Abstract
Problem:
In the CNMI, according to a 2019 Maternal and Child Health Jurisdictional Survey, only 21.2 percent of children ages 3 through 17 years with a mental or behavioral condition receive treatment or counseling. Screening practices for mental health conditions among CNMI pediatric primary care providers are inconsistent and vary across individual practicing providers. Similarly, referrals for mental health treatment or services vary based on individual provider knowledge of available service and comfort level.
Goals and objectives:
Goal 1: Enhance the system infrastructure to integrate behavioral health into pediatric primary care:
- Objective 1.1: By June 2023, complete a comprehensive pediatric behavioral health needs assessment.
- Objective 1.2: By December 2022, establish or enhance existing advisory committee for the project.
- Objective 1.3: By June 2023, develop pediatric primary care Standard Operating Procedures (SOPs) that include behavioral health screening, referral, and treatment practices.
- Objective 1.4: By June 2023, establish a Memorandum of Agreement between Advisory Committee agencies/programs.
- Objective 1.5: By December 2023, identify and implement options for telehealth enhancements.
- Objective 1.6: By December 2023, enroll at least 75% of primary care clinics with the CNMI PMHCA project.
- Objective 1.7: By June 2024, increase the percentage of children 0 through 17 years screened for behavioral health concerns by 10% from baseline.
Goal 2: Increase the pediatric primary care workforce capacity and resources to access or provide behavioral health intervention.
- Objective 2.1: By December 2022, recruit 100% of the project staff needed to establish a CNMI pediatric mental health care team.
- Objective 2.2: By June 2022, complete a provider training and technical assistance plan. .
- Objective 2.3: By June 2024, provide training and/or technical assistance to at least 50% of pediatric primary care clinics in the CNMI.
- Objective 2.4: By December 2023, establish an online website/referral database for the CNMI PMHCA
- Objective 2.5: By June 2024, increase the percentage of children ages 0 through 17 years who access needed behavioral health services by 25% from baseline.
Goal 3: Monitor and evaluate project activities for efficiency and sustainability.
- Objective 3.1: By June 2023, complete a project evaluation plan
- Objective 3.2: By June 2023, develop a sustainability plan to ensure that behavioral health integration into pediatric primary care is sustained beyond the duration of this project.
- Objective 3.3: By August 2023, begin monthly reporting of indicators identified on the project evaluation plan.
- Objective 3.4: Beginning June 2023, conduct annual evaluation reviews and develop annual evaluation reports to evaluate progress on objectives and other performance indicators.
Coordination:
The CNMI Pediatric Mental Health Care Access Project will work with HRSA and HRSA Supported technical assistance centers to coordinate with CNMI pediatric primary care providers, mental health treatment and service providers, an advisory committee comprised of diverse membership representative of the community, and other stakeholders for the purpose of establishing a pediatric mental healthcare team to provide consultation, care coordination support, and other support services.
Evaluation:
The Project will assess process, outcome, and impact measures as part of evaluation activities as indicated in the preliminary project evaluation plan submitted with this proposal. Monthly indicator reports and annual evaluation activities will be conducted to ensure continuous quality improvement efforts are implemented for meeting program goals and objectives.