AR Discretionary Funding Fiscal Year 2020

This project provides evidence-based treatments to Arkansans with serious mental illness (SMI), substance use disorders (SUDs), co-occurring SMI & SUDs, healthcare personnel, & persons with less severe mental health problems. The AR Division of Aging, Adult & Behavioral Health Services submitted this project with the UAMS Psychiatric Research Institute (PRI), as the primary contractor. Although the number of Arkansans whose symptoms have worsened due to the COVID-19 pandemic is unknown, mental health and substance use disorders are a serious problem. Arkansas is in the top 10% of states with opioid use disorder, approximately 150,000 Arkansans suffer from serious mental illness, with roughly 9% of Arkansans suffering from depression. Limited resources are available to help these individuals during this pandemic crisis, particularly providers who are on the front lines of combating this pandemic. This project will utilize the University of Arkansas for Medical Sciences (UAMS) and its Psychiatric Research Institute (PRI) as its prime contractor. UAMS is Arkansas' only academic health sciences center and serves the needs of the entire state of 3 million people. Along with the Governor's office and the Arkansas Department of Health, UAMS is leading the state's COVID-19 response and has been in full-scale preparation for the pandemic for about 7 weeks as of the submission date of this proposal. This project established Arkansas COVID-19 Mental Health/Substance Use Disorder (ACMH/SUD) program. The ACMH/SUD will be a combination of an emergency tele-video/telephone (T/T) urgent response center with screening, substantive T/T assessment and treatment, and referral to available local treatment programs and providers. If no appropriate local providers are available or acceptable to the patient, the ACMH/SUD will continue to treatment via T/T. In Arkansas, approximately half of our citizens have access to residential internet whereas almost all have access to telephones. Thus, to begin access and treatment, as well as follow up, the project will rely on use of either or both T/T. Evidenced-based treatment, for which PRI has a 25 plus year history of investigating and providing, will be used for all conditions. Patient assessment follow-ups will be by T/T, as per patient choice, and occur at one month and six months after initial intake. The needs of these populations will be met by offering statewide full access to tele-video and telephone-based (T/T) emergency stabilization and mental health/substance use disorder (MH/SUD) services.

Project REACH will implement three types of activities: (1) youth-focused integrated behavioral health treatment and other recovery-oriented services; (2) efforts to engage and connect youth to enrollment resources for health insurance, Medicaid, and mainstream benefits (e.g. Supplemental Security Income (SSI)/Social Security Disability Insurance (SSDI), Temporary Assistance for Needy Families (TANF), Supplemental Nutrition Assistance Program (SNAP), etc.); and (3) coordination of housing and services that support sustainable permanent housing. Youth served by Project REACH will: a) have access to housing; b) secure permanent supportive housing; c) participate in trauma-informed, youth-specific behavioral health treatment through motivational interviewing, and other youth-centered treatment approaches; and d) gain and practice life-skills to facilitate self-sufficiency.

AICA Native Connections CFDA: 93.243 Applicant Name: American Indian Center of Arkansas Address: 1100 North University, Ste 143 Little Rock, AR 72207-6344 Phone/Fax: P (501) 666-9032 or 1-800-441-4513 E-mail: michael@aicago.org Population of Focus: Tribal Youth 24 Years of Age and Younger in Arkansas Number of Individuals to be Served: 1200 The American Indian Center of Arkansas (AICA) seeks funding to reduce the risk of suicide among tribal youth tribal youth and young adults ages 24 and below facing mental health issues and those with co-occurring substance abuse. Funding from this project will provide tribal youth suffering from ADD, ADHD, depression, bi-polar disorder, and other mental/behavioral health disorders access to culturally appropriate services to improve behavioral health outcomes. Through the implementation of this program, AICA hopes to accomplish four goals: 1) Develop tribal mental health/substance abuse policies and procedures that will result in improved access and treatment for tribal youth and young adults with mental health issues and/or co-occurring mental health/substance abuse issues. 2) Develop partnerships with key stakeholders including service providers that will result in improved access and treatment for tribal youth with serious mental health issues and/or co-occurring mental health/substance abuse issues. 3) Work with partner organizations to implement culturally appropriate evidence-based strategies to address mental health and/or substance abuse issues among tribal youth. 4) Increase access to treatment services for tribal members age 24 and under that suffer with serious mental health issues and/or co-occurring mental health/substance abuse issues.

Mid-South Health Systems' CCBHC Project will focus on individuals with serious mental illnesses, substance use disorders; children and adolescents with serious emotional disturbances; and individuals with co-occurring mental illness and substance use disorders. MSHS is the Community Mental Health Center servicing 20 Counties in Eastern Arkansas. The Catchment area is inclusive of the Mississippi Delta Region, an area plagued with many problems such as abject poverty, high crime, poor health and myriad issues related to substance use and mental illness. For the purposes of the current project, efforts will focus primarily on 3 counties within MSHS' Catchment Area- Craighead, Crittenden and Mississippi Counties. MSHS' CCBHC Project goas are to expand access to comprehensive behavioral health services that meet the criteria for CCBHCs to individuals with SMIs, SEDs, SUDs and CODs in Craighead, Crittenden and Mississippi Counties, Arkansas. Secondly, to expand the array of behavioral health services and support offered in the CCBHC's Catchment Area. It is also our goal to deliver integrated care for behavioral health and physical health risks and needs; and finally to ensure sustainability of the CCBHC Project Services in the target area. Over the course of the project it is anticipated that 185 individuals will be served annually and 370 individuals over the lifetime of the project.

Ouachita Behavioral Health and Wellness [OBHAW], comprehensive behavioral health provider, will use CCBHC expansion funds to implement a Service Expansion Project, a recovery-oriented rural network of crisis outreach, integrated treatment, and health monitoring, ACT and recovery support with multiple contact points for adults, families, and children/youth with significant behavioral health needs in five rural counties in South Central Arkansas. The Project will serve adults with SMIO, COD, SUD, and OUD and children/youth with SED. The area has very high rates of opioid prescriptions and suicide, and rates of depression and diabetes are significantly higher than national rates. The total area population is 174,513, county populations range from 72-92% white, < 1 to 24% African-American, and 3 to 7% Hispanic. Strategies and interventions include Mobile Crisis Outreach, an ACT Team, Outreach Case managers for care transitions, coordination of care with primary providers, clinical monitoring of chronic disease indicators multiple EBPs for the populations of focus, telehealth, use of Enhances Illness Management and Recovery tools and the MyStrengths mobile/internet platform. Project goals are: 1) Improve the capacity of rural Arkansas adults with SMI and COD and youth with SED to achieve recovery from behavioral disorders and community stability through a team-based, "no wrong door model" of comprehensive, integrated, evidence-based treatments; and 2) Persons with SMI, COD, SUD, or SED and chronic health conditions will improve self-management of co-occurring conditions and increase access to community support systems through the delivery of care coordination, Assertive Community Treatment, case management, and peer support. Objectives include: 90% of CCBHC clients and families involved in a face-to-face psychiatric or substance-related crisis incident will have at least 2 contacts with outreach staff in the week following the incident; 80% of children/youth with SED will demonstrate a 30% or greater reduction in traumatic stress symptoms, as measured by Trauma Symptom Checklist for Children; 70% of clients enrolled in integrated treatment for COD/SMI will demonstrate a 20% or better improvement in psychosocial functioning after a 6 months of enrollment; 50% of clients engaged in SUD and OUD treatment will indicate no past 30-day substance use related to the specific SUD after 6 months of outpatient treatment; 90% of enrolled CCBHC clients with chronic health conditions will have a care coordination plan with identified DCO primary care providers completed within 3 weeks of project enrollment; 95% of CCBHC clients with SMI or COD will receive clinical health monitoring by medically trained staff at 3-month intervals; 80% of persons with SMI and COD enrolled in ACT services will have received a weekly minimum of 90 minutes of face-to-face contact with team members; 80% of clients linked with community support services will receive at least 2 contacts from case managers or peer support staff in community settings within 3 months of engagement. The project will enroll 415 new unduplicated adults and children/youth in Year 1, 620 in year 2 and 1035 for the Project.

The Southern Arkansas University (SAU) Suicide Prevention and Awareness Program will develop a more comprehensive suicide prevention and substance awareness program on the SAU campus. This plan will consist of a multifaceted approach to its Suicide Prevention and Awareness Program. It will encompass training for faculty, staff, and students; awareness and education activities; surveys and assessments; accreditation process for counseling professionals; establishment and dissemination of a suicide prevention plan for the campus; creation of a suicide support network, and reactivating the Crisis Response Team (CRT). Southern Arkansas University’s 2017 fall enrollment is more than 4,600 students, this includes approximately 900 graduate students. Nearly 2,000 students reside in campus housing. Students mainly come from within a 100 mile radius, and 70% originate from within the state. Forty-three percent of the student body comes from a family household earning less than $24,000 annually. Student population is comprised of 54% female and 46% male; 58% White, 23% African American, and less than 5% Hispanic, Asian and other ethnicities. Non U.S. Citizens represent 14% of the student body. The Suicide Prevention and Awareness Program has four main goals. Goal one is to develop infrastructure for support referrals to campus and community based services designed to prevent suicide while improving the efficiency by which follow up interventions are carried out. This goal will be accomplished by hiring a full time coordinator, developing and disseminating resources and creating a variety of specialized teams within the SAU system and local community. Goal two is to annually assess the campus needs concerning mental health, substance abuse, and suicide risk. This goal will be carried out by administering regular assessments, screenings and surveys on campus. Results will be utilized to assess campus needs and target education and awareness campaigns regarding those needs. Goal three is to improve the suicide prevention training practices among faculty, staff, students, and at risk populations on the SAU campus. Key students and personnel will receive specialized training in suicide prevention and substance abuse, approximately 510 people.* Goal four is to build a campus culture of consistent messaging around the issues of substance abuse prevention, mental health access and suicide prevention. Information will be distributed to over 4,000 students throughout the duration of the project to deliberately reduce stigmatization of behavioral health services and to provide information about available resources. Campus, local, regional, and national resources will be accessible in the Counseling Center, on the website and distributed to parents and students. On-campus activities will be planned in collaboration with student organizations, the Counseling Center, and the local community regarding suicide awareness, prevention and substance abuse education.

The University of Arkansas at Little Rock (UA Little Rock) MidSOUTH, in partnership with the UA Little Rock Counseling Services, proposes to enhance its current suicide prevention practices for students attending the university. MidSOUTH is the community outreach arm and training center for the UA Little Rock School of Social Work. Arkansas currently ranks 10th in the national rankings for suicides per capita according to the Centers for Disease Control. UA Little Rock has a very diverse population including students who identify as LGBTQ, have disabilities, and veterans. MidSOUTH plans to work with each of these populations for the campus suicide prevention program. While, UA Little Rock has had numerous suicide attempts as well as deaths by suicide, the benchmark study of UA Little Rock students revealed that only 2.17% of those surveyed reported receiving counseling services on campus. The overarching goal for the UA Little Rock/MidSOUTH Garrett Lee Smith Campus Suicide Prevention Program is to prevent deaths by suicide of university students. More specifically, the goal is to increase awareness, provide needed training, and strengthen the processes and collaboration with behavioral healthcare providers in the community to insure students in need receive the best and most appropriate care to prevent suicide attempts and death by suicide. Project staff, Counseling Services staff, student interns, and a parent advocate (parent of a college student who died by suicide) will comprise the Suicide Prevention Committee that will guide the selection of informational materials and training to be offered. A great need for UA Little Rock is to create a network that will link Counseling Services with healthcare providers in the area. Tools and practices that support continuity of care to ensure patients have timely access to follow-up care will be identified and/or developed that include formal referral agreements, interagency agreements, follow-up contacts, and student and family education. In addition, a formal postvention plan for immediate and long-term needs to be established for UA Little Rock. In year one, UA Little Rock/MidSOUTH will work to develop a network of providers that will coordinate closely with the UA Little Rock Counseling Services. In addition, informational materials will be identified and/or developed to be used to increase awareness of suicide and the Arkansas Hotline. Initial training for students, faculty, and staff will also begin in year one. In years two and three, when appropriate referral services are in place, the focus will be to increase awareness of available services on campus, continue distribution of materials, and increase training for students, faculty, and staff. UA Little Rock/MidSOUTH will collect and report all SAMHSA required data.

Funding support from SAMHSA through CCBHC Expansion Grant will allow Western Arkansas Counseling & Guidance Center, a private, non-profit CMHC providing services for over 48 years, to become a Certified Community Behavioral Health Clinic to advance primary-behavioral health integration, meet service gap needs and use evidence-based practices to increase services to 2,000 new children and adults in 6 Arkansas counties with mental and/or behavioral health disorders, including opioid disorders. (Y1: 900; Y2: 1,100). The catchment area is the 6 most western counties in Arkansas: Crawford, Franklin, Logan, Polk, Scott, and Sebastian. The majority of the geographic area is extremely rural with the urbanization concentrated in Fort Smith. The 6 counties are HRSA-designated Medically Underserved Areas and Health Professional Shortage Areas in primary and behavioral health domains. The target population: children (0+) with Serious Emotional Disturbance (SED) and persons of all ages who have or are at risk for: 1) Serious Mental Illness (SMI) 2) Substance Use Disorders (SUD), including opioid disorders 3) Co-occurring mental health and SUD (COD). WACGC serves 8087 current active clients. The catchment area is approximately 83% White, 14% Hispanic, 7% Black or African American, 5% Asian, and 2% Native American. Funding issues in Arkansas have resulted in recent closures of behavioral health agencies, 3 in our direct service area. WACGC provides the only comprehensive behavioral healthcare system in the western region. The community has identified the need to provide seamless integrated care to persons at risk/or justice involved who are in a cycle of jail, crisis, or treatment. At risk/or youth in detention centers receive no services when detained. The entire population with SMI, SUD, SED, COD, and other complex issues such as trauma, foster care, LGBTQ, or Veteran status will all benefit from access to integrated care on one campus with telemed capabilities. Goal 1: Raise the standard of care by meeting all CCBHC criteria (first 4 months YI). Objective 1.1: Expand the scope of services; staffing; accessibility; and care coordination Goal 2: Increase the provision and scope of services offered by 25% to the target population. Objective 2.1: Enhance the workforce to persons at-risk or detained with behavioral health and/or SUD. 2.2: Provide additional EBP training, including SUD treatment, to all clinical staff involved in the care of the target population. 2.3: Multidisciplinary Treatment teams, law enforcement, medical providers, and other pertinent stakeholders will work with identified clients within the community setting, to implement Assertive Community Treatment (ACT). 2.4: Develop and implement a vaping/smoking cessation outdoor challenge program for youth Goal 3: Increase availability and timely access to integrated care to the target populations across the lifespan Objective 3.1: Enhance the workforce and office space for integrated care and care coordination 3.2: Provide staff with training on integrated care for persons with behavioral health and/or COD issues using the SAMHSA four quadrant integration model. 3.3: Create a mobile mental health team that will take mental health services to the target population through the use of an adapted recreational vehicle.

Ambassadors For Christ Youth Ministries' (AFC) Project EQUIP will utilize coordinate and integrated strategies to deliver substance abuse, HIV and viral hepatitis (VH) prevention education, HIV and VH testing, and navigation services in the geographical catchment area of Pine Bluff, Arkansas - one of the most in need and impoverished areas in the state. The project will target 1,500 racial/ethnic minority youth and young adults (ages 13-24) over the 5 year project period (300 per year), with a special focus on African American males who have sex with males (MSM), illegal drug users, and other at-risk ethnic minorities. The GOALS of Project EQUIP are to: 1) Enhance local capacity and mobilize community resources to implement a coordinated Prevention Navigator model aimed at reducing the onset of substance misuse, and the prevention/transmission of HIV and VH among the target population: 2) Provide intensive case management that will navigate program participants through HIV/VH screening and testing; evidence-based education on HIV/STD prevention and risky behaviors; peer support; and services linkages to HIV, VH and substance abuse treatment; 3) Implement multi-faceted outreach and community awareness campaigns focused on HIV/AIDS and VH prevention and treatment, sexual health, and substance abuse; and the stigmas associated with them; and 4) Generate outcome and process evaluation data to analyze the effectiveness of the project. The OBJECTIVES of the project are to: 1) Host annual strategic planning meetings with partners, local agencies, community-based organizations, advocacy groups, and other community stakeholders with the aim of increasing local capacity and community resources; 2) provide quarterly education/training sessions to healthcare and treatment providers, and other key staff/contractors, on the importance of screening for HIV and assuring that clinical care needs are met if an individual is determined to be infected with HIV; 3) provide evidence-based substance abuse, and HIV/STD prevention cohorts, as well as education on the stigma and rumors associated with them to 1,000 program participants by the end of the fifth project year; 4) increase knowledge about HIV, VH and substance abuse by 80% among program participants; 5) provide HIV testing for 100 program participants annually; 6) reduce the number of program participants who use alcohol, illegal drugs, and/or engage in high-risk sexual behaviors by 30% annually; 7) increase program participants' access to and retention in care through intensive case management by 30% annually; 8) conduct at least 6 public messaging and social media awareness campaigns (annually) on the risk of substance misuse among individuals living with HIV, and the importance of seeking care and treatment; 9) conduct at least 3 community wide special events annually promoting substance abuse and HIV prevention; and 10) facilitate ongoing monitoring and assessment of program effectiveness, fidelity to implementation model, success and challenges, and quality improvement activities; and provide quarterly reports of the findings to the staff and steering committee in order to achieve desired outcomes.

Independence County Hometown Wellness Coalition Drug Free Communities Support Program