OH Discretionary Funding Fiscal Year 2020

The proposed Building a Better Tomorrow for Hancock County project will be led and implemented by Family Resource Center of Northwest Ohio, Inc. (FRC) to serve individuals, workers, and families who are affected or at risk for suicide in Hancock County, Ohio. The project will utilize Zero Suicide framework, a system-wide approach that requires transformative change to prevent suicide and improve community health measures while bridging its population to services. Hancock County is home to about 76,000 people, with more than half (about 41,100) residing in the "micropolitan" county seat of Findlay. It is mostly rural, white (94%), and about 11% live below the federal poverty line. According to the Findlay Police Department's 911 dispatch call data that was gathered from January 2, 2018 to May 9, 2019, 40% (921 mental health calls out of 2,328 total calls) of the calls were related to someone in the community with a behavioral health issue. Within these mental health calls, 55% were suicide calls and 33% were mental health calls form a person suffering from mental illness. Since the COVID-19 pandemic, local community leaders report a significant increase in mental health distress, including suicidality. The project will provide a continuum of services from (1) community prevention through targeted training's and specific awareness/educational campaigns, (2) targeted or population specific interventions through prevention, intervention, screenings, assessments, and direct services, and (3) recovery support services through connected peer connection, community events and responses. Subpopulations to be served include adults age 25 years or older who are at risk for suicide or have attempted suicide, COVID-19 essential workers (e.g., first responders, grocery workers/food distributors, agriculture community (e.g., farmers), veterans, domestic violence victims and their dependents. Evidence-based practices/programs will include Mental Health First Aid, Question, Persuade, and Refer (QPR), Columbia Suicide Severity Rating Scale (C-SSRS), Ohio Local Outreach to Suicide Survivors (LOSS) Teams, Grief Recovery Method, Helping Children with Loss (HCWL) workshop, and VOICES program. The overarching goal will be to change the paradigm about the risk and protective factors associated with mental health, including suicidality, and substance use issues based on the latest science. FRC aims to serve 5,000 individual through direct and indirect services over the 16-month project period. FRC will target 50 individual who receive direct services for the GPRA NOMS data collection.

Project EnhAnCE-IT will Enhance Addiction Care Education through Integrative Technology by developing and implementing Addiction Care Essentials (AddCare), a six-module online curriculum incorporating video tutorials that feature culturally diverse addictions care experts demonstrating essential practices such as screening, brief intervention, and referral to treatment (SBIRT). AddCare is integrated into existing curriculum or as a standalone training. Project EnhAnCE-IT and its online AddCare curriculum will be developed and implemented at Kent State University (KSU), the second largest state-supported university in Ohio. Video production and distance education resources at KSU will be employed. Videos will be filmed on-campus in the TeleProductions studio. Video tutorials will feature addictions care experts from the Northeast Ohio region, including those practicing in top-ranked area hospitals. They will (a) deliver content on pharmacology, prevention, assessment and diagnosis, and treatment of substance use disorders (SUDs), (b) demonstrate corresponding principles and essential skills by interviewing simulated clients, and (c) debrief their demonstration for viewers. Students will be exposed to the same simulated clients, viewing separate video-recorded client monologues and then responding asynchronously to practice the skills demonstrated by featured experts. Once edited and approved by an expert advisory board, video tutorials will be incorporated into the online AddCare curriculum, housed in Blackboard Learn, the course management system used by KSU. Distance education staff will assist with this process. The goals of Project EnhAnCE-IT and its online AddCare curriculum are to (1) add relevant and essential curricular content to existing undergraduate and graduate addictions counseling curriculum; (2) provide online access to addictions care curriculum to non-counseling undergraduate and graduate students, including those at one of KSU's seven regional campuses; (3) complement existing face-to-face addictions counseling curriculum with online and interactive content; (4) incorporate addiction issues into the graduate counseling core curriculum to meet accreditation requirements; (5) expose students to culturally diverse experts and models in addictions counseling featured in video tutorials; (6) provide students opportunity to practice demonstrated skills and receive feedback; and (7) make addictions counseling education accessible beyond KSU to in-career counseling professionals for continuing education credit. Six months after implementation at KSU, at least 75% of students who participated in AddCare will report increased knowledge of SUDs and addiction care practices and greater acceptance of persons with SUDs (i.e., lower stigma). It also will be rated as accurate and complementary/synergistic to current addictions counseling curriculum by advisory board members. The number of students who pursue further addictions counseling education will increase by at least 25% in the first year. It is estimated that 250 persons will participate in AddCare in Year 1 of the project, an additional 300 persons in the second year of the project, and approximately 150 persons each year throughout the lifetime of the project.

The Mercy Health Rural EMS Training Initiative will provide high quality Emergency Medical Services (EMS) training in rural Sandusky and Henry Counties, located in Northwest Ohio. The proposed activities will strengthen the quality and consistency of training of EMS personnel in both counties by delivering continuing education that focuses on the use of hands-on skills using high fidelity manikins with scenarios that mirror common cases and low frequency/high risk procedures. The provided training will be responsive to the needs of the communities in which the EMS personnel serve. In Sandusky County, Mercy Health will partner with Sandusky County EMS, which has five EMS locations. Mercy Health will also partner with the Napoleon Fire and Rescue department, located in Fulton County, in Napoleon, Ohio. The goal to increase the capacity of rural EMS personnel to provide high quality and consistent emergency medical services in their communities will be achieved by training at least 125 EMS personnel in Henry and Sandusky counties. At least 65 EMS personnel will be trained on care of patients with mental and substance use disorders. At least 65 personnel will also be trained on best practices in the administration of opioid overdose antidotes. Training will include special care of COVID-19 patients, including simulation scenarios using personal protective equipment and advanced airway management. The project will result in an infusion of advanced equipment for EMS personnel training, naloxone doses and bag valve masks for overdose treatment, and personal protective equipment such as N-95 masks, goggles, and face shields.

The SUD Highly Qualified Practitioner Training and Preparation Project will ensure that graduates of Miami University will undertake cutting edge SUD training, and will be certified to use the training to provide high quality SUD services in Ohio and elsewhere. Enhancing and integrating SUD topics into Miami’s regular curriculum will deepen the understanding and enhance the skill development of future social service professionals across disciplines. This enhanced understanding will include information related to substance use disorders, case management, when and how to refer for substance use treatment, relapse prevention, how to handle relapse, and how models, such as harm reduction, work in the field. In addition, a key component of this project is developing a clear pathway to certification and licensure through the Ohio Chemical Dependency Professionals Board to increase the pool of eligible applicants for jobs in the region and deepen the SUD knowledge of skilled professionals in a variety of employment settings, including but not limited to social services, nursing, teacher education, psychology, educational psychology, and kinesiology and health. The goals of the project are to 1) increase the capacity of the local SUD workforce by increasing the number of well-trained, educated, skilled, competent, certified, and credentialed providers who can implement high-quality SUD services, and 2) expand our network of partnerships to support newly trained field practicum students by increasing their practical knowledge during the implementation of high-quality SUD services. Our objectives for achieving these goals include a) completing revisions of undergraduate and graduate SUD courses, b) increasing students’ knowledge and usefulness of key SUD concepts, c) using experts in SUD screening, assessment, and treatment to oversee the development, implementation, and revision of the new SUD curriculum to ensure research-informed content, d) increasing field placement students’ knowledge and skills related to SUD screening, assessment, and treatment, e) increasing faculty’s knowledge of SUD screening, assessment, and treatment, and f) expanding partnership resources through membership and participation in the Mental Health & Addiction Advocacy Coalition. To create the biggest impact, this training will be offered to 190 undergraduate and graduate students across the university with specific recruitment efforts targeting social work, nursing, public health, kinesiology, psychology, teacher education, and educational psychology students. Graduate students in the social work program will be required to take a 3-credit hour course on SUD Treatment Techniques, aligning with the State of Ohio’s Chemical Dependency Counselor Assistant and Chemical Dependency Counselor required training content areas.

In 2019, the counties of Greene, Miami, and Montgomery, Ohio, were devastated by an unprecedented 18 EF4 tornadoes. The Ohio Disaster Response Project (ODRP) will address the mental health, addiction, and wraparound needs of both youth and adults in these communities through evidence-based screening, diagnostic, crisis, and treatment services, as well as a comprehensive workforce development plan, serving a total of 69,000 unduplicated individuals. Youth will be served via school-based universal screenings using the SBIRT model and Panorama Social Emotional Learning Assessment. High risk young people will be referred to a Student Resiliency Coordinator who will provide care coordination and linkages to a continuum of services that include prevention, screenings, diagnostic assessments, mental health therapy, case management, and psychiatric services. School districts will also have access to crisis support and a crisis debriefing intervention team as part of their emergency preparedness planning. Evidence-based treatment services for youth will include Cognitive Behavioral Therapy (CBT), Trauma-Focused-CBT, as well as family, group, and play therapies. Adults will be served via the network of behavioral healthcare providers who will integrate trauma questions into their standardized intake forms. As clinically appropriate, evidence-based treatment services for adults will include CBT, Cognitive Processing Therapy, Eye Movement Desensitization and Reprocessing, Community Psychiatric Supportive Treatment, Withdrawal Management, Medication Assisted Treatment, Integrated Dual Disorder Treatment, and Assertive Community Treatment services. Telehealth services will be available in tech-enabled spaces where individuals may meet privately with a remote clinician. All individuals will be assisted with transportation and access to community vocational services. A Mobile Crisis Outreach Team will be deployed for any youth or adult that is deemed to be in imminent danger. Workforce development opportunities will include Youth and Adult Mental Health First Aid, Trauma Informed Approaches, Social Resilience Model, Stewards of Children, Threat Assessment, Crisis Intervention Planning, De-Escalation, NOVA trainings, and several evidence-based treatment modalities. A comprehensive marketing plan will ensure individuals have knowledge of, and access to, community resources via the GetHelpNow software application. Lastly, these communities will come together for planning purposes via the ODRP Community Resilience Committee that will utilize the Adverse Community Experiences and Resilience and the THRIVE models as frameworks for addressing and preventing community trauma. By September 2021: 1) 162 new instructors will be trained in new training curriculum, 2) 2,500 people will be trained, 3) 9 providers will implement treatment EBPs, 4) 5 schools will implement SBIRT, 5) 9 schools will implement SEL assessments, 6) 135 new members will join the Ohio Crisis Response Team, and 7) the Ohio Disaster Response Community Resilience Committee will have met a minimum of six times.

The Ohio Department of Mental Health and Addiction Services (OhioMHAS) will allocate funding from the Emergency COVID-19 grant to enhance existing crisis services and prioritize direct services to Ohio's children and adults with Serious Mental Illness (SMI), Substance Use Disorder (SUD), and co-occurring SMI and SUD. OhioMHAS will also target the state's frontline healthcare professionals as well as other Ohioans with less than severe mental illness who require mental health care as a result of COVID-19. Grantees will be required to split funding into the required sub-categories for providing direct services to healthcare providers (10%) and those that do not have an SMI (20%). Grantees will utilize the rest of their funding (70%) to reinforce the existing mental health crisis system. Funding will be distributed to six lead mental health and addiction Boards that represent established crisis collaboratives in different regains through the state. Each Board will work with their respective catchment area Boards and providers to determine where funding can be used to address gaps within existing crisis services. Targeted crisis services will include mobile crisis teams, children's mobile response stabilization services, crisis stabilization centers, and crisis hotline services/call centers. Possible uses of funds could include: Crisis hotline services/call centers will be enhanced to provide the screening, brief therapeutic intervention and referral (SBIRT) model to identify then direct individuals impacted by COVID-19 to the appropriate level or care; Mobile crisis teams and children's mobile response stabilization services will be expanded to provide additional services to the growing need; and Crisis stabilization centers will work with local hospitals and emergency departments (ED) to expand services for individuals in need of treatment and divert utilization of ED services. Evidence-based therapies will be available through brief intervention or individual therapy, and throughout the continuum of services, grantees will be required to expand the use of telehealth. With this project, OhioMHAS will reach a minimum of 1,500 Ohioans, with a focus on increasing the number of individuals who receive screening as well as increasing the number of available services and positive outcomes such as employment.

Project Title: Addiction treatment Counts: Expanding Interprofessional Training (AtCE IT!) Disciplines included: Marriage and Family Therapy (M.A.), Clinical Mental Health Counseling (M.A), Family Psychiatric Mental Health Nurse Practitioner; Social Work (MSW). A brief overview of the project as a whole: The AtCE IT! program aims to develop an innovative, high-quality, comprehensive curriculum related to interdisciplinary training and clinical practice in the use of SBIRT, assessment, and SUD treatment principles among interdisciplinary trainees in order to improve Health Professionals' use of SBIRT in clinical practice, thereby mitigating the SUD treatment gap. Additional goals for AtCE IT! include improving the educational and supervisory support structure for trainees to learn more about SBIRT throughout their coursework and within their clinical practice, developing a pipeline for trainees to pursue their Chemical Dependency Counseling (CDC) credential and to advocate licensing and certification boards about implementing examination questions related to SUD on relevant exams, and to develop training materials that can be adapted for user-friendly implementation in other Health Professions curricula. Specific, measurable objectives that the project will accomplish: A total of 120 student trainees, 10 faculty members, and 20 site supervisors will complete the AtCE IT! training, and 50 students will pursue the Chemical Dependency Counselor (CDC) license in the state of Ohio Further, 90% of trainees in clinical practice will routinely utilize the skills and knowledge learned from the training as part of their clinical practice, and 90% of trainees will demonstrate improved knowledge and perceptions regarding SUDs, SBIRT, assessment, treatment principles, and interprofessional collaboration. Additionally, all student trainees will experience at least one advocacy experience related to advocating to licensing and certification boards about implementing examination questions related to SUD on relevant exams. Finally, data review will be used to inform modifications of curriculum necessary to improve AtCE IT! and to develop a program manual outlining the training protocol to allow for user-friendly implementation in other Health Professions curricula. How the proposed project will be accomplished: To successfully implement AtCE IT!, we have developed an interdisciplinary research team with diverse content expertise to create the AtCE IT! curriculum within the context of interprofessional collaboration (see Position Descriptions). We have also devised a clear implementation plan and program evaluation plan (see Narrative). AtCE IT! will be built in as required assignments into extant courses to account for both profession-specific training needs and allowing interprofessional education across four Healthcare disciplines.

Zepf Center, in partnership with ProMedica Flower Hospital, Mercy Health St. Charles Hospital, Northwest Ohio Psychiatric Hospital, Bethany House, the YWCA of Northwest Ohio, OhioMeansJobs Lucas County, and the Lucas County Family and Children First Council proposes the Emergency Response for Suicide Prevention Program (ERSP) in Northwest Ohio. We anticipate serving 75 unduplicated individuals over the course of the 16 months, with an anticipated start date of June 30, 2020. This project works directly with two domestic violence shelters (Bethany House and YWCA), three hospital systems, employment services, and family services to create a cross-system approach to addressing suicide due to COVID-19.

The Montgomery County Zero Suicide Project will initiate, improve, and expand suicide prevention services within Federally Qualified Health Centers, Behavioral Health Organizations, Emergency Departments, and VA outpatient clinics in Montgomery County, Ohio. Focusing on adults age 25 and older at greatest risk of suicide, the project will serve 7,200 unduplicated individuals annually and 36,000 over the entire five-year project period.

The proposed Family Resource Center of Northwest Ohio CCBHC (FRC-CCBHC) will serve individuals with severe mental illness (SMI), substance use disorders (SUD), co-occurring disorders (COD), and children and adolescents with serious emotional disturbance (SED) in Hancock County, Ohio. Subpopulations of focus will include veterans and justice-involved individuals. The proposed CCBHC will fill a critical unmet need by offering behavioral health services regardless of residential status or inability to pay. FRC is the county’s largest and most comprehensive provider of SUD and mental health services, including medication-assisted treatment (MAT), outpatient, and recovery support services. The overarching goals of the program are to (1) Expand upon the capacity, effectiveness and efficiency of our behavioral health workforce by facilitating collaboration across departments and systems; (2)Improve care coordination to remove barriers to access for treatment and recovery; (3)Establish, expand, and strengthen behavioral health initiatives to increase consumer engagement in treatment and recovery, including identified subpopulations; and (4)Formalize a data-driven quality improvement process that facilitates efforts to successfully meet the needs of CCBHC consumers and sustain the program. Measurable objectives will include a decrease in countywide HIV/Viral Hepatitis transmission, suicides, and intentional injuries, as well as increased access to primary care and improved consumer retention in care. We also aim to enhance training opportunities, expand and optimize our EHR, and expand our current telepsychiatry service into homes and jails. A Mission Act Certification and the inclusion of Community Care Navigators will help our target population access tailored care and community recovery supports. Finally, formalizing processes for data driven decisions will enhance the delivery of high-quality patient care, help sustain operations, and augment our organization’s ability to remain responsive to an evolving system of value-based health care. FRC aims to serve 1,000 individuals over the two-year project period: 400 in year 1, 600 in 2. FRC’s CCBHC will utilize the Recovery Oriented System of Care (ROSC) framework, an evidence-based organizing concept that has been shown to improve clinical outcomes for those with mental health and substance use disorders by coordinating a network of community-based services and person-centered supports to enhance the resiliencies of families/communities and improve overall health and quality of life for those with or at risk of mental health and/or substance use disorders. Our organization will leverage technology, including telehealth, mobile, and web, to “meet people where they are,” recognizing that most of our target population are online.