January 1st, 2013

Three NE states system of care expansion grants

Maine, New Hampshire and Rhode Island are among 16 recipients of federal Substance Abuse and Mental Health Services Administration (SAMHSA) System of Care Expansion Implementation Grants to improve behavioral health outcomes for children and youth with serious emotional disturbances and their families.

SAMHSA defines “system of care” as an organizational framework for a network of effective community-based services using evidence-based practices. Each state receives $1 million annually over four years to build upon their respective strategic planning efforts and roll out new networks of care for children’s mental health and related recovery support services.

SAMHSA’s Center for Mental Health Services reviewed 32 applications from states, tribal organizations, county and municipal governments and territories competing for $15 million in available funding for the fiscal year beginning October 1, 2012.

The Maine State Department of Corrections (DOC) Division of Juvenile Services will use the funds to implement a statewide strategic plan expanding trauma-informed system of care practices developed by its nonprofit Westbrook-based technical assistance partner, THRIVE, and Children’s Behavioral Health Services, a division of the state’s Office of Child and Family Services. The program will enroll 50 youth ages 12 to 20 in the first year to assess their exposure to trauma and 100 each year thereafter. A total of 142 mental health providers serving children and families, including active military, are being trained in identifying past adverse experiences.

A trauma informed approach asks what has happened to a child arrested for the first time rather than what is wrong with them, says DOC Division of Juvenile Services Associate Commissioner Bartlett H. Stoodley. Youth offenders diverted from the formal court system receive an assessment, treatment and reach an agreement to accept responsibility for criminal acts and make restitution. That process can be completed within 30 days as opposed to a typical two to six month court adjudication period.

“I call this kind of a red flag approach to juvenile corrections rather than taking the punitive approach,” Stoodley says.

“Most of the kids in juvenile corrections come to us not because they’re budding criminals. These are the kids that have lost their way for the most part. Most of them have very little in the way of family and community support and individual resources.”

A youth offender in Maine costs the state approximately $450 a day. Stoodley estimates the new trauma-informed new system of care will reduce the cost to $300 or less while also reducing recidivism.

New Hampshire Families and Systems Together Forward for Children and Youth will develop a system of care for children and youth with serious emotional disturbances at risk for out of home placement who are involved with two or more systems. At least 140 children statewide will be served over the next four years, says Nancy L. Rollins, associate commissioner for the New Hampshire Department of Health and Human Services.

The grant acknowledges the state’s work on children’s behavioral health issues over the last six years, including the development of a broad base of stakeholders.

“It really focuses on one of the clearest unmet needs, which is children who have a serious emotional disturbance who tended to be engaged in a number of systems that are not necessarily well coordinated nor was there necessarily a comprehensive approach to addressing these children’s needs,” Rollins explains.

The goal is to eliminate the gaps in the system and produce better outcomes for children, reducing the use and duration of residential placement, inpatient care and incarceration.

“We’re really looking to keep kids in their own community and support them in their family when and if possible and certainly in their own school,” Rollins says.

The Rhode Island State Department of Children, Youth & Families will implement a statewide infrastructure to expand youth-guided and family-driven mental health services and recovery supports for children and youth with serious emotional disturbances. The department has been working on a system transformation for children’s behavioral health and child welfare since 2009, says Ginny Stack, project director.

The goals include reducing the amount of time that children spend in out of home placement and improving response to psychiatric emergencies for children in placement. Officials also identified the need to develop a more diversified workforce serving children, youth and families to support culturally responsive care.

The number of children and youth served each year will total 780 from birth through age 21, or 3,120 over the four years. These include children in foster and group homes or those working with the department while at home or as they exit the Rhode Island Training School.

“Because it’s an infrastructure grant and it’s really working to make this new system nimble and anticipate the needs of the system and then be able to respond to it, we’re looking at serving all of the children in the system,” Stack says.

By Janine Weisman

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