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FY2006/2007 Mental Health Block Grant: An informational meeting

May 25, 2006

Capitol View

Michigan Department of Community Health


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Introduction

Irene Kazieczko

Director

Bureau of Community Mental Health Services


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Mental Health Block Grant - Overview

  • SAMHSA directives

  • Mental Health System Transformation

  • Eliminate barriers to recovery

  • Development of new high quality and culturally relevant initiatives

  • Working in conjunction with consumers and other stakeholders


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Mental Health Block Grant - Purpose

  • Look at the current system of care

  • Identify barriers in achieving and maintaining recovery

  • Describe how these gaps were identified

  • How consumers are involved in identifying these gaps

  • Proposals should identify how this will fill the identified gaps


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Block Grant ProposalsFunding and other requirements

Patricia Degnan

Manager

Service Innovation and Consultation


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Block Grant Proposals – Funding and Requirements

  • Starting FY 2007

  • Direct Services – Proposals must be two years

  • Maximum of $100,000 for the first year

  • Maximum of $50,000 with an equal contribution from CMHSPs

  • Training only and one time purchases – Maximum of $75,000

  • Clubhouse training - $75,000

  • Evidence-Based Practice – use May 2005 RFP


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Block Grant Proposals – Funding and Requirements

  • No limit as to the number of proposals

  • Second year funding will be based on satisfactory progress achieved during the first year

  • Each CMHSP must complete Attachment C.1 for the entire system

  • Attachment C.2 must accompany each proposal


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Block Grant Proposals – Funding and Requirements

  • Workplans must be very specific

  • Each proposal must address how other local pertinent community agencies will be involved

  • Continuation plan – including funding availability

  • Face sheet – list program areas and target population

  • Proposal reviews

  • Target population


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Block Grant Proposal - Submission

  • Use of Block Grant funds

  • Proposal requirements

  • Proposal reviews, review criteria

  • Submit electronically to Karen Cashen at [email protected] no later than 5:00 p.m. on June 26, 2006

  • Proposal face sheet must be signed by the CMHSP Director and received no later than 5:00 p.m. on June 26, 2006


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Co-Occurring Disorders:Integrated Dual Disorder Treatment (IDDT)

Tison Thomas

[email protected]


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IDDT: Program Enhancement

  • Evidence-Based Practice

  • Resource kit

  • May 2005 RFA

  • System change initiatives

  • IDDT program development

  • Right to access effective services

  • Same team, same location, same time

  • Competitive grant and is for CMHSPs


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IDDT: Program Enhancement

  • Those who initiated the system change process and has an identified IDDT team

  • Funding is for certain Treatment Characteristics

  • Must be supported by IPLT

  • Work closely with the IDDT team and coordinate the project activities with the team


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IDDT: Program Enhancement

  • Must screen for Co-occurring disorders

  • Assess the level of severity of COD and stages of recovery

  • IPOS must address both MH and SA goals and match stage of recovery

  • Work with the State COD:IDDT subcommittee


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IDDT: Program Enhancement

  • Multidisciplinary Team

  • Stage-wise Interventions

  • Access to Comprehensive Services

  • Assertive Outreach

  • Motivational Interviewing

  • Substance Abuse Counseling

  • Group Treatment

  • Self-Help Group

  • Peer Support Specialist


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EBP:COD:IDDT

  • PIHPs only

  • Non-competitive

  • May 2005 RFA requirements

  • 20 steps

  • $140,000 total for two years

  • IPLT membership

  • CA membership

  • State IDDT Subcommittee membership


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Family Psychoeducation

Judy Webb

[email protected]


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Family Psycho-Education

  • Funding available to PIHPs that did not receive MHBG funding for 2005-07 for FPE (Nine are currently being funded)

  • Proposals are non-competitive

  • Use May 2005 Request for Application Requirements posted on MDCH web site


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Family Psycho-Education

  • $140,000 for two years

  • Expectations:

    • Clinicians will participate in 3-day training with Dr. Bill McFarlane (Cost of training includes the provision of supervision from one of his colleagues)

    • Site will send participants to quarterly “Learning Collaboratives”

    • Site will participate in University of Michigan’s evaluation


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Family Psycho-Education

  • Additional expectations:

    • FPE Program Leader will attend the state FPE subcommittee meetings

    • FPE Program Leader will be part of the local Improving Practices Leadership Team


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Family Psycho-Education

  • RFA:

    • Work plan

    • Check list

    • Budget:

      • $5,000 for 2 year evaluation (voluntary)

      • Approximately $500/per clinician for training & supervision (travel expenses are additional)

      • Approximately $180/year/participant in Learning Collaboratives (travel expenses are additional)


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Family Psycho-Education Resources

  • MDCH web site:

    • www.michigan.gov/mdch click on Mental Health and Substance Abuse, then “Evidence Based Practice”, then Family Psycho-Education

    • www.michigan.gov/mdch click on Mental Health and Substance Abuse, then Mental Health, then Reports and Proposals, and scroll to Evidence Based Practice Request for Proposals Q & A and FY 2006 Request for Proposals

    • www.samhsa.gov Click on Evidence-Based Practices Implementation Resource Kits/Family Psycho-Education


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RECOVERY TRANSFORMATION SYSTEMS

Colleen Jasper

[email protected]


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The Recovery Vision:

  • People can and do recover

  • Personal journey for each person

  • Belief in recovery for everyone with mental health problems is essential

  • Barriers to recovery needs to be addressed


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Applicants for Grants:

How to support recovery in your system

  • Education of staff and consumers on recovery

  • Various different models of recovery can be utilized (Mary Ellen Copeland) (WRAP)

  • Proposed plan needs to have 80% participation of consumers with 20% staff

  • Several documents can help

    a. Consensus Statement

    b. 101 Ways to Facilitate Recovery

    c. Recovery Council Mission Statement


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Advance Directives

Colleen Jasper

[email protected]


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Advance Directives (AD):

  • In Michigan Statute

  • Designee of patient advocate

  • Forms and documents website: notice to be sent to all CMHSPs

  • Assist in filling out forms, etc.


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AD Consumer Involvement:

  • Training, education and support of AD

  • Consumers involved distribution of training of AD

  • Consumers to consumer training

  • Other forms of AD can be used


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Anti-Stigma

Colleen Jasper

[email protected]


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Anti-Stigma:

  • Stigma is the major barrier to recovery

  • Exists widely in both community and systems

  • Best way to fight interpersonal connections

  • Hearing consumers stories

  • Realistic viewpoint of mental illness


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Anti-Stigma:

  • Involve both systems and community by primary consumers

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

  • Sustainability of projects.


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Anti-Stigma: (continued)

  • How to fight stigma

    a. Involve consumers

    b. Creative

    c. Helps consumer with leaderships, self esteem and recovery


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Trauma

Colleen Jasper

[email protected]


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Trauma Informed System:

  • 80% percent of consumers experience trauma in their lifetime

  • Post-traumatic stress disorders (PTSD) is a main factor

  • Trauma affects many of life’s domains

  • Emerging practice


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Responses:

  • Written position paper on PTSD

  • Screening and assessment of individuals coming into the system

  • Clinical practice, guidelines and treatment approaches

  • Collaborative approach integrating substance abuse and mental illness

  • Trauma awareness for staff and consumers

  • Reduction or elimination of seclusion and restraints

  • Continuation of funding

  • Consumers need to be involved in aspects in a trauma-informed system


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Assertive Community Treatment

Alyson Rush

[email protected]


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Population characteristics :

1)adults with SMI who have difficulty managing medications without on-going support, or with psychotic/affective symptoms despite medication compliance

2)adults with SMI who also have a co-occurring substance use disorder

3)adults with SMI exhibiting socially disruptive behavior that puts them at high risk for arrest and inappropriate incarceration or those exiting a county jail or prison

4)adults with SMI who are frequent users of inpatient psychiatric hospital services, crisis services, crisis residential or homeless shelters

5) adults over 65 years with SMI with complex medical/medication conditions


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Population needs enhanced:

1)supported employment activities

2)educational supports

3)community integration

4)leisure activities

5)consumer involvement on teams

6)team/staff/program fidelity


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Guidance:

1)consider exploring other successful projects/practices/services for replication

2)explain how need identification occurred in the existing service system to find gaps effecting ACT consumers

3)identify how the service gaps will be addressed (supports, services, staff training, etc.)

4)describe consumer involvement in identification of gaps, planning and creating the proposal

5)provide a clear description of the proposed outcomes to address the service gaps pin the current system

6)describe methods that will evaluate the success of the proposal

7)  tie the workplan, outcomes, evaluation and budget all together

describe how the proposal will be integrated into the current mental health system after the grant funding ends


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Older Adults

Alyson Rush

[email protected]


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Population characteristics:

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

2)may be at risk of suicide

3)have depression or another serious mental illness due to co-occurring medical conditions, chronic diseases or a substance use disorder

4)have Alzheimer’s or another dementia disorder with delusions, depressed mood, behavioral disturbances or another mental illness

5)are family caregivers of isolated older adults with mental illness or progressive disabling medical conditions


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Population needs:

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

2)prompt and easy access to mental health services

3)service penetration rates equal to or above the representation in the service area population

4)improved availability of quality mental health supports-including staff with training in geriatrics

5)improved availability of quality mental health supports and services for family caregivers and awareness of it

6) improved knowledge and skills of PIHP, CMHSP and providers


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Guidance:

1)consider exploring other successful projects/practices/services for replication

2)explain how identification occurred in the existing service system to find gaps effecting the population and their caregivers

3)identify how the identified service gaps will be addressed

4)describe how consumers or their caregivers were involved in planning and creating the proposal

5)provide a clear description of the proposed outcomes to address the service gaps in the current system

6)describe methods that will evaluate success of the proposal

7)tie the workplan, outcomes, evaluation and budget all together!

8)describe how the proposal will be integrated into the current mental health system after the grant funding ends.


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Rural Initiatives

Alyson Rush

[email protected]


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Population characteristics in adults:

1)experiencing Schizophrenia

2)Affective disorders

3)Anxiety disorders

4)Suicidal ideation


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Population needs:

1)The knowledge to recognize serious mental

illness

2)ability or willingness to access treatment

3)to have barriers such as (transportation, age, isolation, substance misuse or unemployment) accessibility and availability addressed

4)knowledgeable and trained staff to provide service

5)access to services that have proven to be effective and efficient


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Guidance:

1)Consider exploring other successful projects/practices/services for

replication

2)explain how the need was identified as a gap in service in the existing

system

3)identify how the service gaps will be addressed (supports, services,

staff training, etc.)

4)describe the consumer involvement in identification of gaps, planning

and creating the proposal

5)provide a clear description of the proposed outcomes to

address the service gaps in the current system

6)describe the methods that will evaluate success of the proposal

7)tie the workplan, outcomes, evaluation and budget all together

8)describe how the proposal will be integrated into the

current mental health system after the grant funding ends


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Other Types of Projects

Alyson Rush


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Other Types of Projects

  • Not all needs or service gaps related to System Transformation will be addressed in the previous sections.

  • Proposals that fit no other category may be submitted under this category.

  • Identify “Other” on the Face Sheet.

  • Proposals in this category may be submitted by both CMHSPs and PIHPs


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Other Types of Projects (cont.,)

  • Proposals may include other initiatives that have a strong base of evidence for both effectiveness and efficiency

  • Explain clearly how the need was discovered and how the gap impacts the ability of people experiencing Serious Mental Illness to move toward Recovery

  • Describe the consumer involvement in the process


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Other Types of Projects (cont.,)

  • Explain how this need will be addressed for individuals, the program, the agency, the system, etc.

  • Clearly tie the identified need with the workplan, the anticipated outcomes, the evaluation , the budget and the system integration plan.

  • Describe clearly how this project/service, etc. will be integrated into the current mental health system after the grant funding ends.


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Case Management

Pam Werner

[email protected]


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Case Management

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


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Peer Support Specialists

Pam Werner

[email protected]


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Peer Support Specialists

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

  • Promote community inclusion, participation, independence, and productivity.

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


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Proposals for Peer Support Specialists must include:

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

  • Determination of work hours and schedules

  • Direct hire or subcontract

  • If subcontract, why?

  • Supports that will be provided for successful employment

  • Team member training

  • Supervision and mentoring

  • Sustainability


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Person-Centered Planning

Pam Werner


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Person-Centered Planning

  • Strengthening the practices and processes

  • Partnership with beneficiaries in writing the proposal

  • Look at the relationship of person-centered processes and recovery, natural supports, independent facilitation, carrying out goals, dreams and desires in the plan


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Self-Determination for People with Mental Illness

Pam Werner


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Self-Determination for Persons with Mental Illness

  • Proposals must contain:

    • Documentation that over 50% of stakeholders involved in the proposal process were consumers

    • How SD principles will be implemented

    • Knowledge, networking and advocacy will occur

    • Systems change to support recovery


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

  • Support from Program Directors, Management and leadership in implementation efforts

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

  • Sustainability of consumer positions if hired


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Consumer Run, Delivered, or Directed Initiatives

Michael Jennings

[email protected]


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Drop-in Program Development or Enhancement

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

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

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

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


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Drop-in Program Development or Enhancement Continuation

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

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

  • Promote consumer choice

  • Maximize the opportunities for consumer autonomy and peer directed and run service alternatives.


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

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


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CONSUMER Run, Delivered or Directed Innovations and Replications

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

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


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

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

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


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Jail Diversion

Michael Jennings

[email protected]


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Jail Diversion

  • Please note Section 207 of the Michigan Mental Health Code requirement for all CMHSP to provide services designed to divert persons with serious mental illness, serious, emotional disturbance or developmental disability from possible jail incarceration when appropriate.

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

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


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Special Populations

Michael Jennings


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Special Populations

  • Innovative ideas for any special population of people with serious mental illness such as women, ethnic minorities, individuals with co-occurring disorders/mental health/criminal justice needs are encouraged.

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

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

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

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


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IMPORTANT NOTE

  • MDCH contracts require that any service, or activity funded in whole or in part with this funding be delivered in a smoke free facility or environment.

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

  • NO ADMININISTRATIVE OR INDIRECT expenses

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


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Supported Housing and Homeless

Sue Eby

[email protected]


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Collaboration is the key

To ending homelessness and expanding independent living options for people with disabilities


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Principles of collaboration

  • Develop and agree on a set of common goals and principles

  • Share leadership and responsibility for attaining those goals

  • Use expertise of each group member

  • Acknowledge that working this way takes time

  • Embrace consensus building, shared decision making and resolving conflict


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Advantages of Collaboration

  • Stimulates excitement at local level

  • Collaboration has more credibility, influence, and ability to accomplish objectives than a single entity

  • Encourages a comprehensive approach, reduces duplication

  • Ensures all voices are heard

  • Creates sustained change


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Local Housing and Service Collaborations are producing Supportive Housing

  • Human Service Agencies

    • Co-led by social services, include Area Agencies on Aging, MI Choice Waiver Agents, Centers for Independent Living, mental health, substance abuse, jobs, and other service providers

  • Local Governments

    • Co-led by largest city or county

    • Include other local jurisdictions

  • Nonprofit sponsors and advocates

    • Some with housing experience

    • Some service providers


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

  • Local supportive housing consortium (Allegan, Genesee, Grand Traverse/Benzie, Kalamazoo, Kent, Livingston, Oakland, Ottawa, Washtenaw, Wayne (Out-County) [email protected]

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

  • City and county government, non-profit housing


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Collaboration can produce…


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The joy of it…

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


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Charles at home


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Model projects

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

  • Washtenaw County

    http://whalliance.ewashtenaw.org/blueprint


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What is a Housing Choice Voucher?

  • Formerly called Section 8s

  • Rental assistance

  • Tenant Pays 30-40% of their income for rent plus utilities, HUD subsidy pays the rest

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

  • Limits on price of unit


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Accessing available Housing Choice Vouchers

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

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

  • PHA Housing Choice tenant-based vouchers

  • PHA housing (Https://pic.hud.gov/pic/haprofiles/haprofilelist.asp


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Other sources of assistance with housing

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

  • Community Action Agency (www.mcaaa.org)

  • Housing Opportunities for Persons with HIV/AIDS ([email protected])

  • MSU Extension Services, Local Housing Non-profits,Local Service Agencies, Churches


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Mortgage options

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

  • MSHDA Counselors at http://136.181.109.11/counselors

  • Rural Development

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

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


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City and County Resources

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

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

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


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Clubhouse

Su Min Oh

[email protected]


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Statewide Clubhouse Training

  • One project for one year

  • Work with all the clubhouses

  • Support recovery, promote and secure employment, member leadership


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Other areas for clubhouse

  • Employment outcomes

  • Long-term housing supports

  • ICCD clubhouse training


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Supported Employment

Su Min Oh

[email protected]


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Supported Employment as EBP

  • Implement core principles of the SE

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


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Cultural Competence

Tison Thomas

[email protected]


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Cultural Competence

  • Improving access to quality care that are culturally competent

  • Culturally competent services

  • Culturally competent agencies


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Cultural Competence

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

  • Recruiting and retaining racial/ethnic minorities/bilingual professionals

  • Developing assessment mechanisms and training curricula


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Cultural Competence

  • Identify gaps

  • Address possible barriers of care

  • Must assess consumers’ cultural diversity

  • Training in communication/interviewing skills

  • Provide staffing that reflects the composition of the community being served

  • Resources


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Mental Health Clinical Skills Development

Tison Thomas


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Mental Health Clinical Skills Development

  • Mental Health Workers in Developing Clinical Skills

  • Substance Abuse Treatment Skills

  • Cognitive Behavioral Therapy

  • Dialectical Behavioral Therapy


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Tips for Preparing Your Budget Proposal

Karen Cashen

[email protected]


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Budget Forms – DCH-0385 & DCH-0386

  • Two Budget Forms Required

    • DCH-0385 – Program Budget Summary

    • DCH-0386 – Program Budget - Cost Detail

  • Formats available in Excel or Word

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


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Budget Points to Remember…

1. Build the Cost Detail first if using Excel.

2. The contractor’s name at the top of each form is the CMHSP or PIHP, not the name of whatever subcontractor you may be using.

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


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Budget Points to Remember…

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

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


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Budget Points to Remember…

6. Supplies vs. Equipment

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

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


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Budget Points to Remember…

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


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Budget Points to Remember…

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

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

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


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Budget Points to Remember…

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

12. Check math for accuracy

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


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Budget Points to Remember…

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

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


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