Innovative Partnerships: Examples of Collaborations Among State Agencies

1. Innovative Partnerships: Examples of Collaborations Among State Agencies

2. State Collaboration “Coming together is a beginning, Keeping together is progress, Working together is success” Henry Ford

3. Where to Start? Start at the Top Look at existing pieces of infrastructure for pieces that may already be in place or provide an entry point to address older adult behavioral health issues - “Asset Mapping” Look for what is already being done in the state that provides/funds behavioral health services for older adults and how combining these pieces can provide synergy and/or a greater funding base for evidence-based models and/or interventions

4. Legislation • See if there is any existing legislation specifically for older adult services or on related topics – e.g., Self-Neglect, Elder Abuse, Suicide Prevention – that might provide a basis or entry point for state support of behavioral health services for older adults • Example: Illinois – Self-Neglect Task Force

5. State Plans • Look at the current state planning process and once again those components that may already address behavioral services for older adults • If they do not already include them, assert them into the planning process. • Perhaps some funding streams can be combined for more comprehensive services. • Look at the different components to see what piece is already provided. • Example: Illinois State Planning Process

6. Statewide Plans • Behavioral Health Authority Strategic Plan • Department on Aging State Plan • Block Grant Reporting • Olmstead Plan • Money Follows the Person • Suicide Prevention Plan

7. Systems Integration • Look at all agencies that impact the delivery of services for older adults and how integration can bolster leveraging of resources, information and services to serve older adults in an evidence-based multidisciplinary approach

8. Partners • State Department on Aging • State Division of Behavioral Health • Department of Public Health • Office of Alcohol and Substance Abuse • Office of Veteran Affairs • Office of Consumer Affairs • Office of Medicaid and Medicare • County Mental Health Boards • Primary Care • PASRR • Federally Qualified Health Centers, Health Homes, and Affordable Care Organizations • Aging and Disability Resource Centers

9. Partners • Department of Corrections • Cost of Housing the older offender • Data on older offenders • Types of older offenders – 1st time offenders; repeat offenders; long-term offenders and sexual predators • Department of Transportation • Long Term Care Rebalancing • Hospitals and Emergency Rooms • Department of Developmental Disabilities (The D.D. population is aging prematurely) • Crisis Services • Senior Centers • Housing Association • MIS Departments Departments for Data Collection

10. Work Groups/Task Force Participation • Self-Neglect • Center for Violence Prevention • State Suicide Prevention Workgroup • Long-Term Care • Anti-Stigma Campaigns • Caregiver Groups and Meetings

11. Work Force Development • Data indicates a lack of trained geriatric professionals in all of these fields. States can leverage their statewide geriatric expertise by sponsoring statewide Behavioral Health and Aging Conferences, having a mental health track in existing conferences, writing manuals and sharing resource information • Illinois: • 3 regional conferences, mental health track at Governor’s conference on aging • Mental Health and Aging Manual – used at forums throughout the state • Use of regional Geriatric Education Centers

12. Types of Professionals to be Trained • Physicians • Other Health Professionals (P.A.’s, Nurse Practitioners and Nurses) • Behavioral Health Professionals • Community Mental Health Centers • Home health and in-home nurses/aids • Medicare professionals • Aging Professionals • Public Health • Long Term Care Workers • Policy makers • Caregivers • Crisis Workers

13. Advocacy/Synergy • NASMHPD – Older Persons Division Representatives • State Mental Health Planning and Advisory Council – have a rep for Older Adults • State Consumer Advisory Council • NAMI • Mental Health of America • Mental Health and Aging Coalitions • Illinois, 4 regional coalitions, 1 statewide coalition

14. Illinois – Start at the Top Find people who are interested! • Point person for behavioral health at DMH and DOA • Geriatric Advisory Council – White Papers, Statewide Assessment • Systems Integration Task Force • Attend Council on Aging Meetings • Attend Mental Health Advisory Council Meetings • Statewide Mental Health and Aging Manual – Forums throughout the state • Participate in Medicaid and Medicare Plans • Offer CEU’s for aging providers at your mental health and aging conferences and trainings Learn a new language so you can communicate!

15. Illinois – Start at the bottom • Co-staff older adult cases with the Area Agencies on Aging or Case Coordination Units - GeroPsych Specialists • Revision of Case Coordination Assessment to include more behavioral health domains – Include training on behavioral health in Case Coordinators training • AoA funds for Caregiver Counseling • 3-D funds – Evidenced-Based Programming • www.healthyaging.org • Behavioral Health - Community Programs –”Healthy Ideas”, “Pearls”, “Prevention and Management of Alcohol Programs in Older Adults”

16. Thank You Charlotte Kauffman, M.A., L.C.P.C., Service Systems Coordinator, Illinois Department of Human Services, Division of Mental Health Chairperson, NASMHPD Older Persons Division 217.524.8383 charlotte.kauffman@illinois.gov

17. Older Ohioans Behavioral Health Network PARTNERS: Ohio Dept. of Aging Ohio Dept. of Mental Health Ohio Dept. of Alcohol & Drug Addiction Services Ohio Assn. of County Behavioral Health Authorities

18. Partnership between State and Stakeholder Organizations GOAL: More behavioral health services will be integrated into aging and healthcare services which will increase the effectiveness and access of behavioral and physical health care. OBJECTIVE: Increase collaboration and training opportunities among behavioral health, physical health and aging systems of care.

19. Older Ohioans Behavioral Health Network Outcomes The Network has proven successful in seeding evidence- based and promising practices in counties throughout the state to help older Ohioans live healthy lives.

20. Long-Term Goal Achievement The goal to integrate behavioral health services with other senior-serving programs and activities was accomplished over a 6-year period in a number of concrete ways. Traditional behavioral health partners and senior- serving agencies were expanded to include the elder abuse/elder justice partners - the Ohio Coalition for Adult Protective Services (OCAPS) and the Ohio Attorney General's Elder Abuse Commission.

21. Products Engaging Partners 18 regional seminars for Healthy IDEAs training & implementation (3 certified Ohio Master Trainers) Statewide Lessons Learned session for Healthy IDEAS Behavioral Health presentation to Ohio Coalition for Adult Protective Services conference Presentation at Older Adult and Substance Abuse seminar Panel presentation on I-Teams for Judges Summit 2 Older Adult Statewide Policy Panel Forums held Regional trainings on best practices for older adults 40 mini-grants totaling $185,000 to Area Agencies on Aging and County ADAMH Boards for EBPs Cross-training of 1,780 professionals

22. By-Products of Successful Partnerships Senior Coalitions Interdisciplinary “I-Teams” Developed an Evidence-Based and Promising Practices Tool-kit Web-based Training Module Use of McNeil-Lichtenberg Decision Tree Vial of Life

23. Additional Partners 12 Area Agencies on Aging 53 Alcohol, Drug Addiction and Mental Health Boards 200+ Behavioral Health Prevention & Treatment Providers 60 Consumer-Operated Service Centers Ohio Suicide Prevention Foundation Ohio Coalition for Adult Protective Services Ohio AARP

24. Ohio’s Opiate Epidemic and State Leadership across Systems The Governor’s Cabinet Opiate Action Team attacks the opiate epidemic on behalf of Ohioans to end opiate abuse by reforming prescribing practices for appropriate pain management, punishing those involved in illegal activity, and treating those who are addicted to enable them to return to productive lives.

25. Governor’s Cabinet Opiate Action Team Workgroups: • Enforcement • Treatment • Professional Education • Public Education • Recovery Supports

26. Unintentional Fatal Drug Poisoning Rates and Distribution Rates of Prescription Opioids in Grams per 100,000 population, For Ohio, 1997 to 2007, with Forecasted Data 2008 to 2010

27. Primary Diagnosis of Opiate Abuse or DependenceOhio MACSIS Data – Preliminary 2011

28. Percentage of ODADAS Clients with an Opiate Diagnosis SFY 2001 through SFY 2012* Percentage Year

29. Don’t Get Me StartedCampaign dontgetmestartedohio.org

30. Talking Points – Don't Get Me Started Campaign Drug addiction can happen to anyone. With opiate painkiller abuse, just once is too much. Starting is easy. Stopping isn’t. More overdose deaths are now associated with prescription medications than any other drug, including cocaine or heroin. Taking opiate painkillers not prescribed for you is dangerous and can cause overdose death. The opiates in painkillers are chemically the same as heroin. Opiate painkillers should not be taken for long term chronic pain because they are addictive.

31. Stacey Frohnapfel-HassonChief, Communication & Workforce Development Stacey.frohnapfel.hasson@ada.ohio.gov 614-644-8456

32. Montrose Counseling Center (MCC) Ann J. Robison, PhD, Executive Director

33. Introduction to MCC • Who we are • Mission • Programs

34. Seniors Preparing for Rainbow Years (SPRY) • First SPRY grant: Targeted Capacity Expansion grant for mental health services for GLBT elders • Outreach, Peer Support Groups, Peer Individual Counseling, Counseling with a Licensed Therapist, Case Management, Psychiatry

35. Current SAMHSA Grant SPRY 2 • SAMHSA Older Adult TCE Grant • Suicide and prescription drug abuse prevention for GLBT elders. • Social awareness and prevention programs

36. Current Grant Description • Volunteer Peer Advocates: Screening for depression (as suicide prevention) and prescription drug abuse—PHQ-2, CAGE-AIDE*. Referral into treatment. • Healthy IDEAS*: an evidenced-based depression treatment. Alcohol and drug abuse treatment if needed, psychiatric referral if needed. • Sustainability

37. Outreach • Peer Outreach Worker • Peer Advocates • Volunteers

38. Key Local Partners • Lesbians Over Age Forty (LOAF) • Prime Timers • Four Seasons • Lesbian Health Initiatives • Legacy Community health Services • Aging Policy Advisory Council (AAA) • Ongoing services funded in Part by AAA

39. Key State Partners • State - MCC is funded by: • DSHS Substance Abuse Services – Treatment and COPSD • TDHCA – Emergency Shelter Housing • Office of the Governor – Victim’s of Crime Act • Office of the Attorney General – Sexual Assault Prevention & Crisis Services • HHSC – Domestic Violence

40. Key Federal Partners • SAMHSA – Targeted Capacity Expansion for Older Americans • SAMHSA – Primary Care & Behavioral Health Integration • Ryan While Care Act • HUD – Continuum of Care

41. Context • MCC attempts to address the needs of a marginalized, underserved and high-risk elder population that is very difficult to reach, especially by traditional providers and programs. • We are piloting programs, such as using volunteer outreach workers, we feel are unique.

42. Thank You Ann J. Robison, Ph.D.Executive DirectorMontrose Counseling Center401 Branard, 2nd FloorHouston, TX 77006Phone: (713) 800-0900E-mail: ajr@montrosecounselingcenter.org