Community Alliance Rehabilitation Services

TRANSFORMING LIVES THROUGH SUPPORTED EMPLOYMENT - COMMUNITY ALLIANCE (CA), A CCBHC IN OMAHA, WILL EXPAND ITS SUPPORTED EMPLOYMENT (SE) PROGRAM AND INTEGRATE SE SERVICES AND PRINCIPLES THROUGHOUT THE ORGANIZATION THROUGH THE TRANSFORMING LIVES THROUGH SUPPORTED EMPLOYMENT PROGRAM. BY SERVING 60 NEW, UNDUPLICATED CLIENTS ANNUALLY AND 300 OVER THE COURSE OF THE GRANT PERIOD, CA WILL REDUCE THE UNMET NEED FOR EVIDENCE-BASED SE AMONG UNEMPLOYED ADULT CLIENTS WITH SMI AND COD BY 50%. CA WILL USE THE GRANT AS A SPRINGBOARD TO DEVELOP A PLAN FOR MEETING 100% OF THE NEED AFTER THE GRANT PROGRAM ENDS. MEMBERS OF THE POF WHO CURRENTLY RECEIVE CLINICAL SERVICES AT CA COPE WITH VERY HIGH LEVELS OF UNEMPLOYMENT (87%). THEY ALSO LIVE IN POVERTY: UPON INTAKE AT CA, MEMBERS OF THE POF HAVE AN AVERAGE OF ONLY A LITTLE UNDER $700 PER MONTH IN INCOME AND ONE IN FOUR HAVE NO INCOME AT ALL. IN A GIVEN YEAR, ONLY 8.5% OF CA CLIENTS IN THE POF UTILIZE CURRENT SE SERVICES, KNOWN AS WORKSOURCE. AFRICAN AMERICAN AND AMERICAN INDIAN CLIENTS ARE EVEN LESS LIKELY TO GAIN ACCESS TO SE SERVICES THAN ARE OTHER CLIENTS. FOR THE GRANT PROGRAM, CA SET SIGNIFICANT GOALS FOR THE POF, INCLUDING A 100% INCREASE IN THE NUMBER OF ADULTS IN NEED WHO RECEIVE SE SERVICES; A CONCOMITANT 100% INCREASE IN THE NUMBER OF CA CLIENTS FROM THE POF WHO BECOME EMPLOYED; A 50% REDUCTION IN SELF-REPORTED UNMET NEED FOR VOCATIONAL SERVICES AND SUPPORTS; AND A LOWERING OF THE UNEMPLOYMENT RATE FROM 87% TO 65% AMONG ALL ADULT CLIENTS AT CA WHO HAVE SMI OR COD. THE PROPOSAL OUTLINES A FEASIBLE PROCESS OF SE EXPANSION AND INTEGRATION OVER THE COURSE OF THE FIVE-YEAR GRANT PERIOD, THAT INCLUDES THE ADDITION OF FOUR SUPPORTED EMPLOYMENT SPECIALISTS, A PEER EMPLOYMENT SUPPORT SPECIALIST, AND A BUSINESS/EMPLOYER LIAISON TO ITS EXISTING SE PROGRAM. CURRENTLY, HALF OF WORKSOURCE EMPLOYMENT SPECIALISTS ARE EMBEDDED IN CA’S CLINICAL TEAMS, INCLUDING FIRST EPISODE PSYCHOSIS CARE AND ASSERTIVE COMMUNITY TREATMENT, BUT THROUGH THE GRANT PROGRAM, CA WILL EMBED ALL NEW AND EXISTING EMPLOYMENT SPECIALISTS IN SIX DIFFERENT CLINICAL PROGRAMS. CA WILL CONTINUE TO EMBRACE THE INDIVIDUAL PLACEMENT AND SUPPORT (IPS) MODEL OF SUPPORTED EMPLOYMENT AND WILL USE THE GRANT FUNDING TO EXPAND TRAINING FOR WORKSOURCE STAFF AND ACHIEVE HIGHER IMPLEMENTATION FIDELITY IN AREAS WHERE WORKSOURCE PREVIOUSLY WAS FOUND TO BE WEAKER. FIDELITY OF IMPLEMENTATION WILL BE ASSESSED BY SIX MONTHS IN YEAR 1 AND ANNUALLY THEREAFTER. DATA AND INFORMATION FROM FIDELITY REVIEWS, GOAL AND OBJECTIVE PROGRESS MONITORING, AND NOMS-BASED OUTCOMES WILL BE USED WITHIN A QUALITY IMPROVEMENT FRAMEWORK TO ENHANCE WORKSOURCE PROGRAM ACCESS, QUALITY AND OUTCOMES, WHILE REDUCING RACIAL/ETHNIC AND OTHER DISPARITIES. CA WILL DEVELOP A BUSINESS ADVISORY COUNCIL WHICH WILL WORK COLLABORATIVELY WITH WORKSOURCE TO IDENTIFY AND DEVELOP AN INCREASING ARRAY OF COMPETITIVE EMPLOYMENT OPPORTUNITIES FOR WORKSOURCE CLIENTS AND, AT THE SAME TIME, MEET THE WORKFORCE NEEDS OF OMAHA AREA BUSINESSES AND ORGANIZATIONS.

COMMUNITY ALLIANCE CCBHC - COMMUNITY ALLIANCE REHABILITATION SERVICES (CA) CCBHC WILL ENSURE THAT PEOPLE WITH SMI/SED/SUD/COD IN DOUGLAS AND SARPY COUNTIES IN NEBRASKA HAVE ACCESS TO COMPREHENSIVE BEHAVIORAL HEALTH (BH) AND PRIMARY CARE (PC) SERVICES. THROUGH THE CCBHC, CA WILL EXPAND BH SERVICES TO CHILDREN, YOUTH, AND TRANSITION-AGE YOUTH AND PROVIDE GREATER ACCESS TO SUD TREATMENT AND INTEGRATED PC AND BH CARE FOR CHILDREN, YOUTH (C/Y), AND ADULTS. CA WILL ENROLL AND SERVE 600 CCBHC CLIENTS: 200 IN YEAR 1 AND 400 IN YEAR 2. A FULL ARRAY OF EVIDENCE-BASED PRACTICES (EBPS) WILL HELP ENROLLEES MANAGE SYMPTOMS AND ATTAIN GREATER INDEPENDENCE, BETTER HEALTH, AND IMPROVED QUALITY OF LIFE. ALL CLIENTS WILL RECEIVE CCBHC-REQUIRED SCREENINGS AND COORDINATION WITH PRIMARY CARE. CA WILL PROVIDE ACCESS TO INTENSIVE SERVICES FOR PEOPLE WITH COMPLEX BH NEEDS, INCLUDING ACT, HIGH-FIDELITY WRAPAROUND, IPS, SUPPORTED EDUCATION, NAVIGATE FOR FIRST EPISODE PSYCHOSIS, PERMANENT SUPPORTIVE HOUSING, INTENSIVE OUTPATIENT (IOP) SERVICES, MAT, AND OUTREACH TO VETERANS AND THEIR FAMILIES FOR EBPS AND SUPPORTS. PRIMARY GOALS AND OBJECTIVES INCLUDE: 1) FORMALLY LAUNCH THE CCBHC BY MONTH 4: A) WITHIN 90 DAYS, RECRUIT, HIRE, AND TRAIN ALL PROJECT STAFF; B) ESTABLISH AN ADVISORY WORK GROUP WITH AT LEAST 51% CCBHC ENROLLEES AND FAMILY MEMBERS; C) FINALIZE DCO AGREEMENTS. 2) UNIVERSALLY SCREEN AND MONITOR HEALTH: A) SCREEN AND MONITOR HEALTH INDICATORS FOR 100% OF ENROLLEES; B) SCREEN AND MONITOR PREVALENCE AND RISK OF DIABETES AND METABOLIC SYNDROME FOR 100% OF ENROLLEES ON PSYCHOTROPIC MEDICATIONS; C) TRAIN SUD CLINICIANS IN SBIRT, MOTIVATIONAL INTERVIEWING, AND RELAPSE PREVENTION BY MONTH 6. 3) INCREASE ACCESS TO INTEGRATED PC/BH CARE: A) 100% OF NEW C/Y CLIENTS WITH COMPLEX BH/PH NEEDS WILL HAVE PC PROVIDER APPOINTMENT WITHIN 10 BUSINESS DAYS OF ENROLLMENT; B) BY MONTH 4, 75% OF YOUTH REFERRED BY DCOS WILL BE ENROLLED IN INTEGRATED PC/BH CARE. 4) EXPAND ACCESS TO INTENSIVE SERVICES FOR CLIENTS WITH COMPLEX BH NEEDS: A) ENHANCE ACT SERVICES TO INCLUDE INTEGRATED PC AND OUTCOMES TRACKING FOR 120 CONSUMERS; B) REFER 100% OF ELIGIBLE C/Y TO WRAPAROUND BY MONTH 4. 5) EXPAND PSYCHOSOCIAL REHABILITATION SERVICES FOR C/Y: A) SERVE AND COORDINATE REFERRALS FOR 150 C/Y BY THE END OF YEAR 2; B) TRAIN C/Y STAFF IN EBPS BY MONTH 6; C) ENROLL AND SERVE 25% MORE TRANSITION-AGE YOUTH IN THE NAVIGATE PROGRAM BY YEAR 2. 6) INCREASE SERVICES TO VETERANS: A) SERVE 20% MORE VETERANS WITH SMI/SUD BY YEAR 2; B) BY MONTH 12, CONNECT 100% OF VETERANS WITH COMPLEX NEEDS TO INTENSIVE SERVICES. 7) DECREASE HEALTH RISK: 50% OF ENROLLEES WITH ELEVATED HEALTH INDICATORS WILL EXPERIENCE A CLINICAL IMPROVEMENT AFTER 12 MONTHS. 8) INCREASE SUD TREATMENT ACCESS AND DECREASE SUBSTANCE USE: A) REFER 100% OF ENROLLEES WHO SCREEN POSITIVE FOR TOBACCO USE TO INTERVENTION; B) 50% WILL PARTICIPATE IN INTERVENTION WITHIN 30 DAYS; C) SERVE AT LEAST 40 IOP CLIENTS IN YEAR 1 AND 75 IOP CLIENTS IN YEAR 2; D) 75% OF CLIENTS ASSESSED TO BENEFIT FROM MAT WILL BE REFERRED WITHIN 10 DAYS; E) 30% OF ENROLLEES WITH SUDS WILL REDUCE SUBSTANCE USE AFTER 6 MONTHS AND 50% WILL REDUCE USE BY 12 MONTHS.

HEALTHY TRANSITIONS - COMMUNITY ALLIANCE’S HEALTHY TRANSITIONS PROJECT, IN COLLABORATION WITH OUR LOCAL BEHAVIORAL HEALTH AUTHORITY, REGION 6 BEHAVIORAL HEALTHCARE AND OTHER KEY PARTNERS, WILL IMPROVE AND EXPAND SERVICES AND SUPPORTS FOR TRANSITION-AGED YOUTH AND YOUNG ADULTS (AGES 16-25) IN DOUGLAS AND SARPY COUNTIES, NEBRASKA WHO EITHER HAVE, OR ARE AT RISK OF DEVELOPING SERIOUS MENTAL HEALTH CONDITIONS. WE WILL HELP MAXIMIZE THE POTENTIAL OF OUR POPULATION OF FOCUS (POF) TO ASSUME ADULT ROLES AND RESPONSIBILITIES AND LEAD FULL, PRODUCTIVE LIVES BY COLLABORATIVELY WORKING TOWARDS THE FOLLOWING GOALS AND OBJECTIVES: (1) THROUGH THE ESTABLISHMENT OF COORDINATING STRUCTURES AT SYSTEM AND AGENCY LEVELS, THE DEVELOPMENT OF INTERAGENCY AND INTRA-AGENCY AGREEMENTS CONCERNING SERVICES TO THE POF, AND THE DEVELOPMENT OF A WELL-REPRESENTED AND WELL-INFORMED ADVISORY COUNCIL, IMPROVE SYSTEM COORDINATION SO THAT THE POF ROUTINELY RECEIVE THE SERVICES AND SUPPORTS THEY NEED. AT LEAST 51% OF THE ADVISORY COUNCIL WILL INCLUDE YOUTH, YOUNG ADULTS, AND FAMILY MEMBERS AND BY YEAR 2, THE ADVISORY COMMITTEE WILL ESTABLISH A PEER-LED EVALUATION TEAM. (2) BASED ON FINDINGS FROM A SYSTEM NEEDS ASSESSMENT, BUILD A MULTI-YEAR PLAN FOR FILLING IN SERVICE AND CARE COORDINATION/NAVIGATION GAPS FOR THE POF AND IDENTIFY THE TRAININGS THAT WILL BE NEEDED TO SUPPORT THE DEVELOPMENT OF SERVICES AND COORDINATION ACTIVITIES. (3) DEVELOP RELIABLE REFERRAL PATHWAYS TO VITAL EVIDENCE-BASED PRACTICES AND OTHER SERVICES WITHIN THE YOUTH-SERVING AND ADULT-SERVING BEHAVIORAL HEALTH SYSTEMS, INCLUDING FOR YOUTH AGING OUT OF CHILD/YOUTH SYSTEMS. (4) DEVELOP A CENTRALIZED CARE COORDINATION RESOURCE THAT DRAWS ON CURRENT BEST PRACTICES TO ENSURE THE POF, PARTICULARLY THOSE WITH MULTI-SYSTEM INVOLVEMENT OR WHO ARE AGING OUT OF YOUTH SYSTEMS, PROMPTLY ACCESS NECESSARY BEHAVIORAL HEALTH SERVICES, INCLUDING EVIDENCE-BASED AND TEAM APPROACHES SUCH AS COORDINATED SPECIALTY CARE (CSC) FOR TRANSITION-AGED YOUTH WITH FIRST EPISODE PSYCHOSIS AND CRITICAL TIME INTERVENTION. (5) PROMOTE THE DISSEMINATION AND ADOPTION OF ADDED SUICIDE PREVENTION BEST PRACTICES AS WELL AS BETTER COORDINATION OF EXISTING PROGRAMS. (6) ENHANCE COMMUNITY ALLIANCE’S SUPPORTED EMPLOYMENT SERVICES TO INCLUDE SUPPORTED EDUCATION AND INCREASE SUPPORTED EMPLOYMENT SERVICE UTILIZATION BY THE POF. (7) STRENGTHEN FAMILY EDUCATION AND FAMILY SUPPORT SERVICES FOR INDIVIDUALS IN THE POF WHO ARE RECEIVING BEHAVIORAL HEALTH SERVICES. (8) IMPROVE OUTCOMES AMONG THE POF ACROSS MULTIPLE DOMAINS AND INCREASE THEIR OPPORTUNITIES TO ENJOY MEANINGFUL ADULT LIVES IN THE COMMUNITY. (9) DEVELOP BETTER ALIGNMENT AND USE OF FUNDING STREAMS TO ENSURE SUSTAINABILITY OF A STRENGTHENED, BETTER COORDINATED AND MORE EFFECTIVE SERVICE SYSTEM FOR THE POF. OVER 5 YEARS, WE WILL PROVIDE OUTREACH SERVICES TO AT LEAST 1,000 UNDUPLICATED MEMBERS OF THE POF. CA AND PARTNERS WILL SCREEN A MINIMUM OF 80 UNDUPLICATED MEMBERS OF THE POF IN YEAR 1, 120 IN BOTH YEARS 2 AND 3, AND 160 IN BOTH YEARS 4 AND 5, RESULTING IN ENROLLMENT AND SERVICE TO 40 UNDUPLICATED INDIVIDUALS IN YEAR 1, ANOTHER 60 IN EACH OF YEARS 2 AND 3, AND THEN 80 IN EACH OF YEARS 4 AND 5, FOR A 5-YEAR TOTAL OF 320 MEMBERS OF THE POF.

REBUILD. RECOVER. RENEW. - COMMUNITY ALLIANCE REHABILITATION SERVICES (CA) CMHC PROJECT - REBUILD. RECOVER. RENEW. - WILL ENSURE THAT INDIVIDUALS AND FAMILIES WITH SMI, SED, OR COD, PARTICULARLY MINORITY AND/OR ECONOMICALLY DISADVANTAGED POPULATIONS IN DOUGLAS, SARPY, CASS, WASHINGTON, AND DODGE COUNTIES IN NEBRASKA, HAVE ACCESS TO RECOVERY-ORIENTED PSYCHOSOCIAL REHABILITATION AND OTHER EVIDENCE-BASED BEHAVIORAL HEALTH (BH) SERVICES TO HELP MEET THEIR NEEDS. CA WILL BOOST STAFFING TO INCREASE OUTREACH AND ENGAGEMENT (OR RE-ENGAGEMENT) IN SERVICES; EXPAND CAPACITY FOR PEER SUPPORT, FAMILY SUPPORT AND EDUCATION, SUPPORTED EMPLOYMENT, AND DAY REHABILITATION; STRENGTHEN TELEHEALTH CAPABILITIES AND REFERRAL PATHWAYS TO CRISIS SERVICES; AND PROVIDE TARGETED STAFF TRAINING TO HELP ADDRESS BH DISPARITIES, EXTEND A TRAUMA-INFORMED CARE (TIC) CULTURE, AND ATTEND TO PANDEMIC-RELATED MENTAL HEALTH NEEDS. CA WILL ENROLL AND SERVE 400 UNIQUE CLIENTS EACH YEAR WITH GRANT FUNDS. CA WILL ALSO ATTEND TO THE MENTAL HEALTH NEEDS OF ITS STAFF BY CREATING A WORK AND WELL-BEING COMMUNITY OF PRACTICE. CAS GOALS AND OBJECTIVES INCLUDE THE FOLLOWING: (1) INCREASE OUTREACH AND CAPACITY FOR PSYCHOSOCIAL REHABILITATION SERVICES: A) BY THE END OF YEAR 1, AN AVERAGE OF 85 INDIVIDUALS WILL RECEIVE DAY REHABILITATION SERVICES EACH DAY, A 27% INCREASE; B) BY THE END OF YEAR 2, AN AVERAGE OF 101 INDIVIDUALS WILL RECEIVE DAY REHABILITATION SERVICES EACH DAY, A 50% INCREASE; C) BY THE END OF YEAR 2, 60% OF CLIENTS ENGAGED IN SUPPORTED EMPLOYMENT SERVICES WILL RETURN TO WORK OR GAINED EMPLOYMENT; D) BY THE END OF YEAR 1, THE NUMBERS RECEIVING OUTREACH AND ENGAGEMENT THROUGH PEER SUPPORT SPECIALISTS WILL INCREASE TO 75% OF PRE-PANDEMIC LEVELS; E) BY THE END OF YEAR 2, THE NUMBERS RECEIVING OUTREACH AND ENGAGEMENT THROUGH PEER SUPPORT SPECIALISTS WILL BE AT 100% OF PRE-PANDEMIC LEVELS; (2) INCREASE TRAINING FOR STAFF IN BH DISPARITIES, CULTURAL COMPETENCY, AND TIC: A) BY THE END OF YEAR 1, ALL STAFF WILL RECEIVE TRAINING IN BH DISPARITIES, CULTURAL COMPETENCY, AND TIC; B) BY THE END OF YEAR 2, THE TIC TRAINER AND DIVERSITY, EQUITY, AND INCLUSION MANAGER WILL CONDUCT 16 TRAININGS WITH STAFF; C) 100% OF PROJECT STAFF WILL RECEIVE ANNUAL BOOSTER TRAINING IN SEEKING SAFETY; (3) DEVELOP A WORK AND WELL-BEING COMMUNITY OF PRACTICE TO MEET STAFF MENTAL HEALTH AND WELLNESS NEEDS: A) BY THE END OF YEAR 2, CA WILL PROVIDE 8 INTERACTIVE LEARNING OPPORTUNITIES AND PEER SESSIONS FOR STAFF TO INTEGRATE WELLNESS STRATEGIES INTO DAILY PRACTICE; B) BY THE END OF YEAR 2, 25% OF STAFF WILL SEE IMPROVED RATINGS OF WELLNESS; (4) IMPLEMENT FAMILY PSYCHOEDUCATION WITH FIDELITY TO SAMHSAS MODEL: A) BY THE END OF YEAR 1, CA FAMILY EDUCATION AND SUPPORT STAFF WILL PROVIDE FAMILY PSYCHOEDUCATION SERVICES AND SUPPORTS TO 250 PEOPLE, A 27% INCREASE FROM 2020; B) BY THE END OF YEAR 2, CA WILL RESPOND TO AT LEAST THREE RECOMMENDATIONS FROM A BASELINE FAMILY PSYCHOEDUCATION FIDELITY ASSESSMENT AND IMPROVED THEIR MEAN FIDELITY SCORE; (5) STRENGTHEN REFERRAL PATHWAYS WITH THE PSYCHIATRIC EMERGENCY SERVICES (PES) UNIT: A) BY THE END OF YEAR 1, CA STAFF WILL ENSURE RESPONSE TO ALL REFERRALS FROM THE PES WITHIN ONE BUSINESS DAY; B) BY THE END OF YEAR 2, CA WILL HAVE SERVED 200 INDIVIDUALS REFERRED BY PES.

OMAHA HEALTH HOME COLLABORATIVE

RECOVERY CONNECTIONS - RECOVERY CONNECTIONS, A PROGRAM OF COMMUNITY ALLIANCE, PROVIDED IN PARTNERSHIP WITH STEPHEN CENTER INTENDS TO REDUCE HOMELESSNESS AND NEGATIVE OUTCOMES FOR ADULTS WITH SERIOUS MENTAL ILLNESS (SMI), SUBSTANCE USE DISORDERS (SUD) OR CO-OCCURRING SMI/SUD WHO ARE EXPERIENCING HOMELESSNESS. THROUGH A TEAM-BASED APPROACH WITH STRONG OUTREACH, CLIENTS WILL BE LINKED TO EVIDENCE-BASED PRACTICES TO GAIN HOUSING, OBTAIN TREATMENT, AND FURTHER THEIR RECOVERY. RECOVERY CONNECTIONS STAFF WILL PROVIDE A CORE SET OF EVIDENCE-BASED PRACTICES (EBPS) INCLUDING CRITICAL TIME INTERVENTION, PERMANENT SUPPORTIVE HOUSING, INTEGRATED DUAL DISORDER TREATMENT, MOTIVATIONAL INTERVIEWING, AND SEEKING SAFETY, AND WILL ALSO SERVE AS A HUB BY CONNECTING PEOPLE TO COMMUNITY ALLIANCE’S OTHER EBPS, SUCH AS ASSERTIVE COMMUNITY TREATMENT AND SUPPORTED EMPLOYMENT, AS NEEDED. THE PRIMARY GOALS AND MEASURABLE OBJECTIVES OF THE PROJECT ARE TO: 1) EXPAND ACCESS TO INTEGRATED HOUSING AND SUPPORTIVE SERVICES: BY END OF YEAR ONE, WE WILL OUTREACH TO AT LEAST 80 PEOPLE ON THE STREET AND IN SHELTERS AND USE AN SBIRT FRAMEWORK AND TOOLS TO SCREEN THEM FOR PROGRAM ELIGIBILITY. WE WILL ENROLL AT LEAST 30 PEOPLE BY END OF YEAR ONE. 2) IMPROVE HOUSING STABILITY AMONG PARTICIPANTS: A) WE WILL LINK AT LEAST 80% OF PARTICIPANTS TO PERMANENT HOUSING WITHIN ONE YEAR OF PROGRAM ENROLLMENT; B) AFTER ACCESSING HOUSING, 70% OF PARTICIPANTS WILL REMAIN STABLY HOUSED TWELVE MONTHS LATER; AND C) 60% OF PARTICIPANTS WILL REMAIN STABLY HOUSED AFTER 24 MONTHS. 3) REDUCE SUBSTANCE USE AMONG PARTICIPANTS: A) 40% OF PARTICIPANTS WITH SUDS AT BASELINE WILL REDUCE SUBSTANCE USE FROM INTAKE TO SIX MONTHS OF PROJECT PARTICIPATION; AND B) BY SIX MONTHS, AT LEAST 50% OF ALL PARTICIPANTS WITH AN SUD WILL ENGAGE IN SUBSTANCE USE DISORDER TREATMENT OR IDDT (IF THEY HAVE A CO-OCCURRING MENTAL ILLNESS). 4) INCREASE ACCESS TO OUTPATIENT BEHAVIORAL HEALTH TREATMENT: A) 80% OF PARTICIPANTS WILL RECEIVE PSYCHIATRIC ASSESSMENT AND TREATMENT; B) AFTER SIX MONTHS OF TREATMENT, 50% WILL DEMONSTRATE CLINICALLY SIGNIFICANT IMPROVEMENT IN BEHAVIORAL HEALTH SYMPTOMOLOGY; C) 80% OF PARTICIPANTS WILL ENGAGE IN RECOVERY-ORIENTED CASE MANAGEMENT SERVICES DURING PROJECT PARTICIPATION. 5) INCREASE MEDICAID, MEDICARE, OTHER HEALTH INSURANCE, SSI, SSDI, AND SNAP ENROLLMENT: A) 60% OF PARTICIPANTS WHO HAVE BEEN ENROLLED IN THE PROJECT FOR AT LEAST SIX MONTHS WILL BE RECEIVING BENEFITS (E.G., SSI/SSDI, TANF, SNAP) OR HAVE OTHER STABLE INCOME; B) 90% OF PARTICIPANTS WHO HAVE BEEN ENROLLED IN THE PROJECT FOR AT LEAST 12 MONTHS WILL HAVE SUSTAINED BENEFITS OR OTHER STABLE INCOME; AND C) 90% OF PARTICIPANTS WHO HAVE BEEN ENROLLED IN THE PROJECT FOR AT LEAST 12 MONTHS AND WHO ARE ELIGIBLE WILL BE ENROLLED IN MEDICAID. THE SERVICE AREA IS DOUGLAS AND SARPY COUNTIES. THE PROJECT WILL SERVE 30 INDIVIDUALS IN YEAR 1, AND ANOTHER 40 INDIVIDUALS EACH YEAR FOR THE SUBSEQUENT PROJECT YEARS, TOTALING 190 PARTICIPANTS OVER THE COURSE OF THE FIVE-YEAR PROJECT.

PROJECT RESILIENCY - PROJECT RESILIENCY, LED BY COMMUNITY ALLIANCE REHABILITATION SERVICES (CA) WILL EXPAND COMMUNITY CAPACITY TO RESPOND TO SUICIDE RISK AMONG ADULTS, 25 OR OLDER, WHO HAVE BEEN AFFECTED BY THE COVID-19 PANDEMIC, WITH SPECIAL ATTENTION TO VICTIMS OF DOMESTIC VIOLENCE, THOSE LIVING WITH SERIOUS MENTAL ILLNESS OR SUBSTANCE USE DISORDER, AND PEOPLE WHO HAVE EXPERIENCED TRAUMA, ANXIETY, GRIEF, LOSS OR ATTENUATED BEHAVIORAL HEALTH NEEDS AS A CONSEQUENCE OF COVID-19. CA WILL STRENGTHEN ITS INTEGRATED PHYSICAL AND BEHAVIORAL HEALTH SERVICES AND PARTNER WITH THE WOMEN’S CENTER FOR ADVANCEMENT (WCA) TO INCREASE SUICIDE RISK IDENTIFICATION, RAPID RESPONSE AND ACCESS TO PREVENTION, TREATMENT, CARE COORDINATION AND RECOVERY SERVICES FOR THOSE AT RISK FOR OR WHO HAVE ATTEMPTED SUICIDE, WHO ARE REFERRED BY HEALTH CARE, DOMESTIC VIOLENCE OR OTHER COMMUNITY PARTNERS, OR WHO SELF-REFER. WITH THE NEBRASKA CHAPTER OF THE AMERICAN FOUNDATION FOR SUICIDE PREVENTION (AFSP-NE), CA AND WCA WILL PROVIDE TRAINING ON SUICIDE PREVENTION AND RISK ASSESSMENT FOR CLINICIANS AND GENERAL AUDIENCES AS WELL AS CROSS TRAINING ON SUICIDE PREVENTION AND DOMESTIC VIOLENCE. THE PROJECT WILL SERVE NEBRASKA’S BEHAVIORAL HEALTH REGION 6 WHICH ENCOMPASSES A 5 COUNTY AREA SURROUNDING METRO OMAHA, ENCOMPASSES 40% OF THE STATE’S POPULATION, AND HAS INCURRED THE LARGEST NUMBER OF CONFIRMED COVID-19 CASES IN NEBRASKA. GRANT FUNDING WILL ADD THE FOLLOWING STRATEGIC RESOURCES: A FULL TIME CA TRAINER TO OFFER AFSP EDUCATION AND TRAINING MODULES, BOTH VIRTUALLY AND FACE-TO-FACE, ON EVIDENCE-BASED SUICIDE RISK IDENTIFICATION, RAPID RESPONSE AND PREVENTION TO MORE THAN 420 COMMUNITY HEALTH AND BEHAVIORAL HEALTH PROVIDERS AND COMMUNITY GROUPS CONNECTED TO PEOPLE AT RISK, INCLUDING HOSPITAL EMERGENCY ROOMS AND PRIMARY CARE PRACTICES, BEHAVIORAL HEALTH AND DOMESTIC VIOLENCE PROFESSIONALS, CHURCHES, SENIOR CENTERS, THE LGBTQ COMMUNITY, AND ORGANIZATIONS SERVING RACIAL, ETHNIC AND LINGUISTIC MINORITIES; A FULL TIME LICENSED MENTAL HEALTH PROFESSIONAL (LMHP) AND FULL TIME CARE COORDINATOR TO JOIN CA’S INTEGRATED CARE TEAM AND PROVIDE SPECIALIZED SUPPORT FOR PEOPLE AT HEIGHTENED SUICIDE RISK AND/OR EXPERIENCING DOMESTIC VIOLENCE; A WCA ADVOCATE TO PROVIDE ADDED SUPPORT TO INDIVIDUALS AFFECTED BY DOMESTIC VIOLENCE INCLUDING COORDINATING LEGAL, FINANCIAL, AND SUPPORT SERVICES VITAL TO AFFECTED INDIVIDUALS AND, WITH CAS LMHP, CO-LEADING GROUP THERAPY FOR DOMESTIC VIOLENCE VICTIMS AND COMMUNITY CROSS TRAINING IN SUICIDE PREVENTION AND DOMESTIC VIOLENCE; AND A FULL-TIME PROJECT DIRECTOR TO LEAD THE MULTI-AGENCY EFFORT, ENGAGE COMMUNITY STAKEHOLDERS AND OVERSEE THE ACHIEVEMENT OF PROGRAM OBJECTIVES AND EVALUATION. SERVICE ACCESS AND RESPONSIVENESS IS FURTHER ENHANCED THROUGH THE ABILITY TO PURCHASE SAFE HOUSING FOR THOSE SEEKING SAFETY AND TELEPHONE, TABLET AND INTERNET RESOURCES FOR CLIENT USE. EVIDENCE BASED PRACTICES EMPLOYED INCLUDE: NATIONAL INSTITUTES OF HEALTH ZERO SUICIDE FRAMEWORK, COLUMBIA SUICIDE SEVERITY RATING SCALE, COGNITIVE-BEHAVIORAL THERAPY, TRAUMA INFORMED CARE, MOTIVATIONAL INTERVIEWING, SEEKING SAFETY, AND THE AFSP TOOLS ICAR2E FOR SUICIDE ASSESSMENT IN HOSPITAL EMERGENCY ROOMS, AND SAFESIDE IN PRIMARY CARE PRACTICES.