Funded Projects

Problem:

Nevada has persistent workforce shortages in nursing, medicine, and behavioral health. Our health professionals are geographically maldistributed across the state, such that 1.9 million Nevada residents are in a health professional shortage area (HPSA). The maldistribution of healthcare professionals in NV is such that even 64.2% of Clark County residents (our most populous county and home to Las Vegas) reside in a HPSA. Our state mental health workforce is even more dire. Three million Nevadan (94.5% of state population) reside in a Mental Health Workforce Shortage area. As of 2021, 100% of Clark County 2.4 million residents reside in a Mental Health Workforce Shortage Area. The state health workforce shortages are especially severe for youth patients. State licensure data from 2021 indicates that our state has 11.9 pediatricians per 100,000 population, and it is estimated that our state needs 214 additional pediatricians to meet the US average. Similarly, our state has 30.4 family medicine physicians per 100,000 population. An additional 74 family medicine physicians are needed to meet the national average. Our state dearth of physicians, nurses, and behavioral health clinicians are the foundation of barriers to care our youth face. Families who are undocumented citizens (roughly ? of our target population) face additional barriers related to lack of insurance benefits. Additionally, state data indicate 24% of youth and families do not have access to reliable high-speed internet. This is a unique barrier to care within our rural/frontier communities, which inhibits the ability to access telehealth resources. Incorporating school-based health clinic mental health supports in a culturally and linguistically appropriate way will mitigate some of the barriers to care. Engaging with our 13 rural critical access hospitals will also alleviate some barriers to care by providing mental health support in home communities.

Goals and Objectives:

• Goal 1: Expand pediatric mental health integration to SBHC
• Goal 2: Expand to rural critical access hospitals
• Goal 3: Create education center: ECHO clinic and asynchronous learning library
• Goal 4: Create Bridge Clinic

Methodology:

The Nevada Department of Child and Family Services (DCFS) has been the HRSA PMHCA awardee for the state since 2018. The NV PAL program will partner with and build upon the experiences DCFS has had to date. Specifically, the UNLV team will expand child psychiatry access program services to school-based health centers and rural critical access hospitals, two populations not included in the state-funded scope of work. The UNLV team will also build upon DCFS educational programming and will create a Project Extension for Community Health Outcomes (ECHO) clinic focused on child & adolescent mental health and will expand DCFS asynchronous training library to focus on topics relevant to the primary care community.

Coordination:

Care coordination supports both psychoeducation to patients and families in a culturally and linguistically appropriate manner. NV PAL aims to improve the knowledge, skills and comfort of primary care clinicians who serve youth with mental and behavioral health diagnoses.

Evaluation:

The University of Nevada, Las Vegas (UNLV), including the Office of Sponsored Programs, is well-equipped to monitor all regulatory and financial aspects of the project. The Kirk Kerkorian School of Medicine (KSOM) at UNLV Department of Psychiatry and Behavioral Health has the capacity to accomplish this project. The Department of Psychiatry and Behavioral Health is experienced in managing and implementing state and federal grant-funded programs, has the faculty expertise to implement goals, and administrative expertise to ensure proper data collection, evaluation and reporting.