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Funding will be used to expand the availability and accessibility of core programming, providing children and their caregivers with access to free grief support through age appropriate, peer-support group sessions. This request would help us expand services for children ages 3-18 and their families in Rhode Island by allowing us to: 1. Host a summer bridge program 2. Increase availability of Program Director/Licensed Clinician to assist schools and other community organizations when the loss of a child/staff member impacts the community 3. Increase availability and accessibility of services to urban and Latinx/BIPOC youth in the Providence County area

The project, Expansion and Enhancement of Mental and Behavioral Health Services, aims to increase and strengthen mental and behavioral health services at Mississippi State University (MSU) to support students and the local community in Northeast and East Central Mississippi. The project involves developing a new mental and behavioral health clinic at the Meridian campus and hiring behavioral health navigators at the Meridian and Starkville campuses to increase students’ access to services. The project targets diverse populations, including low-income, rural, and minority groups, and seeks to improve access to high-quality mental health care, address the shortage of trained professionals, and foster a culture of well-being at MSU. The primary goal of this project is to expand and enhance mental and behavioral health resources and facilities to support faculty, staff, students and the local community at MSU. The objectives for the project are as follows: Objective 1: Prepare a dedicated space for the mental and behavioral health clinic at the Meridian campus. • Renovate space to include 12 clinic rooms and 12 offices • Hire security/police offers and a licensed professional counselor-supervisor (LPC-S) • Purchase furniture and decor for clinic rooms, offices, and waiting room • Purchase office equipment necessary for a successful clinic (i.e., computers, scanners, copiers) • Purchase psychological assessment instruments • Purchase intervention materials necessary for children • Provide professional development for 12 practitioners and 18 students • Provide liability insurance for 12 practitioners Objective 2: Expand access to mental and behavioral health services by hiring behavioral health navigators to further support students on both the Meridian and Starkville campuses • Hire eight behavioral health navigators • Train behavioral health navigators to provide outreach, education, and referral services to students in need of mental and behavioral health support • Increase the number of students who access Student Counseling Services by 10% compared to the previous academic year • Use the evaluation results to inform program improvement and sustainability A total of 39 individuals will receive training: 12 practitioners and 18 students at the new clinic in Meridian will participate in mental health professional development, while 8 Behavioral Health Navigators and 1 program coordinator will be trained to provide outreach, education, and referral services to students in need of mental and behavioral health support. Mississippi State University is committed to providing high-quality mental and behavioral health services and training opportunities to various populations, including college students, children, adolescents, adults, couples, families, rural residents, low-income individuals, and minorities. We have established strong partnerships with local schools, hospitals, clinics, agencies, and organizations that serve the mental and behavioral health needs of the community. We have the expertise, infrastructure, and resources to successfully implement the proposed grant project and achieve its goals and objectives.

Briarpatch Youth Services requests a one year $400,000 SAMHSA grant to plan, develop, and implement its Comprehensive Community Services (CCS) Program. The project will provide clinical and therapeutic counseling services to youth ages 12-17 who have runaway, are experiencing homelessness, have become involved in the justice system, or are otherwise facing challenges. Serving Dane County, Wisconsin, the project will serve approximately 60-75 youth annually when fully operational. CCS is a State of Wisconsin program that is administered by each county in the state. It is an integrated behavioral health program for youth with severe emotional disturbance. The project will employ 5.1FTE employees during the 1-year start-up phase. The goal of the project is to create a sustainable, fully functioning CCS program which will help youth with mental health concerns a) improve health, b) promote wellness, c) achieve personal goals, and d) enhance overall quality of life. To accomplish this goal, the project will hire credentialed staff, develop policies and procedures, complete Dane County CCS provider enrollment, institute a data collection plan according to Dane County requirements, perform client outreach, and begin offering services. At the end of the project period, the CCS Program has a goal to be financially self-sustaining. The program will offer services to promote: a) development of coping skills to manage the issues posed by mental illness, b) development of interpersonal skills, conflict resolution, and assertiveness, c) identification of supports and advocating for those supports, d) therapy/counseling, e) management of medication, f) assistance in gaining and utilizing life skills, g) coordination of services to ensure the individual receives timely and appropriate care, and, h) referral for substance use disorder. Briarpatch Youth Services is uniquely qualified to serve this youth population. Serving Dane County and metropolitan Madison, Wisconsin for more than 53 years, the agency offers a broad array of services to youth and their families. These services include: youth shelter, 24-hour help-line, individual, group, and family counseling, outreach, employment assistance, and restorative justice programming. The Comprehensive Community Services Program, will improve the depth and breadth of counseling services available at the agency, improving its clients’ long-term mental health outcomes.

At the Kettle Moraine YMCA, the Community Care Model has been a guide to the development of the Mental Health Department within our YMCA since 2021. Through this model, we have developed four projects that are intended to act as preventative measures to aid in mitigating the mental health crisis in our communities. The four projects include: 1. Implementation and evaluation of Social and Emotional Learning in our before/after care and day camp programs, 2. Development of a mental and behavioral health initiative within our youth programs, 3. The restructure, development, and implementation of peer-to-peer youth mentorship programs, and 4. Providing mental health education for the YMCA staff and community members. Through these projects, we engage in strategies that increase mental health literacy and awareness. In addition, our efforts reduce risk of mental health crisis through strategies that develop and encourage effective coping skills and community support. Education and training of YMCA staff in topics like crisis management, how to detect signs of struggling and mental illness, and empowering staff to connect with formal support acts as an early intervention in promoting overall mental health within our communities. We anticipate serving approximately 1,200 youth in Washington and Ozaukee Counties annually. Our SEL curriculum objectives will be measured using the DESSA-SSE evaluation tool. All are welcome in our programs regardless of socio-economic status. We offer all of our mental health programs free of charge so as to reduce any barriers to participation.

Egyptian Health Department (EHD) Project Connect 4.0 (PC 4.0) proposes to serve children, youth, and young adults ages 6 to 21, at risk for or with serious emotional disturbance (SED), or serious mental illness (SMI) and their families. An emphasis will be placed on those with multi-system involvement, those in need of crisis services and those needing assistance addressing social determinants of health. The geographic catchment area will be Gallatin, Saline and White Counties in rural southeastern Illinois. There are 41,556 individuals living in the catchment area, of whom 10,125 are ages 0 to 21. The percentage of males ages 0 – 21 is slightly higher (52%) than the percentage of females (48%) in the combined catchment area. An estimated 350 (20%) individuals ages 18 – 21 in the catchment area identify as a sexual minority (Jones, 2023, Gallup, 2023). The 2022 Illinois Youth Survey (IYS) found that 14–22% of 8th, 10th and 12th grade students in Saline County and 10 – 15% of 10th and 12th grade students in White County identify as LGBTQ+. Twenty-four percent (24%) of children under 18 live below the federal poverty level (FPL) in Gallatin County, 21% in Saline County and 18% in White County. All Black or African American residents in Gallatin County and 41% in White County live below the FPL. In Saline County, more than half (56%) of American Indian or Alaska Native individuals live under the FPL. Project Connect 4.0 proposes to serve 600 unduplicated youth over entire grant project with 75 being served in Year 1; 175 in Year 2; 175 in Year 3 and 175 in Year 4. This project builds upon the existing Project Connect System of Care (SOC) that was developed in 2009 and expanded and sustained in 2016 and 2020 with grant awards from the Children’s Mental Health Initiative SOC from SAMHSA. Project Connect 4.0 goals include the implementation of the CAMS (Collaborative Assessment and Management of Suicidality) Framework to work collaboratively with adolescent patients and their families to devise treatment and stabilization plans that build trust and mutual understanding; ensure that youth experiencing crisis receive a trauma-informed, individualized assessment; increase availability and delivery of crisis stabilization supportive services, utilizing a Home and Community Based Services (HCBS) model; develop and implement an Intensive Outpatient Program (IOP) providing trauma-informed Evidence Based practices which will include EMDR (Eye Movement Desensitization and Reprocessing), MAP (Managing Adaptive Practices), and SBIRT; develop and Implement an Intensive Care Coordination Crisis Program, following the Illinois HFS Care Coordination and Support Organization (CCSO) model tailored to youth experiencing crisis who are not yet involved in or are otherwise ineligible for the state-driven CCSO program; leverage and enhance EHD’s CMS-funded Integrated Care for Kids (InCK) program to routinely conduct social determinants of health (SDOH) screenings to identify needs of youth and families in crisis,utilize the Youth Aware of Mental Health (YAM) evidence-based suicide prevention curriculum to decrease suicidality, increase youth awareness of mental health concerns, and improve suicide prevention messaging in schools; and collaborate with the Suicide Prevention Task Force to increase community awareness of suicide among youth, specifically utilizing information within the region. A summary of the measurable objectives include implementation of the CAMS framework and CAMS 4 Teens, Crisis Stabilization Support Plan tool; utilize the Crisis Assessment Tool (CAT) and the Columbia Suicide Severity Rating Scale (CSSR); utilizating SBIRT (Screening, Brief Intervention, and Referral to Treatment) for clients with substance use concerns; hire 2 Family Resource Developers (FRDs) who will serve 50% of caregivers and youth provide Intensive In-home Services and Intensive Outpatient Services and collaborate with SDOH providers.

""System of Care Supports for Youth Crisis Interventions"" (""SOC Supports"") is a project by Elkhart County, IN through its sub-recipient, Oaklawn Psychiatric Center and its system of care, The SOURCE, to expand its infrastructure, collaborations, and programming to support successful transitions from crisis to stability for children and youth through their involvement in Oaklawn's Mobile Response Stabilization Services (MRSS). ""SOC Supports'"" mission is to enhance Elkhart County's youth crisis care continuum serving children and youth ages 6-21 with, or at risk for, serious emotional disturbance. Recognizing that well-crafted transitions are a key to stability following crisis, Elkhart County proposes to expand its system of care's infrastructure and capacity to support successful implementation of the model and achieve expected outcomes. This includes the build-out of intensive home and community-based services in the stabilization and transition phases of MRSS. The build-out of the system will involve mental health services, community supports, and the infrastructure to develop it. Since we know stabilization components in MRSS may continue beyond the immediate crisis needs, depending on youth and/or family preferences, and clinical and functional needs of the family system, an expanded services continuum into which to nest the mobile response is vital. Throughout the life of the project, “SOC Supports” proposes to serve 400 youth averaging 100 annually. Our goals for “SOC Supports” include: (1) To provide access to crisis and stabilization services through an MRSS model integrated across child/youth serving systems; (2) To expand the system of care's focus to support youth with multiple system involvement; (3) To create a group of empowered and educated youth and family members to inform and drive MRSS; (4) To provide access to services for youth without a funding source for mental health services; (5) To increase the county's capacity to prevent youth suicides; (6) To impact disparities in service access; (7) To increase ""transition to adulthood"" services for youth across the county.

Colorado Behavioral Health Administration (BHA), has extensive experience providing behavioral health programming to address the needs of children and youth across the state. This includes prevention, intervention, and programs to address youth with serious and complex needs like youth and families in behavioral health crises. We administer programs to serve youth and families in the home, community, residential settings, and all tiered settings in between. Colorado is a vast landscape of varying communities, from mountain to frontier to plains and populated urban settings; Colorado is also home to two Federally recognized tribes: the Ute Mountain Ute and Southern Ute Indian tribes. These complex geographic and cultural conditions require a flexible and effective approach to integrating behavioral health care for youth and families; High Fidelity Wraparound (HFW) is a promising practice that meets these needs. BHA is currently in its third iteration of HFW with COACT (COACT 3.0). This narrative proposes a fourth iteration of COACT (COACT 4.0), which will continue to address the needs of youth who are at risk of out-of-home placement, returning from out-of-home placement, and those who may have complex behavioral health needs or be multi-system involved. COACT 4.0 will expand HFW access to all of our vendor partners, in preparation for the statewide rollout of HFW as a Medicaid benefit. To prepare our vendor partners for statewide HFW, we are building the provider network, credentialing capacity, statewide education, and knowledge of HFW, as well as overall community readiness for immediate implementation when the HFW Medicaid benefit goes live in one year. BHA will ensure quality care in COACT 4.0 by tracking and monitoring client outcomes, program fidelity, responsible spending, and provider credentialing within the HFW model. With the preparation this grant provides, we are assuring families across the state have little to no wait time, barriers, or lack of prepared providers to receive this promising practice now, and as a Medicaid benefit in 2025.

Luzerne-Wyoming Counties System of Care Expansion (LW-SOCE) will create infrastructure and services for a comprehensive system of care for children birth to age 12, and their families in Luzerne and Wyoming Counties in Northeast Pennsylvania. The focus will be developing developmentally appropriate services and supports for infants, toddlers, pre-school and elementary school age children with or at risk of serious emotional disturbance. A review of data on young children receiving behavioral health services in the two counties between 2021-2023, through the current SOC Initiative reflects a profile of significant diversity and need that will be addressed by LW-SOCE. Data on 106 children ages 5- 12 show that 21.7% reported Hispanic ethnicity, 11.3% reported their race as Black or African American, 4.6% reported sexual orientation of gay, lesbian, bisexual or questioning and 1.9% reported other gender identity. Poverty and trauma are significant challenges for the families of these young children. 28.3% of caregivers reported a family income less than $35,000. 33% reported that their children had experienced trauma, with 91.4% of those indicating that the youth experienced interpersonal violence and 17.1% reported that the youth had experienced community or school violence. Furthermore, the data indicates the need for significant clinical support. Primary caregiver reports show 22.6% of youth had a history of suicidal ideation and 4.7% had a history of suicide attempts. 62.9% of youth scored in the clinically impaired range on the Columbia Impairment Scale assessing functioning and relationships, and 63.2% of youth scored in the clinically impaired range on the Pediatric Symptom Checklist assessing behaviors and emotions. In addition, 33% of primary caregivers scored in the high strain and 49% scored in the medium strain categories on the Caregiver Strain Questionnaire. The strategy of LW-SOCE involves working closely with families/caregivers, child serving agencies, and local organizations to create community-wide embrace of young child wellness. Interventions involve development of a coordinated network of comprehensive mental health and support services to meet the varied needs of children at risk for or with social/emotional disturbance, their families, and caregivers. LW-SOCE goals start with establishment of Young Child Teams working closely with children and their families to identify concerns, develop comprehensive plans, and facilitate services and supports. Evidence-based clinical programs and parenting programs will be created or enhanced. Agreements will be developed for collaboration with Child Welfare agencies, early care and learning centers, and elementary schools in the two counties. There will be a variety of training protocols to help parents, childcare staff, elementary school staff, and child serving agencies learn about how best to support young children with behavioral challenges. Respite services and parent support groups will be available to help parents. Collaboration with faith communities and community organizations will be available to assist families with practical living resources such as food, shelter, transportation, and household good. A public awareness campaign will be established to inform the community about young child development. A Grant Management Team will work with a Governance Team to improve collaboration across child & family-serving programs, guide the implementation of LW-SOCE, monitor impact, and make recommendations for continuous improvement. Clinical services and parent education will be delivered to 50 children in year one, 75 in year two, 85 in year three, and 60 in year four with 270 children being served throughout the grant period. 75% of children served will exhibit reductions in behavioral difficulties, 60% will experience improved social-emotional functioning, and 60% of parents will report improved caregiver practices & child-caregiver interactions.

The Commonwealth of the Northern Mariana Islands (CNMI) System of Care (SOC) Project will engage key stakeholders to collaboratively implement an efficient, coordinated system of care that is aimed at improving mental health outcomes for children and youth. The CNMI SOC Project will serve children and youth, birth to age 21, who are at risk for or with serious emotional disturbances, and their families.

This application, Building Strong Foundations: Expanding and Sustaining Early Childhood Mental health Services (BSF), is submitted by the Mental Health and Recovery Board of Union County (MHRBUC), the behavioral health planning and funding authority for Union County, Ohio. BSF will provide the enhanced infrastructure, processes, and services needed to build strong Early Childhood Mental Health Services as part of our comprehensive system of care. BSF includes a partnership between the MHRBUC, Union County Board of Developmental Disabilities (UCBDD) and their two preschools; Harold Lewis Preschool and LEADS Head Start, Marysville Exempted Village School District (MEVSD), North Union Local Schools (NULS), three local behavioral health providers; Maryhaven, Ohio Guidestone, and Council for Union County Families (CUCF), our region’s largest children’s hospital, Nationwide Children’s Hospital, and University of Connecticut Innovations Institute (UConn). In 2019, MHRBUC began a significant plan to link child serving systems, behavioral health providers and payers to support expanded mental health services to Union County youth across the full Institute of Medicine’s Continuum of Care (Springer & Phillips, 2007). Mosaic, a 2019 SAMHSA System of Care (SOC) award, created local centralized intake, mobile response and stabilization services and service coordination model for youth and families. In 2022, Union County Project AWARE expanded Mosaic, embedding behavioral health services within schools for grades K-12. Union County’s Project AWARE responded to specific needs for students in grades K-12, however, there are gaps in our continuum of care and a growing need for intentionally designed services for children ages 0-8. BSF will support Union County children and families by providing a comprehensive evaluation process, implementing Early Childhood Mental Health Consultation, establishing behavioral health integration within pediatric primary care, enhancing child and family screening, and implementing a variety of early childhood mental health services including parent programs, family peer support, and outreach. BSF will serve at least 25 families per year and 185 families over the grant period. This project will address data-driven areas of need including enhanced collaboration and partnership, mental health literacy, continuum of care access, early intervention, expanded services and support, and continuous quality improvement. The goals of the project include; Goal 1: Enhance collaboration and partnership between child, family, preschool, school, primary care providers, and community behavioral health service providers to increase awareness of mental health and behavioral health issues among young youth (0-8)., Goal 2: Identify and create opportunities to support preschool staff, youth serving providers, families’ mental health literacy and skills to support ECMH and wellbeing., Goal 3: Identify and remove barriers to access, engagement, and service delivery for services across the IOM continuum of care to promote and foster resilience building and mental health well-being., Goal 4: Establish and expand evidence-based, trauma-informed prevention and behavioral health interventions as part of the early childhood preschool system of support framework., Goal 5: Sustain and Expand critical System of Care supports and services across the Institute of Medicine’s Continuum to connect early childhood aged youth with behavioral health challenges to the right service at the right time, and Goal 6: Improve outcomes and reduce disparities through evaluation and continuous quality improvement cycles.

Vaya Health, a regional governmental entity and public managed care organization is applying to fund the “Changing Systems Through Youth and Family Leadership” (CSYFL) project. We are applying to address specific needs related to Comprehensive Community Mental Health Services (CCMHS) through strengthening the System of Care (SOC) approach in six rural North Carolina (NC) Counties. Building a better system for all children with SED is the priority with emphasis on target populations that include (1) Minority populations: two counties have high concentrations of African American citizens and two others have above average Hispanic/Latino citizens; (2) Youth exposed to trauma and neglect; (3) Youth with or at risk of co-occurring substance use disorders (SUD); (4) youth with suicide and self-harm attempts; and (5) Youth in transition, e.g., from foster care, juvenile justice, or high school, age 16-21. We will hire, train, and embed Youth Partners (YP) to work with existing teams of Family Partners (FSP) and SOC Coordinators (SOCC) as new Tri-Care teams for each county. We will recruit and serve at least 1,240 youth with a range of 190-370 per year, screened and served with clinical services and EBPs. Our primary goal is to build youth and family voice and increase the number of Positive Childhood Experiences (PCE) while fostering resilient communities. Healthy Outcomes from Positive Experiences (HOPE), Resources for Resilience (RR), the Engaging Youth to Improve Substance Misuse Prevention model, Collective Impact and Results-Based Accountability will be blended in an intentional approach that will include sustainability planning from day one. Youth in need will have access to the full array of services including enhanced services (e.g., High Fidelity Wraparound or Multisystemic Therapy), and will remain in the CSYFL for Tri-Care support no matter where they are served. System of Care Child Collaboratives in each county will be supported to expand system change capacity. Youth and Family led Support Groups will be supported or expanded in each county and an Annual Youth Led Conference established. We will prioritize Youth and Family Voice identified problems and through Youth-Led Groups and Tri-Care Team support, will generate a proposed solution, develop a data-informed projection of that solution’s impact on outcomes, cost, and youth/family satisfaction and have youth/families review the solution and provide support for implementation and evaluation. With this approach we will target five goals with 25 linked objectives. G1: Expand capacity and access for youth/families with complex mental health needs to screen for and access trauma-focused/trauma-informed screening, prevention, and EBP treatments. G2: Improve Youth/Parent/Family (YPF) engagement and influence with service/resource stakeholders, via engagement and retention efforts and training, e.g., trauma/resilience, PCE, suicide, SUD. G3: Integrate YPF voices with lived experience in key system partners as advisers and advocates while also providing direct support to youth via Youth Partners (NOMS, Quad-Screen), and either support existing or establish YPF-led support groups for each county. G4: Improve stakeholder and community capacity to improve youth connectedness in communities, schools, support groups, PCE enhancing opportunities, and SOCC’s to reduce depression, suicidality, and self-harm. G5: Assess, engage, and support SOCC’s to support improvement in local SOC initiatives through increasing YPF membership and input and by implementing CI/RBA supports to intentionally address resource and service needs. Implementation and Evaluation support will 1) collect, manage, and report data for performance measurement and Continuous Quality Improvement; 2) complete all documentation outlined in application; 3) sustainability planning; 4) disparity impact statement; 5) needs assessments; and 6) to complete an integrated systems, process, and outcome evaluation.

The City of Edmond System of Care (ESOC) will serve children, youth and young adults ages 6-21, at risk for or with serious emotional disturbance (SED) or serious mental illness (SMI) and their families. An emphasis will be placed on those with multi-system involvement and in need of intensive home and community-based services. The geographic catchment area is the City of Edmond, Oklahoma, located in Oklahoma County and the metropolitan area of Oklahoma City. Edmond System of Care (ESOC) providers will identify and assess children, youth and young adults in the population of focus and will connect them to a fully integrated continuum of coordinated behavioral health services. This project aligns with the findings of the Edmond Community Behavioral Health Needs Assessment Final Report and Action Plan and the 2024 Edmond City Council Strategic Plan initiative to ""continue implementation of solutions to meet needs identified in the mental health needs assessment."" Over the course of the four-year grant, the ESOC expects to reach 325 unduplicated children, youth and young adults. The ESOC centers activities on the following goals: (1) strengthening coordination of the city's child-serving agencies by establishing a governance team (GT) to oversee and sustain the ESOC, (2) decreasing emergency room encounters by strengthening and coordinating crisis care across local and state-contracted crisis providers, (3) improving clinical outcomes for children and youth at-risk for SED by increasing public and private provider capacity to provide intensive stabilization services and home and community-based (HCB) services, (4) increasing meaningful family and youth participations at all levels of the ESOC, and (5) increasing Edmond Public School student access to evidence-based (EB) behavioral health interventions in and out of school. The ESOC will complete these goals by hiring a project director, completing a needs assessment that identifies gaps in services; racial and ethnic health disparities; and cultural and linguistic competency needs and identifying and appointing a GT made up of leaders from child-serving agencies, family members and youth, and key stakeholders. A team to support children and youth to transition out of the Urgent Recovery Center will be established, along with a crisis advisory team (CAT) made up of crisis providers, who will map the current crisis continuum to identify opportunities to improve coordination. A wraparound team to provide intensive HCB services will be established and providers will select evidence-based crisis stabilization services to begin providing services to children and youth. The Lead Family Coordinator and the GT will recruit parents and youth to serve on the GT and CAT, assess the capacity of family and peer support and develop a plan to increase youth and family representation in leadership and support capacity. Edmond Public Schools will collaborate with crisis response providers and develop a graduated response system for mental health crises in schools.

The Onondaga County Integrated Mental Health Services System of Care ('OCIMHSOC') will address the disparities of youth aged 0 to 21 facing multiple diagnoses of Serious Emotional Disturbance (SED), including autism and/or developmental, physical, or emotional disabilities within Onondaga County. A particular focus is placed on those entwined with the child welfare and juvenile justice systems, aiming to instate an organized community-based care system for children and youth grappling with serious emotional disturbances and co-occurring developmental disorders. The unduplicated number of individuals to be served is 27 youth annually (15 in year one), 96 over the duration of the grant. The identified outcomes for this project are to reduce the number of and length of stay for hospitalizations and out of home placements for the target population and will be met though the following: (1) development of universal identification, assessment, referral, and linkages process for youth and families experiencing SED and developmental disability challenges; (2) provide access to intensive evidence-based services (e.g. START Model) that this population is traditionally barred from due to eligibility complexities; (3) adaption/enhancement of behavioral health services and system to specifically engage youth and families in culturally competent and trauma informed treatment practices that provide services focused on the whole child; and (4) support families in gaining skills necessary to address the needs of youth experiencing SED/IDD. Children and youth in Onondaga County grappling with both serious emotional disturbances and intellectual or developmental disabilities ('SED/IDD'), face an increased risk of experiencing hospitalizations and out-of-home placements, both within and outside the foster care and/or juvenile justice systems. Complicated administrative regulations and eligibility requirements across four large state systems - Office of Mental Health (OMH), Office for People with Developmental Disabilities (OPWDD), Department of Health (DOH) and Office of Children and Family Services (OCFS) - hinder efficient access, eligibility determination, and treatment delivery. The NYS OPWDD system has the expertise and services but significantly limits access to services with time intensive, complicated and restrictive eligibility processes; for instance, youth in foster care or youth with high levels of functioning are not eligible for services through the OPWDD system. In addition, the NYS mental health systems have a history of not serving individuals with developmental challenges due to traditional clinical approaches not being adapted to meet the population's needs. These factors hinder consistent access to adequate care and effective interventions and services for youth resulting in increased severity of needs, reduced youth functionality and increased caregiver frustration. This often leads caregivers to seek hospitalization or out-of-home placement to address their child's needs, or it could result in the youth facing criminal justice involvement and being placed in detention. In the past six months, the Onondaga County System of Care Complex Case meeting has problem solved on six different cases of youth with SED/IDD who were/are stuck, for months at a time, in a hospital emergency room, inpatient unit, detention or were disrupting from a foster care residential facility. Of the 80 youth in residential foster care, approximately 30% percent are youth with SED/IDD (24 youth). On average, 20% to 25% of youth served in intensive mental health services are youth experiencing SED/IDD. Successful structures are already in place for program administration, governance, strategic planning, engagement of community stakeholders, cross-system service development, and evaluation. Those existing structures would be refocused to support the target population and scope of OCIMHSOC.

The Mental Health & Recovery Services Board (MHRSB) of Allen, Auglaize & Hardin Counties, a governmental entity formed by the State of Ohio, proposes to partner with Coleman Health Services (CHS) and other behavioral health providers and community organizations within the Allen County system of care to improve outcomes for 600 children, youth and young adults, ages 0-21, who experience or are at risk for serious emotional disorders (SED). The target population are at-risk youth and their families in Allen County, Ohio, many of whom will live in the City of Lima, a small rustbelt city with ""big city"" problems, including poverty, stressed single-parent families, concentration of racial minorities, and high crime rates, as well as a pervasively high level of violence experienced by youth. Allen County has suffered high rates of early morbidity and ranks #60 of 88 Ohio counties on physical and mental health measures. In recent years the resulting trauma and poor mental health have become behaviorally expressed through child-to-parent ""domestic violence."" Parents or caregivers in this conservative sociopolitical culture, have traditionally turned to law enforcement at crisis points to de-escalate family conflict and mitigate their child's ""bad"" behavior. In response to rising numbers of children as young as age 7 being arrested, detained and charged with domestic violence, the Allen County Common Pleas Court, Juvenile Division, has developed a diversionary program. At the heart of the program is an ACCESS center where youth, referred by police, schools, community organizations, and directly by parents, are screened for SED and adverse childhood experiences that put them at risk for SED. Many of these youth are referred to community-based services and resources. While parents participate in the assessments, few elect to receive services themselves, and most do not recognize the role of the family system in the youth's behavioral problems. Services for youth in the community frequently have waiting lists, and many youth do not receive the recommended treatment or service coordination. The Allen County CMHI project will provide culturally appropriate family advocacy and engagement activities, as well as connect families to 24/7/365 mobile crisis services. The project will also increase the capacity of the community to provide more rapid access to youth- and family-focused evidence-based mental health care and service coordination, as well as connection to services for parents with unmet behavioral health needs. Goals include improving family stabilization, while reducing the overreliance on law enforcement and the juvenile justice detention system. The program will seek to improve mental health and life outcomes for children and youth, help youth and families heal from trauma, and develop stronger pathways to successfully transition youth to adult services, roles and responsibilities. It also aims to change the culture from one of punishment that can itself be traumatizing, to one that recognizes that ""bad"" behaviors are often symptoms of a treatable mental health condition. The Allen County Family and Children First Council will serve as the governing organization for this system-of-care program.

Summary: EHN endeavors to meet the unfulfilled requirements of children, young adults, and their families in El Paso who are either experiencing or at risk of serious emotional disturbance (SED). This objective will be achieved by extending its services within schools and the community. The aim is to guarantee that these individuals have access to sufficient mental health services, early intervention, and support for recovery, along with the transitional assistance they require during service transitions. Project Name: EHN Children Mental Health Initiative (CMHI) Population to Be Served: El Paso County males, females, and LGBTQ+ members, between the birth to 21 years old, experiencing some serious emotional disturbance (SED), and/or serious mental illness (SMI), prominently Hispanics (83%). Project Goals and Objectives: The program aims to address the multifaceted needs of children, young adults, and their family members in El Paso facing serious emotional challenges through a comprehensive approach. EHN will focus on enhancing access to mental health services by increasing availability and establishing partnerships with community agencies, with specific outcomes targeting service expansion, mental health awareness targeting students and their caregivers. In addition, EHN would emphasize early intervention and recovery support, aiming to implement evidence-based practices and provide training on referral pathways. Moreover, would seek to integrate system of care values into the CMHI program, prioritizing holistic approaches and offering support from youth peers and family partners. Lastly, facilitating transitional support, by empowering youth to continue receiving adequate services. Number to Be Served: The CMHI grant will enable EHN to provide mental health services to these individuals and intends to serve the following people for the length of the program: EHN will serve 180 unduplicated individuals un the course of the grant, by serving 35 in year one, 45 in year two, and 50 for year three and four.

The Nevada Division of Child and Family Services (DCFS) has spent the last decade building a children's behavioral health system of care in Nevada. Despite many successes, Nevada has faced challenges in providing accessible, effective, evidence-based treatment to children with complex, multi-agency needs. Nevada has identified children and youth ages 0-21 with a designation of serious emotional disturbance (SED) and intellectual and/or developmental disabilities (ID/DD) statewide as the population of focus for this project, including diverse and underserved populations. Nevada lacks the coordination, training, evidence-based practices, and provider network to meet the needs of the population of focus and will use this grant to address these deficiencies. This project has three goals: (1) Assemble a statewide Leadership Committee to oversee the grant goals and outcomes and more broadly to address systemic barriers and build a sustainable infrastructure to provide services to the population of focus; (2) Develop a program of services to provide accessible, equitable, and quality community-based evidence-based practices for children and youth in the population of focus; and (3) Implement a Statewide Training Plan to enhance the knowledge and skills of government and community organizations who work with children, youth, and families to utilize evidence-based, non-clinical interventions (e.g., supportive, consistent environments, teaching replacement behaviors, praise and positive statements) to support the population of focus to remain in their homes/communities reducing the need for residential intervention. DCFS will partner with community-based providers to execute Goal 2, building sustainability in Nevada’s service array. DCFS estimates that 275 children/youth and their families will be served by the end of the four-year grant. Through these goals and objectives, DCFS will enhance statewide, cross-system collaboration and coordination with respect to Nevada’s children’s behavioral health system of care, increase the availability of evidence-based practices provided by current community-based providers in Nevada, and enhance the skills of child-serving entities statewide, all with the ultimate goal of providing effective services to children, youth, and families in Nevada.

The primary focus of Beaver County Therapeutic Responses for Intervening Early (BC-THRIVE) is to support and provide resources to improve the mental health outcomes for children, youth, and young adults through age 21 who are at risk for or with Serious Emotional Disturbances (SED), along with their families in Beaver County, Pennsylvania. BC-THRIVE will include an additional emphasis on supporting children ages birth through five. Beaver County, located in southwestern Pennsylvania (PA), is approximately 30 miles from Pittsburgh, bordering Ohio and West Virginia. The racial composition is 93% Caucasian followed by African Americans at 8% (U.S. Census Bureau 2020). According to the 2020 Census, there are 37,524 children and youth under the age of 21. 40% of those children are eligible for Medicaid funded behavioral health services. This includes 8,357 children birth to five years old. BC-THRIVE will build on existing successful collaborations among behavioral health, child welfare, and schools to enhance and expand its System of Care (SOC). This expansion will create a collaborative infrastructure to support Early Intervention (EI) and additional school-based mental health services and supports. BC-THRIVE will strengthen cross-agency collaboration, enhance policies and procedures, secure sustainable funding, and increase evidence-based and evidence-informed services and practices. Family-driven programs will be provided by individuals familiar with the local values, culture, and norms. The BC-THRIVE expanded and enhanced SOC, along with the implementation of additional school-based services and supports, will change the life trajectory for children and youth in Beaver County, and provide important supports to their families.

Educational Service District (ESD) 112's proposed project, Lifegiving Integrated Network of Key Support (LINKS), would create a comprehensive system of care to serve children, youth, and young adults aged birth to 21, in a six-county region in southwest Washington state who have, or are at risk for, serious emotional disturbance (SED) and their families. According to the Washington Healthy Youth Survey (2021), the youth in ESD 112’s region have high rates of depression, anxiety, suicidal ideation, and adverse childhood experiences. Moreover, youth who experience these problems are disproportionately BIPOC, not cisgender, LGBTQ+, and more likely to have food insecurity compared to all youth in the region. The specific goals of the implementation of the LINKS project are: 1. Create a comprehensive System of Care that meets the varied needs of children, youth, and young adults at risk for or with SED and their families and caregivers. 2. Increase access to and connect youth with or at risk for SED and their families to the full spectrum of evidence-based, trauma- and grief-informed, and culturally appropriate mental health and related services. 3. Reduce disparity in services provided to youth with or at risk of SED from underserved and minority populations. 4. Prevent the occurrence of suicide among youth with or at risk for SED. To achieve these goals, the project will create a System of Care Governance Board and a Family & Youth Advisory Council, provide comprehensive trauma- and grief-informed mental health and related supportive services to youth with or at risk for SED and their family members, develop collaborative partnerships with community-based organizations, conduct outreach with underserved populations to reduce disparity, and implement suicide prevention/intervention/ postvention strategies to reduce the occurrence of suicide among the region’s youth. The project plans to provide mental health and related supportive services to approximately 2,700 children over the four years of the project.

Summary. The NFusion Metro System of Care will improve mental health outcomes for children, youth and young adults (birth to age 21) at risk for or with serious emotional disturbance (SED) and their families by expanding access to trauma and grief informed, culturally responsive evidence-based mental health services and related recovery support services, improved policy, practice and infrastructure, cross-agency collaboration and sustainable financing Hinds County (Region 9 Mental Health), a rural medically underserved county in Central MS. The NFusion Metro System of Care expansion will ensure that children, youth, and young adults at risk for or with SED, and their families, receive quality SOC services within their communities, and that providers collaborate to coordinate care in a family-friendly and culturally responsive manner. EBPs will include Screening, Brief Intervention and Referral to Treatment; Trauma-Focused Cognitive Behavioral Therapy; Transition to Independence Process (TIP) Model; Parent Child Interactive Therapy; Wraparound; Crisis Intervention Team (CIT) training; Mental Health First Aid/Youth Mental Health First Aid/Question, Persuade, Refer (QPR); youth-guided peer support and family leadership. Project Name: NFusion Metro System of Care. Populations served: 51% Female; 48% Male; 1% Transgender; 5% LGBTQIA+; 90% African American; 2% Multiracial; 1% American Indian; 1% Asian; 2% Hispanic/Latinx/Spanish Speaking; 50% trauma/grief-involved; 45% COD; 85% below poverty level; Birth to 21: 1% birth < 5; 1% ages 5-9; 11% ages 10-12; 37% ages 13-15; and 50% ages 16-21. Strategies: The SOC expands trauma and grief informed care, cultural and linguistically responsive evidence-based mental health services, suicide prevention and intervention, policy development with a co-serving network of agencies strengthening transitional planning, integrated mental health treatment with cross-agency care coordination coupled with wraparound recovery support services with linkages to vocational counseling, education services, primary healthcare, dental, substance abuse prevention, stable housing, including independent living. Each participant will work with a care team that facilitates the identification and implementation of an individualized service plan in partnership with the child/youth, family, supports to achieve their personal goals. The SOC expansion will include family/youth peer support, family and youth leadership development, mentoring, and youth-guided activities. Goals: 1) Expand, integrate and sustain the SOC improving access, infrastructure and sustainable financing while ensuring a flexible, innovative CQI approach, cross-agency collaboration, implementing trauma/grief informed care; 2) Meaningfully involve children, youth and young adults and family/caregivers in their own care and the broader governance of the SOC; 3) Facilitate a network of co-serving providers wrapped around the system of care who use trauma and grief-informed care, evidence-based practices and programs to assess, screen, treat, and manage mental health, including suicide risk; 4) Improve mental health functioning, embedding evidence-based and evidence-informed services and supports in early childhood, youth and young adult intervention services and mental health disorders treatment; and 5) Improve health equity with targeted outreach in underserved communities to engage racial, ethnic and LGBTQIA+ minorities. Objectives: Between 9/30/24-9/29/28: 1) 100% of 400 will improve access; 2) 80% will improve mental health functioning; 3) 80% will improve employment/education; 4) 80% will reduce criminal justice involvement; 5) 80% will improve housing stability; 6) 80% will reduce admissions to inpatient psychiatric hospitals; 7) 80% will improve social connectedness; and 8) 85% will report high client perceptions of care. # served: 100 in Year(s) 1-4, totaling 400 in four years.

The San Carlos Apache Tribe's Wellness Center will begin wraparound care coordination for the community's serious emotionally disturbed youth currently being referred through the tribal juvenile court system and the Life is Precious crisis team. The project will develop a team of supports for families involved in multiple services to address their immediate needs and coordinator care focused on healing the family as a whole. The project aims to serve 300 community youth annually.

The Pascua Yaqui tribe is federally recognized, located in Pima County, Arizona, outside of Tucson, AZ, 50 miles from the border with Mexico. Services will be provided on reservation trust lands, New Pascua reservation and the newly granted Old Pascua Pueblo. The population of focus: Children, ages 0 to 21, and families of the Pascua Yaqui Tribe. The tribal Centered Spirit Mental Health Program, an SOC partner agency, diagnosed over 860 clients with opioid dependence from 2016 – 2020 (PYT, 2022). Drug-induced deaths are the third highest leading cause of death among the Pascua Yaqui community, which just under diabetes and heart disease (PCHD, Nov 2023). Poverty, a leading factor affecting the health and wellbeing of Tribal members, represents a substantial challenge within the Pascua Yaqui community, with 30.5% of the total population living below poverty level in 2021, which is double that of Pima County (14.6%) and the state of Arizona (12.8%). We share a common goal with SAMHSA: To improve behavioral health outcomes for tribal children and youth birth through 21, through the implementation, expansion, and integration of the System of Care approach, using screening and assessment and an array of counseling, life skills, and cultural supports to prepare children and youth at risk for or with SED. A team of eight SOC/CMHI experienced, culturally focused staff will create a sustainable infrastructure of services that are established on the reservation and expand system of care screening and assessment treatment and support services to children on our expanded reservation site to improve mental health outcomes for all our tribal children and youth. Over 90% served will be tribal heritage, and the funds requested will be used to address the disparity of services among underserved and minority populations, specifically our tribal children. The Pascua Yaqui Health Services Division submits this application, selecting the Sewa U’usim Community Partnership (SUCP) as the lead agency, which is a current provider of a System of Care grant. The project goal will be achieved through Objectives, which will include: Obj1. Increase public awareness, expansion of culturally appropriate resources, EB models of care, and training of professionals to increase mental health outcomes for youth by10% annually. Obj2. Create a comprehensive support team to increase by 20 over the 4-year period the number sustained resources available to the new tribal land to better understand community needs and impact positive outcomes for youth and families. Obj3. Improve number of children served by tribal providers by 10% annually in the area of treatment, targeted substance, suicide and aftercare services. Increase by 10% annually the number of youths taking part in life skills activities and skills to adult across both existing and the new tribal community. Obj4. Increase harm reduction activities within the PYT community by 10% annually. Central to delivery of services will be a youth technology capability, which will focus on youth and young adults using PSA’s, streaming videos and a communitywide awareness and prevention campaign. We will screen youth with practice based and EB White Bison prevention training and EB cognitive behavioral treatment. We are requesting funding consideration for a four-year, $1,000,000 a year grant. With those funds, we will enroll 425 youth into SOC services, provide awareness/prevention activities and screening to 750 youth, conduct outreach to 6,250 individuals, and train 300 individuals throughout the four-year funding period. To that end, we will provide four workshops for professionals annually, and youth will create three radio PSA videos for screening purposes, prevention, and resources for those at risk for SED.

The Lawrence County (IL) Health Department (LCHD) and a consortium of children, youth and family related partner and collaborating organizations will expand and sustain efforts to improve mental health outcomes for children and youth (age 0-21), at risk for or with serious emotional disturbances (SED), and their families and/or caregivers. This population of focus (POF) will be provided high-quality services within a well-coordinated and integrated System of Care (SOC) that is already being operated by LCHD. Targeted subpopulations within the POF include: those with or at risk for SUDs; single-mothers; and, communities of color, including those who may have linguistic and/or culturally specific needs, demonstrating health disparities or unique mental health challenges. The project will serve at least 1,600 persons over a four year project period. The project service area (PSA) consists of eight rural counties in southwestern Illinois with a total population of over 100,000 persons. The counties served are Lawrence, Wabash, Crawford, Richland, Jasper, Effingham, Edwards and Clay Congressman Mike Bost (IL-012) is a strong supporter of the project. The project objectives are to: 1) Provide high-quality behavioral health and primary care and services to those in the POF diagnosed with SEDs and/or co-occurring disorders; 2) Deliver well-coordinated, integrated care within LCHD's SOC, while also providing wrap-around services and other key health, human and social service supports; 3) Conduct community-based prevention, education and outreach activities focusing on those at-risk for SEDs and/or co-occurring disorders; and, 4) Maximize collaborations with community-based organizations, such as health care and health services providers, non-profits providing wrap-around supports for participants, local and State government agencies, private sector businesses, community and grassroots groups, faith-based organizations, etc. The project will prepare children and youth at risk for or with SED for successful transition to adulthood and assumption of adult roles and responsibilities. LCHD will deliver cost-effective services to participants and will coordinate care in a family-friendly and culturally responsive manner. All care and services provided will be based on research-validated evidence-based practices (EBPs). LCHD will carry out the project in close coordination with a wide array of community-based partner and collaborating organizations. LCHD is the largest public health provider in the service area, and also is the area's State designated Community Mental Health Center (CMHC). It has the organizational experience, expertise and capacity to carry out this project effectively. It has significant experience in the administration and oversight of federal grant funding, and is currently a SAMHSA grantee under the Certified Community Behavioral Health Clinic (CCBHC) grant program. LCHD is requesting $1,000,000 in federal funding annually for the project, and will also be providing an estimated $334,000 (1/3 match) annually in non-federal in-kind funding.

Family Connections: A Community-Based Approach to Expanding Mental Health Access and Engagement for SED Youth system-of-care is intended to offset historic patterns of inequity in access to mental health care based on race and ethnicity, as well as to respond to the urgent mental health needs of migrant children and families who are arriving daily in Massachusetts' gateway communities in an effort to reduce the growing risk of youth suicide. Our proposed Family Connections system-of-care will include Cambridge Health Alliance’s primary care providers whom we will assist in launching broad-based screening of their adolescent patients for depression and substance use disorders. The Family Connections mobile team will be located in the community, but also onsite within CHA’s Family Medicine and Pediatric clinics in the towns of Cambridge, Somerville, Malden, Everett and Medford. This integrated care team will use a collaborative practice approach in primary care to support early identification of mental health needs and reduce time to treatment for SED youth. The team will actively collaborate with specialty mental health providers at CHA, also CBHCs providing 24/7 mobile crisis access, and CBOs providing non-traditional services, to improve treatment access and engagement. Culturally sensitive, peer-to-peer parent support specialists are a key ingredient for our Family Connections model, which involves uncovering barriers to care and developing individualized, family-driven remedies. Our target population is children 3-18 years old, including LGBTQ youth, with depression, trauma and/or SUD. Pre-pandemic data indicates Massachusetts had the highest rate of child abuse and neglect in the US during 2016 (DHHS, 2017). Approximately 25% of these children live below the federal poverty level (American Community Survey, 2011-2013). Before the surge in migration, the ""gateway"" cities we are especially targeting in Metro-Boston (Malden and Everett) had 2-3 times the rate of foreign-born residents (43% vs. 18%) compared to the rest of the MA, and twice the statewide rate of children whose parental language is not English (54% vs. 22.3%). CHA’s Children’s Health Initiative leadership will combine evidence-based interventions from its earlier MHSPY program (family support, care management and shared goals) with new strategies learned from our SafetyNet program, such as mobile (either face-to-face or telehealth) interdisciplinary child mental health evaluation teams, and intensive dyadic work with parent and child for multi-generational trauma. Clinical expertise will be combined with peer-to-peer parent/guardian support for trauma-informed care delivery to both parent and child. All aspects of the care continuum will be provided in a culturally and linguistically competent manner. We anticipate serving 200 children and families in total, at approximately 50 children per year. Program goals include: 1) Promote earlier recognition of child mental health needs to reduce risk of suicide; 2) Family-driven assessment approach to disrupt disparities and encourage treatment engagement; 3) Facilitate regional system of care, using SOC principles, and disseminate findings to state and local policy makers. Objectives: 1) Assess presence of SED (Serious Emotional Disturbance) via Standardized measures of Clinical Functioning (CGAS and CAFAS), 2) Screen for adverse childhood experiences (ACEs), depression and SUD, 3) Increase access to child mental health evaluation and treatment (Pre-post measures of patterns of service use for study participants and propensity-score weighted comparison group), 4) Improve family care experience, as measured by Family Professional Partnership Scale assessments, 5) Improve clinical functioning, including suicidal ideation, as measured by Baseline and follow-up CGAS and CAFAS assessments.

The Sayaqagvik System of Care was developed over eight years by Maniilaq Association and the 12 federally-recognized Iñupiat tribes within its Northwest Alaska service area. Sayaqagvik (Iñupiaq, meaning 'a place to heal') employs a primary care medical home model to bring evidence-based and culturally-grounded mental health services to established, trusted, and highly-utilized points of care, including pediatric primary care, women's health, community clinics, assisted living, and hospital settings. Sayaqagvik encompasses four core initiatives, each corresponding to a population of focus, health care team, and site of care: 1) miq?iqtuuraq (infant and early childhood mental health services), miq?iqtuq (child and adolescent wraparound services), i?i?gaa?iit (family care), and na?irvik (provider and health system capacity-building). Goals and objectives under this award focus on extending prevention, early intervention, and treatment services equitably throughout all 12 service area villages through community field clinics and telemedicine. This award will serve 1,240 unduplicated children, youth, and family caregivers over four years, including 340 in year 1, 320 in year 2, 280 in year 3, and 300 in year 4. Maniilaq Association is a designated tribal health organization serving 38,000 square miles of the Alaskan arctic and subarctic. The area population is 8,467, 83% of whom are Alaska Native (AN) and 45% of whom are under the age of 22. Northwest Alaska communities are unified by strong cultural traditions and a deep connection to the land, which has been inhabited continuously by Iñupiat for thousands of years. Our region's children, youth, and families also face significant challenges. More proximate social determinants of mental health (SDMH) reflect our region's history of colonial settlement, displacement to boarding schools, epidemic disease, and other forms of historical trauma. Adverse SDMH experienced by AN children and youth within a one-year span include child poverty (30%), childhood witness to violence (10%), lack of trusted adult social support (54%), and adult binge drinking (19%). One- third of AN adults experienced four or more adverse childhood experiences cumulatively. As a result, Northwest Alaska children, youth, and families face a range of behavioral health and health care disparities. Common behavioral and substance use concerns among Alaska Native youth, described as a percentage of adolescents who experience the condition in a one-year period, include depression (43%), suicide attempt (24%), prescription pain medicine misuse (14%) and binge drinking (11%). The age-adjusted suicide rate in our region is eight times the U.S. average, while rates of depression, adolescent intimate partner violence, and substance misuse mark additional disparity areas. Taken together, these conditions signal a deep level of social suffering that requires a comprehensive, culturally-grounded, evidence-based approach to care, as well as coordinated, community-led efforts to address the upstream causes of distress. Sayaqagvik goals and objectives center on 1) improving developmental conditions among infants and children at risk for SED through community-based screening, prevention, and early intervention services; 2) improving social and behavioral outcomes for children and youth with SED through community-based wraparound care; 3) addressing the social determinants of SED by connecting families to cultural, clinical, and community resources; and 4) increasing the capacity of first-contact caregivers to provide culturally-grounded and evidence-based mental health services. Core service lines include competency-based infant and early childhood mental health services, trauma-focused cognitive-behavioral therapy and dialectic behavior therapy, child and adolescent psychiatric emergency services, and primary care-integrated psychiatry, addiction medicine, and culture-based parenting and family support services.

Children’s Mental Health Initiative (CMHI) Abstract The Ramsey County Mental Health Urgent Care (MHUC) expansion to provide robust stabilization services to youth will 1) increase access to community-based mental health and behavioral health services, specifically to youth thirteen to seventeen in underserved communities that experience high disparities, 2) decrease youth boarding in emergency rooms without active care, 3) provide rapid outpatient mental health care to bridge gaps within the continuum of care. Our target population focuses on African American males, ages 14-17, experiencing mental and behavioral health needs. Secondarily, intersections through the LGBTQ+, families experiencing poverty, and youth boarding in emergency rooms will experience a direct benefit from the MHUC. Ramsey County (RC) is the smallest and most densely populated county in Minnesota. It is predominantly urban with around 550,000 residents. 57% of the youth population are children of color. Youth of color in RC experience harsh economic and health disparities. For example, of those youth living in poverty in RC, 60% are Native American/Alaska Native , 30% are Asian. 41% are Black, 27% are Latino and 5% are White. Before COVID-19, 20% youth had a mental health disorder that affected their life at home, school or in the community. A 2021 poll of RC youth showed that more than 70% are struggling with mental health disorders. The Certified Community Behavioral Health Center (CCBHC) and the MHUC are centrally located to provide comprehensive behavioral health care to residents but have experienced large service gaps among its various youth populations due to capacity limits and limited referral sources. From 2021-2022, 682 unduplicated youth were served at the CCBHC, 619 of those referrals came from RC Children’s Crisis. As an extension of the CCBHC, the MHUC will support the nine core services, and specifically support the enhancement of Children’s Therapy, Children’s Targeted Case Management (CMH-TCM) and Children’s Therapeutic Services and Support (CTSS). Services will be provided in home, and with connection to community-based providers of a client’s choice to best support their recovery. Along with care coordination with current and future providers, and to residents who experience hospitalizations to prevent decompensation and rehospitalization. We foresee strong coordination and participation from the 5888 Child Protection calls (2790 that did not warrant case management), 367 youth receiving CMH-TCM, and the 153 youth accessing Children’s Hospital Emergency Room in 2023. The intent of seeking the SAMHSA -Grants Children’s Mental Health Initiative (CMHI), is to offer continuous support in the creation of the MHUC. It will fund necessary positions including 1 Full time (FT) Mental Health Professional, 1 FT Project Director, 1 FT Mental Health Supervisor, .5 FT MHUC Manager and .5 FT Evaluation manager. The grant will also support new contracted services to provide respite beds for youth who have been accessing shelter through the Children’s Hospital emergency beds, when they could be utilizing crisis respite beds in a home like setting. Additional contracts supported will be a contract for a Family Lead Coordinator with Partnerships for Permanence to work with an individual with lived experience to walk with families through the MHUC experience. Security services will also be needed due to increased hours evening hours of the MHUC and crisis services, as well as increased access to our NEXT GEN medical record system and increased psychiatric services to include serving youth. These are the primary requests within the grant, some additional funding will be used to serve those without insurance and those under insured, costs for program expenses, clothing expenses, and indirect costs incurred.