NE Discretionary Funding Fiscal Year 2023

Community Alliance’s Healthy Transitions project, in collaboration with our local behavioral health authority, Region 6 Behavioral Healthcare and other key partners, will improve and expand services and supports for transition-aged youth and young adults (ages 16-25) in Douglas and Sarpy counties, Nebraska who either have, or are at risk of developing serious mental health conditions. We will help maximize the potential of our population of focus (POF) to assume adult roles and responsibilities and lead full, productive lives by collaboratively working towards the following goals and objectives: (1) Through the establishment of coordinating structures at system and agency levels, the development of interagency and intra-agency agreements concerning services to the POF, and the development of a well-represented and well-informed advisory council, improve system coordination so that the POF routinely receive the services and supports they need. At least 51% of the advisory council will include youth, young adults, and family members and by Year 2, the advisory committee will establish a peer-led evaluation team. (2) Based on findings from a system needs assessment, build a multi-year plan for filling in service and care coordination/navigation gaps for the POF and identify the trainings that will be needed to support the development of services and coordination activities. (3) Develop reliable referral pathways to vital evidence-based practices and other services within the youth-serving and adult-serving behavioral health systems, including for youth aging out of child/youth systems. (4) Develop a centralized care coordination resource that draws on current best practices to ensure the POF, particularly those with multi-system involvement or who are aging out of youth systems, promptly access necessary behavioral health services, including evidence-based and team approaches such as Coordinated Specialty Care (CSC) for transition-aged youth with first episode psychosis and Critical Time Intervention. (5) Promote the dissemination and adoption of added suicide prevention best practices as well as better coordination of existing programs. (6) Enhance Community Alliance’s supported employment services to include supported education and increase supported employment service utilization by the POF. (7) Strengthen family education and family support services for individuals in the POF who are receiving behavioral health services. (8) Improve outcomes among the POF across multiple domains and increase their opportunities to enjoy meaningful adult lives in the community. (9) Develop better alignment and use of funding streams to ensure sustainability of a strengthened, better coordinated and more effective service system for the POF. Over 5 years, we will provide outreach services to at least 1,000 unduplicated members of the POF. CA and partners will screen a minimum of 80 unduplicated members of the POF in Year 1, 120 in both Years 2 and 3, and 160 in both Years 4 and 5, resulting in enrollment and service to 40 unduplicated individuals in Year 1, another 60 in each of Years 2 and 3, and then 80 in each of Years 4 and 5, for a 5-year total of 320 members of the POF.

Community Alliance (CA), a CCBHC in Omaha, will expand its supported employment (SE) program and integrate SE services and principles throughout the organization through the Transforming Lives Through Supported Employment program. By serving 60 new, unduplicated clients annually and 300 over the course of the grant period, CA will reduce the unmet need for evidence-based SE among unemployed adult clients with SMI and COD by 50%. CA will use the grant as a springboard to develop a plan for meeting 100% of the need after the grant program ends. Members of the POF who currently receive clinical services at CA cope with very high levels of unemployment (87%). They also live in poverty: upon intake at CA, members of the POF have an average of only a little under $700 per month in income and one in four have no income at all. In a given year, only 8.5% of CA clients in the POF utilize current SE services, known as WorkSource. African American and American Indian clients are even less likely to gain access to SE services than are other clients. For the grant program, CA set significant goals for the POF, including a 100% increase in the number of adults in need who receive SE services; a concomitant 100% increase in the number of CA clients from the POF who become employed; a 50% reduction in self-reported unmet need for vocational services and supports; and a lowering of the unemployment rate from 87% to 65% among all adult clients at CA who have SMI or COD. The proposal outlines a feasible process of SE expansion and integration over the course of the five-year grant period, that includes the addition of four supported employment specialists, a peer employment support specialist, and a business/employer liaison to its existing SE program. Currently, half of WorkSource employment specialists are embedded in CA’s clinical teams, including First Episode Psychosis Care and Assertive Community Treatment, but through the grant program, CA will embed all new and existing employment specialists in six different clinical programs. CA will continue to embrace the Individual Placement and Support (IPS) model of supported employment and will use the grant funding to expand training for WorkSource staff and achieve higher implementation fidelity in areas where WorkSource previously was found to be weaker. Fidelity of implementation will be assessed by six months in Year 1 and annually thereafter. Data and information from fidelity reviews, goal and objective progress monitoring, and NOMS-based outcomes will be used within a quality improvement framework to enhance WorkSource program access, quality and outcomes, while reducing racial/ethnic and other disparities. CA will develop a Business Advisory Council which will work collaboratively with WorkSource to identify and develop an increasing array of competitive employment opportunities for WorkSource clients and, at the same time, meet the workforce needs of Omaha area businesses and organizations.

Educational Service Unit 2 (ESU 2) is a regional service center in east central Nebraska. The agency supports school districts in the counties of Burt, Cuming, Dodge, and Saunders with student enrollments of 12,000 across 16 school districts. In rural areas more than 60% of individuals live in an area with mental health professional shortage. Rural residents who are wanting supports have nowhere to turn.

Educational Service Unit 2 (ESU2) is in Fremont, NE and serves 16 school districts in Burt, Cuming, Dodge, Sunders, and parts of Lancaster Counties. ESU 2 will partner with our 16 districts, the Nebraska Department of Health and Human Services, Nebraska Department of Education, our Regional Behavioral Health Systems, local mental health service delivery agencies, and local universities to build a capacity and sustainability for comprehensive school mental health services through evidence based practices. Through this project, over 12,000 students, their families and 958 teachers will be impacted by the development of ESU 2 ACCESS Project AWARE. Mental Health IS Health. This is the rallying cry for members of the ESU 2 ACCESS team. Charged with supporting the ever-increasing requests for mental health and behavioral supports from schools, ESU 2 assembled team ACCESS. ACCESS stands for All Children Celebrated, Educated, Save, and Secure. The project goals include: 1) Prevent development of mental health and behavioral disorders among students at each district by providing a positive, supportive, and trauma-informed learning environment; 2) Increase development of student skills fostering resilience and pro-social behaviors at each district through strength-based approaches and/or social emotional learning (SEL); 3) Increase the school-based mental health services available to students at each district site; 4) Increase each district's capacity to identify and immediately respond to the mental health needs of students exhibiting behavioral or psychological signs requiring clinical intervention; and 5) Establish school-based, culturally relevant, and evidence-based suicide awareness, prevention, and postvention for secondary schools. Through the implementation of evidence-based, trauma-informed practices in mental health screening, assessment, interventions, and treatment, up to 13,000 students will be served through the project each year.

This project will increase the capacity of Kearney Public School (KPS) staff and community partners to identify significant symptoms of mental health illness and de-escalation strategies. This will be accomplished by training in Youth Mental Health First Aid and Crisis Preventions and Interventions training. The project will also expand community resources and support for KPS students with serious mental health illness (SMI) and serious emotional disturbance (SED). This will be accomplished by providing a referral network of community providers and supports that KPS staff and community organizations will use to help KPS students receive assistance. Buffalo County Community Partners, a partner in this project, will also engage in a evidence-based social media campaign to help raise awareness of mental health conditions among children and youth in our community. And, this project will establish referral mechanisms and support for KPS students with SMI and SED. We will develop referral forms and hold quarterly meetings with an advisory board of community mental health partners who will guide the direction of this project by looking at the data collected through training and referrals to help identify challenges and opportunities for project improvement.