Did the Mayor expand access to mental health services through partnerships with Chicago’s federally qualified health centers?

During the Chicago State Univerisity Mayoral Election Runoff Forum Mayor Emanuel said that his administration expanded mental health services through partnerships with federally qualified health centers.

Is it true?

When CDPH closed 7 neighborhood or primary care health centers in 2012 it contracted with 7 federally qualified health center organizations (“FQHCs”) to take over and provide services at the neighborhood clinic sites. Heartland took over the Uptown Clinic, Aunt Martha’s took over Roseland, etc. (see list below).

According to CDPH, “Six out of seven FQHC partners now provide mental health services onsite.”   The 6 FQHC organizations CDPH referenced were providing mental health services prior to moving into the former CDPH neighborhood health center sites.  While the national Health Resources and Services Administration (“HRSA”) website confirms that the 6 FQHCs provide mental health services, it doesn’t necessarily mean that they provide these services at each and every one of their clinic locations and the CDPH report should be verified.

CDPH reported last June and August of 2014 that Chicago-based FQHCs provided mental healthcare to 53,000 people over a three year period from 2010 to 2012.  But these reports have not been substantiated (see CDPH response letter).  Instead, the HRSA reports show that about 18,000 to 22,000 people received mental healthcare from a Chicago-based FQHC annually from 2010 to 2013.  It is reasonable to question whether the current claim, that the 6 FQHC partners provide mental health services at the former CDPH primary care clinic sites, is based on a similar CDPH cursory review of the HRSA Web reports.

CDPH-FQHC vendor contracts do not mention mental health services. Mental healthcare is not listed under the “scope of services.” In other words, mental health services provided by the 6 FQHCs appear to be side effects rather than the direct effect of the CDPH contract or “partnership.”

CDPH hasn’t produced any data showing that more or an equal number of persons are being served by the 6 identified federally qualified health centers than were served by the six mental health clinics it closed.

Calendar year 2013 HRSA data (the latest available) indicate that the number of persons served with a mental health visit did increase at 4 of the 6 FQHC organizations when compared to year 2012. The portion of the increase attributable to services provided at the former CDPH sites is not known because HRSA does not breakdown the data for each FQHC site.

Nevertheless, assuming that these 6 FQHCs are providing mental health services onsite at the former CDPH neighborhood health center locations, the mayor is partially correct. The contracts with the FQHCs have provided 4 new mental health service access sites at the former South Chicago, South Lawndale, Uptown, and West Town neighborhood health center locations. The Englewood and Roseland locations were already service access sites and are duplicative.  Adding it up then, the mayor did add 4 new access sites, while eliminating 6 mental health centers.

Former CDPH Health Center <> FQHC [number served 2012 to number served 2013]

Englewood      <> University of Illinois Mile Square Health Center  [426 to 895]

Lower West     <> Mercy Family Health Center   [no mental health services]

Roseland         <> Aunt Martha’s Youth Service Center  [ 6,145 to 5,497]

South Chicago <> Chicago Family Health Center   [733 to 817]

South Lawndale <> Esperanza Health Center  [290 to 728]

Uptown            <> Heartland International Health Center[1,867 to 1,822]

West Town      <> Erie Family Health Center  [1,410 to 1,597]

Net change from 2012 to 2013 = 485

The six closed clinics served 2,714 in 2011 and 843 in 2012 [Source: CDPH]

Overall or citywide, only about 4 percent of persons served by a Chicago-based FQHC received a mental health service that was directly provided by the FQHC in 2013 – a rate that is inadequate to meet the estimated needs of the population. [See HRSA website and draft review.]

Judy King

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