State grants of up to two-hundred thousand dollars have been awarded to help mental health professionals go mobile in Michigan. Experts say the move is particularly helpful in rural parts of the state. However, in some rural communities that cover a lot of territory, going mobile all day, every day....is just not feasible.
AuSable Valley Community Mental Health Authority Chief Clinical officer, Teresa Tokarczyk said they would have liked to offer services 24/7, but staffing was a challenge as well as safety issues. She said having access to cell service and internet makes sending people out into a dangerous situation, just not doable.
“If I'm expected to send two staff into a rural area to help alleviate a mental health situation, they have to have the ability to contact someone in case of a crisis. And in case it turns into an emergency,” Tokarczyk said.
AuSable Valley Community Mental Health Authority received $198,000 in grant money to at least expand their services along with a community partner to better service their area in northeast Michigan.
Grant recipients from statewide Community Mental Health organizations were eligible for up to $200,000 each from Michigan Department of Health and Human Services for expansion of services.
Each grantee could apply for up to $200,000 in funding for fiscal year 2023 and may receive additional funding in fiscal years 2024 and 2025. MDHHS will assess the maximum funding amount for the entire program in fiscal years 2024 and 2025 based upon the number of applications.
MDHHS Public Information Officer Bob Wheaton said one part of the grant program was to help Community Mental Health agencies to expand Intensive Crisis Stabilization Services (ICSS) for Children.
"It's to address crisis situations for young people who are experiencing emotional symptoms, behaviors or traumatic circumstances that have compromised or impacted their ability to function within their family, living situation, school/childcare, or community. This service will be available regardless of current participation in or eligibility for CMH services, and CMHs would be able to use grant funding to design services that are proactive in nature and address crisis situations prior to further escalation," he said.
MDHHS has identified two sets of activities (see below) that CMHs may use grant funding to support.
· Phase 1 (Preparation)
o Staff Time on Preparing for Implementation of Best Practices for ICSS for Children
o Contracting for Consultation and Technical Assistance for Implementation of Best Practices for ICSS for Children
o Modifications to Electronic Health Records or Acquisition of Other IT Equipment to Support Improvements to ICSS for Children
· Phase 2 (Implementation)
o Hiring and Retention of Clinical Staff, Peer Professionals, and Parents/Caregivers with Lived Experience to Expand ICSS for Children
o Contracting for Clinical Staff, Peer Professionals, and Parents/Caregivers with Lived Experience to Expand ICSS for Children
o Ongoing Training for Teams in Best Practices for ICSS for Children
o Outreach to Children, Youth, and Families, and Community Partners to Promote Awareness of the Availability of ICSS for Children
MDHHS has identified a set of best practices that grantees can implement as part of the grant program. They include:
· Expanding ICSS for Children to address crisis situations for young people who are experiencing emotional symptoms, behaviors, or traumatic circumstances that have compromised or impacted their ability to function within their family, living situation, school/child care, or community. This includes but is not limited to identification of specific needs of:
o Young people who are Individuals with Developmental Disabilities including Autism Spectrum Disorder or (2) have Substance Use Disorders and implementation of specific trainings for ICSS teams to meet these needs.
o Young children (under 5 years of age) and families and adaptation of services to meet their specific needs.
o Young people with involvement in multiple child-serving systems (e.g., child welfare, schools/child care, juvenile justice, etc.) and adaptation of services to meet their specific needs.
· Expanding access to all young people regardless of insurance status (including children and youth who do not have Medicaid coverage). This service will be available regardless of current participation in or eligibility for CMH services.
o Planning for and incorporation of practices to support cultural and linguistic competence and health equity in service delivery.
o Recognition and partnership with federally recognized Tribal Nations in planning for service delivery.
· Planning for and utilization of telemedicine to support clinical consultations in responding to the initial crisis.
· Expanding access to ICSS to 24/7 coverage.
· Planning for and implementation of protocols for transitioning young people to appropriate follow-up care after the initial crisis.
· Planning for and implementation of stabilization services for up to 8 weeks after the initial crisis.
· Incorporating trained peer professionals (e.g. parent peer professional, youth peer professionals, etc.) and parents/caregivers with lived experience into mobile response teams. Peer professionals and parents/caregivers may provide support through (1) engaging with the young person or parent/caregiver through lived experience, (2) supporting the voice of the young person or parent/caregiver in the service delivery process, (3) validating and normalizing the feelings of the young person and parent/caregiver, and (4) supporting communication, connection, and coordination across the young person, family, mobile response team, and other system partners.
· Collecting data and using metrics to measure performance and support continual quality improvement.
· Establishing a partnership with local:
o Child welfare offices and providers to provide ICSS for young people in foster family homes or other community-based settings.
o Courts, law enforcement, and other juvenile justice partners to promote access and utilization of ICSS services for young people that are served within community-based settings.
o Intermediate school districts to coordinate follow-up care for young people who experience a crisis at school.
o Hospital partners to coordinate follow-up care for young people who experience a crisis and are at an emergency department.
· Improving coordination across the CMH mobile response and admission processes at hospitals and alternative settings (e.g. Crisis Stabilization Unit, Crisis Residential, etc.).
· Planning for and supporting integration activities with the Michigan Crisis Access Line and 988.
Wheaton said the benefits of awarding these grants will allow the CMHs to develop staffing at the local level in order to increase access to this service. He added ," increased utilization will also help inform the development of Medicaid rates through the Prepaid Inpatient Health Plans to allow for sustainable provision of this service to an expanded population of youth and families. and will allow CMHs to test best practices using flexible General Fund dollars, and the “lessons learned” will inform Medicaid policy decisions as permissible under federal law and regulations."
Total grant money for the entire program..... $9.2 Million. However, the total amount that was available would only be granted if all 46 CMHs in the state applied and requested the full amount. Only part of that $9.2 million in FY 23 was utilized. MDHHS will assess the maximum funding amount for the entire program in FY 24 and FY 25 based upon the number of applications.
