Case Study: Early Assessment of the Mental Health Block Grant Set-Aside Program for Addressing First Episode Psychosis and Other Early Serious Mental Illness. Appendix

09/29/2015

Identification of Grantees

TABLE A1. Identification of Grantees
State Number of Grantees Grantee Description
California
  • Exact number is not known because implementation is at the county level.
  • 4 interviewed
San Luis Obispo FEP Program
  • San Luis Obispo County
  • Affiliated with: Cal Poly

Fresno First Onset Psychosis Program

  • Fresno County
  • Affiliated with Felton Institute of San Francisco

Alameda PREP Program

  • Alameda County

Imperial FSP Program

  • Imperial County
  • Imperial's Youth and Young Adult Program
Colorado
  • 1 total
  • 1 interviewed
Jefferson Center for Mental Health
  • Jefferson County
Connecticut
  • 2 total
  • 2 interviewed
STEP Program
  • New Haven County
  • Affiliated with Yale University

IOL Program

  • Hartford County
Idaho
  • 1 total
  • 1 interviewed
St. Luke's Regional Health Center
  • Twin Falls County
  • St. Luke's Magic Valley Medical Center
Iowa
  • 2 total
  • 2 interviewed
CMHC
  • Des Moines
  • Iowa Department of Human Services

CMHC

  • Cedar Rapids
  • Iowa Department of Human Services
Nevada
  • 1 total
  • 1 interviewed
The Children's Cabinet of Northern Nevada
  • Reno
  • Washoe County
New York
  • ~30 total
  • 1 interviewed
Northern Rivers Family Services
  • Albany County
North Carolina
  • 3 total
  • 2 interviewed
OASIS, Carrboro, Orange County
  • Clinic established by the UNC Center for Excellence in Community Mental Health, within the Department of Psychiatry at UNC-Chapel Hill's School of Medicine

Wake STEP (extension of OASIS) Clinic

  • Raleigh-Durham
  • Wake County
Texas
  • 2 total
  • 2 interviewed
MHMRA of Harris County
  • Harris County
  • CSC program located in Southeast Clinic, LMHA

Dallas Metrocare

  • Dallas County
  • CSC program (ePEP) located in the Metrocare Pathways Clinic, NTBHA
Virginia
  • 8 total
  • 4 interviewed
Alexandria DCHS/CSB
  • City of Alexandria
  • CSC program (TRAILS) located in Center for Adults

Fairfax-Falls Church CSB

  • Fairfax County and cities of Falls Church and Fairfax
  • CSC program: Turning Point

Highlands Community Services

  • Washington County and Bristol, Virginia

Western Tidewater CSB

  • Cities of Suffolk and Franklin and the Counties of Isle of Wight and Southampton
Washington
  • 1 total
  • 1 interviewed
Central Washington Comprehensive Mental Health
  • Yakima County
Wisconsin
  • 1 total
  • 1 interviewed
JMHC
  • Dane County

State-Specific Case Study Methods

Tier 1 States

California

An initial phone discussion was conducted with officials within the California Department of Health Care Services (DHCS), the agency responsible for administering the state's MHBG. That discussion highlighted the decentralized nature of decisionmaking regarding the use of MHBG funds for the set-aside, with most critical decisions made at the county level rather than at the state level. State-level officials were not able to provide detailed information on the policymaking processes occurring at the county level and did not yet have the county plans for using the set-aside funds, which counties will be submitting to the state over the summer and fall of 2015. To better understand use of the set-aside funding at the county level, we conducted additional discussions, by phone and in person during a site visit to Sacramento, with representatives of the California County Behavioral Health Directors Association.ae We also worked with respondents at DHCS to select several counties for site visits. DHCS provided RAND with sections of seven county mental health plans that described the intended use of the set-aside funds. These counties were selected because they had submitted their plans to DHCS earlier than other counties. Of those seven counties, we arranged to have phone discussions with county-level policymakers from four: San Luis Obispo, Fresno, Alameda, and Imperial. These counties were selected because their plans suggested that they intended to use their set-aside funds to support new programs for ESMI. Thus, the counties described in this report are not representative of California counties as a whole; rather, they represent a group that initiated a CSC program using their set-aside funds. We were not able to systematically investigate uses of the set-aside funds across all of California's county behavioral health departments.

Connecticut

An initial phone discussion was held with officials within the Connecticut Department of Mental Health and Addiction Services (DMHAS), the agency responsible for administering the state's MHBG, on February 5, 2015. Follow-up discussions were then held during a site visit to the state on February 25, 2015. RAND's site visit to the Connecticut DMHAS provided background information pertaining to the state's two existing ESMI programs (the STEP Program and the IOL Program) and Connecticut's strategy for use of the set-aside funds under the new policy. Telephone discussions were held with each of the providers in the state on April 21, 2015. Respondents from the STEP Program included the program director; respondents from the IOL Program included the program director, manager, and outreach clinician and coordinator.

New York

The set-aside program was initially discussed with officials from the New York State Office of Mental Health, the agency responsible for administering the state's MHBG, and with a staff member from the state's CSC program, OnTrackNY, located in the Center for Practice Innovations at the New York State Psychiatric Institute. Following the initial call, a site visit was made to one of the newly funded OnTrackNY programs. The program we visited, located in a large human services agency in Albany, was still in early planning stages and had not yet fully staffed their program or begun to accept clients.

Tier 2 States

Idaho

One discussion was conducted by telephone while a second was conducted during a site visit. Respondents included members of the Idaho Division of Behavioral Health Services within the Idaho Department of Health and Welfare--the agency responsible for administering the state's MHBG--and staff from Idaho's funded provider, St. Luke's Regional Health Center, including the senior director in specialty medical practice, the clinical supervisor and team lead, and the regional psychologist. The initial telephone call with Idaho state officials was held in February 2015, and the in-person discussions with state officials and St. Luke's staff were held on April 14, 2015.

North Carolina

An initial discussion conducted by telephone was followed by in-person discussions with members of the North Carolina Department of Health and Human Services--the agency responsible for administering the state's MHBG--including the Division of Mental Health and Substance Abuse Services block grant manager and the program manager for the Quality Management Team, as well as staff from the OASIS Program, including the medical director of OASIS, the clinical instructor/program director of the OASIS Wake site, program director of the OASIS Carrboro site, a child and adolescent trained psychiatrist, a licensed clinical social worker and clinical therapist, and a data coordinator. The initial telephone call with state officials and the in-person discussions with state officials and OASIS staff were held in June 2015.

Texas

Three phone calls were conducted between February 2015 and March 2015. The site visit was conducted in April 2015. Discussions were held with four representatives from the Mental Health and Substance Abuse Division of the Department of State Health Services (the agency responsible for administering the state's MHBG), three ESMI program staff members from the ePEP based at the Metrocare Pathways clinic, two members of the program evaluation team from the UT Medical School at Houston Department of Psychiatry and Behavioral Sciences, three ESMI program staff members from the MHMRA of Harris County Southeast clinic, and one member of the program evaluation team from the UT Southwestern Medical Center at Dallas.

Virginia

Four phone calls were conducted between February 2015 and May 2015. The site visit was conducted in June 2015. Discussions were held with three representatives from the Office of Mental Health within the Department of Behavioral Health and Developmental Services (the agency responsible for administering the state's MHBG), three ESMI program staff members from the Alexandria CSB, three ESMI program staff members from the Fairfax CSB, one ESMI program staff member from the Highlands Community Services, and two ESMI program staff members from the Western Tidewater CSB.

Wisconsin

Two phone calls were conducted between January 2015 and June 2015. The site visit was conducted in April 2015. Discussions were held with four representatives from the Division of Mental Health and Substance Abuse Services within the Department of Health Services (the agency responsible for administering the state's MHBG) and four ESMI program staff members from the JMHC.

Tier 3 States

Colorado

The Colorado set-aside plan was discussed during a telephone call in February 2015 with staff from the Office of Behavioral Health within the Colorado Department of Human Services, the agency responsible for administering the state's MHBG. From that conversation, RAND learned that the state had been delayed in contracting with a CSC provider and was still preparing a request for proposals from potential provider organizations. Due to the very early stage of development of the program, a site visit was not conducted. A second telephone conversation was held with the state officials in June 2015 to collect information on subsequent steps towards establishing a CSC program.

Iowa

Two discussions were conducted by phone and one discussion was conducted during a site visit. While Iowa had two contracts in place with CMHCs to implement FEP (non-affective) programs at the time of the second phone call, both CMHCs were undergoing training and had not yet begun serving individuals. For this reason, we held a discussion with the state-level FEP program manager and MHBG planner. Respondents included members of the Division of Mental Health and Disability Services within the Iowa Department of Human Services (the agency responsible for administering the state's MHBG), including the MHBG planner and Community Services and Planning Bureau chief, and the state-level project manager for the set-aside grantees. The initial telephone call to discuss strategy for use of the set-aside funding was held in February 2015. The in-person RAND discussion was held in March 2015, and the telephone call with Iowa staff on behalf of contractors administering the two CMHC-based ESMI programs was held in June 2015.

Nevada

Information on the use of the set-aside funds in Nevada was collected during a phone discussion with officials from the state Division of Public and Behavioral Health (the agency responsible for administering Nevada's MHBG) and an in-person discussion with officials at the Children's Cabinet, an agency selected to implement an FEP program using the set-aside funds in Reno. Although the program at the Children's Cabinet was still in the planning phase and not yet operational, a site visit with a one-hour key informant discussion was conducted at the agency during a two-day site visit to the state focused on the MHBG.

Washington

Two telephone discussions were conducted with representatives from the Division of Behavioral Health and Recovery within the Washington State Department of Social and Health Services, the agency responsible for administering the MHBG. The first discussion was conducted in early March 2015 and included planning officials from the state department of mental health. At that point in time, the state had decided on an overall strategy for use of the MHBG set-aside funds, the provider organization had been selected and the state was consulting with experts in neighboring Oregon regarding design of the program. The second discussion was conducted in early June and, in addition to the state planner, also included the administrator from the provider agency that will be administering the program and a member of the consulting team from Oregon. At the time of the second discussion, many additional details regarding the implementation plan had been resolved but the team was not yet operational.

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