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Local Project Pilot Sites
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The largest of Oregon’s SIG grant has been awarded to four Oregon communities to improve local behavioral health systems of support for young children. These communities will bring traditional behavioral health and other efforts and will create a comprehensive, collaborative approach to identifying risks and providing supports. These four “pilot projects” will effectively integrate behavioral health services in settings commonly used by families with young children. The four Oregon Communities and their targeted areas are:
Klamath Tribes - Project Pilot Site
Description The Klamath pilot project will be conducted by Klamath Tribal Health and Family Services in partnership with Klamath County Mental Health. The project will target two populations historically underserved in traditional behavioral health services: descendents and other “family” within the Klamath Tribes, and a similar population drawn from the Hispanic/Latino community accessed migrant and traditional Head Start programs.
A unique and historic partnership between Klamath Tribes and Klamath County Mental Health has been formed to increase collaboration between tribal and non-tribal systems of care. While an array of services has been available in the community, the systems have been poorly integrated and the ability of non-traditional child serving providers to access other systems has been dependent on personal knowledge or relationships - not need. Cultural, language and legal barriers, along with trust, have often compounded the barriers.
Under the pilot project, the existing “Klamath Family Partnership” will be expanded to include a broad-based coalition of parents, child-serving providers andschools to focus on young children. The Klamath Family Partnership will provide service coordination, policy development, data-driven planning, decision support and quality oversight for the entire behavioral health prevention and treatment system. Program components of all agencies will be expanded to include families in the policy and program development and evaluation stages. In addition, evidence-based principles will be used to:
The Klamath Tribal pilot project will involve Oregon Child Development Coalition (Migrant Head Start and Klamath Family Head Start), Klamath Youth Development Center, and Cascade Comprehensive Care. It will target children in the communities of Malin, Merrill, Bonanza and Chiloquin.
Lake County - Project Pilot Site
Description Lake County’s SIG project will train and locate a “screening specialist” in each primary care setting in the county to conduct behavioral health risk screening and to train staff in each setting. The project will use the Parents’ Evaluation of Developmental Status to screen 300 children for behavioral health risks and provide well-child visits in two primary care offices. In addition, an “Early Intervention/Family Coordinator” (EIFC) will be placed at the medical center and primary care offices. This EIFC will work with families in their homes to develop an individualized follow-up plan to serve and support children/families screened positive for behavioral health risks (an estimated 60-120). Individualized follow-up services will include alcohol and other drug treatment, mental health counseling, in-home training, parent education, psychiatric consultation and evaluation or other services as needed. These follow-up services will be provided in client homes and other non-traditional settings, outside of behavioral health offices.
In addition, Lake County will create a coalition, meeting monthly, of traditional and non-traditional behavioral health providers to strengthen the connection between health care, behavioral health and non-traditional providers, including family members. It will be the responsibility of this coalition to design and develop procedures, policies, data collection and other infrastructure tools that will sustain the screening and service coordination protocols after the end of the grant.
Lake County’s pilot project is a collaboration between Lake County Mental Health run by Lutheran Community Services Northwest and the Oregon Rural Practice-based Research Network at OHSU.
Lane County - Project Pilot Site
Description Lane County’s project will integrate family support including wraparound funds, non-traditional site staff training, onsite mental health and substance abuse consultation for non-traditional providers, linkages to community-based treatment and a systems change approach to ensure that policies, procedures and protocols are developed and integrated into an early childhood and behavioral health systems.
LaneCare (the local mental health organization) and Lane Family Connections (the local child care resource and referral organization) will provide training to early childhood providers on screening and referral as well as prevention and intervention related to behavioral health. Therapists will provide onsite substance abuse and mental health consultation and services at child care and other early childhood sites. LaneCare will train Oregon Health Plan panel providers to increase their skills at serving young children. A collaborative multi-disciplinary team will create and implement a system of care for children and families with behavioral health problems. As a result, behavioral health will be added as a dimension of all existing early childhood services. Protocols, procedures and policies will be designed to address the following areas:
The Lane County pilot project will target South Lane County, including the communities of Cottage Grove and Creswell and surrounding rural areas. The project involves a collaboration of Lane County Health and Human Services, LaneCare, Family Relief Nursery, Lane Family Conenctions, South Lane Family Resource Center and Head Start.
Washington County - Project Pilot Site
Description Washington County will take a multi-faceted approach to their pilot project. The county seeks to build sustainable capacity in the behavioral health as well as the early childhood system, to identify children and families with behavioral health concerns and to develop pathways to culturally appropriate prevention, early intervention and treatment services in settings where children and families spend time, such as Head Start centers or health clinics. The initiative is consistent with findings of needs assessments and system development goals that emerged from multiple recent community planning efforts.
Key elements of this initiative will include: Systems Change: A system design workgroup will be established to help guide the project. The workgroup will identify system barriers that impede project implementation that may deter families from accessing behavioral health services, or that may restrict treatment providers from providing services in familiar settings for families in culturally appropriate and relevant ways, and identify strategies to address barriers identified. The workgroup will be composed of parents from partner programs, staff from the county mental health office, line and administrative staff from partner early childhood programs and behavioral health programs.
Staff Training and Development: A consistent theme is the need for staff training and development for behavioral health professionals and early childhood program staff to increase community capacity to support children’s development and respond to behavioral health concerns. For behavioral health staff, training will include increasing knowledge of early childhood mental health and treatment approaches; increasing capacity to provide treatment in non-traditional settings; increasing cultural competence in addressing how culture influences child rearing, perceptions of behavioral health, and approaches to addressing behavioral health in diverse cultures. For early childhood staff, training will include increasing familiarity with behavioral health issues in young children and families; screening and referral to treatment; establishing environments that support children’s positive social-emotional development, strategies to identify and address emergent behavioral concerns; engaging parents as partners in children’s development and responding to concerns; increasing cultural competence in addressing such areas as how culture influences child rearing practices, perceptions of behavioral health, etc.
An additional focus on staff training and development for this project relates to the lack of bilingual-bicultural early childhood staff and behavioral health staff and clinicians. Therefore, a key element will be investing extensively in the training and staff development of two paraprofessional parent educator/mental health promotoras and to support access to higher education and career advancement in the behavioral health field.
Parent Education: The need to expand capacity to offer evidence-based parent education and support has also consistently been identified in Washington County community planning processes. In several projects, the county has implemented the Incredible Years curriculum with good results. We seek to further expand capacity to offer this curriculum, particularly within the Latino community. Additionally, we seek to build capacity to offer this parenting in the settings where families are already actively engaged in programming and services in Head Start centers and Virginia Garcia health clinic sites. Staff from these programs will be trained as co-facilitators to build capacity to continue offering the classes as this grant ends.
Mental Health Promotoras: Increasingly, the concept of health promotoras to provide health education, screening and support to under-served populations to increase access to essential health services is being tested as a model to increase access to needed behavioral health services for under-served populations. Research in New Mexico, and elsewhere, has found this to be an effective approach, particularly with the Latino population. Mental health promotoras were found to help address cultural and linguistic barriers and the stigma associated with mental health treatment. Mental health promotoras are paraprofessional staff who serve as bridges between cultures and languages and between early childhood and behavioral health, and they help prepare families for participation in parenting education and treatment services, and they help systems and families better understand each other in order to effectively address the behavioral health concerns of families with young children.
Washington County’s pilot project is a collaboration between the county, the Virginia Garcia Memorial Health Center, and the Oregon Community Development Corporation.
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