Golden County PEI Programs Overview and Description

1. Golden County PEI Programs Overview and Description Presentation to GROUP DATE

2. Goals • Do our current PEI programs and activities address local priorities? What local priorities are not being met? Are there areas that are getting too much attention? • Do the types of programs reflect our community values? Do the programs promote access and acceptance for the diverse people of California? • Is this the right allocation of our budget across programs and activities? • Do we have the right distribution of programs between Prevention and Early Intervention? • Do our programs link people with early onset of serious mental illness with medically necessary care provided by county mental health programs? Are we doing enough outreach to potential responders to help them identify early signs of potentially severe mental illnesses? • Are we meeting the needs of different underserved populations and age groups? • Are there public health goals we are not addressing that we should?

3. Overview • Background • Golden County PEI Programs Description • Stakeholder feedback and discussion

4. MHSA Requires Counties Prepare a 3-Year Program and Expenditure Plan • Plan must be developed with “meaningful stakeholder input” • Clients and families must be involved in all aspects of community planning process • Plan must be updated annually • “Knowledge is power”

5. How We Collected Program Information All Program Description Excel Workbook Individual Program Questionnaire Stakeholder Presentations Slide Deck

6. Individual Program Description Questionnaire • Filled out individually for each PEI program in the county • Purpose: Collect accurate data about each PEI program

7. Questionnaire Design Guided By Logic Model Does it make a difference? (Short and long-term goals) Where is it going? (Programs) What is it doing? (People served, # of visits) PEI Funding Are there public health benefits? • New and enhanced prevention resources • Outreach and public awareness campaigns • Community strengthening programs • Gatekeeper training and education • Counseling and support • New and enhanced • early intervention • Screening/ referral • Treatment of mild-moderate mental illness • Treatment for new onset SMI • Increasedcollaboration and coordination among agencies • System change efforts • More and better prevention • Exposure to social marketing efforts • More teachers trained • More parents receiving coping skills training • More and better early intervention • Access/utilization of first-break early intervention programs • Use of school-based counseling services • Reduced suicide • Mental-health related • Prolonged suffering • Incarceration • Homelessness • School drop out • Foster care • Unemployment • Differences across groups • Changed knowledge, behaviors and attitudes • Increased general knowledge and supportive attitudes about mental illness • Increased identification of at-risk clients • Increased help-seeking • Decreased risk behaviors • Improved resilience and emotional well-being • Decreased psychological distress • Improved individual functioning • Improved family functioning • Increased community resiliency • Community Planning Process • Identified needs • Target populations

8. Golden County PEI Programs –What Information We Will Provide • List of programs and characteristics • Cost • Count of participants • Intensity • What activities programs are doing and distribution of dollars across activities • Target participant characteristics • Short term goals • Public health goals

9. List of Programs and Characteristics

10. Distribution of Programs by Primary Focus

11. Types of Activity • Outreach and public awareness campaigns • Community strengthening • Gatekeeper education and training • Counseling and support • Screening and referral • System change efforts • Clinical services for early intervention

12. How Many Programs are Doing Each Type of Activity?

13. How are PEI Funds Distributed Across Activities?

14. How Intensive are Programs?

15. Demographics of Participants • Race/Ethnicity • Primary Language • Age groups (children, school-age, TAY, adults, seniors) • Gender • Special populations • Veterans, military • Foster care, undocumented, undeserved • Low income, Medicaid eligible • LGBTQ

16. How many programs mainly target each racial/ethnic group?

17. How many programs mainly target each age group?

18. How Many Programs Target Special or Underserved Groups?

19. Are Materials and Program Activities Provided in Languages Other than English?

20. How Many Programs Mainly Address Each Short-Term Goal?

21. How Many Programs Seek to Reduce Each Public Health Problem?

22. Questions for Stakeholders • Do our current PEI programs and activities address local priorities? What local priorities are not being met? Are there areas that are getting too much attention? • Do the types of programs reflect our community values? Do the programs promote access and acceptance for the diverse people of California? • Is this the right allocation of our budget across programs and activities? • Do we have the right distribution of programs between Prevention and Early Intervention? • Do our programs link people with early onset of serious mental illness with medically necessary care provided by county mental health programs? Are we doing enough outreach to potential responders to help them identify early signs of potentially severe mental illnesses? • Are we meeting the needs of different underserved populations and age groups? • Are there public health goals we are not addressing that we should?

23. Back-Up SlidesCan Be Used If More Detail Is Required

24. Overview of Questionnaire Items 1. What is the name of the program you are describing? (Please provide full name and any acronym commonly used)

25. 2. Is this program primarily focused on: (Please check one box) 1Prevention, or 2Early intervention, or 3System change efforts

26. 3. What are the main activities that this program carries out? Many programs do a bit of everything, so try to identify the most important activities for this program, which are directed at the target population for the program. Please refer to Guide below in determining program activities. (Check all that apply) 1Outreach and public awareness campaigns 2Community strengthening 3Gatekeeper education and training (including program staff training) 4Counseling and support 5Screening and referral 6System change efforts 7Clinical services for early intervention 8Other – what activity? __________________________

27. 4. What was the approximate total amount of PEI funding for this program in fiscal year 2012-13? Do not include funding for the program that comes from other sources. $ ____________

28. 5. Please indicate as best you can how the total funding was used across the main activities of this program in fiscal year 2012-13. If an activity is not part of this program, leave the line blank. ACTIVITIES% OF total program FUNDING Outreach and public awareness campaigns %_________ Community strengthening %_________ Gatekeeper education and training %_________ Counseling and support %_________ Screening and referral %_________ System change efforts %_________ Clinical services for early intervention %_________ Other – what activity? %_________ 100% = TOTAL FUNDING

29. 6. What is the intensity of this program’s main activities taken as a whole? (Please check one box) 1 Single or light touch activities 2 More intensive activities 3 Both levels

30. About how many individuals were served by this program in 2012, based on a duplicated and/or unduplicated count? • Duplicated count – individuals may be counted more than one time if they receive several services within one program within the same reporting period. • Unduplicated count – individuals are counted only once, no matter how many different services a client is receiving within a program in the same reporting period. 7. Please provide an unduplicated count if possible. ______________ Number of unduplicatedindividuals or [ ] Unduplicated count not available

31. 8. Please provide a duplicatedcount if available. ______________ Number of duplicated individuals or [ ] Duplicatedcount not available

32. 9. What are the age groups mainly targeted by this program? (Check all that apply) 1Children – Age 0-15 2TAY – Age 16-25 3Adults – Age 26-59 4Seniors – Age 60+ 5No main group(s) – targets all ages equally

33. 10. What are the race/ethnicities mainly targeted by this program? (Check all that apply) 1Hispanic/Latino 2White 3Black/African American 4Asian 5American Indian, Native American, Alaskan Native 6Native Hawaiian, Pacific Islander 7Other 8No main group(s) – targets all equally

34. 11. Are materials and program activities provided in languages other than English? (Please check one box) 1Yes – most of them 2Yes – some of them 3Materials and activities are in English only

35. 12. What special groups are mainly served by this program? (Check all that apply) 1Veterans 2Military 3Foster care children/youth and/or families 4LBGTQ 5Undocumented immigrants 6Low income, Medicaid eligible 7Underserved 8Program designed to serve everyone, no targeting of any special group 9Other 10NONE OF THESE

36. 13. In the design or operations of this program have there been any specific adaptations to make it more culturally appropriate for the target group(s)? (Please check one box) 1Yes 2No 3Not applicable

37. 14. We are going to ask about the program and public health goals targeted by this program. Programs may have multiple goals so please try to identify the main goals for the program. What are the main goals for this program? By goals we mean the most immediate intended results of this program. (Check all that apply) 1Increased knowledge and more supportive attitudes about mental illness 2Decreased risk behaviors and/or increased coping skills 3Decreased distress and/or fewer and less severe symptoms Could also include preventing crisis situations from escalating 4Improved individual functioning (could be at home, school, and work) and increased resilience and well-being 5Improved family functioning 6Increased help-seeking and utilization of additional assessment and/or treatment services 7Increased community resiliency, such as improved social climate, reduced stigma and discrimination, and more social supports available in the community 8Improved systems of care which could include more coordinated and culturally responsive services, increased capacity and access, improved policies and protocols for how individuals move between systems (e.g.,primary care to specialty care, or juvenile justice to the school system)

38. 15. Programs may or may not directly target public health goals, but may be intended to contribute to reducing mental health related public health problems. What mainpublic healthproblems is this program intended to reduce:(Check all that apply) 1Suicide 2School dropout related to mental health 3Removal of children from the home related to mental health 4Incarceration related to mental health 5Homelessness related to mental health 6Unemployment related to mental health 7Stigma and discrimination related to mental health 8Prolonged suffering related to mental health 9Disparities related to mental health treatment access and/or utilization

39. 16. Are there main program goals that were not covered in these questions? (Please check one box) 1 Yes -> What goals? 2NO, ALL WERE COVERED

40. Guide to classifying program activities OUTREACH AND PUBLIC AWARENESS CAMPAIGNS Purpose:To increase public knowledge and awareness. Target:General public - individuals not identified on the basis of a specific risk factor. Examples:Public service announcements; developing and hosting informational websites; creating and distributing pamphlets or other printed material for wide scale distribution; stigma reduction campaigns; hosting health fairs. Note:Do not include outreach intended to recruit program participants or build community partnerships in this category.

41. Guide to classifying program activities COMMUNITY STRENGTHENING Purpose:To increase community resources and resiliency, or to improve social climate and increase social support. Target:These are universal prevention activities and are not directed towards individuals who have specific risk factors. Examples:A resource or drop in center (if the primary purpose of the resource program is community strengthening); a school-based anti-bullying program directed at the entire school or community; an exercise program for the elderly; NAMI Family to Family programs and vocational programs; Parent education programs for all parents; school readiness programs that are targeted at all children.

42. Guide to classifying program activities GATEKEEPER EDUCATION AND TRAINING Purpose:To train and educate individuals to recognize someone who is in distress and could benefit from further evaluation or treatment and/or to create a safe and non-stigmatizing environment where someone can self-identify as needing help. Target:Community leaders, school personnel, emergency workers, and other gatekeepers. Examples:Teacher training programs, training for suicide hotline operators, training for outreach workers and community leaders. Note:This category includes training of program staff.

43. Guide to classifying program activities COUNSELING AND SUPPORT Purpose:To reduce risk factors and increase copies skills. Target:At-risk individuals, rather than individuals with a known diagnosis. These programs do not include universal prevention programs. Examples:Peer support programs; Resource centers (if the primary purpose is to provide counseling and support); Suicide hot and warm lines; Parent training programs for children with identified needs or risk factors; Violence prevention programs directed at selected children or youth; Promotoras home visiting programs. Note:These activities are generally conducted by individuals who are not licensed mental health clinicians.

44. Guide to classifying program activities SCREENING AND REFERRAL Purpose:To identify individuals who might benefit from additional assessment and/or counseling. Target:At risk individuals such as foster youth, new moms, frail elderly. Examples:School-based screening; suicide hot and warm lines, some Promotoras programs.

45. Guide to classifying program activities SYSTEM CHANGE EFFORTS Purpose:To improve system functioning in order to increase appropriate identification of need and access to services. Target:Public and private systems. Examples:Efforts to develop and disseminate culturally appropriate policies and procedures and culturally competent services, as well as data systems to track individuals. Development of referral networks and efforts to increase and make more efficient collaboration across systems and programs. Efforts to increase access and capacity by reducing inefficiencies could also be included here.

46. Guide to classifying program activities CLINICAL SERVICES FOR EARLY INTERVENTION Purpose:To keep mental illnesses from becoming chronic and increasing in severity. Target:Individuals with either a known or likely diagnosis or symptoms related to a diagnosis. Examples:First break psychosis programs, PTSD/PTSD symptom treatment programs; primary care integration programs; school-based trauma treatment; family therapy. Note:These activities are generally conducted by licensed mental health clinicians.

47. Duplicated vs. Unduplicated Counts • Duplicated Count: Refers to a program participant who may be counted more than one time in a grant year. This might occur if a client received multiple services in the same reporting period within one program or across multiple programs • Unduplicated Count: is one (1) person/client that is counted only once, no matter how many different services the client is receiving during the funding period– could be within or across programs. • Can we get unduplicated counts? • Within individual PEI programs? • Across PEI programs in a county? 47

48. Methods for Capturing Unduplicated Counts • Enroll participants and assign program IDs • Use an online system to support unique records • Create prepopulated service forms with client name and ID for providers • Train providers in the importance and methods for enrolling and tracking services • Have programs submit data on individuals (without personal identifiers) for more meaningful analyses • Or – agree that unduplicated counts are OK, but be consistent and clear

49. How We Handle Counts • Collected “duplicated” counts for all programs • This is most common form of information counties have • Graphic displays based on “duplicated” counts since most programs can provide this information