fy2006/2007 mental health block grant: an informational meeting

FY2006/2007 Mental Health Block Grant: An

informational meeting

May 25, 2006

Capitol View

Michigan Department of Community Health

Introduction

Irene Kazieczko

Director

Bureau of Community Mental Health Services

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

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

Block Grant ProposalsFunding and other

requirements

Patricia Degnan

Manager

Service Innovation and Consultation

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

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

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

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

Co-Occurring Disorders:Integrated Dual Disorder

Treatment (IDDT)

Tison Thomas

Thomasti@michigan.gov

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

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

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

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

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

Family Psychoeducation

Judy Webb

Webb@michigan.gov

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

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

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

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)

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

RECOVERY TRANSFORMATION SYSTEMS

Colleen Jasper

jasper@michigan.gov

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

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 Statementb. 101 Ways to Facilitate Recoveryc. Recovery Council Mission Statement

Advance Directives

Colleen Jasper

Jasper@michigan.gov

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.

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

Anti-Stigma

Colleen Jasper

Jasper@michigan.gov

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

Anti-Stigma:

Involve both systems and community by primary consumers

Support groups, plays, publications, artwork, open forums, open gatherings, etc.

Sustainability of projects.

Anti-Stigma: (continued)

How to fight stigma

a. Involve consumers

b. Creative

c. Helps consumer with leaderships, self esteem and recovery

Trauma

Colleen Jasper

Jasper@michigan.gov

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

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

Assertive Community Treatment

Alyson Rush

Rusha@michigan.gov

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

Population characteristics :

1)     supported employment activities

2)     educational supports

3)     community integration

4)     leisure activities

5)     consumer involvement on teams

6)     team/staff/program fidelity

Population needs enhanced:

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 proposal7)  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

Guidance:

Older Adults

Alyson Rush

Rusha@michigan.gov

1) are over 65 years of age diagnosed with a serious mental illness

2) may be at risk of suicide3) 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

Population characteristics:

1) committed outreach into the community to identify and serve older adults with SMI

2) prompt and easy access to mental health services3) service penetration rates equal to or above the

representation in the service area population4) improved availability of quality mental health supports-

including staff with training in geriatrics5) improved availability of quality mental health supports

and services for family caregivers and awareness of it6) improved knowledge and skills of PIHP, CMHSP and

providers

Population needs:

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 addressed4)  describe how consumers or their caregivers were involved in planning

and creating the proposal5)  provide a clear description of the proposed outcomes to address the

service gaps in the current system6)  describe methods that will evaluate success of the proposal7)  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. 

Guidance:

Rural Initiatives

Alyson Rush

Rusha@michigan.gov

1)     experiencing Schizophrenia

2)     Affective disorders

3)     Anxiety disorders

4)     Suicidal ideation

Population characteristics in adults:

1) The knowledge to recognize serious mental illness2) ability or willingness to access treatment3) to have barriers such as (transportation, age,

isolation, substance misuse or unemployment) accessibility and availability addressed

4) knowledgeable and trained staff to provide service5) access to services that have proven to be effective and

efficient

Population needs:

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 proposal7)  tie the workplan, outcomes, evaluation and budget all together8)  describe how the proposal will be integrated into the

current mental health system after the grant funding ends

Guidance:

Other Types of Projects

Alyson Rush

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

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

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.

Case Management

Pam Werner

Wernerp@michigan.gov

Case Management

MDCH will support projects that improve the ability and capacity for case managers to assist consumers in attaining goals as identified in the person-centered planning process

Peer Support Specialists

Pam Werner

Wernerp@michigan.gov

Peer Support Specialists

Expanded as a b(3) additional service and required as a choice in the PCP process.

Promote community inclusion, participation, independence, and productivity.

Successful proposals will be given priority to attend MDCH peer training at Ralph MacMullen Center

Proposals for Peer Support Specialists must include:

Information on recruitment, training, support and matching with case managers

Determination of work hours and schedules Direct hire or subcontract If subcontract, why? Supports that will be provided for successful

employment Team member training Supervision and mentoring Sustainability

Person-Centered Planning

Pam Werner

Person-Centered Planning

Strengthening the practices and processes Partnership with beneficiaries in writing the

proposal Look at the relationship of person-centered

processes and recovery, natural supports, independent facilitation, carrying out goals, dreams and desires in the plan

Self-Determination for People with Mental Illness

Pam Werner

Self-Determination for Persons with Mental Illness

Proposals must contain:• Documentation that over 50% of stakeholders

involved in the proposal process were consumers

• How SD principles will be implemented

• Knowledge, networking and advocacy will occur

• Systems change to support recovery

Self-Determination for Persons with Mental Illness Proposals Must Contain (cont.,)

Support from Program Directors, Management and leadership in implementation efforts

How consumers will be involved in development, implementation and evaluation of the grant.

Sustainability of consumer positions if hired

Consumer Run, Delivered, or Directed Initiatives

Michael Jennings

Jennings@michigan.gov

Drop-in Program Development or Enhancement

Identify and explain how gaps in the system of care are preventing consumers with serious mental illness from achieving their goal of recovery.

For proposals that seek the development of transportation supports and maintenance or the provision of support of current consumer programs in the area of equipment purchases, computer training, furniture/supplies that will enhance the facility, the proposal must address how these services, activities or items will fill identified gaps and what specific outcomes can be expected.

Proposals must be a partnership between the CMHSP and the consumer-run drop-in

The partnership must reflect the collaborative development of the proposal, sharing of budget information, narrative program implementation, quarterly narrative progress report format, and by supplying a sub-agreement or sharing the grant award contract when the award is made.

Drop-in Program Development or Enhancement Continuation

Proposals should demonstrate how both the CMHSP and the consumer groups are equally involved in the total preparation and implementation of any grant initiatives submitted.

Proposals should be address the values of the public mental health systems to reduce stigma, promote recovery, facilitate independence,, personal responsibility and allow for full participation in community life.

Promote consumer choice Maximize the opportunities for consumer autonomy

and peer directed and run service alternatives.

Block grant support in these areas should demonstrate outcomes which support system transformation and consumer recovery which is the goal of the block grant effort.

Drop-in Program Development or Enhancement Continuation (cont.,)

CONSUMER Run, Delivered or Directed Innovations and Replications

Proposals should target the development of innovative, new consumer-run, delivered or directed initiatives.

Examples such as Project STAY, Person Centered Planning within a drop-in center setting, Peer Case Management Support and Statewide Resource Development are encouraged.

It is expected that all proposals in this area address all of the review criteria contained in the FRP.

Equipment purchases, supplies, furnishing, computer training etc., require addressing each of the review criteria for funding along with the primary criteria of identifying gaps and specific outcomes related to systems transformation and assisting consumer to achieve and maintain recovery

CONSUMER Run, Delivered or Directed Innovations and Replications (cont.,)

Jail Diversion

Michael Jennings

Jennings@michigan.gov

Jail Diversion Please note Section 207 of the Michigan Mental Health Code

requirement for all CMHSP to provide services designed to divert persons with serious mental illness, serious, emotional disturbance or developmental disability from possible jail incarceration when appropriate.

Proposals in the jail diversion area must utilize The Council of State Government’s Criminal Justice/Mental health Consensus Project report as the basis for systems transformation and consumer recovery.

Proposals must go beyond the basic MDCH requirements related to jail diversion and implement aspects of the forty six (46) policy statements contained in the Consensus Report. Reference material can be found at http://consensusproject.org/pvt/home

Special Populations

Michael Jennings

Special Populations Innovative ideas for any special population of people with

serious mental illness such as women, ethnic minorities, individuals with co-occurring disorders/mental health/criminal justice needs are encouraged.

Special populations who may require unique services and supports based on cultural diversity, ethnic diversity, unique barriers or differences not mentioned in any of the other targeted areas.

Special population proposals can address any of the aforementioned categories with the emphasis placed on a special population.

Submit proposals in this area and not any other specialty areas focus.

All proposals must demonstrate an effort and direction towards system transformation and consumer recovery.

IMPORTANT NOTE MDCH contracts require that any service, or activity

funded in whole or in part with this funding be delivered in a smoke free facility or environment.

This RFP emphasizes that the following restrictions include: NO VEHICLE PURCHASES, LEASES OR VEHICLE INSURANCE.

NO ADMININISTRATIVE OR INDIRECT expenses

All quarterly narrative progress reports must utilize and conform to the contract outline provided in attachment C of the signed contract.

Supported Housing and Homeless

Sue Eby

Ebys@michigan.gov

Collaboration is the key

To ending homelessness and expanding independent

living options for people with disabilities

Principles of collaboration

Develop and agree on a set of common goals and principles

Share leadership and responsibility for attaining those goals

Use expertise of each group member Acknowledge that working this way takes time Embrace consensus building, shared decision

making and resolving conflict

Advantages of Collaboration

Stimulates excitement at local level Collaboration has more credibility,

influence, and ability to accomplish objectives than a single entity

Encourages a comprehensive approach, reduces duplication

Ensures all voices are heard Creates sustained change

Local Housing and Service Collaborations are producing Supportive Housing

Human Service Agencies• Co-led by social services, include Area Agencies on Aging,

MI Choice Waiver Agents, Centers for Independent Living, mental health, substance abuse, jobs, and other service providers

Local Governments• Co-led by largest city or county• Include other local jurisdictions

Nonprofit sponsors and advocates• Some with housing experience• Some service providers

Design your Community Mental Health Block Grant Proposal to build on local collaborations

Local supportive housing consortium (Allegan, Genesee, Grand Traverse/Benzie, Kalamazoo, Kent, Livingston, Oakland, Ottawa, Washtenaw, Wayne (Out-County) john.peterson@csh.org

Local Continuum of Care process and homeless initiatives. http://www.michigan.gov/documents/mshda_Continuum_of_Care_Contact_List_81043_7.xlsLocal housing authority Https://pic.hud.gov/pic/haprofiles/haprofilelist.asp

City and county government, non-profit housing

Collaboration can produce…

The joy of it…

• Homeless for over 10 years, now has completed college and has his own web design business

Charles at home

Model projects

Southwest Solutions at http://www.swsol.org/

Washtenaw County

http://whalliance.ewashtenaw.org/blueprint

What is a Housing Choice Voucher?

Formerly called Section 8s Rental assistance Tenant Pays 30-40% of their income for

rent plus utilities, HUD subsidy pays the rest

Less than 50% of median income Housing Quality Standards must be met

Limits on price of unit

Accessing available Housing Choice Vouchers

Housing Choice project based vouchers (http://www.mshda.info/housing/)

MSHDA Housing Choice Vouchers tenant-based voucher(http://www.michigan.gov/mshda/0,1607,7-141-5555_23634-22085--,00.html)

PHA Housing Choice tenant-based vouchers PHA housing (

Https://pic.hud.gov/pic/haprofiles/haprofilelist.asp

Other sources of assistance with housing

Dept. of Human Services (www.michigan.gov/dhs) County office locations: http://www.michigan.gov/dhs/0,1607,7-124-5461---,00.html

Community Action Agency (www.mcaaa.org) Housing Opportunities for Persons with

HIV/AIDS (ebys@michigan.gov) MSU Extension Services, Local Housing Non-

profits,Local Service Agencies, Churches

Mortgage options

MSHDA Single Family Mortgages: Information at: http://www.michigan.gov/mshda/0,1607,7-141-5485_5486---,00.html. Find a lenders at: http://136.181.109.11/lenders/index.jsp?lender_type=SF

MSHDA Counselors at http://136.181.109.11/counselors

Rural Development

http://www.rurdev.usda.gov/mi/Office%20List.htm

http://www.rurdev.usda.gov/mi/mapsmain.htm

City and County Resources

U.S. Department of Housing and Urban Development provides Community Development Block Grant (CDBG) and Home dollars to states, cities and counties.

A Consolidated Plan Process is available to plan for the expenditure of these funds. Public hearing are held each year to take input from citizens.

Contact your city or county and find out how these funds are currently being spent.

Clubhouse

Su Min Oh

Ohs@michigan.gov

Statewide Clubhouse Training

One project for one year

Work with all the clubhouses

Support recovery, promote and secure employment, member leadership

Other areas for clubhouse

Employment outcomes

Long-term housing supports

ICCD clubhouse training

Supported Employment

Su Min Oh

Ohs@michigan.gov

Supported Employment as EBP

Implement core principles of the SE

Supported Employment Implementation Resource Kit at: www.mentalhealth.samhsa.gov/cmhs/communitysupport/toolkits

Cultural Competence

Tison Thomas

Thomasti@michigan.gov

Cultural Competence

Improving access to quality care that are culturally competent

Culturally competent services Culturally competent agencies

Cultural Competence

Engaging minority consumers and families in workforce development, training and advocacy

Recruiting and retaining racial/ethnic minorities/bilingual professionals

Developing assessment mechanisms and training curricula

Cultural Competence

Identify gaps Address possible barriers of care Must assess consumers’ cultural diversity Training in communication/interviewing skills Provide staffing that reflects the composition of

the community being served Resources

Mental Health Clinical Skills Development

Tison Thomas

Mental Health Clinical Skills Development

Mental Health Workers in Developing Clinical Skills

Substance Abuse Treatment Skills Cognitive Behavioral Therapy Dialectical Behavioral Therapy

Tips for Preparing Your Budget Proposal

Karen Cashen

Cashenk@michigan.gov

Budget Forms – DCH-0385 & DCH-0386

Two Budget Forms Required• DCH-0385 – Program Budget Summary

• DCH-0386 – Program Budget - Cost Detail Formats available in Excel or Word Instructions for completing budget forms are

available at www.michigan.gov/mdch, click on Mental Health & Substance Abuse, click on Mental Health, click on Reports & Proposals, click on FY2006/2007 Mental Health Block Grant Request for Proposals (RFP).

Budget Points to Remember…

1. Build the Cost Detail first if using Excel.2. The contractor’s name at the top of each

form is the CMHSP or PIHP, not the name of whatever subcontractor you may be using.

3. The budget period for year one will be October 1, 2006 thru September 30, 2007 and for year two, if applicable, will be October 1, 2007 thru September 30, 2008.

Budget Points to Remember…

4. Please remember to calculate the composite rate for fringe benefits (Total Fringe Benefits/Total Salaries & Wages).

5. The ‘Travel’ line item is only to be used when you have positions listed under Salaries & Wages. If you do not have positions listed under Salaries & Wages, any travel costs for the project should be listed under ‘Other Expenses.’

Budget Points to Remember…

6. Supplies vs. Equipment

- Supplies: all consumable and short-term items with a value of less than $5,000.

- Equipment: a single item purchase with a useful life of more than 1 year and a value of $5,000 or greater.

Budget Points to Remember…

7. Subcontractors - must have name, complete address, and dollar amount listed. If you do not know who you will be subcontracting with, you can put ‘To be determined’ on this line but you must notify me of the person or company name and address after they have been hired. If a significant amount of the grant dollars will be subcontracted out, please submit a subcontractor budget as well, so that we know how the dollars are being spent. The subcontractor budget will not be part of the contract, but is for our information only.

Budget Points to Remember…

8. State Agreement – This is the amount of funding requested from MDCH.

9. Local – This is where you would list the 50% required match for the 2nd year of a 2 year project or any voluntary funds the CMHSP is contributing to the project.

10. The State Agreement amount and the Local amount (if applicable) should add up to what is listed on the Total Funding line.

11. Be sure that all information listed on the Program Budget Summary matches what is on the Cost Detail.

12. Check math for accuracy

13. Check to make sure all applicable box have been completed.

Budget Points to Remember…

Budget Points to Remember…

14. Make sure budget expenditure categories requiring explanations/detail/documentation are complete.

15. Make sure the Program Budget Summary, the Cost Detail, the project Face Sheet, and the Budget Narrative totals all match.