SAMHSA announced last week that the proposed funding for up to six new Statewide Family Network grants would not be made available due to budgetary constraints. Our phones have been ringing off the hook about this, as have the phones of a number of other children's mental health advocacy groups. Amidst the angst of realizing that the proposed size of the grants for 2014 had been raised to 98 thousand per year (for a lucky five recipients) only to see those dreams dashed due to the need to trim the budget, it is important to keep several factors in perspective. As the advocacy community moves forward with planning efforts to raise awareness about the importance of statewide family networks there are realities that need to be addressed and factored in to any planning efforts.
- We can't say we weren't warned, but it still hurts that families are taking it on the chin.
When the original announcement was made back in late December we posted it on our website. The language in the announcement was clear - "Funding estimates for this announcement are based on an annualized Continuing Resolution and do not reflect the final FY 2014 appropriation. Applicants should be aware that funding amounts are subject to the availability of funds." The cutting of these new grant awards serves as a good reminder that as advocates we can never really rest. The Statewide Family Network grants are the only grants funded by SAMHSA that focus on families who have children with serious emotional challenges. Yes, this one hurts and if there is a single question to be raised it would have to be about snipping at the heels of the only truly family-driven grant effort emanating out of SAMHSA.
- Forget 2014 - focus on the 2015 budget.
Now I am big believer in the motto "never say never" but the 2014 funding train has left the station so it is hard to imagine any change for this year. Think of this year as a great opportunity to mobilize for 2015 budget planning. It will be here sooner than you think.
- A swift kick in the pants is not always a bad thing.
The sudden cut of funding for new grants doesn't mean that statewide family network grantees should slink into the shadows. To the contrary, if this is the kick in the pants that was needed to get family organizations and those who care about the work of family organizations mobilized then in a strange sort of way this is a good thing. A number of national consumer and family organizations (whose members are direct recipients of many of the existing grants) are meeting to develop strategy and the Children's Mental Health Network stands at the ready to help in whatever way we can. Both the Federation of Families for Children's Mental Health and the newly formed Family Run Executive Leadership Association (FREDLA) should be front and center on this issue.
- Stop relying on SAMHSA!
I want you to think about it for a minute before you throw something at your computer screen. Federal funding for statewide family networks began in 1988 with 5 demonstration projects and has continued to evolve with the assistance of federal funding (meager as it may have been) to present day. At some point, Statewide Family Network grantees need to look to alternative funding strategies so that they don't get in the pickle of single-source funding that may or may not be available from year to year. To be clear, the funding from SAMHSA has been instrumental in helping family organizations get a foothold - one that may have never materialized if these grants had not been funded. But to rely on this source of funding as a make or break equation is foolhardy at best. This is a complicated discussion point and raises all sorts of equity questions but is a sustainability discussion Statewide Family Network grantees need to have - over and over again. Rest assured the Children's Mental Health Network has no problem chewin' on the ankles of SAMHSA to drive home a point when warranted, but the responsibility of sustainability works both ways. I strongly encourage those who are interested in the evolution of this grant program to read The History and Evolution of Statewide Family Organizations Addressing Children's Mental Health (Friesen, Koroloff, Anderson, 2005).
- Pack your toolkit with the essentials.
Way back in May 2013 (seems like yesterday) we focused on the joint Medicaid bulletin issued to states by the Centers for Medicare and Medicaid Services (CMS), along with the Substance Abuse and Mental Health Services Administration (SAMHSA) regarding "their options for structuring mental health benefits as part of an agency-wide effort to draw attention to behavioral health services." How many of you have read the bulletin? How many of you have acted on the recommended strategies we laid out, especially as it relates to youth and family involvement? We have to take the bull by the horn folks. If you want the concept behind this particular grant program to flourish (which is the bottom line intent of federal grants like this) then you can't passively wait for someone to do it for you. CMS and SAMHSA have actually given all of us a gift in that the joint memo provides an opportunity to open up dialogue with Medicaid about increasing the array of fundable services. I encourage you to revisit our Morning Zen post written back in May and begin strategizing how you can implement the recommended action steps.
Understand that I am not advocating that Statewide Family Networks provide these services but Statewide Family Networks should be at the forefront of advocacy efforts on behalf of increasing the array of effective services for youth with emotional challenges and their families. While some network grantees provide services and do so well, the overall intent of the grant program as originally designed is to strengthen the voices of families at the local and state level in areas of policy, program design and development.
The other document that you should know backwards and forwards is the recently released final rule on Home and Community-Based Services (HCBS). For those states that choose to pursue an HCBS waiver this final rule means great things for youth with emotional challenges and their families regarding the flexibility and opportunity to provide services and supports that are more closely aligned with what youth and families need, not necessarily what a particular provider has to offer. Click here to read the Morning Zen post written a few weeks back.
Being able to converse about these two documents ups your game and increases your credibility in state circles. Whether your state pursues these options are not, the point is that you can be the one bringing them up. You can be the one scheduling meetings with your state Medicaid Director to talk about how to improve services for youth and families. You can be the one to talk about the importance of sustaining family-driven efforts like the Statewide Family Network program beyond federal funding. These are but two tangible examples of how you can begin to leverage yourself into the funding conversation on behalf of your Network program.
- Read the tea leaves.
The days of being able to rely on a federal grant to fund a program year after year are over. Yes, the anger over the cutting of these new funds in what appears to be a disproportionate share of the overall cut is real and should be addressed with SAMHSA. But don't use all of your anger-driven energy to convince SAMHSA. Save some of it to fuel the discussion around the question "What if SAMHSA did not exist to give federal funds to Statewide Family Network efforts? What would we do then? That, to me, is the more important question. Fight the good fight with SAMHSA, but be equally prepared to fight the good fight with colleagues and those who espouse a family-driven and youth-guided approach at the local and state level.
Okay, so if you haven't unsubscribed from Friday Update just quite yet, let me share a final thought. I have had the amazing good fortune to have been involved with the Statewide Family Network grants in one way or another since their inception. I will never forget the constant juxtaposition of geography (i.e., Texas vs. Rhode Island vs. frontier Utah), disparities in income, existing access to services and cultural realities for those early grantees who were all getting the same meager amount of funding and being asked to do the same thing, regardless of the vast differences between funded states. It was an uphill climb then and it is an uphill climb today. But what remained inspiring then and continues today is the resilient spirit of family leaders across the country who continue to sacrifice, not of their own choosing, but of life's circumstances, on behalf of youth with emotional challenges and their families. We at the Network will continue to follow the developments with regard to the Statewide Family Network grants and will continue to highlight the important work they do. As well, we will continue to push us all to take a stratified approach to funding important initiatives like the Statewide Family Network grants.
President & CEO
Children's Mental Health Network