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HomeMy WebLinkAboutResolutions - 1998.11.19 - 25481November 19, 1998 Miscellaneous Resolution #98303 BY: Public Service Committee, David Moffitt, Chairperson IN RE: Community Mental Health - Annual Program Plan and Budget Submission FY 98/99 To the Oakland County Board of Commissioners Chairperson, Ladies and Gentlemen: WHEREAS the Department of Community Health (DCH) requires each Community Mental Health Board to submit an annual Program Plan and Budget (Program Plan); and WHEREAS the information included in toe Program Plan is aggregated and used by the DCH ir. determining their annual budget request; and WHEREAS the CMH Board has reviewed the submission and has held a public hearing on the document in accordance with DCH guidelines. WHEREAS any changes approved by the CMH Board will be incorporated into the final document which will be sent to DCH by September 18, 1998. WHEREAS the Program Plan must be approved by the CMH Board prior to its submission on September 18, 1998. WHEREAS the OCCMHSP Board approves the Annual Program Plan and Budget submission for FY 98/99. WHEREAS on 10/27/98, the Oakland County Community Mental Health Services Board approved a resolution (#1659810p) regarding Annual Program Plan and Budget Submission FY 98/99. NOW THEREFORE BE IT RESOLVED that the Oakland County Board of Commissioners approves the Annual Program Plan and Budget Submission FY 98/99. Chairperson, on behalf of the Public Service Committee, I move the adoption of the foregoing resolution. Phblic Service CoWittee Public Services Committee Vote: Motion carried on unanimous roll call vote with Jacobs absent. From: Nancy Birdwell To: Wenzeln Date: 11/13/98 9:32am Subject: Program Plan Summary Approval of Annual Program Plan and Budget Sumbission 98/99 Each year the Department of Community Health (DCH) requires each Community Mental Health Board to submit an Annual Program Plan and Budget (Program Plan). This information is aggregated and used in DCH's annual request for its budget. The Board must hold a public hearing on and approve of the Program Plan.The Board will then need to hold a public hearing and review the plan at its meeting on September 15, 1998. Any changes in the plan resulting from that meeting will be incorporated into the draft and a completed document will be sent to DCH. Resolution #98303 November 19, 1998 Moved by Moffitt supported by Jensen the resolution be adopted. AYES: Huntoon, Jensen, Johnson, Kaczmar, Kingzett, Law, McCulloch, McPherson, Millard, Moffitt, Obrecht, Palmer, Schmid, Taub, Wolf, Amos, Coleman, Dingeldey, Douglas, Garfield, Gregory, Hoffman, Holbert. (23) NAYS: None. (0) A sufficient majority having voted therefor, the resolution was adopted. STATE. OF MICHIGAN) COUNTY OF OAKLAND) I, G. William Caddell, Clerk of the County of Oakland, do hereby certify that the foregoing resolution is a true and accurate copy of a resolution adopted by the Oakland County Board of Commissioners on November 19, 1998 with the original record thereof now remaining in my office. In Testimony Whereof, I have hereunto set my hand and affixed the seal of the County of Oakland at Pontiac, Michigan this y9th day og November 1998. G. William Caddell, County Clerk OAKLAND COUNTY COMMUNITY MENTAL HEALTH SERVICES BOARD / • / PROGRAM BUDGET PLAN FY 1998-1999 TABLE OF CONTENTS FORM SUBMISSION CHECKLIST - 1998 1 ASSESSMENT OF NEED CERTIFICATION OF THE ACCURACY OF COMMUNITY NEED AS TRANSMIT-ED IN 1997 2 ASSESSMENT\OF „CURRENT CLIENT NEED SUMMARY 3 ASSESSMENT OF CURRENT CLIENT NEED SUMMARY 6 ASSESSMENT OF CURRENT CLIENT NEED SUMMARY 9 4.- • 44)GMESpiNAITING LIST - MOVEMENT REPORT 11 MHSP WAITING LIST - MOVEMENT REPORT 12 A ! RESIDENTIAL BED CAPACITY - ALL CLIENT GROUPS 13 FULL MANAGEMENT TRADE-OFF DOLLARS PROJECTED EARNED DURING FY 98-99 IN FY 97-98 STATE SHARE DOLLARS 14 PERSONS WITH SERIOUS MENTAL ILLNESS RECEIVING CLIENT SERVICE MANAGEMENT - PROJECTED FY 97-98 15 CENSUS PROJECTIONS - HOSPITALS, CENTERS AND NURSING HOMES - 1998 SUBMISSION 16 FEDERAL BLOCK GRANT REPORTING REQUIREMENT SYSTEM OF CARE SERVICES FOR CHILDREN WITH SERIOUS EMOTIONAL DISTURBANCE 17 FEDERAL BLOCK GRANT PROGRAM REVISION REQUESTS 18 Youth Transition Intervention Project 19 Employment Specialist Training 23 Needs Assessment and Child Care Provider Training to Prevent Expulsion of Young Children from Child Care Settings through 4C's Council 26 4-H/OCCMH Community Collaborative Designed Especially for Children with Severe Emotional Disturbance 30 New Club House Training for St. Joseph Mercy - Central and Mercy Network - Central 32 Club House Employment Specialist Training for St. Joseph Mercy Network - Central . . . 37 Dual Diagnosis (MI/SA Clubhouse Integration Project for St. Joseph Mercy Oakland and Mercy Network - Central 40 Expansion of Arab-chaldean Mental Health Services 47 Clubhouse Employment Specialist Training for Our House Clubhouse - Alternative Community Living 49 Supplies for Drop In Center and Training for Clubhouse Staff for Goodwill Industries of Greater Detroit 51 MORC, Inc. - Adult M.I. Social Integration Project 55 ESTIMATED FTE'S 58 CMHSP SUMMARY OF CURRENT CONTRACTS FOR MENTAL HEALTH SERVICES DELIVERY 59 CMHSP PERSONS SERVED 60 RESPITE CARE - CONTINUATION FUNDING APPLICATION 61 •• \ • ;'-*. OAKLAND COUNTY CAMISP Page I CMHSP: Oakland County FORM SUBMISSION CHECKLIST - 1998 CHECKLIS.WPD The followinglorms/narrative must be included in the CMHSP's submission. Please enter an "X" to inClicite theinformation is provided. - e . /4,-::se-4ment of Need Certification form (CERTNEED.WPD) , / Assessment of Current Client Need Summary form - one for each client population rPtCLIENTND.WPD) Assessment of Community Need form (COMMNEED.WPD) / _X_ CMHSP Waiting List—Movement Report (optional in 1996; required in 1997) (WAITOUT.VVPD) _X. Residential Bed Capacity - all client groups (BEDCAP.VVPD) X Full Management Trade-Off Dollars Projected (FMTO.VVPD) Persons with Serious Mental Illness Receiving Client Service Management (SMI.WPD) _X_ Census Projections - Hospitals, Centers and Nursing Homes (CENPROJ.VVPD) _X_ Federal Block Grant Reporting Requirement—System of Care Services for Children with Serious Emotional Disturbance (FEDBG.VVPD) _X_ Federal Block Grant Program Revision Request and Narrative (PRR-FBG.1NPD) (FBGNARRINPD) Estimated FTE's (FTES.VVPD) _X_ CMHSP Summary of Current Contracts for Mental Health Services Delivery (CONTRACT.VVPD) Persons Served (SERVED.VVPD) X Respite Care - Continuation Funding Application (RESPITE.VVPD) Ae" OAKLAND COUNTY CNIMSP - Page 2 ASSESSMENT OF NEED CERTIFICATION OF THE ACCURACY OF COMMUNITY NEED AS TRANSMITTED IN 1997 CERTNEED.WPD f THE ASSESSMENT OF COMMUNITY NEED NARRATIVE AND THE ASSESSMENT OF COMMUNITY NEED FORM, AS SUBMITTED IN 1997 FOR THE Oaklanditounty (CMHSP) MEET THE `- FOLLOWING,OBJECTIVES: • )-6 satisfy the requirements of 330.1124(2) and 330.1226 of the Mental Health Code which Aty i*Oilire the maintenance of waiting list information and an annual examination and evaluation of the mental health needs of the CMHSP's catchment area. Accurately represents the service needs of persons currently receiving mental health services through the CMHSP. • Accurately represents the mental health service needs and associated costs of persons in the community who are eligible for public mental health services. Certified: (Name) (Title) Questions regarding the CMHSP's assessment of need should be directed to: Alex Braitman (name) at: Z48-858-5478 (phone number), OAKLANOCOUNTYCMHSP-Page3 CLIENT GROUP 4c40041 tfJil /444.4.4431ifel.' ASSESSMENT OF CURRENT CLIENT NEED SUMMARY CMHSP Oakland County CLIENTMILWPD Cases which are partially served--different, Cases which would benefit from additional service receiving services in a different Number underserved recommended program _ FY 98 Additional Expected Amount of Indicate Cases Same Recommended Current Recommended Associated PROGRAM ELEMENT Served Service Associated Service Associated Service Service Net Required Maximum Program Maximum Program(s) Program(s) Maximum Cases Match Cost Cases Match Cost Cases Cases Match Cost — , Local. Inpat t 592 6 33,240 3 16,620 t , State Inpat' 99 • Emergen cc 1964 Clin S- 6993 1 2422 117 283,374 68 88 48,440 00 P ial;.. .italization 124 10 24930 66 144,738 , 1 29 61,404 s cial Rehabilitation 327 3 251 103,861 69 283,659 11116b r Day Program 1 12,333 211 2,793,102 29 MHSP Managed--Residential 35,809 78 Orr 1,038,461 Crisis Residential 593 35 190,085 Supported Independence 264 142 4,054,810 1 19 5N,990 Assertive Comm. Treatment 561 9 55,620 52 321,360 64 43 (129,780) , Crisis Stabilization Team . , Comm, Treatment Team--CT? Client ServiCes Management 3282 305 945,500 2 6200 250 6 (756,400) Family Support 12 _ Home Based Ingegrated Employment 161 26 , Comm-Integrated Services 147 1 778 18 14004 20 15,560 Respite Services 630 5 5098 45 22,941 5 5,098 - . Direct Service--Prevention 42 25 Other Prevention 59 25 TOTAL ALL ABOVE ROWS 15,787 341 1,112,730 1083 - 8,879,095 384 - 384 - 1.080,432 OAKLAND COUNTY CMH3P - Page 4 ASSESSMENT OF CURRENT CLIENT NEED FOR ADULTS WITH MENTAL ILLNESS NARRATIVE Current client need for this population was as‘essed by gathering data over a three month period from clinical staff. This required staff to reexamine their current caseloads to identify clients who v,veT-under served. This data was aggregated and reviewed by administrative staff for this narrative:-.. _ - The methodology for assessing the need for other program elements not highlighted in this narrativelivere‘deTived in the same manner as other program elements discussed below. , , f Associated Maximum Match Cost / ne associated maximum cost shown in columns 3 and 5 is the highest average cost of all pAviders in the related program element multiplied by the number of persons identified as /Onderserved in columns 2 and 4. For example, in the Clinic Services program element, the 'IV!" -- additional person identified in column 2 would be served for a cost of $2,422.00. Associated Net Maximum Match Cost The associated net maximum cost represents the cost of servicing the additional persons identified in column 7 of the program element less the cost of servicing the individuals identified in column 6 who would be better served in a different program element. In the Clinic Services program element, the cost for serving the additional 88 persons in column 7 would be $213,136.00 less the cost of the 28 persons ($67,816.00) in column 6 who no longer need services in this program element. Local Inpatient Staff identified 6 persons as requiring additional units of service in this same program element. Three persons were identified as needing services in this program element in addition to services that they are already receiving. The associated costs for this program element was computed by multiplying the average per diem rate for local inpatient providers ($435.00) by the average length of stay (13 days)for persons receiving services in this program element. The associated match cost for partial hospitalization programs was computed in the same manner. Clinic Services Clinical staff indicate that there is an increased need for this type of service. Only one person was identified as requiring additional services of this same program element. 117 persons have been identified who would benefit receiving from this service in addition to other services already being received. Staff indicate that 28 persons are currently receiving this service that would be better served in another program element. 88 persons would benefit from receiving this service rather than the service that they are currently receiving. Services in this program element include enhanced OAKLAND COUNTY CPANSP - Page 5 individual therapy, medication reviews, and other treatment services. Psychosocial Rehabilitation Three persons were identified as needing additional units of this program element. Staff identified 25) persons as needing this service in addition to current services being received. 69 personsMerhidentified as needing this service in place of other services that they are already receiving. Iniscal year 1999, OCCMH will begin to provide Clubhouse services to all four quadrants:of the county. Prior to this, there was no provider in the Western or Northern quadrahtUnfnet need is expected to decrease with the addition of the providers in these quadrants. fi / t Commtintty Integration Services ,"ANeast 147 persons are expected to receive services at the existing drop-in center located in th% Central quadrant of the county. Data collected from staff indicate that an 18 additional ersons would benefit from attending a drop-in center. 20 persons were identified as needing this service instead of a service currently being received. Prior to October 1, OCCMH will be distributing an RFP to vendors to bid on providing this service to the remaining quadrants of the county. OCCMH currently does not provide services in the Family Support, Integrated Employment, Direct Service Prevention, or Other Prevention program elements for this population. However, staff identified these areas as program elements in which clients could benefit. Future efforts may be devoted to developing services in these areas as funding permits. OAKLANOCOUNTYCktitSP-Pagea tt CLIENT GROUP 1.4110446e14 LAI 5E-0 ASSESSMENT OF CURRENT CLIENT NEED SUMMARY CMNSP Oakland County CLIENTND.WPD Cases which are partially served--different, Cases which would benefit from additional service receiving services in a different Number underserved recommended program FY 98 Additional Expected Amount of Indicate Cases Same Aecommeqded Curgent Recommended Associated PROGRAM ELEMENT Served Service Associated Service Associated Service Service Net Required Maximum Program Maximum Program(s) Program(s) Maximum Cases Match Cost Cases Match Cost Cases Cases Match Cost - Local Inpat t 107 1 3284 2 6568 State Inpat '''• 15 ' . , _ Emergen - .. ce 359 `... Clin - S 650 13 22,228 2 3420 26 3 (39,330) P • ial italization 48 r s _ octal Rehabilitation )01' r Day Program . • . MNSP Managed—Residential 54 Crisis Residential 13 217,264 - Supported Independence 1 Assertive Comm. Treatment Crisis Stabilization Team _ — Comm. Treatment Team--CTT 4 . Client Services Management 437 5 10,010 7 2 10,010 , Family Support 12 5 7083 2 13 15,583 Home Based 217 . , Ingegrated Employment _ Cones. Integrated Services Respite Services 1022 2 1488 — _ Direct Service--Prevention Other Prevention TOTAL ALL ABOVE ROWS 2922 _ 13 22,228 13 _ 23,797 35 _ 35 271,583 J OAKLAND COUNTY CPAHSP - Page 7 ASSESSMENT OF CURRENT CLIENT NEED FOR CHILDREN WITH SERIOUS EMOTIONAL DISTURBANCE Current client need forlhis population was assessed by gathering data over a three month period from clinical staff. Staff were asked review their caseloads to identifnJ any clients who were under served' This data was aggregated and reviewed by administrative staff for this narrative. # I / Associated 'Maximum Match Cost ) The associated maximum cost shown in columns 3 and 5 of the worksheet is the highest averagOcoit of all providers in the related program element multiplied by the number of peT6oni/dentified as underserved in columns 2 and 4. For example, in the Family Support imogram element, the additional 5 persons identified in column 4 would be served for a cost of 83.00. „Associated Net Maximum Match Cost The associated net maximum cost represents the cost of servicing the additional persons identified in column 7 of the program element less the cost of servicing the individuals identified in column 6 who would be better served in a different program element. In the Family Services program element, the cost for serving the additional 13 persons in column 7 would be $18416.00 less the cost of the two persons ($2833.00) in column 6 who no longer need services in this program element. Local Inpatient Staff identified one person as requiring this service in additional to other services being provided. Two persons were identified as needing this service in place of other services currently being received. The associated costs for this program element was computed by multiplying the average per diem rate for local inpatient providers ($333.00) by the average length of stay (12 days) for persons receiving services in this program element. Clinic Services Staff identified 13 persons who could benefit from receiving more units of service in this program element. Limited resources in terms of staffing hours is the primary cause of this unmet need. 26 persons were identified as needing other services such as Family Support, Respite, and Residential Services in place of services being provided in this program element. Residential Services OCCMH is currently providing residential services to 54 children and adolescents. There are 13 providers rendering service in the program element. Staff identified 13 persons would who benefit from residential placements in place of other services provided by OCCMH. As the range of average annual costs for this service vary from a low of $18,950.00, to a high of $40,500.00, the weighed average cost of providers was used to compute the associated net maximum cost in column 8. OAKLAND COUNTY CMNSP - Page II Client Services Management 437 persons are expected to receive case management services during this fiscal year. Clinical staff inditate that at least 5 persons would benefit from receiving case management services as a different, additional service. Two persons were identified as needing case management services in place of other services currently being received. • Family SOportV if / ,t.ezt,ree Stal4eniortithat five persons are in need of the counseling, educational training, and supports , orovideagn this program element. Staff indicate that these services are needed in addition to —1-4- Aserv,rces that they are already receiving. 13 persons were identified as needing this service in 'ace of other services currently being received. Two persons were identified as no longer 'ding services in this program element. Respite Services Currently 1022 clients and their families receive some form of respite services provided by the Board. The number of persons reported as receiving services in this program element is higher than numbers reported in previous years. As a result of this, staff did not indicate any unmet need in this program element. However, 2 cases were identified as needing Respite as a different service from those currently being received. CLIENT GROUP "043cal 42. v414 OAKLAND COUNTY CMHSP -Page, • 41'444 ASSESSMENT OF CURRENT CLIENT NEED SUMMARY CMHSP Pakland County * _ CLIENTND.WPD Cases which are partially served--different. Cases which would benefit from additional service receiving services in a different Number underserved recommended program ,-...). FY 98 Additional Expected Amount of Indicate , Cases Same Becommended Current Recommendeq Associated PROGRAM ELEMENT Served Service Associated Service Associated Service Service Net Required Maximum Program Maximum Program(s) Program(s) Maximum Cases Match Cost Cases Match Cost Cases Cases Match Cost Local Inpat t State Inpat 23 ' -* Emergen ce - . Clin'. S 1070 160 27,459 . - P ial•italization t - s .-. •cial Rehabilitation III r Day Program 642 - . 4 WISP Managed--Residential 1191 - , - Crisis Residential - - , Supported Independence 231 , . .._ -1 Assertive Comm. Treatment 1- Crisis Stabilization Team - Comm. Treatment Team--CTT ,. - Client Services Management 736 - - Family Support 285 100 75,626 , Home Based , - Ingegrated Employment . . , Comm. Integrated Services Respite Services 1202 — - Direct Service--Prevention . * Other Prevention - TOTAL ALL ABOVE ROWS 5380 260 103,085 _ _ OAKLAND COUNTY ClANSP -Page 10 ASSESSMENT OF CURRENT CLIENT NEED FOR PERSONS WITH DEVELOPMENTAL DISABILITIES NARRATIVE Current client need for this population was assessed by requesting clinical staff for persons with developmental disabilities to review their current cases loads to identify clients who were under serveil. tiii0:ipta-was aggregated and reviewed by administrative staff for this narrative. AssociatedMiximum Match Cost The as.sod*edmaximum cost shown in column 3 of the worksheet is the highest average costfál peoviders in the related program element multiplied by the number of persons idehtifiedis underserved in columns 2 . For example, in the Clinic Services program element, 'Additional 160 persons identified in column 2 would be served for a cost of $27,459.00. L Associated Net Maximum Match Cost J- The associated net maximum cost represents the cost of servicing the additional persons identified in column 7 of the program element less the cost of servicing the individuals identified in column 6 who would be better served in a different program element. Clinic Services 160 persons were reported as being under served in this program element which includes counseling, medical and psychological testing, support coordination, and ancillary services. Family Support Staff identified 100 persons who would benefit from receiving more of this same service. Limited staffing resources is the primary reason for this unmet need. Staff also report that there is a need for crisis residential services for this population. Clinical staff cite many occasions where clients have experienced breakdowns and were clearly in need of crisis intervention. Future efforts may be devoted to developing services in these areas as funding permits. OAKLAND COUNTY ChiliSP - Page 11 1.1 CMHSP WAITING LIST - MOVEMENT REPORT AVERAGE WAIT FOR NON-EMERGENCY SERVICES — MANDATORY SUBMISSION IN 1998 WAITOUT.WPD CLIENT GROUP: Adults with Serious Mental Illness CMHSP: Oakland County INFORMATION AS OF: 8125/98 (date) - Persons Currently on Waiting List Persons Removed from Waiting List No. 7., No. Persons from 10/1/97 through 8/25/98 (date) Persons Placed on Waiting Waiting , for List Since Average Service 10/1/97 Requested Service Received Number of . as of Removal Needs Requested Number of Weeks Waiting ft 10/1/97 from List Changed Service Other Total Persons for Service SERVICE Delivery rvices Partial Hospitalization " 41)111' Psychosocial Ftehab. Other • . freersidential Specialized Residential 35 79 31 31 47 78 28 32 Crisis Residential 4. Supported Independence 12 58 39 39 26 65 13 21 _ Support Services Assert.Comm.Treatment .- Crises Stabilization Team Community Treatment Team Client Services Mgrnt Family Supp.Services Home Based Integrated Employment , Community Integration . Respite Services _ Prevention _ Direct Service _. :.c: _ TOTAL ABOVE ROWS 47 137 70 143 _ 70 _ 73 0 53 OAKLAND COUNTY CMHSP - Pag4P12 CMHSP WAITING LIST - MOVEMENT REPORT AVERAGE WAIT FOR NON-EMERGENCY SERVICES — MANDATORY SUBMISSION IN 1998 WAITOUT.WPD CLIENT GROUP: Permrs with Developmental Disabilities CMHSP: Oakland County INFORMATION AS OF: 8/25198 (date) Persons Currently on Waiting List Persons Removed from Waiting List No. '14.fic .. No. Persons from 1011/97 through 8125198 (date) Persons Placed on . _ Waiting Waiting for List Since Average Service 10/1197 Requested Service Received Number of as of Removal Needs Requested Number of Weeks Waiting 10/1/97 from List Changed Service Other Total Persons for Service SERVICE i ,), Delivery Outpai oiti._ rvices 11b4.114' - Partial Hospitalization • Psychosocial Rehab. • Other 196 34 36 27 63 167 212 . esidential Specialized Residential 62 109 38 6 89 133 58 47 _ Crisis Residential , k Supported Independence 25 13 12 1 6 19 19 , 23 Support Services Assert.Comm.Treatment Crises Stabilization Team . Community Treatment Team Client Services Mgmt , Family Supp.Services Home Based - Integrated Employment , Community Integration , Respite Services Prevention Direct Service , , TOTAL ABOVE ROWS 303 _ 156 86 7 122 _ 0 _ 215 :::: 282 OAKLAND COUNTY CMHSP - Page 13 RESIDENTIAL BED CAPACITY - ALL CLIENT GROUPS AVAILABLE BEDS AS OF JULY 31, 1998 BEDCAP.WPD CMHSP: Oakland County . . 7 i ADULTS WITH CHILDREN WITH PERSONS WITH I.-- ../ MENTAL ILLNESS MENTAL ILLNESS DEVELOPMENTAL DISABILITIES 'BED TYPE ..., •...,:- . Actual Avalable Bees Actual Available Beds Actual Available Beds , , "-I., - as of 713168 as of 7/31/98 as of 7/31/98 TOTAL A.. SUPPORTED LIVINtinsLoTs- 225' 4' _ 125' 354 B. ALL OTHER SPECIALIZED RESIDENTIAL , .4•An Resigito, . _ , 12* 12 .4gOriie Per Diem through $64.99 24' 1* 147' 172 ../ In-Home Per Diem $65 through $94.99 18' 113' 131 • -. .4.-4n44ome Per Diem S95 through $124.99 87' 141' 228 ./--- -., In Home Per Diem $125 through $154.99 43' 221' 264 In-Home Per Diem $155 and Higher , 17- 161' 178 — .. All CC) Regardless of Cost 28 28 — TOTAL 189 29 795 1013 C.. RESIDENTIAL CAPACITY NOT INCLUDED ABOVE (DESCRIBE) Staffing only 24 24 , TOTAL CMHSP CAPACITY (A. + B. + C.) 414 33 944 1391 *Includes MORC bed capacity. MORC figures do not include lease amounts "OCCMHSP pays for staffing only OAKLAND COUNTY CM14915 - Pas* 14 Earned Trade-Offs During FY 98-99 Utilization Estimated for FY 98-99 FULL MANAGEMENT TRADE-OFF DOLLARS PROJECTED EARNED DURING FY 98-99 IN FY 97-98 STATE SHARE DOLLARS FMTO.VVPD CMHSP: Oakland County Client Group( Facility Program DOA Col. 1 t(a.-ram sychiatric Hospital _UP • North" Psychiatric Hospital Ciir.INtegirinItenter 2,920 1 $610,280 2,920 $610,280 6 1 2,190 1 $457,710 25 8,213 $1,903,095 2,190 $457,710 Projected Days Associated Census Reduced State as of Dollars Projected Census Change FY 98-99 Co1.10 0 0 2 3 5 0 0 9-30-99 1 Col. 7 1 Col. 8 1,892 I $495,704 2 1 (304) I ($72,481) 3 1 365 I .$87,235 Col. 9 $152,570 $152,570 6 6 $469,854 7 I 2,373 20 4,326 , $980,312 730 730 9-30-98 in FY 98-99 Stale as of Days Dollars Census Total Col. 4 Co1.5 Col. 6 1,825 1 $436,175 I 5 I 1,460 1 $348,940 5,476 1 $1,084,248 10 I 3,103 $614,394 2,920 1 $765,040 730 $174,721 $1,260,744 $102,240 2 4,812 426 Total Stale Days Dollars in FY 97-98 Col. 2 Col. 3 myyrilt 12,539 TOTAL - ADULTS WITH MENTAL ILLNESS $2,883,407 10 15 7,351 $1,242,319 $471,172 $771,147 4,563 2,788 0 182 183 365 $37,413 $37,412 $74,825 7.718 1 $1,317,144 I 16 1 4,746 1 $808,560 I 10 I 2,970 I $508,584 23,175 I $4,810,831 I 47 I 15,149 I $3,169,365 I 36 I 8,026 1 $1,641,466 GRAND TOTAL Mt Pleasant Center Southgate Center TOTAL - PERSONS WITH DEVELOPMENTAL L DISABILITIES 5 1 6 11 Utilization Projected for FY 97-98 /*Kr Reuther Psychiatric Hospital Hawthorne Center TOTAL - CHILDREN WITH EMOTIONAL DISTURBANCE 440.400*(** .-.:::::oo•Nmava:.::ottAtnttnttog:::nggo OAKLAND COUNTY CMHSP - Page 15 PERSONS WITH SERIOUS MENTAL ILLNESS RECEIVING CLIENT SERVICE MANAGEMENT- PROJECTED FY 97-98 SMI.WPD CMHSP: Oakland County /- / /1"..r...1 (COIL + D = Col. 13) (Col. B - D = Col. C) (Col. B - C = Col. D) .., ,- - ,i__--'.;', "'-4--- ./*--•;--:m:., _.; FY 97-98 Projected / . FY 97-98 Projected FY 97-98 Projected FY 97-98 Projected Number of SMI If: / Total Number Total Number Number of SMI Who DID NOT $ Poeliatioll of MI Cases of SMI Cases Who Received CSM Receive CSM Column A Column B Column C Column D . V- , Child/Adolescents 1356 783 679 104 (ages 0-17) Adults 6323 3489 3001 488 (ages 18-54) Older Persons 1162 840 611 229 (ages 55+) , , 7841 5112 4291 821 Totals KEY: MI means total cases of persons with mental illness served by CMH. SMI means total cases of persons with serious mental illness served by CMH. CSM means client service management including client management services which are provided through bundled services program concepts such as ACT, PSR, home-based services and wraparound. OAKLAND COUNTY CPAHSP - Page 16 CENSUS PROJECTIONS - HOSPITALS, CENTERS AND NURSING HOMES .1998 SUBMISSION CENPROJ VVPD CMHSP: Oakland County . EXPECTED RESIDENT CENSUS AS OF DATE SPECIFIED ;k-::.,.2.• 9130198 to 9/30/99 to 9/30/97 7/31/98 9/30/98 9/30/99 9/30/99 9/30/2000 9/30/2000 Actual Actual Expected _ Expected Change Expected Change PSYCHIATRIC HOSPITALS FOR ADULTS Caro 8 8 8 8 0 a o I Kalamazoo PH 1 1 2 2 ) 0 1 (1) _ - Northville PH 3 4 5 3 (2) 2 (1) , — ' Reuther 8 10 10 7 (3) 5 (2) Subtotal 20 23 , 25 , 20 (5) 16 _ (4) PSYCHIATRIC HOSPITALS FOR CHILDREN Hawthorn _ 6 3 6 61 0 i 61 0 CENTERS FOR PERSONS WITH DEVELOPMENTAL DISABILITIES Mt. Pleasant , 11 11 15 10 (5) 10 0 Southgate 1 1 1 o (1) , 0 0 Subtotal _ 12 _ 12 16 10 _ (6) 0 SPECIAL NURSING HOMES Birchwood i 1 1 1 GENERAL NURSING HOMES _ Persons with DD Requiring Placement 7 3 3 o (3) 0 0_ Persons with MI Requiring Placement 1 0 0 0 0 o o , Subtotal 8 3 , (3) 0 0 4 OAKLAND COUNTY CMHSP - Page V? FEDERAL BLOCK GRANT REPORTING REQUIREMENT SYSTEM OF CARE SERVICES FOR CHILDREN WITH SERIOUS EMOTIONAL DISTURBANCE FEDBG.WPD • — CMHSP: OaklandsCotinty 1 / Contact Person (nit N . he, phone) Richard Deighton (248-858-1210) In order to compf y'.vtti the federal conditions of approval for the block grant, specific information about certain children's servicesAusfteprovided to the federal government. The information requested below is essential to maintaining this ndiogland6hadld be reported regardless of the funding source for the programs listed. Program Number of Estimated Estimated Offered by Current Cases Cases to be CMHSP Programs Served Served Funded Y = Yes by/through 10/1/97- 10/1/98- N = No the CMHSP 9/30/98 9130199 ., A. Home Based Services Y 2 276 276 Programs - B. Wraparound Y 1 22 50 Services *Note: If the CMHSP reports cases served in either of the two subsequent columns, there must be an entry in this column. Description of the source of the information provided above; comments and/or explanation. if FEDERAL BLOCK GRANT PROGRAM REVISION REQUESTS OAKLAND COUNTY CmHSP - Page 19 FEileRAL BLOCK GRANT AND PREVENTION PILOT PROGRAM REVISION REQUEST PRR-FBG WPD CMHSP: Oakland County PRR Title: Youth Transition intervention Project Time Required to Implement: Date Submitted 9-4-98 (in months) 12 months t PRR ID Number: 98-0001 "I Client Group: MI-A :MkC Prevention Gross Cost: $30,080 Board Block Grant Priority: (circle one) 1 of , 12 _ /* A - Board Prevention Priority: _- ...., _ of 4. Wraparound Psychosocial Rehab Other X Transition Services Federal Block Grant ,PRRptiPose (check one): / Aging Seryiceis,,,,/ ACT Teams 4.= Emoymenfoii61- Consumer Run or Directed Initiatives Prevention - integrated Services (Clubhouses) Pilot for Young Children - Infant Mental Health Services Prevention Coordinator / Adults with Children with Board *-AsePINANCING SUMMARY Mental Illness Mental Illness Other Administration Total Estimated clients to be served by PRR 20 (Approx.) PROJECTED FUNDING SUMMARY Projected Gross Funding $30,080 $30,080 SAMHSA (Federal) Block Grant $30,080 $30,080 - Ist/3rd/SSI Reimbursement Estimate" State Other (detail): - . . , , SAMHSA ist/3rd/SSI (Federal) Block Reimbursement Other 5. BUDGET DETAIL Grant Estimate` Funding Total Personnel salaries/wages and fringe benefits , Equipment Travel - Supplies, etc. (One time expenses for consumers) $10,000 $10,000 - . Contractual services (subcontract, etc.)-specify below $20,080 $20,080 (20 HoursNVk at $20.08 for 1000 hours.) Contract with Youth Transition Intervention Specialist Subtotal $30,080 $30,080 Indirect- . Occupancy Communication - _ , TOTAL Block grant funds may not be used to match other federal funds. Per Ft 102-3R1, Section 19165, administrative expenses may not exceed 5 percent. OAKLAND COUNTY CMHSP - Page 20 CMHSP: Oakland County NA.RRATIVE FOR PROGRAM REVISION REQUESTS FEDERAL BLOCK GRANT FBGNARR.WPD PRR Title/Purpose: Youth Transition Intervention Project Time Required to Ynplement: Date Submitted: 9-4-98 (in months) 12 months . PRR ID Number: 98-0001 Client Group: MI-A "AL4 -': DO Bd Admin. Prevention . FY of Implementation: Board Block Grant Priority: (circle one) I .., ...,:, FY 98-99 1 of 12 ...../ Board Prevention Priority: , _ of A - Narrative (attach additional pages as necessary): Tire-folio' Wing outline should be followed for the PRR narrative (attach additional pages as necessary) .• ncliitie,non-bolded items for a Wraparound PRRI: .azwist.,. • Demonstrated need for the subpopulation and/or intervention, Oakland County CMHSP continues to see an increasing demand for transitional services for young adults. During the past two years, 10 young adults, ages 17-22 were referred to OCCMH for SIP placement. Three young adults did not meet criteria and were denied admission to SIP programs and returned to the community. There is currently one young adult (age 19) being served in the wraparound program. The program has had difficulty meeting that young adult's needs due to the lack of services available in the community. In addition, 23 young adults ages 16-20 remained in residential placement longer than necessary due to a lack of transitional supports in the community. Some of these young adults in placement were in the community living with parents, relatives or friends and did not receive the community supports necessary to ensure their successful transition to adulthood. Therefore, those cases were referred to OCCMHSP as crisis residential placements after the young adults and their support network became frustrated or burned out. Although there are not a large number of cases, these young adults always demand an inordinate amount of time and resources from staff due to the lack of appropriate services in the community. OCCMHSP does not have the capacity to give this population the special attention that it needs. To create successful community based transitional services for this population requires coordination internally, between the OCCMHSP Children's and Adult services, and externally with schools and other community organizations. • Demonstrated knowledge and understanding of the sub-population, the principles of psychosocial interventions and/or the principles of the model or intervention proposed. The adult service system focuses on persons with serious and persistent mental illness and is over-burdened with a demand for long term residential placements and, therefore, is not able to accommodate the transitional service needs of this population. And many young adults do not qualify for the level of case management that they require, based on their diagnosis. Yet, if they could access a more intense level of case management for a shorter time, they may be able to succeed on their own, without further intervention. As a result of the lack of capacity and coordination with the adult system, clinicians in the Children's system end up keeping cases open until the young adult is age 20, 21 or 22. These cases require joint transition planning between the Children's and Adult services systems. In addition, educational and vocational options for these young adults are lacking. Once a young adult in the special education program receives his or her diploma, they are no longer eligible for services through the school system. Transition planning for these young adults has not been effectively coordinated. And when transition planning does occur, more attention has been given to the transitional needs for young adults with developmental disabilities than for young adults with emotional disturbance. Currently, there are few vocational options. Adult vocational providers are not equipped to address the defiant behavior and lack of motivation of some young adults. Programs are needed that specialize in transitional youth services. OAKLAND COUNTY CIAHSP Page 21 Partnerships are necessary with the schools to improve transitional planning. OCCMHSP has been informed that Oakland Schools is seeking a planning grant to address the transitional needs of young adults. OCCMHSP would collaborate in this process should the grant funds be received. In addition, community agencies such as OLSHA may have some transitional vocational services for young adults. Community colleges are another untapped resource which may have services to assist with meeting the educational needs of this population. Finally, support services such as planned respite are needed for parents, relatives and friends of these young adults who may be willing to provide a place for them to live while they are in transition. The focus should be on early intervention 0:provide support services in order to divert young adults from residential placements. In addition, support,servicOs for the family are needed after a young adult is discharged from a residential placement in order for theyoung adult to return home successfully. -„ OCCMH is4i.ropoiing a part time, contracted Youth Transition Intervention Specialist who would serve two functions. ThePrImary responsibility of this position would be to focus on coordination issues within OCCMHSP and vilith Athe community partners, particularly the schools. These efforts would benefit all case managers working with4hispop6lation, by approaching the problems from a systems level. Second, they would work with young atittlarid families to develop services to meet their needs. This process would incorporate the principles of Merscip—;centered planning and a wraparound approach. As a part of this PRR, OCCMHSP is requesting that i0i.000 be set aside as discretionary funds for the Specialist to utilize for one-time expenses. This fund is essential to offer the flexibility of undesignated funds to meet emergency needs of consumers and families. Some of other expenditures. This money may be used in the form if a respite services and a variety al f the things that may be funded include car repairs, transportation, food, utilities, clothing, in home supports, temporary temporary loan or a grant to the family. The Oakland County community wraparound program is currently in a state of transition and does not have the staff to meet the needs of these young adults, nor does its leadership have the resources to pursue these integral partnerships at a systems level. The position funded through these federal block grant funds could be the catalyst for systems change and could develop resources and service models that could benefit the entire wraparound program, as well as meeting internal OCCMHSP coordination needs. • Demonstrated commitment by the board to the proposal, as reflected by the level of CMH funds or other public agency funds directed to the initiative. OCCMHSP has demonstrated its commitment to meeting the transitional residential needs of this population by allocating nearly $400,000 for two transitional supported independent living programs. One of these programs is operational and currently serving four young women. The other will be opening in September and serving five young adults. While this has addressed some of the needs for this population group, community based services that would divert a young adult from residential placement are lacking. This project would create program enhancements and community services to fill that existing service gap. In addition, outpatient therapy services are being added to OCCMHSP's continuum of care this Fall. These services would be available to young adult meeting criteria. Finally, the Director of OCCMHSP has been in contact with Oakland Schools regarding potential partnership opportunities, however, those discussion have not yet resulted in any programmatic or service delivery changes. The existence of this temporary position could help to stimulate and move those efforts ahead. • Define outcomes expected as a result of the service and how It will be evaluated. The work of the Youth Transition Intervention Specialist over the next 12 months will build a foundation and create options for young adults in the community that currently do not exist.. In order to evaluate the effectiveness of the services provided by the contracted Youth Transition Intervention Specialist, OCCMH will track the young adults and families to determine whether the young adults are maintaining successful living arrangements and whether they are participating in educational/vocational opportunities. In addition, over time the number of out of home placements and the length of stay in current placements should be reduced. The services provided by this specialist will no doubt result in documented community partnership activities and possibly letters of agreement or understanding with the school districts and other partners for vocational and education services. Finally, OCCMH will examine its own system after 12 months to determine whether the OAKLAND COUNTY CMKSP - Pigs 22 amount of coordination between adult and children's service has improved including a documented process for transitioning young adults from one system to the other and a list of all. available resources. TOTAL $668.00 $668.00 OAKLAND COUNT( CkiNse • Page 23 FE9ERAL BLOCK GRANT AND PREVENTION PILOT PROGRAM REVISION REQUEST PRR-FBG.VVPD CMHSP: Oakland County -7.. PRR Title: Employment Specialist Training Time Required to Implement: Date Submitted: 94-98 (in months) 1 month I, PRR ID Number: 98-0002 - . - Client Group: MS-A ;:1; MIZC Prevention Gross Cost: $668.00 Board Block Grant Priority: (circle one) _t_ . . of 12 „ .. ... - Board Prevention Priority: .• • _ . - .--.. of — — / Wraparound Psychosocial Rehab — Other Transition Services Federal BlockfGra9t`PRR, T-urpose (check one): .4/ 'rviciesk - ACT Teams _METP11)Y7T.,4 Consumer Run or Directed Initiatives Prevention Integrated Services (Clubhouses) Pilot for Young Children Infant Mental Health Services Prevention Coordinator _ Adults with Children with Board eINANCING SUMMARY Mental Illness Mental Illness Other Administration Total _ Estimated clients to be served by PRR _ PROJECTED FUNDING SUMMARY Projected Gross Funding , $668.00 $668.00 SAMHSA (Federal) Block Grant ,.. $668.00 $668.00 , 1st/3rd/SSI Reimbursement Estimate' . State , , Other (detail): - - _ .. SAMHSA ist./3rd/SS I (Federal) Block Reimbursement Other B. BUDGET DETAIL Grant Estimate' Funding Total 1- Personnel salaries/wages and fringe benefits Equipment Travel (Hotel: 4 nights @ $63; Mileage: 150 miles @ .30 cents $373.00 $373.00 per mile; Meals: 4 days breakfast/dinner at $19 per day) . Supplies, etc. $295.00 _ $295.00 Contractual services (subcontract, etc.)-specify below Subtotal Indirect" 'Block grant funds may not be used to match other federal funds. Per PL 102-3R1, Section 1916B, administrative expenses may not exceed 5 percent. OAKLAND COUNTY CMNSP - Pap 24 NARRATIVE FOR PROGRAM REVISION REQUESTS FEDERAL BLOCK GRANT FBGNARR.VVF'D CMHSP: Pakland County PRR Title/Purpose: Employment Specialist Training / Time Required to Implement: Date Submitted. 9-4-98 (in months) 1 month I, PRR ID Number: 98-0002 Client Group: MI-A f MI,C;,•• D ., • 13clAdmin. Prevention FY of Implementation: 98-99 Board Block Grant Priodty: (circle one)§_, ._. : . _ of 12 ...: ---- \ - Board Prevention Priority: . - of Narrative (atiacliadditional pages as necessary): •‘Zemonstrated need for the sub-population and/or intervention. OCtMH recognizes that employment opportunities are critical for person with mental illness in order to maintain financial independence and to increase community integration. Data from FY 97 reflects and employment rate among OCCMH consumers with mental illness of 19.4%. That incudes 1060 persons with mental illness who were employed full time and another 860 persons who were employed part time. OCCMH is concerned about the level of employment among its population and the agency has been planning strategies to improve upon its performance in this area. OCCMH has contracts with vocational providers and day programs, primarily for persons with developmental disabilities, and OCCMH has four new contracts for Club House programs. However OCCMH is in need of an internal person to provide leadership in the development and enhancement of employment services. • Demonstration that the intervention is an enhancement or innovation. There are currently no staff at OCCMH whose position and functions are dedicated solely to increasing employment opportunities for consumers. OCCMH is in need of an individual with extensive knowledge of employment needs of consumers as well as the ability to partner with potential employers and provides in the community. OCCMH is in the process of hiring a Program Developer/Employment Specialist to focus on the development of employment programs and innovative approaches to increasing community employment opportunities for all populations served by OCCMH, particularly persons with mental illness. This individual will have some prior experience in developing vocational and employment opportunities for persons with mental illness. However, the training provided through this federal block grant will enhance and update the skills and knowledge of this individual which will lead to improved job performance. • Demonstrated knowledge and understanding of the sub-population, the principles of psychosocial interventions and/or the principles of the model or intervention proposed. OCCMH would like to send the new PD Employment Specialist to The Employment Training Specialist (ETS) Training Through Michigan State University in Lansing. The training program will focus on person centered employment planning, job development and marketing strategies, employer negotiations, work site analysis, job selection, task analysis and other areas of interest. OCCMH is requesting the registration fee of $295 plus 4 nights lodging and mileage costs. OCCMH anticipates filling this new position by January 1, 1999 and requests funding for training to take place in the Winter/Spring session (February or March, 1999). • Demonstrated commitment by the board to the proposal, as reflected by: • Level of CMH funds directed to the initiative. • Plan for continuation of effort. OAKLAND COUNTY CMHSP - Page 25 • OCCMH has demonstrated its commitment to increasing employment opportunities for all of the populations it serves by committing a position to develop new programs, collaborative approaches and community partnerships to enhance employment opportunities. OCCMH is committed to ongoing training of its staff, and the PD Employment Specialist will be available to continue to enhance the knowledge and skills and of this critical position. • Defined expectations or outcomes to be expectedand how they will be evaluated. c7; OCCMH anticipatet thathrolUgh this training, the PD Employment Specialist will increase his/her knowledge of supported empl4ment1echniques and the employment needs of persons with mental illness. This knowledge will allow the PD ,E?nployment Specialist to develop creative programs and partnerships with providers to enhance employrryinTbp, pohuhities for OCCMH consumers. In addition, the PD Employment Specialist will be able to share the informatit4yith other OCCMH staff in order to improve their ability to work with consumers and develop voc.ationatiemployment opportunities. ACT Teams Consumer Run or Directed Initiatives Federal Block Grant PRIi(PU-ipose (check one): 7 Aging Servicés,./ 4.--.Employryientvir" `11-, r ° Prevention Wraparound Integrated Services Psychosocial Rehab (Clubhouses) X Pilot for Young Children Other Infant Mental Health Services Transition Services Prevention Coordinator OAKLAND COUNTY CNI1.4913 - Page 26 FEDERAL BLOCK GRANT AND PREVENTION PILOT PROGRAM REVISION REQUEST PRR-FBG.WPD CMHSP: Oakland County PRR Title: Needs Assessment and Child Care Provider Training to Prevent Time Required to Implement: Date Submitted. 9-4-98 Expulsion of Young Children from Child Care ,Settings through 4C's Council (in months) 12 months PF6R ID Number: 98-0003 • Client Group: MI-A 41-,S Prevention Gross Cost: $19,850 Board Block Grant Priority: (circle one) .1. `-- - s _a_. of _12_ Board Prevention Priority: .- of ./- Adults with Children with Board .11D5F1NANCING SUMMARY Mental Illness , Mental Illness Other Administration Total Estimated clients to be served by PRR , PROJECTED FUNDING SUMMARY Projected Gross Funding $19,850 $19,850 SAMHSA (Federal) Block Grant $19.850 $19,850 lst/3rd/SSI Reimbursement Estimate* State Other (detail): . SAMHSA. 1st/3rd/SSI (Federal) Block Reimbursement Other B. BUDGET DETAIL Grant Estimate* Funding Total . Personnel salaries/wages and fringe benefits $17,000 $17,000 . Equipment 250 250 _ Travel 200 200 Supplies, etc. 650 650 ' Contractual services (subcontract, etc.)—specifli below 1- Subtotal $18,100 $18.100 I Indirect** 1 i Occupancy 750 750 I_ Communication 1,000 1,000 TOTAL $19,850 $19,850 *Block grant funds may not be used to match other federal funds. Per PL 102-3R1, Section 19168, administrative expenses may not exceed 5 percent. NAftFtATIVE FOR PROGRAM REVISION REQUESTS FEDElkAL BLOCK GRANT FBGNARR.WPD CMHSP: Oaklanc. OAKLAND COUNTY CMHSP - Page 27 PRR Title/Purpose: Needs Assessmgnt and Child Care Provider Training to Time Required to Implement: Date Submitted: 9-04-98 Prevent Expulsion of Young Children from Child Care Settings through 4C's On months) 12 months i , Council PRR ID Number 98-0003 Client Group: MI-A ,. ffl.,& '. DD Br) Admin. Prevention FY of Implementation: 98-99 Board Block Grant Priority: (circle one) /- .. ---' _I_ of . 12 Board Prevention Priority: - of Narrative (attachiadditional pages as necessary): The folloivingbutline should be followed for the PRR narrative (attach additional pages as necessary) (include non-bolded items fore Wraparound e;PRR Demonstrated need for the subpopulation and/or intervention. ti `a survey by Project Find of Pre-Primary Impaired programs, 17 out of 28 school districts replied. In those 17 istricts, teachers identified 43 children as having extreme behaviors. These are the kind of children which day care centers are unprepared for. Parents of these children need to go to work, but day care centers eject their children, thus jeopardizing the parents' employment. Many of these youngsters already have attachment problems, and being placed in one day care center after another, only to be rejected again, makes their behavior worse and their attachments more tenuous. • Demonstrated knowledge and understanding of the sub-population, the principles of psychosocial interventions and/or the principles of the model or intervention proposed. Developing secure attachment relationships is among the most important developmental tasks for young children. The child who forms an attachment to an adult caregiver makes a smooth transition between home and child care, and later to the school setting, and then uses the caregiver as a secure base during the day. The child who forms attachments to a series of caregivers, all of whom leave, may find it too painful to continue the cycle and conclude that human relationships are to be avoided. We hope to intervene so that this cycle of rejection will not occur for these vulnerable youngsters. The Oakland County Community Coordinated Child (4C's) Council will be our partner for this planning grant. The Council is a child care resource and referral agency and processes over 5500 child care referrals for families each year. In addition the Council supports the 1700 registered/licensed Oakland County child care providers through training, resource library and technical assistance. Through Strong Families/Safe Children the Council facilitates a child care scholarship program which assists low to moderate income families in paying for child care. The Council also administers the Lekotek of Oakland County which is a play center and toy lending library for families with children with special needs. Currently there is no mechanism to track children who have been expelled from child care. This initiative will establish data and anecdotal information regarding the issue. Families will be accessed through the child care referral process and the Council's network of child care providers. Children who are identified as needing psychiatric services will be referred to CMH for screening. Through fund from this federal bock grant, two survey instruments will be developed: One which is completed by child care providers, and one completed by families. The surveys will identify the factors involved in the expulsion and collect anecdotal information including historical context and preventable issues. They will also be used to gather information on the appropriateness of the placement. The survey results will be shared with our other collaborators on the Children's Summit conference including FIA, Family Court, Early On, the Intermediate School District and numerous private agencies. The information from this survey can be used as a case finding mechanism for CMH so that we can intervene early with families and children who may be at risk for later out-of- home placement. OAKLAND COUNTY CMHSP . Page 28 . OCCMH is also requesting funding for a Community Child Care Consultant, who will be employed by the 4C's Council. That individual will make site visits and provide consultation support to child care providers who have children with challen'ging behaviors. The purpose of the consultation is to help determine the appropriateness of . the placement, facilitate inclusion and refer to community resources, including CMH. This individual can also, upon request, serve as an enhanced support worker who will provide short-term, temporary additional staffing for the child care provider to provide modeling for other child care workers on site l OCCMH has found this model of providing a respite worker to be extremely useful in latchkey programs, allowing children who otherwise would be excluded to participate.,in latchkey so that their parents can retain their jobs. In addition to f;).e stajijor-tlie. Child Care Consultant, OCCMH is requesting funding for equipment and supplies. This includesIdning retOurce materials, copying costs and mailing costs for the surveys. Indirect expenses include officetiOce .and training space, as well as communication expenses such as follow-up phone calls to families and4child.dare providers. „ emonstrated commitment by the board to the proposal, as reflected by the level of CMH funds or er public agency funds directed to the initiative. thoard's commitment to the program is manyfoid: OCCMH is sponsoring general educational programs in the community to help parents and providers dealing with challenging behaviors, and is involved in collaboration with any agencies in the Children's Summit Birth to Six project. OCCMH is also offering a wide range of clinical and in-home support services to the SED children and their families who will be identified through the survey. In addition, OCCMH, along with the Intermediate School District, Early On, 4C's and the MPCB, CMH is sponsoring a series of free workshops by Maurice Moses for parents and care givers of children ages 2-5 on how to handle challenging behaviors. There is room for 300 attendees. • Define outcomes expected as a result of the service and how it will be evaluated. The surveys will help us understand and service the needs of this population better. OCCMH also will be able to evaluate the efficacy of consultation and enhanced staffing at day care centers with data from this project. Families and children identified through the project will receive an array of CMH services which may prevent out- of-home placement in the future, Sincerely, Sandra M. Lindsey, MSW. ACSW Director OAKLAND COUNTY CINKSP - Page 211 cc rvi PA Li Isi 1 -1-"Nr• Furl E N 17A_L- HE ALT H 1200 N. Telegraph • Pontiac, MI 48341 • Phone(248) 858-1221 • Fax(248) 975-970 August 31, 1998 Mr. John Almstad Oakland County HSCC 2100 Pontiac Lake Road Waterford, MI 48328 Dear Mr. Almstad, Oakland County Community Mental Health is in the process of submitting its annual Program Plan to the State of Michigan. Through this process, OCCMH may apply for federal block grant funds for program enhancements, including pilot projects for young children expelled from child care settings. Lack of available child care services for this population places the child at risk and impacts the ability of the parents to maintain gainful employment. Through our research, OCCMH has discovered that there is currently no method of tracking young children expelled from day care settings within Oakland County. Through this program revision request, OCCMH is partnering with the Oakland County Community Coordinated Child Care (4C's) Council to develop survey instruments to gather data on this vulnerable population. This data will be shared with our community partners and will be used to identify cases for early intervention services. In addition, training will be provided to child care providers to assist them in dealing with challenging behaviors. Due to the collaborative approach that being proposed, OCCMH is required to obtain a letter of support from our local multi-purpose collaborating body. Enclosed is a copy of OCCMH's program revision request as well as a recommended format for the letter of support. If this letter meets with the approval of the HSCB, I would request that you forward a signed original to me as soon as possible so that it may be included with OCCMH's Program Plan. Thank you for your consideration of this important request. FY of Implementation: 98-99 Board Block Grant Priority: _j of 12 Board Prevention Priority: of Client Group: MI-A at:_c DIY Bd Admin. Prevention (circle one) OAKLAND COUNTY CMHSP • Page 31 NA,RRATIVE FOR PROGRAM REVISION REQUESTS FEDERAL BLOCK GRANT FBGNARR.VVPD CMHSP: Oakland County PRR Title/Purpose: 4-H/OCCMH Community Collaborative Designed Especially for Children with Sever Emotional Disturbance Time Required t,‘ Implement: (in months) 12 months Date Submitted: 9-04-98 PRR ID Number: 98-0004 / Narrativelittach additional pages as necessary): onstrated need for the subpopulation and/or Intervention. In Oakland County the number of families faced with the challenge of raising and coping with children diagnosed with severe emotional disturbance (SED) continues to rise. Last year Oakland County Community Mental Health successfully served 400 consumers and their through our 4H-Community Mental Health Respite Collaborative. With a combination of Tobacco Tax and County funding MSU-4H ;;T" and Oakland County Community Mental Health have designed and implemented a year round program that provides the SED consumer an educationally based, developmentally appropriate, hands-on experience. All activities focus on the social-emotional skill areas. Through this model we have been able to provide SED youth a typical childhood experience in a positive supported environment. Each year consumers and families stress a need to continue to provide the summer camp arid a year round 4H program. • Demonstrated knowledge and understanding of the sub-population, the principles of psychosocial interventions and/or the principles of the model or intervention proposed. This collaborative is unique to our community and one we've developed as a national Respite model for effectively and creatively serving our SED youth. Program components include: a four week day camp, weekly 411 club meetings, horseback riding club, seasonal family weekend camps, and 4 family highlight activities. To ensure the success of this program and community partnership, OCCMH has dedicated staff to the project to support the efforts of the 4H trained volunteers and the wealth of Michigan State University's Extension program and in kind support. 4H and OCCMH are committed to serving the whole family. The program's focus creates an overall support structure for SED youth and their families. Families learn crucial coping skills while engaging in positive experiences with their children. Families also have opportunity to develop a cross family support system that fosters parental self esteem and parenting skills with someone who can readily relate to their situation. Each program component has a unique, innovative way to achieve outlined goals. Participation in the 4H programs builds skills in the social-emotional learning domains while incorporating science, math, language, and technology education. For parents, the project offers tools to learn valuable coping skills through team work, patience, and family strength development. 4H families will have an opportunity to volunteer their time, resources, and expertise to benefit all 4H clubs, events and activities. Encouragement for parents to become trained volunteer leaders in their child's clubs, activities designed to include siblings and parents, and highlight events where children can share their newly acquired skills and talents with their families are the core components of the project. Integrating parents into their child's activities provides critical services to both the child and family. Interaction meetings offer an avenue for parents to meet and form relationships with other parents and families in similar circumstances. These meetings help to foster cross family support networks and communication. • Demonstrated commitment by the board to the proposal, as reflected by the level of CMH funds or other public agency funds directed to the initiative. MSU-4H and Community Mental Health have offered to share this model with other CMH boards, both at state and national levels. The collaborative project between Michigan State University Extension-4H Youth Programs and Oakland County Community Mental Health has been supported by the board and successfully piloted for four years. 411 and MSU provide volunteers and other in-kind suport for this program. OCCMH provides matching funds to support this program. • Define outcomes expected as a result of the service and how it will be evaluated. Every youth and family consumer of Oakland County Community Mental Health who participate in this project will receive quality, innovative, respite through a person-centered, educational model. Each program component will be facilitated by a trained 4H volunteer, program facilitator, or 4H Project Educator and Coordinator. Each aspect of the planning, development, and attainment of goals has been carefully reviewed and piloted before implementing in the core curriculum. 414 is recognized nationally for its 'hands on approach to helping people of all populations explore the world around them while maintaining the highest standards of learning activities. This collaboration not only provides the SED youth and their families a positive, educational experience, but gives access to the unlimited educational possibilities that the 4H programs have to offer. Travel (Registration and Travel Expenses for Training) $4,250 $6,150 $1,950 TOTAL $4,250 61,950 $6,150 OAKLAND COUNTY CMHSP - Page 32 FEQER.AL BLOCK GRANT AND PREVENTION PILOT PROGRAM REVISION REQUEST PRR-FBG.VVPD CMHSP: Oakland County • PRR Title: New Club House Training for St. Joseph Mercy - Central and Mercy Time Required to Implement: Date Submitted: 9-04-98 Network - Central (In mo:fiths) 12 .. PRR ID Number: 98-0005 C „,- 4::. - Client Group: MI-A j /MI-C ,, . Prevention Gross Cost: $6.150 Board Block Grant Priority: (circle one) ja... of 12 • Nr.: - Board Prevention Priority: ______ of 74. Federal Bloc* Graht.RRR Purpose (check one): A., nKervices ACT Teams Consumer Run or Directed Initiatives Nc- Wraparound _g_Psychosocial Rehab (Clubhouses) Other Transition Services Prevention Integrated Services Pilot for Young Children Infant Mental Health Services Prevention Coordinator Adults with Children with Board A. FINANCING SUMMARY Mental Illness Mental Illness Other Administration Total , Estimated clients to be served by PRR PROJECTED FUNDING SUMMARY — Projected Gross Funding $6,150 $6,150 SAMHSA (Federal) Block Grant $4.250 $1,950 $6,150 1st/3rd/SSI Reimbursement Estimate State Other (detail): , r - SAMHSA 1 st/3rd/SSI (Federal) Block Reimbursement Other B. BUDGET DETAIL Grant _ Estimate _ Funding Total It Personnel salarieshvages and fringe benefits Equipment Supplies, etc. Contractual services (subcontract, etc.)-specify below Subtotal Indirect 'Block grant funds may not be used to match other federal funds. Per PL 102-3R1, Section 1916B, administrative expenses may not exceed 5 percent. OAKLAND COUNTY CMHSP Page 33 CMHSP: Oakland CountY NAFFtATIVE FOR PROGRAM REVISION REQUESTS FEDERAL BLOCK GRANT FBQNARR.WPD PRR Title/Purpose: New Club House Training for St. Joseph Mercy - Central and ( Time Required to Implement: Date Submitted: 9-04-98 Mercy Network - Central (in months) 12 PRR ID Number: 98-0005 Client Group: MI-A :: MliCi, DO, Bd Admin. Prevention FY of Implementation: 98-99 Board Block Grant Priority: (circle one) - / A_ of —12- -. / - Board Prevention Priority: of Narrative (attactradditiona) pages as necessary): The feibiving ii.utfirie should be followed for the PRR narrative (attach additional pages as necessary): Demonstrated need for the sub-population and/or intervention. ç,-Demonstration that the intervention is an enhancement or innovation. • Demonstrated knowledge and understanding of the sub-population, the principles of psp:hosocial interventions and/or the pr,,;,P principles of the model or intervention proposed. • Demonstrated commitment by the board to the proposal, as reflected by: • Level of CMH funds directed to the initiative. • Plan for continuation of effort. • Defined expectations or outcomes to be expected and how they will be evaluated. • Relative priority of the proposal • Demonstrated need for the sub-population and/or intervention Effective October 1,1998 Mercy Network Central will be assuming responsibility for the operation of an existing clubhouse, New Beginnings Clubhouse, in downtown Pontiac, in Oakland County. Seven new staff will be hired who will have had limited or no experience with clubhouse services for the severely and persistently mentally ill population. * Demonstration that the intervention is an enhancement or innovation Mercy Network Central is aware that this training opportunity is a necessary step in the process of developing a quality clubhouse program. The training is based on ICCD standards which are the *Cadillac' of clubhouse program standards. First hand reports from staff who have attended the training confirm its value and importance for staff and members. * Demonstrated knowledge and understanding of the sub-population, the principles of psychosocial interventions and/or the principles of the model or intervention proposed Mercy Network Central has been operating a comprehensive case management services program in the central quadrant of Oakland County since August 1995 for persons with severe and persistent mental illness. In July 1998, Mercy Network Central was awarded a contract to operate a clubhouse program in the central quadrant of Oakland County. The plan is for two clubhouse staff, and one clubhouse member to attend for three weeks, and one Program Administrator will attend the training for one week at one of the approved sites. A copy of a brochure from the training site, Independence Center in St. Louis, Missouri is attached as an example of the training program. The expected cost of the training is $4250 plus costs for airfare at $1200 and per diem costs for twenty eight days at $25/day of $700. Total cost of the training is $6150. Demonstrated commitment by the Provider to the proposal as reflected by: St Joseph Mercy Hospital - Oakland and Mercy Network Central have demonstrated their commitment to clubhouse services to these consumers through the central quadrant contract, and their successful bid to operate OAKLAND COUNTY CMHSP - Page 34 _ a clubhouse program in the central quadrant. * Level of provider funds directed to the initiative Mercy Network Centre contribute the travel and per diem costs estimated at $1950 through its operating budget. * Defined expectations or outcomes to be expected and how they will be evaluated , . Anticipated‘Outcorties are: ree- / i • iaftwillincrease their knowledge and skill levels in operating clubhouse programs • MeniEer program outcomes will be enhanced by staff participation in the training program _ Improvements in members' vocational functioning ;improvements of members' quality of life • Clubhouse staff will monitor the member satisfaction surveys of the clubhouse program. 1111 Sit Uteki , lr " uae ti.0111S3 St Louis Attic-lotions While homing in St Louis, colleagues will have the oppoitunity to visit many 01 the attractions that have made St 1.011IS CI t011iiM M(K.X.X1 for the lc.rst ',.IIIIITy th.o Pinion.; Gateway Arch. lho largest Ilower y iii f Jtk Americo. Anheusei Busch. I blest Park (silo ol Ilie 1Q04 Wor ld Pala Union Station. the Botanical Golden!: the Saint Louis Zoo the Art Museum hisloyir: Lactedd: Landing and many wilily others 1111 if W .111101)(1 , CPrItet is accredited by the lpilu v itir,ri it ("enter for Clubhouse I)(veloprnerit ill (*II) Ihe Commission on Accredikrhon of Poliabilitalion tor limes ((A16') and through 11111“, I. svr,tr I l 11(11 by Bo. Joint Commission on A., r,lii 1 e,1 1 le ,• 1111)c (itv ()tqamzellionr, (ICAI10) II hr 1( "AI 4 Colleague Training at West Pine House and Midland House OAKLAND COUNTY CMHSP Page 36 tor Inlormati4)1110.q(ircimg frothing and tuition. call Indtvenderwo (-ellif 'I CLIO (Mk tor Colleague 11, lining Infonnalion (1141 t 4 (rid ext 212 or (.114) .511.6511 lax Iill! ',I li 172 Il rni 311 .1.1(111111).11( utolcom i• 1 , I 0? to• oo,I• VI. 11.111.• II ex, en t e7.3 • z ! co ,•, C d Id c I r 0,0 orO er'1* • s or, C..: -r -! St. Louis Independence Center 41,011,%,,t hre i1uuii rd `4t I \11ouri n,11IN (3141;11--r ,.0e‘t 212 or (114) ;116;11 iftellimatillow The Clubhouses 0 2 We Are West Pine House and Midland House The -Clubhouse Moder oi psychiatric rehabilitation, developed 111 NeW Nbrk in the 1950s, has been replicated internationally and now serves people with serious and persistent mental illnesses Illuoughoul the woild West Pine House and Midland House have been providing training experiences since 1985 Ond are proud to be one of only ten recognized' training bases in the world Centrally located in St Louis. the Gateway to the West. Midland I louse and West Pine House have provided training experiences to over 520 colleagues horn 39 states arid 4 countries. West Pine House and Midland House were established in the early eighties by a group of parents and friends of people with mental illnesses Over the years. the clubhouses have developed comprehensive Illogic:1ms and services designed to assist adults with serious and peisistent mental illnesses to live and work in the community independently and with dignity. Collectively we mill ourselves Independence Center Independence Center offers the rinique experience of training within two distinct clubhouses. West Pine House is a larger urban clubhouse with an average daily attendance of approximately 130 members. Midland House, with an average daily attendance of 70 members, allows colleagues to experience the clubhouse model in a smaller. suburban setting. Accommodations While training in St. Louis. colleagues stay at our Guest House located near West Pine House. The Guest House is equipped for the combo Of our colleagues with a full kitchen and living room. cable television and VCR. plenty of sleeping space and, of course, good company and exciting conversation. The Guest House is conveniently located in St. Louis' 'Central West-End7 known as the Greenwich village of St. Louis and one of the most exciting areas in town With a variety of restaurants, specialty shops, outdoor cafes and pubs, adventurous colleagues will be sure to find something to their liking in the area Training Programs Developed in concert with the Li item( it,nriil (-.1.0../ for Clul)house DoveInprnoni w., n ,11,r (1 1i, 11/ curriculum designed to iii'. 't I ii expel ion, 'r , I (111, !new dui In, 1i 11 • r. .111 I ..1 rot pingft lift.sImply S ,,ek111",.1 11110111i 111, ii•••1,! !! Cita-41011Se 1110(101. we Me st Po I t+, OH. i cloy experientiut h I oily to piovide ciii oveiVICW of the I ii iii p this orient(rtion. we highlit 1111 th•• model (Ind give visitors (1 (rlimi it w it in the clubhouse such a hopeful!1ext liii For programs fully committed to skIrtinq clubhouse or Jor •st(11)11.,11, I clubhouses, we offer both !he traditional thir, week comprehensive training us well us ki otw week employment track :training What to Expect While training at West Pine House and Midland House you cun expect to learn with us the way we learn from each other: side by side All training Includes three basic aspects • Practical. hands-on experience iii the clubhouse work units • Small group discussions about clubhouse philosophy and practice • Informative specific presentations facilitated by experienced members and staff As a colleague, you can expec,4 to be challerigort informed and welcomed into the warmth and friendship of our clubhouses Board Block Grant Priority . _LQ. of _12_ Prevention Client Group: MI-At z . MPG Gross Cost: $2,100 (circle one) Board Prevention Priority: of OAKLAND COUNTY CMHSP Page 37 FEWFAL BLOCK GRANT AND PREVENTION PILOT PROGRAM REVISION REQUEST PRR-FBG.WPD CMHSP:JJ,_ad nd County PRR Title: Club House Employment Specialist Training for St. Joseph Mercy Network - Central 1 Time Required to Implement: (in months) 12 Date Submitted 9-04-98 IDRR ID Number: 98-0006 .1.1••n• Federal Elio* Graht.ERR Purpose (check one): ACT Teams Consumer Run or Directed Initiatives Wraparound X Psychosocial Rehab Other Transition Services Prevention Integrated Services (Clubhouses) Pilot for Young Children Infant Mental Health Services Prevention Coordinator ,Aging•Services : Adults with Children with Board A. FINANCING SUMMARY Mental Illness Mental Illness Other Administration Total ,. Estimated clients to be served by PRR _ PROJECTED FUNDING SUMMARY I Projected Gross Funding $2,100 $2,100 SAMHSA (Federal) Block Grant $2,100 $2,100 _ I lstf3rd/SSI Reimbursement Estimate* State _ , Other (detail): _ SAMHSA 1st/3rd/SSI (Federal) Block Reimbursement Other B. BUDGET DETAIL Grant Estimate* Funding Total , Personnel salaries/wages and fringe benefits Equipment , Travel (Registration fees and travel expenditures for training) $2,100 $2,100 Supplies, etc. Contractual services (subcontract, etc.)—specify below , Subtotal _ Indirect** TOTAL $2,100 $2,100 'Block grant funds may not be used to match other federal funds. 'Per PI- 102-3R1, Section 1916B, administrative expenses may not exceed 5 percent. OAKLAND COUNTY CMHSP - Page 38 CMHSP: Oakland County NARRATIVE FOR PROGRAM REVISION REQUESTS FEDERAL BLOCK GRANT FBGNARR.VVPD — PRR Title/Purpose: Club Hour Employment Specialist Training for St. Joseph Time Required to Implement: Date Submitted: 9-04-98 Mercy Network - Central (in months) 12 I PRR ID Number: 98-0006 . - .1-- '_'• Client Group: MI-A MI-CV'F. DD ,.,-' Bd Admin. Prevention FY of Implementation: 98-99 Board Block Grant Priority: (circle one) / i; - , J_Q_ of_u_ - ,:- Board Prevention Priority: - of Narrative (attacitaddffional pages as necessary): ',The iiiitirre should be followed for the PRR narrative (attach additional pages as necessary). sk_glia Demonstrated need for the sub-population and/or intervention. Nee Demonstration that the intervention is an enhancement or innovation. Demonstrated knowledge and understanding of the sub-population, the principles of psychosociel interventions and/or the principles of the model or intervention proposed. • Demonstrated commitment by the board to the proposal, as reflected by: • Level of CMH funds directed to the initiative. • Plan for continuation of effort. • Defined expectations or outcomes to be expected and how they will be evaluated. • Relative priority of the proposal Demonstrated Need for the sub-population and/or intervention Effective October 1, 1998 Mercy Network Central will be assuming responsibility for the operation of an existing clubhouse, New Beginnings Clubhouse, in downtown Pontiac, in Oakland County. Seven new staff will be hired who will have had limited or no experience with employment services for the severely and persistently mentally ill population as well as limited or no experience in clubhouse programing. The current clubhouse in Pontiac had minimal activities related to developing and operating employment services. We are aware from focus groups that were held with current clubhouse members that they were very interested in having employment opportunities available. Thus, the opportunity to have the new staff participate in the ETS will enhance our ability to produce employment outcomes for the clubhouse members. The training is offered three times a year in Lansing and runs for four consecutive days. • Demonstration that the intervention is an enhancement or innovation Mercy Network Central is aware that past participants in the Michigan State University ETS Program reported that they were able to successfully use the training on supported employment techniques for their consumers with mental illness. They also achieved positive long term outcomes for the consumers because of the training. Supported employment will be one of the possible employment outcomes developed in the Mercy Network Central clubhouse. " Demonstrated knowledge and understanding of the sub-population, the principles of psychosocial Interventions and/or the principles of the model or intervention proposed Mercy Network Central has been operating a comprehensive case management services program in the central quadrant of Oakland County since August 1995 for persons with severe and persistent mental illness. We have supported our consumers efforts to access employment services by having a full time vocational services coordinator available to our staff. We understand the need for and importance of offering employment opportunities to our consumers. All seven staff employed et the Mercy Network Central Clubhouse will attend the training. The estimated cost of the training which includes seven staff attending at $300 for each staff person is $2100. • Demonstrated commitment by the Provider to the proposal as reflected by: OAKLAND COUNTY CMHSP • Page 39 • . St. Joseph Mercy Hospital-Oakland and Mercy Network Central have demonstrated their commitment to employment services to these consumers through the central quadrant contract, and their successful bid to operate a clubhouse program in the central quadrant. Our organization works collaboratively with Oakland County • Community Mental Health to provide these services. • Level of provider funds directed to the initiative Mercy Network Central will contribute the use of an agency van to transport two groups of staff at different times of )6. 6/ * Defined expjtctatioknsair outcomes to be expected and how they will be evaluated Anticipated oOtrittiles- are: * Staff wil 1 increase their knowledge of available employment strategies for this population * SfffiIl diveiop more employment opportunities for this population • pt,etf_ ents of members' vocational functioning 'ftpprovements of members' quality of life the year. lubhouse staff will monitor the number of employment opportunities developed, the number of clubhouse embers who choose to work, and the duration of the members' work experiences. ACT Teams Consumer Run or Directed Initiatives Wraparound Aysychosocial Rehab Other Transition Services Federal Block GrariteRR Purpose (check one): ' 9Yinint Prevention Integrated Services (Clubhouses) Pilot for Young Children Infant Mental Health Services Prevention Coordinator OAKLAND COUNTY CMHSP - Page 40 FEKRAL BLOCK GRANT AND PREVENTION PILOT PROGRAM REVISION REQUEST PRR-FBG.WPD CMHSP: Oakland County PRR Title: Dual Diagnosis (MI/SA Clubhouse Integration Project for St. Joseph Time Required to Implement: Date Submitted: 9-04-98 Mercy OaklaFd and Mercy Network - Central (in months) 6 I, PRR ID Number: 98-0007 Client Group: MI i -A i .; MI-C Prevention Gross Cost: $8,925.00 Board Block Grant Priority: i •. (circle one) . ‘„, j... of _12_ r‘ ., Board Prevention Priority: of ;- Adults with Children with Board A. FINANCING SUMMARY Mental Illness Mental Illness Other Administration Total r Estimated clients to be served by PRR 20 . PROJECTED FUNDING SUMMARY Projected Gross Funding $9.350 $9,350 SAMHSA (Federal) Block Grant $9,350 $9,350 1st/3rd/SSI Reimbursement Estimate* State Other (detail): - , . , SAMHSA 1st./3rd/SSI (Federal) Block Reimbursement Other B. BUDGET DETAIL Grant Estimate Funding Total , Personnel salaries/wages and fringe benefits $7,800 $7,800 Equipment Travel . Supplies, etc. $700 $700 Contractual services (subcontract, etc.)-specify below Subtotal $8,500 $8,500 r 1 Indirect - $850 $850 i 1 h TOTAL $9350 $9350 'Block grant funds may not be used to match other federal funds. *Per PL 102-3R1, Section 1916B, administrative expenses may not exceed 5 percent. OAKLAND COUNTY CNIHSP P&p 41 NARRATIVE FOR PROGRAM REVISION REQUESTS FEbERAL BLOCK GRANT FBGNARR.WPD CMHSP: Oakland County pRR Title/Purpose: Dual Diagnosis (MI/SA Clubhouse Integration Project for St. Time Required to Implement: Date Submitted: 9-04-98 Jeseph Mercy Oakland and Mercy Network - Central l (in months) 6 PRR ID Number: 98-0007 - . Client Group: boll-A , MI-C , DD Bd Admin. Prevention . FY of Implementation: 98-99 Board Block Grant Priority: (circle one) i . ..-,. - ....5._ of _i_z_ \ . Board Prevention Priority: - of Narrative (attach additional pages as necessary): The folorilng olitlineihould be followed for the PRR narrative (attach additional pages as necessary): Demonstrated need for the sub-population and/or intervention. Demonstration that the intervention is an enhancement or innovation. •:--Demonstrated knowledge and understanding of the sub-population, the principles of psychosocial interventions and/or the principles of the model or intervention proposed. • Demonstrated commitment by the board to the proposal, as reflected by: • Level of CMH funds directed to the initiative. • Plan for continuation of effort • Defined expectations or outcomes to be expected and how they will be evaluated • Relative priority of the proposal * Demonstrated Need for the sub-population and/or intervention Mercy Network Central is aware, as a result of operating a comprehensive case management service program in OCCMH's central quadrant since August of 1995, that a substantial number of our consumers have substance abuse histories and that traditional efforts to meet the multiple and complex needs of their mental health and substance abuse disorders have not been effective. The current literature according to Dual Disorders Specialists such as Dr. Bert Pepper, Kathleen Sciacca, and Dr. Robert Drake indicate that the most effective type of intervention with consumers with the dual disorders of mental illness and substance abuse is one based on an integration of mental health and substance abuse services. * Demonstration that the intervention is an enhancement or innovation Mercy Network Central is a aware that services for the dual disorders (MI/SA) consumer population are not currently provided for in the DCH Guidelines for psychosocial rehabilitation programs, and are not being provided by other clubhouses in Oakland County. We believe that an innovative/demonstration project should be implemented to determine if these services can be effective within the context of a psychosociaV clubhouse program in Michigan. • Demonstrated knowledge and understanding of the sub-population, the principles of psychosocial interventions and/or the principles of the model or intervention proposed The Mercy Network Central Clubhouse Program Director visited two programs in New Jersey in November, 1997 that have developed an integrated substance abuse service component within the context of a clubhouse program. Those programs are the MICA Club in Cherry Hill, New Jersey, and The Club in New Brunswick, New Jersey. Both programs have reported successful outcomes of reduced use of chemicals, reduced use of inpatient services, improvements in psychological functioning, and improvements of quality of life. Mercy Network Central will be taking over the operation of an existing clubhouse program in Pontiac effective October 1 ,998. It would be our intent to star the proposed services in the seventh month of our Clubhouse program year offering a range of supportive group and individual counseling and didactic services to members with the dual disorders of mental illness and substance abuse. The reason for the phase in approach is to assure that the standard clubhouse organizational elements are in place and successfully operating before introducing innovative elements to the program. OAKLAND COUNTY CMHSP - Pip 42 Program Elements The Dual disorders program would include the following for eight to ten members at any given time: 1. Supportive group counseling twice a week for one and a half hours 2. Educational/didactic groups once a week for w ile hour 3. A self-help 12 stepAgroup meeting twice a week for two hours; once during the daytime and once during one of the scheduledtiVening programs. 4. Five hours weéklYsof individual counseling time available to the eight to ten members 5. Six hourS46ekly forscreening, intake, members/staff conferences, planning, documentation, paperwork Staffing/1 Services would be provided by a part-time substance abuse counselor with previous experience working with the severely/and:persistently mentally ilL The dual disorders counselor would be contracted for fifteen hours weekly 4i,...,,:it„,,,Whictyinaludes planning, documentation, case conferences and delivery of services. The Program/Peer Aide will assist.iivith the operation of this service. „ Cost ...1r7 Projected annual cost for the dual disorder services in the first year would be $9350 based on 390 hours of services at $20/hour plus $700 in support costs for educational and training items, and 10% administrative cost at $850. In summary, we would offer up to thirteen hours a week of professional and self-help dual disorder (MI/SA) services within the structure of the program. Clubhouse members with dual disorders would also be encouraged to participate in other community based self-help groups and activities. It is our belief that the special dual disorder services combined with the traditional psychosocial rehabilitative services would have a powerful impact on helping members reach and maintain recovery from both the mental illness and substance abuse. Demonstrated commitment by the Provider to the proposal as reflected by: St. Joseph Mercy Hospital - Oakland and Mercy Network Central have demonstrated their commitment to services to these consumers through their inpatient contract, the central quadrant contract, and their successful bid to operate a clubhouse program in the central quadrant Both organizations work collaboratively with OCCMH in the provision of these services. • Level of provider funds directed to the initiative The services being proposed here are being developed within the context of services already being provided through other contracts with the Oakland County CMH Board for a clubhouse program and case management services. The staff being proposed in this request would be supervised by the Clubhouse Supervisor and office space and program space would be provided. * Plan for continuation of effort Our suggestions for possible ongoing funding for the dual disorders program are: 1. Oakland County Community Mental Health Board 2. Oakland County Substance Abuse Coordinating Agency 3. Michigan Jobs Commission Innovation/Expansion Grants 4. Skillman and other Foundations * Defined expectations or outcomes to be expected and how they will be evaluated Anticipated outcomes are: OAKLAND COUNTY CMHSP - Pap 43 • Reduced use of alcohol and other drugs • Reduced use of psychiatric inpatient services • Reduced use of substance abuse residential treatment services * Improvements in psychological functioning • Improvements of quality of life The Dual Disorders Clubhouse counselor will monitor the use of chemicals and inpatient and residential treatment facilities. On a quallsif-basis, the Dual Disorders Clubhouse Counselor will monitor in conjunction with other clubhouse staftandAferring case managers the status of the members' psychological functioning and quality of life. BASIS 4 sqofik:PQ45' scores, GAF scores and Lehman Quality of Life ratings will be used. Prevention Client Group: MI-A (cede one) Gross Cost: $6.300 Board Block Grant Priority. _a_ Of 12 Board Prevention Priority: of OAKLAND COUNTY ChiHSP - Page 44 FEIDERAL BLOCK GRANT AND PREVENTION PILOT PROGRAM REVISION REQUEST PRR-FBG.VVPD CMHSP _Oakland County PRR Title: Board Training for Consumer Run Drop In Center Programs Time Required to Implement: (in months) 6 months Date Submitted-04-98 PRR ID Number. 98-0008 - Federal Block.f.Gragt-PRFI:Purpose (check one): r 42,,Agictgpervices;' ACT Teams 7:04nplbant X Consumer Run or Directed Initiatives Prevention Wraparound Integrated Services Psychosocial Rehab (Clubhouses) Pilot for Young Children Other Infant Mental Health Services Transition Services Prevention Coordinator .. Adults with Children with Board A. FINANCING SUMMARY Mental Illness Mental Illness Other Administration Total Estimated clients to be served by PRR PROJECTED FUNDING SUMMARY Projected Gross Funding $6.000 $6,000 . SAMHSA (Federal) Block Grant $6,000 $6,000 1st/3rd/SSI Reimbursement Estimate' State - Other (detail): _ SAMHSA 1sV3rd/SSI (Federal) Block Reimbursement Other B. BUDGET DETAIL Grant Estimate Funding Total Personnel salaries/wages and fringe benefits .. Equipment Travel (mileage for Consumer Board members, trainers) $400 $400 Supplies, etc. (For training resource materials) $800 . $800 II Contractual services (subcontract, etc.)-specify below $4,800 $4,800 ; Speakers fees for contract with Board Trainer - Subtotal . _ . Indirect** (for Meeting Space and coordination, $300 $300 communication, etc.) n n -4 TOTAL $6,300 - $6,300 _ 'Block grant funds may not be used to match other federal funds. Per PL 102-3R1, Section 1916B, administrative expenses may not exceed 5 percent. OAKLAND COUNTY CIM1SP • Page 45 NARRATIVE FOR PROGRAM REVISION REQUESTS FEDERAL BLOCK GRANT FBGNARR.WPD CMHSP: Oakland County PRR Title/Purpose: Board Training for Consumer Run Drop In Center Programs Time Required to Implement: Date Submitted: 9-4-98 (in months) 6 i PRR ID Number 98-0008 Client Group: MI-A ,, MI-C -DD , Bd Admin. Prevention FY of implementation 98-99 Board Block Grant Priority: (circle one), / _a_ of _ia_ ,-- -- ,.., .-. ..- : Board Prevention Priority: . — — of -- !-. Narrative (attatadditional pages as necessary): - ''';:Petlyonstrated need for the sub-population and/or intervention urrrigIfY 98-99, Oakland County Community Mental Health will be expanding its capacity for the provision of ,, ipp In Center programs. Currently there is one consumer-run Drop in Center located in Oakland County, and tkiree new programs will be added this year. As a result, three new Drop In Center Boards will be created, mi 'composed of primary and secondary consumers. Some of these new Drop In Center Board members may not have experience in serving on a Board, or familiarity with Board procedures and protocols. For the existing Drop In Program in Oakland County, the Consumer Run Board has already expressed an interest in specific Board training to assist the Board in its effectiveness. The need for additional consumer-run Drop In Centers in Oakland County had been substantiated by Oakland County CMH prior to the issuance of a Request for Proposals for Drop In Centers. The existing program only serves the central part of the county. As a result of a competitive bid process, OCCMH will fund three new programs covering the West, North and South Quadrants of the county. Drop in programs are an important part of the continuum of required CMH services, to provide advocacy, information, support, education and knowledge to persons in a safe and socially engaging environment. For some of the persons who attend Drop In programs, these services may be the only mental health related services they choose to receive from the County. Other goals of the programs are to enhance self confidence and self esteem for members and to reduce the stigma of mental illness and promote integration within the community. Oakland County's RFP specifies a preference for consumer run models of proposed drop in centers. In fact, this service was bid out last Spring and the proposals were rejected due, in part, to a lack of consumer focus and a consumer run approach. Oakland CMH is rebidding this service in order to ensure that it is consumer and not staff driven. Therefore, Oakland CMH expects that there will be specific need for Board training during FY 99 for consumers who agree to serve on these Boards. In order for these Boards and programs to develop and maintain the consumer run and managed focus as preferred, Board training could provide the crucial link necessary for members to successfully operate and provide consumer leadership for these programs. Oakland CMH is committed to the development and continued funding of the these programs to meet all needs of appropriate and interested consumers in Oakland County. • Demonstration that the intervention is an enhancement or innovation. Bidders for this program expansion were requested to indicate how programs would ensure consumer run operations for Drop In services. The existing program and the newly funded programs by Oakland CMH, currently do not have costs included for specifc Drop In Center Board training. Futhermore, the Board training that will be provided will be specific to the needs of a consumer run organization. Consumer Board members will have input into the development of the training to best meet their needs to be effective Board members and operating boards. • Demonstrated knowledge and understanding of the sub-population, the principles of psychosocial interventions and/or the principles of the model or intervention proposed Oakland CMH has experience in contracting with consumer run programs and has recognized the unique challenges that consumer run programs face in Board functioning. The Oakland CMH Board has also focused on specific policy development and operational elements for its functioning and is planning to engage in further Board training of its own. These two components - knowledge of drop in services and recognition of Board training OAKLAND COUNTY CMHSP - Page 46 importance for all Boards but perhaps most especially consumer run programs - provides the basis for successful development of the consumer run program board training series. This PRR requests funding for the development and implementation of specific Board training for members of I Drop In Centers. OCCMH is planning a two day training session for each of the four Boards. Planning consultation will be made with the Justice in Mental Health Organization, a consumer advocacy group that has / already been involved on a consultant basis, in the development of these programs. The Board training will include informatiort on how to use Roberts Rules of Order, how to plan an agenda and conduct a meeting, effective decision makirlij and conflict resolution skills.:A Trainer will be selected that will consult with Oakland CMH, JIMHOsnd the:Drop In .Programs to develop the desired training program to best meet the needs for persons involved,iddayandtounty Drop In programs. In addition to the cost of the trainers (approximately $1,200 per Bitipfdlor a two day session), OCCMH is asking for mileage costs to reimburse consumer Board members and thrisupply costs, primarily for printing or purchase of appropriate resource materials for Board membersd.r., ; NaAl: OCGMHignd the trainer will evaluate the effectiveness of the training provided by surveying the participants to determioevigether their needs or expectations were met Over time the benefits of the training should be evident, Drop In Center Board's seek to conduct their business effectively and communicate with each other in a ttive and meaningful way. Demonstrated commitment by the board to the proposal, as reflected by: • Level of CMH funds directed to the initiative. • Plan for continuation of effort. Oakland CMH is committed to the expansion of this service area and has demonstrated through the bid process the promotion of drop in programs as consumer run organizations. Oakland CMH is committing funds to the continued operation of four drop in programs in the county, from the current one program in operation. Once the training package has been developed and implemented, Oakland CMH would intend to evaluate the outcomes from the training through survey of the Drop In Center Board members who participated. Oakland CMH is committed to the provision of continued resources in this area, including renewed Drop In Center Board training as appropriate in the future. • Defined expectations or outcomes to be expected and how they will be evaluated Participants will be asked to participate in the development of the Board training as well as evaluate the helpfulness of the Board training. Outcomes include: 1) higher level of satisfaction in Board role for members, 2) additional knowledge on procedures in conducting and participating in board meetings, and 3) greater effectiveness in decision making for drop in operation of Board members. PROGRAM REVISION REQUEST SPENDING DETAIL BOARD: OAKLAND COUNTY OAKLAND COUNTY CAMP - Page 47 .n•iip PRRITitle/Purpose: Time Required to Implement Date Submitted 9/98 On months)- 0 / Expansion of Arab-chaldean Mental Health Services PRR IC) Number 95-03 Client Group: isMI-A o MI-C' o DD o Bd Admin. 0 Prevention FY of Implementation: Board Priority: ?„,..../ _ - ... FY 98-99 of ' i Full Year Cost Full Year Cost Full Year Cost Full Year Cost Full Year Cost Full Year Cost „'T- N., Residential Partial Day Outpatient/ Cue Management Other Total „ FISCAL SUMMARY - • " ''' Level Clinical Support .- , I. Service Pion Summary / ..„ Number of Bedek- / ..- , j Asses ,6,-,. , . 40 40 ,- A . -. 366 366 —*-7--'',: • - A. Sourciiif7nonang - D. Mimi-num 1 1 100% State Match -0" -100% State Inpatient , -100% Residential -100% MSHDA. TSW. Other a Reimbursements (1) Medicaid Federal Share (2) Client SSI I (31 Client Fees & Insurance i Net Cost 000% State) (1) Medicaid State Match (2) State match • . 2. State and Local Match 55,556 , I Reimbursements (1) Medicaid Federal Share , (2) Client SSI . (3) Client Fees & Insurance b. Net motthaote Cost , (1) Local Match Requirement 5,556 (a) Title XIX Replacement , 1 (b) Other 1! (2) State Match Requirement (a) Medicaid State Share - (b) DMH Match - - State Portion of CMH Budget - - 50,000 Line Gib Mu Line G.2b(2) , Financing to be Presided via Full Maregemant Trade-Offs _ 50,000 Net Stall Costs n a EsesArnm er.r. • •• IMO% B•.•••nn•n• 11.1.nn•n••n0•Tf. IlEbet • lebri ",.....n--, ,---n_. OAKLAND COUNTY CIANSP - Page 48 PRR Title/Purpose: Expansion of Arab-chaidean Mental Health Services Time Required to Implement Date Submitted • 9-04-98 (in months)- 0 PRR ID Number: 98-0009 s Client Group: BMI-A 0 MI-C 0 DD c Bd Admin. 0 Prevention FY of Implementation: 98-99 Board Priority: / _:21 _ of 12.._ Narrative (attach additionalfiagekasi necessary): 1. . Clinical description 0iiseaple to be placed. 2. Indicate what case nianagement and outpatient services will be provided. 3. Explain the typealinpunt-s,:and assumptions about reimbursement. Include the full array of reimbursement (as appropriate) including SSI, personal care, clinic servicesAort)Oind.community based waiver, or ICF reimbursement. 4. Explain how/zither ;related PRR's coordinate with this PRR, ,f-f;- (117.tti z` Because the Arab-Chaldean community is a family-oriented culture, clients have a tendency to bring other mbers of their immediate or extended family into the service process. This phenomena is quite normal, but it ,iAtbles the work load of the Arab-Chaldean Mental Health Program. As a result, treatment methods must be OCidified to accommodate the unique needs of this population. in addition, the stigma associated with receiving of ental health treatment in the Arab-Chaldean Community is extremely high because it is a "shame based culture," and the phenomena of social work and the helping process is a brand new experience. Finally, the clientele have to go through a pre-treatment stage in which orientation services are provided to engage them in the mental health treatment process. All these services are provided in the client's native language and/or, quite often, in three languages: Arabic, Chaldean, and English. Services are provided to both adult and child consumers and their families. The position being requested through this expansion of services is one (1) F.T.E. psychologist to provide assessments, psychological evaluations, psychological testing, family and individual therapy and supports, and prevention services. The expected case load for the psychologist will be 40 cases. Due to changes in the funding formula proposed for FY 98-99, no direct reimbursement impact is expected. other than ability to pay and any third party payments that might exist for consumers served. As this is a unique service it does not coordinate with other FY 98-99 PRR's. Client Group: (circle one) Prevention Gross Cost $703.50 Board Block Grant Priority: _.L of _12_ Board Prevention Priority: of MI-A . MI-C Wraparound Psyc.hosocial Rehab (Clubhouses) Other Transition Services Prevention Integrated Services ____ Pilot for Young Children Infant Mental Health Services Prevention Coordinator OAKLAND COUNTY CMHSP - Page 49 FEBEAAL BLOCK GRANT AND PREVENTION PILOT PROGRAM REVISION REQUEST PRR-FBG.WPD • .M1•nnn• CMHSP: Oakland County PRR Title: Clubhouse Employment Specialist Training for Our House Clubhouse • Alternative Community Living Time Required to Implement: Date Submitted: 9-04-98 (in months) 9 PRR ID Number: 98-0010 Federal Block Grant.PROrp- ose (check one): / . Aging..Services.re ACT Teams aLEmpitippeneia,--- Consumer Run or Directed Initiatives i ,../ Adults with Children with Board .--ICIPINANCING SUMMARY Mental Illness Mental Illness Other Administration Total Estimated clients to be served by PRR 70+ , PROJECTED FUNDING SUMMARY _ ; Projected Gross Funding 730.50 703.50 ; . ' SAMHSA (Federal) Block Grant 703.50 703.50 , 1stJ3rd/SSI Reimbursement Estimate* , State Other (detail): I SAMHSA 1stt3rd/SSI (Federal) Block Reimbursement Other B. BUDGET DETAIL Grant Estimate Funding Total Personnel salaries/wages and fringe benefits r Equipment Travel Supplies, etc. - Contractual services (subcontract, etc.)-specify below (Training & Lunch For Two Staff) 670.00 670.00 — Subtotal 670.00 670.00 , Indirect" 33.50 33.50 _ TOTAL 703.50 703.50 . Block grant funds may not be used to match other federal funds, Per PL. 102-3R1, Section 1916B, administrative expenses may not exceed 5 percent. OAKLAND COUNTY CMHSP • Page 50 NARRATIVE FOR PROGRAM REVISION REQUESTS FEDERAL BLOCK GRANT FBGNARR.WPD CMHSP: Oakla_ndCouniy PRR Title/Purpose: Clubhouse Employment Specialist Training for Our House Time Required to IVplement: Date Submitted 9-4-98 Clubhouse - Alternative Community Living (in months) 9 PRR ID Number: 98-0010 .f. Client Group: MI-A / MI,C,t - DD / Bd Admin. Prevention FY of Implementation: 98-99 Board Block Grant Priority: (circle one) t / \'' . -.T" _2_ of _a_ i - \•.-; Board Prevention Priority: of \: ..` Narrative (a ch_dditional pages as necessary): follOiving igirie should be followed for the PRR narrative (attach additional pages as necessary): bttonstrated need for the sub-population and/or intervention. rnonstration that the intervention is an enhancement or innovation. v onstrated knowledge and understanding of the sub-population, the principles of psychosocial interventions and/or the principles of the model or ,ntion proposed. monstrated commitment by the board to the proposal, as reflected by: Level of CMH funds directed to the initiative. • Plan for continuation of effort. • Defined expectations or outcomes to be expected and how they will be evaluated. • Relative priority of the proposal Persons with severe and persistent mental illness experience rejection in all aspects of their lives, including employment. Employment provides a consumer with the opportunity to become a productive member of society, to strive for financial independence, to socialize with others and to enhance their self-esteem. Our House Clubhouse believes that one of the major outcomes of the Psychosociat Rehabilitation Program is employment. We presently have fifteen clubhouse members employed in the community. Over the years, numerous consumers have attended the clubhouse, become successfully employed and then left the clubhouse setting. We believe that we can do more in this area — especially as Managed Care is stressing the need for -outcomes — one of which is employment. Our House Clubhouse has just been awarded a new three year contract with Oakland County Community Mental Health. Through this contract, CMH is now funding the position for job developer. We would like to enhance our Employment Program by having two clubhouse staff attend the Clubhouse Employment Specialist Training at Michigan State University. The training will enhance the effectiveness of staff in: Person Centered Employment Planning Job Development and Marketing Strategies Employer Negotiations Work Site Analysis Job Selection-Matching Task Analysis Instructional Strategies Documentation On-going Support Natural Supports ACT Teams X Consumer Run or Directed Initiatives Federal Block Grant PRIRRu-rPose (check one): if Aging Services. nt4r-4' /16 Prevention Wraparound Integrated Services Rehab (Clubhouses) Pilot for Young Children Other Infant Mental Health Services Transition Services Prevention Coordinator OAKLAND COUNTY CMHSP -Page si FEDERAL BLOCK GRANT AND PREVENTION PILOT PROGRAM REVISION REQUEST PRR-FBG.WPD CMHSP: Oakland ;ountv PRR Title. Supplies for Drop In Center and Training for Clubhouse Staff for Time Required to Implement: Date Submitted. 9-04-98 Goodwill Industries of Greater Detroit (in months) /D PRR ID Number: 98.0011 _ . Client Group: MI-A ,MI-C Prevention Gross Cost: $ 16,745 Board Block Grant Priority: (circle one) j.. . 1.i. (: ' . ..„9,_ of '2L_ (. / ...-- ,::,.,.. , Board Prevention Priority: , / ." Adults with Children with Board .4AlsrF1 NANCING SUMMARY Mental Illness Mental Illness Other Administration Total , , Estimated clients to be served by PRR 270 270 PROJECTED FUNDING SUMMARY Projected Gross Funding $16,745 $16.745 SAMHSA (Federal) Block Grant , 1st/3rd/SSI Reimbursement Estimate* State . Other (detail): SAMHSA 1st/3rd/SSI (Federal) Block Reimbursement Other B. BUDGET DETAIL Grant Estimate Funding Total Personnel salaries/wages and fringe benefits , Equipment , $2,635 $2.635 Travel , $4,700 $4,700 Supplies. etc. - Contractual services (subcontract, etc.)—specify below Training & Lunch For Two Staff $9,410 $9,410 Subtotal $16,745 $16.745 Indirect- _ TarAl. $16,745 $16,745 ,.. 'Block grant funds may not be used to match other federal funds. Per PL 102-3R1, Section 191613, administrative expenses may not exceed 5 percent OAKLAND COUNTY CMHSP Page 52 NARRATIVE FOR PROGRAM REVISION REQUESTS FEDERAL BLOCK GRANT FBGNARR.WPD CMHSP: Oakland County PRR Title/Purpose: Supplies for Drop In Center and Training for Clubhouse Staff for Goodwill Industries of Greater Detroit Tyne Required to Implement: (in months) 9 Date Submitted: 9-4-98 PRR ID Number: 96-0011 Client Group: (circle one) • MI-A ,..MkC DD Bd Admin. Prevention /' - / *.t.- FY of Implementation: 98-99 Board Block Grant Pnority: of _12_ Board Prevention Priority: of Narrative (attEch/additional pages as necessary): The follo(ring yuyinehshould be followed for the PRR narrative (attach additional pages as necessary): stkated need for the sub-population and/or intervention. --atu)-i-pbeknor,.Istration that the intervention is an enhancement or innovation. . niffitrated knowledge and understanding of the sub-population, the principles of psychosocial interventions and/or the principles of the model or ..VriVre' nub n proposed. • 1Pernonstrated commitment by the board to the proposal, as reflected by: Level of CMH funds directed to the initiative. • Plan for continuation of effort. Defined expectations or outcomes to be expected and how they will be evaluated. Relative priority of the proposal Demonstrated need for the sub-population and/or intevention. F.A.I.R. Drop-In Center is in the process of moving into a different facility in the Pontiac area. Although the current plans call for a kitchen, there is no funding in the budget for kitchen appliances. The adults who use this center will be benefited by the addition of kitchen appliances. They will be able to prepare refreshment using the electric ranges. Members who would like to learn to prepare there own meals could use the kitchen to do so. Members who are temporarily homeless will be able to prepare meal. Refrigerators will be used to store perishable food items. The dishwasher will be a time saving appliance to insure proper cleaning of eating utensils and dishes. Employment is the goal of members of the Clubhouse programs. Transitional Employment (TE) job placements are essentially entry-level positions requiring minimal training or job skills and are used to link individuals to eventual full- time, independent employment. The new clubhouse, operated by Training and Treatment Innovations, Inc. (IT!) will train staff and consumers in an overview of the development and operation of the Fountain House clubhouse model. Therefore, this population in the Northeast section of the county will received the same types of services provided in the other sections of the county. Demonstration that the intervention is an enhancement or innovation. Currently F.A.I.R.'s refreshments are brought in daily. Perishable items may not be kept for the following day's activities as there is no appropriate place to store them. Consumers who do not have cooking facilities or privileges at their places of residence will be able to prepare or learn to prepare meals at the Center. New TE placements in the business community are first performed by a staff worker for a few hours longer if necessary — so that an accurate assessment can be made of the requirements that must be met if the job is to be handled successfully by individual members. Staff who initiate new TE placements are also able to evaluate the work environment and its compatibility with the needs of the vocationally disabled individual. Staff and consumers form a partnership in the new clubhouse and will therefore learn together the needs of the population. They will also discover what works and does not work as they implement the model at their location. The Fountain House has served a model for many similar programs. 5.4.41# • OAKLAND COUNTY CMNSP • Pane 63 Demonstrated knowledge and understanding of the sub-population, the principles of psychosocial interventions and/or the principles of the model or intervention proposed. On December I. 1997, Goodwill Industries of Greater Detkoit was asked by OCCMH to become the fiduciary for the F.A.I.R. Drop In Center program to assist their Board of Directors in regaining itself as a member-run service. Since that time. Goodwill has increased the Board of Director from 3 to 7; developed a relationship with the Justice in Mental Health Organizations (JIMH0); hired a consumer as an administrative director and assistant; developed policies and procedure' enhancetalailiprogramming by providing outside social and recreational activities; increased daily attendancefim 10-12%embers to an average of 50 members per day; as successfully assessed by outside financial auditors as meeting Generally Accepted Accounting Practices; and regained a positive reputation. , A properly-traified staff is better equipped to assist members with dealing with specific program and job related issues. pmett th t--ose needs, training in Clubhouse and Employment Services is designed for new and established clubhouses . pSfic issues related to developing and maintaining a clubhouse program, enhanced by employment services. - di 'Zonally, Employment Training Specialist (ETS) training offered locally through Michigan State University is ;tared towards specific training in job development, job placement, job follow-along, etc. Staff turnover has left at the urrent clubhouse with the need to re-establish new training opportunities for members by using new "Best Practices" within the employment arena. Demonstrated commitment by the board to the proposal, as reflected by: Level of CMH funds directed to the initiative. Plan for continuation of effort. OCCMH could have refused to continue funding F.A.I.R. in 1997 but chose to appoint a fiduciary (Goodwill Industries) as an alternative. OCCMH awarded Goodwill/FIRR a new contract through a Referral for Proposal process. The new contract will begin October 1, 1998 with the expectation that it will be maintained for a three-year period ending September 30, 2001. OCCMH has mandated through the Request for Proposal process that all Oakland County funded PSR/clubhouse programs have a strong affiliation with the Michigan Jobs Commission for the duration of the three-year contract between each clubhouse program. Additionally OCCMH has been supportive of Clubhouse, Employment and Employment Specialist trainings in the past to enhance these services. There is no need for continuation of these efforts. Defined expectations or outcomes to be expected and how they will be evaluated Drop In centers by nature are designed to meet the social/recreational needs of its members. Daily attendance will be one outcome measure with the expectation that this number will be increased and/or maintained at 50+ members per day. OCCMH is requiring that daily attendance be reported monthly and those statistics, in turn, are reported to DCH as mandated. The ultimate expectation is that this service will be ultimately maintained as an independent, consumer-run program within the City of Pontiac as long as this service is needed. The expectation is that each PSR/clubhouse program will incorporate an employment component within its organizational structure that will ensure the development of individual Vocational Action Plans (VAP) for any members who choose to have one. Employment statistics will be reported to Department of Community Health (DCH) and combined and compared with other like programs across the state. Once "Best Practices" are defined by DCH, they will then become part of the evaluation process. 4,250 12.44 OAKLAND COUNTY CIPANSP - Page 54 Detail of Request: For F.A.I.R.: 2 electric ranges $ 1,098 2 refrigerators / 1,138 1 dishwashielq. 399 For Dreams Untiriiged Clubhouse: .. ‘1"1:' - /Employrent Training $ 2,400 . Tlivelofor Training 1,200 re' Tnployment Training Specialist Training 2,760 ravel for Training 1,200 .5/0. ew Clubhouse operated by Training and Treatment Innovations, Inc. (T71) Clubhouse Training Travel for Training TOTAL REQUEST $ 16,745 FEDERAL BLOCK GRANT AND PREVENTION PILOT PROGRAM REVISION REQUEST PRR-FBG WF'D CMHSP: Oakland County OAKLAND COUNTY CMHSP • Page 55 ••=t-=•- PRR Title: MORC, Inc. - Adult M.I. Social Integration Project Time Required to Implement: Date Submitted 9-04-98 i (in months) 2 ' PRR ID Numbet. 98-0012 , - Client Group: MIAL ,MI-C Prevention Gross Cost: $ 120,950 Board Block Grant Priority: • . (circle one) ..4-. ( -J. 11 of _11_ • ir' , - / ....." e. .-,' ''. Board Prevention Priority: v..- of -----.- -- - ACT Teams Consumer Run or Directed Initiatives - Federal Block Grant PRRPUrpose (check one): ,}? Aging Services •Emplornent Wraparound Psychosocial Rehab (Clubhouses) X Other Transition Services Prevention Integrated Services Pilot for Young Children Infant Mental Health Services Prevention Coordinator / Adults with Children with Board • )AiNANCING SUMMARY Mental Illness Mental Illness Other Administration Total •-• Estimated clients to be served by PRR _ 45 45 PROJECTED FUNDING SUMMARY Projected Gross Funding $120,950 $120,950 - i SAMHSA (Federal) Block Grant $120,950 $120,950 - i 1st/3rd/SSI Reimbursement Estimate* NA NA . - State NA NA Other (detail): NA NA . - - SAMHSA 1st/3rd/SSI (Federal) Block Reimbursement Other _ B. BUDGET DETAIL Grant Estimate* Funding Total Personnel salarieshvages and fringe benefits $ 57,690 $57,690 _ Equipment 0 0 Travel/Transportation $12,500 $12,500 ., Supplies, etc. $45,000 $45.000 Contractual services (subcontract, etc.)-specify below , 0 0 , Training & Lunch For Two Staff $5,760 $5,760 Subtotal , $ 120,950 $ 120.950 Indirect** 0 0 - ) _ , TOTAL - 120,950 $ 120,950 _ — Block grant funds may not be used to match other federal funds. Per PL 102-3R1, Section 1916B, administrative expenses may not exceed 5 percent. OAKLAND COUNTY CMHSP -Page 56 NARRIATIVE FOR PROGRAM REVISION REQUESTS FEDERAL BLOCK GRANT FBGNARR.WPD CMHSP: Oakland County PRR Title/Purpose: MORC, Inc. - Adult M.I. So5al Integration Project Time Required to Implement: Date Submitted: 9-4-98 (in months)2 I - PRR ib Number: 98-0012 Client Group: MI-A _MIc --, /-: - , DD Bd Admin. Prevention FY of Implementation: 98-99 Board Block Grant Priority: (circle one) /\. , 11 of 12 ../ , '-' $ 120,950 .,_ Board Prevention Priority: .•., -. of ____ , Narrative (attach idditional pages as necessary): Thefiollowtng otitline should be followed for the PRR narrative (attach additional pages as necessary): ek-4 t_Demonstrated need for the sub population and/or intervention se ...44 - *-1„, stttn,, Demonstration that the intervention is an enhancement or innovation. cVfor Demonstrated knowledge and understanding of the sub-population, the principles of psychosocial interventions andlor the principles of the model or intervention proposed. ;Or Demonstrated commitment by the board to the proposal, as reflected by: • Level of CMH funds directed to the initiative. • Plan for continuation of effort. • Defined expectations or outcomes to be expected and how they will be evaluated. • Relative priority of the proposal. • Demonstrated need for the sub-population/and/or intervention: Within the MORC Community Residential Services (CRS) program, 45 individuals currently do not participate in any MORC/OCCMH sponsored day program or any other regularly scheduled structured community activity or vocational pursuit. Factors which contribute to this sub-population's lack of involvement include physical aggression, inability to maintain focus on structured tasks, anxiety, stress related health problems, and active psychotic symptoms, i.e., hallucinations and delusions, lack of motivation, previous failure in formalized programs, and inability to relate in a socially appropriate manner. The age breakdown for this group of individuals follows: Years of Age: 21-35 - 6 36-50 - 15 51-65 - 9 Over 65 - 15 An array of individualized programs are implemented within the residential setting, however, interaction in community activities amounts to little more than 2-4 hours per week. This generally consists of shopping excursions, medical appointments, van rides and informal recreational pursuits. The remainder of time is spent in the residence which fosters social isolation and a lack of motivation to pursue other community options. • Demonstration that the intervention is an enhancement or an innovation: A wide variety of vocational, day programs, work and residential programs are available to meet the individualized needs and choices of more than 300 other CRS consumers. The sub-population addressed in this proposal does not afford themselves of the opportunities presently available and requires an enhancement of existing resources to prepare and motivate them to become involved in structured daily activities outside of the residential setting. • Demonstrated knowledge and understanding of the sub-population, the principles of psychosocial interventions and/or the principles of the model or intervention proposed: Services offered will be consistent with the psychosocial rehabilitation interventions provided to develop, enhance, and/or OAKLAND COUNTY CMHSP - Pap 57 • • retain psychiatric stability, social competencies. and personal and emotional adjustment when these abilities are impaired by the symptoms of mental illness. Social and recreational programs will be individualized and enable consumers to choose from among a full range of comdunity-based leisure pursuits available to every other citizen. Examples include: fitness centers, gymnasiums, swimming facilities, individual sporting preferences. concerts. theaters. museums and the like. Through involvement in activities which promote physical, therapeutic or psychosocial stimulation, participants will improve coordination, muscle tone. er,durance and motor skills - all of which have been found to lower stress and encourage adoption of a wellness-oriented lifestyle. • • Demonstra4d:Commitment by the CMHSP to the proposal, as reflected by: forContinuation Leie1,01CMH funds directed to the initiative; of effort Nss17 While no CMH.funkitre currently directed to this program request, OCCMH strongly supports the principles associated with communCiiiteiration and self-determination. Defined expectations or outcomes to be expected as a result of the initiative: rndividuals will be involved in community-based activities at least eight hours per week which minimally doubles their current involvement. The goal of this program proposal is to eliminate barriers which inhibit personal growth and development. implementation of this proposal is expected to: Develop social skills and social integration Enhance self-image Expand interests in leisure activities Heighten community awareness Provide an outlet for physical aggression Reduce stressors Increase attention span involving structured activities Promote personal choice and self-determination Successful achievement of program objectives will promote the likelihood that these mentally ill adults will be motivated to pursue more structured endeavors. Outcomes of the program will be evaluated against individualized objectives specified in each participant's plan of service. Progress notes will be documented at least monthly to measure increased involvement in community activities and improvement of psychosocial skills. At the conclusion of the project, aggregate data will be compiled and analyzed. Results will be utilized to modify and improve the service delivery system as indicated. — _ The rMbIS.P..1.5 committed to continued implementation of programs which support the development of psychosocial skills tcfpromote integration of the defined sub-population into the mainstream of community activities. RSTIMATID FTR'S FTES.WPD CMHSP: Oakland County OAKLAND COUNTY CMHSP Page s, Estimated FTE's as of 9/30/98 , (A) Estimated number of FTE equivalent employees on the CMHSP payroll as of 9/30/98 Full-tim • Jentj employees are defined as hours of paid (including 368.8 sick/ann. r week. , , (B) The ey E-equivalent of persons providing services to the CMHSP through a perg& , ices contract with the CMHSP. Only persons providing approved mental heet p gram 46.5 or example, a contract with a psychiatrist for 20 hours of service per week = .5 FTE. _ -7 t(/ C) or contracts for mental health service, provide estimated FTE equivalents which are funded by the CMHSP Include FTE's associated with residential services such as staffed group homes. .. Exclude staff associated with general AFC residential room, board and supervision. If the contract pays for additional staffing, provide the FTE 2962.1 equivalent. This would include program add-on funding. .. Exclude FTE's associated with all community inpatient programs. .. Exclude all state provided services. --• Estimate FTE equivalents based on data available to the CMHSP in relation to contract spending if no other information is available. TOTAL ESTIMATED FTE'S 3377.4 Describe the methodology used to provide this information. Figures based on total number of FTE's multiplied by a percent reflective of OCCMHSP's consumers to total served. "St" added to reflect estimated number of FTE's directly supporth these consumer services. OAKLAND COUNTY CAMP - Page 59 • CMHSP SUMMARY OF CURRENT CONTRACTS FOR MENTAL HEALTH SERVICES DELIVERY --EXCLUDING STATE PROVIDED SERVICES-- CONTRACT.WPD CMHSP: Oakland County - FY98 --------7 Rate paid per unlit of service. Total FY 98 Provide range if more than one rate is Expected CMHsP Number of Paid. Contractual Program Type /. Contracts Rate Paid (range) Obligation ADULTS WITH MENTAL ILLNESS Community Inpatient Inpatiepl 5150 - $470 per day $ 2,067,885 , Bd Managicr*asidential inc. 6 Net Cost 19 .. $ 15,020,619 SIP ,'.' .6 „..- . $13.32 - $233.76 per day Day rograTat C. Net Cost 4pr7: N3.6- $34 - $59.61 per day $ 2,324,899 ,tputP4tient Services 10. Net Cost $32. 87 $ 21,241,79C — , ihtIpportive Services 18 $1.30 - $86 per incident (varies per $ 955,953 diem) ' Prevention Individual professional 3 $5 - $100 per hour $ 61,000 service contracts 6 CHILDREN WITH SERIOUS EMOTIONAL DISTURBANCE Community Inpatient 1 $172 - $352 per day $ 411,200 Bd Managed Residential inc. 19. $8.88 - 303.79 per day $ 1,582,408 SIP Day Programs Outpatient Services 2 $36 - $165 $ 7,332 Supported Services 14 $1.30 - $86 per incident $ 271,514 , Prevention Individual professional 4 $30 - $90 per hour $ 49,340 service contracts PERSONS WITH DEVELOPMENTAL DISABILITIES Community Inpatient 1.. Bd Managed Residential inc. 46. $7.39 - 320.67 per day $ 40,330,594 SIP Day Programs 16. $11.54 - $112 $ 13,886,666 Outpatient Services 5' $70 - $250 $ 5,726,387 Supportive Services 80 include transportation $ 6.267,418 , Prevention — Individual professional 7 $45 - $46 per hour $ 201.458 , services contracts IMORC included in contract count and dollars "Duplicated count and services bundled. Dollar amount ma y be split out or ciculated under primary service area. • CMNSP PERSONS SERVED SERVED. WPD CMHSP: Oakland County OAKLAND COUNTY CMHSP • Page 00 k 1 FY 96-97 Actual Projected FY 97-98 I Projected FY 98-99 YERSONS WITH MENTAL ILLNESS A 0-17 years 1181 3.534 1549 18-54 yearstv )--,t' 6201 6571 6637 $ ..•• `,..=',,.. .. 55 and over.-- X.?• 2338 1415 1429 ..$$.- f -- Age unknown 20 ,-- Subto'ia1Th r4f 9740 9520 10498 d!' PERSONSi4ine'DEVELOPMENTAL DISABILITIES _. I- • :....., NO17 N1rs 505 1016 1027 .f.c.,, , 4 years 1566 2166 2188 Tess and over 194 240 242 Age unknown Subtotal 2265 3422 3457 OTHER PERSONS SERVED GRAND TOTAL 12005 12942 13955 OAKLAND COUNTY CMHSP - Page 61 fESPITE CARE - CONTINUATION FUNDING APPLICATION RESPITE. WPD COHSP: Oakland County SED RESPITE SERVICES EXPENDITURES/FUND USE PLAN . FUND SOURCE(S) / Acr,Other DCH/ i A CMHSP ( - Funding Federal including , Tobacco Block Local Tax Grant Other Total 1. Number cofiChiili'en Served - FY 98 Projected 250 2. NuAgerAf - piildren to be Served - FY 99 Plan 300 iAt -.7 . . . . 74cted Expenditures - FY 98 (Total) 217,000 130,000 347,000 s'174fr Direct services 217,000 40,000 257,000 Respite services coordination 60,000 60,000 r C. Administration 30,000 30,000 - D. Other (specify) , T _4. Projected Expenditures - FY 99 (Total) $458,000 50,889 508,889 . . A. Direct services $375,000 30,005 405,005 B. Respite services coordination 65,000 20,004 85,004 . , C. Administration 18,000 880 ledmio D. Other (specify) 5. FY 99 Estimated Spending by Quarter A. 10/1/98 through 12/31198 80,000 12,722 92,722 B. 1/1/99 through 3/31/99 98,250 12,722 110,972 C. 4/1/99 through 6/30/99 105,000 12,722 117,722 D. 7/1/99 through 9/30/99 174,750 12,723 187,473 B. NARRATIVE Provide an accompanying narrative which: 1. Describes the SE D respite services program including all fund sources. 2. Documents the need for services. 3. Describes parent and family involvement in planning, development and oversight. 4. Describes training and outreach. A. OAKLAND COUNTY CMHSP - Page 62 *B. Narrative Oakland County Community Mental Health has been providing Respite Services to severely emotionally I disturbed youth since the summer of 1995. Last year, OCCMH served 250 children with sever emotional disturbance through its Respite programs. Through family surveys, OCCMH has documented that Respite is the service that is most often requested by families and it is the most effective prevention tool for keeping SeN4rely Emotional Disturbed children at home with their families. Oakland County ;Respite Services for SED children offers four choices of service: vouchered In-Home, 4H-CMH collaborative; Family to Family, and Community Education and Outreach. Note: Respite Services for SED children through the Respite Department do not include services through Wraparound, children's flexible funding, Residential Respite or Respite through waivers. / Our voucheredin home respite program offers families flexible funds to purchase respite services from thed-prOder of choice, thus giving families complete autonomy in the planning, development, and scheduling of their services. Ongoing assistance in identifying providers and utilization is offered. A N'.'-,-- ase'amount of funding is allocated to each family at the beginning of the fiscal year. Funding ‘isources are amended as family need indicates, Camperships are offered separate from the base in hgne respite fund, but provided within this vouchered program. It has become increasingly difficult to locate high quality, competent Respite providers in our county. With the shift toward self-determination and reduced length of stay in hospitals for our Mentally Impaired, Developmentally Disabled, and Geriatric populations there is a documented shortage of in- home and community supports providers. Increased hourly reimbursement for In-Home Respite services may help families secure qualified respite care givers. $1,000 per year per consumer, for example, will provide 10 hours of respite per month at $8.00 per hour. For those consumers with higher needs, the current reimbursement rate is $12.00-$15.00 per hour, with the families respite need being greater than 10 hours per month. The budget for these consumers is calculated at a much higher rate. In the new fiscal year, OCCMH would like to utilize the existing vouchered respite model to fund before and after school services for families unable to access community child care. Before and after school latchkey services for example are not available to middle and high school aged children. Last year, OCCMH provided nearly 800 individual service encounters to children ages 12 through 18. Of this group, a large percent have single working parents, unable to effectively supervise their children before and after school. Many SED children are being left home alone or with siblings who are ill equipped and unprepared. Respite funding to families in securing before and after school child care would ease the burden of being a single working parent as well as provide the safety and structure for the SED youth alone in the community. Each February, Oakland County Community Mental Health Respite Services sponsors a camper fair. This event is held on site at OCCMH and brings in representatives from state and local camps that offer camping opportunities to SED youth. At this event, youth and families can talk with representatives from each camp in order to determine which camp best meets their needs. OCCMH encourage families, clinicians, and educators to plan ahead for the most demanding time for our SED youth - the unstructured summer months. Camperships of up to $500 per consumer are offered to support our SED youth enjoying and participating in a camp experience of their choice. Children with severe emotional disturbances have participated for the fourth year in the 4H/CMH camp collaborative. Offering the 4H educational camp experience with therapeutic supports has afforded both children and clinical staff unique fulfilling day camp experiences. 4H in-kind contributions to this program is $80,000. CMH's contribution is $55,000 worth of staff time. The Family to Family program is funded by a two year grant from the Skillman Foundation. Oakland County Community Mental Health is able, with this funding, to provide 108 days per year of out of home OAKLAND COUNTY CMHSP - Page 63 respite with a co-parenting family to 25 SED youth. This project is utilized as a prevention program and alternative to residential placement. Oakland County Community Mental Health continues to work with the supported Association of Children's Mental Health in starting a local chapter. Respite services are provided to those families in attendance, and CMH staff attend each meeting as well. Parents, families epd community are involved in planning, development and oversight of Respite services. Fartillies4lave full control in the voucher program and request assistance when they need it. ACMH heti:404H tb4i6erstand the needs of its constituency. We continue our networking with the surrounding/iOimties to develop, expand and implement innovative respite services through attendance at bi-monthly reskite round-tables. This„ptist4err-:i collaborative effort with the Oakland County Child Care Coordinating Council (4C's) waeinitifitedi. This collaboration provides training to 4C's providers in group as well as 11, specific to tgi4EDViipulation. Our goal is to increase community awareness and provide resources, resulting in n ezcpansion of trained community providers to our consumers. Oakland County Community Mental 'WA, together with the 4C's, Strong Family Strong Children, and Oakland Schools has teamed up to present a community training series this Fall/Writer to 300 to child care providers and Afamilies.September 4, 1998 Jr' •