Building a Behavioral Health Clinic and the Workforce to Staff It
A Rural, Community-Based Model for Behavioral Health Access
Seed Sower uses opioid settlement funding to establish outpatient behavioral health services in southern West Virginia and prepare students, peer recovery support specialists, and community members through internships and training.
The Challenge They Were Addressing
In southern West Virginia, adults and families affected by substance use disorder needed housing, transportation, and continuing support to participate in recovery. Seed Sower opened in 2021 with 11 recovery housing beds for women. Residents often had to travel more than 20 miles to reach medical appointments, work, court, or probation visits. The organization added transportation after seeing how those distances limited access to services.
Seed Sower later opened a recovery community organization in Beckley. As of September 2026, its broader operation included 45 housing beds, a transportation service, and 35 employees. Short-term grants helped establish services, but the organization needed dependable revenue to retain staff and maintain its housing and community center. Transportation contracts became one source of operating income after the original startup grant ended.
The next investment focused on outpatient behavioral health care and the people who would provide it. Seed Sower wanted to add clinical services for people with substance use disorders and co-occurring mental health conditions, while giving students and peer recovery support specialists more opportunities for training. The organization sought settlement funding to cover startup costs while it completed licensing and insurance contracting.
What They Built
Seed Sower received a $250,000 award through the West Virginia First Foundation's Momentum Initiative Grant program to establish behavioral health services and develop the regional provider workforce. The grant supported staff hiring, software, training, and operating infrastructure. Seed Sower planned to sustain clinical services through payments from Medicaid and private insurance.
As of September 2026, the clinic had not opened. Insurance contracting had taken several months longer than expected, delaying the anticipated April or May 2026 opening. Seed Sower planned to begin seeing patients covered by each payer as the corresponding contract was finalized. The grant period was described as beginning in 2025 and ending in January 2027.
The training and internship components were already operating. Seed Sower paid for a staff member to become a Mental Health First Aid instructor and budgeted for 100 free seats for participants. Seed Sower teaches the classes on site for the public, including students, first responders, and peer recovery support specialists seeking additional mental health training. An agreement with West Virginia University Institute of Technology creates behavioral health internships for psychology students at the recovery community organization, located about half a block from campus.
Founder and Executive Director James "Jay" Phillips explained that the Seed Sower name refers to a biblical parable about creating conditions for planted seeds to grow. The behavioral health expansion builds on the recovery housing, peer support, and transportation that the organization already provides.
Key Program Components
Who You Need at the Table
What made a willing partner essential vs. optional?
The clinical expansion depends on startup funding and payer agreements that allow Seed Sower to bill for care. The university partnership is required for the internship component as designed. The other partners support the existing housing, transportation, and employment services on which the expansion builds. Their functions can be adapted to the organizations and resources available in another community.
Phillips asks partners to commit to specific work before submitting a grant application. Partners need to understand what they will do once funding arrives. Seed Sower also shares policies and transportation startup information with other organizations, and regular meetings with the Fletcher Group provide a forum to ask questions and exchange operating experience.
Budget Breakdown
What is the minimum viable budget to replicate this?
A training-only version of this model requires a certified instructor, participant materials, and funded staff time. Phillips estimated approximately $3,000 to certify a Mental Health First Aid instructor and $40 per participant for materials. For 100 participants, those items total approximately $7,000 before staff time, space, and other delivery costs. These estimates cover training only. Phillips advised that a $75,000 budget would support staff training and practical teaching resources but would be insufficient to open a behavioral health clinic.
What Worked and Why
Specific decisions or design features that drove success
Seed Sower used settlement funding for startup expenses while preparing a clinical revenue source. The organization had already used this approach in transportation. An Appalachian Regional Commission grant helped purchase four vehicles, and service revenue paid for additional vehicles and drivers. Phillips reported that net transportation revenue helped maintain housing and community center operations through gaps between grants. The clinical revenue plan remained untested because the clinic had not yet opened.
A staff instructor allows Seed Sower to teach Mental Health First Aid at its own site. The organization had used approximately half of the 100 free seats and had already met its first-year objective to train 25 people in Mental Health First Aid and suicide prevention. That work continued while the clinic awaited insurance contracts.
The nearby university provides students with opportunities to learn about substance use disorder services during their psychology training. Phillips reported approximately three active interns toward the first-year target of six. He also hired a volunteer and intern coordinator through a separate SAMHSA grant to support the organization's internship work.
The behavioral health plan includes rides to appointments. Seed Sower's existing transportation operation had grown to 17 vehicles and approximately 120 trips per day. Those figures describe the broader transportation service, which began before the current settlement-funded project. Appointment attendance in the new clinic will be a separate measure.
Early outcomes and data
Seed Sower reported meeting its first-year objective to train 25 people in Mental Health First Aid and suicide prevention.
The organization reported using approximately half of the 100 free Mental Health First Aid seats funded by the grant. This is a separate measure from the 25-person training objective.
Approximately 3 student interns were participating as of September 2026, compared with a first-year target of 6.
The project set a first-year target of 150 individuals receiving outpatient behavioral health services. The clinic had not opened as of September 2026.
The project set targets of 80% client satisfaction and 80% appointment attendance with transportation support. Results were not yet available.
Lessons Learned
Allow more time for insurance contracting. Seed Sower completed substantial startup work before it could begin seeing insured patients. Phillips expected to request an extension because the delay reduced the time available to meet clinical service targets.
Confirm what partners will do. Phillips described grant partnerships that require active work after the award. Agree on responsibilities before submitting an application, including who will place interns and how services will be paid for.
Use the mission to screen funding opportunities. Seed Sower evaluates opportunities against its work in housing, transportation, and recovery support. Phillips advised supporting existing providers when a proposed activity falls outside that focus.