Block Grant comment update

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Network faithful - thanks to all who have sent in comments to SAMHSA about the 2014 Block Grant application. We are appreciative of the work the SAMHSA team put into responding to not only our questions, but the questions from others as well. The response log is 150 pages long but a worthwhile read. It gives you insight into the tenor of the approach on the part of SAMHSA to the block grant process. Download it here if you dare... And while your at it, download the updated block grant application.

Our thumbnail analysis is pretty simple:

SAMHSA is limited in what it is able to require versus encourage due to the authorizing legislation for the block grant. For us, that means we need to double our diligence to press for information in the areas that SAMHSA cannot. Most of our recommendations regarding the block grants are going to require shining a bright light at the state level - we can't expect SAMHSA to "require" transparency in the planning process to the level that we would like. So bottom line - it's on us folks to make sure that states are held accountable to ensuring an appropriate focus on children and adolescents with mental health challenges and their families. We will continue to push SAMHSA when appropriate, but in reality, our focus needs to be on what is taking place at the state level and in Congress. So hitch up your britches and be ready.

When the Block Grant application for 2014 is finalized there will be work group activity spearheaded by SAMHSA to address issues identified in the public comment period that ends today. We will keep you abreast as these work groups are formed and the process for public involvement.

SAMHSA responses to our comments
Let's start with some good news from our review of the proposed application. As you may remember, there were no sections on Children and Adolescent Behavioral Health in last year's application (there were random references scattered throughout). The current application is an improvement with the addition of a section on Child and Adolescents Behavioral Health Services section under Environmental Factors in the Introduction and the new Section O under the Behavioral Health Assessment and Plan. Here are excerpts from both sections:

The responses to our specific requests regarding the block grant that were sent to SAMHSA on September 7th are as follows:

Recommendation One: Full public transparency in all block grant planning processes
States and Territories will be required to post on a publicly accessible website the following information: Composition of membership of block grant planning committee - Website information shall include names of individuals, constituency and/or agency representation (family, youth, adult, etc).; Announcement of Block Grant meetings and inclusion of time for public comment - Announcements of block grant meetings will include encouragement for the public to attend. Block grant meetings shall include time on the agenda for public comment; and Process utilized for arriving at funding recommendations - The process used to develop and implement Block Grant funding decisions will be fully described.

Recommendation Two: Equity in funding between child and adult mental health services
Block grant plans will exhibit equity in funding for children's mental health services that is proportional to each state's child/youth population at a minimum but also takes into account level of need of children and youth with serious emotional challenges and their families.

Recommendation Three: Comprehensive Care Coordination
Comprehensive care coordination for children and youth with serious emotional challenges and their families will be considered a funding priority.

Recommendation Four: Wraparound Child and Family Teams
Wraparound Child and Family Teams will be supported as the vehicle to develop family-driven and youth-guided plans to further coordinate a family driven, youth guided, comprehensive community-based ongoing service planning and implementation process.

Recommendation Five: Agency Contracts Must be Monitored
Contracting between the state and local entities must include language and conditions that support the active utilization of Wraparound Child and Family Teams, Care Review, as well as other areas that support system of care principles. The responsible organization must monitor all service provider organizations to ensure adherence to active utilization of wraparound child and family teams and care review.

Recommendation Six: Family and Youth Partners
Specific funding strategies will be identified to support youth and family support like Family Partners or Youth Peer Support who provide informal care coordination, navigation, engagement and linkage to services for children, youth and families.

Recommendation Seven: Care Review Process
A community based Care Review process must be in place with active representative participation and responsibility from all major child-serving agencies, organizations, youth and families.

Recommendation Eight: Family-Driven and Youth-Guided
Plans will embrace a family-driven and youth-guided approach, which requires among other things:

Stigma reduction - A clear plan to reduce stigma and engage in community-based health promotion activities; and

Family and youth involvement in Governance - Clear evidence of parents and youth involved in local governance around the design and delivery of services and supports to youth with emotional challenges and their families.

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