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4/2/24 - We invite all BHC voting members to please register your formal vote at this link:  https://forms.gle/YjdrRzxLqbZ1QXQX6

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Attendees:   Jim Novelli, DBH; Dunia Faulx, JHC; Gabbie Caudill, BiR; Chief Bret Black, EJFR; Peggy Webster, Housing Project Manager, OlyCAP; Karen Bondurant, Property Manager, OlyCAP; and Dan Taylor, CFO, DBH.

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Goal 1: Service Delivery Establish and/or expand coordinated and comprehensive substance use disorder (SUD) treatment and recovery services.

Goal 2: Workforce Develop a responsive SUD workforce, which includes both peers and clinical providers with diverse scopes of practice.

Goal 3: Supportive Services Establish and/or enhance coordination with supportive social services to ensure that rural individuals and families impacted by SUD have the greatest opportunity possible for sustained, long-term recovery.

Goal 4: Sustainability Develop innovative, multi-sectoral approaches to ensure the continued availability of RCORP-Impact supported services in the target rural service area.

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Application Due May 6, 2024

Approximately 16 grant awards

Up to $750,000 per year

The program and estimated awards depend on the future appropriation of funds and are subject to change based on the availability and amount of appropriations.

Cost sharing/match not required

Period of performance:

September 1, 2024 to August 31, 2028 (4 years)

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Jefferson County Sheriff re: Navigator Requirement

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Jefferson County Sheriff re: Navigator Requirement

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Q: Can a staff member at the sheriff's office, specifically a navigator, count towards the required staff for the program?

A: Yes, existing navigators can fulfill required staff roles. It does not need to be a separate navigator dedicated solely to the program, but the grantee must ensure appropriate FTE allocation without supplanting funds.

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Q: Will this funding opportunity be available again next year or in future years?

A: The availability of future funding opportunities for the RCORP grant will depend on budgetary considerations, and at that time. The HRSA Rep, Sarah O'Donnell could not confirm future competitions or the availability of the grant in upcoming years. She mentioned the need to wait for the FY 24 budget to understand better what might happen in FY 25 and 26, but they anticipated that the RCORP impact would likely be competed at regular intervals, although the exact timing wasn't specified.

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Sarah O'Donnell noted the requirement for grantees to significantly expand or add new services that impact more people. She mentioned that awardees are expected to establish new or significantly expand substance use disorder treatment and recovery service lines, either by creating entirely new services or significantly expanding existing ones within the target rural service area. This expansion or establishment of new services should be comprehensive and is aimed at increasing the number of individuals receiving these services throughout the duration of the grant period.

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Sarah O'Donnell noted applicants must specify the direct treatment and/or recovery services that the network will deliver in every rural and partially rural county included in the target rural service area. This requirement ensures that there is a collaborative effort to provide comprehensive services across multiple counties within the rural service area.

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1. Question on HRSA's Preference

Question: Does the Health Resources and Services Administration (HRSA) prefer applicants who have not been previously funded, or are past recipients considered equally?

Answer: There's no funding preference related to previous awards. All applicants are judged equally based on their application merits.

2. From a tribal health clinic in rural Alaska

Question: For a tribal health clinic that already provides Medication-Assisted Treatment (MAT) and wants to expand services with a mobile clinic within tribal boundaries, how should the grant be written, considering the unique operational constraints within tribal areas?

Answer: This question is best handled through direct communication with the program's support team via the rural opioid response inbox for more specific feedback.

3. General Inquiry about Availability of Presentation Slides

Question: Will the presentation slides be available after the webinar?

Answer: Yes, the slides will be made available. Interested parties should email the rural opioid response inbox to receive them.

4. Anonymous Question on Direct Service Delivery

Question: Do grantees have to deliver direct services, or is this only required for the network?

Answer: Direct services must be delivered, potentially through contracts with network members who have the capacity for treatment.

5. Question about Network Partners

Question: Are distinct departments within a county considered as separate network partners or as one entity?

Answer: Network partners are considered as organizations, not counties, and should be separately owned entities within the county.

6. Question on Syringe Purchase Ban

Question: Is there a universal ban on purchasing syringes, or does it only apply to syringes for injecting illicit drugs?

Answer: Generally, syringes are not an allowable purchase, but for specific inquiries, it's suggested to send an email for further discussion.

7. Question on Treatment and Recovery Services in Service Area Counties

Question: Is it necessary to deliver both treatment and recovery services in every county, or can they be provided in separate counties as long as all services are covered across the service area?

Answer: It's acceptable to provide different services in different counties as long as all types of services are covered across the entire service area.

8. Question on Including Tribal Nations in Service Area

Question: Can tribal nations be included in the service area even if services are not delivered on reservation lands?

Answer: Tribal nations can be included in the service area, but there might be discussions around rural requirements which can be addressed via direct communication.

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Link to Informational Webinar Zoom Recording

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Link to Informational Webinar Zoom Recording

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306 attendees were noted.

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1. Welcome and Brief Overview (5 minutes)

2. Rapid Stakeholder Insights (10 minutes)

3. Identifying Shared Goals (10 minutes)

4. Brainstorming and Next Steps (10 minutes)

5. Wrap-Up and Commitments (5 minutes)

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Go to this link for the 3/22 meeting video: https://youtu.be/izFPCjypL9U  

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I invite those whose perspectives are represented in the attached meeting notes - take a moment to review how your perspective has been summarized. Let me know any updates or refinements you'd like me to incorporate ASAP, and I'll update the narrative in the document and put the updated document here on the padlet.

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Community Support: Notable figures like Chief Black and Dunia expressed strong support for the project, with Chief Black notably snapping Jim Novelli out of his chair with his enthusiasm and commitment to writing a letter of support if the project moves forward.

Acknowledged Need: All participants recognized the need for the proposed services within the community, indicating a shared understanding of the challenges faced by community members with substance use disorder and/or mental health issues.

No Infrastructure Changes Required: Jim Novelli mentioned that the proposed project wouldn't require any infrastructural changes, only possibly more staffing. This could make the project more feasible and attractive since the initial setup costs could be lower.

Existing Facilities and Services: The discussion highlighted that there are already facilities and services that could be leveraged for the project, such as the available space for providing services and the ability to provide meals through an existing kitchen. This existing infrastructure supports the feasibility of the project.

Potential for Future Funding: While discussing the broad strokes of the project, there was a mention of the possibility that, even if this particular grant isn't pursued now, the planning and discussions could lay a foundation for future funding opportunities.

Broad Consortium Support: Despite some absences, there was a good turnout for the meeting with various stakeholders from different sectors, indicating a broad base of potential support for pursuing the grant.

Opportunity for Strategic Planning: The discussions also touched on the idea of using the grant application process as a strategic planning exercise to further refine the project idea, even if the grant is not immediately pursued.

These considerations reflect a cautious optimism about the potential benefits of the project and the grant, focusing on community support, existing resources, and the strategic value of planning for future opportunities.

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The considerations mentioned for potentially declining to pursue the RCORP-Impact grant funding include:

Data and Demand Concerns: There were questions about whether there is sufficient data to demonstrate a clear need for the services proposed. Specifically, there were concerns about the ability to provide evidence showing enough people would need the service to justify the cost.  We would need that data compiled quickly to pursue the RCORP-Impact grant.

Resource and Time Constraints: While supporting the approached outlined in the discussion, doubts were expressed about the BHC’s  capacity to compile the necessary application materials and data within the given timeline, indicating it would be a significant undertaking requiring time and resources they might not have readily available.  (True for Lori, Jefferson Healthcare, possibly others?)

Infrastructure and Staffing: While it was noted that the project wouldn't require infrastructural changes, there was a mention of possibly needing to hire more staff, which could be a resource constraint.

Future Planning and Readiness: There was a suggestion that even if the grant was not pursued at this time, continuing to meet and plan would be beneficial. This suggests a preference for ensuring thorough preparation and alignment before committing to a grant application.

Broad Strokes and Need for Detail: The discussions so far have been broad, and there's an acknowledgment that more detailed planning and understanding are needed. This might indicate a need for more groundwork before pursuing funding.

Operational Complexities: There may be potential operational complexities, particularly concerning service provision and partnership roles, which might complicate grant application or project implementation.

These considerations highlight a cautious approach, emphasizing the need for thorough preparation, clear demonstration of demand and capacity, and strategic planning before pursuing significant grant funding.

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The BHC could consider developing a strategic plan around the concepts discussed by Jim Novelli, even without immediate pursuit of the RCORP-Impact grant. Steps the BHC might consider to prepare for future funding opportunities include:

1. Needs Assessment and Data Collection

Conduct a comprehensive community needs assessment to identify the specific behavioral health challenges, including substance use disorders and mental health issues.

Gather data on current service gaps, demand for services, and the potential population that could benefit from programs like PHP and AOT.

2. Stakeholder Engagement

Engage a wide range of stakeholders, including mental health professionals, law enforcement, judicial representatives, community organizations, and individuals with lived experience, to gather insights and build support.

Host workshops or forums to discuss needs, potential interventions, and collaborative opportunities.

3. Review Best Practices and Models

Research and review evidence-based models and best practices in community-based mental health services, including PHP and AOT, to identify adaptable approaches.

Consider site visits or consultations with established programs to gain practical insights.

4. Resource and Capacity Evaluation

Assess the BHC's current resources and capacities, including staffing, infrastructure, and partnerships, to determine what is needed to implement proposed programs.

Identify potential barriers and strategies to address them, such as training needs or infrastructure improvements.

5. Program Design and Planning

Develop detailed program plans for proposed services, outlining service delivery models, patient pathways, and integration with existing services.

Consider the legal, ethical, and operational implications of PHP or even AOT, ensuring alignment with local regulations and community values.

6. Financial Planning and Sustainability

Develop a financial model for proposed initiatives, identifying potential funding sources, estimating costs, and considering sustainability.

Explore partnerships with local government, foundations, and private funders to diversify funding streams.

7. Pilot Projects and Evaluation

Consider launching pilot projects to test the feasibility and effectiveness of proposed services, allowing for adjustments before full-scale implementation.

Establish robust evaluation frameworks to assess outcomes, impact, and areas for improvement.

8. Community Education and Advocacy

Implement community education campaigns to raise awareness about mental health issues, the value of proposed services, and the importance of community support.

Advocate for policy changes or funding at local, state, and federal levels to support behavioral health initiatives.

9. Grant Readiness

Develop a grant readiness strategy, including a grant prospect database, templates for common application sections, and a timeline for grant opportunities.

Build relationships with potential funders and stay informed about grant opportunities aligning with the BHC's strategic goals.

10. Strategic Review and Adaptation

Regularly review the strategic plan in response to emerging needs, funding opportunities, and program outcomes, allowing for adaptability and growth.

By following these steps, the BHC can lay a strong foundation for future initiatives, ensuring readiness to pursue funding opportunities that align with community needs and strategic goals.

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Brent Simcosky from Jamestown has not connected back with Dunia as yet.

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Partial Hospitalization Program (PHP)

Intensity and Structure: PHPs are intensive outpatient programs that provide a high level of care, typically including several hours of therapy per day, several days a week.

Voluntary Participation: Individuals usually choose to participate in PHP voluntarily, although they might be strongly encouraged by healthcare providers or family members.

Setting: While PHPs offer intensive care, participants return home at the end of the day, allowing them to maintain some normalcy in their daily lives.

Services Offered: PHPs often include a wide range of therapeutic services, such as individual and group therapy, medication management, and sometimes educational and vocational training.

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Assisted Outpatient Treatment (AOT):

Legal Framework: AOT involves a legal process where a court mandates outpatient treatment for individuals with severe mental illness who, due to their condition, are unlikely to voluntarily seek or maintain treatment.

Involuntary Participation: Participation in AOT is typically not voluntary, as it's court-ordered for individuals who meet specific criteria, such as a history of repeated hospitalizations or arrests due to untreated mental illness.

Community-Based Care: AOT is designed to ensure individuals receive necessary mental health services within their community, aiming to improve their quality of life and reduce the need for hospitalization.

Monitoring and Enforcement: AOT programs include mechanisms for monitoring compliance with treatment plans, and there can be legal consequences for non-compliance, though the emphasis is on providing care and support rather than punishment.

While both PHP and AOT aim to provide effective mental health treatment outside of the hospital setting, PHP is more about intensive therapeutic care on a voluntary basis, and AOT involves court-ordered treatment to ensure individuals with severe mental illnesses receive necessary care in the community.

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The discussion centered on the consortium's readiness, the adequacy of data or lack thereof, and the strategic fit of the grant. Concerns were raised about the capacity to compile a competitive application and the necessity of strategic planning. The consensus leaned towards postponing the grant application in favor of strategic preparation for future opportunities.