KY Discretionary Funding Fiscal Year 2016

AWARE: Boone County will train 60 instructors and 400 community members in Youth Mental Health First Aid to help adolescents, ages 12-18 developing mental/behavioral health problems or in a crisis in mental health. The project will be focused on meeting the needs of the 20,500 youth in Boone County Schools addressing 12,500 adolescents and the 2,500 freshman at Northern Kentucky University. Objectives include: to train a minimum of 400 individuals in Youth Mental Health First Aid by September 30, 2018; to certify a minimum of 60 individuals to provide training to the community and schools in Boone County and at Northern Kentucky University by September 30, 2017; and to build community infrastructures to support identifying and referring individuals who would benefit from referral to mental health or related services by September 30, 2018.

Kentucky's System of Care Strategic Expansion Plan is designed to enhance the capacity of the statewide SOC infrastructure to improve, implement, expand, and sustain comprehensive services and supports consistent with SOC philosophy. Funds from this cooperative agreement will afford Kentucky the opportunity to ensure effective implementation of the various strategies comprising its comprehensive strategic plan for system of care expansion and sustainability. By doing so, the capacity of the SIAC and RIACs will be maximized to more effectively fulfill their intended legislated scope of responsibility as the state and regional governing bodies for services and supports to children and youth with or at-risk of developing behavioral health challenges and their families and, ultimately, to promote positive outcomes among children and youth with serious behavioral health challenges and their families.

Eastern Kentucky University's Suicide Awareness and Focus on Suicide (EKU SAFE) seeks systematically to create a safer and more caring campus community, to assist those at-risk for suicidal behavior, and to support those who are concerned regarding the welfare of members of the community. This project will be accomplished by using a public health model which expands on current campus practices to create a systemic program of suicide prevention, intervention, and postvention that integrates service, policy and referral networks. EKU SAFE will more closely tie efforts between the Psychology Clinic, Counseling Center, Student Health Center, and academic departments, such as the Departments of Psychology, Social Work, Nursing, Occupational Therapy, and Paramedicine. EKU SAFE will expand current prevention and gatekeeper training efforts, increase awareness and availability of mental health services to students, and better link the various means by which student's access support and mental health resources at EKU. The goal is to reduce both direct and indirect population risk while also sealing the cracks in high-risk or critical cases by improving appropriate referral, treatment and follow-up.

Gateway Community and Technical College's (Gateway) Project Campus Assessment, Response, and Evaluation is designed to reduce risk factors and increase protective factors that play a critical role in suicide prevention. The overall purpose of Project CARE is to build capacity and infrastructure to support expanded efforts to promote wellness and help-seeking of all students. The program incorporates outreach to vulnerable students, including those experiencing substance abuse and mental health issues who are at greater risk for suicide and suicide attempts. Gateway's strategies build and sustain a foundation for mental health promotion, suicide prevention, substance abuse prevention, and other prevention activities such as interpersonal violence and by-stander interventions. Gateway's student population is about 4,500 and includes the following demographics: 50 percent male/female; 48 percent non-traditional age 25); almost 90 percent have individual incomes of less than $25,000; and over 50 percent are first in their family to attend college. Project CARE's goals include: Goal 1: Increase collaboration among campus and community partners to deliver the message that suicide prevention is everyone's responsibility. Goal 2: Increase the amount of training to students, faculty, and staff on suicide prevention and mental health promotion. Goal 3: Increase the number of educational seminars and informational materials for students, faculty, staff, and family members on suicide prevention, identification and reduction of risk factors. Goal 4: Increase help-seeking among students and reduce negative attitudes for seeking care for mental and substance use disorders among students. The total number of people to be served annually includes approximately 4,700 students, faculty, staff, and their families through various strategies.

Kentucky Partnership for Families and Children, Inc.'s (KPFC) mission is to "empower families affected by behavioral health challenges to initiate personal and systems change." Building an infrastructure for a family-driven and youth-guided system of care requires parent/primary caregivers and youth to have initiated personal change in strengthening their own advocacy and leadership skills. Once personal change is set into motion, the momentum from the parents and youth is unstoppable. Once families and youth understand their power in being catalysts for transforming Kentucky's system of care, their excitement and energy moves forward to strengthen the movement and toward systems change-the change to create a strong, viable, responsive system of care in Kentucky.

Kentucky AWARE will allow Kentucky schools to create even safer and more respectful environments for learning, promote the behavioral health of school-aged children and youth, and help to ensure that we reach our goals aimed at improving educational results and outcomes for all students.

While Kentucky is largely a rural state, the three pilot districts- Jefferson, Fayette and Pulaski are three of Kentucky's largest (1st, 2nd, and 14th, respectively). All three districts have invested in the Kentucky Positive Behavior Interventions and Supports (KY-PBIS) initiative, which will provide a base of understanding for children with behavioral needs.

The Kentucky AWARE goals are: Goal 1: Expand the capacity of the KDE, and other state and local child, youth, and family serving agencies to increase awareness of mental health issues among school-aged youth. Goal 2: Connect children, youth and families, who may have behavioral health issues, with appropriate services. Goal 3: Provide training to school personnel and other adults who interact with school-aged youth to detect and respond to mental health issues in children and young adults. Goal 4: Provide effective governance and organization for interagency collaboration and grant management of the project.

In year one of the grant, 450 first-aiders will be trained. During year two this total increases to 2,025. For years three through five the total will be 2,550 annually. Over the five years of this grant 10,125 first-aiders will be trained (450 + 2,025 +2,550 + 2,550 + 2,550 = 10,125).

The Kentucky Initiative for Zero Suicides (KIZS) will provide safer suicide care services for youth and young adults ages 10 - 24 who are at a higher risk of suicide. Built on the foundation that suicide should be a "never event" among Kentucky youth, KIZS will use a comprehensive system of care approach, integrating best practices in suicide care and prevention, modeled after the U.S. Air Force Suicide Prevention Program and the Suicide Care in Systems Framework(Zero Suicide in Healthcare) report by the National Action Alliance for Suicide Prevention. This comprehensive approach will be implemented in the Adanta community mental health region (Region 14) initially and will then be expanded throughout the Commonwealth. "Zero Suicide in Systems of Care" is both a philosophy and a care model. Three critical factors will lead to success: the belief and commitment that suicide can be eliminated in a population under care, by improving service access and quality and through continuous improvement (rendering suicide a "never event" for these populations); taking systematic steps across systems of care to create a culture that no longer finds suicide acceptable, set aggressive but achievable goals to eliminate suicide attempts and deaths among members, and organize service delivery and support accordingly; and the use of Evidence-Based Clinical Care Practice delivered through the system of care with a focus on productive patient/staff interactions.

Kentucky's project, entitled TAYLRD (Transition Age Youth Launching Realized Dreams) will improve access to treatment and support services for youth and young adults ages,16 - 25 years old that either have, or are at risk of developing serious behavioral health (mental health and/or substance abuse) conditions; hereafter referred to as transition age youth (TAY); Kentucky has chosen two very distinct population areas of the state: 1) Pathways, is located in a ten county area of the Appalachian Region, and 2) Seven Counties Services (SCS) which comprises seven counties in north central Kentucky. TAYLARD will implement a TAY guided specialized array and continuum of behavioral health care which will include awareness efforts for community partners, youth, young adults and their families; outreach and engagement of youth and young adults; identification, screening, assessment and referrals to appropriate evidence supported treatments; and coordination of care. The focus will be on building services and supports, in the areas of employment and education, career planning, life skills, medication management, health care navigation, peer supports, age specific and developmentally appropriate behavioral health services and coordination of care in a youth/young adult friendly environment.

Kentucky will improve access to high quality services by supporting the delivery of evidence-based, recovery oriented, integrated care approaches for adults with serious mental illness, children with serious emotional disturbance, and those with long-term and serious substance use disorders, as well as others with mental illness and substance use disorders. Community mental health centers representing diverse geographic areas, including rural and underserved areas will work toward certification and a minimum of two will become CCBHCs during the planning grant period. Kentucky plans to use the PPS-1 daily rate methodology and will develop a core set of required evidence-based practices.

Mountain Comprehensive Care Center, in partnership with Big Sandy Health Care, Inc., Pike County Health Department, and Pikeville Medical Center, will provide the Pikeville Integrated Care Clinic offering coordinated and integrated services through the co-location of primary and specialty care medical services in MCCC's community-based behavioral health center for the benefit of adults with serious mental illness in Pike County, Kentucky. Services will target adults with SMI and those with co-occurring substance use disorders who have or are at risk for co-morbid primary care conditions and chronic diseases. The targeted population will reflect many of the same characteristic of this rural, homogenous population including high rates of poverty and unemployment, low educational attainment and half of participants who identify as "disabled." Primary diagnosis reflect a high rate of mood disorders followed by schizophrenia/other psychotic disorders, anxiety disorders and a smaller rate of co-occurring SMI and substance use disorders.