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Enhancement and Expansion of Treatment and Recovery Services for Adolescents, Transitional Aged Youth, and their Families Grant Comprehensive Healthcare (CHC) is a community-based organization with 48-years of providing behavioral healthcare services. The intent of this project is to increase access to behavioral health care for children, adolescents and young adults. We will deploy evidence-based services for the treatment of individuals with serious mental illness, substance use disorders, including opiate use disorder, severe emotional disturbance, individuals with co-occurring mental health and substance use disorders throughout Benton, Franklin and Walla Walla Counties in Washington State. CHC will serve an additional 450 unique children, youth and young adults over the five-year project. Comprehensive Healthcare has an extensive history of providing high quality, evidence-based care to individuals throughout the region and seeks to expand and enhance the services to the populations in the project area. Access to mental health providers in Washington State averages 270 persons:1 provider. Benton County is currently at 390:1; Walla Walla County is 350:1 and Franklin County in 750:1.

LifeStream Behavioral Center's Children Clinical Onsite Services has expanded their continuum of care by offering the Youth and Family TREE program. This program will enhance and expand comprehensive treatment, early intervention, and recovery support services for at-risk adolescents, youth and their families/primary caregivers with mental health disorders, substance use disorders, and those who are co-occurring. The goal is to provide these services to the youth and their families who reside in Citrus, Lake, and Sumter counties, Florida. Treatment includes group and individual therapy for at-risk children, adolescents, and their primary caregivers; including family therapy, parenting support groups, child-parent relationship treatment services, as well as assessments and treatment referrals for any co-occurring or substance use disorders identified. Our goal is to break the lines of generational trauma by working with the whole family unit. Through multiple evidence-based practices, Youth and Family TREE staff will provide a whole-system approach, screen participants by using assessments to identify parental stress levels, behavioral and social emotional issues, trauma reactions, child-parent relationship issues, substance use or misuse, and mental health diagnoses. Our program goals include strengthening the child-parent relationship, decrease parental stress, decrease externalizing behaviors that are unhealthy and lead to substance use, and improve the level of functioning within the entire family unit. Some of our objectives for this program are decreasing assessment scores in at least 75% of participants from pre to post-treatment, screen 100% of caregiver participants for substance use, mental health, and trauma to provide appropriate treatment, and increase the level of function in 75% of youth participants. The Youth and Family TREE program plans to serve 65 unduplicated participants by the end of year one and reach 100 youth in year two, continually adding to that number in each subsequent year to serve a total of 510 participants throughout the lifetime of the project. This program is so vital to the rural communities that CCOS serves where there are high rates of opioid use and access to drugs and alcohol for at-risk youth.

Bay Rivers Telehealth Alliance Telehealth Enabled Access to Youth Substance Abuse Treatment & Recovery Abstract Bay Rivers Telehealth Alliance(BRTA), in partnership with the Middle Peninsula Northern Neck Community Services Board(CSB) and five rural schools systems in Eastern Virginia, will deliver effective and coordinated family-centered, telehealth-enabled substance abuse services including prevention, early intervention, treatment, and recovery support services to adolescents and youth in transition with or at risk for Substance Use Disorder(SUD) and Co-Occurring Disorders(COD). By enhancing and expanding the system of care with comprehensive evidence-based practices, building telehealth infrastructure linking Middle and High Schools in the region with integrated trauma-informed, outpatient services, as well as support for families and caregivers, and case management to link with wrap-around services to meet social determinants of health, the proposed system of care will meet the complex needs of adolescents with or at risk of developing Substance Use Disorder and Mental Illness, and their families/primary caregivers. The geographic catchment area for service delivery comprises six counties of two contiguous, rural regions in Eastern Virginia known as the Northern Neck (Lancaster, Northumberland, Richmond, and Westmoreland counties) and the Middle Peninsula (Essex and Middlesex counties). Evidence-Based Practices to be used to deliver services include the Adolescent Community Reinforcement Approach (A-CRA), Community Reinforcement and Family Training (CRAFT), Seeking Safety: An Evidence-Based Model for Substance Abuse and Trauma/PTSD, Change Companies Curriculum, and Ecosystemic Structural Family Therapy (ESFT). By initiating, expanding and facilitating Behavioral Health Services for Prevention and Early Intervention in the Schools (Goals 1 and 2), it is anticipated that more youth and families will be identified and effectively referred for the new capacity developed for SUD Treatment and Recovery Support Services by the MPNNCSB (Goal 3). Utilizing telehealth enabled systems of care to connect students, families and clinicians in school, at home and in clinical settings, will increase access to care by reducing the barriers many families face in this region due to travel distances, time constraints, limited income and family responsibilities. In addition to training staff at the schools and the MPNNCSB, the project anticipates serving the following number of unduplicated youth. Total Number of Unduplicated Individuals Served by Project: Year 1 – ending 8/31/22: 60; Year 2 – ending 8/31/23: 100; Year 3 – ending 8/31/24:120; Year 4 – ending 8/31/25:140; Year 5 – ending 8/31/26: 160; Total - 580

Population of Focus: Adolescents aged 12-17 and transitional aged youth aged 18-21 with substance use disorders (SUD) and/or co-occurring substance use disorders and mental disorders (COD) and their families and primary caregivers. Geographic Catchment Area: Ocean and Monmouth Counties, New Jersey Strategies/Interventions: HMH's Department of Behavioral Health and Psychiatry is positioned to integrate and enhance existing services and address the defined need of the population of focus. HMH clinical departments and healthcare providers, as well as representatives from community agencies such as schools and county juvenile justice systems serving the population of focus, will be engaged in the project to ensure that adolescents and transitional aged youth experiencing SUD and/or COD are referred to HMH to initiate SUD and COD screening and integrated treatment. Expanded services include (1) personnel specifically dedicated to address SUD and COD, (2) a comprehensive, evidence-based program for intervention and treatment, and (3) technology to support the population of focus in SUD and/or COD treatment. Goals and Measurable Objectives: Three program goals each have underlying specific, measurable, attainable, relevant, and time-driven objectives to ensure project success: Goal 1: Establish a comprehensive and consistent system of screening, early intervention, and treatment for SUD and COD in adolescents and transitional aged youth from the catchment area. Goal 2: Incorporate activities that engage patient families/primary caretakers in treatment into the comprehensive and consistent SUD and COD screening, early intervention, and treatment services. Goal 3: Establish evidence-based practices and treatment for the population of focus who receive comprehensive and consistent screening, early intervention, and treatment for SUD and COD. Number of Individuals Served: 450 individuals over 5 years (50 in Year 1, 100 each in Years 2-5). Abstract: The epicenter of the opioid crisis in New Jersey is Ocean County and neighboring communities, including Monmouth County. With a shortage of board-certified child and adolescent psychiatrists and few agencies providing early intervention services, youth are at risk for problems related to substance use and drug-related death. Hackensack Meridian Health proposes an integrated program informed by evidence-based practices to screen, diagnose, and provide comprehensive early intervention services to 450 adolescents and transitional aged youth over a five-year period.

Project ENTER (Engaging in Needed Treatment & Empowering Recovery) focuses on 13-21 year-old youth and their families involved with the NYC Administration for Children’ Services (ACS). The project will provide age-appropriate screening, brief interventions, evidence-based treatment and youth recovery mentoring to 550 youth with substance use disorders (SUD) to create a comprehensive system of care for adolescents and their caregivers. Project ENTER was born out of a vital need to reduce the disproportionate impact of substance use on NYC’s most vulnerable youth, i.e., those whose families are involved in child welfare investigations, those entering foster care, and those who are juvenile justice-involved and in detention; some 95% of these youth are from communities of color. ACS leadership realizes the need to break down silos, identify youth with high SUD risk more effectively, and innovate the way vulnerable youth are connected to effective SUD services and supports. Through cross-system collaboration, the Educational Alliance, Inc., ACS, and specialty adolescent substance use treatment providers will strengthen the existing system of care to ensure more ACS-involved youth gain access to strength-based, recovery-oriented, trauma-informed, and culturally-responsive care. At relevant ACS sites, Project ENTER will implement SnapShotNYC, an evidence-based, youth-focused screening, brief intervention, and treatment referral (YSBIRT) process; SnapShotNYC allows for accurate risk stratification and the immediate delivery of prevention messages along with brief motivational interventions. Following a positive screen and assessment, 75 youth in Y1, 100 in Y2, and 125 in each of Y3, Y4, and Y5 for a total of 550 youth will be fully enrolled in Project ENTER with the goal of strengthening their motivation and readiness for treatment, ensure successful initiation of evidence-based treatment, and ongoing engagement in treatment and recovery activities. The project’s Youth Recovery Mentors (YRMs) will serve as credible messengers and provide practical referral and recovery supports to youth and caregivers; they will work hand in hand with both referring ACS staff and community treatment providers and support youth’s transition and progress. Evidence-based Contingency Management, via an innovative virtual application, will be employed to strengthen youth engagement. Project ENTER will enhance SUD treatment in ACS detention settings via implementation of evidence-based practices (e.g. MI, MET, CBT, FFT), and ensure that youth in the community will be referred to licensed, qualified SUD providers. Caregivers will be engaged to support their children, as well as participate in screening and, if needed, services for their own wellbeing in support of their family. Project ENTER’s implementation and collective impact will be guided by its Steering Committee and input from its Advisory Committee, which in addition to system partners will include youth and caregivers with lived experience.

The purpose of this project is to expand and enhance comprehensive treatment, early intervention, and recovery support for adolescents 12-18 and transitional aged youth ages 16-15.

Summary. Bridging Access to Care (BAC) is proposing a program to enhance and expand comprehensive treatment, early intervention, and recovery support services for transitional aged youth (ages 18-25) with SUD and/or COD, and their families/primary caregivers; the project will serve NYC, with a focus on Brooklyn. BAC proposes to serve 120 unduplicated individuals annually and 540 over the entire project period. Project name. Brooklyn Expansion of Treatment and Recovery Services Program Populations to be served. BAC’s population of focus (POF) will be transitional aged youth (ages 18 to 25) with substance use disorders (SUD) and/or co-occurring substance use and mental disorders (COD), and their families/primary caregivers. BAC’s catchment area where services will be delivered will be the underserved and high-need communities in New York City (NYC), with a focus on Central Brooklyn, East New York, East Flatbush, and Bushwick. Strategies/interventions. BAC’s program activities will include: 1) providing a comprehensive, family-centered, trauma-informed, evidence-based, coordinated, and integrated outpatient system of care, which includes early intervention and recovery support services; 2) screening clients for alcohol misuse and illicit drug use; 3) screening all clients and their family members for tobacco use; 4) education and messaging on making healthy choices; 5) housing and housing placement services; 6) testing for HIV and Viral Hepatitis; and 7) implementing the following EBPs: Motivational Interviewing, Cognitive Behavioral Therapy, and Contingency Management. Project goals and measurable objectives. The program’s goal is to enhance and expand comprehensive treatment, early intervention, and recovery support services for the POF. The program’s objectives include: Provide comprehensive, family-centered, trauma-informed, evidence-based, coordinated, and integrated outpatient services, including intervention and recovery support services, to 60 clients in year 1 and 120 participants per year in each of the following years; Screen clients (60 in year 1, 120 in subsequent years) and their family members/primary caregivers, who are included in treatment planning, for alcohol misuse and illicit drug use, including marijuana, opioids, stimulants, inhalants, and benzodiazepines; Provide persons engaged in risky or hazardous drinking with brief behavioral counseling interventions to reduce alcohol misuse; Screen all clients (60 in year 1 and 120 in subsequent years) and their family members/primary caregivers for tobacco use and provide tobacco use counseling and interventions as part of a standard of practice, as appropriate. Provide augmented, pregnancy-tailored counseling for pregnant clients who use tobacco products; Provide tobacco cessation counseling to 60 clients per year; Provide education and messaging on making healthy choices that includes no use of any substances through social media and social marketing, reaching 500 persons from the POF per year; Provide recovery housing to 2-3 clients in year one (3 – 5 in subsequent years); and Provide HIV and HCV testing for 50 clients per year.

Summary of Project: Youth Advocate Programs, Inc. (YAP) is proposing to implement the Recovery Advocacy Program providing strategies that include wraparound and peer recovery support services in conjunction with evidence-based treatment to the population of focus defined as adolescents (ages 12-17) and transitional age youth (ages 18-21) with substance use disorder or co-occurring disorders and their families/primary caregivers in Tarrant County, TX. Project Name: Recovery Advocacy Program Population(s) to be Served: Adolescents (ages 12-17) and transitional age youth (ages 18-21) with SUD and COD and their families/primary caregivers in Tarrant County, TX. Strategies/Interventions: Wraparound and peer recovery support services in conjunction with evidence-based treatment (Seeking Safety, ACRA, Family Support Network) Project Goals/Measurable Objectives: Goal 1: Increase access to comprehensive treatment services to adolescents and transitional age youth and their families/caregivers. Objectives: 1. By January 31, 2022, 7 collaborative partnerships will be established between YAP and community partners. 2. By August 30, 2026, 450 participants will be enrolled in the program as measured by participant records. Goal 2: Reduce SUD and COD symptoms of program participants and improve social connectedness and motivation toward change. Objectives: 1. 60% of all participants will reduce illicit drug use and problem alcohol use at 6 months post-baseline as measured by results of the GPRA and SASSI. 2. 30% of all participants will remain abstinent from drugs at 6 months post-baseline as measured by results of the GPRA and SASSI. 3. 60% of participants who present with psychosocial/behavioral health issues will show a decline in psychiatric symptoms at 6-months post-baseline as measured by results of the GPRA and SASSI. 4. 60% of participants will show improvement in motivation towards treatment at 6-months post-baseline as measured by results of the GPRA and SASSI. 5. 80% of participants will show improvement in social connections with their peers as measured by results of the GPRA and SASSI. Goal 3: Improve family functioning and parenting skills. Objective: 1. 60% of participants will show improvement in family functioning and relationships within the family as measured by results of the GPRA and SASSI. Goal 4: Establish systems linkages and wraparound, recovery support services to ensure successful community transitions. Objectives: 1. 95% of participants in need of education services will attend school or preparation for general equivalency diploma (GED). 2. 95% of participants in need of housing will either be in their own residence or recovery housing transitional living facilities. 3. 95% of participants in need of medical coverage will have medical coverage. 4. 95% of participants in need of transportation services will be provided physical transportation and/or bus passes. Number of People to be Served: 50 in Year 1 and 100 in Years 2, 3, 4 and 5 to serve a total of 450 youth and their families/primary caregivers during the lifetime of the project.

The purpose of Georgia’s Youth and Family TREE (Enhancement and Expansion of Treatment and Recovery Services for Adolescents, Transition-Age Youth, and Their Families) is to improve the lives of youth and young adults with substance use or co-occurring disorders through community outreach and education, screening, detection, assessment, treatment, and recovery services provided through a comprehensive, coordinated, and integrated approach. In partnership with key stakeholders, the Georgia Department of Behavioral Health and Developmental Disabilities (DBHDD) will implement this initiative by focusing on the following goals: (1) expanding and enriching the array of treatment and recovery services for youth and young adults (Y/YA) with substance use or co-occurring substance use and mental health disorders in an urban and a rural area of middle Georgia; (2) identifying youth/young adults at Clinical High Risk for Psychosis (CHR-P) and provide evidence-based treatment, monitoring, and referral to appropriate services; and (3) building the capacity of the substance use and mental health treatment provider communities to meet the unique needs of Y/YA and their families. DBHDD has selected two providers with unique and complementary expertise. Grady Health System, in metro Atlanta, has extensive experience working with Y/YA with first-episode psychosis, many of whom also have co-occurring substance use disorders. iHOPE, Inc., in rural middle Georgia, is a statewide leader in recovery-focused services for individuals with substance use disorders in an underserved and socioeconomically disadvantaged region of the state. In their respective geographic areas, these providers will target Y/YA ages 14-25 with substance use or co-occurring substance use and mental health disorders. Through proven screening and detection strategies and the provision of a variety of evidence-based treatments, including the Matrix Model, Motivational Enhancement Therapy + CBT, Multifamily Group Therapy, and Seeking Safety, Grady and i-HOPE will leverage their experience and community partnerships to meet the needs of the individuals and families they will serve. Approximately 50 Y/YA and/or family members will be served in the Youth and Family TREE program in the first year. In subsequent years, this number will increase to 100, for a total of 450 individuals served over the five-year period of the project. Expected outcomes include improved clinical, occupational, and social functioning, as evidenced by reduced rates of substance use, reductions in overdose deaths, reductions in rates of hospitalization and legal system involvement, and increased participation and success in academic and vocational pursuits. Improving their life trajectories and preventing fewer youth and young adults from falling through the cracks is the overarching goal of Georgia’s Youth and Family TREE.

Community Care Alliance, located in Woonsocket RI is a combined behavioral health and community action program serving a diverse population of over 16,000 people annually. Through its Youth & Family TREE program, CCA will strengthen and expand the continuum of care for youth and transitional aged youth engaging in risky alcohol and other substance use, as well as other risky behaviors and/or who have co-occurring mental health issues. Emphasis is placed upon identifying and eliminating disparities for females and racial and ethnic minorities. Because substance use impacts the entire family, services will be offered to support the entire family, including prevention activities, treatment, and basic needs (e.g., food, rental assistance, utility assistance). By supporting the whole family, youth are expected to experience improved outcomes. The Harbour Youth Center will serve as the hub of services, building upon the foundation of drop-in center and employment support to engage youth and connect them to the full array of substance use and co-occurring mental health services offered at CCA. Strong working alliances with other community providers will close any gaps in access to services. Referrals for YFT may originate from any agency program or community provider. Upon referral, youth will be screened. Those identified as engaging in risky behavior will be referred to the Program Coordinator for discussion of how YFT can help them. Families will be involved at this stage depending upon age and the consent of the person seeking services. A comprehensive bio-psychosocial assessment will lead to identification of needs across several domains. This information will be used to build a person-centered recovery plan. The YFT Navigator will establish a working alliance with the youth and family, guiding them through the services available to them. Upon program completion, youth will experience an increase in strengths, engagement in meaningful activity, reduced or eliminated alcohol/substance use, improved mental health and more positive relationships with family members. YFT will also offer other supportive services that include HIV/Hepatitis C testing, smoking prevention and cessation with targeted education for pregnant women, and will engage in community education activities aimed at promoting healthy, substance-free living by using messaging aimed at people across the spectrum of readiness for change. All of these activities will be completed in accordance with SAMHSA’s expectations, including data collection using the GPRA and other outcome tools. This data will be used to inform the service team regarding efficacy, providing useful information to guide performance quality improvement efforts in order to achieve maximum outcomes.