Provision of Specialty Mental Health Services by Rural Health Clinics
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.
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.
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.
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