1. Transforming Mental Health in America Sybil Goldman, M.S.W. Special Assistant for Children Office of the Administrator Gary M. Blau, Ph.D. Chief, Child, Adolescent & Family Branch Center for Mental Health Services Substance Abuse, Mental Health Services Administration

2. “Imagination is the beginning of creation. You imagine what you desire, you will what you imagine and at last you create what you will.” ~ George Bernard Shaw ~ “Imagination is the beginning of creation. You imagine what you desire, you will what you imagine and at last you create what you will.” ~ George Bernard Shaw ~

3. The President’s New Freedom Commission on Mental Health Achieving the Promise: Transforming Mental Health Care in America

4. 4 Transforming Mental Health Care in America “We envision a future when everyone with a mental illness will recover, a future when mental illnesses can be prevented or cured, a future when mental illnesses are detected early, and a future when everyone with a mental illness at any stage of life has access to effective treatment and supports - essentials for living, working, learning, and participating fully in the community.” ~ Presidents New Freedom Commission on Mental Health – Achieving the Promise: Transforming Mental Health Care in America ~ “We envision a future when everyone with a mental illness will recover, a future when mental illnesses can be prevented or cured, a future when mental illnesses are detected early, and a future when everyone with a mental illness at any stage of life has access to effective treatment and supports - essentials for living, working, learning, and participating fully in the community.” ~ Presidents New Freedom Commission on Mental Health – Achieving the Promise: Transforming Mental Health Care in America ~

5. The Goals of a Transformed System Goal 1 Americans Understand that Mental Health Is Essential to Overall Health Goal 2 Mental Health Care Is Consumer and Family Driven Goal 3 Disparities in Mental Health Services Are Eliminated * Includes 19 Key Recommendations The Goals of a Transformed System Goal 1 Americans Understand that Mental Health Is Essential to Overall Health Goal 2 Mental Health Care Is Consumer and Family Driven Goal 3 Disparities in Mental Health Services Are Eliminated * Includes 19 Key Recommendations Commission on Mental Health President’s New Freedom Commission on Mental Health

6. The Goals of a Transformed System Goal 4 Early Mental Health Screening, Assessment, and Referral to Services Are Common Practice Goal 5 Excellent Mental Health Care Is Delivered and Research Is Accelerated Goal 6 Technology Is Used to Access Mental Health Care and Information * Includes 19 Key Recommendations The Goals of a Transformed System Goal 4 Early Mental Health Screening, Assessment, and Referral to Services Are Common Practice Goal 5 Excellent Mental Health Care Is Delivered and Research Is Accelerated Goal 6 Technology Is Used to Access Mental Health Care and Information * Includes 19 Key Recommendations Commission on Mental Health President’s New Freedom Commission on Mental Health

7. 7 Defining Transformation:  A continuous and complex process  New behaviors, new competencies  New sources of power  New partners  Profound changes in structure, culture, policy and programs  Will not happen over night  A continuous and complex process  New behaviors, new competencies  New sources of power  New partners  Profound changes in structure, culture, policy and programs  Will not happen over night

8. 8 The process of Transformation includes three distinct types of activities: Continuous small stepsContinuous small steps A series of exploratory medium jumps, andA series of exploratory medium jumps, and A few big jumpsA few big jumps

9. Goal 1: Americans Understand That Mental Health Is Essential to Overall Health Recommendations 1.1 Advance and implement a national campaign to reduce the stigma of seeking care and a national strategy for suicide prevention 1.2 Address mental health with the same urgency as physical health Recommendations 1.1 Advance and implement a national campaign to reduce the stigma of seeking care and a national strategy for suicide prevention 1.2 Address mental health with the same urgency as physical health

10. Goal 2: Mental Health Care Is Consumer and Family Driven Recommendations 2.1Develop an individualized plan of care for every adult with a serious mental illness and every child with a serious emotional disturbance 2.2Address mental health with the same urgency as physical health Recommendations 2.1Develop an individualized plan of care for every adult with a serious mental illness and every child with a serious emotional disturbance 2.2Address mental health with the same urgency as physical health

11. Goal 2: Mental Health Care Is Consumer and Family Driven Recommendations 2.3Align relevant Federal programs to improve access and accountability for mental health services 2.4Create a Comprehensive State Mental Health Plan 2.5Protect and enhance the rights of people with mental illnesses Recommendations 2.3Align relevant Federal programs to improve access and accountability for mental health services 2.4Create a Comprehensive State Mental Health Plan 2.5Protect and enhance the rights of people with mental illnesses

12. Goal 3: Disparities in Mental Health Services Are Eliminated Recommendations 3.1—Improve access to quality care that is culturally competent 3.2—Improve access to quality care in rural and geographically remote areas Recommendations 3.1—Improve access to quality care that is culturally competent 3.2—Improve access to quality care in rural and geographically remote areas

13. Goal 4: Early Mental Health Screening, Assessment, and Referral to Services Are Common Practice Recommendations 4.1—Promote the mental health of young children 4.2—Schools should have the ability to play a larger role in mental health care for children Recommendations 4.1—Promote the mental health of young children 4.2—Schools should have the ability to play a larger role in mental health care for children

14. Goal 4: Early Mental Health Screening, Assessment, and Referral to Services Are Common Practice Recommendations 4.3—Screen for co-occurring mental and substance abuse disorders and link with integrated treatment strategies 4.4—Screen for mental disorders in primary health care, across the lifespan, and connect to treatment and support Recommendations 4.3—Screen for co-occurring mental and substance abuse disorders and link with integrated treatment strategies 4.4—Screen for mental disorders in primary health care, across the lifespan, and connect to treatment and support

15. Goal 5: Excellent Mental Health Care Is Delivered and Research Is Accelerated Recommendations 5.1—Accelerate research to promote recovery and resilience and, ultimately, to cure and prevent mental illnesses 5.2—Advance evidence-based practices (EBPs) using dissemination and demonstration projects and create a public-private partnership to guide their implementation Recommendations 5.1—Accelerate research to promote recovery and resilience and, ultimately, to cure and prevent mental illnesses 5.2—Advance evidence-based practices (EBPs) using dissemination and demonstration projects and create a public-private partnership to guide their implementation

16. Goal 5: Excellent Mental Health Care Is Delivered and Research Is Accelerated Recommendations 5.3Improve and expand the workforce providing evidence-based mental health services and supports 5.4Develop the knowledge base for… –Eliminating mental health disparities –Assessing long-term effects of medications –Reducing impact of trauma –Improving acute care Recommendations 5.3Improve and expand the workforce providing evidence-based mental health services and supports 5.4Develop the knowledge base for… –Eliminating mental health disparities –Assessing long-term effects of medications –Reducing impact of trauma –Improving acute care

17. Goal 6: Technology Is Used To Access Mental Health Care and Information Recommendations 6.1Use health technology and telehealth to improve access and coordination of mental health care, especially for Americans in remote areas or in underserved populations 6.2Develop and implement integrated electronic health record and personal health information systems Recommendations 6.1Use health technology and telehealth to improve access and coordination of mental health care, especially for Americans in remote areas or in underserved populations 6.2Develop and implement integrated electronic health record and personal health information systems

18. 18 Federal Partners for Transformation U.S. Department of Health & Human Services AoANIH/NIDA ACFNIH/NIMH AHRQHHS/OS - ASPE CDC - OCR CMS - OD - OPHS HRSASAMHSA IHS U.S. Department of Health & Human Services AoANIH/NIDA ACFNIH/NIMH AHRQHHS/OS - ASPE CDC - OCR CMS - OD - OPHS HRSASAMHSA IHS Other Partners Dept. of Education Dept. of Housing and Urban Development Dept. of Justice Dept. of Labor Social Security Adm. Dept. of Veterans Affairs White House Office of Faith-Based Community Initiatives

19. 19 SAMHSA A CCOUNTABILITY C APACITY E FFECTIVENESS Measure and report program performance Increase service availability Improve service quality V ision: A Life in the Community for Everyone M ission: Building Resilience and Facilitating Recovery for people with or at risk for mental or substance use disorders “One SAMHSA”

20. Each strand is individual and unique. Woven together they transform into a strong and mighty cloth.

22. 22 Major SAMHSA Initiatives  Implementing the Strategic Prevention Framework  Building Substance Abuse Treatment Capacity: Access to Recovery  Addressing Needs of Youth and Adults with Co-occurring Mental and Substance Use Disorders  Transforming the Mental Health System

23. 23 SAMHSA’s Children and Families Workgroup Membership: Membership: Key policy and program leadership for children across three Centers & OA: CMHS, CSAP & CSAT Purpose: Purpose: Align SAMHSA vision, goals and activities to improve the quality and availability of — that includes prevention, early intervention, and treatment —for children, with or at risk for mental and/or substance use disorders, and their families. Align SAMHSA vision, goals and activities to improve the quality and availability of a comprehensive, integrated continuum of services and supports — that includes prevention, early intervention, and treatment —for children, with or at risk for mental and/or substance use disorders, and their families. Action Plan

24. More grows in the garden than the gardener sows. ~ Spanish Proverb ~ More grows in the garden than the gardener sows. ~ Spanish Proverb ~

25. 25 SAMHSA Matrix Action Plans Children and Families Strategic Prevention Framework Mental Health Transformation Co-occurring Disorders Action Plans available online: www.samhsa.gov

26. 26 Children and Families two-year Action Plan – Selected TA Strategies Resource/toolkit on SA and MH screening for use in multiple settings TA document to help States use standardized screening tools Resource document on primary care/behavioral health interface: MH/SA screens of children 0 to 3 and their caregivers, and facilitated referrals

27. 27 Children and Families two-year Action Plan – Selected TA Strategies Pilot project, “Transforming, Linking and Caring (TLC),” links regional CMHS child-focused grantees to develop continuum of care Financing guide on strategies for integrating funding streams for SA and MH services and supports Prototype of individualized plan of care for children and their families

28. 28 Children and Families two-year Action Plan – Selected Grant Opportunities Create and award Child and Adolescent State Infrastructure Grants (SIG) Create new State Mental Health Transformation Grants (to include children and families, and build on Child and Adolescent SIG) Develop prototype grants to fund a State adolescent SA treatment coordinator to build State infrastructure and capacity for services integration

29. 29 Children and Families two-year Action Plan – Selected Collaborations Collaborate with Dept. of Education to expand school- based MH programs Collaborate with ASPE, ACF, CMS and Depts. of Education and Justice on eliminating practice of parents giving up custody for treatment National Child Traumatic Stress Initiative (increase outreach to build new collaborative partnerships)

30. 30 SAMHSA’s 4 Standard Grant Announcements Services Grants – provide funding to expand and strengthen effective, culturally competent mental health and substance abuse services Services Grants – provide funding to expand and strengthen effective, culturally competent mental health and substance abuse services Infrastructure Grants – support identification and implementation of systems/structures, but not designed to fund services Infrastructure Grants – support identification and implementation of systems/structures, but not designed to fund services Best Practices Planning & Implementation Grants– help communities and providers identify practices to effectively meet local needs, develop strategic plans for implementing/adapting those practices, and pilot- test practices prior to full-scale implementation Best Practices Planning & Implementation Grants– help communities and providers identify practices to effectively meet local needs, develop strategic plans for implementing/adapting those practices, and pilot- test practices prior to full-scale implementation Service-to-Science Grants – provide funds to document and evaluate innovative—but not yet proven effective–practices that address service gaps Service-to-Science Grants – provide funds to document and evaluate innovative—but not yet proven effective–practices that address service gaps Note: Some funding opportunities do not fit standard announcements; separate stand- alone grant announcements will be published in those instances

31. “Frisbeetarianism is the belief that when you die, your soul goes up on the roof and gets stuck..” ~ George Carlin ~ ~ George Carlin ~ “Frisbeetarianism is the belief that when you die, your soul goes up on the roof and gets stuck..” ~ George Carlin ~ ~ George Carlin ~

32. T = (V + B + A)  (CQI) 2

33. The Transformation Equation Transformation  (Vision  Belief  Action)  ( Continuous Quality Improvement ) 2 The primary strategy of the Child, Adolescent & Family Branch for transforming mental health involves helping states, local communities & tribal organizations build strong systems of care. Key elements of this strategy include: –Vision that provides direction for the work we do –Belief that guides the work we do –Action that is taken to make our vision and beliefs a reality; and –Continuous Quality Improvement which helps ensure that our actions reflect the wishes and needs of the community being served Transformation  (Vision  Belief  Action)  ( Continuous Quality Improvement ) 2 The primary strategy of the Child, Adolescent & Family Branch for transforming mental health involves helping states, local communities & tribal organizations build strong systems of care. Key elements of this strategy include: –Vision that provides direction for the work we do –Belief that guides the work we do –Action that is taken to make our vision and beliefs a reality; and –Continuous Quality Improvement which helps ensure that our actions reflect the wishes and needs of the community being served

34. Center for Mental Health Services Child, Adolescent and Family Branch Vision –All children and their families live, learn, work, and participate fully in communities where they experience joy, health, love, and hope. Mission –Through investment and partnerships in home and community-based systems of care, the Child, Adolescent and Family Branch promotes potential and the well-being of children and youth who have, or are at risk of having, a serious emotional or behavioral disturbance, and their families. Accomplished by… Embracing families and their cultures, Eliminating disparities and fostering cultural and linguistic competence, Establishing effective service delivery models, Collaborating with other public and private child-serving systems and organizations, and Ultimately transforming children’s mental health care across America. Vision –All children and their families live, learn, work, and participate fully in communities where they experience joy, health, love, and hope. Mission –Through investment and partnerships in home and community-based systems of care, the Child, Adolescent and Family Branch promotes potential and the well-being of children and youth who have, or are at risk of having, a serious emotional or behavioral disturbance, and their families. Accomplished by… Embracing families and their cultures, Eliminating disparities and fostering cultural and linguistic competence, Establishing effective service delivery models, Collaborating with other public and private child-serving systems and organizations, and Ultimately transforming children’s mental health care across America.

35. Context CASSP Program begins in 1993 A budget of 4.9 million in when the CASSP program was initiated. CASSP Program begins in 1993 A budget of 4.9 million in when the CASSP program was initiated.

36. Children’s Program Federal Funding Fiscal Year (FY) 2004 budget: $102,353,000 Context

37. Eastern Kentucky North Carolina (10 counties) California 5 (Santa Cruz, San Mateo, Riverside Ventura, & Solano Counties) Vermont 1 (statewide) Lyons, Riverside, & Proviso, IL Bismarck, Fargo, & Minot, ND Northern Arapaho Tribe, WY Sault Ste. Marie Tribe, MI Rhode Island 2 (statewide) Hillsborough County, FL Charleston, SC King County, WA Clark County, WA Clackamas County, OR Vermont 2 (statewide) Passamaquoddy Tribe, ME Rhode Island 1 (statewide) Maine (4 counties) Edgecombe, Nash, & Pitt Counties, NC Alexandria, VA Baltimore, MD South Philadelphia, PA Mott Haven, NY Detroit, MI Northwoods Alliance, WI Milwaukee, WI Navajo Nation Sacred Child Project, ND San Diego County, CA Napa & Sonoma Counties, CA Lane County, OR Santa Barbara County, CA Greenwood, SC West Palm Beach, FL Contra Costa County, CA Birmingham, AL North Carolina (11 counties) Oglalla Sioux Tribe, SD Lancaster County, NE Willmar, MN Pima County, AZ Marion County, IN Charleston, WV Montgomery County, MD Delaware (statewide) Burlington County, NJ Westchester County, NY Worcester, MA New Hampshire (3 regions) Gwinnett & Rockdale Counties, GA System-of-Care Communities of the Comprehensive Community Mental Health Services Program for Children and Their Families United Indian Health Service, CA Nebraska (22 counties) San Francisco, CA Clark County, NV Rural Frontier, UT Denver, CO Las Cruces, NM Wichita, KS Parsons, KS Travis County, TX u u u u u u u u u u u u u u u u u u u Sacramento County, CA Glenn County, CA Colorado (3 counties) El Paso County, TX u Oklahoma Ft. Worth, TX Choctaw Nation, OK St. Charles County, MO Missouri Broward County, FL Connecticut (statewide) Washington, DC u New York, NY Lake County, IN Illinois (Chicago area) Idaho Wai'anae & Leeward, HI Fairbanks, AK Yukon Kuskokwim Delta Region, AK Guam Puerto Rico Oakland, CA Monterey County, CA Four Counties, OR u Allegheny County, PA Southern Consortium & Stark County, OH Cuyahoga County, OH Jackson, MS St. Louis, MO Nashville, TN Louisiana (5 parishes) 3 counties & Catawba Indian Nation, SC 9-1-93 4 2-1-94 7 9-1-94 9 11-1-94 2 9-1-97 9 10-1-98 13 DateNumber u u u Funded Communities 11-1-98 1 9-30-99 20 5-1-00 1 7-1-00 1 10-1-02 18 9-30-03 7 u DateNumber Montana Iowa Arkansas

38.  Ninety-six systems of care grants and cooperative agreements funded since 1993  Each community funded for 6 years  Forty-five communities have completed federal funding phase (graduated) Context: System of Care Development Efforts

39.  Forty-eight States impacted by the Children’s Program  364 counties served by the Program since 1993  Number of children served: More than 60,000 Context: System of Care Development Efforts

40. Philosophy of the Program  Driven by the needs and preferences of the child and family;  Addressed through a strength-based approach;  Focus and management of services occurs in multi- agency and community base;  Services, partners and programs are responsive to cultural characteristics of the populations served and:  Families are partners in all phases of the program.

41. Systems of Care as a Transformation Strategy Relentless customer focus Beliefs + Actions x (CQI) 2 Family Involvement Technical Assistance Research System of Care Transformation Cultural Competence Site Improvement Youth Involvement Moving from family involvement to family driven Fully embracing youth involvement Opening the data set Establishing key benchmarks Recovery, resilience, prevention - defining how systems of care contribute Integrating technical assistance activities Moving from concept to reality. Tools & strategies Improving the site visit process Council on Collaboration and Coordination Family driven

42. Funded Communities: Transforming Systems of Care Integrated & Coordinated Technical Assistance Transformation Leadership Research Agenda Family Driven Youth Guided Reducing Disparities Continuous Quality Improvement Approach Council on Coordination & Collaboration Priority Focus Areas

43. Council for Coordination & Collaboration Priority Focus Areas 1.Continuous quality improvement Ensuring the quality of outputs and outcomes of the sites, the partners and the Council. 1.Continuous quality improvement Ensuring the quality of outputs and outcomes of the sites, the partners and the Council.

44. Council for Coordination & Collaboration Priority Focus Areas 2. Leadership to transform children’s mental health Synthesizing “lessons learned” regarding best practices for organizing and implementing mental health services to children and their families with a focus on practical outcomes of care. Strengthen overall program goals and activities. Move from “good” to “great.” Define recovery and resilience for children and families. 2. Leadership to transform children’s mental health Synthesizing “lessons learned” regarding best practices for organizing and implementing mental health services to children and their families with a focus on practical outcomes of care. Strengthen overall program goals and activities. Move from “good” to “great.” Define recovery and resilience for children and families.

45. Council for Coordination & Collaboration Priority Focus Areas 3A. Family Driven Define “family-driven” Strengthen roles of families in systems of care Lessons learned about family involvement Further develop concept of family choice Develop concept of youth guided care 3A. Family Driven Define “family-driven” Strengthen roles of families in systems of care Lessons learned about family involvement Further develop concept of family choice Develop concept of youth guided care

46. Council for Coordination & Collaboration Priority Focus Areas 3A. Family Driven Define “family-driven” Strengthen roles of families in systems of care Lessons learned about family involvement Further develop concept of family choice Develop concept of youth guided care 3A. Family Driven Define “family-driven” Strengthen roles of families in systems of care Lessons learned about family involvement Further develop concept of family choice Develop concept of youth guided care

47. Council for Coordination & Collaboration Priority Focus Areas 3B.Youth Guided Develop National Youth Development Board Protocols and orientation for youth attending local and national meetings 3B.Youth Guided Develop National Youth Development Board Protocols and orientation for youth attending local and national meetings

48. Council for Coordination & Collaboration Priority Focus Areas 4. Reduce disparities and enhance cultural and linguistic competence among policy-makers, administrators and service providers Emphasize essential role of cultural & linguistic competence in achieving the vision & mission of the Branch and the Program. Enhance organizational capacity for cultural and linguistic competence. 4. Reduce disparities and enhance cultural and linguistic competence among policy-makers, administrators and service providers Emphasize essential role of cultural & linguistic competence in achieving the vision & mission of the Branch and the Program. Enhance organizational capacity for cultural and linguistic competence.

49. Council for Coordination & Collaboration Priority Focus Areas 4. Reduce disparities and enhance cultural and linguistic competence among policy-makers, administrators and service providers Increase awareness and knowledge of factors that contribute to disparities. Develop specific approaches that contribute to the goal of eliminating disparities. 4. Reduce disparities and enhance cultural and linguistic competence among policy-makers, administrators and service providers Increase awareness and knowledge of factors that contribute to disparities. Develop specific approaches that contribute to the goal of eliminating disparities.

50. Council for Coordination & Collaboration Priority Focus Areas 4. Reduce disparities and enhance cultural and linguistic competence among policy-makers, administrators and service providers Support Branch efforts to implement principles and concepts of cultural and linguistic competence. 4. Reduce disparities and enhance cultural and linguistic competence among policy-makers, administrators and service providers Support Branch efforts to implement principles and concepts of cultural and linguistic competence.

51. Council for Coordination & Collaboration Priority Focus Areas 5. Develop a research agenda to enhance the understanding of how to develop and provide effective, efficient and coordinated services within systems of care. Priority list of research areas to guide the national evaluation Searchable electronic knowledge management system Infrastructure for supporting activities of a National Evaluation Data Users Group CQI report card 5. Develop a research agenda to enhance the understanding of how to develop and provide effective, efficient and coordinated services within systems of care. Priority list of research areas to guide the national evaluation Searchable electronic knowledge management system Infrastructure for supporting activities of a National Evaluation Data Users Group CQI report card

52. Council for Coordination & Collaboration Priority Focus Areas 6. Provide an integrated and coordinated approach to technical assistance to CMHS system of care sites Develop a single coordinated technical assistance plan and feedback mechanism to meet the needs of the community. Clarify for funded sites the roles and assistance provided by Federal Partners 6. Provide an integrated and coordinated approach to technical assistance to CMHS system of care sites Develop a single coordinated technical assistance plan and feedback mechanism to meet the needs of the community. Clarify for funded sites the roles and assistance provided by Federal Partners

53. Council for Coordination & Collaboration Priority Focus Areas 6. Provide an integrated and coordinated approach to technical assistance to CMHS system of care sites Develop peer-to-peer network Review strategies for reducing paperwork requirements of sites. Identify areas of duplication of effort. 8 Create CQI plan for Technical Assistance Partners – Consumer Technical Assistance Program 6. Provide an integrated and coordinated approach to technical assistance to CMHS system of care sites Develop peer-to-peer network Review strategies for reducing paperwork requirements of sites. Identify areas of duplication of effort. 8 Create CQI plan for Technical Assistance Partners – Consumer Technical Assistance Program

54. Individualized Plans of Care Identify and promote the development of guidelines for individualized planning of care that focus on developing comprehensive, consumer and family-driven service plans -with an outcome of recovery and resiliency - that cross various systems and funding sources.

55. Individualized Plans of Care Two-phase process –Phase I, SAMHSA/CMHS will identify evidence-based approaches to service planning and develop guidelines for the implementation of such models. –Phase II will include the convening of regional policy academies for State-based teams to encourage the implementation of such approaches and to refine the guidelines based on State experiences. Two-phase process –Phase I, SAMHSA/CMHS will identify evidence-based approaches to service planning and develop guidelines for the implementation of such models. –Phase II will include the convening of regional policy academies for State-based teams to encourage the implementation of such approaches and to refine the guidelines based on State experiences.

56. Individualized Plans of Care Collaboration –Collaboration between the CMHS Associate Directors for Consumer and Medical Affairs, and the Child, Adolescent, and Family Branch of the Division of Services and Systems Improvement along with consultation with the SAMHSA Medical Director. Collaboration –Collaboration between the CMHS Associate Directors for Consumer and Medical Affairs, and the Child, Adolescent, and Family Branch of the Division of Services and Systems Improvement along with consultation with the SAMHSA Medical Director.

57. Next Stage of Development for Transforming Systems of Care 1)Strengthen the language regarding implementing family involvement in systems of care. This includes asking applicants to operationalize how they will address “family-driven” care. 2)Include additional requirements regarding collaboration (e.g. identify priorities that are consistent with the Action Agenda, including Child Welfare and Juvenile Justice. 1)Strengthen the language regarding implementing family involvement in systems of care. This includes asking applicants to operationalize how they will address “family-driven” care. 2)Include additional requirements regarding collaboration (e.g. identify priorities that are consistent with the Action Agenda, including Child Welfare and Juvenile Justice. Collaboration Language

58. Next Stage of Development for Transforming Systems of Care 3)Develop specific requirements to ensure strong linkages between local systems of care and statewide transformation efforts. Require applicants to provide examples and develop a plan for how they will address this issue. 4)Require applicants to demonstrate how they will coordinate with other relevant federally funded initiatives, including the Mental Health Block Grant, Safe Schools, Healthy Students…etc. 3)Develop specific requirements to ensure strong linkages between local systems of care and statewide transformation efforts. Require applicants to provide examples and develop a plan for how they will address this issue. 4)Require applicants to demonstrate how they will coordinate with other relevant federally funded initiatives, including the Mental Health Block Grant, Safe Schools, Healthy Students…etc. Coordination Collaboration Linkages Language

59. Next Stage of Development for Transforming Systems of Care 5)Add language requiring the development of youth involvement and youth leadership. Require Youth Coordinator position. Youth involvement Coordination Collaboration Linkages Language

60. A problem can not be solved with the same consciousness that created it. ~ Albert Einstein ~