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SM-17-001 Individual Grant Awards 2017SYSTEM OF CARE
|Award Number||Organization||Grantee State Sort descending||City||Funding amount|
|1 H79 SM080161-01||
The School District of Osceola County, Florida aims to build local capacity to promote and protect students’ health, well-being, and learning ability by expanding the System of Care approach. Efforts will build on previous advances that emerged from the Safe Schools/Healthy Students Initiative and Project AWARE outcomes, such as creation of a centralized mental health services referral system and training of more than 400 Mental Health First Aiders. Community agency leaders realize that services offered in silos adversely impact children and families. This expansion will continue the important work of eliminating these gaps and integrating critical services. Collaboration will involve the Osceola County Children’s Cabinet, Florida Department of Children and Families (Current SAMHSA Grantee), Park Place Behavioral Health Care, and other organizations. The goal of the proposed Osceola County System of Care Expansion is to improve the outcomes and supports for children (Prekindergarten through 5th grade), including their families and caregivers, who have been diagnosed or are diagnosable SED/co-occurring disorder including early onset and/or first episode psychosis and struggling in multiple life domains. Activities will reach an estimated 15-20 families annually for a total of 60-80 families over the four-year project period. The project will aim to increase the widespread adoption of the Five Protective Factors Framework, which includes Parent Resources, Knowledge of Parenting and Child Development, Social and Emotional Competence of Children, Social Connections, Concrete Support in Time of Need. Provision of intensive wrap-around services will strengthen families who will become more self-reliant and better able to cope with chronic mental health conditions and acute mental health crises. The project objectives are to: 1. Increase availability of and access to quality mental health services and supports to children, youth and their families for mental health and/or co-occurring disorders; 2. Increase the prevalence of community providers offering services in line with evidence based or evidence-emerging practices (e.g. Wraparound Process) to ensure sustainability of OCSOC goals and widespread adoption of the values and principles of Systems of Care; 3. Increase collaboration among child-serving and adult-serving mental health and substance abuse providers and systems; 4. Increase youth and family engagement in the creation, implementation and management of the treatment plan; 5. Improve outcomes across multiple life domains; and 6. Decrease placements in restrictive or institutional settings. The intensive wrap-around services process will become the standard approach through systemic changes, training, and workforce development.
|1 H79 SM080157-01||
ABSTRACT - Executive Summary: The Lake County Health Department and Community Health Center (LCHD/CHC) will expand and improve a county-wide, sustainable System of Care approach to providing child and adolescent behavioral health services by both increasing capacity for services and investing in System of Care infrastructure. Project Name: Lake County System of Care Expansion Population to Be Served: The Lake County System of Care (SOC) Expansion project will target children and adolescents who have experienced serious emotional disturbances (SED), have signs of, or who are at risk of mental illness. While the project will serve children throughout Lake County, the focus will be on five communities in Lake County with significant low-income populations. Demographic and clinical characteristics: -Demographic: At least 57% of the population enrolled in services is expected to be a racial/ethnic minority or have a preferred language other than English -Clinical: All children will be screened at intake to determine eligibility for the program. In order to begin care, children must have an emotional, socio-emotional behavioral or mental disorder as diagnosable under the DSM-IV. Strategies/Interventions: The Lake County System of Care team will take a two-fold approach to improve behavioral health services in the county. First, the proposed activities will expand capacity for behavioral health services including adding staff at the local Children’s Advocacy Center and Juvenile Justice facility. Second, the proposed activities will invest in local and state infrastructure to improve the overall network of care available to youth in Lake County. This will include interaction with state SOC partners, training with local providers and coordination of care according to wrap principles. Project Goals/ Measurable Objectives: The System of Care Project has six goals. Measurable objectives are included in full application. Goal 1: Increase System Capacity; Goal 2: Improve the continuum of care; Goal 3: Increase access through social marketing and outreach; Goal 4: Raise the level of competence among community providers; Goal 5: Build a coordinated network of community-based services; Goal 6: Engage with state partners to improve state SOC services. SOC Enrollment goals: By year 4, LCHD/CHC aims to enroll at least 250 new, unduplicated consumer in evidence-based SOC services per year for a total of at least 1,000 over the life of the grant.
|1 H79 SM080145-01||
System of Care Expansion and Sustainability Cooperative Agreements Funding Opportunity Announcement (FOA) No. SM-17-001 Transition Age Youth and Young Adults System of Care Access Initiative Abstract Massachusetts (MA) proposes to use this CMHI Cooperative Agreement to implement a Transition Age Youth and Young Adults System of Care Access Initiative (TSAI) that will create attractive and accessible gateways to system of care (SOC) services for Transition Age Youth and Young Adults (TAYA) ages 16 to 21 with mental health (MH) and co-occurring substance use disorders (SUD). These gateways will be informal, flexible, safe, welcoming to diversity, and committed to having TAYA achieve their own goals. TAYA entering this service system will be engaged in Wraparound Planning and assisted to get other needed services. The TSAI will build on the MA Medicaid (MassHealth) Children’s Behavioral Health Initiative (CBHI), a well-established high fidelity statewide SOC delivered by Community Service Agencies (CSAs). TAYA are at high risk for MH and co-occurring substance use challenges, but their unique needs are often not met within either the child or adult service systems, and they are often disconnected from any services. DMH’s current CMHI cooperative agreement, Success for Transition Age Youth (STAY), has enhanced services in 11 CSAs to better service TAYA, which has increased TAYA participation. However, MA has determined that its MH SOC needs additional TAYA engagement resources. MA will establish Access Centers focused on engaging high risk TAYA with MH and co-occurring SUD in Worcester and Springfield, the largest cities in Central and Western MA. Both cities have a greater than average share of TAYA – some who are homeless, considerable ethnic and racial diversity and substantial populations living in poverty. Both communities have TAYA-enhanced CSAs that will partner with Access Centers to serve newly engaged TAYA. Access Centers will be staffed by trained peers, provide drop-in spaces, assertively outreach to TAYA disconnected from services, teach life skills and assist TAYA to access needed SUD treatment, housing, education, and employment. The goal of the TSAI is to increase the numbers of TAYA with MH and co-occurring SUD at high risk who engage in TAYA-enhanced SOC planning and access child and adult services on their own terms and in service of their own goals. After start-up, the TSAI expects to serve 150 to 300 annually or 500 to 1,000 in total. It expects social marketing to reach 1,000-2,000 TAYA annually and 4,000-8,000 in total. Measureable objectives of TSAI include: (1) Number of TSAI engaged in services and reached through social media (2) Yearly increase in the number using TAYA-enhanced SOC services or adult MH services (3) Yearly increase in the number with a co-occurring SUD using in substance abuse treatment and recovery supports. (4) Yearly increase in the number who access adult community services. (5) Implement TAYA-friendly, trauma-informed coordination processes among community providers (6) Amplify TAYA voice to guide TAYA-serving community programs. (7) Improve coordination between child and adult services at the local and state levels. (8) Achieve a replicable, sustainable Access Center service model.
|1 H79 SM080156-01||
Early SMART (Screening, decision Making, Assessment, Referral and Treatment) for Children and Families (E-SMART) is submitted by the Carroll County Department of Health to enhance and expand the early childhood system of care by implementing a model that bridges early childhood infrastructure and supports with quality care coordination and services to meet the needs of young children experiencing serious emotional disturbances and their families. E-SMART will layer and integrate a core early childhood infrastructure with new care coordination technologies to test a model for an early childhood system of care (ECSOC) that includes improved and sustainable capacity for an expanded home- and community-based service array, inclusive of evidence-based practices and family support. Data indicate that children age 0-8 in Carroll County do not have access to a comprehensive service array. Evidenced-based practices are limited and not widely available across funding streams and other services and supports typically are designed for older children and do not translate to meet the complex needs of young children with SED and their families. Following SAMHSA’s Theory of Change and Maryland’s success in moving SOC from planning and implementation into sustainable policy and practice, E-SMART will build upon existing work in the state and the county to increase the capacity of services for children and families, build the skills and competencies of professionals, and connect efforts to the larger system development within the state. E-SMART will utilize a strengths-based, family-driven approach that engages the family as a unit while individualizing the specific interventions needed to support the child. E-SMART will enhance and expand the current early childhood system of care in Carroll County by implementing a continuous model of trauma informed, evidenced-based or promising practices to address the current gap in services. Services to be funded by this proposal include Quality Intermediate Care Coordination (QIC2), evidence-based practices (Child Parent Psychotherapy [CPP], Circle of Security-Parenting [COS-P], and Parents As Teachers [PAT]), family navigation and support, and discretionary funds to cover the cost of identified services and supports from the plan of care when there is no alternative funding source. E-SMART will support enhanced collaborations with early intervention and education providers to expand support to children, families, and professionals, strengthening families and 75the workforce simultaneously. E-SMART anticipates serving up to 75 children and families in the first year and at least 750 over the course of the 4 year cooperative agreement.
|1 H79 SM080155-01||
ABSTRACT The Minnesota Department of Human Services, in partnership with families and youth, the Departments of Corrections, Education and Health, 36 Minnesota counties, the Fond du Lac Band of Lake Superior Chippewa, the University of Minnesota, child serving collaboratives, and community and advocacy organizations across the state, proposes to expand the current system of mental health care for youth experiencing serious emotional disturbances and their families. The proposed transformation of Minnesota’s existing system of care will address disparities in mental health services for children ages birth to 21 who have been traditionally under served. Minnesota System of Care Expansion (MN SOC XP) will pilot and demonstrate new and enhanced services and create financing and policy reforms necessary to sustain a system of care that is family driven, youth-guided, culturally relevant and respectful, and grounded in sound scientific evidence. In year one of the initiative, the goal is to serve 3,000 youth with serious emotional disturbances and their families. These are children who receive clinical mental health services and targeted case management, and who are likely involved in multiple systems. By the end of the four-year initiative, the system of care will reach 18,129 youth annually. The Vision of the Minnesota System of Care Expansion initiative is to build healthy communities through partnership, innovation and hope for all Minnesota children and families. Measurable goals for Minnesota’s expanded system of care are 1) identify children and youth early in the emergence of SED to provide service and support that promotes full community integration, and 2) build local and state leadership to coordinate across jurisdictions for data-informed system of care development, policy reform, and financial sustainability. In order to accomplish these goals, the partners are committed to providing services that are grounded in the SAMHSA System of Care Values and Principles: clinically appropriate and individualized; provided in the least restrictive environment; family-driven, with families engaged as active participants; guided by youth; community- based with care management occurring at the community level; culturally and linguistically competent, and collaborative across child-serving systems.
|1 H79 SM080139-01||
Crossover Xpand System of Care Project The Mississippi Department of Mental Health (MS DMH) is proposing to expand current and graduated System of Care (SOC) programs in two jurisdictions served by Pine Belt Mental Healthcare Resources and Weems Community Mental Health by prioritizing underserved children and youth who are involved in the child welfare/advocacy system and/or the juvenile justice system, referred to as “crossover youth,” and those at risk for becoming crossover youth, and their families. The priority children and youth will have a diagnosed serious emotional disorder (SED), co-occurring disorder (COD), or first episode of psychosis (FEP), be ages 3 -21, reside in Forrest, Jones, Lauderdale, or Marion Counties in Mississippi, and be involved with child protection services and/or juvenile justice, or be at risk for involvement. We intend to redesign service systems at the county level to identify and intercede at strategic intercept points within the systems of care. Targeted case managers will be integrated within primary care, child welfare, youth court, schools, detention centers, and child advocacy centers to provide universal screening and assessments, service system navigation, and trauma-informed mental and behavioral health care. A family nurse practitioner will be integrated into several mental health sites to provide brief primary care interventions. We hope to create a paradigm shift by redesigning the service approach to incorporate the SOC philosophy and use wraparound principles, including coordinated, community-based, comprehensive, trauma-informed, and integrated services that are youth guided and family driven, as well as culturally and linguistically competent. The goals of Crossover Xpand SOC are: 1) to expand Mississippi’s SOC by targeting at risk and crossover youth (ages 3-21) with SED/COD/FEP and their families and expanding integrated care with evidence-based interventions; 2) to increase awareness of, and community commitment to, the mental health issues of at risk and crossover youth; 3) to improve organizational and systemic capacity to serve at risk and crossover youth with SED/COD/FEP across five levels of care; 4) to expand youth and family roles as full and equal partners within an integrated system of care; and 5) to use continuous quality improvement to drive and sustain effective service delivery for replication. Crossover Xpand SOC will annually engage a minimum of 100 at risk or crossover youth, for a total of 400 youth over the entire project period. Other objectives include improving time to engage youth by integrating services at strategic intercept points, expanding access to care, and creating a skilled trauma-focused workforce.
|1 H79 SM080138-01||
Project Abstract The Montana Office of Public Instruction (OPI) Systems of Care (SOC) Project implements culture-based high fidelity wraparound services in seven rural/frontier schools that serve reservation youth in sixth through twelfth grade (n=1118). The target population for wraparound services is youth with SED/SMI (including early onset) (n=125). Youth at risk of SED/SMI and the entire population of the communities (29,066) are targeted with communication and training strategies to strengthen natural supports and recovery supports. Governance structures are targeted to improve infrastructure and sustainability. GOAL 1: Implement high fidelity wraparound services for tribal students. 1.1: Credential and support staff. 1.2: Deliver culture-based wraparound services to up to 56 youth annually, 77 over four years. 1.3: Increase model fidelity to the highest level by implementing Wraparound Fidelity Assessment System (WFAS). Goal 2: Increase trauma informed care (TIC) knowledge and skills; and increase cultural knowledge/skills for all school staff. 2.1 Annually engage seven wraparound project schools and at least one other stakeholder to conduct a TIC system assessment and improvement plan. 2.2 Train 75% of school and partner staff and 20% of community in “101 level” introduction to TIC. 2.3 Train 50% of the school staff and one other stakeholder in a “201” level TIC skills. 2.4 Create, implement, and sustain in policy and practice a two part “Cultural Orientation” for school staff members. Goal 3: Promote SOC values/knowledge/tools, and increase access to services for the entire population (29,066) 3.1: Develop and implement annual communications plan 3.2 Increase access to a sustainable, accurate resource referral guide by partnering with www.Montana211.org to increase tribal resources in the system. Goal 4: Pilot project to increase the number of youth with early onset of SED/SMI or high risk who are systemically identified and connected to services. 4.1 In Y1 adapt OPI Early Warning System, embed protocols within the existing tribal Crisis Response Protocol. 4.2 At risk youth are identified and served through pilot project implementation (baseline # TBD). Expand to additional site in Y3. 4.3 Evaluate and produce Implementation Guide. Goal 5: Strengthen local and state governance systems to sustain and scale wraparound. 5.1 Facilitate and strengthen participation of Local Advisory Teams and State Advisory Team through evidence based system change model training/coaching; quarterly meetings; formal MOUs. 5.2 Sustainability plans completed by Year 2, implemented in Years 3-4. 5.3. Four Family/Youth Advisory Councils (one per reservation) meet monthly; provide input for governance, communication, evaluation. Goal 6: Administer all Grant Requirements. 6.1 Data collection, evaluation, continuous improvement. 6.2 Financial grants management. 6.3 SAMHSA grantee meetings
|1 H79 SM080143-01||
ABSTRACT The Partners North Carolina Systems of Care Expansion Project (PNC-SOC) will expand SOC to 4 counties in West/Central NC, serving 100-410 youth annually (1,100 total) with SED/SMI or first episode psychosis and families. High Fidelity Wraparound (HFW) and Whole Person Integrated Care (WPIC) are introduced along with additional evidence-based practices. A comprehensive systems-based evaluation sets the stage for continued expansion. The systems based Collective Impact (CI) model is merged with Quadruple Aim (Q-A) as a way to build wider, deeper and more sustainable service and support networks for the SOC. This is coupled with providing the evidence-based Positive Parenting Program (Triple P), Buffering Toxic Stress (BTS) and Transitions to Independence (TIP) interventions. The project will meet 7 goals. Goal 1: To prioritize and address health disparities and social determinants of health that contribute to life adversity and toxic stress identified as key County and State level priorities for establishing healthy families and communities through implementation of the State SOC Strategic Plan and a local comprehensive needs assessment integrated with the SOC Readiness Assessment specific to this project. Goal 2: To continue to develop and implement a sustainable plan for enhancing the ability of the workforce to implement SOC infrastructure and services with fidelity in each expansion county. Goal 3: To ensure a comprehensive, modern continuum of mental health and substance use services that extends from promotion and prevention to crisis stabilization and chronic conditions, including healthcare, employment, housing, education, informal youth supports, trauma screening and trauma-informed care, is evidence-based, includes all required activities, while using Public Health approaches to address disparities in access, service use, and outcomes. Goal 4: To facilitate and support grantee communities to implement system change for SOC expansion that includes the full participation of family and youth at all stages of the process. Goal 5: To improve integration of services and a sustainable infrastructure within and between counties that is consistent with SOC through implementation and synthesis of an Integrated Model (CI, Q-A,WPIC, and HFW). Goal 6: To utilize successful engagement strategies from the state level SOC implementation to continue to develop and implement a culturally and linguistically competent Social Marketing and Strategic Communications plan designed to promote the health of and positively affect social inclusion of children and youth with SED and their families. Goal 7: To use a participatory and CI consistent evaluation model to evaluate the project and assess the performance measures specified in the FOA as well as objectives and outcomes specific to this project. Twenty-three measurable objectives along with six formative/implementation and outcome questions and six CI/systems based outcomes will ensure the program is implemented with quality. This will result in extensive documentation and development of products (e.g. Strategic Financing Plan) to continue to replicate and expand the model formulated into an Integrated System of Care Plan (ISCP).
|1 H79 SM080140-01||
The Ohio Mental Health & Addiction Services (OhioMHAS) is submitting a proposal in response to SAMHSA’s System of Care Expansion and Sustainability Cooperative Agreement, which we have titled “ENGAGE 2.0.” OhioMHAS envisions this opportunity as a bold and strategic investment to “scale up” mobile response and stabilization services (MRSS), high fidelity wraparound, and intensive service coordination for children and youth ages 0 to 21 with severe emotional disturbances and their families. These services will foster a transformative widespread and sustainable system of care across Ohio. This proposal demonstrates SAMHSA’s Theory of Change, which will infiltrate and sustain a seamless children’s System of Care (SOC) focus with interest in increasing awareness and access to mental health best practices including screening and assessment. The plan will advance collaboration across systems to promote person-centered social, emotional wellness and recovery for Ohio’s children, youth, and families. Two local planning jurisdictions for children’s behavioral health will lead a multi-county region “Hub Center.” The MRSS teams will provide 24/7 hotline, on-site mobile response triage, clinical assessments, referrals and follow-up services including wraparound, for approximately 5,000 children, youth, young adults and families annually. Over the 4 years, the project will serve approximately 20,000. Primary goals and measurable outcomes for the project include: 1) Youth and Family will be the subject matter experts in the planning and implementation of the project as measured by the increased number of certified young adults and parent peer support specialists, as well as a listserv of young adult peer supporters; 2) Local system partners including schools, law enforcement, courts, hospitals, and youth-serving community organizations will be educated on and able to use mobile response appropriately as measured by the reduction in school expulsion rates, ER visits, and juvenile court involvement in the selected counties; 3) Children and families will have increased access to mobile response stabilization services in the targeted service areas as measured by the number of individuals and families served through mobile crisis.
|1 H79 SM080147-01||
ABSTRACT The Pennsylvania System of Care Partnership (SOC Partnership) will build on the work of previous System of Care, and other SAMHSA Grants, to support counties in developing comprehensive Systems of Care for children, youth, and families. A Learning and Support Collaborative will support expansion, and sustainability, in the number of counties as well as in the array of services and supports, including a focus on trauma and early onset of serious illness. The SOC Partnership will involve development and enhancement of System of Care infrastructure and services at the state and county level. Two counties, Crawford and York, will serve as the initial sites for local system of care development. Two counties will be added in each of years two, three, and four of the grant. The population to be served includes youth from birth to age 21, with, or at-risk of developing, serious behavioral health challenges. Services and supports will also be developed to help families that are caring for youth with behavioral health challenges. There will be at least 25 youth served in the first year of the grant, with an increase each year in the number served so that a total of 250 youth will be served during the four years of the grant. The demographic characteristics in Pennsylvania reflect a significant and diverse population in need of a comprehensive system of care for young people who experience complex behavioral health challenges and have multi-system involvement. The SOC Partnership will serve a varied population, including Caucasian, Hispanic, African-American, and Asian youth and families, as well as youth that identify as Lesbian, Gay, Bisexual, Transgender, or Questioning. The SOC Partnership will address a wide variety of clinical needs, including first episode psychosis. A comprehensive plan will be developed during the first six months that will include plans for cross-agency collaboration, the creation of policy, and the development and implementation of evidence-based and evidence-informed services and supports. The plan will build on the work of other SOC grants and integrate the work of Safe Schools/Healthy Students, Healthy Transitions, Project LAUNCH, and Youth Suicide Prevention as part of a comprehensive System of Care. The plan will address access, service use, and outcomes among minority populations. The plan will include training and workforce development, especially for trauma and first episode psychosis. The result of the SOC Partnership will be expansion in the number of counties implementing Systems of Care, expansion in the services and supports for youth birth to age 21, and increased community understanding of the needs of youth with complex behavioral health problems, and their families. The child serving systems in the counties will coordinate their services and supports for youth and families. There will be more extensive outreach to identify youth in need, especially those who are affected by trauma or are in the early stages of a serious illness. There will be state and county youth and family organizations for self-help and advocacy.
|1 H79 SM080152-01||
Sustaining a Texas System of Care is a statewide initiative led by the Texas Health and Human Services Commission (HHSC) to improve behavioral health outcomes for children and youth with serious emotional disturbances and their families by expanding utilization of high-fidelity Wraparound to engage children and youth in the juvenile justice system, child welfare, and residential treatment center placement. The initiative also delivers youth peer support services. HHSC will collaborate with the Texas Institute for Excellence in Mental Health at the University of Texas at Austin and other behavioral health stakeholders for implementation of goals that were developed through a comprehensive strategic planning process. Initial local community partners for system of care expansion activities include LifePath Systems in Collin County and Burke, which serves a 12-county region in east Texas. LifePath Systems and Burke are both local mental health authorities (LMHAs) and providers of public mental health services. Two additional communities will be selected to implement expansion activities in later years of the cooperative agreement. To participate in services, children and youth must be 3 to 21 years old with a serious emotional disturbance and meet clinical eligibility for enrollment in Wraparound, an intensive, individualized care planning and management process. It is anticipated that about 40 percent of youth served will be Hispanic or Black and will be from low income families. Project activities will include referring children and youth from juvenile justice and child welfare systems to the LMHAs for diagnostic and evaluation services; engaging youth and families in the Wraparound process, including using Wraparound with youth in residential treatment center placements and their families; providing Wraparound training and coaching to achieve fidelity to the model; training youth peer support providers and their supervisors; providing outreach and education to child-serving agencies on first episode psychosis; and updating residential treatment center licensing standards to incorporate and sustain Building Bridges Initiative best practices. It is expected that 137 children and youth will be served in Year 1, followed by 238 in Year 2, 300 in Year 3, and 325 in Year 4. A total of 1000 youth and families will be served through the four-year cooperative agreement. Goals and objectives in the Sustaining a Texas System of Care initiative will facilitate access to high-fidelity Wraparound to all eligible children and youth, develop youth peer support services to improve participation in treatment and outcomes for transition-age youth, strengthen state and community system of care leadership, align fiscal strategies to support sustainable infrastructure, and promote youth and family members as leaders in system planning efforts to expand and sustain the system of care framework.