Along with an array of mental health and substance abuse programs, Region V Systems engages in initiatives that augment existing community-based services. Following are initiatives currently underway with the intent to bolster the existing public behavioral health system:
Complexity Capable Care
Since FY 12-13, Network Providers in all six Behavioral Health Regions have participated in a quality improvement initiative utilizing the values and principles of “Complexity Capability” to advance both organizationally and clinically effective care for individuals and families with complex co-occurring mental health and substance abuse disorders.
The initiative links the COMPASS-EZ, an organizational self-assessment tool, with the evidence-based practice of Stages of Change to create recovery plans that include appropriate stage-based interventions and seeks to remove organizational and clinical barriers to effective care. Statewide and local trainings were facilitated by Drs. Ken Minkoff and Christie Cline, ZIA Partners, Inc. and developers of the COMPASS-EZ, on the Comprehensive Continuous Integrated System of Care.
Network Providers administered the COMPASS-EZ, setting a baseline to identify each agency’s co-occurring capability in the following domains:
- Program Philosophy, Program Policies, Quality Improvement and Data
- Access, Screening and Identification, Recovery Orientation Assessment
- Person-Centered Planning, Recovery Programming, Recovery Relationships
- Recovery Program Policies, Psychopharmacology, Discharge/Transition Planning
- Collaboration/Partnerships, Staff Training, Staff Competency
Strengths, areas for continued growth, and plans for improvement were outlined. Reassessments of providers in FY 16-17 identified Region-wide progress in all domains.
Trauma Informed Care
Trauma-Informed Care is a statewide initiative to ensure all Network Providers:
- are informed about the effects of psychological trauma;
- screen for trauma symptoms and history of traumatic events;
- provide ongoing assessment of trauma symptoms and problems related to trauma;
- offer services that are recovery-oriented and trauma-sensitive;
- increase the provision of trauma-informed and trauma-specific services; and
- understand that re-traumatization may occur if safe, effective, and responsive services are not available for consumers.
Region V Systems facilitates a Trauma-Informed Workgroup comprised of consumers, Network Providers, Region V staff, and other community stakeholders, responsible for planning, developing, marketing, implementing, and evaluating strategies to increase awareness and promote a trauma-informed service delivery system. In FY 17-18, the Trauma-Informed Workgroup focused on increasing evidence-based, trauma-specific treatment services within Region V by sponsoring and coordinating Eye Movement Desensitization and Reprocessing (EMDR) training and ongoing consultation. Trauma funds also supported the annual Behavioral Threat Assessment Training (BETA), which is geared towards law enforcement with one training objective being to increase the understanding of trauma and increase trauma sensitivity amongst law enforcement officers who work with mutual consumers in our emergency services.
For more information about the Trauma-Informed Workgroup, please contact Amanda Tyerman-Harper at firstname.lastname@example.org.
Culturally and Linguistically Appropriate Services (CLAS)
CLAS is broadly defined as care and services that are respectful of and responsive to the cultural and linguistic needs of all individuals. Health inequities result in disparities that directly affect quality of life. National CLAS standards have been defined to advance health equity, improve quality, and help eliminate health care disparities. CLAS Standards establish a blueprint to guide efforts that address racial and ethnic health disparities and implement culturally and linguistically appropriate services.
Since 2003, Region V Systems has hosted a CLAS Coalition to address cultural and linguistically specific issues. Coalition membership is open to anyone interested in cultural and linguistic services and supports.
Through CLAS identified funding, the Coalition helps to reimburse providers for interpretation services and other supports related to CLAS activities.
Opioid Crisis Grant
Region V partnered with Nebraska Department of Health & Human Services, Division of Behavioral Health in implementing the State Targeted Response to the Opioid Crisis Grant, a grant funded by the Substance Abuse and Mental Health Services Administration (SAMHSA), Center for Substance Abuse Treatment (CSAT) and Center for Substance Abuse Prevention (CSAP). These funds aim to address the opioid crisis by increasing access to treatment, reducing unmet treatment need, and reducing opioid overdose-related deaths through the provision of prevention, treatment, and recovery activities for opioid use disorder (OUD) (including prescription opioids as well as illicit drugs such as heroin). In Region V, funds supported the following activities:
- Implementation of primary and secondary prevention using evidence-based methods defined by SAMHSA or CDC, proven to reduce the number of persons with OUDs and OUD-associated deaths.
- Expanded access to the clinically appropriate evidence-based practices (EBP) of medication-assisted treatment (MAT) for opioid disorders. Individuals received assistance with treatment and support of their path to recovery by providing funding for medication-assisted treatment through the use of the FDA-approved medication, buprenorphine.
For more information on the Prevention activities funded under the Opioid Crisis Grant, please see page 20.
Behavioral Health/Primary Care Integration
Public behavioral health providers and primary care providers demonstrate a belief in and commitment to whole healthcare and understand that treating mental health, physical health, and substance use in an integrated care fashion maximizes consumer outcomes and recovery.
The purpose and focus of the behavioral health/primary care integration initiative in Region V has been to support a patient-centered medical home model and the integration of primary care and behavioral health care. Region V Systems has promoted integration since 2011 by supporting access for individuals to primary health care and a medical home at Bluestem Health, formerly known as People’s Health Center (PHC), utilizing vouchers for consumers to receive behavioral health services. Conversely, Bluestem prioritizes behavioral health screening and referral to treatment. In FY 17-18, 256 persons served received primary health care services through Region V Systems’ voucher funding.
Medication support is a service enhancement and quality improvement component of services, attempting to favorably impact the clinical and economic outcomes for consumers. It provides:
- ancillary assistance in the delivery of medication management services in an outpatient behavioral health setting; and
- interim access to medications as other more sustainable means are secured for the persons served.
In FY 17-18, funding in the amount of $55,261 was utilized for mental health services and $42,761 for substance use disorder services to provide this ancillary service enhancement.
Projects for Assistance in Transition From Homelessness (PATH)
PATH Street Outreach
CenterPointe’s street outreach program staff actively seek consumers who are homeless and have serious mental illness or co-occurring mental health and substance use issues. Outreach workers assist consumers living in shelters, on the streets, or in inappropriate settings through face-to-face contact. This allows the worker and consumer to tap into appropriate services for behavioral and primary healthcare, housing, and entitlement programs. Through the program, the participant’s immediate needs are also addressed (e.g., crisis intervention, food, clean clothing, hygiene kits, and blankets).
PATH Care Management Services
Through community referrals or street outreach contacts, enrolled participants are assigned a care manager who coordinates their care. Care management services are provided in a variety of locations including: the consumer’s home, shelters, the street, soup kitchens, and program staff offices. Based on individual needs, PATH Care Management focuses on appropriate housing while addressing participants’ behavioral and primary care issues.