1 California Department of Mental Health Emily Nahat, Chief Prevention and Early Intervention Branch Prevention and Early Intervention Branch Prevention.

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California Department California Department of of

Mental Health Mental Health

Emily Nahat, ChiefEmily Nahat, Chief

Prevention and Early Intervention BranchPrevention and Early Intervention Branch

Prevention and Early Intervention Prevention and Early Intervention Guidelines WebcastsGuidelines Webcasts

October 22, 2007October 22, 2007November 2, 2007November 2, 2007

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PEI Guidelines OverviewPEI Guidelines Overview

• Prevention and Early Intervention GuidelinesPrevention and Early Intervention Guidelines

• Part I – Purpose, Background and DefinitionsPart I – Purpose, Background and Definitions

• Part II – Community Program PlanningPart II – Community Program Planning

• Part III – PEI ProjectsPart III – PEI Projects• PEI Resource MaterialsPEI Resource Materials

• Part IV – FundingPart IV – Funding

• Part V – Accountability and EvaluationPart V – Accountability and Evaluation

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Prevention and Early Intervention Prevention and Early Intervention Guidelines – Information Notice 07-19Guidelines – Information Notice 07-19

http://www.dmh.ca.gov/DMHDocs/docs/notices07/07_19_Notihttp://www.dmh.ca.gov/DMHDocs/docs/notices07/07_19_Notice.pdfce.pdf

PEI: Key to TransformationPEI: Key to Transformation• Community CollaborationCommunity Collaboration• Cultural CompetenceCultural Competence• Individual/family-driven programs and Individual/family-driven programs and

interventions, with specific attention to interventions, with specific attention to individuals from underserved communitiesindividuals from underserved communities

• Wellness focus, which includes the concepts of Wellness focus, which includes the concepts of resilience and recoveryresilience and recovery

• Integrated service experience for individuals Integrated service experience for individuals and their familiesand their families

• Outcomes-based program designOutcomes-based program design

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Part I: Purpose, Background Part I: Purpose, Background and Definitionsand Definitions

Key Community Needs:Key Community Needs:

• Disparities in access to mental health servicesDisparities in access to mental health services

• Psycho-social impact of traumaPsycho-social impact of trauma

• At-risk children, youth, and young adult At-risk children, youth, and young adult populationspopulations

• Stigma and discriminationStigma and discrimination

• Suicide riskSuicide risk

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Part I: Purpose, Background Part I: Purpose, Background and Definitionsand Definitions

PEI Priority Populations:PEI Priority Populations:

• Underserved cultural populationsUnderserved cultural populations• Individuals experiencing onset of serious Individuals experiencing onset of serious

psychiatric illnesspsychiatric illness• Children/youth in stressed familiesChildren/youth in stressed families• Trauma-exposed individualsTrauma-exposed individuals• Children/youth at risk for school failureChildren/youth at risk for school failure• Children/youth at risk of or experiencing Children/youth at risk of or experiencing

juvenile justice involvementjuvenile justice involvement

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Part I: Purpose, Background Part I: Purpose, Background and Definitionsand Definitions

PreventionPrevention

• Involves reducing risk factors or stressorsInvolves reducing risk factors or stressors

• Builds protective factors and skillsBuilds protective factors and skills

• Promotes positive cognitive, social and Promotes positive cognitive, social and emotional developmentemotional development

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Part I: Purpose, Background Part I: Purpose, Background and Definitionsand Definitions

Early InterventionEarly Intervention

• Addresses a condition early in its Addresses a condition early in its manifestationmanifestation

• Is of relatively low intensityIs of relatively low intensity

• Is of relatively short duration (usually less Is of relatively short duration (usually less than one year)than one year)

• Has the goal of supporting well-being in Has the goal of supporting well-being in major life domains and avoiding the need major life domains and avoiding the need for more extensive mental health servicesfor more extensive mental health services

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Part I: Purpose, Background Part I: Purpose, Background and Definitionsand Definitions

Exception for ARMS (At Risk Mental State) or Exception for ARMS (At Risk Mental State) or

First Onset:First Onset:

Specialized programs for individuals at risk Specialized programs for individuals at risk of or who are experiencing first onset of a of or who are experiencing first onset of a psychiatric illnesspsychiatric illness

Based on transformational interventions Based on transformational interventions from Australia, Europe, Canadafrom Australia, Europe, Canada

Identify and provide services to youth/TAY Identify and provide services to youth/TAY in non-stigmatizing, non-MH settingsin non-stigmatizing, non-MH settings

Program is generally 2-5 years in durationProgram is generally 2-5 years in duration

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Part II: Community Program Planning Part II: Community Program Planning ProcessProcess

Purpose and Logic ModelPurpose and Logic Model

• Identification and selection of Key Community MH Identification and selection of Key Community MH Needs and related PEI Priority PopulationsNeeds and related PEI Priority Populations

• Assessment of community capacity and strengthsAssessment of community capacity and strengths

• Selection of PEI programs to achieve desired Selection of PEI programs to achieve desired outcomesoutcomes

• Development of projects with timeframes, staffing Development of projects with timeframes, staffing and budgetsand budgets

• Implementation of accountability, evaluation and Implementation of accountability, evaluation and program improvement activitiesprogram improvement activities

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Part II: Community Program Part II: Community Program Planning ProcessPlanning Process

• Process and timeline for funds in Information Process and timeline for funds in Information Notice 07-17Notice 07-17

http://www.dmh.ca.gov/DMHDocs/docs/noticeshttp://www.dmh.ca.gov/DMHDocs/docs/notices07/07-17.pdf07/07-17.pdf

• Involvement of required and recommended Involvement of required and recommended sectorssectors

• Outreach and engagement to underserved Outreach and engagement to underserved communitiescommunities

• Logic modelLogic model

• Required comment period and public hearingRequired comment period and public hearing

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Part II: Community Program Part II: Community Program Planning Process Planning Process

Form No. 2Form No. 2

• Describe Community Program PlanningDescribe Community Program Planning• StaffingStaffing

• Stakeholder participation processStakeholder participation process

• TrainingTraining

• Summary of the effectiveness of Community Summary of the effectiveness of Community Program PlanningProgram Planning

• Public hearingPublic hearing• Summary and analysis of recommendationsSummary and analysis of recommendations

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Part II: Community Program Part II: Community Program Planning ProcessPlanning Process

UC Davis Center for Reducing Health DisparitiesUC Davis Center for Reducing Health Disparities

• Focused outreach and engagement to Focused outreach and engagement to underserved racial and ethnic communitiesunderserved racial and ethnic communities

• Principles of community engagementPrinciples of community engagement

• Outreach methodsOutreach methods

• Preliminary findingsPreliminary findings

• Suggestions emerging for PEI Community Suggestions emerging for PEI Community Program Planning ProcessProgram Planning Process

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Part III: PEI ProjectsPart III: PEI Projects

Connected to PEI priority populations and Connected to PEI priority populations and achieving outcomesachieving outcomes

County selection of programsCounty selection of programs

• Based on PEI Priority Populations and PEI Based on PEI Priority Populations and PEI Key Community NeedsKey Community Needs

• Counties may select from the PEI Resource Counties may select from the PEI Resource MaterialsMaterials

• Counties may select alternative strategies Counties may select alternative strategies with a rationalewith a rationale

• Reducing disparities is an overarching goalReducing disparities is an overarching goal

• Priority age – 51% of funds to children and Priority age – 51% of funds to children and youth; small counties excludedyouth; small counties excluded

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PEI Resource MaterialsPEI Resource Materials

Elements of the Resource MaterialsElements of the Resource Materials1.1. DescriptionDescription2.2. Prevention of mental health problemsPrevention of mental health problems3.3. Early Intervention for mental health Early Intervention for mental health

problems and concernsproblems and concerns4.4. Linkage and support in navigating service Linkage and support in navigating service

systems and other providers as neededsystems and other providers as needed5.5. System enhancements to improve and System enhancements to improve and

sustain MH programs and interventionssustain MH programs and interventions6.6. General resourcesGeneral resources

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PEI Resource MaterialsPEI Resource Materials

• Program examples – by priority populationsProgram examples – by priority populations

• Program examples – by key community Program examples – by key community needsneeds

• Chart of selected programs with outcomes Chart of selected programs with outcomes

• Draft PEI logic modelDraft PEI logic model

• Potential outcomes of PEI programsPotential outcomes of PEI programs

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Part IV: PEI FundingPart IV: PEI Funding

• Planning estimates Planning estimates • $307.6M available funding through FY 2008-$307.6M available funding through FY 2008-

0909• Community Program Planning--$25MCommunity Program Planning--$25M• Planning Estimate--$115M (includes $25M Planning Estimate--$115M (includes $25M

for Planning) FY 07/08, $192.6M FY 08/09for Planning) FY 07/08, $192.6M FY 08/09• Non-supplantNon-supplant• Allowable ExpendituresAllowable Expenditures• Non-allowable expendituresNon-allowable expenditures• LeveragingLeveraging

$

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Part V: Accountability and EvaluationPart V: Accountability and Evaluation

Importance of Accountability and Evaluation:Importance of Accountability and Evaluation:• Demonstrate accountability to the publicDemonstrate accountability to the public

• Document progress towards meetings overall Document progress towards meetings overall aims of PEIaims of PEI

• Inform both policy and practice about the PEI Inform both policy and practice about the PEI component of MHSAcomponent of MHSA

• Create a cooperative learning environment Create a cooperative learning environment among stakeholdersamong stakeholders

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Part V: Accountability and EvaluationPart V: Accountability and Evaluation

Evaluation Questions:Evaluation Questions:Individual Person/Family LevelIndividual Person/Family Level• Improved mental health status?Improved mental health status?• Reduced risk for emotional and behavioral Reduced risk for emotional and behavioral

problems?problems?

System LevelSystem Level• How is PEI money being spent?How is PEI money being spent?• What programs show promise and/or evidence of What programs show promise and/or evidence of

being effective especially with underserved being effective especially with underserved populations?populations?

• What impacts are there from PEI on the mental What impacts are there from PEI on the mental health system and other organizations, agencies and health system and other organizations, agencies and systems?systems?

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Part V: Accountability and EvaluationPart V: Accountability and Evaluation

• Tracking of expenditures at the PEI Project Tracking of expenditures at the PEI Project levellevel

• Semi-annual narrative reporting Semi-annual narrative reporting • Participation in on-site program reviewsParticipation in on-site program reviews• Participation in surveying of PEI Participation in surveying of PEI

implementation, funding, and collaborative implementation, funding, and collaborative partnerspartners

• Participation in special state evaluation of Participation in special state evaluation of selected local programsselected local programs

• Conducting a local outcome evaluation of the Conducting a local outcome evaluation of the programs within one PEI Projectprograms within one PEI Project

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

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

1.1. PEI Community Mental Health NeedsPEI Community Mental Health Needs

2.2. PEI Priority Population (s)PEI Priority Population (s)• Data analysisData analysis

3.3. PEI Project descriptionPEI Project description

4.4. List programsList programs Program titleProgram title Proposed number of individuals to be Proposed number of individuals to be

servedserved Provide unduplicated countProvide unduplicated count

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

5.5. Alternate programs, if applicableAlternate programs, if applicable• Provide rationaleProvide rationale

6.6. Linkages to Community MH and providers of Linkages to Community MH and providers of other servicesother services

7.7. Collaboration and system enhancementsCollaboration and system enhancements

8.8. Intended outcomesIntended outcomes

9.9. Coordination with other MHSA componentsCoordination with other MHSA components

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PEI Projects PEI Projects PEI Revenue and Expenditure Budget PEI Revenue and Expenditure Budget

Worksheet - Worksheet - Form No. 4Form No. 4

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PEI Projects PEI Projects PEI Revenue and Expenditure Budget PEI Revenue and Expenditure Budget

Worksheet - Worksheet - Form No. 4Form No. 4

• ExpendituresExpenditures Personnel ExpendituresPersonnel Expenditures Operating ExpendituresOperating Expenditures

• Facility costFacility cost• Other operating expensesOther operating expenses

Subcontracts/professional servicesSubcontracts/professional services Proposed PEI Project budgetProposed PEI Project budget

• RevenuesRevenues Other revenue sourcesOther revenue sources Total funding requested Total funding requested Total in-kind contributionsTotal in-kind contributions

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PEI ProjectsPEI ProjectsPEI Administration PEI Administration

Budget Worksheet - Budget Worksheet - Form No. 5Form No. 5

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

• ExpendituresExpenditures Personnel ExpendituresPersonnel Expenditures Operating ExpendituresOperating Expenditures

• Facility costFacility cost• Other operating expensesOther operating expenses

County Allocated OverheadCounty Allocated Overhead

• RevenueRevenue Other Revenue SourcesOther Revenue Sources Total Funding RequirementsTotal Funding Requirements Total In-kind ContributionsTotal In-kind Contributions

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PEI ProjectsPEI ProjectsPEI Budget SummaryPEI Budget Summary

Form No. 6Form No. 6

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PEI Projects PEI Projects Budget SummaryBudget Summary

Form No. 6Form No. 6

• List all proposed county PEI projectsList all proposed county PEI projects

• 51% of overall budget dedicated to programs 51% of overall budget dedicated to programs for CY/TAY (birth-25)for CY/TAY (birth-25)

• Funds requested by fiscal year and age Funds requested by fiscal year and age groupgroup

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

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PEI ProjectPEI ProjectLocal Evaluation of a PEI Local Evaluation of a PEI

Project - Project - Form No. 7Form No. 7

1.1. PEI Project to be evaluatedPEI Project to be evaluated2.2. Program outcomesProgram outcomes3.3. Demographics of individuals to be servedDemographics of individuals to be served4.4. Outcomes to be measuredOutcomes to be measured5.5. Data collection and analysisData collection and analysis6.6. Program/evaluation culturally competentProgram/evaluation culturally competent7.7. Fidelity in implementing the programsFidelity in implementing the programs8.8. Dissemination of evaluation reportDissemination of evaluation report

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Project Name: Project Name: “School-Family Connections”“School-Family Connections”

((Example of a PEI Project)Example of a PEI Project)

• Form No. 3 – PEI Project SummaryForm No. 3 – PEI Project Summary

• Form No. 7 – Local Evaluation of a PEI Form No. 7 – Local Evaluation of a PEI ProjectProject

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Training, Technical Assistance Training, Technical Assistance and Capacity Buildingand Capacity Building

• Fund up to $12 million annually for four Fund up to $12 million annually for four years to support specific PEI programsyears to support specific PEI programs

• $6 million annually for four years directed $6 million annually for four years directed to SMHIto SMHI

• Preliminary plans for training/TAPreliminary plans for training/TA

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Next StepsNext Steps

• Upcoming PEI trainingsUpcoming PEI trainings

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Contact InformationContact Information

DMHDMH

Attn: Prevention and Early InterventionAttn: Prevention and Early Intervention

1600 91600 9thth Street, Room 350 Street, Room 350Sacramento, CA 95814Sacramento, CA 95814

Phone:Phone: (916) 653-2358(916) 653-2358Fax:Fax: (916) 654-2739(916) 654-2739

E-mail:E-mail: [email protected]@dmh.ca.gov

Website:Website: http://www.dmh.ca.gov/mhsahttp://www.dmh.ca.gov/mhsa