On behalf of Centered Spirit Program a division of the Health Department we request your approval to apply for a new grant opportunity, The Substance Abuse and Mental Health Services Administration (SAMHSA), Center for Mental Health Services (CMHS), is accepting applications for fiscal year 2019 Transforming Lives through Supported Employment grant. The purpose of the program is to support community, tribal efforts to refine, implement, and sustain evidenced-based supported employment programs and mutually compatible and supportive evidenced-based practices (supported education) for transition-aged youth/young adults (ages 16-25) with serious emotional disturbance (SED) Heart Loss Thought Loss, and Adults with serious mental illness (SMI) or co-occurring mental and substance disorders (COD). Centered Spirit Program expects that this program will increase tribal community capacity to implement and sustain Supportive Employment Program (SEP) models and integrated supports to improve competitive employment outcomes for individuals with SED, SMI, COD and Heart Loss Thought Loss. We propose to start projects that use benefit planning, workforce incentives, and part-time employment to help people with SED, SMI, COD, and Heart Loss Thought Loss. We strongly believe that through investing and promoting employment models that are inclusive, all individuals with mental health concerns will gain economic stability and security. The SEP will address the issues of financial capability and lack of connection to community supports. We will use a client-centered peer support approach to provide financial coaching and facilitated connections to accessible and appropriate community services while assisting with employment search and on the job supportive employment. We will collaborate with T.E.R.O, TANF, Sewa Uusim, Center for Employment and Training, Education and W.I.O.A. Program Goal: Assist the community member to actively develop effective employable skills, provide assistance in finding the right job and help to maintain employment in the most satisfying environment. These are some of the main aspects the grant is to address: Identify and implement supported employment evidence-based services, practices, and strategies and mutually supportive practices/strategies that are responsive to the selected population(s) of focus and adhere to practice fidelity or standards. These services must be individualized and tailored to the needs of the client and provide comprehensive mental health services (psychiatric services including psychotropic medication, psychotherapeutic interventions, as indicated, inclusive of individual, group, family therapy(ies), case management, physical healthcare, social services supports including housing, legal services assistance, assistance accessing state/federal benefits) in conjunction with vocational services. Identify and implement SEP workforce development strategies and training for individuals who work with the selected population(s) of focus (e.g., mental health clinicians/providers, employment/vocational specialists) to (1) increase workforce expectations of competitive employment as an outcome; and (2) expand workforce capacity to actively support competitive employment. Provide pre-employment services and counseling as necessary with the goal of identifying appropriate employment opportunities. Establish linkages and coordination with labor and vocational rehabilitation departments; local representatives of organizations, service providers, businesses, and educational Institutions that serve the population of focus Establish relationships with local employers to provide employment opportunities for program participants. Engage in sustainability planning and create a plan that identifies sustainable funding approaches. With support, they can work in competitive jobs or start their own businesses, enabling them to increase their work activity and earnings over time.

Award Number Grantee Organization Name Grantee City Grantee Statesort descending Project Director Last Name Project Director First Name Award Amount
SM082427-01 PASCUA YAQUI TRIBE TUCSON AZ FABIAN JILL $800,000

WestCare Kentucky, Inc., a subsidiary of WestCare Foundation, seeks a SAMHSA grant for its Kentucky Supported Employment Program (KY SEP) to will implement and sustain evidence-based supported employment programs and mutually compatible and supportive evidence-based practices for transition-aged young adults with serious emotional disturbance (SED), and adults with serious mental illness (SMI) or co-occurring mental and substance use disorders (COD) through existing WestCare Kentucky, Inc. (WCKY) outpatient and residential treatment projects, court diversion projects, and jail-based programs in Eastern Kentucky. The project will target the high-risk rural area of Floyd, Pike, Knott, and Letcher counties in the Appalachian Mountains of Eastern Kentucky. KY SEP will serve 370 individuals over the 5-year grant period. The 370 individuals served will be assessed to determine SED, SMI, and/or COD counseling and/or treatment depending on their diagnosis. This population will also receive supported employment services as well as including engaging and connecting clients to enrollment resources for health insurance, Medicaid, and mainstream benefits; coordination of housing and services that support sustainable permanent housing; and recovery support and other identified individualized support services. Proposed strategies/evidence-based models include: Cognitive Behavioral Therapy, Motivational Interviewing, Thinking for a Change, Medication Assisted Treatment, trauma-informed strategies including Moral Recognition Therapy, and SAMHSA’s evidenced based Supported Employment Toolkit. Program goals and objectives include: 80% of participants will have decreased MH symptoms at discharge and 70% will maintain/ decrease at six months post baseline; 80% of participants will be drug free at discharge and 70% will remain drug free at six months post baseline; 80% of participants will be successfully employed at discharge and 70% will remain employed at six months post baseline; 80% without stable living admission will have it at discharge; 70% will maintain it at six months post baseline; and 80% who complete their treatment plans will improve social connectedness at discharge; 70% maintain improvements at six months post baseline; 80% who complete their treatment plans will improve social connectedness at discharge; 70% maintain improvements at six months post baseline; and 80% not having a primary care provider at admission will have a linkage to one by discharge.

Award Number Grantee Organization Name Grantee City Grantee Statesort descending Project Director Last Name Project Director First Name Award Amount
SM082424-01 WESTCARE KENTUCKY, INC. IRVINE KY WRIGHT STEPHEN $757,907

Mi Camino/My Pathway to Economic Independence will be a bilingual/bicultural supported employment program integrated with behavioral health treatment that seeks to address the educational and vocational needs of Latinx individuals with co-occurring substance use and mental health disorders in order to increase their economic independence, stabilize their families, and support long-term success in recovery. Project will serve 48 unduplicated clients in year 1 and 72/year for Years 2-5, for a total of 336 unduplicated clients over five years. Casa Esperanza serves highly vulnerable Latinxs with co-occurring conditions from the Greater Boston area who often have little work experience and lack the life skills, interpersonal skills, and literacy to obtain and maintain competitive employment. In addition, individuals in early recovery often lack “soft” skills, such as personal grooming, getting to work on time, showing initiative, and communicating clearly, verbally and in writing. Based on current demographics, we anticipate 100% of clients will have a co-occurring mental illness in addition to their SUD; 70% will identify as male, 29% as female, and less than 1% as transgender; 40% will be monolingual Spanish speakers and 40% will have limited English skills with limited written literacy in either English or Spanish; 93% lack a source of income and have lived in poverty for most of their lives, and 61% lack a GED. More than 95% have been court involved, with 79% incarcerated in the past five years. Nearly all (96%), have at least one significant medical condition. Based on data from previous SAMHSA-funded projects we anticipate only 31% received mental health treatment previously, despite 97.7% reporting at least one co-occurring mental health disorder. Of these, 98% will meet criteria for serious mental illness; 55.2% will report recent depression, 61.4% will report recent anxiety, 15% will report recent thoughts of suicide, and 3% will have recently attempted suicide. The goals of this project are: 1) Improve vocational/educational assessment and service planning for Latinx with CODS; 2) Create and deliver a culturally-focused Leadership Development Program that supports Latinx with CODS in becoming leaders and working in the Latino recovery community; 3) Increase access to educational and vocational opportunities through the establishment of Community Partnerships; and 4) Provide clinical and case management services to support clients’ full engagement in the development, implementation and completion of goals in both clinical treatment plans and economic service plans.

Award Number Grantee Organization Name Grantee City Grantee Statesort descending Project Director Last Name Project Director First Name Award Amount
SM082420-01 CASA ESPERANZA, INC. ROXBURY MA CANUTO MELISA $800,000

This KCMHSAS Supported Employment project transforms and elevates the system implementation of evidence-based supported employment. The population of focus is individuals age 16 and older with Serious Emotional Disturbance SED), Serious Mental Illness (SMI) and/or co-occurring substance use disorder (COD) in Kalamazoo County. A subpopulation of focus is Youth/Young Adults (YYA) aged 16-25 years old with SMI, SED, or COD. Population of Focus: This population has low employment rates (14%), is racially diverse (28% Black vs 11.6% for general population) and experiences housing difficulty (17% are homeless), and COD (30%). Population of focus demographics include: a) Gender: 49.5% female, 50.4% male, 0.73% transgender/other; b) Race: 62.28% White/Caucasian, 28.14% Black/African American, 9.58% Other; c) Ethnicity: 4.36% Hispanic/Latinx; d) Age: 20.32% 16-25; 12.34% 26-30; 42.47% 31-50; 24.87% 51+; e) Language: 1.5% other than English at home; f) sexual orientation: 3.76% LGBQ. Veterans make up 1.47% of the population and 78.62% are not employed or in school. YYA subpopulation (20% of the population) differs slightly from the broad population of focus with more females (52.33%), transgender (1.58%), LGBQ (5.68% ages 16-25 and 7.32% ages 18-25) and racial and cultural diversity (53.31% white/Caucasian and 5.99% Hispanic/Latinx). 27% of the sub-population is ages 16-17. Homeless rates for the subpopulation are 9.5% (12.07% of ages 18-20). Strategies and intervention: This project implements supported employment services through the Individual Placement and Support (IPS) model enhanced by Motivational Interviewing (MI) evidence-based strategies. The project will increase Employment Specialist staff capacity and foster closer integration with mental health treatment teams. Goal 1: Increase access to evidence based supported employment. Objective 1: The number of adults (26+) with SMI who received SE will increase to 1200 by the end of year 5. Objective 2: The number of YYA (16-25) with SED/SMI who received SE will increase to 200 by the end of year 5. Objective 3: The average amount of services individuals receive while participating in SE will increase by 100% to 12 hours per episode of care by the end of year 5. Goal 2: Integrate supported employment with comprehensive mental health services. Objective 1: Executive leadership in KCMHSAS and partner organizations will promote supported employment as outlined in Memoranda of Understanding (MOU). Objective 2: 100% of mental health workforce serving target population will receive training to increase knowledge and support of competitive employment. Objective 3: Employment Specialists will be active members of clinical teams consistent with IPS standards, based on independent fidelity reviews. Goal 3: Improve competitive employment outcomes for people enrolled in the project. Objective 1: 50% of SE participants (Adults 26+ with SMI) will obtain and remain in competitive employment for 90 days. Objective 2: 30% of SE participants (YYA 16-25) will obtain and remain in competitive employment for 90 days. Objective 3: 350 individuals will receive benefit specialist services by end of Year 5. A total unduplicated count of 1400 individuals will be enrolled in the project over 5 years; Year 1 = 200, Year 2 = 300, Year 3 = 350, Year 4 = 350, and Year 5 = 200.

Award Number Grantee Organization Name Grantee City Grantee Statesort descending Project Director Last Name Project Director First Name Award Amount
SM082478-01 KALAMAZOO COMMUNITY MENTAL HEALTH AND SUBSTANCE ABUSE SERVICES KALAMAZOO MI SHAFFER DIANNE $800,000

Care Plus NJ's ""Transforming Lives"" program will provide integrated, evidence-based Supported Employment Program (SEP, often referred to interchangeably as Individual Placement and Support) services, psychiatric care, and complimentary activities (i.e. Supported Education) to improve competitive employment and recovery outcomes for adults with Serious Mental Illness (SMI) in Bergen and Passaic counties in New Jersey, with a particular focus on young adults ages 18-25. It is estimated that approximately 80% of individuals with SMI are unemployed, compared with the 3.8% national average for the general population (NAMI, 2014; Bureau of Labor Statistics, 2019). New Jersey's unemployment rate is above the national average, and Passaic County's unemployment rate in particular is more than 60% higher (Bureau of Labor Statistics, 2019). This is compounded for young adults who have nearly twice the rate of SMI than other age groups, with the fastest growing rates of SMI, major depression, and suicidality (SAMHSA, 2018). It is found that employment can significantly benefit individual's recovery, including improvement in symptoms, increased self-esteem, and satisfaction with finances. It is found that 60% of individuals with SMI can gain successful employment with the support of evidence-based SEP services (SAMHSA, 2009). The Transforming Lives program will increase the community's capacity to implement and sustain SEP models and integrated supports to improve competitive employment outcomes for individuals with SMI. Provider training, community outreach, and employer collaboration would provide the infrastructure to foster individual success and the sustainability of the SEP model. CPNJ will serve 450 unduplicated individuals in the population of focus over the 5 year grant period. Goal 1: Empower individuals in the population of focus to obtain and maintain competitive employment to improve recovery outcomes. Objective 1.1: 60% of enrolled individuals will gain competitive employment each year. Objective 1.2: 80% of enrolled individuals will have first contact with an employer within 30 days of enrollment. Objective 1.3: 75% of enrolled individuals will have retained employment at 3-month follow up. Goal 2: Provide outreach, training, and community education to improve individual's employment outcomes and support the sustainability of the Transforming lives program. Objective 2.1: Over the 5 year grant period, 500 people in the mental health and related workforce will be trained in SEP. Objective 2.2: Over the five year grant period, 50 organizations will collaborate, coordinate, and share resources as a result of this grant. Objective 2.3: Over the five year grant period, 100 employers will be outreached to receive education regarding the SEP model and ways to support individuals with SMI. CPNJ's 40 years of experience serving the population of focus and over 25 years of providing supported employment services will assist individuals reach and exceed their employment goals. The Transforming Lives program will offer the opportunity for individuals to find hope for personally meaningful recovery.

Award Number Grantee Organization Name Grantee City Grantee Statesort descending Project Director Last Name Project Director First Name Award Amount
SM082494-01 CARE PLUS NJ, INC. PARAMUS NJ GIRONA GIESEL $800,000

LifeWorks- Supported Employment for Recently Housed Transition-Age Youth will utilize an evidence-based supported employment model, Individual Placement and Support (IPS), and Community-Based Counseling (CBC) to help 420 unduplicated 16-25-year old youth with Serious Emotional Disturbance (SED) overcome barriers to obtaining and retaining employment during this 5-year project. In Fiscal Year 2018, LifeWorks served 4,674 youth ages 16-26 with counseling, workforce, education, and housing services. Of the 97 youth served in workforce, 50% were male, 46% were female, and 1% were transgender. Racial and ethnic identities were 41% Caucasian, 40% Hispanic, 29% African American, 4% mixed race, and 14% other. The majority reported very low socioeconomic status - (96%) earned less than 200% of the Federal Income Poverty Level. Nonprofit agencies in the City of Austin and Travis County have come together in a community movement to end homelessness for transition-age youth (TAY). The success of this effort is dependent on increasing no barrier, mental health centered employment access and expanding community-wide IPS knowledge, support and capacity. LifeWorks is currently the only agency within the coalition providing TAY with IPS supported employment at fidelity, which has demonstrated an increase in sustained employment. The model focuses on each person’s strengths and interests and offers a range of supports tailored to the individual, including resume writing, job search and application assistance, interview coaching, assistance with transportation and work clothes, job shadowing; and ongoing communication with employers. Additionally, CBC counselors utilize the evidence-informed model, Integrated Treatment for Complex Trauma for Adolescents (ITCT-A). ITCT-A is a multi-model therapeutic approach that is associated with reduced mental health symptoms among youth with histories of trauma. Project goals include: #1 Improve competitive employment outcomes for TAY with serious emotional disturbance in our community; #2 Increase the capacity to implement and sustain integrated supports in the Austin community for TAY with serious emotional disturbance; #3 Promote recovery and mental health stability among TAY with serious emotional disturbance in the Austin community; and #4 Promote housing stability among TAY with serious emotional disturbance in our community. The project has five objectives, including: training community professionals on IPS, connecting TAY in need of mental health services to the appropriate resources, and reducing the returns to homelessness among TAY youth. The agency will leverage decades of experience providing employment and mental health services to youth, licensed clinical staff, existing partnerships with other community providers, and evidence-based practices. LifeWorks is uniquely positioned to deliver quality services that will have a lasting impact on transition-age youth needing supported employment services.

Award Number Grantee Organization Name Grantee City Grantee Statesort descending Project Director Last Name Project Director First Name Award Amount
SM082406-01 YOUTH AND FAMILY ALLIANCE, INC. AUSTIN TX SCHOENFELD ELIZABETH $796,615

Milwaukee County Behavioral Health Division (BHD) Wraparound Milwaukee (WM) submits this application for 3,985,445 (over five years) to implement and sustain an evidence-based practice (EBP) Supported Employment (SE) program, and mutually compatible and supportive EBPs of Wraparound Care Coordination, Supported Education (SEd), and Supported Housing (SH) for transition-aged youth (TAY) with serious emotional disturbance (SED). The focus population are youth enrolled in the WM Older Youth Emerging into Adult Heroes (OYEAH) Program, all of whom have a DSM-V Mental Health Diagnosis; experienced mental health challenges for at least six months and be expected to persist for a year or longer; and been involved in two or more service systems such as mental health, social services, special education, child welfare, or juvenile justice. All OYEAH TAY reside in areas below the federal poverty rate, 38.2% living in areas exceeding the state average and another 31.9% living in areas more than triple the state rate. Approximately 8.6% OYEAH TAY are homeless and another 45.7% are “doubled up.” Services will be delivered in Milwaukee County as the geographic catchment area, with an urban population of 952,085. Based on an OYEAH average length of stay at 14.62 months, 78% retention, and increasing caseloads per EBP fidelity, the projected unduplicated number to be served are: Year 1, 30; Year 2, 22; Year 3, 10; Year 4, 25; and Year 5, 28; 115 youth over the 5-year project period. Strategies and interventions include delivering a robust training structure providing basic and intensive EBP training; implementing the SE program first in pilot and at a demonstration site; designating SE and SEd leaders to think through and develop the structure of the programs, and a benefits counselor for consumers to have accurate information to make informed choices; ensuring staff-to-consumer ratios are small enough so all employment and education specialists learn how to practice high-fidelity SE and SEd; engaging peer specialists as job and education coaches for OYEAH youth; establishing a Business Advisory Council to engage and elicit feedback from local employers; and creating peer specialist employment opportunities. Project goals are to provide access to EBPs in delivering comprehensive mental health and vocational services; actively engage the public and government sectors in supporting SE implementation; and sustain ongoing support and growth of the SE model. Measurable objectives are to: (1) initiate a SE workforce training and outreach plan to ensure fidelity of EBP implementation; (2) integrate SE EBP and mutually supportive EBPs; (3) establish collaborative feedback mechanisms for SE program implementation; (4) build the infrastructure for competitive employment within integrated settings with local employers; (5) create a plan with sustainable funding approaches for the SE program; and (6) use data-informed practices to develop a SE expansion plan for all Wraparound programs. Providing SE involves incorporating a new program into the service delivery system, contributing directly to SE program services transitioning to the Wraparound Milwaukee Provider Network as a foundation for project sustainability.

Award Number Grantee Organization Name Grantee City Grantee Statesort descending Project Director Last Name Project Director First Name Award Amount
SM082438-01 MILWAUKEE COUNTY DHS-BEHAVIORAL HEALTH DIVISION MILWAUKEE WI CHERRY RASHAAN $797,092