October 2005 NACBHDD Newsletter
The monthly newsletter for the National Association of County Behavioral Health and Developmental Disabilities Directors
In this Issue...
The 2005 NACBHDD Newsletter series is brought to you by:
NACBHD's New Board Starts Work
At the October meeting, the Board elected the following new officers, who start their two year terms this month.
Chair. Margaret Hanna, Executive Director, Bucks County D & A Commission, Warminster, PA
Vice Chair. Leon Evans, Executive Director, The Center for Health Care Services, San Antonio, Texas
Secretary. David Dangerfield, Director, Mental Health, Salt Lake County, Salt Lake City, Utah
Treasurer. Jim Dill, Executive Director, Alabama Council of Community Health Boards, Birmingham, Alabama
Immediate Past Chair. Deborah Donaldson, Executive Director, COMCARE of Sedgwick County, Wichita, KS
Medicaid Update
Congressional developments
While Congress embarks on the FY 2006 budget reconciliation process and developments around Medicaid unfold
quickly, Melissa Staats continues to update members by email about current Congressional and advocacy activities.
In a recent communication, sent to members October 24, is a newsletter from the American Network and Community
Options and Resources (ANCOR), a national association representing developmental disabilities providers; NACBHD
and ANCOR share affiliation in one another's organizations. The newsletter addresses Senate and House committee
activities around Medicaid, including specific numbers and areas of concern. To view the entire newsletter,
click here.
NACBHD also sent an additional budget update on October 31. That update can be viewed here.
And, NACBHD continues to work with the Campaign for Mental Health Reform to address specific Medicaid concerns in Congress, particularly around targeted case management and the rehabilitation option. See the update in this newsletter on the Campaign for Mental Health Reform.
More on NACBHD Medicaid advocacy efforts
In addition to ongoing work with the Campaign for Mental Health Reform on Medicaid, NACBHD is also putting a high priority on other Medicaid advocacy activities at this critical time, including:
NACBHD's Central Points on Medicaid Reform:
Counties Play a Critical Role in Managing Care for Vulnerable Populations
Counties play a vital role in the management and delivery of services to persons with special needs. With decades of experience in managing the care of the most disabled members of their communities, county government authorities have developed effective and efficient care management models, which have demonstrated both improved outcomes for individuals, and cost savings for Medicaid. It is critically important that these long established safety net systems of care not be jeopardized as Medicaid Reform proceeds.
NACBHD Supports Medicaid Reform
NACBHD acknowledges the Medicaid program is overdue for significant reforms to achieve cost savings, efficiencies and better outcomes. NACBHD supports current efforts underway to design and implement these reforms, provided that essential services for mandated populations are retained.
Unintended Consequences to the Most Vulnerable and Disabled Must be Avoided
Reform of a program as large and complex as Medicaid carries with it the very real possibility of bringing about damaging unintended consequences to needy and vulnerable populations. For example, current proposals in some quarters to restrict targeted case management, or the payment for certain rehabilitation services, could result in the loss of the ability for persons with certain disabilities to live independently outside hospital or institutional settings.
Essential Services to Vulnerable Populations Must be Preserved
To protect against these unintended consequences, it is important to identify the populations most at risk, and the accompanying services essential to their maintaining independent lives in the community. Examples of vulnerable populations include adults with severe and persistent mental illness (SPMI); children with severe emotional disturbance (SED); persons with developmental disabilities; children in the foster care or juvenile justice system; etc.
Examples of services essential to maintaining these vulnerable populations outside of protected living include case management; mobile crises services; medication supports; crises residential service; supported housing; supported employment; etc. To assure these services have the most relevance to the individual, NACBHD also supports mechanisms which promote self directed care.
NACBHD Supports Underlying Principles of the National Governor's Association Proposal for Medicaid Reform
The National Governors Association (NGA) has undertaken a thoughtful and complete evaluation of the Medicaid program, and developed recommendations for achieving Medicaid Reform. NACBHD supports the underlying principles of the NGA proposals. Specifically NACBHD applauds the NGA's recognition of certain vulnerable populations and the need to protect and preserve essential services to these groups. NACBHD also supports the NGA proposal to give states significantly more flexibility to design Medicaid programs to more closely fit the unique needs of individual states.
The entire document can be viewed here.
Medicare Update: More Resources as MMA Implementation Approaches
Important dates. In fall 2005, CMS will auto-enroll approximately six million dually eligible beneficiaries (those receiving both Medicare and Medicaid) into Medicare prescription drug plans. These new Medicare drug plans will replace Medicaid as it is currently used by the dually eligible (and others) to support their access to medications. Starting November 15, 2005, beneficiaries may select another plan from the one in which they are auto-enrolled. The new prescription coverage begins on January 1, 2006.
An ongoing inventory of resources for implementation of the MMA
NACBHD is working with CMS and other advocacy partners to provide the best information about MMA implementation so that members can be fully informed and ready for the transition period this fall and the implementation January 1, 2006. Given the oversight and planning responsibilities of county governments and county based authorities, communities will rely on the NACBHD membership as points of dissemination of information.
NACBHD's Developmental Disability Committee has taken the lead in supporting the cataloging of resources to help the NACBHD membership as implementation of the MMA proceeds, and to aid the membership in better understanding and planning for such activities as beneficiary plan selection, eligibility determination, formularies selection, and provider training. Maeghan Gilmore is compiling an inventory of outreach and education resources, which will be available on the NACBHD website soon. Beneficiaries, guardians, providers, physicians, pharmacists and case managers are those stakeholders who will likely have a direct role in implementation and will benefit from the inventory. In addition, NACBHD is routinely updating members on outreach and education efforts in the newsletter.
Two new resources are now available. If members have staff who can review these materials or any resource materials listed in past newsletters, it would be helpful to do so. In addition, members are urged to reach out to their State Health Insurance Programs (SHIPs) for resources that they can share locally.
Medicare will mail people with Medicare and full Medicaid coverage an auto-enrollment notice on yellow paper by November 5th to inform them about the change in their drug coverage from Medicaid to Medicare. The notice explains the following:
The notice includes a one-page letter, and two pages of questions and answers about Medicare prescription drug coverage. The notice is available here.
Click here to view a fact sheet describing the mailing of the auto-enrollment notice.
Update on the Campaign for Mental Health Reform
The Campaign for Mental Health Reform continues to actively work with national advocacy partners on critical issues, such as Medicaid, and is also planning some events to focus the agenda for the coming year and to recognize efforts in the mental health arena. The current emphasis is on:
Medicaid
The Campaign continues to concentrate on advocacy efforts around Medicaid, specifically concerns about targeted
case management (tcm), including possible problematic provisions in the tcm legislative language and the
rehabilitation option, and more broadly, minimizing the possible reductions.
In addition, the Campaign sent a letter to Senate Majority leader Bill Frist October 23 urging that S. 1716, the emergency Medicaid bill, be brought to the Senate floor as a separate measure and not included in the Budget Reconciliation bill, which would require offsetting cuts in other Finance Committee programs, including Medicaid and Medicare. The bill has been endorsed by governors and most leading health advocacy organizations, but has been opposed by a few senators.
December policy retreat will focus priorities for 2006
The December 1 policy retreat, which will be attended by Campaign member executive directors and lead policy staff, will provide a time for Campaign partners, which includes NACBHD, to focus on two or three priorities to focus on for 2006.
First Annual Awards Dinner for Leadership in Mental Health
The First Annual Awards Dinner for Leadership in Mental Health, scheduled for March 29, 2006, at the Washington, DC, Grand Hyatt, will honor members of Congress and others who have made mental health a national priority. Melissa Staats is a Dinner Co-Chair of the event, along with other directors of Campaign partner organizations.
NACBHD Membership Campaign Continues
The membership campaign materials for 2006 have been mailed to all NACBHD members and potential members in NACBHD member states. Unfortunately, as members may have noted from a September 22 email, the materials included an invoice dated 2005, which is an error. A 2006 invoice was included with the September 22 email. If you need a hard copy of the 2006 invoice, or have any questions, please contact the NACBHD office at (202) 661-8816 or at mgilmore@nacbhd.org. NACBHD apologizes for any confusion this may have caused.
In addition to the yearly Campaign, Melissa Staats has been visiting NACBHD members states to make statewide presentations of survey findings as part of the deliverables of NACBHD's SAMHSA grant (see September newsletter). She has visited Georgia, Kansas, Alabama, and she will be visiting California and Ohio in November and Illinois in December. In Ohio, she will visit the Developmental Disabilities Association, and in California she will represent NACBHD at the NACo conference in San Francisco, along with NACBHD board members Sandra Naylor-Goodwin and Bob Egnew. Egnew is also NACBHD's policy consultant, and Naylor-Goodwin is also the newsletter's managing editor and Executive Director of the California Institute of Mental Health.
Annual Conference: "Transformation, Recovery, & Self-Determination" Information Soon Will Be Available
The NACBHD Annual Meeting took place October 20-22 in Portland, Oregon. The theme for this year's conference was "County Government and County-Sponsored Authorities Leading Transformation, Recovery, & Self-Determination." Consumers, county authorities, and staff from national advocacy organizations led discussions on issues critical for transformation to a recovery-based system. Information about the conference will be available in the November newsletter and soon on the NACBHD website.
Mark Your Calendars for the Legislative Conference: March 1, 2, and 3
Members are urged to mark their calendars for the NACBHD Annual Legislative Conference scheduled for March 1, 2, and 3 in Washington, DC. Registration and hotel information will be available on the website and in the newsletter soon. NACBHD is hoping to host a special panel of state Medicaid directors and state mental health programs directors to talk about the future of Medicaid.
The Meth Crisis: More on a 2006 NACBHD Priority
NACBHD has made the methamphetamine epidemic a priority in its work plan for the coming year, and the National Association of Counties (NACo), of which NACBHD is an affiliate, recently announced the formulation of a Meth Action Group to address the methamphetamine epidemic in communities. At the Meth Action Group's first meeting on September 27, twenty-three county officials addressed issues related to the problem in an effort to promote communication among federal, state, and local officials and the private sector.
As NACBHD begins to address the crisis and formulate a policy, NACBHD will update members on the issue in the newsletter. See the September newsletter for the first article, which reviewed issues facing the Meth Action Group and how NACBHD might represent county behavioral health interests, which will be important to the NACBHD work plan. This month, NACBHD spoke with Pat Fleming, Director, Salt Lake County, Utah, Division of Substance Abuse Services, also a NACBHD member and a member of the NACo Meth Action Group, about the September 27 Meth Action Group meeting.
The meeting involved elected officials, county commissioners, sheriffs, and county executives, Fleming characterized the meeting as "quite balanced between interdiction, legislation, prevention, and treatment. Presenters included a SAMHSA official who talked about block grant funding, Representative Chris Cannon (R-UT), who is very active in the Congressional Meth Caucus, and someone from the DEA, who discussed interdiction. In terms of recognition of the meth problem, Fleming said the western and midwestern states are well aware of the problem there, and the eastern states are becoming more aware of the impact. International distribution is also starting to grow, with meth shipped from the Far East through Mexico and Canada. And, this foreign meth is more potent, which may become an area of special concern if the more potent foreign meth reaches more parts of the United States.
Fleming reported that a lot of work was accomplished in the day and half meeting, and that the group agreed that more needs to be done in the areas of law enforcement, treatment, child protective services, prevention, education, public health, cleanup, research, and precursor control. This is reflected in the statement of NACo First Vice Eric Coleman (Commissioner, Oakland County, Michigan) before the U.S. House of Representatives Energy and Commerce Committee: Joint Hearing of the Subcommittees on Health and Environment and Hazardous Materials "Comprehensively Combating Methamphetamines:
Impacts on Health and the Environment" on Oct. 20. (See www.naco.org.)
Information on funding and treatment for elected officials. Fleming said that while counties share the burden of treatment costs for meth and that there was definite concern that meth is driving up county costs, there is no one place where all the data for the public treatment system is put together. One of the big questions from public officials present at the meeting was: How are public treatment services funded in the United States? A paper on this will give county officials a good snapshot of how public substance abuse treatment is financed, and Fleming is working on it now. He reported that there was a lot of support by elected officials to put more money into treatment, with support to increase the SAPTBG to $1.67 to 2 billion. It is more expensive to treat methamphetamine addiction, and some of these costs filter down to county government. Block grants are the single most stable source of funding for substance abuse treatment; they reach the lowest level of provider and are the base dollars for providing services.
In addition, Fleming is working on a kind of "Substance Abuse Treatment 101" primer for elected officials. The meeting revealed that they did not have good information on meth treatment, or substance abuse treatment in general; there are several good models available for meth treatment. And, Fleming said the cognitive and social aspects of meth need to be carefully examined. When substance abuse treatment is partnered with closely linked, good community supervision, there are better outcomes. This is even truer for meth users, whose cognitive abilities are likely to be compromised from the damage to the brain from meth use.
The proven treatment models that Fleming will cover in his meth treatment primer are CBT models, including the CBT Matrix Model. Meth impacts the whole cognitive area of the brain, and there is not yet any medical detox available. As a result, both detox and treatment take longer for meth users than for individuals involved in other substance abuse, and inevitably, longer courses of treatment for meth users are more costly. Block grants support the marriage of good community supervision and longer treatment.
Possible reductions in the Medicaid program are a concern. Fleming says the cuts in targeted case management that are under discussion would impact the people most predisposed to meth use. And, the meth crisis further begs questions about health insurance in the United States, such as including substance abuse treatment coverage in health insurance.
A concern about prevention and education. Fleming noted that the elected officials kept returning to the issues of prevention and education in their discussions. Fleming said meth is "all about the market." Meth is cheaper and easier to get. There is a need to educate parents and policymakers, and to enhance treatment for those addicted. He also cited a need to partner with state and county parole programs to have effective parole programs; 75-80% of those facing parole have substance abuse problems.
Next steps: NACo legislative package and possible legislation. A position paper will be developed on each issue the group has decided to examine, and eventually these will be presented to NACo as a legislative package. NACo staffers will then work to push the package forward in Congress. Some possible legislation includes: limits on the amount of pseudophedrine that can be sold in pharmacies and some enhanced penalties. Limiting the amount of pseudophedrine products would involve restrictions in terms of quantities sold, including a possible database of frequent users. However, there are issues to be grappled with in this area, such as consumer privacy and education of pharmacy managers. And, in terms of penalties, many feel there are already "good teeth" in the drug laws, and that more emphasis may needs to be put on borders and trafficking.
Resource information on the meth crisis. For more information on the Meth Action Group and NACo's meth initiative, and to access surveys showing the growing problem in counties around the country see www.naco.org. Also, Pat Fleming reports that Jim Mulder, a Minnesota official, provided a powerful Power Point presentation on the devastating impact of methamphetamine, especially on the mouth. Dentistry costs associated with meth are becoming quite costly for counties when meth users are jailed. The presentation will soon be available on the NACo web site; Fleming urges members to view it.
Look for continuing updates in the newsletter. The next meeting of the Meth Action Group will take place in November in San Francisco. There is a summit on model state drug laws in November in Honolulu; Fleming says there is hope that because of the location, countries in the Far East may attend. NACBHD will continue to report on developments related to meth.
SAMHSA Announcements
From an October 7 SAMHSA press release:
New SAMHSA Disaster Planning and Response Training Available Online
Those who experience and respond to disasters can be especially vulnerable to substance abuse and mental illness in the aftermath of the crisis. For this reason, SAMHSA is developing a new series of programs aimed at providing crisis response professionals, public health officials, and others with information about how best to plan for and manage mental health and substance use components of their disaster response efforts.
The first two "ChimeraCasts" (enhanced Webcasts) are now available online through the SAMHSA Web site at www.samhsa.gov, under the "Latest News" drop-down menu. The programs in this six-part series will address:
New ChimeraCasts will be posted throughout the fall as they are completed.
From a September 28 SAMHSA press release:
$92.5 Million Awarded for Mental Health Transformation State Incentive Grants
SAMHSA has announced the award of $92.5 million to seven states over five years for Mental Health Transformation State Incentive Grants (MHT SIGs). These cooperative agreements will provide funds to transform state mental health service delivery systems - from systems dictated by outmoded bureaucratic and financial incentives to systems driven by consumer and family needs that focus on building resilience and facilitating recovery.
The states that receive the awards, administered by SAMHSA's Center for Mental Health Services, will serve as platforms for learning about what strategies and activities do and do not work in transforming the states' mental health and related systems. In partnerships with these states, SAMHSA will communicate successful strategies and activities to other states, territories, and tribes and tribal organizations in order to improve and accelerate transformation across the nation. The grants require the grantees to enlist consumers and family members as active partners in all transformation planning and activities. They also require grantees to take a life span approach to services and to provide a continuum of services including promotion, prevention, treatment, and recovery.
Over $18.5 million will be awarded in the first year and a similar amount will be distributed among the awardees in the subsequent years. Award grantees are:
Connecticut - $2,730,000 for the first year -- to continue developing a recovery-oriented system of mental health care in which state and local systems work together seamlessly to offer all of the state's citizens, across the lifespan, an array of effective, accessible services and recovery supports to prevent mental illness and promote resilience and recovery.
Ohio - $2,388,700 for the first year- to fully orient the mental health and other systems to recovery, resilience, and culturally competent practices. Youth and adult consumers and families will be actively engaged in their service and recovery experiences, which will include person-centered planning, peer support, and recovery and resilience-oriented policy making.
Oklahoma - $ 2,730,000for the first year - to develop a strong, sustainable infrastructure to promote lasting changes across all state agencies, enabling persons with mental illness to access individualized care and support expeditiously and to achieve and sustain recovery.
Washington - $2,730,000 for the first year- to build the infrastructure for an on-going process of planning, action, learning, and innovation in mental health care. Key elements will include a social marketing initiative to increase awareness and reduce the stigma of mental illness and strengthening of the statewide infrastructure for consumer and family support.
Maryland - $2,713,887 for the first year- to facilitate deep and lasting change in the way services are delivered, in part by enhancing the already strong public-academic and public-private provider partnerships in the areas of evidence-based practices and by emphasizing a recovery-focused approach to service.
New Mexico - $2,546,363 for the first year - to bring fragmented systems into a coherent whole, integrate the behavioral health services and perspectives of 15 state agencies; bring together critical partners locally throughout communities across the state; and expand behavioral health coverage to the most isolated corners of the state.
Texas - $2,730,000 for the first year- to build a solid foundation for delivering evidence-based mental health and related services, foster recovery, improve quality of life, and meet the multiple needs of mental health consumers across the life span, and to move the system from disparate programs to a coordinated system of care that offers promotion, prevention, and treatment services to Texans across the life span.
SAMHSA Awards $184.5 Million in Grants for Child Mental Health Services
SAMHSA has announced the award of 25 cooperative agreements totaling $184.5 million over six years to provide comprehensive community mental health services for children and youth with serious emotional disturbances and their families. These grants will be used to implement a "Systems of Care" approach to services that is based on the premise that the mental health needs of children and adolescents can be best met within their home, school, and community and families and youth should be the driving force in the transformation of their own care. The grants will be used to establish a full array of mental health and support services organized into a coordinated network in order to meet the unique clinical and functional needs of each child and family.
The awards are for up to $1 million in the first year and are renewable for up to six years. The total funding for 2005 is $23.5 million. There is a requirement for an increasing ratio of non-federal matching dollars to federal dollars for this program. Continuation of these awards is subject to availability of funds as well as the progress achieved by the awardees. Awards went to counties in Arkansas, California, Connecticut, Florida, Illinois, Massachusetts, Maine, Michigan, Montana, New York, North Carolina, Oregon, Pennsylvania, Rhode Island, South Dakota, Tennessee, Texas, and Wyoming. For more information, see www.samhsa.gov, news releases.
From an October 7 SAMHSA press release:
SAMHSA Awards $7.2 million for Jail Diversion Grant Programs
SAMHSA has announced $7.2 million over three years in new grants to divert individuals with mental illness away from the criminal justice system and into community-based mental health and substance abuse treatment services.
Treatment services must be based on the best known practices and include case management, Assertive Community Treatment, medication management, integrated mental health and substance abuse treatment, psychiatric rehabilitation, and gender based trauma services. Grantees will coordinate with social service agencies to ensure that life skills training, housing placement, vocational training, job placement, and health care are available to diverted persons.
Six grants were awarded in five states: California, Illinois, Louisiana, New York, and Virginia. For more information, see www.samhsa.gov, news releases.
From a September 30 SAMHSA press release:
Almost $70 Million Awarded to Help Children and Adolescents Who Have Experienced Traumatic Events
SAMHSA has announced almost $70 million in grant awards to provide help to children and adolescents who have experienced traumatic events. These grants will fund a network of community-based treatment and services centers that are supported by national expertise. SAMHSA's National Child Traumatic Stress Initiative has three components. The National Center for Child Traumatic Stress advances the network structure, coordinates network activities, and promotes national education and training efforts. The Treatment and Services Adaptation Centers provide national expertise on specific types of traumatic events, population groups, and service systems and supports the specialized adaptation of effective treatment and service approaches for communities across the country. The Community Treatment and Services Centers provide services to children who have experienced traumatic events and evaluate the effectiveness of trauma treatment and services in community and service system settings.
Nineteen Community Treatment and Services Centers were awarded grants for a total of $30.4 million over four years. Eight Treatment and Services Adaptation Centers were awarded grants for a total of $19.2 million over four years. The University of California Los Angeles was awarded $20 million over four years to operate the National Center for Child Traumatic Stress in partnership with Duke University.
The 19 Community Treatment and Services Centers funded are:
Alaska Anchorage Community Mental Health -- $398,037 in the first year, and similar amounts thereafter, to establish the first Alaska Child Trauma Center in Anchorage. The Center will collaborate with community partners to establish a trauma-focused coalition and treatment network to establish best practices-based services for children and adolescents (ages 3 to 18), who have suffered trauma.
Arizona Jewish Family and Children's Services, Tucson -- $400,000 per year to support the Child and Adolescent Traumatic Stress Services Center of Southern Arizona, which will improve the availability and quality of services and treatment for children and adolescents who have experienced trauma by implementing and evaluating evidence-based interventions in a variety of community settings, including schools, residential treatment facilities and out-patient counseling centers.
California Children's Hospital of Los Angeles -- $400,000 per year to establish and sustain evidence-based clinical treatment and trauma services for runaway and homeless youth in the Hollywood community. The grant will enable the program to transform the service delivery system so that the entire system of care is more educated about trauma and its impact, and more able to effectively respond to these needs.
Connecticut Clifford W. Beers Guidance Clinic, New Haven -- $400,000 per year to create a community-based clinical center for excellence for the treatment of children and families who have been exposed to trauma. The program will improve the quality of the treatment services available to those families within the greater New Haven Region by assisting other human service agencies in implementing evidence-based practices.
Delaware Department of Services for Children and Youth, Wilmington -- $400,000 per year to expand statewide capacity to identify and assess child traumatic stress and increase access to effective, community-based trauma-specific treatment. The target population is children in public child welfare, juvenile justice, and child mental health systems with acute trauma related to sexual abuse, physical abuse, or witnessing violence.
Illinois La Rabida Children's Hospital, Chicago -- $399,268 in the first year, and similar amounts thereafter, to serve inner city African Americans and other Chicago area children exposed to the full range of traumatic events, including medical trauma and complex trauma. The Chicago Child Trauma Center will increase program capacity and evaluate the effectiveness of interventions modified for urban African American children.
Massachusetts The Justice Resource Institute, Inc., Boston -- $400,000 per year to the Trauma Center at Justice Resource Institute, in collaboration with the Child Trauma Recovery Foundation, to establish the New England Trauma Services Network. The network will expand the training and services of the program to high-need, under-resourced communities.
Minnesota The Tubman Family Alliance, Minneapolis -- $400,000 per year to develop the Minnesota Child Response Center to raise the standard of care for traumatized minority, homeless and formerly homeless children by embedding evidence-based treatment models into the community system of care. The program will extend its impact throughout Minnesota and the upper Midwest.
New Hampshire Trustees of Dartmouth College, Hanover -- $383,220 in the first year, and similar amounts thereafter, to implement and evaluate best practices for severely emotionally disturbed adolescents who have experienced trauma and who are served by the community mental health system in New Hampshire.
New Jersey International Institute of New Jersey, Jersey City -- $400,000 per year to promote the well-being of refugee children and their families in Northern New Jersey through culturally and linguistically accessible services designed to reduce the effects of trauma associated with the refugee experience and resettlement.
New York Jewish Board of Family and Children, New York -- $400,000 per year to develop, improve and systematize trauma-focused assessment and treatment services for traumatized children from low-income and racially diverse neighborhoods. The program will address needs seen at both inpatient and outpatient services. Safe Horizon Inc., New York -- $400,000 per year to provide innovative, evidence-based treatment and services to traumatized children and adolescents in New York City by adapting and implementing a range of evidence-based engagement and treatment models in agency programs for children and youth St. John's University, Queens -- $397,647 in the first year, and similar amounts thereafter, to develop and sustain a community-wide network of providers who are trained in implementing trauma-informed, evidence-based services. The goal is to train primary care personnel to use trauma-informed, evidence-based services and provide these services with underserved, inner city, traumatized children.
Ohio The Toledo Hospital -- $400,000 per year to provide direct services using Trauma Focused Cognitive Behavioral Therapy and adaptations for very young and physically or mentally disabled children. The program will expand the array of trauma-informed treatments by extending agency reach to high-risk children in school and juvenile justice setting.
Oregon Children's Relief Nursery, Portland -- $399,943 in the first year, and similar amounts thereafter, to implement an Early Childhood Community Treatment Center to meet the needs of children ages birth through three in North Portland by identifying, implementing, and adapting evidence-based and research-informed interventions for children ages birth through three who have experienced trauma, and their families. Willamette Family Treatment Services, Eugene -- $399,970 in the first year, and similar amounts thereafter, to integrate a program of gender sensitive trauma services into currently offered substance abuse treatment services for adolescent girls in Lane County. Services will also reach into numerous rural Oregon communities and onto several Native American Reservations.
South Dakota Wakanyeja Pawicayapi, Inc., Porcupine -- $400,000 per year to develop a Community Treatment and Services Center to serve children and youth ages 3-18 who have experienced trauma on the Pine Ridge Indian Reservation in southwestern South Dakota.
Texas Serving Children and Adolescents in Need, Laredo -- $400,000 per year to improve and expand the service delivery system in Webb County for children and adolescents experiencing traumatic stress through the design and implementation of trauma-informed services. The targeted population is composed almost entirely of first generation Mexican Americans or Mexican immigrants who are bilingual or primarily Spanish speaking.
West Virginia Youth Health Services Inc., Elkins -- $388,249 in the first year, and similar amounts thereafter, to improve the mental health status of children and adolescents who have experienced complex trauma and to improve community practices and collaborations for the care of traumatized children and adolescents. Training, public education and community collaboration will be combined to create an environment that supports and sustains the delivery and use of effective best practices for trauma-focused treatment and care services.
The 8 Treatment and Service Adaptation Centers funded are: California Miller Children's Hospital, Long Beach-- $600,000 per year to support collaboration between the Miller Children's Abuse and Violence Intervention Center and the University of Southern California to form a Child and Adolescent Trauma Program. The program will provide leadership, program development and training in the treatment of multiply traumatized children and adolescents. Los Angeles Unified School District-- $599, 814 per year to disseminate sustainable school-based trauma services. The district's center will identify evidence-based and promising practice programs for use in school settings; assess school and community needs and capacity to deliver trauma-informed services; and support adaptation, implementation, and sustainability of practices and interventions in schools across the country. Children's Hospital and Health Center, San Diego-- $600,000 per year to expand their center's role in the identification and dissemination of the Trauma Assessment Pathway (TAP) model and other evidence based practices, for children traumatized by maltreatment, neglect or exposure to interpersonal violence. The Center will adapt the model and practices for Spanish-speaking clientele. The Regents of the University of California, San Francisco--$600,000 per year will support the efforts of the Early Trauma Treatment Network, a collaborative of four national programs that have pioneered trauma treatment, training, and dissemination for children ages birth to five exposed to family/community violence, physical/sexual abuse and traumatic bereavement. The network will also sponsor trainings in this area nationwide.
Connecticut Yale University School of Medicine, New Haven -- $600,000 per year will be used by the school's Childhood Violent Trauma Center for the development, evaluation, and dissemination of prevention models for children exposed to potentially traumatic events. Intervention protocols developed by the center are employed collaboratively by police officers and mental health providers for children and families impacted by violence.
New York North Shore University Hospital, Manhasset -- $600,000 per year to enable the hospital's Adolescent Trauma Treatment Development Center to focus on alleviating the impact of traumatic stress in adolescents. It will continue to develop, adapt, and disseminate interventions for chronically traumatized adolescents. It will also develop an Adolescent Traumatic Stress Resource Center for professionals, teens, and families on adolescent trauma, development and trauma interventions.
Oklahoma Board of Regents of the University of Oklahoma, Oklahoma City -- $599,999 per year to establish and manage the Terrorism and Disaster Center. The center will concentrate on improving the standard of care and access to culturally proficient mental health services for children and families affected by mass trauma resulting from terrorism and disasters.
Pennsylvania Allegheny-Singer Research Institute, Pittsburgh -- $599,970 per year to support the hospital's Center for Traumatic Stress in Children and Adolescents. The center will emphasize collaborative efforts to further disseminate specialized models of Cognitive Behavioral Therapy for the treatment of sexually abused and multiply traumatized children, physically abused children, and children experiencing traumatic grief. They will also expand training activities and nationally disseminate childhood traumatic grief products.
From an October 12 SAMHSA press release:
$13.2 Million in Grants Awarded for Mental Health Services for Older Adults
SAMHSA has announced $13.2 million in grant awards to provide mental health services to older adults in need. These grants will help community-based organization increase capacity or improve the array of services available to people 60 years and older who are at risk for or are experiencing mental health problems.
Just over $4 million will be awarded in the first year and a similar amount will be distributed among the 11 awardees in the subsequent two years. Award grantees are:
Arizona Chiricahua Community Health Center, Elfrida -- $400,000 per year to provide a culturally-based intervention program that addresses behavioral health prevention of depression, both related and unrelated to diabetes and dementia, in residents over the age of 60. The project is designed to increase social interaction, provide mentally stimulating programs and physical exercise. Valle del Sol, Inc., Phoenix - $398,800 in the first year and similar amounts in subsequent years to target Latino elderly, ages 60 years and older, at risk for or experiencing mental health problems in southwest Phoenix and the communities of Surprise and El Mirage. The program will use evidenced-based models of outreach prevention, and treatment targeting seniors with depression or at-risk for suicide. Consumer-driven and culturally adapted services will be provided to Latino seniors.
Colorado Jefferson Center for Mental Health, Arvada- $395,340 in the first year and similar amounts in subsequent years to provide services based on the "Gatekeeper" model in a five county area, Jefferson, Boulder, Gilpin, Clear Creek and Broomfield. The service model includes a single point-of-entry call center and outreach teams hired and trained to be sent on referred home visits of elderly adults in need.
Hawaii University of Hawaii, Honolulu -- $400,000 per year to increase the capacity of the state to provide specialized and enhanced mental health and social services to people over the age of 60. Hawaii will provide education and support to caregivers and service providers dealing with older adults with serious mental illnesses and offer enhanced clinic services to older adults with serious mental illnesses through the use of an evidence-based, community-based geriatric mental health treatment team.
Massachusetts Cambridge Public Health Commission -- $400,000 per year to expand access to underserved elderly residents in the Metronorth area of Boston through the efforts of the Cambridge Health Alliance. The project will expand accessible mental health services to functionally-homebound elderly persons with serious mental illness in the four-city region of Malden, Everett, Revere and Medford utilizing the evidence-based practices in place in the adjoining cities of Cambridge and Somerville. The program will also integrate mental health and primary health care.
New York Nachas Health and Family Network, Inc., Brooklyn - $400,000 per year to address the needs of Holocaust survivors and their older adult children. Project Chai will address the needs of persons ages 60 and older who live in three sections of Brooklyn that have heavy concentrations of Holocaust survivors. The project will enhance outreach, engagement and referral services needed by isolated, withdrawn Holocaust survivors and their aging children by adapting the Assertive Community Treatment (ACT) model. Assertive Community Treatment is an evidence-based mental health services delivery model for delivering key medical, rehabilitative and social services to persons with severe and persistent mental illness in the community.
Ohio Cuyahoga City Community Mental Health Board, Cleveland -- $376,536 in the first year and similar amounts in subsequent years to increase access and capacity through collaboration of mental health service providers, the county department of senior and adult services and adult guardianship services. The program will serve older people in crisis or who are homeless and will engage seniors with mental health needs through outreach services. The program will adapt several evidence based treatment practices for helping family members learn more about mental illness and helping them respond appropriately to the needs and behaviors of family members with mental illness, and helping mental health consumers learn to self-manage their illness and work toward recovery.
Tennessee Centerstone Community Mental Health Center, Nashville - $400,000 per year to deliver mental health outreach, treatment and prevention services for adults ages 60 and older in Davidson County. The manualized evidenced-based model for treating elder depression known as the IMPACT model (Improving Mood Promoting Access to Collaborative Treatment for Late Life Depression) will be implemented for seniors as well as enhanced electronic medical records.
Texas Longview Wellness Center, Inc., Longview - $399,940 in the first year and similar amounts in subsequent years to develop a community-based service delivery system and infrastructure that will work through area organizations to reach people over 60 at risk for mental illness. The project is designed to improve the coordination of care between physicians and mental health practitioners and implement a fully integrated treatment program through a primary health care clinic. Montrose Counseling Center, Inc., Houston - $400,000 per year to provide peer outreach, education and counseling by adults ages 60 and older, as well as professional counseling and case management for 250 vulnerable adults ages 60 and older in each of the three years.
Virginia Boat People, SOS, Inc., Falls Church - $400,000 per year to provide access to mental health services for approximately 3,000 Vietnamese elders in Northern Virginia, including some 1,000 torture survivors and their spouses. Few of these have been able to access mental health care because of the lack of linguistically and culturally-appropriate services. Home-based mental health care, peer support services, and clinical counseling will be provided.
ICL Integrated Behavioral Healthcare Network in New Wins 2005 Wernert Award
From a September 19 TAC, Inc. press release:
The Technical Assistance Collaborative, Inc. (TAC), in collaboration with NACBHD, presented the $10,000 2005 Thomas M. Wernert Award for Innovation in Community Behavioral Healthcare on October 21, 2005, in Portland, Oregon to the Institute for Community Living's (ICL) Integrated Behavioral Healthcare Network in New York, New York.
The ICL Integrated Behavioral Healthcare Network is a program designed specifically for treating persons with serious mental illness with co-occurring healthcare conditions. The Integrated Behavioral Healthcare Network is a service delivery model that coordinates and integrates mental health and healthcare services into its outreach, clinic and residential programs for consumers with serious mental illnesses.
Programs receiving honorable mention are: Peer Bridger Project - New York Association of Psychiatric Rehabilitation Services (NYAPRS) in Albany, New York; Crossroads Early Childhood Services - Crossroads Lake County Adolescent Counseling Service, Lake County, Ohio; and Pathways to Housing, New York, New York.
The Thomas M. Wernert Award for Innovation in Community Behavioral Healthcare is an annual award that grants $10,000 to a state, county, or community-based non-profit organization providing exemplary behavioral health services. TAC, the Lovell Foundation, and NACBHD are committed to supporting and honoring innovation in community behavioral health. The annual award program seeks to identify and give national recognition to a program demonstrating innovation and creativity while ensuring community and consumer participation.
This award is given in memory of Thomas M. Wernert, former Executive Director of the Lucas County Mental Health Board in Toledo, Ohio. The winning programs embody the ideas and ideals that Mr. Wernert exercised in his leadership in public behavioral healthcare.
For additional information please contact Evette Jackson at the Technical Assistance Collaborative, Inc., Boston, Massachusetts at (617) 266-5657. Applications for the 2006 award will be available on the TAC website in February 2006.
Consumer workbook developed by the National Mental Health Association
NACBHD members and staffs should also review the consumer workbook developed by the National Mental Health Association. This is an excellent, comprehensive and easy to understand resource. It can be viewed at: http://nmha.org/federal/MedicareConsumerWorkbook.pdf
