1. 1 California Department of Mental Health Emily Nahat, Chief Prevention and Early Intervention Branch Prevention and Early Intervention Branch Prevention and Early Intervention Guidelines Webcasts October 22, 2007 November 2, 2007

2. 2 PEI 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

3. 3 Prevention and Early Intervention Guidelines – Information Notice 07-19 http://www.dmh.ca.gov/DMHDocs/docs/notices07/07_19_ Notice.pdf http://www.dmh.ca.gov/DMHDocs/docs/notices07/07_19_ Notice.pdf http://www.dmh.ca.gov/DMHDocs/docs/notices07/07_19_ Notice.pdf PEI: Key to Transformation Community Collaboration Community Collaboration Cultural Competence Cultural Competence Individual/family-driven programs and interventions, with specific attention to individuals from underserved communities Individual/family-driven programs and interventions, with specific attention to individuals from underserved communities Wellness focus, which includes the concepts of resilience and recovery Wellness focus, which includes the concepts of resilience and recovery Integrated service experience for individuals and their families Integrated service experience for individuals and their families Outcomes-based program design Outcomes-based program design

4. 4 Part I: Purpose, Background and Definitions Key Community Needs: Disparities in access to mental health services Disparities in access to mental health services Psycho-social impact of trauma Psycho-social impact of trauma At-risk children, youth, and young adult populations At-risk children, youth, and young adult populations Stigma and discrimination Stigma and discrimination Suicide risk Suicide risk

5. 5 Part I: Purpose, Background and Definitions PEI Priority Populations: Underserved cultural populations Underserved cultural populations Individuals experiencing onset of serious psychiatric illness Individuals experiencing onset of serious psychiatric illness Children/youth in stressed families Children/youth in stressed families Trauma-exposed individuals Trauma-exposed individuals Children/youth at risk for school failure Children/youth at risk for school failure Children/youth at risk of or experiencing juvenile justice involvement Children/youth at risk of or experiencing juvenile justice involvement

6. 6 Part I: Purpose, Background and Definitions Prevention Involves reducing risk factors or stressors Involves reducing risk factors or stressors Builds protective factors and skills Builds protective factors and skills Promotes positive cognitive, social and emotional development Promotes positive cognitive, social and emotional development

7. 7 Part I: Purpose, Background and Definitions Early Intervention Addresses a condition early in its manifestation Addresses a condition early in its manifestation Is of relatively low intensity Is of relatively low intensity Is of relatively short duration (usually less than one year) 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 Has the goal of supporting well-being in major life domains and avoiding the need for more extensive mental health services

8. 8 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 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 Based on transformational interventions from Australia, Europe, Canada Identify and provide services to youth/TAY in non-stigmatizing, non-MH settings Identify and provide services to youth/TAY in non-stigmatizing, non-MH settings Program is generally 2-5 years in duration Program is generally 2-5 years in duration

9. 9 Part II: Community Program Planning Process Purpose and Logic Model Identification and selection of Key Community MH Needs and related PEI Priority Populations Identification and selection of Key Community MH Needs and related PEI Priority Populations Assessment of community capacity and strengths Assessment of community capacity and strengths Selection of PEI programs to achieve desired outcomes Selection of PEI programs to achieve desired outcomes Development of projects with timeframes, staffing and budgets Development of projects with timeframes, staffing and budgets Implementation of accountability, evaluation and program improvement activities Implementation of accountability, evaluation and program improvement activities

10. 10 Part II: Community Program Planning Process Process and timeline for funds in Information Notice 07-17 Process and timeline for funds in Information Notice 07-17 http://www.dmh.ca.gov/DMHDocs/docs/notice s07/07-17.pdf http://www.dmh.ca.gov/DMHDocs/docs/notice s07/07-17.pdf Involvement of required and recommended sectors Involvement of required and recommended sectors Outreach and engagement to underserved communities Outreach and engagement to underserved communities Logic model Logic model Required comment period and public hearing Required comment period and public hearing

11. 11 Part II: Community Program Planning Process Form No. 2 Describe Community Program Planning Describe Community Program Planning Staffing Staffing Stakeholder participation process Stakeholder participation process Training Training Summary of the effectiveness of Community Program Planning Summary of the effectiveness of Community Program Planning Public hearing Public hearing Summary and analysis of recommendations Summary and analysis of recommendations

12. 12 Part II: Community Program Planning Process UC Davis Center for Reducing Health Disparities Focused outreach and engagement to underserved racial and ethnic communities Focused outreach and engagement to underserved racial and ethnic communities Principles of community engagement Principles of community engagement Outreach methods Outreach methods Preliminary findings Preliminary findings Suggestions emerging for PEI Community Program Planning Process Suggestions emerging for PEI Community Program Planning Process

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14. 14 Part III: PEI Projects Connected to PEI priority populations and achieving outcomes Connected to PEI priority populations and achieving outcomes County selection of programs County selection of programs Based on PEI Priority Populations and PEI Key Community NeedsBased on PEI Priority Populations and PEI Key Community Needs Counties may select from the PEI Resource MaterialsCounties may select from the PEI Resource Materials Counties may select alternative strategies with a rationaleCounties may select alternative strategies with a rationale Reducing disparities is an overarching goalReducing disparities is an overarching goal Priority age – 51% of funds to children and youth; small counties excludedPriority age – 51% of funds to children and youth; small counties excluded

15. 15 PEI Resource Materials Elements of the Resource Materials 1. Description 2. Prevention of mental health problems 3. Early Intervention for mental health problems and concerns 4. Linkage and support in navigating service systems and other providers as needed 5. System enhancements to improve and sustain MH programs and interventions 6. General resources

16. 16 PEI Resource Materials Program examples – by priority populations Program examples – by priority populations Program examples – by key community needs Program examples – by key community needs Chart of selected programs with outcomes Chart of selected programs with outcomes Draft PEI logic model Draft PEI logic model Potential outcomes of PEI programs Potential outcomes of PEI programs

17. 17 Part IV: PEI Funding Planning estimatesPlanning estimates $307.6M available funding through FY 2008-09$307.6M available funding through FY 2008-09 Community Program Planning--$25MCommunity Program Planning--$25M Planning Estimate--$115M (includes $25M for Planning) FY 07/08, $192.6M FY 08/09Planning Estimate--$115M (includes $25M for Planning) FY 07/08, $192.6M FY 08/09 Non-supplantNon-supplant Allowable ExpendituresAllowable Expenditures Non-allowable expendituresNon-allowable expenditures LeveragingLeveraging $

18. 18 Part V: Accountability and Evaluation Importance of Accountability and Evaluation: Demonstrate accountability to the public Demonstrate accountability to the public Document progress towards meetings overall aims of PEI Document progress towards meetings overall aims of PEI Inform both policy and practice about the PEI component of MHSA Inform both policy and practice about the PEI component of MHSA Create a cooperative learning environment among stakeholders Create a cooperative learning environment among stakeholders

19. 19 Part V: Accountability and Evaluation Evaluation Questions: Individual Person/Family Level Improved mental health status? Improved mental health status? Reduced risk for emotional and behavioral problems? Reduced risk for emotional and behavioral problems? System Level How is PEI money being spent? How is PEI money being spent? What programs show promise and/or evidence of being effective especially with underserved populations? 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? What impacts are there from PEI on the mental health system and other organizations, agencies and systems?

20. 20 Part V: Accountability and Evaluation Tracking of expenditures at the PEI Project level Tracking of expenditures at the PEI Project level Semi-annual narrative reporting Semi-annual narrative reporting Participation in on-site program reviews Participation in on-site program reviews Participation in surveying of PEI implementation, funding, and collaborative partners Participation in surveying of PEI implementation, funding, and collaborative partners Participation in special state evaluation of selected local programs Participation in special state evaluation of selected local programs Conducting a local outcome evaluation of the programs within one PEI Project Conducting a local outcome evaluation of the programs within one PEI Project

21. 21 PEI Projects Form No. 3

22. 22 PEI Projects Form No. 3 1. PEI Community Mental Health Needs 2. PEI Priority Population (s) Data analysis Data analysis 3. PEI Project description 4. List programs Program title Program title Proposed number of individuals to be served Proposed number of individuals to be served Provide unduplicated count Provide unduplicated count

23. 23 PEI Projects Form No. 3 5. Alternate programs, if applicable Provide rationaleProvide rationale 6. Linkages to Community MH and providers of other services 7. Collaboration and system enhancements 8. Intended outcomes 9. Coordination with other MHSA components

24. 24 PEI Projects PEI Revenue and Expenditure Budget Worksheet - Form No. 4

25. 25 PEI Projects PEI Revenue and Expenditure Budget Worksheet - Form No. 4 Expenditures Expenditures Personnel Expenditures Personnel Expenditures Operating Expenditures Operating Expenditures Facility costFacility cost Other operating expensesOther operating expenses Subcontracts/professional services Subcontracts/professional services Proposed PEI Project budget Proposed PEI Project budget Revenues Revenues Other revenue sources Other revenue sources Total funding requested Total funding requested Total in-kind contributions Total in-kind contributions

26. 26 PEI Projects PEI Administration Budget Worksheet - Form No. 5

27. 27 PEI Administration Budget Worksheet - Form No. 5 Expenditures Expenditures Personnel Expenditures Personnel Expenditures Operating Expenditures Operating Expenditures Facility costFacility cost Other operating expensesOther operating expenses County Allocated Overhead County Allocated Overhead Revenue Revenue Other Revenue Sources Other Revenue Sources Total Funding Requirements Total Funding Requirements Total In-kind Contributions Total In-kind Contributions

28. 28 PEI Projects PEI Budget Summary Form No. 6

29. 29 PEI Projects Budget Summary Form No. 6 List all proposed county PEI projects List all proposed county PEI projects 51% of overall budget dedicated to programs for CY/TAY (birth-25) 51% of overall budget dedicated to programs for CY/TAY (birth-25) Funds requested by fiscal year and age group Funds requested by fiscal year and age group

30. 30 Local Evaluation of a PEI Project - Form No. 7

31. 31 PEI Project Local Evaluation of a PEI Project - Form No. 7 1. PEI Project to be evaluated 2. Program outcomes 3. Demographics of individuals to be served 4. Outcomes to be measured 5. Data collection and analysis 6. Program/evaluation culturally competent 7. Fidelity in implementing the programs 8. Dissemination of evaluation report

32. 32 Project Name: “School-Family Connections” ( Example of a PEI Project) Form No. 3 – PEI Project Summary Form No. 3 – PEI Project Summary Form No. 7 – Local Evaluation of a PEI Project Form No. 7 – Local Evaluation of a PEI Project

33. 33 Training, Technical Assistance and Capacity Building Fund up to $12 million annually for four years to support specific PEI programs Fund up to $12 million annually for four years to support specific PEI programs $6 million annually for four years directed to SMHI $6 million annually for four years directed to SMHI Preliminary plans for training/TA Preliminary plans for training/TA

34. 34 Next Steps Upcoming PEI trainings Upcoming PEI trainings

35. 35 Contact Information DMH Attn: Prevention and Early Intervention 1600 9 th Street, Room 350 Sacramento, CA 95814 Phone:(916) 653-2358 Fax:(916) 654-2739 E-mail:Caitlin.Viscardi@dmh.ca.gov Caitlin.Viscardi@dmh.ca.gov Website: http://www.dmh.ca.gov/mhsa http://www.dmh.ca.gov/mhsa