STATE OF MARYLAND Department of health and mental Hygiene

1. STATE OF MARYLAND Department of health and mental Hygiene Mental Hygiene Administration Office of Special Needs Populations Access to Recovery Provider Forum October 24, 2013

2. Office of Special Needs Populations • Office within the Mental Hygiene Administration • Responsible for planning, development, monitoring, and coordination of services for adults who have a mental illness who are considered special populations • Special Populations • Homeless • Those incarcerated in local detentions or transitioning from prison • Trauma survivors – physical or sexual abuse or as a result of a man-made or natural disaster • Deaf and Hard of Hearing

3. Office of Special Needs Populations’ Programs • Criminal Justice – Maryland Community Criminal Justice Treatment Program (MCCJTP), Trauma, Addictions, Mental Health and Recovery (TAMAR), Chrysalis House Healthy Start Program, Reach-In Program (partnership with Department of Public Safety and Correctional Services) • Homelessness– Projects for Assistance in Transition from Homelessness (PATH), Shelter Plus Care Housing, SSI/SSDI, Outreach, Access, and Recovery (SOAR), Homeless ID Project

4. (MCCJTP) - Jail Project Maryland Community Criminal Justice Treatment Program • Was started in 1992 as a pilot project in 4 local detention centers to meet the comprehensive needs of those who have a mental illness and to reduce recidivism to homelessness, detention centers, and psychiatric hospitals. • Currently funded at $1.9 million and operational in 22 local detention centers • Provides jail-based mental health services, including: screening, assessment, case management, therapy, crisis intervention, medication management, aftercare planning, and diversion. • In FY 2012, an estimated of 9,600 referrals, providing over 6,000 hours of psychiatric services, nearly 22,000 hours of combined individual and group psychotherapy, and 21,000 hours of case management. • Estimated recidivism rate between 5 to 10 percent.

5. TAMAR In 1998 the Office of Special Needs Populations received $824,331 over two years from the Substance Abuse and Mental Health Services Administration (SAMHSA) through the Women and Violence Demonstration grant. Maryland was one of fifteen sites across the nation and the only site to focus on women in the criminal justice system. This pilot project provided a full array of training and clinical services to women incarcerated in detention centers who have been traumatized by physical or sexual abuse. Currently funded at $440,000 through state funding and provides treatment for over 500 incarcerated men and women who have histories of trauma and have been diagnosed with a mental illness and co-occurring substance use disorder. Services include screening for trauma, 10 week education program, aftercare planning, and community follow up 3 months post-release. Sites: Anne Arundel, Baltimore, Caroline, Dorchester, Frederick, Garrett, Harford, Prince George’s, Washington Counties and Springfield Hospital Center.

6. Chrysalis House Healthy Start Program • The Chrysalis House Healthy Start Program was created by the Mental Hygiene Administration in partnership with various agencies within the Department of Health and Mental Hygiene, the Department of Public Safety and Correctional Services (DPSCS), the Administrative Office of the Courts, Baltimore Mental Health Systems, Inc. and the Archdiocese of Baltimore. • The Chrysalis House Healthy Start Program, which opened in July 2007, is a 16-bed statewide diagnostic and transitional program for pregnant and post-partum women 18 years of age or older and their babies. Provides comprehensive treatment and services including, pre-natal, post partum services, mental health, substance abuse, parenting, trauma, child care, case management, smoking cessation, and childcare. Since program opened over 89 women and 55 babies.

7. Second Chance Grant • Department of Public Safety and Correctional Services (DPSCS) submitted a grant to develop a Reach-In Program in partnership with DHMH. • Grant funds case management and peer support services to 75 individuals per year who have a co-occurring disorder who are transitioning from prison to the community (Baltimore City). • In reach services provided 3-4 months pre-release from prison and 6 months post-release.

8. PATH Program Maryland’s Projects for Assistance in Transition from Homelessness (PATH) was developed in 1991. PATH is a federal formula grant from Substance Abuse Mental Health Services Administration (SAMSHA) Center for Mental Health Services. PATH was created under the McKinney Act of 1990.

9. PATH Program (Continued) PATH provides flexible community and detention center based services to individuals who are homeless or at imminent risk of becoming homeless and have a mental illness or co-occurring substance use disorders. PATH provides the following: • Outreach, screening and diagnostic services • Case management • Community mental health • Alcohol and drug treatment services • Supportive services in residential settings • Housing assistance

10. Continuum of Care (CoC) formerly known as Shelter Plus Care Housing Program In July 1995, the United States Department of Housing and Urban Development (HUD) granted MHA a 5.5 million Shelter Plus grant to provide housing for five years to individuals who were homeless who had a serious mental illness and were coming out of jail. A total of $24 million dollars of Shelter Plus Care Housing funding has been obtained since the program’s inception.

11. Continuum of Care (CoC) formerly known as Shelter Plus Care Housing Program (Continued) • Shelter Plus Care (S+C) Housing Program is authorized • under Subtitle F of the McKinney-Vento Homeless • Assistance Act. • The purpose of the program is to provide permanent • housing in connection with supportive services to • homeless people with disabilities and their families. • Unlike transitional housing programs, no time limit can be • placed on tenancy in a Shelter Plus Care assisted unit. • However, rental assistance is contingent on federal HUD • funding being available.

12. SOAR Initiative SSI/SSDI Outreach, Access and Recovery (SOAR) is a strategy that helps states to increase access to mainstream benefits for individuals who are homeless or at risk of homelessness through training, technical assistance and strategic planning. Typically 10 – 15 percent of all homeless adults who apply for Supplemental Security Income (SSI) and Social Security Disability Insurance (SSDI) Programs through the Social Security Administration (SSA) are approved on the initial application. Access to these benefits can be very challenging for individuals who are homeless with mental health problems due to the complexity of the process. Nationally through SOAR, 66% of SSI and SSDI applications are approved on the initial application in an average of 98 days.

13. Maryland’s SOAR Outcomes (September 2013) • Within Maryland as a whole, there has been 570 SOAR related approvals (81%). • Many applicants have previously had claims denied prior to using the SOAR process. • Average processing time for initial claims is 71 days. • Over $2.5 million in federal dollars are estimated to have been brought into the state through the SOAR Program.

14. Homeless ID FUND Individuals are often unable to access services and other supports due to lack of identification. In FY 2012, MHA has been awarded $500,000 in funding through Alcohol Tax Appropriation to provide birth certificates, state identification, and assistance with SOAR and other entitlements for individuals who are homeless and at risk for homelessness.

15. Deaf and Hard of Hearing The letter O The letter Y The Office of Special Needs Populations works with community-based programs, Springfield Hospital Center, and the Maryland Advisory Council for the Deaf and Hard of Hearing to ensure individuals who are deaf or hard of hearing and have a mental illness have access to community and inpatient services . Currently, services are available through PMHS and with additional supports and interpreting services funded $644,089 in state funding.

16. Deaf Services • Coordinate and monitor the delivery of interpreting and cultural competent services provided through signing staff, which supports outpatient mental health, supported employment, residential rehabilitation, and psychiatric rehabilitation services. • Collaborate with Governor’s Office of Deaf and Hard of Hearing and Deaf-blind to provide cultural sensitivity and awareness training to agencies. • Represent the department on the Maryland Advisory Council on Deaf and Hard of Hearing and the behavioral health subcommittee. • Examine best practices and explore resources to implement these practices, i.e. tele-psychiatry, regional treatment teams, WRAP training, etc.

17. Behavioral Health Disaster Services The Office of Special Needs Populations has the responsibility for coordinating the delivery of behavioral health services in response to natural and man-made disasters. The Mental Hygiene Administration has been the recipient of several grants from SAMHSA’s Center for Mental Health Services and the Federal Emergency Agency. Isabel Outreach Project which provided short-term crisis counseling to assist survivors of Hurricane Isabel with recovery. Emergency Response Capacity grant to assist Maryland’s Mental Hygiene Administration and Alcohol and Drug Abuse Administration to develop coordinated, All-Hazards Behavioral Health Disaster Plans.

18. Other Office Activities • SB 556 Work Group to expand trauma informed care to state psychiatric hospitals • HIV Community Planning • Mental Health and Criminal Justice Partnerships • Represent MHA on Veterans Workgroups • Homeless Continuum of Care Planning • Housing Workgroups

19. Moving Forward Behavioral Health Integration • Under Deputy Director, Clinical Services. • Special Populations, Women’s Services, Treatment and Recovery, Adult Service Combined Office. • Opportunity for further coordination, blending of resources, and provide services in an integrated manner.

20. Contact Information (continued) Office of Special Needs Populations, Mental Hygiene Administration, Spring Grove Hospital Center – Dix Building 55 Wade Avenue, Catonsville, MD 21228 Phone (410) 402-8353 Fax (410) 402-8301 marian.bland@maryland.gov

21. THANK YOU