MI Discretionary Funding Fiscal Year 2014

The Association for Children's Mental Health (ACMH), through statewide parent-to-parent peer support, education, information and referral provided to parents/caregivers of children and youth with serious emotional disturbance, will empower families raising children and youth to have the skills, abilities and knowledge needed to navigate their child and family's service experience, use their voice to influence key decision makers, and become active participants in the policy level decision making that will affect all children and families throughout Michigan.

This proposal includes enhanced and expanded access to Parent Support Partners for families raising children and youth with serious emotional disturbance. . Expanded outreach and education will allow increased awareness for persons frequently encountering young people with mental health needs who do not have the training or understanding how to be helpful.

Our integrated 'health home' project will enhance and build on primary care services currently provided within the 55,000 square foot Community Mental Health Services of Muskegon County (MCMH) facility located in culturally diverse, downtown Muskegon, Michigan. Services will expand to include comprehensive nurse care management, peer and family support, health and nutrition education, wellness programs, and referrals and follow-up for adults living with severe mental illness (SMI) including those with co-occurring substance use disorders (COD) and those who are uninsured/under-insured who receive services at MCMH. We will serve at least 200 persons within these populations in year one; at least 375 persons in year two; at least 475 persons in year three; and at least 600 persons in year four, and plan to continue the project well beyond the life of the grant. We will train nurses in comprehensive care coordination and certify trainers in Motivational Interviewing, Trauma Informed Care, and Recovery and Wellness; recruit medical staff and add dental services and children's healthcare; expand days and hours of operation; utilize electronic prescriptions, laboratory results and health records; add peer and family supports and wellness/cessation programs; and implement continuous quality improvement. Collaborations and care continuums will ensure health needs of are met. We will expand and enhance the current CMH located primary care clinic collaborative. We will recruit and hire or reassign and train 20 FTE staff and integrate them into our integrated clinic. We will provide an array of culturally competent services, to 1,675 persons with severe mental illness or severe emotional disturbance using a team-based, integrated approach to improve overall health and well-being, enhance access to care, prevent unnecessary emergency room utilization and provide early identification of problems by January 2013.

Project HEART is a collaborative between a culturally competent community mental health agency and a nationally-regarded school of osteopathic medicine, plus multiple community support agencies including a Federally Qualified Health Center and a major trauma hospital to establish an Integrated Health Center (IHC) which will provide coordinated and integrated primary and behavioral health care services to low-income, high-risk Detroiters who suffer from serious and persistent mental illness and who have or are at risk of a primary care condition or chronic disease. The target population is low-income Detroiters who (1) have a serious and persistent mental illness, (2) have or are at high risk for one or more chronic health conditions, and (3) have one or more of the following: two or more hospitalizations in the past year, three or more emergency room visits in the past six months, who have been homeless in the last year, or face imminent homelessness in the next month. Strategies and Interventions include best practice models of on-site physical medicine, collaborative care, and case management, along with person-centered planning, chronic disease management, dental services, substance abuse screening and treatment, health promotion and prevention, transitional care planning, and medically-necessary referrals, Evidence-based practices of Assertive Community Treatment, Integrated Dual Diagnosis Treatment, Motivational Interviewing, MI-PATH, WRAP, InSHAPE, Food Education for People with Serious Psychiatric Disabilities, Peer-to-Peer Tobacco Dependence Recovery Program, and TREM will be used, along with Supportive Housing, literacy programs, supportive employment and other supports.

Wayne County, Michigan and the Detroit-Wayne County Community Mental Health Agency (D-WCCMHA) in partnership with American Indian Health and Family Services (AIHFS) plans to integrate two existing Systems of Care, serving 468 annually and 1,800 over the life of the grant. The goals of the partnership are to: 1) Strengthen, expand and sustain the SOC values and principles and to develop sustainable sources of funding, increase the number of agreements, and to offer culturally and linguistically relevant services to SED children (age birth to 21) in Wayne County, and specifically Native children, youth and families who are "out of balance and challenged by spiritual unrest;" 2) Develop ongoing education, training and assessment to workers across all systems to create and facilitate widespread adoption of comprehensive policies at the community, county and state levels; 3) Increase the number of child/youth serving agencies/ organizations/communities that demonstrate improved readiness to change their systems; 4) Increase the number of organizations collaborating/ coordinating/ sharing resources with other organizations. 5) Increase the number of youth/family members involved in all aspects of the SOC; 6) Expand social marketing efforts to increase mental health awareness messages.

By creating a Health Home we improve access, clinical quality, and the efficiency of health care delivery by: improving communication and coordination of care; reducing unnecessary tests and procedures; leveraging information technology and process improvement techniques to reduce operational and administrative redundancies; and fostering research and evaluation. Goals include: 1. Improve health status, increase life expectancy and quality of life for consumers 2. Improve management of chronic conditions 3. Achieve efficiency in utilization of health care resources resulting in cost savings 4. Enhance consumer's experience of care 5. Transform health care systems by coordinating community resources and influence flexibility in funding of care coordination. We are expanding our current integrated care program that began in 1994 with collocated primary care services in our clinic, but with limited interactions between physicians and behavioral health staff, to a second generation of increased collaboration, to this third generation that reflects integration of treatment plans, health promotion/education and introduces Care Support Specialists to promote enhanced coordination and integration of health care services. Care Support Specialists blend the roles of care coordinators and case managers. Of the projected 1,650 adults to be served, they reflect largely low-income, uninsured or Medicaid enrolled individuals who are Black/African American (85%), between the ages of 18 and 85 (75% between 18 and 64), and equally representative of females and males. We expect to reduce unnecessary health care services, resulting in an overall decrease in annual health care expenses by 25 percent of the Michigan average for persons with dual eligibility (Medicare and Medicaid).

Dial Help, Inc. serves the 15 county rural area in Michigan known as the Upper Peninsula. The region has a higher suicide rate per 100,000 than the national average. The population in Dial Help's service area is comprised of several groups at higher risk of suicide, notably the elderly, GLBTQIA individuals, a high prevalence of non-Hispanic White males, and Native Americans. These groups are also currently at a disparity for receiving free suicide crisis intervention help from Dial Help. Additionally, several service gaps for suicide prevention exist across the area, notably that most counties in the region with no free or sliding scale mental health counseling options.

The Gun Lake, Nottawaseppi Huron and Pokagon Bands-all federally recognized Potawatomi tribes located in their ancestral homeland in southwest Michigan and/or north central Indiana--have formed a Consortium to promote the wellbeing of Potawatomi children from birth to 8 years living in its service area by addressing the physical, social, emotional, cognitive, behavioral and cultural aspects of their development using evidence-based practices. The Consortium's Project will build on existing tribal programs, especially those provided through the four Tribal Health Clinics and three Tribal Head Start Programs that already reach the targeted children and families. A variety of evidence-based practices will be implemented, including Incredible Years and Positive Indian Parenting. Various trainings will increase skill levels of a host of caregivers and providers, including parents, foster care and child care providers, Head Start staff, medical providers, and social workers. Trainings will focus on screening and assessment, mental health consultation, enhanced home visitation, family strengthening, parent skills training and cultural competency.

Peers Employed in Evidence-based practice for Recovery (PEER) will combine the dual efforts of peer-driven mental health system transformation and the implementation of evidence-based practices for adults with serious mental illness. The project will integrate and evaluate the impact of peer services embedded in evidence-based practices on outcomes and system change throughout the region. This initiative will employ the recovery oriented workforce in Southwest Michigan to provide the infrastructure, workforce development, fidelity and outcome monitoring, and program evaluation to successfully employ peers in established Supported Housing, Supported Employment, Integrated Dual Disorder Treatment, Assertive Community Treatment, and Supported Education. These practices will establish partnerships with individuals served to assure that they achieve the life they want. PEER will include peer-run and traditional mental health service organizations that serve adults with serious mental health. Individual outcomes will be determined using the NOMs tool reported in TRAC, and the Illness Management and Recovery (IMR) individual recovery measure. PEER will employ the Recovery Self Assessment (RSA) and use focus groups to assess organizational change. Finally, fidelity scales (both Treatment and General Organizational Indexes) will be utilized to determine the degree of fidelity to the evidence-based model. PEER hopes to add to the evidence of the efficacy of employing peers in existing Evidence-Based Practices (EBPs) on individual and system outcomes.

The Community Family Partnership (CEP) of Kent County, Michigan extends its existing cross-agency efforts to a broader unified network of all county providers serving children with serious emotional disturbances (SED) and their families as well as regionalizing with other CMHI grantees. The CFP emphasizes on-going leadership and governance of families, youth, and system stakeholders while incorporating practices that affirm community diversity. The CFP's individualized strengths-based approach to services recognizes the importance of family, school, and community and addresses the child's physical, emotional, educational, cultural, linguistic and social needs while providing supports to maximize their greatest potential.

This project transforms the way services are delivered to young adults at risk of mental illness providing a consumer driven, recovery oriented and trauma informed system of supports and services that is based on evidence practices of Motivational Interviewing and Seeking Safety. The system transformation to trauma informed care will be extended throughout Kent County, Michigan, supported by the Creating Cultures of Trauma Informed Care change process. Services will be designed to identify and address recognized risk factors of mental illness, starting with young adults, and will provide outreach, screening and early intervention services based on culturally competent behavioral health care specifically designed for adults age 18-25 with noted risk factors. The service project will serve 500 young adults (100 new adults each year) over the course of 5 years. While all of these young adults will have significant trauma in common, they will vary in their stages of development as well as cultural backgrounds. This project will provide an alternative to traditional adult service models that are not well suited to a youth culture and their developmental needs.