new york state oﬃce of mental health

Community Mental Health Services Block Grant Supplement Legislative Funding Report October 2021

New York State Office of Mental Health

CMHS Block Grant Supplement Legislative Report 1


Purpose and Background This report is prepared and submitted in accordance with Chapter 53 of the Laws of 2021, regarding supplementary federal Community Mental Health Services Block Grant funding, which directs the New York State Ofce of Mental Health (OMH) to:

“Prepare annual reporting to the chairperson of the senate fnance committee, the chairperson of the assembly ways and means committee, the chairperson of the senate committee on mental health, the chairperson of the assembly mental health committee, on the disbursement of funding for each pur-pose. Such reports shall include: (a) description of types of projects supported by these funds; (b) total funds committed by project type; (c) total funds liquidated by project type; and (d) number of mental health providers who have received direct grant payments.”

COMMUNITY MENTAL HEALTH SERVICES BLOCK GRANT SUPPLEMENTAL FUNDING OVERVIEW

Federal Authority and Funding Description In 2021, two federal laws were enacted in response to the COVID-19 pandemic, The Coronavirus Re-sponse and Relief Supplemental Appropriations Act and The American Rescue Plan Act, both providing supplemental funding to mental health services through time-limited expansions of the United States Substance Abuse and Mental Health Services Administration (SAMHSA) Community Mental Health Ser-vices Block Grant (CMHS Block Grant).

According to SAMHSA:

“[The CMHS Block Grant] is designed to provide comprehensive community mental health services to adults with serious mental illness (SMI) or children with serious emotional disturbance (SED). States may use this supplemental COVID-19 Relief funding to prevent, prepare for, and respond to SMI and SED needs and gaps due to the on-going COVID-19 pandemic. The COVID-19 pandemic has signif-cantly impacted people with mental illness. Public health recommendations, such as social distancing, are necessary to reduce the spread of COVID-19. However, these public health recommendations can at the same time negatively impact those with SMI/SED. The COVID-19 pandemic can increase stress, anxiety, feelings of isolation and loneliness, the use of alcohol or illicit substances, and other symp-toms of underlying mental illness.

Too many people with SMI and SED cannot access the treatment and support that they need, and the pandemic has further disrupted access and care for even greater numbers. The Biden-Harris Admin-istration is committed to advancing behavioral health and addressing the particular challenges the pandemic has brought to the forefront (e.g., concerning suicide and overdose rates). The MHBG is a critical source of funding to states to support a continuum of prevention, intervention, treatment, and recovery services. SAMHSA recommends that states use the COVID-19 Relief supplemental funds wherever possible to develop and support evidence-based crisis services development and to in-crease access to evidence-based treatment and coordinated recovery support for those with SMI and SED.”

2 CMHS Block Grant Supplement Legislative Report


Funding Amounts Allocated to OMH and Timeline of Funding Availability

The supplemental CMHS Block Grant funding allocated to OMH under the Coronavirus Response and Relief Supplemental Appropriations Act totals $46,339,285 and must be expended during the period of March 15, 2021 to March 14, 2023.

The supplemental CMHS Block Grant funding allocated to OMH under the American Rescue Plan Act totals $80,040,583 and must be expended during the period of September 1, 2021 to September 30, 2025.

Federal Priorities and Set-Asides

In awarding this funding to OMH, SAMHSA has provided specifc recommendations for potential fund-ing use and identifed requisite minimum “set-asides” for specifc mental health service types.

Regarding the Coronavirus Response and Relief Supplemental Appropriations Act CMHS Block Grant supplement, SAMHSA required funding be set-aside or dedicated specifcally to crisis services (5%), frst-episode psychosis services (10%), and child, youth, and family mental health services (25%) and provided the following recommendations:

“In addition to meeting the standard goals and objectives of the [CMHS Block Grant] to provide evi-dence-based services to individuals with SMI/SED, COVID-19 Relief supplemental funds can be used for: (a) operation of an “access line,” “crisis phone line,” or “warm lines” to address any mental health issues for individuals; (b) training of staf and equipment that supports enhanced mental health crisis response and services; (c) Mental Health Awareness training for frst responders and others; (d) hire of outreach and peer support workers for regular check-ins for people with SMI/SED; (e) prison and jail re-entry and enhanced discharge from inpatient settings in order to reduce risks of COVID-19 transmis-sion; and (f) COVID-19 related expenses for those with SMI/SED, including testing and administering COVID vaccines, COVID awareness education, and purchase of Personal Protective Equipment (PPE).”

Regarding the American Rescue Plan Act CMHS Block Grant supplement, SAMHSA provided the following recommendations for funding utilization and identifed specifc set-asides for both crisis (5%) and frst episode psychosis or early SMI programs (10%):

“SAMHSA encourages states to consider a focus on support of a behavioral health crisis continuum. An efective statewide crisis system afords equal access to crisis supports that meet needs anytime, anyplace, and for anyone. This includes those living in remote areas and underserved communities as well as youth, older adults, persons of diverse backgrounds, and other marginalized populations; the crisis service continuum will need to be able to equally and adeptly serve everyone. SAMHSA recom-mends states consider use of the ARPA MHBG funds to develop, enhance, or improve the following:

• Develop partnerships with the emerging Suicide Lifeline (9-8-8) systems, Law Enforcement, EMS, health care providers, housing authorities, Housing and Urban Development (HUD) Continuum of Care, hospital systems, peer-based recovery organizations, and substance use specifc treatment providers, all of whom have a critical role in the crisis continuum.



• Utilize fve percent of funds for crisis services, as described in the FY 2021 appropriations language. A comprehensive 24/7 crisis continuum for children including screening and assess-ment; mobile crisis response and stabilization; residential crisis services; psychiatric consulta-tion; referrals and warm hand-ofs to home- and community-based services; and ongoing care coordination.

• Provide increased outpatient access, including same-day or next-day appointments, for those in crisis.

• Improve information technology infrastructure, including the availability of broadband and cellular technology for providers, especially in rural and frontier areas; use of GPS, to expedite response times, and to remotely meet with the individual in crisis.

• The adoption and use of health information technology, such as electronic health records, to improve access to and coordination of behavioral health services and care delivery.

• Consider digital platforms, such as Network of Care, which facilitate access to behavioral health services for persons with SMI-SED.

• Advance telehealth opportunities to expand crisis services for hard to reach locations, es-pecially rural and frontier areas. Expand technology options for callers, including the use of texting, telephone, and telehealth. Note: States cannot use the funds to purchase any items for consumers/clients.

• Implement an electronic bed registry that coordinates with existing HHS provider directory ef-forts and treatment locator system that will help people access information on crisis bed facili-ties, including their locations, available services, and contact information.

• Support for crisis and school-based services that promote access to care for children with SED.

• Develop medication-assisted treatment (MAT) protocols to assist children and adults who are in crisis, which may leverage telehealth when possible.

• Expand Assisted Outpatient Treatment (AOT) services.

• Develop outpatient intensive Crisis Stabilization Teams to avert and address crisis.

• Technical Assistance for the development of enhanced treatment and recovery support ser-vices including planning for Certifed Community Behavioral Health Clinics (CCBHC).”

Description of CMHS Block Grant Rules and Limitations

States are required to spend the CMHS Block Grant supplemental funding in accordance with existing statute governing all CMHS Block Grant expenditures, as defned in 42 U.S.C. Chapter 6A, Subchapter XVII, Part B, Subpart I. In general, states are restricted from expending CMHS Block Grant funds on the following:

• To provide inpatient hospital services;

• To make cash payments to intended recipients of health services;



• To purchase or improve land, purchase, construct, or permanently improve (other than minor remodeling) any building or other facility, or purchase major medical equipment;

• To satisfy any requirement for the expenditure of non-Federal funds as a condition for the re-ceipt of Federal funds; and

• To provide fnancial assistance to any entity other than a public or nonproft private entity.

SAMHSA Waivers Requested by OMH

States may request waivers from SAMHSA with respect to allowable activities, timelines, or reporting requirements as deemed necessary to facilitate a grantee’s response to coronavirus, consistent with the United States Department of Health and Human Services (HHS) Disaster Relief Flexibilities.

Regarding the CMHS Block Grant funding awarded under the Coronavirus Response and Relief Sup-plemental Appropriations Act, OMH has requested the following waivers:

• Waiver from the exclusion of capital expenditures as an allowable expense of MHBG funds, consistent with the SAMHSA recommendation that supplemental funds can be used on crisis phone line infrastructure.

• Waiver of the prohibition of funding a for-proft entity in order to facilitate the purchase of hard-ware and software and/or training needed to develop and implement a fully functional crisis line and/or crisis services consistent with the NYS comprehensive crisis system plan.

• Waiver of the target population in order to fund preventative, intervention, treatment and re-covery services to at-risk children, youth and families prior to a diagnosis of serious emotional disturbance. Such services are necessary to address the emotional and behavioral needs of children who have had adverse childhood experiences as a result of the pandemic which could lead to future behavioral health care needs. SAMHSA did not approve this waiver request, as “MHBG dollars cannot be used for prevention eforts (with the exception of prevention in the SMI/SED population).”



CMHS Block Grant Planning Process Stakeholder Feedback Process and Analysis

OMH solicited extensive feedback regarding the CMHS Block Grant supplement funding opportunities, as well an enhanced Federal Medical Assistance Percentage (FMAP) funding opportunity. OMH hosted eight stakeholder feedback meetings, which included: fve regional meetings, one meeting with con-sumers, one meeting with provider associations, and one meeting with county Directors of Community Services. In all, over 700 stakeholders participated in these feedback sessions.

OMH also launched a website to inform the public and system stakeholders about the CMHS Block Grant supplement funding opportunities, which included a contact form that invited individuals to pro-vide feedback that was used in the planning process for these funds.

In response to OMH’s feedback solicitation, the agency received over 325 comments, through direct verbal testimony, WebEx chat remarks, and other written correspondence. OMH analyzed all com-ments received and incorporated much of the feedback into the planning process for the current im-plementation of these funds. OMH will continue to incorporate feedback received as the planning and implementation process continues.

The regional feedback meetings were recorded and are available on the OMH website: https://omh. ny.gov/omhweb/planning/cmhsbg-fmap/index.html

OMH has identifed initial key priorities and potential investments within the mental health system that could be further supplemented by the additional CMHS Block Grant funds. OMH will continue to devel-op and refne applicable priorities as the process to program these funds moves forward.

https://ny.gov/omhweb/planning/cmhsbg-fmap/index.html

https://omh



CMHS Block Grant Funding Priorities, Allocation, and Programming Status The Ofce of Mental Health has embarked upon a multi-year process to redesign the mental health system, with a primary goal of ensuring universal, immediate access to a comprehensive range of men-tal health services which allow individuals in need of care to remain in their homes, connected to their natural support systems during treatment, while avoiding unnecessary and disruptive inpatient hospi-talizations.

To realize this redesign and guide the planning for new and expanded services, OMH is:

• Prioritizing prevention across the lifespan and investing in programs which support the early identifcation and intervention of emotional disorders and mental illnesses, including frst epi-sode psychosis.

• Supporting children, youth, and families in need of care, exacerbated due to the traumatic im-pact of COVID-19, including school-based services, home and community-based services and crisis intervention.

• Developing robust community services, including a comprehensive and coordinated crisis response system, which will address the emergent and immediate needs of New Yorkers of all ages and at the same time, connect individuals to the wider mental health system.

• Addressing the intersection of the criminal justice and behavioral health systems, connecting individuals in crisis to care through the training of law enforcement, advancing innovative crimi-nal justice system diversion programs, and serving and supporting individuals exiting incarcera-tion as necessary to avoid reincarceration and/or hospitalization

• Transforming New York’s mental health system to advance a culturally competent, ambulatory network of recovery-oriented treatment and support services that meet children, adults and families when, where, and how they need it most, and includes the integrated delivery of sub-stance use disorder and physical health treatments.

• Implementing specifc strategies on payment parity and provider sustainability needed to re-duce disparities in access and treatment outcomes for communities across New York State.

With these goals in mind, OMH is continuing to plan and program the initial $46.3 million supplemental CMHS Block Grant award and the secondary $80 million supplemental CMHS Block Grant award, while continuing to solicit stakeholder input throughout the process and taking a fexible approach to pro-grammatic development and refnement to best meet community need.

The four key areas currently prioritized are outlined below: Statewide Crisis Services; Child, Youth, and Family services; Adult Ambulatory and Peer Services, and Mental Health Workforce/System Capacity Building.



The table below provides an overview of total funding for each priority area identifed by OMH.

CMHS Block Grant Funding by Priority Area

CMHS Supplemental Block Funding Amount Grant Priority Area

Crisis Service $45,203,165

Child, Youth, and Family Services $25,855,215 Adult Ambulatory & Peer Services $28,087,987 Workforce/System Capacity Building $20,914,508 OMH Administration $6,3188,993 Total $126,379,868

Crisis Services Priorities - $45,203,165 • 988 Call Center Preparation- Support and development of framework and technological assets

necessary to develop capacity for an interoperable, statewide 988 crisis call center network in New York by July 2022, including a single point of access database. Technology and data sys-tem development to monitor service distribution and utilization. Expansion of capacity for call center network to meet expected increases in call volume with 988 implementation

• Mobile Crisis Response- Support for start-up costs related to the state-wide expansion of re-gional mobile crisis teams to include immediate response and 24/7/365 availability and cre-ation of innovative service models

• Crisis Residence Start-Up and Expansion- Funding for both new and existing crisis residences for children and adults, start-up stafng support for new providers, and connections to fol-low-up services for children and adults

• Crisis Stabilization Start-Up and Expansion- Programmatic development and implementation of new integrated mental health/substance-use disorder crisis stabilization models, aimed at providing stabilization services, peer supports, medication administration and management, medication for addiction treatment and mild to moderate detoxifcation, and connections to follow-up services for children and adults

• Law enforcement training and diversion



Current Crisis Services Allocations

Mobile Crisis Service Development- $5,000,000

OMH has allocated $5,000,000 of the CMHS Block Grant supplemental award to support the expan-sion of mobile crisis services across New York State, as part of OMH’s overall strategy to provide New Yorkers with a comprehensive crisis care continuum.

Target Date: OMH is developing technical assistance resources in 2021 and anticipates deploying grant funding and resources in early 2022.

Mobile crisis services interrupt or ameliorate a behavioral health crisis by engaging with an individual in crisis, reducing their immediate symptoms, and stabilizing the individual. Mobile crisis teams are dis-patched to an individual’s home or any community location where a crisis may be occurring, to provide brief intervention and facilitate access to other crisis/behavioral health services. They provide appro-priate care and support while avoiding unnecessary law enforcement involvement, emergency depart-ment use and hospitalization.

These funds will be used by future awardees to launch mobile crisis services in counties where these services are not currently available and provide technical assistance to OMH-approved/designated mo-bile crisis programs in order to expand the ability of mobile crisis teams to respond, improve the quality of response, identify mobile crisis response standards and best practices, and improve billing.

988 Call Center Capacity Building, Crisis Stabilization Program Expansion, and Crisis Residential Pro-gram Expansion- $37,603,165

OMH has allocated $37,603,165 of the CMHS Block Grant supplemental award to build capacity within 988 call centers, and expand the availability of crisis stabilization and crisis residence programs across New York State, as part of OMH’s overall strategy to provide New Yorkers with a comprehensive crisis care continuum.

Target Date: OMH anticipates releasing funding to existing 988 call centers for the maintenance and expansion of capacity in October 2021; releasing a procurement request to expand crisis stabilization programs in Fall 2021; and releasing grant funding to support the rollout of crisis residential programs in early 2022.

988 call center funding will support call centers while they continue to assist in New York State’s devel-opment of a 24/7, statewide 988 crisis call center network by July 2022, maintain and expand the cur-rent answer rates of existing call centers, and empower the ongoing integration of crisis service pro-gramming within and across state agencies. The current call centers which will receive this funding are as follows: Tompkins County Suicide Prevention & Crisis Services, Response of Sufolk County, Contact Community Services, Goodwill Services of the Finger Lakes, and Vibrant Emotional Health.

Crisis stabilization funding will provide short-term, start-up support for the development of crisis stabi-lization programs across New York. This funding will support two models, serving children, youth, and adults in crisis: supportive crisis stabilization and intensive crisis stabilization. Crisis stabilization cen-



ters provide New Yorkers with crisis services which include stabilization of the immediate crisis, direct linkages to services, medication administration and management, including medication for addiction treatment, and mild to moderate detoxifcation.

Residential crisis funding will support the expansion of both new and existing crisis residential pro-grams in New York State. Crisis residential programs serve a vital role in New York’s crisis continuum for children, youth, and adults, and this funding will allow these programs to grow while expanded, sustainable funding sources are implemented, such as Medicaid and commercial insurance reimburse-ment. Crisis residential programs provide short-term stabilization services and connection to communi-ty supports and treatment programs.

Jail Diversion Program Expansion- $2,100,000

OMH has allocated $2,100,000 of the CMHS Block Grant supplemental award for the expansion of jail diversion programs across New York State.

Target Date: OMH anticipates deploying grant funding for this proposal by November 2021.

To better assist individuals in crisis, jail diversion programs aim to reduce arrest and incarceration of persons with SMI and better connect criminal justice-involved individuals to treatment. These programs meet diferent needs on the Sequential Intercept Model developed by the SAMHSA. The Sequen-tial Intercept Model identifes key points for “intercepting” individuals with behavioral health issues and then linking them to services and preventing further penetration into the criminal justice system. Points of intercept include, but are not limited to pre-arrest, pre-booking, post-booking, pre-sentencing, post-sentencing, pre-release from incarceration, and post-release for incarceration.

Current examples of jail diversion programming include:

• An initiative for individuals booked into jail for violations or non-violent misdemeanors. Individ-uals with mental health diagnoses and/or co-occurring substance use disorders are assessed, provided with any needed prescriptions, and released from custody to a care coordinator who link each individual to community-based services.

• A jail diversion drop-of center for individuals with mental illness at the pre-booking, post-book-ing, and pre-sentencing intercept points. The center will operate 24/7 and be available to individuals of all ages, accepting direct drop-ofs from law enforcement. Connecting individuals to jail diversion alternatives, the center provides evaluation, assessment, and referral to mental health and substance use disorder services, with embedded peer supports.

• A parole diversion program to divert parolees diagnosed with serious mental illness from reincarceration due to parole violations. The parole diversion program works with parolees struggling to comply with conditions of parole and who have become disengaged from com-munity-based mental health treatment. This program engages community-based treatment pro-viders and coordinates mental health care and treatment for parolees to ensure communication and coordination with community supervision to avoid violation of parole, when possible.



• A pretrial services screening and supervision release pilot program where the probation de-partment works across the criminal justice system to identify individuals with mental illness and/ or co-occurring substance use disorders, at post-booking and pre-sentencing intercept points, who are deemed to be appropriate for community release. Probation Ofcers work with the individual, their families and appropriate parties, and treatment providers to develop assess-ment-based case plans, with short and long-term goals.

Crisis Intervention Team Program Expansion- $400,000

On July 1, 2021, this funding was awarded to Coordinated Care Services, Inc., OMH’s current CIT ser-vices contractor, to expand CIT programming to certain law enforcement agencies in nine additional New York State counties, as follows: Chautauqua, Clinton, Franklin, Jeferson, Livingston, Saratoga, Schenectady, St. Lawrence, and Tompkins.

CIT’s promote collaboration and partnership among law enforcement, the mental health system, crimi-nal justice representatives, emergency services, and consumer and family advocacy groups. The over-all mission of the CIT program is to improve interactions between police, individuals with mental illness and mental health treatment providers with an emphasis on diversion from criminal justice system and into mental health treatment.

At the center of the CIT program is a mapping exercise that identifes all local stake holders needed to successfully implement this initiative, along with gaps in the current processes and points in the local criminal justice continuum where crisis intervention is most needed. In addition, patrol ofcers and su-pervisors receive a 40-hour training on mental illness, including:

• Signs and symptoms of mental illness;

• Contributing factors to emotional disturbance;

• State mental hygiene law;

• Communication skills and intervention techniques;

• Scenario-based training to practice skills;

• Experimental exercises; and

• Presentations and discussions with local treatment providers, emergency facilities/mental health services and consumers and families living with a mental illness.

Additionally, OMH ofers training entitled “Mental Health First Aid” for other law enforcement person-nel, corrections personnel, frst responders and 911 operators. On-going mental health related trainings designed to ofer technical assistance are also delivered as a component of the CIT program.

Law Enforcement Mobile Access Program Expansion- $100,000

OMH has allocated $100,000 of the CMHS Block Grant supplemental award for the expansion of the Law Enforcement Mobile Access Program (MAP) across New York State.

On July 1, 2021, this funding was awarded to Coordinated Care Services, Inc., OMH’s current CIT ser-



vices contractor, to expand the MAP program in certain law enforcement agencies in 19 additional New York State counties, as follows: Cattaraugus, Cayuga, Chautauqua, Chemung, Franklin, Greene, Jef-ferson, Lewis, Madison, Niagara, Oneida, Onondaga, Orange, Otsego, Putnam, Rockland, Seneca, St. Lawrence, and Wyoming.

The MAP serves as an extension of the CIT program. The goal of MAP is to connect individuals to resources for mental health consultation while avoiding unnecessary transports to hospitals. MAP is a collaboration between the criminal justice system and mental health system. Under MAP, police ofcers and mental health professionals are each equipped with iPads that can be used by the ofcers when responding to calls. The ofcers can remotely connect an individual to a mental health professional without necessarily having to transport to a diferent location such as the hospital or jail, unless that level of intervention is deemed necessary.

MAP includes training for all jurisdictions and ongoing technical support for equipment. MAP also sup-ports the equipment purchase/monthly contracts, as well as staf time for data collection and reporting.

Child, Youth, and Family Services Priorities - $25,855,215 • Developing a coordinated system of care for children and families, across all applicable mental

health services, with additional support of service navigation and awareness training, including youth-specifc mental health training across systems

• Comprehensive crisis services, including additional crisis residential services, directed to chil-dren and families are critical to addressing the need of New York communities. New York’s crisis continuum is being built within the context of a comprehensive, coordinated system of care, which includes all other child-serving systems, such as schools, child welfare, and juvenile justice

• Screening and early identifcation of children and youth who could beneft from evi-dence-based assessment and mental health treatment

• Developing and further expanding Youth Assertive Community Treatment programs and home-based/mobile outreach and treatment services

• Expanding and enhancing clinical services that support short-term and fexible use of services, particularly to serve pandemic-related MH heads such as complicated bereavement, anxiety, depression, and PTSD, as well as the needs of high-risk populations including youth with co-oc-curring disorders

• Improving access to the comprehensive service array in Medicaid for non-Medicaid youth

• Expanding school-based and college-based mental health capacity

Current Child, Youth, and Family Services Allocations

Intensive Community-Based Services for Children and Youth- $1,900,000

OMH has allocated $1,900,000 of the CMHS Block Grant supplemental award for the development of



intensive community-based services for children and youth.

On August 31, 2021, OMH issued a Request for Applications for one-time funding of up to $50,000 per agency to providers of OMH-licensed Clinic Treatment, Partial Hospitalization, and Home-Based Crisis Intervention services. Applications for this funding are due by November 1, 2021.

The intent of this funding is to increase service volume and expand timely access to in-person and telehealth services that divert youth from higher level of care and/or allow safe stepdown from higher level of care. These programs will have an emphasis on higher intensity services, coordinated hand-of to a lower level of care, family engagement, and provision of services in the home or community, as appropriate.

To address the present volume of need for individualized, intensive, community-based services and support, these funds will assist with the following:

• Expansion of program operations to serve a greater number of children/families and/or an expanded catchment area;

• Creation of formal mechanisms for connections/partnership to Emergency Departments/ Comprehensive Psychiatric Emergency Programs/Inpatient settings/Mobile Crisis programs/ Crisis Residences/Mobile Integration Teams, etc. for seamless referral processes and timely access to care; and

• Eforts in marketing to, hiring, onboarding, and retaining more qualifed staf for the growth and expansion of access to services.

OMH will seek the following outcomes from awarded programs:

• Increased service capacity to eligible and appropriate referrals; • Decreased length of stay on program and reduced time to appointments; • Increased workforce to be able to support service access and service provision to eligible

children and families; and

• Increased community awareness and education regarding the services and their availability/ how to access them.

Systems of Care Expansion- $500,000

OMH has allocated $500,000 of the CMHS Block Grant supplemental award to fund the expansion or implementation of the Systems of Care service planning approach in counties across New York State.

Target Date: OMH anticipates releasing a procurement request for this funding in October 2021.

This funding will enable awarded counties to improve systems coordination that promotes access to care for children, youth and young adults with SED through implementation of the Systems of Care framework. This framework has been shown to help counties institute changes that include better col-



laborative structures, communication, and service outcomes, develop local infrastructures and mecha-nisms that address the needs to youth with complex cross-system needs, and advance service aware-ness, education, and accessibility across the various child-serving systems.

Awarded counties will receive either expansion or start-up funding to support personnel costs associ-ated with Systems of Care implementation, training and consultation expenses needed to implement this model, data collection and dissemination, consultation costs to improve funding methodologies for services, funding to support the recruitment and retention of qualifed staf to grow and expand ser-vices, and the development of formal mechanisms to empower seamless referrals and access to care across mental health service settings.

School Based Mental Health Clinic Satellite Expansion- $3,000,000

OMH has allocated $3,000,000 of the CMHS Block Grant supplemental award for the expansion of school-based mental health clinic satellites across New York State.

Target Date: OMH anticipates releasing a procurement request for this funding in October 2021.

This funding will allow for the additional development of school-based clinic treatment satellite sites in high need and currently underserved communities in New York State in the wake of the COVID-19 pandemic. Greater availability of school-based mental health services is a critical post-pandemic efort to address the current and prevent the long-term needs of children and families, through both early identifcation of mental health needs and increased access to treatment services. Successful school-based clinics improve service outcomes for children with SED and their families, increase a communi-ty’s service capacity for children and youth, decrease lengths of stay on program and reduce the time to appointments, and increase community awareness and education about SED and how to access services.

Awardees will receive funding to support the establishment of new clinic satellite locations within schools to serve a greater number of children and families and/or a wider service area, expand in-per-son and telehealth service accessibility, develop mechanisms for partnerships with school districts and their personnel to facilitate seamless referrals and access to care across mental health service settings.

Youth Assertive Community Treatment Program Expansion- $5,950,000

OMH has allocated $5,950,000 of the CMHS Block Grant supplemental award for the expansion of the Youth Assertive Community Treatment (ACT) program.

On August 4, 2021, OMH issued a Request for Proposals to procure this expansion, with an anticipated award notifcation date of October 22, 2021. Ten awards will be available statewide, in each of the fve OMH regions as outlined below.

https://omh.ny.gov/omhweb/rfp/2021/youth-act-statewide/index.html



Region

New York City

Number of Teams

2

Location of Teams

1. Manhattan 2. Staten Island

Long Island 1 1. Nassau

Hudson River 3 1. Warren/Washington/Saratoga 2. Schenectady/Albany 3. Westchester

Central New York 2 1. Onondaga 2. Broome

Western New York 2 1. Monroe 2. Erie/Niagara

The Youth ACT program is a team-based service providing care to children/youth with Serious Emo-tional Disturbance (SED), who are returning home from inpatient settings or residential services, at risk of entering such settings, or have not adequately engaged or responded to treatment in more tradi-tional community-based services.

Youth ACT ensures the child and their family have the level of support services and access to clinical professionals they require to sustain any gains made in crisis response or high-end services. Youth ACT teams deliver intensive, highly coordinated, individualized services and skilled therapeutic inter-ventions through an integrated, multi-disciplinary team approach to better achieve success and main-tain the child in the home, school and community. The majority of services are provided by Youth ACT staf directly (not brokered) and are delivered in the home or other community-based settings.

Team interventions are focused on improving or ameliorating the signifcant functional impairments and severe symptomatology experienced by the child/youth due to mental illness or serious emotional dis-turbance (SED). Clinical and rehabilitative interventions are also focused on enhancing family function-ing to foster health/well-being, stability, and re-integration for the child/youth. Services are delivered using a family-driven, youth guided and developmentally appropriate approach that comprehensively addresses the needs of the child/youth within the family, school, medical, behavioral, psychosocial, and community domains. Youth ACT ofers support on 24 hours a day, 7 days a week basis.

To address the needs of children and adolescents eligible for this comprehensive service, the ACT team is multi-disciplinary with professional staf including mental health clinicians and psychiatric pre-scribers. Other members of the team include peer advocate (family and youth), clinical staf, and pro-gram assistant.

Youth ACT promotes a myriad of interventions, including: the active participation of the family and other natural supports; the utilization of promising practices and evidence-based treatment interventions fo-cused on family and systems approaches; re-integration and meaningful connections within the home and community; and preparations for transition to adulthood; all as applicable to the population served. The ACT team must also ensure that services are comprehensive, and principle driven.



An additional $14,505,215 in child, youth and family services funding is still in development. OMH will continue to work with stakeholders across New York State as these funds are programmed.

Adult Ambulatory Services Priorities - $28,087,987 • Telehealth services expansion and support

• Programmatic and fnancial support to encourage expansion of Mobile clinic services

• Additional peer-delivered and rehabilitative services including crisis programs (living room, crisis respites, support lines), recovery centers, and peer-bridger programs. Expansion for peer workforce across ambulatory programming

• Assertive Community Treatment enhancements, including developing Assertive Community Treatment models for Young Adults, supporting implementation of standardized functional needs and social determinants of health and developing state-wide data infrastructure with EHR interoperability

• Support implementation of standardized functional needs and social determinants of health and develop state-wide infrastructure with EHR interoperability.

• Support for Certifed Community Behavioral Health Clinics

• Fostering closer linkages among ambulatory, housing, and inpatient care providers with the comprehensive crisis system currently in development and by implementing Critical Time Inter-vention models

• First Episode Psychosis Team Expansion to supplement existing OnTrackNY frst episode psy-chosis capacity, targeted to young adults experiencing their symptoms of psychosis, further expanding programmatic reach across New York State

Current Adult Ambulatory Services Allocations

Assertive Community Treatment Program Expansion- $3,600,000

OMH has allocated $3,600,000 to of the CMHS Block Grant supplemental award expand Assertive Community Treatment (ACT) services with 8 additional ACT programs to be sited in communities across New York State.

Target Date: OMH anticipates releasing a procurement request for this funding by December 2021.

ACT programs are multi-disciplinary mental health treatment teams which deliver comprehensive and efective services to individuals who are diagnosed with severe mental illness and whose needs have not been well met by more traditional service delivery approaches. ACT is an evidence-based practice that integrates treatment, rehabilitation, case management, and support services, and is delivered by a mobile team.



This funding will allow OMH to expand ACT services into areas which have an identifed need for ACT services, but which do not currently have access to this programming, increase the number of individ-uals who will have access to ACT services in New York City and other regions with existing ACT pro-grams, and provide start-up costs to support the development of these new programs.

Peer-to-Peer Supported Transition Program Development- $1,000,000

OMH has allocated $1,000,000 of the CMHS Block Grant supplemental award to develop the Peer-to-Peer Supported Transition Program in New York State.

On August 26, 2021, OMH issued a Solicitation of Interest for the development of this program, with indications of interest due by September 17, 2021.

This funding will support creation of a community-frst support program intended to assist individuals and their chosen support group/family in creating a time limited, successful, and sustainable transition from their treatment setting into their community of choice with a focus on wellness, sustained commu-nity inclusion and practical strategies to use in emerging crises. This program will have an emphasis on higher intensity services, coordinated hand-of to a lower level of care, family engagement, and provi-sion in the home or community as appropriate.

To address the present volume of need for individualized, intensive, community-based services and support, funds will assist with the following

• Expansion of program operations or creation of program to serve a greater number of individu-als statewide;

• Creation of formal mechanisms for connections/partnership to supports, activities, and services in the community promoting whole person wellness;

• Program will serve youth and adults with SMI/SED in various demographics including but not limited to: individuals discharged from a variety of treatment courts, correctional institutions, Veterans courts, hospitals, residential treatment, rehabilitation centers, adult homes, and psy-chiatric centers;

• Eforts in marketing for hiring, onboarding, and retaining more qualifed staf to train staf in agencies licensed, funded, or overseen by OMH;

• Education: In-person and virtual, ongoing technical assistance and continuing education as support models emerge;

• Increased service capacity to eligible and appropriate referrals;

• Decreased length of stay in programs/facilities and reduced time to appointments;

• Increased workforce to be able to support service access and service provision to eligible en-rolled individuals;

• Increased and sustained community inclusion for enrollees;

• Increased awareness of community support, benefts support, educational and employment support in the community for enrollees and their families/chosen support group;



• Focus on successful community integration/reintegration so connections with quality-of-life providers is encouraged; and

• Training culturally, linguistically, geographically appropriate staf to provide services.

Young Adult Assertive Community Treatment Program Development- $850,000

OMH has allocated $850,000 of the CMHS Block Grant supplemental award for the development of two Young Adult Assertive Community Treatment (ACT) programs in New York State.

On July 29, 2021, OMH issued a Request for Proposals for the development of a Young Adult ACT program in New York City, with anticipated award notifcation on October 20, 2021. On August 21, 2021, OMH issued a Request for Proposals for the development of a Young Adult ACT program in Western New York, with anticipated award notifcation on November 15, 2021.

Each Young Adult ACT program will serve 48 individuals, age 18 to 25, who have been diagnosed with SMI and who have not been successfully engaged by the traditional mental health treatment and reha-bilitation system and who can beneft from the specialty ACT Team goals which include helping young adults on their path to independence including vocational/educational support, real-world skills and help to strengthen or develop a social/family support network.

Young Adult ACT is a multidisciplinary, evidence-based, team approach to providing comprehensive and fexible treatment, support, and rehabilitation services. ACT teams are confgured to have a low individual-to-staf ratio (9.9 to 1) with professional staf that include the disciplines of nursing, psychia-try, licensed mental health clinicians, vocational support, substance use counseling, and peer support. Most services are provided by ACT staf directly and in the community or where the individual lives. In this way, newly acquired skills are applied in their real-world environment and situations. Services may be provided in groups, when appropriate and if an individual is willing/interested in participating in a group, which may also ofer an opportunity to apply newly acquired skills.

Young Adult ACT is designed to be fexible and responsive to the needs of individuals, ofering support 24 hours a day, 7 days a week. ACT is “assertive” and intentional in its engagement methods, incorpo-rating individual choice, concrete services, consistency, persistence, and understanding of the unique developmental characteristics/needs of young adults. Finally, ACT is structured to provide a review during team meetings of every individual on the Young Adult ACT team’s caseload. This level of ac-countability allows for immediate changes in service planning and leads to improved outcomes.

Young Adult ACT will serve individuals who may need support developing a productive vocational or educational plan, do not have a sufcient social/family support system and/or lack sufcient real-world skills to successfully become independent adults. The expansion of ACT represents a commitment by OMH to develop specialty ACT Teams that are designed to better meet the needs of specifc popula-tions, e.g., providing access to an evidence-based practice for young adults with SMI and high continu-ous needs that are not met in traditional community-based services.

OnTrackNY First Episode Psychosis Program Expansion- $12,637,987

OMH has allocated $12,637,987 of the CMHS Block Grant supplemental award for the expansion of the OnTrackNY First Episode Psychosis program.

https://omh.ny.gov/omhweb/rfp/2021/ya-act/

https://omh.ny.gov/omhweb/rfp/2021/act-wny/index.html



On June 18, 2021, OMH issued a Solicitation of Interest for the frst phase expansion of this program, with indications of interest due by July 12, 2021. OMH is in the process of awarding the frst phase ad-ditional funding to 15 existing OnTrackNY First Episode Psychosis programs to increase the number of peer full-time employees at each of the programs, identifying existing programs for capacity expansion, and identifying sites for new OnTrackNY programs across New York State.

OnTrackNY is an innovative, evidence-based team approach to providing recovery-oriented Coordinat-ed Specialty Care (CSC) treatment to young people who have recently begun experiencing psychotic symptoms. OnTrackNY helps young adults aged 16 to 30 with newly emerged psychotic disorders achieve their goals for school, work, and relationships.

OnTrackNY follows principles of care, which include shared decision making, youth friendly and wel-coming environments, and fexible and accessible recovery-oriented services to all referred individuals meeting clinical admission criteria without wait list and regardless of their insurance status or ability to pay.

Goals of OnTrackNY First Episode Psychosis (FEP) teams are to:

• Help young adults with early psychosis achieve their goals for school, work, and relation-ships;

• Ensure that participants experiencing a frst episode psychosis receive CSC treatment as quickly and efectively as possible;

• Engage participants and families and minimize treatment drop out; • Provide participants with cost efective, recovery-oriented services, minimizing the disrup-

tion of illness and maximizing their capacity to return to meaningful lives; and • By promoting recovery for individuals with FEP, OnTrackNY aims to decrease the subse-

quent service use of this group, including hospitalizations and disability benefts.

OnTrackNY teams provide a range of on and of-site treatments (including via telehealth as applica-ble), including: screening; initial and ongoing psychiatric assessments; relapse prevention; crisis inter-vention; individual supportive therapy and illness management; medication management; integrated substance use treatment; case management; family therapy; patient psychoeducation; family psycho-education; skill training including social skills and coping skills; educational/employment support; peer support; primary care coordination; and education about physical health and wellness.

Services are provided in individual and group formats according to participant preferences. A signif-cant portion of CSC participants will be under the age of 18, and require parental/guardian permission and participation in treatment, and many other participants will have family actively involved in treat-ment. Collateral contacts occur with the participant’s family and others who are signifcant in their life, according to the participant’s preferences.

Teams also have the ability to provide care fexibly and assertively both in the clinic and in the commu-nity, provide 24/7 crisis support, and focus on the needs and preferences of young people and their family members using shared decision making to promote recovery. Teams have the ability to provide web-based and telephonic services as needed. Program enrollment is time-limited and participants are enrolled for an average of two years, with fexibility as needed based on individual needs. Discharge



plans are created with clients and families to ensure that follow-up services are identifed, and linkages are made.

An important aspect of a CSC model program is intensive community outreach and education to help identify individuals experiencing their frst episode of treatment and enroll them in specialized CSC treatment as soon as possible-thus reducing the duration of untreated psychosis. OnTrackNY Teams employ outreach strategies with a high value on engaging and retaining participants and families over time.

An additional $10,000,000 in adult ambulatory and peer services funding is still in development. OMH will continue to work with stakeholders across New York State as these funds are programmed.

Workforce Investment/System Capacity Building Priorities - $20,914,508 • Investing in recruitment and retention of culturally competent mental health service system

employees

• Expanding and supporting certifed peer capacity across OMH programming

• Addressing training and implementation support for evidence-based assessment and treatment

• Collaborate with institutions of higher education to foster development of potential mental health workforce

Current Workforce Investment/System Capacity Building Allocations Strengthen New York’s Mental Health Workforce - $20,914,508

OMH has allocated $20,914,508 of the CMHS Block Grant supplemental award to strengthen the work-force of eligible OMH-licensed outpatient and community support programs across New York State.

Target Date: OMH anticipates issuing guidelines for the use of workforce funds for eligible OMH-li-censed outpatient and community support programs and notifying providers of their allocations in October 2021.

These funds address a statewide need to support the mental health workforce and by virtue of a stronger workforce, reinforce New York’s mental health system and improve access to mental health services in communities across the state. Eligible outpatient and community support program providers will receive funding to be utilized at their discretion across a number of key spending categories, which include: recruitment and retention bonuses, educational expenses, career development, and ongoing employee support. In addition, eligible providers must commit to eforts to recruit a workforce that is representative of the people they serve and to develop cultural competency skills in their current and prospective workforce through staf development and training.



The following strategies comprise a list of eligible activities that will be supported by this funding, to implemented in a manner that meets the needs of each provider

• Recruitment and Retention Incentives º Retention and hiring bonuses º Longevity pay º Retirement contributions and other fringe benefts º Diferential pay º Hazard pay º Relocation incentives

• Educational Expenses º Tuition fees for new/existing staf, including college-level professional development

courses and continuing education º Exam and application fees for new/existing staf º Courses related to cultural competence and diversity training º Registration fees for conferences

• Career Development º Creation, promotion, enhancement of internship, fellowship and/or other career devel

opment programs º Collaborations with academic and policy institutions to develop strategies for training of

staf • Ongoing Support

º Employee engagement and workforce development strategies such as developing or acquiring training curricula, funding registration fees, and covering expenses for employees to attend or provide training


Appendix A: Current OMH CMHS Block Grant Allocation Table

Program Name Current Allocation Amount ($) Mobile Crisis Service Development $5,000,000 988 Call Center Capacity Building Crisis Stabilization Program Expansion, and Crisis Residential Program Expansion $37,603,165 Jail Diversion Program Expansion $2,100,000 Crisis Intervention Team Program Expansion $400,000 Law Enforcement Mobile Access Program Expansion $100,000 Crisis Services Subtotal $45,203,165 Intensive Community-Based Services for Children and Youth $1,900,000 Systems of Care Expansion $500,000 School-Based Mental Health Clinic Satellite Expansion $3,000,000 Youth Assertive Community Treatment Program Expansion $5,950,000 Child, Youth, and Family Services - In Development $14,505,215 Child, Youth, and Family Services Subtotal $25,855,215 Assertive Community Treatment Program Expansion $3,600,000 Peer-to-Peer Supported Transition Program Development $1,000,000 Young Adult Assertive Community Treatment Program Development $850,000 OnTrack First Episode Psychosis Program Expansion $12,637,987 Adult Ambulatory and Peer Services - In Development $10,000,000 Adult Ambulatory and Peer Services Subtotal $28,087,987 Expanded Funding for Clinic Treatment and Community Support Program Workforce Recruitment and Retention $20,914,508 Workforce Investment/System Capacity Building Subtotal $20,914,508 OMH Administration $6,318,993 All Current OMH CMHS Block Grant Allocations Total $126,379,868

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