The neurobehavioral clinic began with an idea in 1988 for a clinic that could provide mental health care to complex children with developmental disabilities in conjunction with psychiatric and medical problems. Dr. David Nilsson was looking for opportunities to set up collaborations with physicians at Primary Children’s Hospital (PCH), and Dr. Rich Ferre was always looking for ways to provide better systems of care to children with mental illness within PCH. The clinic was started in 1990 by Dr. Nilsson, Dr. Douglas Gray, Dr. Rich Ferre, and Dr. Jack Madsen at PCH.
The addition of Dr. Madsen, an epileptologist, meant they could take on very difficult seizure patients with developmental disabilities and other medical co-morbidities. Dr. Madsen, despite severe illness and advice from colleagues to take a break, served patients in the program until his death. Dr. Scott Stiefel joined the program in 1992 after completing his residency and eventually took on the leadership of the program.
Move to Research Park
Later, DSPD funded a mental health program for adults with developmental disabilities with care provided by Dr. Chris Lang and Dr. Rick Zaharia. This program was known as the Neuropsychiatric Clinic for People with Disabilities and was situated at University of Utah Hospital. Dr. Stiefel also worked in this clinic from 1992, and eventually both clinics became located in Research Park with Dr. Stiefel as director. In the mid 1990s, increased support from DSPD enabled an expansion of services in terms of the number of patients served, the provision of outreach clinics, and resident training.
In 2000 the Department of Pediatrics under Dr. Ed Clarke and the PCH foundation under Dr. Doug Nelson enhanced the existing clinic and insured its survival for several years. During the same period, Dr. Stiefel was approached by the Robert Wood Johnson Foundation, Utah Department of Health, to create a coordinated care program (as part of the Medicaid Redesign Project).
The idea was to blend medical and mental health funding streams for people with developmental disabilities to provide continuous clinical services to meet their complex medical and mental health needs. Without the blending of funds, the clinic was under resourced and underfunded, which made the program unsustainable.
Three Programs for People With Disabilities
Josette Dorius spearheaded to effort to blend funding streams. This program was named the UNI HOME Project. The clinic in Research Park now had three programs: The Neurobehavior Clinic, the Neuropsychiatric Clinic for People with Disabilities, and the UNI HOME Project. The UNI HOME Project grew to 120 DSPD clients from the central region over the next two years. HOME referred to "Healthy Outcomes Medical Excellence" as well as a "medical home" model of care.
Due to the effectiveness of the UNI HOME Project in meeting the needs of its patients while managing costs, Medicaid agreed to allow the program to grow beyond the original limit of 120 people. It would be considered by the Centers for Medicare and Medicaid Services (CMS) as a separate Health Maintenance Organization (HMO), effective January 2006, in addition to being a clinical program. The clinic as a whole was renamed the UNI Neurobehavior HOME Program to remove artificial distinctions based upon funding sources rather than approaches to care.
In July 2005, the clinic moved to Research Park, and after outgrowing that space, the clinic relocated again in Fall of 2019. The HOME Program’s clinic is currently located in South Salt Lake and proudly serves over 1200 people of all ages with developmental disabilities.