Provision of Mental Health Services by Critical Access Hospital-Based Rural Health Clinics

Authors

John A. Gale MS, University of Southern Maine, Maine Rural Health Research CenterFollow
Zachariah T. Croll MPH, University of Southern Maine, Maine Rural Health Research CenterFollow
Nathan First LCSW, MSW, MA, University of Southern Maine
Sara Kahn-Troster MPH, University of Southern Maine, Maine Rural Health Research CenterFollow

Document Type

Briefing Paper

Publication Date

6-1-2020

Keywords

MRHRC, behavioral health, Rural Health Clinics, RHC, critical access hospitals, rural, mental health, health policy

Abstract

Residents of rural communities face longstanding access barriers to mental health (MH) services due to chronic shortages of specialty MH providers, long travel distances to services, increased likelihood of being uninsured or under-insured, limited choice of providers, and high rates of stigma. As a result, rural residents rely more heavily on primary care providers and local acute care hospitals to meet their MH needs than do urban residents. This reality highlights the importance of integrating primary care and MH services to improve access to needed care in rural communities. Critical Access Hospitals (CAHs) are ideally positioned to help meet rural MH needs as 60 percent manage at least one Rural Health Clinic (RHC). RHCs receive Medicare cost-based reimbursement for a defined package of services including those provided by doctoral-level clinical psychologists (CPs) and licensed clinical social workers (LCSWs).

This briefing paper explores the extent to which CAH-based RHCs are employing CPs and/or LCSWs to provide MH services, describes models of MH services implemented by CAH-based RHCs, examines their successes and challenges in doing so, and provides a resource to assist CAH and RHC leaders in developing MH services. It also provides a resource for State Flex Programs to work with CAH-based RHCs in the development of MH services.

FMI: John Gale, john.gale@maine.edu

Funding Organization

Federal Office of Rural Health Policy (FORHP), Health Resources and Services Administration (HRSA), U.S. Department of Health and Human Services (HHS)

Grant Number

U27RH01080

Recommended Citation

Gale, J, Croll, Z, First, N, Kahn-Troster, S. Provision of mental health services by critical access hospital-based rural health clinics. Portland, ME: University of Southern Maine, Maine Rural Health Research Center, Flex Monitoring Team; June 2020. Briefing Paper #45.