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The New York State Office of Mental Health will improve the outcomes of children and transition aged youth with Serious Emotional Disturbance from birth through 21 statewide. The Project, known as the New York State System of Care will expand the SOC county infrastructure and the use of High Fidelity Wraparound in Health Homes Serving Children throughout NYS for 1,650 new and unduplicated children with SED and their families beginning in two rural counties, Yates and Essex, and adding more counties each year. The Research Foundation for Mental Hygiene on behalf of the New York State Office of Mental Health and in partnership with multiple state, local, and county stakeholders, will build on the successes and lessons learned from the initial System of Care (SOC) Grant received in 2016. This initiative has helped to change the service delivery system and outcomes for Children with Serious Emotional Disturbance (SED) and their families throughout NYS and in specific counties in need of strengthening their coordinated system of care. New York State System of Care (NYS SOC) will foster the statewide adoption of High Fidelity Wraparound within the Health Home Serving Children model to enhance family and youth voice and support the highest quality care planning for those children and youth with the highest acuity levels of clinical and service need, and will integrate Family and Youth Peers working with Care Managers in the coordination and delivery of support and services to children with SED and their families. The NYS Cross Systems Committee and local SOC county and regional governance bodies will work to address barriers to coordinated care and will expand as this project reaches more children and families throughout NYS. By the end of the grant period, it is anticipated that each county in NYS will be in the process of developing, or will have already established, a local SOC, and be utilizing High Fidelity Wraparound practice model. Working with their partners, NYS will provide training and technical assistance to counties, family and youth peers, Health Home Care Management Agencies and throughout the state via the provision of evidence-based, culturally and linguistically competent, family-driven and youth guided practices within a strengthened, responsive, and sustainable community infrastructure. NYS SOC recognizes that NYS is a large jurisdiction with great diversity across counties and therefore will afford counties, beginning in Essex and Yates, flexibility to outline a county specific path to building out the SOC infrastructure. Additional county cohorts will be engaged during the four-year period. Evidence-based and evidence informed practices will be incorporated throughout the project and at all levels- state and county. These include High Fidelity Wraparound, Health Homes Serving Children, Health Habitus Motivational Interviewing, Prevent-Teach-Reinforce (PTR), Nurturing Parents, and Transition to Independence (TIP).

The New York City Department of Health and Mental Hygiene ("the Health Department") requests funding through the System of Care Expansion and Sustainability Grant from the Substance Abuse and Mental Health Services Administration to deliver a project titled "Centering Children and Families in NYC's System of Care." This project will 1) serve the estimated 55,600-118,600 NYC youth ages 10-21 with severe emotional disturbance (SED) and their parents/caregivers who currently utilize or are eligible to utilize the SOC through engagement with Community-Based Participatory Action Research (CBPAR) and 2) will also provide HFW services to a total of at least 48 unique youth aged 12-21 with SED, multiple system involvement (i.e. foster care, mental health services) who have been referred to or recently discharge from a Residential Treatment Facility (RTF) and their families in Queens over the four year grant period. By engaging in CBPAR and expanding HFW services to Queens, the Health Department intends to: 1) assess the impact of NYS reforms on NYC youth with SED and their families to make structural, policy, or programmatic changes to the local SOC and 2) address gaps in intensive care coordination for youth in Queens to improve health outcomes and demonstrate the cost-effectiveness of the HFW model so it can be scaled and sustained over time. Through the implementation of CBPAR, we intend to build understanding for how recent statewide reforms have impacted access to mental health care and partner with community members to create, act upon, and implement relevant and culturally-sensitive solutions. The expansion of HFW services from two current sites in Brooklyn and the Bronx to a third site in Queens will address the high rates of RTF admission within that borough and support early, intensive intervention to hopefully maintain more children in their homes and communities. At the conclusion of the activities outlined in this proposed project, the Health Department intends to provide CBPAR trainings to stakeholders, implement policy and structural changes to the SOC, and demonstrate the feasibility and cost effectiveness of incorporating HFW into the SOC so it can be scaled and sustained over time.