Ecosystem Description Health Care Safety Net Ecosystem Description

Department of Mental Health Primary funder of public sector treatment services for mental health, substance abuse and developmental disability disorders Historically underfunded in respect to mission and need, frequently first to be cut Over past two decades has become almost a totally Medicaid funded system Visionary and progressive leadership, well respected Extremely good position currently with Mo Health Net

Missouri Coalition for Community Behavioral Health Care 30 member agencies and 2 associate member agencies (5 substance abuse only) Significant variation between agencies based on size, geographic location, services (above core) provided and population characteristics Serves as liaison/advocate with governor, legislature and DMH on behalf of members Excellent partnership with DMH and Director Established on a “all for one and all for one” founding principle of supporting member agencies. Provides necessary information to members

Behavioral Health Network of Greater St. Louis (board) 29 agencies represented including: 5 hospital systems (SSM, St. Anthony, Mercy, BJH and the PSC) 12 behavioral health providers (IC, PfP, BJC, Crider, Comtrea, Great Circle, Hopewell, Adapt) 3 health centers FQHC’s (Grace Hill, Peoples Family Care) 3 youth serving providers (Youth in Need, Maternal Child & Family Coalition, Epworth) 3advoacy organizations (NAMI, MHA, NCADA) 1 county tax authority (Children’s Resource board of St. Charles County) Behavioral Health Response (regional crisis service) Regional Health Commission DMH (ex officio) 48 additional agencies represented on adult advisory board

BHN (cont.) Product of 4 year study focused on planning and coordination of the public sector behavioral health system sponsored by the Regional Health Commission (Eastern Region Behavioral Health Initiative 2006-2010) BHN successes (hospital linkage, bridges to care, housing collaborative, longevity) Will continue to be primary platform for increasing access, efficiency, effectiveness & accountability of system of care Anticipate increased pressure to collect and share system-wide data (accountability)

Regional Health Commission Created as response to a crisis due to closing of last public hospital in St. Louis (Regional) in 2001by Civic Progress task force which recommended a commission including government, providers & community members to ensure health care access to the under and un-insured 18 appointed commissioners (3 mayor, 3 county exec., 3 community, 2 governor, 2 hospital, 2 FQHC, 2 advisory board & 1local medical schools) The commission is informed by at 30 member provider advisory board and 30 member community board Has served as an effective convening body for addressing immediate issues but also in truly protecting the health care safety net, particularly in absence of Medicaid expansion

Integrated Health Network Created in 2003 in response to a recommendation from the RHC to create a permanent regional network of safety net community health providers to coordinate and integrate care to the medically underserved. 11 member board including health centers (People’s, FCHC, Grace Hill, Myrtle Hilliard, St. Louis County & Crider); BJH, SLU, St. Louis City and Missouri Primary Care Assn. Similar in mission to BHN, but dues are much higher and, because FQHC’s exist in federal law, there are significant provider benefits that have and continue to be available through this structure

PFP Service Area St. Louis City & County BJC Behavioral Health Hopewell Center Adapt of Missouri Independence Center Queen of Peace Preferred Family Health Bridgeway Behavioral Health Family Care Health Center People’s Health Center Grace Hill Health Center Myrtle Hilliard Davis Health Center

Social Service Agencies Grace Hill Neighborhood Services St. Patrick Center Peter and Paul Community Services St. Louis City Dept. of Human Services St. Louis County Dept. of Human Services St. Louis County Housing Authority St. Louis City Housing Authority St. Louis Area Food Bank Bi-State Development Agency (transportation)

St. Louis Empowerment Center Consumer Run Programs St. Louis Empowerment Center Self-Help Center AA & NA