Cutler Institute for Health and Social Policy

Population Health and Health Policy

Provision of Specialty Mental Health Services by Rural Health Clinics

1/1/2005 - 1/3/2006
John Gale
Principal Investigator: 
David Hartley
Research Staff: 
John Gale
David Hartley
David Lambert

<p>It has been well established that the primary care system delivers a substantial proportion of mental health services in rural areas, due primarily to the shortage of specialty mental health services. As a result, primary care settings form a major element of the rural MH delivery system.<p>

<p>Rural Health Clinics are an important part of the rural primary care infrastructure with close to 3,500 clinics providing primary care services to rural residents. Since the late 1980's, Rural Health Clinics have be eligible to receive cost-based Medicare and Medicaid reimbursement for the services of clinical psychologists and social workers practicing in these settings. Despite this incentive, few Rural Health Clinics have chosen to do so.<p>

<p>Given the critical need for mental health care in rural areas, this study will explore why more Rural Health Clinics are not providing specialty mental health services. It will do so through an analysis of Rural Health Clinic cost reports to identify all RHCs currently offering specialty mental health services and to analyze the organization characteritics of those offering these services compared to those that are not. We will then interview a subset of those Rural Health Clinics who are offering specialty mental health services to determine how they developed the service, any barriers they have encountered, and how these barriers were overcome.<p>

Start Date: 
Sat, 2005-01-01
End Date: 
Tue, 2006-01-03
Legacy Muskie ID: 

Cutler Institute awarded $600,000 to help youth raised in foster system

Marty Zanghi

USM's Cutler Institute for Health and Social Policy has been awarded a $600,000 grant to help young people raised in Maine's foster system to prepare for college and the workforce.

The money comes from the Annie E. Casey Foundation as part of a $5.4 million national effort aimed at youth who are homeless or in either the foster care or juvenile justice systems.

"Many of these young people have suffered abuse or trauma and were raised in poverty and neglect," said Marty Zanghi, the Cutler Center's youth development director.

The money -- including an expected $400,000 more in matching funds -- will pay for contracted work with agencies in the target areas, starting with the greater Portland area and Penobscot, Kennebec and Somerset counties.

Nationally and in Maine, only about 3 percent of people who grow up in the foster care system achieve a college degree, he said.

"It's dramatically lower than the rate for the general population," Zanghi said. "It's a horrible outcome."

It doesn't have to be that way, though.

"There are young people that overcome these circumstances," he said. "I know people who have master's degrees and Ph.Ds."

The Casey Foundation's national effort is being called the "Learn and Earn to Achieve Potential" (LEAP) initiative.

The initiative is working on partnerships in Maine and nine other areas: Alaska, Arizona, California, Massachusetts, Michigan, Minnesota, Nebraska and New York. In each case, people will adapt two evidence-based models to meet the needs of these youth, including support to address the trauma they may have experienced in their lives.

In Maine, the work will include a pair of successful programs, Jobs for Maine Graduates (JMG) and Jobs for the Future. Results will be carefully tracked, Zanghi said.

After the first year, the program is expected to grow.

"Eventually, the additional help will be available to all children, 14 and over, in the foster care system in the state of Maine," Zanghi said.

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