 ext. 3046

Fax: (352) 793-3959

E-mail: bkuzbyt@hotmail.com