Project Resiliency, led by Community Alliance Rehabilitation Services (CA) will expand community capacity to respond to suicide risk among adults, 25 or older, who have been affected by the COVID-19 pandemic, with special attention to victims of domestic violence, those living with serious mental illness or substance use disorder, and people who have experienced trauma, anxiety, grief, loss or attenuated behavioral health needs as a consequence of COVID-19. CA will strengthen its integrated physical and behavioral health services and partner with the Women’s Center for Advancement (WCA) to increase suicide risk identification, rapid response and access to prevention, treatment, care coordination and recovery services for those at risk for or who have attempted suicide, who are referred by health care, domestic violence or other community partners, or who self-refer. With the Nebraska Chapter of the American Foundation for Suicide Prevention (AFSP-NE), CA and WCA will provide training on suicide prevention and risk assessment for clinicians and general audiences as well as cross training on suicide prevention and domestic violence. The project will serve Nebraska’s Behavioral Health Region 6 which encompasses a 5 county area surrounding metro Omaha, encompasses 40% of the State’s population, and has incurred the largest number of confirmed COVID-19 cases in Nebraska. Grant funding will add the following strategic resources: A full time CA trainer to offer AFSP education and training modules, both virtually and face-to-face, on evidence-based suicide risk identification, rapid response and prevention to more than 420 community health and behavioral health providers and community groups connected to people at risk, including hospital emergency rooms and primary care practices, behavioral health and domestic violence professionals, churches, senior centers, the LGBTQ community, and organizations serving racial, ethnic and linguistic minorities; a full time Licensed Mental Health Professional (LMHP) and full time Care Coordinator to join CA’s Integrated Care Team and provide specialized support for people at heightened suicide risk and/or experiencing domestic violence; a WCA Advocate to provide added support to individuals affected by domestic violence including coordinating legal, financial, and support services vital to affected individuals and, with CAs LMHP, co-leading group therapy for domestic violence victims and community cross training in suicide prevention and domestic violence; and a full-time Project Director to lead the multi-agency effort, engage community stakeholders and oversee the achievement of program objectives and evaluation. Service access and responsiveness is further enhanced through the ability to purchase safe housing for those seeking safety and telephone, tablet and internet resources for client use. Evidence based practices employed include: National Institutes of Health Zero Suicide Framework, Columbia Suicide Severity Rating Scale, Cognitive-Behavioral Therapy, Trauma Informed Care, Motivational Interviewing, Seeking Safety, and the AFSP tools ICAR2E for suicide assessment in hospital emergency rooms, and SafeSide in primary care practices.
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NE Discretionary Funding Fiscal Year 2021
Nebraska Urban Indian Health Coalition, Inc. (NUIHC) was incorporated as a 501 (c) (3) non-profit in Lancaster County, NE. on May 28, 1986. NUIHC was founded by a forward thinking group of Native Americans who identified the need for culturally appropriate health care and substance abuse treatment services to serve the urban Indian population in Lincoln and Omaha Nebraska and Sioux City, Iowa. The mission statement, “to elevate the health status of urban Indians and other underserved population reflects the original goal, values, and the on-going commitment of the organization. NUIHC employs both a vertical and horizontal management structure. Governance is provided by a seven member Board of Directors which meets on a quarterly basis. The annual meeting is held in January during which time elections are held. During the annual meeting the Board reviews and approves organizational policies and procedures, position descriptions and property inventory. All The President has served 10 on the NUIHC Board of Directors. The Board President provides leadership to the board members. The Chief Executive Officer reports to the board and is responsible for the day- to-day operations of the business. Each program component is managed by a program director. The primary area of focus for NUIHC is the Inter-Tribal in-patient treatment, Outpatient Counseling Services and the Eagle Heights Transitional Living Program to provide access to culturally and linguistically appropriate substance use disorder and mental health (SUD/MH) services, in-patient treatment, out-patient treatment along with sober living and job readiness training for American Indian/Alaskan Natives (AI/AN) men and women aged 18 and older that reside in the Great Plains Area (North and South Dakota, Nebraska and Iowa) as designated by Indian Health Services (IHS). In accordance with the Indian Health Service (IHS) mission to raise the physical, mental, social, and spiritual health of American Indians and Alaska Natives to the highest level, these existing programs attempts to lower the incidence and prevalence of substance use disorders among AI/AN adult men and women to a level at or below that of the general population in the U.S. Inter-Tribal in-patient treatment is a 10-bed facility for those with SUD/MH and those with co-occurring disorders who identify as AI/AN in the Great Plains Area of the IHS. Clients receive in-patient treatment on an average of 60 – 90 days. During the COVID-19 pandemic Inter-Tribal has reduced the bed access to 5 so that social distancing can be achieved. NUIHC out-patient counseling services are generally done on-site by 3 dually licensed counselors that also spread their time across in-patient, out-patient and transitional housing clients. During the COVID-19 pandemic out-patient counseling services are being transitioned to tele-behavioral health and NUIHC is in the process of contracting with a reputable tele-health platform. This may not be appropriate for all clients which will be determined on a case-by-case basis. Eagle Heights is a non-medical transitional living program designed to facilitate the rehabilitation of SUD/MH clients by placing the client in a structured therapeutic environment. Eagle Height’s serves chemically dependent AI/AN who are accepted on the basis of an approved program plan, who are capable of self-care and self-support, are ambulatory, are not in need of acute medical care, and who now need assistance in making the transition back to independent living in the community. Eagle Heights regards itself as a part of the continuum of care for the chemically dependent provided in the community. The therapeutic environment of Eagle Heights is a long-term (120+ days) highly-structured program including diagnostic services; access to individual and group counseling; SUD/MH education: psychological self-awareness: decision-making skills development; and building self-esteem.
Community Alliance Rehabilitation Services (CA) CMHC project - Rebuild. Recover. Renew. - will ensure that individuals and families with SMI, SED, or COD, particularly minority and/or economically disadvantaged populations in Douglas, Sarpy, Cass, Washington, and Dodge counties in Nebraska, have access to recovery-oriented psychosocial rehabilitation and other evidence-based behavioral health (BH) services to help meet their needs. CA will boost staffing to increase outreach and engagement (or re-engagement) in services; expand capacity for peer support, family support and education, Supported Employment, and day rehabilitation; strengthen telehealth capabilities and referral pathways to crisis services; and provide targeted staff training to help address BH disparities, extend a trauma-informed care (TIC) culture, and attend to pandemic-related mental health needs. CA will enroll and serve 400 unique clients each year with grant funds. CA will also attend to the mental health needs of its staff by creating a Work and Well-Being Community of Practice. CAs goals and objectives include the following: (1) Increase outreach and capacity for psychosocial rehabilitation services: a) By the end of Year 1, an average of 85 individuals will receive day rehabilitation services each day, a 27% increase; b) By the end of Year 2, an average of 101 individuals will receive day rehabilitation services each day, a 50% increase; c) By the end of Year 2, 60% of clients engaged in Supported Employment services will return to work or gained employment; d) By the end of Year 1, the numbers receiving outreach and engagement through peer support specialists will increase to 75% of pre-pandemic levels; e) By the end of Year 2, the numbers receiving outreach and engagement through peer support specialists will be at 100% of pre-pandemic levels; (2) Increase training for staff in BH disparities, cultural competency, and TIC: a) By the end of Year 1, all staff will receive training in BH disparities, cultural competency, and TIC; b) By the end of Year 2, the TIC Trainer and Diversity, Equity, and Inclusion Manager will conduct 16 trainings with staff; c) 100% of project staff will receive annual booster training in Seeking Safety; (3) Develop a Work and Well-Being Community of Practice to meet staff mental health and wellness needs: a) By the end of Year 2, CA will provide 8 interactive learning opportunities and peer sessions for staff to integrate wellness strategies into daily practice; b) By the end of Year 2, 25% of staff will see improved ratings of wellness; (4) Implement family psychoeducation with fidelity to SAMHSAs model: a) By the end of Year 1, CA family education and support staff will provide family psychoeducation services and supports to 250 people, a 27% increase from 2020; b) By the end of Year 2, CA will respond to at least three recommendations from a baseline family psychoeducation fidelity assessment and improved their mean fidelity score; (5) Strengthen referral pathways with the Psychiatric Emergency Services (PES) unit: a) By the end of Year 1, CA staff will ensure response to all referrals from the PES within one business day; b) By the end of Year 2, CA will have served 200 individuals referred by PES.
Community Alliance Rehabilitation Services (CA) CCBHC will ensure that people with SMI/SED/SUD/COD in Douglas and Sarpy counties in Nebraska have access to comprehensive behavioral health (BH) and primary care (PC) services. Through the CCBHC, CA will expand BH services to children, youth, and transition-age youth and provide greater access to SUD treatment and integrated PC and BH care for children, youth (C/Y), and adults. CA will enroll and serve 600 CCBHC clients: 200 in Year 1 and 400 in Year 2. A full array of evidence-based practices (EBPs) will help enrollees manage symptoms and attain greater independence, better health, and improved quality of life. All clients will receive CCBHC-required screenings and coordination with primary care. CA will provide access to intensive services for people with complex BH needs, including ACT, High-Fidelity Wraparound, IPS, Supported Education, NAVIGATE for first episode psychosis, Permanent Supportive Housing, intensive outpatient (IOP) services, MAT, and outreach to veterans and their families for EBPs and supports. Primary goals and objectives include: 1) Formally launch the CCBHC by Month 4: a) Within 90 days, recruit, hire, and train all project staff; b) Establish an advisory work group with at least 51% CCBHC enrollees and family members; c) Finalize DCO agreements. 2) Universally screen and monitor health: a) Screen and monitor health indicators for 100% of enrollees; b) Screen and monitor prevalence and risk of diabetes and metabolic syndrome for 100% of enrollees on psychotropic medications; c) Train SUD clinicians in SBIRT, motivational interviewing, and relapse prevention by Month 6. 3) Increase access to integrated PC/BH care: a) 100% of new C/Y clients with complex BH/PH needs will have PC provider appointment within 10 business days of enrollment; b) By Month 4, 75% of youth referred by DCOs will be enrolled in integrated PC/BH care. 4) Expand access to intensive services for clients with complex BH needs: a) Enhance ACT services to include integrated PC and outcomes tracking for 120 consumers; b) Refer 100% of eligible C/Y to Wraparound by Month 4. 5) Expand psychosocial rehabilitation services for C/Y: a) Serve and coordinate referrals for 150 C/Y by the end of Year 2; b) Train C/Y staff in EBPs by Month 6; c) Enroll and serve 25% more transition-age youth in the NAVIGATE program by Year 2. 6) Increase services to veterans: a) Serve 20% more veterans with SMI/SUD by Year 2; b) By Month 12, connect 100% of veterans with complex needs to intensive services. 7) Decrease health risk: 50% of enrollees with elevated health indicators will experience a clinical improvement after 12 months. 8) Increase SUD treatment access and decrease substance use: a) Refer 100% of enrollees who screen positive for tobacco use to intervention; b) 50% will participate in intervention within 30 days; c) Serve at least 40 IOP clients in Year 1 and 75 IOP clients in Year 2; d) 75% of clients assessed to benefit from MAT will be referred within 10 days; e) 30% of enrollees with SUDs will reduce substance use after 6 months and 50% will reduce use by 12 months.
Heartland Family Service (HFS) CCBHC will enable HFS to strengthen behavioral health services in Pottawattamie, Mills and Harrison Counties in southwest Iowa. Depression, suicide and substance use disorder are key issues of concern in Iowa, along with low availability of mental health services. The CCBHC model will be used to further improve the integration of physical and behavioral health care for mental illness and substance use disorder. HFS has been a State Block Grant provider since 1981. As an Integrated Provider Network grantee, HFS provides substance use and problem gambling services and was selected based on ability to educate the public, assess local needs, provide effective co-occurring treatment, deliver prevention methodologies, and offer wrap-around services. Total population of this area is 122,730. The CCBHC funding will allow HFS to serve 1,800 people over two years. HFS provides person- and family-centered integrated services to SAMHSA’s targeted population and will welcome the opportunity to serve additional clients under the CCBHC grant. HFS has experienced staff who apply appropriate Evidence-Based Practices to effectively serve each client’s needs. HFS currently coordinates care with many other providers and agencies in southwest Iowa who serve the targeted populations, including Micah House shelter, Methodist Jennie Edmundson Hospital, One World Community Health Center, Children’s Square, All Care Health Center, Douglas County Veterans Services, and others. HFS offers a unique breadth of services to a broad population. HFS will continue to directly provide and expand crisis mental health services; screening, assessment and diagnosis; risk assessment; patient-centered treatment planning; comprehensive mental health and substance use services including psychotropic medication; screening for HIV and viral hepatitis; case management; psychiatric rehabilitation services; social support; peer support services; intensive community mental health care for members of the armed forces/veterans, and Assertive Community Treatment. HFS will use Designated Collaborating Organizations to provide medical substance use detoxification services and outpatient clinic primary care screening/monitoring and quality health care to meet all CCBHC requirements. Outcomes projected for the CCBHC include serving 700 clients in the first year of the award, and 1,100 in the second year of the award through expanded availability of behavioral health services. HFS will collect and provide the data elements required under the award to support evaluation and quality improvement activities for SAMHSA. HFS will ensure data sharing and quality measures with collaborating providers to better assess and impact population health and disparity reduction. A third goal is to provide more client and peer input into program approaches through the development of an Advisory Work group comprised of individuals with mental and substance use disorders, and family members, to provide input and guidance to the CCBHC on implementation of services and policies by 12/01/2020
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