40. Community Need According to the 2021 Regional Community Health Needs Assessment, mental health is the second most prevalent health condition facing Montgomery County citizens and the leading unmet need across the region. The growing demand for behavioral health services exacerbates the urgency for accessible, coordinated care across health care, judicial and law enforcement agencies.

The Montgomery County Board of County Commissioners recognized this demand and requested the establishment of a Behavioral Health Task Force facilitated by the Greater Dayton Area Hospital Association (GDAHA) and the Montgomery County Office of Strategic Initiatives. This task force was convened to enable discussions between the multiple entities involved in this work, including hospitals, behavioral health providers, jails, law enforcement and civil and criminal courts. The goal of the task force was to develop a set of recommendations for improving behavioral health coordination and treatment.

A priority recommendation the task force established is the creation and implementation of a Behavioral Health Safety Net Portal to assist agencies that serve people in crisis. The Safety Net Portal system will allow agencies, departments and organizations across the Behavioral Health Continuum to communicate and collaborate with each other in order to provide the best possible treatment for those needing services.

System features and functionality will support the following: centralized information stored and managed securely within the confines of the Health Insurance Portability and Accountability Act (HIPAA) and Substance Abuse Confidentiality Regulation 42 CFR Part 2; secure communication channels for messaging, alerts, notifications and referrals; enhanced holistic, longitudinal record of history and interactions; resource integration for referrals; post-discharge planning; outcomes tracking and crisis management to ensure continuity of care for those with immediate needs.

Implementing a Safety Net Portal has three primary community benefits:

1. Ensure individuals receive appropriate care and services for behavioral health and substance use disorder needs.
2. Create better systems and processes to improve continuity of care and reduce unnecessary utilization of services not equipped to treat these individuals,
such as the hospital emergency departments and jails.
3. Support an environment with limited resources and increased staff burn-out.

While this project focuses on better care delivery for individuals with behavioral health disorders, there are also cost-saving opportunities. Cost per affected patient is expected to decrease significantly due to a reduction in medical care visits and redundant diagnosis/treatment plans.

As the prevalence of behavioral health and substance use disorder cases continues to rise post-pandemic, individuals must be directed to the appropriate level of care within the community. As new services are established, such as crisis stabilization and mobile crisis response, we must ensure connectivity between those programs and services to create a collective community strategy around individuals intersecting with various parts of the system. Better communication and collaboration will increase the chance of individuals successfully accessing and staying in recovery.

With an increased volume of residents who need services, much of the utilization is being put on the emergency departments and jails, which are not best equipped to treat acute behavioral health and substance use cases that require ongoing treatment support and coordination. These facilities are becoming holding tanks and need the systems and processes in place with the rest of the care continuum to ensure warm hand-offs and post-discharge care.

Creating a network that allows the health systems, justice system and behavioral health providers to coordinate on the care path of an individual will not only reduce unnecessary utilization and cost but also enable the standardization and efficiency necessary to reduce the recidivism rate and increase the recovery rate. Multiple studies have shown that connecting people to the appropriate services reduces utilization, and we must enable the community to coordinate across all departments to maximize the impact of the limited services.

The Safety Net Portal will also create better systems and processes to reduce the manual burden and inefficient care coordination. Currently, patient communication is performed through calls, texts and emails without standard protocols or a central point of collaboration. We must streamline this process. Not only does it impact efficiency, but it also impacts workplace safety. For example, nurses and other staff are physically harmed by patients with acute psychiatric disorders or dual diagnoses in the emergency department. The jails are also overwhelmed and asked to treat individuals they do not have the infrastructure or resources to support. A Safety Net Portal will help alleviate some of the pressure to ensure, at a minimum, visibility of an individual's interactions such that the appropriate coordination can take place to prevent engagement with parts of the continuum that are ill-equipped to handle the level of need.

The Safety Net Portal in Montgomery County will serve as the first pilot location. Montgomery County and other community stakeholders, including the regional hospitals, will contribute to the budget requirement for this initial development. Once the Safety Net Portal is implemented, there will be the opportunity for the Greater Dayton Region, including 10 surrounding counties, to explore growing the Safety Net Portal. This is vital because individuals frequently cross county lines for services.

Support for the Behavioral Health Safety Net Portal is integral to leading the way in implementing solutions for one of the most unmet needs in our community. It will not only improve care coordination efficiency but also improve behavioral health outcomes throughout the Miami Valley region and ensure patients can successfully get the care they need and deserve.