Emily Nahat, Chief

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California Department of Mental Health
Prevention and Early Intervention Guidelines
Webcasts October 22, 2007November 2, 2007

• Emily Nahat, Chief
• Prevention and Early Intervention Branch

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PEI Guidelines Overview

• Prevention and Early Intervention Guidelines
• Part I Purpose, Background and Definitions
• Part II Community Program Planning
• Part III PEI Projects
• PEI Resource Materials
• Part IV Funding
• Part V Accountability and Evaluation

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Prevention and Early Intervention Guidelines
Information Notice 07-19http//www.dmh.ca.gov/DMH
Docs/docs/notices07/07_19_Notice.pdf

• PEI Key to Transformation
• Community Collaboration
• Cultural Competence
• Individual/family-driven programs and
  interventions, with specific attention to
  individuals from underserved communities
• Wellness focus, which includes the concepts of
  resilience and recovery
• Integrated service experience for individuals and
  their families
• Outcomes-based program design

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Part I Purpose, Background and Definitions

• Key Community Needs
• Disparities in access to mental health services
• Psycho-social impact of trauma
• At-risk children, youth, and young adult
  populations
• Stigma and discrimination
• Suicide risk

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Part I Purpose, Background and Definitions

• PEI Priority Populations
• Underserved cultural populations
• Individuals experiencing onset of serious
  psychiatric illness
• Children/youth in stressed families
• Trauma-exposed individuals
• Children/youth at risk for school failure
• Children/youth at risk of or experiencing
  juvenile justice involvement

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Part I Purpose, Background and Definitions

• Prevention
• Involves reducing risk factors or stressors
• Builds protective factors and skills
• Promotes positive cognitive, social and emotional
  development

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Part I Purpose, Background and Definitions

• Early Intervention
• Addresses a condition early in its manifestation
• Is of relatively low intensity
• Is of relatively short duration (usually less
  than one year)
• Has the goal of supporting well-being in major
  life domains and avoiding the need for more
  extensive mental health services

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Part I Purpose, Background and Definitions

• Exception for ARMS (At Risk Mental State) or
• First Onset
• Specialized programs for individuals at risk of
  or who are experiencing first onset of a
  psychiatric illness
• Based on transformational interventions from
  Australia, Europe, Canada
• Identify and provide services to youth/TAY in
  non-stigmatizing, non-MH settings
• Program is generally 2-5 years in duration

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Part II Community Program Planning Process

• Purpose and Logic Model
• Identification and selection of Key Community MH
  Needs and related PEI Priority Populations
• Assessment of community capacity and strengths
• Selection of PEI programs to achieve desired
  outcomes
• Development of projects with timeframes, staffing
  and budgets
• Implementation of accountability, evaluation and
  program improvement activities

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Part II Community Program Planning Process

• Process and timeline for funds in Information
  Notice 07-17
• http//www.dmh.ca.gov/DMHDocs/docs/notices07/07-1
  7.pdf
• Involvement of required and recommended sectors
• Outreach and engagement to underserved
  communities
• Logic model
• Required comment period and public hearing

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Part II Community Program Planning Process
Form No. 2

• Describe Community Program Planning
• Staffing
• Stakeholder participation process
• Training
• Summary of the effectiveness of Community Program
  Planning
• Public hearing
• Summary and analysis of recommendations

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Part II Community Program Planning Process

• UC Davis Center for Reducing Health Disparities
• Focused outreach and engagement to underserved
  racial and ethnic communities
• Principles of community engagement
• Outreach methods
• Preliminary findings
• Suggestions emerging for PEI Community Program
  Planning Process

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Break for Lunch
Back at 100 p.m.
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Part III PEI Projects

• Connected to PEI priority populations and
  achieving outcomes
• County selection of programs
• Based on PEI Priority Populations and PEI Key
  Community Needs
• Counties may select from the PEI Resource
  Materials
• Counties may select alternative strategies with a
  rationale
• Reducing disparities is an overarching goal
• Priority age 51 of funds to children and
  youth small counties excluded

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PEI Resource Materials

• Elements of the Resource Materials
• Description
• Prevention of mental health problems
• Early Intervention for mental health problems and
  concerns
• Linkage and support in navigating service systems
  and other providers as needed
• System enhancements to improve and sustain MH
  programs and interventions
• General resources

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PEI Resource Materials

• Program examples by priority populations
• Program examples by key community needs
• Chart of selected programs with outcomes
• Draft PEI logic model
• Potential outcomes of PEI programs

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Part IV PEI Funding

• Planning estimates
• 307.6M available funding through FY 2008-09
• Community Program Planning--25M
• Planning Estimate--115M (includes 25M for
  Planning) FY 07/08, 192.6M FY 08/09
• Non-supplant
• Allowable Expenditures
• Non-allowable expenditures
• Leveraging

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Part V Accountability and Evaluation

• Importance of Accountability and Evaluation
• Demonstrate accountability to the public
• Document progress towards meetings overall aims
  of PEI
• Inform both policy and practice about the PEI
  component of MHSA
• Create a cooperative learning environment among
  stakeholders

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Part V Accountability and Evaluation

• Evaluation Questions
• Individual Person/Family Level
• Improved mental health status?
• Reduced risk for emotional and behavioral
  problems?
• System Level
• How is PEI money being spent?
• What programs show promise and/or evidence of
  being effective especially with underserved
  populations?
• What impacts are there from PEI on the mental
  health system and other organizations, agencies
  and systems?

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Part V Accountability and Evaluation

• Tracking of expenditures at the PEI Project level
• Semi-annual narrative reporting
• Participation in on-site program reviews
• Participation in surveying of PEI implementation,
  funding, and collaborative partners
• Participation in special state evaluation of
  selected local programs
• Conducting a local outcome evaluation of the
  programs within one PEI Project

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PEI Projects Form No. 3
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PEI Projects Form No. 3

• PEI Community Mental Health Needs
• PEI Priority Population (s)
• Data analysis
• PEI Project description
• List programs
• Program title
• Proposed number of individuals to be served
• Provide unduplicated count

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PEI Projects Form No. 3

• Alternate programs, if applicable
• Provide rationale
• Linkages to Community MH and providers of other
  services
• Collaboration and system enhancements
• Intended outcomes
• Coordination with other MHSA components

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PEI Projects PEI Revenue and Expenditure Budget
Worksheet - Form No. 4
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PEI Projects PEI Revenue and Expenditure Budget
Worksheet - Form No. 4

• Expenditures
• Personnel Expenditures
• Operating Expenditures
• Facility cost
• Other operating expenses
• Subcontracts/professional services
• Proposed PEI Project budget
• Revenues
• Other revenue sources
• Total funding requested
• Total in-kind contributions

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PEI ProjectsPEI Administration Budget Worksheet
- Form No. 5
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PEI Administration Budget Worksheet - Form No. 5

• Expenditures
• Personnel Expenditures
• Operating Expenditures
• Facility cost
• Other operating expenses
• County Allocated Overhead
• Revenue
• Other Revenue Sources
• Total Funding Requirements
• Total In-kind Contributions

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PEI ProjectsPEI Budget SummaryForm No. 6
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PEI Projects Budget SummaryForm No. 6

• List all proposed county PEI projects
• 51 of overall budget dedicated to programs for
  CY/TAY (birth-25)
• Funds requested by fiscal year and age group

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Local Evaluation of a PEI Project - Form No. 7
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PEI ProjectLocal Evaluation of a PEI Project -
Form No. 7

• PEI Project to be evaluated
• Program outcomes
• Demographics of individuals to be served
• Outcomes to be measured
• Data collection and analysis
• Program/evaluation culturally competent
• Fidelity in implementing the programs
• Dissemination of evaluation report

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Project Name School-Family Connections(Exampl
e of a PEI Project)

• Form No. 3 PEI Project Summary
• Form No. 7 Local Evaluation of a PEI Project

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Training, Technical Assistance and Capacity
Building

• Fund up to 12 million annually for four years to
  support specific PEI programs
• 6 million annually for four years directed to
  SMHI
• Preliminary plans for training/TA

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Next Steps

• Upcoming PEI trainings

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Contact Information

• DMH
• Attn Prevention and Early Intervention
• 1600 9th Street, Room 350
• Sacramento, CA 95814
• Phone [phone]
• Fax [phone]
• E-mail Caitlin.Viscardi_at_dmh.ca.gov
• Website http//www.dmh.ca.gov/mhsa