FY2006/2007 Mental Health Block Grant: An informational meeting

1. FY2006/2007 Mental Health Block Grant: An informational meeting May 25, 2006 Capitol View Michigan Department of Community Health

2. Introduction Irene Kazieczko Director Bureau of Community Mental Health Services

3. Mental Health Block Grant - Overview • SAMHSA directives • Mental Health System Transformation • Eliminate barriers to recovery • Development of new high quality and culturally relevant initiatives • Working in conjunction with consumers and other stakeholders

4. Mental Health Block Grant - Purpose • Look at the current system of care • Identify barriers in achieving and maintaining recovery • Describe how these gaps were identified • How consumers are involved in identifying these gaps • Proposals should identify how this will fill the identified gaps

5. Block Grant ProposalsFunding and other requirements Patricia Degnan Manager Service Innovation and Consultation

6. Block Grant Proposals – Funding and Requirements • Starting FY 2007 • Direct Services – Proposals must be two years • Maximum of $100,000 for the first year • Maximum of $50,000 with an equal contribution from CMHSPs • Training only and one time purchases – Maximum of $75,000 • Clubhouse training - $75,000 • Evidence-Based Practice – use May 2005 RFP

7. Block Grant Proposals – Funding and Requirements • No limit as to the number of proposals • Second year funding will be based on satisfactory progress achieved during the first year • Each CMHSP must complete Attachment C.1 for the entire system • Attachment C.2 must accompany each proposal

8. Block Grant Proposals – Funding and Requirements • Workplans must be very specific • Each proposal must address how other local pertinent community agencies will be involved • Continuation plan – including funding availability • Face sheet – list program areas and target population • Proposal reviews • Target population

9. Block Grant Proposal - Submission • Use of Block Grant funds • Proposal requirements • Proposal reviews, review criteria • Submit electronically to Karen Cashen at cashenk@michigan.gov no later than 5:00 p.m. on June 26, 2006 • Proposal face sheet must be signed by the CMHSP Director and received no later than 5:00 p.m. on June 26, 2006

10. Co-Occurring Disorders:Integrated Dual Disorder Treatment (IDDT) Tison Thomas Thomasti@michigan.gov

11. IDDT: Program Enhancement • Evidence-Based Practice • Resource kit • May 2005 RFA • System change initiatives • IDDT program development • Right to access effective services • Same team, same location, same time • Competitive grant and is for CMHSPs

12. IDDT: Program Enhancement • Those who initiated the system change process and has an identified IDDT team • Funding is for certain Treatment Characteristics • Must be supported by IPLT • Work closely with the IDDT team and coordinate the project activities with the team

13. IDDT: Program Enhancement • Must screen for Co-occurring disorders • Assess the level of severity of COD and stages of recovery • IPOS must address both MH and SA goals and match stage of recovery • Work with the State COD:IDDT subcommittee

14. IDDT: Program Enhancement • Multidisciplinary Team • Stage-wise Interventions • Access to Comprehensive Services • Assertive Outreach • Motivational Interviewing • Substance Abuse Counseling • Group Treatment • Self-Help Group • Peer Support Specialist

15. EBP:COD:IDDT • PIHPs only • Non-competitive • May 2005 RFA requirements • 20 steps • $140,000 total for two years • IPLT membership • CA membership • State IDDT Subcommittee membership

16. Family Psychoeducation Judy Webb Webb@michigan.gov

17. Family Psycho-Education • Funding available to PIHPs that did not receive MHBG funding for 2005-07 for FPE (Nine are currently being funded) • Proposals are non-competitive • Use May 2005 Request for Application Requirements posted on MDCH web site

18. Family Psycho-Education • $140,000 for two years • Expectations: • Clinicians will participate in 3-day training with Dr. Bill McFarlane (Cost of training includes the provision of supervision from one of his colleagues) • Site will send participants to quarterly “Learning Collaboratives” • Site will participate in University of Michigan’s evaluation

19. Family Psycho-Education • Additional expectations: • FPE Program Leader will attend the state FPE subcommittee meetings • FPE Program Leader will be part of the local Improving Practices Leadership Team

20. Family Psycho-Education • RFA: • Work plan • Check list • Budget: • $5,000 for 2 year evaluation (voluntary) • Approximately $500/per clinician for training & supervision (travel expenses are additional) • Approximately $180/year/participant in Learning Collaboratives (travel expenses are additional)

21. Family Psycho-Education Resources • MDCH web site: • www.michigan.gov/mdch click on Mental Health and Substance Abuse, then “Evidence Based Practice”, then Family Psycho-Education • www.michigan.gov/mdch click on Mental Health and Substance Abuse, then Mental Health, then Reports and Proposals, and scroll to Evidence Based Practice Request for Proposals Q & A and FY 2006 Request for Proposals • www.samhsa.gov Click on Evidence-Based Practices Implementation Resource Kits/Family Psycho-Education

22. RECOVERY TRANSFORMATION SYSTEMS Colleen Jasper jasper@michigan.gov

23. The Recovery Vision: • People can and do recover • Personal journey for each person • Belief in recovery for everyone with mental health problems is essential • Barriers to recovery needs to be addressed

24. Applicants for Grants: How to support recovery in your system • Education of staff and consumers on recovery • Various different models of recovery can be utilized (Mary Ellen Copeland) (WRAP) • Proposed plan needs to have 80% participation of consumers with 20% staff • Several documents can help a. Consensus Statement b. 101 Ways to Facilitate Recovery c. Recovery Council Mission Statement

25. Advance Directives Colleen Jasper Jasper@michigan.gov

26. Advance Directives (AD): • In Michigan Statute • Designee of patient advocate • Forms and documents website: notice to be sent to all CMHSPs • Assist in filling out forms, etc.

27. AD Consumer Involvement: • Training, education and support of AD • Consumers involved distribution of training of AD • Consumers to consumer training • Other forms of AD can be used

28. Anti-Stigma Colleen Jasper Jasper@michigan.gov

29. Anti-Stigma: • Stigma is the major barrier to recovery • Exists widely in both community and systems • Best way to fight interpersonal connections • Hearing consumers stories • Realistic viewpoint of mental illness

30. Anti-Stigma: • Involve both systems and community by primary consumers • Support groups, plays, publications, artwork, open forums, open gatherings, etc. • Sustainability of projects.

31. Anti-Stigma: (continued) • How to fight stigma a. Involve consumers b. Creative c. Helps consumer with leaderships, self esteem and recovery

32. Trauma Colleen Jasper Jasper@michigan.gov

33. Trauma Informed System: • 80% percent of consumers experience trauma in their lifetime • Post-traumatic stress disorders (PTSD) is a main factor • Trauma affects many of life’s domains • Emerging practice

34. Responses: • Written position paper on PTSD • Screening and assessment of individuals coming into the system • Clinical practice, guidelines and treatment approaches • Collaborative approach integrating substance abuse and mental illness • Trauma awareness for staff and consumers • Reduction or elimination of seclusion and restraints • Continuation of funding • Consumers need to be involved in aspects in a trauma-informed system

35. Assertive Community Treatment Alyson Rush Rusha@michigan.gov

36. Population characteristics : 1)adults with SMI who have difficulty managing medications without on-going support, or with psychotic/affective symptoms despite medication compliance 2)adults with SMI who also have a co-occurring substance use disorder 3)adults with SMI exhibiting socially disruptive behavior that puts them at high risk for arrest and inappropriate incarceration or those exiting a county jail or prison 4)adults with SMI who are frequent users of inpatient psychiatric hospital services, crisis services, crisis residential or homeless shelters 5) adults over 65 years with SMI with complex medical/medication conditions

37. Population needs enhanced: 1)supported employment activities 2)educational supports 3)community integration 4)leisure activities 5)consumer involvement on teams 6)team/staff/program fidelity

38. Guidance: 1)consider exploring other successful projects/practices/services for replication 2)explain how need identification occurred in the existing service system to find gaps effecting ACT consumers 3)identify how the service gaps will be addressed (supports, services, staff training, etc.) 4)describe consumer involvement in identification of gaps, planning and creating the proposal 5)provide a clear description of the proposed outcomes to address the service gaps pin the current system 6)describe methods that will evaluate the success of the proposal 7)  tie the workplan, outcomes, evaluation and budget all together describe how the proposal will be integrated into the current mental health system after the grant funding ends

39. Older Adults Alyson Rush Rusha@michigan.gov

40. Population characteristics: 1)are over 65 years of age diagnosed with a serious mental illness 2)may be at risk of suicide 3)have depression or another serious mental illness due to co-occurring medical conditions, chronic diseases or a substance use disorder 4)have Alzheimer’s or another dementia disorder with delusions, depressed mood, behavioral disturbances or another mental illness 5)are family caregivers of isolated older adults with mental illness or progressive disabling medical conditions

41. Population needs: 1)committed outreach into the community to identify and serve older adults with SMI 2)prompt and easy access to mental health services 3)service penetration rates equal to or above the representation in the service area population 4)improved availability of quality mental health supports-including staff with training in geriatrics 5)improved availability of quality mental health supports and services for family caregivers and awareness of it 6) improved knowledge and skills of PIHP, CMHSP and providers

42. Guidance: 1)consider exploring other successful projects/practices/services for replication 2)explain how identification occurred in the existing service system to find gaps effecting the population and their caregivers 3)identify how the identified service gaps will be addressed 4)describe how consumers or their caregivers were involved in planning and creating the proposal 5)provide a clear description of the proposed outcomes to address the service gaps in the current system 6)describe methods that will evaluate success of the proposal 7)tie the workplan, outcomes, evaluation and budget all together! 8)describe how the proposal will be integrated into the current mental health system after the grant funding ends.

43. Rural Initiatives Alyson Rush Rusha@michigan.gov

44. Population characteristics in adults: 1)experiencing Schizophrenia 2)Affective disorders 3)Anxiety disorders 4)Suicidal ideation

45. Population needs: 1)The knowledge to recognize serious mental illness 2)ability or willingness to access treatment 3)to have barriers such as (transportation, age, isolation, substance misuse or unemployment) accessibility and availability addressed 4)knowledgeable and trained staff to provide service 5)access to services that have proven to be effective and efficient

46. Guidance: 1)Consider exploring other successful projects/practices/services for replication 2)explain how the need was identified as a gap in service in the existing system 3)identify how the service gaps will be addressed (supports, services, staff training, etc.) 4)describe the consumer involvement in identification of gaps, planning and creating the proposal 5)provide a clear description of the proposed outcomes to address the service gaps in the current system 6)describe the methods that will evaluate success of the proposal 7)tie the workplan, outcomes, evaluation and budget all together 8)describe how the proposal will be integrated into the current mental health system after the grant funding ends

47. Other Types of Projects Alyson Rush

48. Other Types of Projects • Not all needs or service gaps related to System Transformation will be addressed in the previous sections. • Proposals that fit no other category may be submitted under this category. • Identify “Other” on the Face Sheet. • Proposals in this category may be submitted by both CMHSPs and PIHPs

49. Other Types of Projects (cont.,) • Proposals may include other initiatives that have a strong base of evidence for both effectiveness and efficiency • Explain clearly how the need was discovered and how the gap impacts the ability of people experiencing Serious Mental Illness to move toward Recovery • Describe the consumer involvement in the process

50. Other Types of Projects (cont.,) • Explain how this need will be addressed for individuals, the program, the agency, the system, etc. • Clearly tie the identified need with the workplan, the anticipated outcomes, the evaluation , the budget and the system integration plan. • Describe clearly how this project/service, etc. will be integrated into the current mental health system after the grant funding ends.