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The Hancock County Alcohol, Drug Addiction, and Mental Health Services (Hancock ADAMHS) Board proposes the Hancock ADAMHS System of Care (Hancock SOC) project to expand and integrate a sustainable infrastructure to bolster the services of the 2017 SAMHSA-funded program in northwest Ohio. The Hancock SOC aims to provide resources and improve mental health outcomes for children and youth ages 0-21 and their families, with emphasis on ages 8-14 with serious emotional disturbances (SED), children of veterans, youth at risk for out-of-home placement, and youth who experience suicidality. More than half of Hancock County's 74,920 residents live in the City of Findlay. Of county students pre-K-grade-12, 27% are from economically disadvantaged households; 14% have a disability; and 23% out-of-home placements were kinship. Ohio experiences one youth death by suicide every 34 hours; Hancock County's suicide rate is 16/100,000 persons and 14.9 for ages 15-24. Evidence shows an eight percent increase in six months of youth ages 11-21 who indicated they were so depressed that nothing could cheer them up either all or most of the time; and a 13 percent increase who reported having thoughts of suicide. Youth with SED who had made a suicide attempt decreased by 44% after one-year of SOC services/supports. In response, the Hancock SOC will deliver service provisions for youth/families while prioritizing emerging needs of youth/families (out-of-home placements, suicidality). The proposed project will integrate expanded services with additional peer-support specialists, and a sustainable infrastructure with improved county-wide processes for communication, service delivery, and education enhancements. The Hancock SOC strategies include a collaborative approach through a Recovery Oriented System of Care (ROSC) and Trauma-Informed Care (TIC) framework for assessment, diagnosis, treatment, care and support services to youth and their families to improve health outcomes and help youth develop potential to thrive at their fullest potential. The ROSC, TIC, and Cultural and Linguistically Appropriate Services (CLAS Standards) purposefully address improved health equity by removing barriers to access comprehensive mental health services and streamlined wraparound supports provided by Hancock ADAMHS primary service provider, Family Resource Center of NW Ohio (FRC) who will implement service support for 200 unduplicated youth and families over funding period (Yr.1=50, Yr. 2=50, Yr. 3=50, & Yr. 4=50). The union of Hancock ADAMHS and FRC will consist of a credentialed, experienced, and well-prepared project team with robust training in evidence-based/-informed practices and interventions such as ROSC, TIC, Motivational Interviewing, Mental Health First Aid, Peer-Support, Intensive Home-Based Treatment, Positive Parenting and Healthy Relationship programs, along with principles of the Zero Suicide model and CLAS Standards. Program goals will 1. increase the capacity of Hancock ADAMHS to expand family engagement/inclusion to influence care pathways for youth ages 8-14; children of veterans; and at high-risk for out-of-home placement; 2. increase capacity to expand youth engagement/ inclusion to influence decisions about service provisions of Youth THRIVE programs/services; 3. increase awareness about youth trauma and mental health resources for ages 0-21; 4. expand, stabilize, and sustain infrastructure for improved SOC; and 5. increase health equity/inclusion among the target population and their families. Activities include an awareness campaign focused on youth-/family-focused communication about SOC services/support, youth mental health, trauma, stigma, and adverse health outcomes; medical mobile unit outreach; youth/parent peer-support; youth-centered/parent-focused engagement opportunities, and ongoing professional development for staff and providers. The Hancock County ADAMHS Board requests SAMHSA funding of $4,000,000 for the Hancock SOC project.

The purpose of the Help Me Grow (HMG)/Help Me Thrive (HMT) SoC is to establish an expanded system of comprehensive, coordinated treatment, and community-based services that are family-centered, trauma-informed, and evidence-based. The HMG/HMT SoC will be implemented in three project phases - expansion and enrichment of HMG into HMT (Phase I), planning and implementation of HMT (Phase II), and alignment with other SoCs in North Texas (Phase III). This system of care (SoC) geographic catchment area includes 10 North Texas counties (Collin, Cooke, Denton, Ellis, Fannin, Grayson, Kaufman, Navarro, Rockwall, Wise). These counties span an immensely large area, covering 7,116.2 square miles (US Census Bureau, 2020). MHMR seeks to respond to the HMG/HMT SoC population of focus including all families with young children (birth to age 16) and their caregivers to promote healthy social-emotional development and prevent mental, emotional, and behavioral disorders. Additionally, to prevent SED/SMI, children exhibiting behavioral concerns or having adverse experiences/trauma will be of focus. Targeted populations also include rural, poverty, and those living in homelessness. Phase I of the project will focus on Cooke, Denton, Ellis, Navarro, and Wise counties. During Phase I, the program will begin to offer navigation in schools, primary care settings, and community locations where families/youth visit such as Family Resource Centers (FRCs) and community/recreation centers. Phase II will focus on HMG planning and implementation in Collin, Fannin, Grayson, Kaufman, and Rockwall counties. We will leverage existing resources to advance an integrated, cross-sector system to 1) promote the optimal development of all children and youth; 2) identify concerns and needs among families with adolescents; 3) link families to community-based resources; 4) work in partnership with families by prioritizing parent and caregiver goals for their children's well-being; and 5) follow-up with families as well as their service and health care providers to ensure a synergistic approach to support. During Phase III, HMG/HMT will collaborate with other SoCs, including Dallas County, to create a Comprehensive North Texas Regional System of Care. Goals for the project include 1) To enhance the Help Me Grow, Help Me Thrive collaborative framework of a high-quality, innovative, and sustainable family support system, with each element informed by the needs and challenges of children/youth (birth to age 16) at-risk for SED/SMI and their families, by 09/29/2026; 2) Expand access to a continuum of behavioral and mental health services and ensure early identification of families with children/youth, age birth to 16, who are at-risk for SED/SMI, by 09/29/2026; 3) Strengthen 1,010 children/youth (birth to age 16) at risk for SED/SMI, their parents, and providers by providing high-quality customized navigation, direct services, and effective evidence-based family strengthening programs, by 09/29/2026; and 4) Establish SoC linkages and comprehensive support services to increase participant's ability to live independently and responsibly, by 09/29/2026. The project aims to serve 730 families through navigation and 280 through intervention across 4 years (120 navigation/40 intervention in year 1, 160 navigation/60 intervention in year 2, 200 navigation/80 intervention in year 3, and 250 navigation/100 intervention in year 4).

The purpose of ND's System of Care Expansion and Sustainability grant is to improve the mental health outcomes for children and youth, birth through age 21, with SED and their families. The ND Department of Human Services' Behavioral Health Division (BHD) has identified two goals for the SOC grant. The first goal is to develop a sustainable infrastructure to support the SOC approach for ND children with SED and their families. The second goal is to increase access of high-quality and culturally appropriate services and supports available to children with SED and their families in the identified regions. The BHD is estimating to serve approximately 900 unduplicated individuals in year one of the grant, with an expected increase of 10% each year of the grant program. The estimated total number of unduplicated individuals for the whole project is 1,197. The SOC will be implemented in two regions of the state, Lake Region Human Service Center (LRHSC; Region III) and West Central Human Service Center (WCHSC; Region VII). LRHSC serves a six-county area as well as the Turtle Mountain Reservation and Spirit lake Reservation. This 6,756 square mile area is home to about 43,168 people. WCHSC serves a ten-county area that includes the Standing Rock Indian Reservation, and part of the Fort Berthold Indian Reservation. This 14,452 square mile area is home to approximately 130,000 people. In 2021, LRHSC served approximately 301 children with SED. WCHSC served approximately 3,133 clients in 2021, 543 of which were children with SED. To accomplish the first goal to develop a sustainable infrastructure to support the SOC approach for ND children with SED and their families, the BHD has identified four objectives. The first objective is the establishment of a local steering committee in each of the two implementation regions as evidenced by a committee meeting agenda and minutes with membership to include individuals across child-serving agencies, providers and programs. The second objective is the BHD will have a complete needs assessment which addresses gaps in service delivery for the children/youth to be served by the project in the two regions of the state, as evidenced by a complete assessment report. The third objective is the BHD will have a training plan and calendar for service providers developed, as evidenced by a written plan. This training plan will include methods in which the BHD will support service providers in all aspects of SOC development and implementation, including evidence-based processes and practices. The fourth objective is the BHD will have a sustainability plan to ensure system of care activities will continue, as evidenced by a written plan. To accomplish the second goal to increase access of high-quality and culturally appropriate services and supports available to children with SED and their families in the identified regions, the BHD has identified two objectives. The first objective is the BHD will enter into agreement with the two regional, publicly-funded behavioral health clinics within the implementation regions to build upon current service delivery for children and youth with SED and their families. The second objective is the BHD will enter into agreements with private agencies in the two regions in order to begin new service delivery to build a comprehensive system of care in each geographic catchment area.

PROJECT ABSTRACT Hennepin County Family Response and Stabilization Services (FRSS) Project SAMHSA System of Care Expansion and Sustainability Grant NOFO No. SM-22-007 The Hennepin County Family Response and Stabilization Services (FRSS) Project will provide culturally specific Family Response and Stabilization Services (FRSS) for youth age 5-18 with Severe Emotional Disturbance and their families in Hennepin County, MN. FRSS services will help youth and families address mental health crisis and unsafe behaviors and put ongoing community-based mental health supports in place, reducing the need for deep-end interventions. Hennepin County is a large and diverse county that includes 45 cities (including Minneapolis) and is home to many Black, Latino, Somali, and American Indian youth and families who are underserved by community-based mental health supports and experience repeated deep-end system involvement. The Hennepin County FRSS project will provide Family Response (FR) for 1,175 youth ages 5-18 and their families that includes an in-person response within one hour and 72 hours of crisis support following the initial contact. FR will serve 200 youth and families in Year 1, 250 in Year 2, 325 in Year 3, and 400 in Year 4. The project will also provide culturally specific Stabilization Services (SS) of up to eight weeks duration to help 470 youth and families navigate systems, put natural and formal supports in place, and improve ability to manage symptoms and unsafe behaviors. Hennepin County will contract with 4-5 culturally specific mental health agencies led and staffed by Black, Latino, Somali, and American Indian communities to deliver Stabilization Services. SS will serve 80 youth and families in Year 1, 100 in Year 2, 130 in Year 3, and 160 in Year 4. Partnerships with 15 individual schools serving large numbers of students from these racial and cultural populations of focus will be the primary FRSS referral mechanism. The goal of FRSS is to stabilize more children/youth with SED and their families in community settings and to reduce racial disparities in access and outcomes. Key objectives are to reduce emergency department utilization, total days spent out of home, and law enforcement involvement related to psychiatric or emotional problems by 20% in the population of Stabilization Services participants, as well as achieving youth and family satisfaction targets related to involvement in their own care, cultural responsiveness of SS, and reductions in problem behaviors and symptoms. Hennepin County will also promote youth/family engagement in the development, implementation and evaluation of its system of care and establish an SOC Governance Board. A .75 FTE Lead Family Coordinator will partner with additional project staff to conduct outreach to existing BIPOC parent groups, facilitate information-sharing and feedback events regarding the System of Care in BIPOC community spaces, recruit BIPOC youth and parent leaders, conduct youth and family surveys and focus groups, and participate on the Project Team and SOC Governance Board. The Project Director will establish the SOC Governance Board, recruit and train Board members including both youth and family representatives and decision-makers from child-serving systems, and convene the group monthly to review SOC reforms and progress.

Rhode Island Executive Office of Health and Human Services (EOHHS) is submitting this SAMHSA System of Care Expansion and Sustainability Grant request for $10,598,585 over four years, to support our work to strengthen Rhode Island's Behavioral Health System of Care for children and youth, birth through age 21, with serious emotional disturbances (SED) and their families. RI's existing services for children with SED now include a range of evidence-based and culturally competent diagnostic and evaluation services. The gaps in the system - and what this grant will fill - are unified Mobile Response and Stabilization Services and a Community-Based Intensive Care Program to ensure that children with SED and their families receive timely urgent and emergent care in the least restrictive settings, and adequate intensive services. Please see RISOC's one-page Project Abstract, which is uploaded as an attachment.

Washington State Health Care Authority (HCA)'s Division of Behavioral Health and Recovery (DBHR) seeks to implement a family and youth-specific crisis intervention model that is designed as as an upstream, comprehensive array of services to maintain youth safe in their communities in its SOC Expansion and Sustainability project, Mobile Response and Stabilization Services (MRSS) for Youth, Families, and Caregivers. The population of focus is youth ages 0-21 with a serious emotional disturbance (SED) and their families and caregivers in Pierce and Spokane counties. As part of the project, DBHR will develop policy changes, identify infrastructure needs, and develop financing mechanisms to ensure that all youth and families have access to a continuum of culturally responsive, community-based care while ensuring coordination with the implementation of the 988 crisis service that was passed into law under HB 1477 in 2021. HCA will partner with Behavioral Health Administrative Services Organizations (BH-ASOs) in both counties, which are entities responsible for administering crisis and other services under fully integrated managed care, to design services that respond to an increased need for MRSS as emergency departments (EDs), inpatient facilities, and other out-of-home treatment settings continue to be overwhelmed. Data show that youth in both areas are struggling with increased depression, anxiety, suicidal ideation, and suicide attempts, with higher rates for youth of color, LGBTQ+ youth, youth with cross-systems involvement, and disabled youth. Furthermore, families and caregivers have indicated a desire to see systemic transformation to center on family-centric care models. DBHR will use SOC funding to pilot both a family-focused 72 hour response and 8-week stabilization phase comprised of an array of services, evidence-based practices, peer support, and linkages to community resources to demonstrate the model's effectiveness in improving behavioral health outcomes and diverting from more costly, trauma-inducing interventions. The goals and objectives are: Goal 1. Ensure that all youth and families in Pierce and Spokane counties have access to a continuum of crisis prevention and intervention by 1A. Providing MRSS to 300 youth and families in year 1 and 400 for each subsequent year; 1B. Developing payment methods to ensure all can receive services regardless of coverage; 1C. Developing a sustainability plan for MRSS. Goal 2: Maintain youth safe at home and in the community and prevent movement to more restrictive settings by 2A. Reducing ED admissions by 20% for clients in pilot programs; 2B. Improving mental health status and functioning for 80% of clients that participate in ongoing services; 2C. Decreasing psychiatric hospitalizations by 20% for program clients. Goal 3: Increase community awareness of behavioral health needs by providing prevention and treatment oriented education and outreach by 3A. Providing outreach to area schools, providers, and organizations; 3B. Reaching at least 400 youth and families in the first year and 500 in subsequent years through outreach. Goal 4: Infuse family and youth voice into crisis systems by 4A. Providing training to at least 100 community members on MRSS and evidence-based practices each year; 4B. Providing parent/youth peer support to at least 50 individuals per year; 4C. Developing MRSS advisory sub-committee as part of the Children's Behavioral Health Governance Structure. Goal 5: Develop infrastructure and data collection processes to support Statewide sustainability of MRSS by 5A. Developing and refining data collection processes to capture key indicators; 5B. Implementing a continuous quality improvement plan to monitor and enhance MRSS in concert with youth and family-led organizations. At least 300 youth and families will receive direct services in Year 1, and 400 will be served each subsequent year for a total of 1,500 over the life cycle of the grant.