This grant endeavor is in response to the SAMHSA initiative to recruit and train EMS personnel in rural areas. The development of the HCHC EMS Training and Recruitment Program will capture the strengths of participants, encourage professional growth and address challenges that limit progress to date. This work will benefit both EMS providers, community volunteers and patients, and strengthen our rural region’s health care environment. Activities and processes developed will be targeted towards EMS professionals and volunteers, and patients receiving care in Henry County, Iowa and adjacent townships; approx. 66 EMS responders and 26,500 area residents. Located in southeast corner of Iowa, Henry County is comprised of 473 square miles with a population density of 46 people per square mile. A regional program will allow the development of tailored solutions responsive to local needs, share resources, further servicing area Medical First Responders (MRF), and aid in personnel retention. To accomplish the charge, HCHC EMS will: • Establish a regional partnership with area Community Colleges (CC) to identify and address issues with current education/training processes that inhibit student enrollment; • Increase area CC’s capacity to transition EMT students to Paramedic certification by partnering with HCHC EMS in developing a robust preceptor program; • Expand regional partnership between HCHC EMS and county-wide MRF Agencies by providing training and managerial support that reduces the administrative burden on MFR directors and improves compliance with state licensing; • Increase the availability of educational offerings and further develop critical care and cultural sensitivity skills of career EMS staff and volunteer MFRs through the purchase and implementation of technology-enhanced educational equipment and educational/ monitoring software. • Improve EMS personnel safety through the purchase, implementation and training on PPE including turnout gear and N95 fit-testing equipment. Our expected outcomes for the Program by the end of 12 months are: • Improved organizational and community collaboration for EMS recruitment and retention; • Improved access to and coordination of EMS training programs; • Strengthened network of responders and partners better capable of addressing psycho-social and medical needs of our local communities.
The Iowa Department of Public Health (IDPH), the single state authority for substance abuse, and the Department of Human Services (DHS), the state mental health authority, propose to provide collaborative services to address mental health and substance use needs of Iowans impacted by novel coronavirus (COVID-19). Utilizing a telehealth model of service delivery, Iowa will expand availability of services to individuals ages 18 years or older with serious mental illness (SMI); those with substance use disorders (SUDs), those with co-occurring SMI and SUD, and those with a mental health issue less severe than a SMI. Iowa's Emergency COVID-19 project will expand the capacity of statewide telehealth services through the delivery of additional recovery support, emergency crisis management, and treatment services for Iowans. During the project period, Iowa will serve a minimum of 500 individuals in need of services using the following goals: 1. Develop and implement a comprehensive plan of evidence-based mental health and/or substance use disorder treatment services for individuals impacted by the COVID-19 pandemic by increasing access to services through telehealth. a. Contract with licensed substance use disorder and accredited mental health providers to delivery telehealth based treatment services for individuals with a SUD, SMI, SUD and SMI, or mental health issues less severe than SMI. 2. Screen and assess clients for the presence of mental health and substance use disorders and/or co-occurring disorders to ensure access to appropriate treatment services. a. Utilize recognized screening and assessment instruments such as the DSM-5, ASAM, PHQ-9, and GADS-7 to determine the presence of a SUD/MH issue. 3. Provide evidence-based and population appropriate treatment services to improve outcomes for individuals with SMI, SUD, or co-occurring SMI and SUD that have been impacted by COVID-19. a. Develop individually tailored treatment plans and deliver evidence-based services appropriately matched to the needs of individuals seeking services. 4. Provide recovery support services to improve access, remove barriers, and increase retention in services. a. Establish a menu of recovery support services for individuals enrolled in the program that match appropriate resources to client needs. 5. Expand crisis mental health services in Iowa to increase call capacity, and accommodate for increased demand on Iowa's existing provider network. a. Contract with telehealth based providers of emergency crisis services and peer support/recovery coaching providers for the expansion of service availability.
Project Name: Seasons COVID 19-ERSP Project Applicant: Northwest Iowa Mental Health Center dba Seasons Center for Behavioral Health Project Summary: To increase access to behavioral health services for individuals, families and communities during the COVID-19 pandemic and enhance efforts to prevent suicide and suicide attempts within nine counties in rural northwest Iowa. Target Population to be Served: The target population for the proposed project is adults age 25 and older struggling with behavioral health challenges as a result of the recent COVID-19 crisis. The project will target three unique subpopulations: victims of domestic violence, farmers and ag-related workers, and immigrants and refugees. Demographic and Clinical Characteristics of Target Population: The geographic service area for the project encompasses 9 counties in rural northwest Iowa: Buena Vista, Clay, Dickinson, Emmet, Lyon, O’Brien, Osceola, Palo Alto, and Sioux. The service area has a population of 137,943 residents (Census 2018 Estimates). Seasons provided behavioral health services to 4,382 individuals in 2019, including 2,827 adults, from the nine county service area. Evidence-Based Strategies and Interventions: Adult Mental Health First Aid (MHFA), Cognitive Behavioral Therapy (CBT), Dialectical Behavioral Therapy (DBT), Trauma-Focused Cognitive Behavioral Therapy (TF-CBT), Eye Movement Desensitization and Reprocessing (EMDR), Motivational Interviewing (MI), Seeking Safety (SS), Matrix Model, Assertive Community Treatment (ACT). Project Goals and Measurable Objectives: Goal I: To create the organizational capacity to implement grant activities, ensuring the required elements of the grant are delivered on time and as intended, specifically the sub-population of victims of domestic violence. Goal II: To equip mental health professionals with skills, knowledge, and resources to provide high quality, evidence-based, trauma-informed, and culturally responsive services, targeting identified sub-populations. Goal III: To ensure individuals and families are able to easily obtain behavioral health services, resources, and supports along a continuum of prevention, early intervention, and treatment, including suicide prevention. Goal IV: To enhance collaboration with other service systems, community agencies, and local businesses to raise awareness on mental health, suicide, and domestic violence during the COVID-19 pandemic and beyond. Number to be Served Throughout Lifetime of Project: The targeted total number of individuals to be served by the project over the 16 month project period is 1,820. A breakout of the number served includes: Direct Services-150, Training in Mental Health Practice-16, and Training in Mental Health Prevention or Promotion-1,820.
In Linn County, IA, Abbe Center CCBHC Project will implement strategies to engage individuals who over-utilize or are "at-risk" for presenting at the emergency department (ED) instead of utilizing more cost-effective community-based services due to lack of engagement, timely access to services and/or understanding how to navigate the service system. Current populations served are children and adults with mental illness, serious mental illness, serious emotional disturbance, substance use disorders & co-occurring disorders. In 2019, Abbe Center served 7,144 individuals in these categories. It is estimated that 15% of these individuals will be determined "at-risk." The population of focus for this grant is "at-risk" individuals as determined by the following criteria: 1) being recently discharged from the ED or inpatient unit after a behavioral health visit; 2) utilizing a mobile crisis or crisis stabilization service; 3) having an interaction with law enforcement due to a behavioral health reason; or 4) having an urgent social determinant of health need. Abbe Center CCBHC will serve 1,072 unduplicated individuals determined to be "at-risk" each year (1,608 unduplicated over the 2-year grant project period). Project Goal 1: Decrease ED utilization by CCBHC clients by 20% by providing timely access to services and enhancing care coordination to individuals identified as "at-risk". Objective A: Engage "at-risk" individuals and coordinate behavioral health services. 1. By January 1,2021, Implement a "One Step" referral process for quick engagement of clients from the ED to Abbe. 75% of the people referred from the ED will engage by having a service with Abbe. 2. By August 29, 2021, 60% of individuals "at-risk" will receive outreach/care coordination. Objective B: Provide timely access to services through urgent care services and Access Center. 1.By April 30, 2021, Abbe Center will expand an established urgent care track to include 20 hours per week availability of Prescriber services. 2. By August 29, 2021, increase by 50% law enforcement "drop-offs" at an Access Center. Project Goal 2: Integrate the management of physical health and behavioral health by creating and implementing care pathways for clients with diabetes, smoking, and cardiovascular disease. Objective A: Increase the number of clients who are actively engaged with their PCP. 1. By July 1, 2021, implement tracking of primary care visits and work with clients identified as "at-risk" to ensure at least 70% have had at least one primary care visit with in the last year. 2. By April 1, 2021, Abbe will co-locate a primary care provider within the CMHC setting and develop an integrated workflow to co-manage healthcare needs.
Eyerly Ball Community Mental Health Services (CMHS) will enhance the continuum of behavioral health care services through its proposed CCBHC project entitled, “Increasing Access to Mental Health and Substance Use Treatment Services, Improving Coordination Between Healthcare Providers, and Enhancing Availability of Crisis and Suicide Prevention Services.” This project’s population of focus includes children and adults with mental illness (MI), serious mental illness (SMI), serious emotional disturbance (SED), substance use disorders (SUD), and co-occurring disorders (COD). In order to most effectively serve this identified population, Eyerly Ball CMHS will be utilizing the following evidence-based practices: Assertive Community Treatment (ACT), First Episode Program (FEP), Intensive Psychiatric Rehabilitation (IPR), Motivational Interviewing, Peer and Family Support Specialists, and Medication Assisted Treatment (MAT). Specifically within our outpatient clinics, psychotherapeutic interventions such as Cognitive Behavioral Therapy (CBT), Mindfulness, and Eye Movement Desensitization and Reprocessing (EMDR) Therapy are tailored based on an individual’s developmental phase in life. With project funding, Eyerly Ball CMHS is proposing the following goals: increase engagement in behavioral health services by improving access to care and creating a presence in area hospital systems, decrease hospital and emergency department utilization by increasing availability and awareness of crisis and suicide prevention services, and increase continuity of care through comprehensive screening activities to ensure individuals have access to the resources needed to maintain their physical and mental health and well-being. Specific, measurable, achievable, realistic, and time-bound objectives have been developed for each goal, including expanding the Eyerly Ball Enrollment Team by hiring ten new Navigators, Behavioral Health Coordinators, and Access Coordinators; decreasing consumer emergency department utilization by 15% by making use of appropriate crisis services; and increasing the number of referrals to a PCP as indicated through age-appropriate screenings for key health indicators and health risks, as well as diabetes, metabolic and cardiovascular risk factors. Eyerly Ball CMHS will serve 2,000 unduplicated consumers during the first year and 3,800 unduplicated consumers over the project period of two years.
Hillcrest Family Services proposes to develop a CCBHC project for Dubuque and Jackson Counties, Iowa for the purpose of increasing access to and improving the quality and coordination of community mental health and substance use disorder treatment. The populations of focus include adults with serious mental illness (SMI), youth with serious emotional disturbance (SED), individuals with substance use disorders (SUD), and individuals with co-occurring mental health and substance use disorders (COD). Specific focus areas include children up to age 17, African American, Native Hawaiian/Pacific Islander, and Hispanic/Latino populations, veterans, uninsured, underinsured, and underserved, individuals with commercial insurance but inability to pay, individuals and families living in poverty, and households without vehicle access. The proposed two-year project requests $2,000,000 per year to enhance and improve services to target populations for a total of at least 2,584 individuals over the span of the project. Evidence-based, comprehensive outpatient mental health and substance use services, including medication management (including medication-assisted treatment), a continuum of crisis services, intensive psychiatric rehabilitation, primary care services, ACT, peer and family supports, HIV/Hepatitis screening, and case management will be delivered with a person centered and family-centered focus. Hillcrest Family Services will leverage existing behavioral health services through community mental health centers in Dubuque and Jackson Counties. In FY 2019, Hillcrest provided services to 8,639 individuals including therapy, medication management, mobile crisis outreach, HIV and Hepatitis, crisis residential, intensive psychiatric rehabilitation, integrated health homes, peer support and assertive community treatment. When overlaying data from the National Association of Mental Health (NAMI) with census data from the targeted counties, it is estimated that there are 22,477 adults with SMI, 2671 children with SED, 14,918 with co-occurring mental health and substance use issues, 12,532 individuals living in poverty, 5,304 uninsured, and 7,795 veterans. Hillcrest Family Services will utilize evidence-based practices such as Dialectical Behavioral Therapy (DBT), Eye Movement Desensitization and Reprocessing Therapy (EMDR), Multidimensional Family Therapy (MFT), Theraplay, Motivational Interviewing, Acceptance and commitment Therapy, Trauma-Focused Cognitive Behavioral Therapy, Medication Assisted Treatment, ACT, and IPR to facilitate achieving the goals of the project. Major goals of the project include Goal 1: Decrease the unnecessary use of emergency resources by diverting participants with behavioral health conditions, SUD, or COD from ERs and/or Law Enforcement encounters by providing crisis response; Goal 2: Reduce hospital emergency department visits for individuals with SMI, SED, SUD and COD by improving management of chronic conditions and increasing care coordination with primary care; Goal 3: Reduce all causes of hospitalization readmissions by increasing follow-up after hospitalization for mental illness, SUD or COD. Goal 4: Increase comprehensive screening activities to identify individuals in need and to link to appropriate services and supports. Strategies that will support the achievement of goals include standardized screening and assessment, meeting all CCBHS certification requirements by 4 months post award, enhancing an existing advisory group, building additional infrastructure around electronic health record software, increasing capacity for population health data management, and further enhancement of continuous quality improvement methodologies to support and enhance the project.
The Iowa Department of Public, Health, Bureau of Substance Abuse proposes a state led Treatment Individuals Experiencing Homelessness (IA-TIEH) to expand and enhance the states' capacity to provide integrated treatment, case-management, and recovery supports for homeless adults and those at risk for homelessness with co-occurring substance use and serious mental disorder. IDPH will implement IA-TIEH in six of the state's highest need communities. Community need levels are determined through defined metrics including the homeless population served through the community-level Continuums of Care (COC's), those at immediate homeless totals in Iowa counties as calculated by the Institute for Community Alliances. Annually 250 individuals will enroll in IA-TIEH or 1,250 for the five year period. The project population represents an estimated 55% males and 45% females. Caucasians represent 75%; African Americans 20% and Hispanics 5%. An estimated 60% of females will report histories of domestic or sexual violence. Primary substances for homeless with co-occurring disorders include alcohol, 31%; methamphetamine 42%; opioids, 12%; all others, 15%. The following goals and relevant measurable objectives drive Iowa TIEH activities: 1) Increase the capacity to screen, case-manage, provide integrated care and Recovery Support Services (RSS) to homeless and those at risk for homelessness with co-occurring mental health and substance use disorders. Iowa will select a minimum of six SUD providers from the state's highest need communities and will conduct evidence-supported Readiness Assessment and IDDT training with all participating community-based providers. 2) To increase the number of individuals who receive case management, IDDT, and RSS for homeless and at risk persons with co-occurring disorders. The IDPH Project Director, Evaluator and key partners develop and expand screening, referral and information sharing relationships with HUD Coordinated Entry agencies, PATH, shelter and domestic violence sites and correctional facilities in each target community. IA-TIEH will support the engagement and retention in services by providing a broad array of Recovery Support Services. 3) To improve the health, behavioral health, housing, occupational and criminal justice outcomes for homeless and at risk persons participating in the project. Iowa will expand screening and assessment and will advance supported collateral referrals for all identified needs. IA-TIEH providers and clients will develop outcome goals consistent with enrollees' needs and priorities. The project will realize improvement in at least two measure outcomes for a minimum of 50% of enrolled participants.
The North Central Iowa Mental Health Center, Inc. dba Berryhill Center in Fort Dodge, Iowa is a not for profit entity associated with UnityPoint Health and located in rural Webster County, Iowa. Through federal CCBHC grant funding, we seek to expand existing mental health services thereby addressing mental health needs of our community. It is our goal to increase treatment accessibility, improve pathways to mental health services and expand crisis intervention services. The Berryhill CCBHC Expansion Project will be available to all persons with mental health needs in Webster County (population 36,277) which is located in rural North Central Iowa. Berryhill served 8.7% (3,158) Webster County Residents in 2019, and is the primary safety-net mental health services provider in the region. It is estimated that in year one of our project 3,393 individuals will be served and in year two that number will increase to 3,628 individuals, for a total of 7,021 persons served over the lifetime of the project. To reach our overarching goal of improvement and expansion of mental health services in our region, we have used local data to identify three key areas and related goals with measurable objectives to achieve the most impactful outcomes. Goal #1: To reduce by a measurable amount the inappropriate usage of the emergency room by CCBHC patients as a pathway to care. This goal will be achieved through the use of carefully implemented and monitored continuing care plans for CCBHC patients deemed to be frequent users of the ED and prolific data sharing with other area safety net providers. Success will be measured by an actual reduction in usage by identified patients. Goal #2: To provide a unified community system for patients in crisis situations. This goal will be achieved through the CCBHC acting as coordinator and in collaboration with other area safety net providers to provide a comprehensive and targeted system of care for patients in crisis. Data will be used to determine community needs and pinpoint areas of crisis intervention opportunity. This data will also indicate improvements made in care delivery over time. Goal #3: To provide a more direct pathway for appropriate care for individuals with mental health issues that present to the emergency department, thereby avoiding inappropriate or over usage of the ED. This goal will be achieved through the provision of a Behavioral Health Consultant to work directly in the ED for care integration of patients with mental health concerns. Success will be measured through utilization and documented encounters with the Behavioral Health Consultant.
Project Name: Seasons CCBHC Enhancement Project Applicant: Northwest Iowa Mental Health Center dba Seasons Center for Behavioral Health Project Summary: To increase access to and improve the quality of community behavioral health services and care though the expansion of CCBHC services in nine rural counties in northwest Iowa. Target Population to be Served: The target population for the proposed project is adults with a serious mental illness, children with a serious emotional disturbance, and individuals with co-occurring disorders. The project will target subpopulations: infants and young children; youth in foster care, out of home placement, kinship care or adopted; and veterans and military families. Demographic and Clinical Characteristics of Target Population: The geographic service area for the project encompasses 9 counties in rural northwest Iowa: Buena Vista, Clay, Dickinson, Emmet, Lyon, O’Brien, Osceola, Palo Alto, and Sioux. The 9 county region has a population of 137,943 residents (Census 2018 Estimates). Seasons provided behavioral health services to 4,382 individuals in 2019, including 1,729 children within this service area. Evidence-Based Strategies and Interventions: Assertive Community Treatment (ACT), Intensive Psychiatric Rehabilitation (IPR), Medication Assisted Treatment (MAT), Matrix Model, Motivational Interviewing (MI), Cognitive Behavioral Therapy (CBT), Dialectical Behavioral Therapy (DBT), Seeking Safety (SS), Trauma-Focused Cognitive Behavioral Therapy (TF-CBT), Parent Child Interactive Therapy (PCIT), Eye Movement Desensitization and Reprocessing (EMDR), and Theraplay. Project Goals and Measurable Objectives: The goals of the project are: Goal I: To equip mental health professionals with skills, knowledge, and resources to provide high quality, evidence-based, trauma-informed, and culturally responsive CCBHC services. Goal II: Conduct data collection and evaluation activities as required by SAMHSA, to monitor and report on project effectiveness, and evaluate outcomes for use with expansion and sustainability as a CCBHC. Goal III: To ensure families are able to easily obtain behavioral health services, resources, and supports, along a continuum of prevention, early intervention, and treatment, within their local communities. Goal IV: To create the organizational capacity to lead and champion a sustained, high-quality CCBHC within a rural geographic service area. Number to be Served Annually and Throughout Lifetime of Project: The targeted number of individuals to be served over the two-year project period is 1,150, and to maintain at least 80% of the individuals throughout the course of the project.
Plains Area Mental Health, Inc. CCBHC target population is adults with a serious mental illness (SMI), children with a serious emotional disturbance (SED), adults with long term and chronic substance use disorders including opiate addiction, and individuals with co-morbid mental health and/or substance use disorder (SUD). The geographic focus area for CCBHC will concentrate on thirteen counties in Northwest Iowa. The population is 206,995 across 7,790 square miles. All of the identified counties in the target area are designated by Health Resources and Services Administration (HRSA) as Medically Underserved Areas/Populations (MUA/P) and Health Professional Shortage Areas (HPSAs) for mental health, primary care, and dental. According to the American Foundation for Suicide Prevention, suicide was the 9th leading cause of death for the overall population in Iowa, and the 2nd leading cause of death among youth aged 13–19. Iowa has the 5th highest rate of binge alcohol drinking in the U.S. according to the National Survey on Drug Use & Health, 2015-2016. According to Your Life Iowa, a resource hub and call center, there are only 5 MAT providers in our targeted area and located in 3 of the 13 counties. Last year a longstanding SUD provider suddenly closed their doors leaving a significant void of SUD services in 8 Northwest Iowa counties, including five of the counties in our targeted service area. The proposed targeted service area and population lacks access to coordinated care for co-occurring disorders, physical healthcare, and social determinants of health such as housing, employment, transportation, and nutrition. There is a lack of coordinated care between and among the SUD and Mental Health providers resulting in a siloed service system, barriers to access and missing the synergistic impact of co-occurring disorder treatment and higher costs of care. The 2018 Rural Health Forum, A Summary to Promote Action, a joint report by the Iowa Department of Public Health and the Iowa Healthcare Collaborative, stated access to care is one of the biggest challenges affecting rural health and rural communities along with lack of core specialty services, including behavioral health, and lack of capacity to address social determinants of health. Plains Area Mental health CCBHC will increase access to coordinated mental health, substance abuse disorder (SUD), and physical healthcare to 1500 new individuals by increasing service capacity, cultural competency for service to veterans, and expansion of evidenced based services to adults and children.