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Serving Children and Adults in Need (SCAN), Inc., is proposing to implement its Serenidad Comprehensive Behavioral Health Project in Webb County, Texas, situated along the Texas-Mexican Border. Project Purpose and Population of Focus. The project aims to provide comprehensive, coordinated and evidence-based services to improve housing stability and behavioral health outcomes for male and female individuals, youth, and families with serious mental illness (SMI), serious emotional disturbance (SED), or co-occurring disorder (COD) who are experiencing homelessness or are at imminent risk of homelessness. Persons to be Served. The project will serve a total of 500 unduplicated clients (60 per year) throughout the five-year project. Statement of the Problem. U.S. Hispanic households face poor housing conditions, high rent burdens, overcrowding, and are often underrepresented in housing and homelessness assistance programs. Nationally, Texas has the 2nd highest prevalence rate for adult mental illness, the 3rd highest prevalence rate for substance use disorder in the past year, the 3rd highest rate for adults with serious thoughts of suicide, and ranks 6th highest for the number of adolescents with a substance use disorder. Texas ranked very low (44th) for its high prevalence of mental illness and low rates of access to care for both children and adults, last (51st) for access to care, and 50th for number of adults with mental illness who are uninsured. Webb County is a Health Professional Shortage Area (HPSA) for behavioral health services. The areas with highest risks for homelessness and behavioral needs are concentrated pockets of poverty in South Laredo and in unincorporated subdivisions that lack adequate housing and basic services. Strategies/Interventions. SCAN will provide outreach and engagement and will implement a linguistically-and culturally-appropriate service delivery plan that will include screening for mental health, substance use and CODs; care management; psychiatric services; telehealth; and integrated treatment in collaboration with medical care providers. EBPs used include Motivational Interviewing, Seeking Safety, Acceptance and Commitment Therapy, Dialectical Behavioral Therapy, and the Matrix Model. The project addresses the co-occurring needs of clients with mental health and substance use disorders in outpatient and residential settings. SCAN will provide comprehensive peer support recovery services led by staff with lived experiences that will include childcare and recovery housing. All clients will be linked to the CoC's Coordinated Entry System to help them access housing assistance. The project will have grievance and conflict resolution processes in Spanish and English in simple language that is accessible to all participants. The project will create a culturally and linguistically diverse Steering Committee composed of community partners, individuals, and family members who are currently experiencing homelessness or have experienced homelessness and are recovering from behavioral disorders. Project Goals: Implement a trauma-informed, culturally responsive, and developmentally appropriate service delivery plan that addresses the comprehensive needs of adults, youth, and families in homeless situations or at risk of homelessness, including recovery and peer support, case management, care coordination, and ongoing care; Address barriers to access that contribute to disparities by meeting the cultural and linguistic needs of the clients and their families; Provide treatment that facilitates recovery and leads clients to experience significant improvements in health, wellness, and housing stability at discharge and 6-month follow-up; Ensure the project is rooted in the community through seamless integration of the project into the community's infrastructure, regular support and feedback from community stakeholders, and meaningful engagement of participants in the ongoing direction of the project.

Bridgeway Center Inc.’s (BCI) TIEH Project will create a comprehensive, coordinated, and evidence-based service delivery system to provide behavioral health treatment, recovery support, and assistance seeking sustainable housing for individuals, youth, and families experiencing a serious mental illness (SMI), serious emotional disturbance (SED) or co-occurring disorder (COD) who are unhoused or at risk of homelessness in Okaloosa County, Florida. The TIEH Project will serve 50 individuals in the target population each year of the grant, a total of 250 individuals throughout the lifetime of the grant. The TIEH Project will focus on SAMHSA’s Four Dimensions of Recovery (Health, Home, Purpose, Community) and do so in a way that fosters behavioral health equity, diversity, inclusion, and accessibility. The TIEH Project’s goal is to reduce rates of homelessness, as well as provide treatment for those experiencing SMIs, SEDs, and CODs that generally accompany housing insecurity. The TIEH Project will achieve four goals: (1) Enhance stabilization for persons residing in Permanent Supportive Housing to reduce decompensation rates that contribute to exacerbation of SMIs and/or SEDs; (2) advocate for an increase in the capacity of beds, including emergency shelter beds, rapid re-housing beds, and permanent supportive housing beds, to reduce unsheltered homelessness; (3) collaborate with homeless organizations and service providers to increase the number of homeless individuals moving from shelter/rehousing programs to permanent housing to reduce decompensation rates; and (4) strengthen the outreach program to provide access to treatment services to target the intended population and encourage stabilization as individuals/families seek permanent housing. Many individuals who experience homelessness have high rates of chronic and co-occurring health conditions and mental and substance use disorders. These issues, coupled with increased rates of malnutrition, unsanitary living conditions, and limited access to healthcare, exacerbate the difficulties that persons experiencing homelessness face. Okaloosa County’s 2022 Point in Time Count (PIT) documented 403 persons experiencing homelessness. Behavioral health diagnoses, demographic data, everyday functionality, housing stability, education and employment status, criminal justice status, perception of care, and social connectedness will be measured to demonstrate the efficacy of the project’s goal of reducing rates of homelessness, SMI, SED, and CODs. The TIEH Project will employ a Project Director, Evaluator, Clinical Advisor, two Therapists, and two Case Managers to complete the following tasks: Engage and connect participants with behavioral health treatment, case management, and recovery support services; Assist with identifying sustainable permanent housing by collaborating with homeless service organizations and housing providers; Provide coordination of services that supports stability across services and housing transitions. BCI expects 50% of those served to have a reduction in reported impairing symptoms of their SMIs or SEDs, 10% of those served to move into permanent housing, and 20% of those served to complete Life Stabilization Skills classes or engage in behavioral health treatment. BCI will partner with the following organizations to assist homeless individuals’ experiencing SMI, SED, and/or COD: Crestview Area Shelter for the Homeless (CASH), Fort Walton Beach Police Department (FWBPD), Lakeview Center (LCI), Okaloosa County Sheriff’s Office (OCSO), Homeless & Housing Alliance (HHA), Fort Walton Beach Housing Authority (FWBHA), and One Hopeful Place (OHP). These organizations have decades of experience assisting the intended population in Okaloosa County, Florida, and BCI will leverage this experience to treat a high volume of participants in a highly effective and equitable manner.

MaineHealth, through the Maine Medical Center-Preble Street Learning Collaborative (PSLC) seeks SAMHSA funding to launch ProjectCONNECT, a mobile harm reduction, housing and treatment program designed to outreach, engage, and house individuals experiencing, or at imminent risk of, homelessness, with co-occurring psychiatric and substance use disorders in Greater Portland, Maine. ProjectCONNECT will assemble the currently-disparate puzzle pieces that comprise the region’s homeless resources, using evidenced-based practices and leveraging community-based resources to meet the essential needs of unhoused persons as they engage in recovery. The program targets adults unsheltered or in shelter facilities within the communities of Portland, South Portland, Scarborough and Westbrook, Maine, and will provide direct, onsite treatment at local encampments and other sites through a van-based Mobile Health Unit that will serve as the program’s service hub. The number of chronically homeless persons in Greater Portland has surged in recent years, more-than-tripling in the wake of the pandemic. Likewise, unhoused individuals who are veterans and survivors of domestic violence also spiked post-pandemic, as did those with children (2022 Point in Time survey). Significant gaps currently impede persons experiencing homelessness from accessing the continuum of outpatient psychiatric and case management services available through community mental health agencies and hospital-affiliated outpatient clinics. Extensive waitlists, raging from closed entirely to openings within two-to-six months or more, can deter people experiencing homelessness who are ready to initiate treatment, and many program models assume prospective patients have health insurance, as well as a smart phone with video and internet access, reliable transportation, and a level of organization that is inconsistent with the experience of homelessness, SMI and active substance use. Moreover, none of the existing outpatient clinics offer outreach or mobile treatment and only a portion offer peer support. ProjectCONNECT participants include those who are: 1) unable to overcome systemic barriers to accessing outpatient care, due to symptoms of the very conditions for which they need treatment (e.g. disorganized thinking and behavior, paranoia, impulsivity); 2) ‘lost to follow-up’ at critical care transitions from EDs, crisis stabilization units, medically supervised withdrawal centers (detox), hospitals and carceral settings; 3) over-reliant on emergency departments and law enforcement/EMS for crisis intervention; 4) unlikely to access benefits and housing resources without assertive intervention and support; and 5) unseen by formal systems of care due to the isolation of homelessness, shame of substance use, history of negative or harmful experiences with helping systems, and the unique symptomatology of psychotic and affective disorders that disconnects people from community. The proposed project will address the complex needs of this population by providing essential resources and services, either directly or through referrals to partner organizations. Interventions to be provided include, but are not limited to, the following: 1. Integrated behavioral health treatment and recovery support services, including medications for opioid use disorder (MOUD) and psychiatric medication management; 2. Support to enroll for health insurance (MaineCare), and other mainstream benefits, such as TANF, SNAP, Social Security Income and/or Social Security Disability Insurance; and 3. Coordination of housing – through partnership with Preble Street, a MaineHousing Continuum of Care provider, to provide Rapid Re-Housing Services and case management. The program will be housed within the Preble Street Learning Collaborative. MaineHealth is seeking grant funds totaling $500,000 per year for five years under this SAMHSA opportunity (SM-23-006), with a start date of September 30, 2023.

Sunset Park Health Council, Inc. (dba Family Health Centers at NYU Langone or FHC) will implement Project LAUNCH to: identify early behavioral/developmental concerns in young children (0-8 years), mental/behavioral health disorders among parents/caregivers (p/c), improve coordination across child/family-serving programs, provide p/c and provider trainings, provide expert consults, and implement a public awareness plan. The Brooklyn (NY) target population will include predominantly racial/ethnic minorities; immigrants; persons served in a non-English language; and persons with low household incomes. With 4 program partners? FHC’s Department of Community-based Programs; FHC’s SAMHSA funded Center for Childhood Trauma Treatment (FHC-N-CT); Together Growing Strong (TGS); and the Department of Child and Adolescent Psychiatry (DCAP) at Hassenfeld Children’s Hospital at NYU Langone? Led by, Aaron Reliford, MD, Principal Investigator, FHC proposes: Goal 1. To enhance FHC’s Early Childhood Parent Advisory Group (Young Child Wellness Council or YCWC). Obj. 1.1. In month (M) 4, to implement a meeting schedule to ensure program planning and implementation includes service area residents’ voices. Obj. 1.2. Beginning in M5, to increase representation of the YCWC by 10% with members of health, public health, behavioral health, education, Head Start, early intervention, etc. Goal 2. To implement a plan to improve coordination and collaboration across child and family-serving systems. Obj. 2.1. Beginning in M4, to provide case management with referrals to social support/prevention services to 100% of participants with FHC’s Dep’t. of Community-based Programs. Goal 3. To conduct culturally and linguistically appropriate, validated screening to identify early behavioral and developmental concerns in young children and screening for mental/behavioral health disorders among p/c. Obj. 3.1. At M4, to conduct initial meetings with 100% of staff and grant collaborators. Obj. 3.2. Beginning in M5, staff will conduct outreach and engagement to 600 children/p/c (Y 1) and 1,100 per year (Y 2-5). Obj. 3.3a. Beginning in M5 (Y 1) and M1 (Y 2-5), staff will initially screen and assess 100% of the target population (young children and p/c). Obj. 3.3b. Of the children screened and initially identified for risk of behavioral and/or developmental concerns, including ASD, the team will engage them in formal developmental evaluation, treatment planning, and/or advanced treatment access/referral support to agencies specializing in the support of children with developmental concerns (75 children in Y 1, 100 annually in Y 2-5). Obj. 3.3c. Of the p/c screened and identified for mental and behavioral health concerns, the team will make a referral for further evaluation and treatment planning (75 p/c in Y 1, 100 annually in Y 2-5). Obj. 3.4. Beginning in M5, the Project LAUNCH social worker will make referrals to FHC-N-CT as needed to 100% of children, p/c, and families identified who have experienced trauma (Y 1-5). Goal 4. To provide training to p/c and providers with consultation services to providers to ensure competent clinicians with resources to address the needs identified. Obj. 4.1. Beginning in M5 of Y 1 and ongoing, 50 family and p/c trainings will be held. Obj. 4.2. Beginning in M4 in Y 1, 2 provider trainings will be held. Obj. 4.3. Beginning in M2 of Y 1, the DCAP team will provide 4 mental health provider consults monthly. Goal 5. To expand implementation of a public awareness plan in multiple languages. Obj. 5.1. Beginning in M5 of Y 1, to leverage TGS’ communication modalities to 500 service area p/c weekly. Goal 6. To implement process and outcome evaluation to assess progress on goals and objectives. Obj. 6.1. The Project Evaluator/Data Manager will monitor data collection and conduct performance assessment in Y 1-5. FHC will outreach to 5,000 unduplicated individuals and identify 470 unduplicated individuals for services (Y1-5).

Erie County Project LAUNCH (ECPL) works to promote and enhance an environment in Erie County, PA, that is pro-mental health, collaborative, and aware of resources/services and referral systems, while providing clear pathways for children 0-8 and their parents/caregivers to be screened, assessed, and receive culturally sensitive, trauma-informed, evidence-based services in their community. Erie County (EC) has 269,011 residents including 28,979 children ages 0-8 and 42,976 parents. 82% of residents are White and 16.3% are BIPOC with Indo-European (3.2%) and Spanish (2%) as the top language groups besides English (93.4%). EC's socioeconomic status puts children at high risk – families are unwell physically and mentally, living in poverty, with high levels of food insecurity. Multiple food deserts (12) and three areas that are either Primary Care, Primary Care Low-income Health Professional Shortage Areas or Medically Underserved/ Medically Underserved Population Service areas. To achieve this vision, ECPL will (1) improve Erie County’s public awareness of early childhood wellbeing and establish clear pathways to navigate the systems and supports available for children 0-8, (2) increase early identification and coordination of care for social, emotional, cognitive, physical and behavioral concerns of children 0-8 and parents/caregivers through culturally and linguistically appropriate screening and assessment (3) equip and empower parents, caregivers, and professionals with training and resources focused on prevention and mental health promotion and (4) strengthen families and improve early child development and health outcomes through comprehensive prevention and intervention services across home, school, and community settings. ECPL seeks to reach 75% of EC parents/caregivers through multimedia campaigns and online resources to reduce stigma of mental healthcare, educate parents on child development and mental health, and increase screenings for conditions (i.e., drug/alcohol abuse and depression) that put their children at risk for future social, emotional, cognitive, physical or behavioral (SECPB) issues. ECPL will build 2,100 parent/caregiver’s knowledge through training and 5,000 families will be reached through resource distribution. ECPL strives to have at minimum 60 child-serving or adjacent organizations collaborating on a Young Child Wellness Council focused on unifying and streamlining screenings, assessments, referral pathways to ensure children 0-8 are identified early and provided appropriate services expeditiously. ECPL will provide 1,800 families of children 0-8 with a central call and resource center – LAUNCH CTRL - for all SECPB needs. LAUNCH CTRL is manned by Patient Access Coordinators who help families navigate and follow up to ensure completion of the screen-assessment-referral-interventions process, serve as a go-between for families and physicians, assist in families getting state health insurance, if needed. Through their work, the PAC efforts hope to increase the initiation of services by 5% each year and thus increase the number of individuals receiving evidence-based services by 10% each year. ECPL will increase the number of unduplicated EC children 0-8 screened or assessed and referred for SECPB issues by 15%, respectively; increase the number of parents/caregivers who are screened for depression and substance misuse by 13.5%; and the number of parents referred by 25%. These increases will occur by training 20 physical health providers/provider entities and 250 early childhood educators in daycare, pre-school and early elementary settings. Technical Consultations will be given to at least 125 providers and educators including a team of highly qualified Early Education Consultants who will push into the schools to offer support in SECPB areas. Through this work, ECPL hopes to reduce the suspension and expulsion rates at these schools and increase parental involvement by 10%.

Santa Fe Recovery Center (SFRC) proposes to develop and implement a five-year LAUNCH program where it is needed most – in New Mexico (NM). New Mexico, with its majority minority population including citizens of 23 federally recognized tribes, ranks at or near the bottom of all four categories used by Annie E. Casey Kids Count to evaluate children’s wellness. In Education, NM ranks last with a meager 24% of elementary students proficient in reading and 900 K-2 students (ages 5-8) being suspended or expelled from school in one year (2021-2022) due to an “incredible shortage” of BH providers to help preschool and elementary school facilities address problematic behavior and avoid out of school suspensions. Agency-wide transformations have begun at the state’s Children, Youth and Families Department (CYFD) and Public Education Department (PED) in response to civil lawsuits alleging systemic maltreatment and inadequate provision of behavioral health (BH) services for children of minority populations. As part of the Kevin S Settlement, CYFD identified a lack of successful “transitions of children, youth, and families within and across agency services” in addition to a need for “community-based partnerships using evidence-based programs and parent education.” To achieve the 6 objectives under Goal 1 (Promote the wellness of young children by addressing their five-domain development), SFRC will screen/assess 125 young children, parents and caregiving adults in Year 1 to identify MH/BH issues. To achieve the 6 objectives under Goal 2 (Increase access to resources to disseminate effective and innovative early childhood MH practices and services), SFRC will conduct parent and family training, primary care provider training, and early care and education consultations, and it will establish a Young Child Wellness Council (YCWC) with the required stakeholder representation including family members. To achieve Goal 3 (Reduce inequities among children and families of color), SFRC will improve coordination through the YCWC to support equity-focused advocacy and direct a public affairs communications plan to maintain a rate of at least 70% of all program participants from racial/ethnic minority populations. Total unduplicated individuals served in Year 1 is 355 individuals. Five-year total is 2,195 unduplicated individuals. The proposed program of direct services, training, and improved coordination and collaboration will address unmet needs within the five domains of NM children's development to mitigate the impacts of systemic deficiencies and implicit bias in NM, advance young children’s overall wellness, and prepare them to thrive in school and beyond.

The Midwest Asian Health Association (MAHA) is pleased to request funding from SAMHSA to implement a project entitled: Addressing Asian Children’s Health (AACH), targeting the Asian immigrant children and caregivers in Chicago. The overall aim is to improve healthy development of young Asian immigrant children by promoting mental health awareness and enhancing access to culturally competent and linguistically appropriate mental health and substance use screenings, assessments, treatment and early intervention services to 500 individuals throughout the five-year project and 100 individuals per year. Children of foreign-born Asian families are at greater risk for poor physical and mental health, due to countless barriers to culturally and linguistically appropriate health care, such as limited English proficiency, cultural mental health stigma, “The Model Minority Myth” and the inability to navigate the health care system, all of which are worsened by the fear of violence from anti-Asian hate. Lack of bilingual mental health resources for early intervention also contributes to low mental health service utilization among Asian immigrant parents and children. MAHA is a non-profit community-based organization with more than 10 years of experience providing culturally and linguistically appropriate mental health services to the target population in Chicago. MAHA is the only state licensed Community Mental Health Center and Substance Abuse Treatment Center in the south side of Chicago serving Asian immigrant populations. MAHA is also the only CARF accredited Asian mental health center serving Asian adults, adolescents, and children, The proposal has five goals developed with measurable objectives as described below: Goal 1. Improve community mental health awareness through disseminating a culturally/linguistically competent public awareness campaign. Objectives 1a-1b: Ongoing and by 8/31/2024, collaborate with 25 CBOs and community partners using culturally informed outreach approaches to promote the mental health awareness for the hard-to-reach populations in Chicago. Goal 2. Increase community collaboration to enhance access to holistic services for immigrant children and caregivers in Chicago, regardless of ability to pay. Objectives 2a-2c: Ongoing and by 8/31/24: establish a Young Child Wellness Council (YCWC) with 10% parent/caregivers; link 90% Medicaid eligible clients or Medicaid enrollment; link 100% clients who need primary or specialty care to partner providers. Goal 3. Increase healthy child development/wellness through provider/parent trainings. Objectives 3a-3c: By 3/15/24, develop a training plan for YCWC, parents, providers/caregivers on evidence-based and trauma informed mental health child development. 90% of staff and council members will receive two culturally/linguistically appropriate trainings. Goal 4. Increase screening, assessment, treatment for mental health and substance use concerns among Asian immigrant children (birth to 8) and their parents/caregivers Objectives 4a-4d: By 8/31/2024, assess 150 children & caregivers; create treatment plans for 100% children/caregivers with emotional, social, cognitive or behavioral distress; offer treatment planning to 100% of children/caregivers in care; assess impact via satisfaction surveys, improvement in functioning and knowledge. Goal 5. Improve program quality and impact by developing a data collection/evaluation plan Objectives 5a-5c: By 12/30/23, and ongoing, evaluate program using SAMHSA data tools; Submit SPARS reports on disparity reduction; disseminate outcomes to YCWC and public.

The DC SAMHSA Project LAUNCH project will serve more than 1,300 young children, parents, early childhood educators and primary pediatric care providers in Wards 7 and 8 and portions of Ward 5 where lack of access to mental health resources and stigma limit the type of screening and intervention that could position children for academic success and life-long wellness. The District of Columbia has a high incidence of risk factors and barriers to mental health (MH) care, combined with low rates of MH care access. Over 22% of children have experienced two or more adverse childhood events (ACEs) including trauma, abuse, and neglect- all of which are strongly correlated to MH issues. The DC Department of Behavioral Health reports that 70,000 youth from historically marginalized communities in Washington, DC., have MH conditions, yet only 20% of youth from these communities under the age of 18 receive care. Only 30% of children in D.C. who are diagnosed with a MH need are served through Medicaid and Mental Health Rehabilitation Services. Our project will increase the workforce skills, capacity, and cultural competency can help close this gap. The project team will recruit and train nine community mental health workers (CMHWs) with lived experience and place them in early childhood education (ECE) centers and primary pediatric clinics (PPCs) to screen more than 500 children and 350 parents over five years. 330 ECE staff, 15 ECE mental health consultants, and 10 PPC staff will engage in provider wellness training (PWT) and 60 ECE and PPC staff will engage in additional Facilitating Attuned iNteractions (FAN) and trauma-informed Strengthening Family Coping Resources (SFCR) interventions training and other professional development to increase the quality of MH care in the district. Our project partners include Children's National Hospital (CNH) and MedStar Georgetown University Hospital Division of Community Pediatrics (DCP) and United Planning Organization (UPO), a major provider of Early Head Start and Head Start ECE in D.C. We will build on existing partnerships to establish a Young Child Wellness Council (YCWC) that includes 22 Project LAUNCH partners, DC government agencies, Head Start, MH practitioners, and families to promote coordination among early childhood stakeholders. CentroNia, DC Council, DC Family Child Care Association, DC DBH, National Children's Center, Zero to Three, the George Washington University, Appletree Institute, Ascend at the Aspen Institute, Alliance for Early Success, House of Ruth Kidspace, Mary's Center. New partners to join with these partners to compromise the YCWC: DC Child and Family Services Administration, MGUH DCP, CNH, MGUH CAP, GUCCHD, D.C. Center for Mental Health Services, SAMHSA: CNH will host Project ECHO model telemonitoring and quality improvement (QI) training that will be available to CMHWs, and ECE, PPC, and YCWC staff and leadership. Members of the YCWC will work together to leverage existing digital assets to collaboratively market the program, and CMHWs will co-create and share resources for families to destigmatize mental health in the communities they serve.

Through coordinated cross-sector systems, the Merrill Palmer Skillman Institute Project LAUNCH (MPSI-PL): Promoting Young Child Wellness in Detroit program will educate and support parents/caregivers and increase access to high quality early childhood care and education for children birth-8 years of age. By improving the capacities of those adults who care for young children, MPSI-PL will help prevent serious emotional and behavioral problems and address concerns early to promote healthy development and reduce health disparities. MPSI-PL will focus on the population of Detroit, Michigan. Thirty percent of people in Detroit live below the poverty line; 43% of children live in poverty (21% in extreme poverty). The majority of young children in Detroit are Black (79% for birth-5 years, 77% for 5-9 years of age), with approximately 11% and 13% Hispanic, respectively. About 40% of children have experienced >2 Adverse Childhood Experiences (ACEs), and more than 70% of those seen in community health settings have experienced >3 potentially traumatic events. Detroit is rated very high (.82 out of 1.0) on ‘social vulnerability’ based on the Centers for Disease Control and Prevention’s Social Vulnerability Index, and much of the geographic catchment within Detroit has a 10 out of 10 on the Area Deprivation Index; both indices are based on Census tract data and key Social Determinants of Health (SDOH). Well over 50% of young children do not have access to high quality early education and care and, to our knowledge, no pediatric practice in Detroit has prevention-oriented integrated primary care for young children. The goals of MPSI-PL are to: 1) conduct culturally appropriate behavioral health screening and assessments of children birth-8 years old and their parents/caregivers, 2) provide infant and early childhood mental health intervention services, 3) provide family and parent training about early child development and culturally appropriate and effective parenting strategies, 4) provide behavioral health training in primary care settings as part of integrated pediatric primary care, 5) provide mental health consultation in early care and education settings, and 6) establish a Detroit Young Child Wellness Council (DYCWC). Objectives are: 1a-c) screen 50% of children and 50% of parents/caregivers in a pediatric integrated care clinic in Year 1, increasing by 7.5% each year to reach 80% by end of Year 5, 1d) assess 325 young children each year (total 1,625 children), in community mental health partner agencies; 2a-c) provide the Michigan Model of Infant Mental Health Home Visiting by 45 providers and 3 interns to 325 families a year (total 1,625 families); 3a-b) provide parent training to 130 parents/caregivers a year (total 650 by Year 5), 3c) deliver Parenting Young Children Check-Up to 50 parents in Year 1, 75 parents in Year 2, and 100 parents in Years 3-5 (total 425 parents), 3d) Train 30 professionals in Years 1-4 to deliver Attachment Vitamins to 50 parents/caregivers a year (250 in total), 3e) Send 12 parenting newsletters to 1,100 caregivers a year (total 13,200 distributions); 4a-d) A 4-part training series on early childhood and culturally appropriate, trauma-informed pediatric care will be delivered to 10 providers each year (total 50) at our pediatric partner, and to 30 additional community providers in Years 3-5; 5a-b) establish a Detroit Child Care Consortium to meet quarterly, 5c-d) two interns will provide Infant and Early Childhood Mental Health Consultation for 20 children a year (total 100 consultations), and a MPSI-PL consultant will serve two additional childcare centers a year (total 48 providers, 228 children in Years 3-5); 6a-d) quarterly meetings of the DYCWC will support the project and increase coordinated care and public awareness.

Gemma's LaunchPAD Program: Empowering Families and Professionals through Behavioral Health Education aims to address the unmet needs of children ages 0-8 in Southeast Pennsylvania through three specific strategies: 1) a focuses campaign on connecting existing services to families; 2) providing an evidence-based training program (Mental Health First Aid) for adults who have contact with youth and caregivers and 3) offering an evidence-based parenting program (Family Check-Up Online) for families with a child ages 2-8. The overall goal of the LaunchPAD program is to promote child wellness by building capacities in adult caregivers to promote healthy social and emotional development and to educate professionals in the community to identify and address behavioral concerns before they develop into serious emotional disturbances. Gemma Services, located in both Philadelphia and Montgomery Counties, has extensive experience providing education, behavioral health and prevention services to children and families in the surrounding communities. This work has highlighted the critical need for early detection of mental health symptoms in young children and their caregivers, as well as services that are easily accessible and well-coordinated within the systems of care. Gemma's LaunchPAD program intends to serve approximately 4,000 individuals each year, with 20,000 being served over the five-year life of the grant-funded program. Families with children ages 0-8 in the Pennsylvania counties of Philadelphia, Montgomery and Delaware will be the focus of the LaunchPAD program. The Pennsylvania Future Ready Index from 2022 indicates that 57-96.6% of all children in these targeted communities are economically disadvantaged with 14-23% being enrolled in Special Education. The communities are comprised primarily of people of color, with 32-85% of the children identified as Black, 10-47% identified as Hispanic, 12-31% identified as White and the remaining identified as Asian, Pacific Islander, Native American or two or more races. The LaunchPAD specific program goals are to: 1) Support up to 1000 families at a time by providing education about early childhood and caregiver mental health, coaching in positive parenting practices, and robust screening and assessment tools to help identify additional needs and services. The interventions will be to offer the evidence-based practice called Family Check-Up Online and supported by Family Support Partners that connect and support the families through the process and in navigating the local system of care. 2) Implement a public awareness campaign to promote early childhood development, and mental health support through established partnerships with childcare, healthcare, schools, early intervention programs, and the organizations interacting with these entities and community members in Philadelphia, Montgomery and Delaware Counties. 3) To facilitate system change by increasing ease of access to information and services by bringing key stakeholders together. LaunchPAD will establish and lead a Youth Child Wellness Council (YCWC) with representation from healthcare, behavioral health, education, childcare , Head Start, child welfare and early intervention partners. Measures of success for this program include number of families and children participating in the Family Check-Up Online model, participants trained in Mental Health First Aid, participating entities in the YCWC, and ultimately the number of families and children receiving the identified services they need within their own communities.

Luzerne-Wyoming LAUNCH (L-W LAUNCH) will develop a coordinated, comprehensive system serving children birth to age 8 with social/emotional/behavioral challenges in Luzerne and Wyoming Counties in North East Pennsylvania. L-W LAUNCH will promote wellness of young children and their families, and address social/emotional skill deficits, child care expulsions, lack of kindergarten entry skills, the risk for school failure, deprivation, and trauma. US Census Bureau data shows that there are 37,774 children birth to age 8 in the two counties. The Casey Foundation, Kids Count Data Center, shows that 32.2% of children in Luzerne County and 15% of children in Wyoming County under the age of 5 are living in economically high-risk families with incomes at or below 100% of the federal poverty level. There has been a dramatic change in the racial/ethnic makeup of Luzerne County in the past two decades. Luzerne County's Hispanic population accounted for 1.2% of residents in 2000; by 2022, that percentage increased to 16%. African Americans comprised 5 % of the population in 2020, up from 1.7% in 2000. Parents and child serving agencies report significant numbers of children who are not being accepted by child care programs due to social/emotional behaviors. Schools report that children are entering kindergarten not accustomed to structure and discipline, with little understanding of personal space, manners, and showing aggressive behaviors. The COVID experience was traumatic for many families as it disrupted economic and social supports that are especially essential for young children. Data from the Casey Foundation Kids Count for 2021 show that there were reports of abuse or neglect for over 500 children in the two counties, and an estimated 20% of children were in homes where there was intimate partner violence. L-W LAUNCH involves numerous goals and objectives. Screening will be done to identify young children at-risk (1,000 children to be screened each year, 5,000 over the course of the grant). Comprehensive service planning will be done for at-risk young child and their families (200 families each year, 1,000 over the course of the grant, including 10% increase each year in the number of Black and Hispanic families served). There will be training and education for families (100 families to be served each year, 500 over the course of the grant) and provision of training for service providers (75 staff per year, 375 staff over the course of the grant). Linkages will be established between primary health and young child serving systems (collaboration contract with 1 primary care provider in year 1, and 9 contracts over the course of the grant). Evidence-based behavioral interventions will be provided (50 children will be served per year, 250 over the course of the grant). There will be expanded use of Mental Health Consultation so that there is a 10% increase each year in the number of child care and early learning centers utilizing Consultation for young children. A Young Child Wellness Council will be established to improve collaboration across child and family-serving systems (5 memorandums of understanding each year), develop a comprehensive public education campaign, and guide L-W LAUNCH implementation. As a result of L-W LAUNCH Luzerne and Wyoming Counties will be caring communities with widespread understanding of how to support social, emotional, cognitive, physical and behavioral development of young children. Effective systems will be built to coordinate resources to help young children and their families throughout Luzerne and Wyoming Counties. There will be tangible, real-life outcomes: 75% of children served across racial/ethnic and socioeconomic backgrounds will exhibit improved behavioral functioning and school readiness; 60% will display improved social-emotional skills; and 60% of parents will report improved caregiver practices and child-caregiver interactions.

Baltimore-Linking Actions for Unmet Needs in Children's Health (B-LAUNCH) seeks to improve the social, emotional, cognitive, physical, and behavioral development of Black children aged 0–8 by expanding access to culturally-responsive promotion and evidence-based early childhood mental health screening and prevention interventions. The proposed project will be overseen by the University of Maryland School of Medicine's Division of Child and Adolescent Psychiatry in collaboration with primary care teams from the Johns Hopkins School of Medicine and the All Walks of Life mental health team, as well as 18 devoted B-LAUNCH community and cross-sector partners. The project will benefit 10,400 (2,080 annually) young children and their caregivers by implementing evidence-based behavioral health screening, referrals, and early childhood mental health prevention interventions in the target areas' primary care clinics and childcare programs. Additionally, the project will train 1,720 (344 annually) providers, interns, parents/caregivers, and community partners in early childhood mental health promotion, screening, and prevention intervention to strengthen the workforce and the community's ability to address the developmental and social/emotional needs of young children. B-LAUNCH will enhance family resilience and achieve health equity in Baltimore City's racially minoritized communities through group initiatives and genuine community relationships, including developing the Young Child Wellness Council to bring together professionals with lived experience, science-based understanding, and systems of care knowledge. Over 76,000 young children ages 0 to 8 reside in the "Black Butterfly" neighborhoods of the west and east sides of Baltimore, where 59–68% of households are headed by women and 37–51% of individuals live in poverty and lack access to high-quality health and early care/education resources, which has a negative impact on birth outcomes (late or no prenatal care, low birth weights, and infant mortality) and kindergarten readiness (just 25 percent of children are school-ready at age 5).1,2,3,4 Families are constantly concerned about their safety due to the prevalence of neighborhood violence and the fact that homicide is the greatest cause of death for children under 18 years old.12 This trauma increases the likelihood of developing long-term physical and mental health problems and impairs the stress response, brain development, gene regulation, and immune function. To address this risk, the effort will implement an integrated care program, HealthySteps, in two Johns Hopkins Medical System primary care locations and implement Early Childhood Mental Health Consultation in a large childcare facility in west Baltimore. We will supplement the selected interventions with parent education (Chicago Parent Program), social skills instruction (Second Step), and trauma recovery intervention (Attachment Regulation Competency) to promote young children's capacity to "love well and learn well" and to help families recover from the COVID-19 pandemic and trauma-related stress. Community partners will conduct family-strengthening activities that emphasize the cultural assets of black communities (Parent Café, Community Café) and promote family-centered early childhood development activities (PBS Kids, Sesame Street in Communities). Employing and educating early childhood professionals in evidence-based screening, referral, and prevention, as well as providing culturally relevant resources and support for parents, can help eliminate mental health stigma and close service access gaps. This project builds on the synergy between community wisdom and scientific innovation to improve the health and education of young children and to increase family and community resilience in the Black Butterfly areas of Baltimore.

This project will promote the wellness of and improve outcomes for low-income children from birth to 8 years, by providing infant and early childhood mental health promotion, screening, referral, and treatment services for children and parents/caregivers, developing the workforce by training educators, clinicians, primary care providers, and community agencies that serve this population, and raising public awareness in the San Fernando Valley in Los Angeles. ECDA has four goals for this work: 1. Improve outcomes and promote wellness for low-income infants and children, particularly those who have experienced trauma and who are at significant risk of developing, showing early signs of, or who have been diagnosed with a mental illness, through screening, early intervention, and caregiver support. 2. Increase the capacity of staff in primary care settings, educators, clinicians, schools, and community agencies to understand and address early social and emotional development, trauma's impact on development, and how to identify and address social, emotional, and behavioral concerns. 3. Strengthen collaboration between community organizations and public agencies that serve children 0-8. 4. Raise community awareness of early childhood development and ways to promote young child wellness. We have set the following outcomes for numbers to be served for this project: 1. Caregivers of 90 children annually (450 over life of project) will receive therapy and evidence-based mental health-related services, including infant massage, Child Parent Psychotherapy, Los Ninos Bien Educados, and Motivational Interviewing. 2. 175 individuals annually (875 total) will be screened for mental health or related intervention. 3. 150 individuals annually (750 total) will be referred to mental health or related services. 4. 128 (85%) of individuals annually (640 total) will access mental health or related services after referral. 5. Train 50 providers in primary care settings annually (250 total) in addressing child and caregiver behavioral health issues through screening, assessment, and referrals. 6. Train 460 people annually (2,300 total) in the mental health and early childhood education workforce, in child development, behavioral health screening, the impact of trauma on development and equity in early childhood education. 7. Conduct reflective groups and consultation for 150 early childhood educators, mental health providers, and other organizations serving children 0 to 5 annually (750 total). 8. 5 organizations annually (25 total) will collaborate, coordinate, or share resources with other organizations as a result of the award.