Kansas All-Hazards Behavioral Health Program Preparedness, Response, and Recovery For Kansas Communities

KAHBH Personnel Dr. Briana S. Nelson Goff, KSU/Family Studies & Human Services Charlie Griffin, KSU/Family Studies & Human Services Becky Rinehart, SRS Mental Health, Topeka Stephanie Wick, FSHS MS Student Anthony Walker, FSHS MS Student Michael Smith, Psychology Undergraduate Student Lizette Vargas, BRIDGES & DSP Undergraduate Student

“Behavioral Health” Mental Health + Substance Abuse

“It is important to remember that mental health intervention is a prompt and effective medical response to a bioterrorism attack. Early detection, successful management of casualties, and effective treatments bolster the public’s sense of safety and increase confidence in our institutions. Because the overriding goal of terrorism is to change people’s beliefs, sense of safety, and behaviors, mental health experts are an essential part of planning and responding.” Statement from the Conference Transcript: Responding to Bioterrorism: Individual and Community Needs, October 19-21, 2001

“Mental Health is the linchpin to an effective response.“ Statement from April 2005 TOPOFF 3 Exercise

All-Hazards = All-Hazards Disasters Bioterrorism Major Community Crises

State-Level Role of KAHBH During a disaster in Kansas, the Kansas Mental Health Authority through SRS collaborates with the Kansas Department of Emergency Management, Local Community Mental Health Centers, and FEMA in a Presidentially declared disaster FEMA has required each State to develop a crisis response plan in meeting the mental health and substance abuse needs at state and local levels, which are formally integrated into the State Emergency Operations Plan

KDHE established a contract with KMHA to provide funds for 1 year to coordinate the development and implementation of the All-Hazards Behavioral Health Plan –2 nd year began 1/06 In January 2005, Kansas Department of Social and Rehabilitation Services, Mental Health Authority, subcontracted with Kansas State University, School of Family Studies and Human Services The Kansas All-Hazards Behavioral Health (KAHBH) Project was developed through the subcontract

Event City Response County Response State Response KDEM Application National Disaster Presidentially Declared Disaster 60 Days 1) On-Site Command 2) Local Outreach workers 3) Supplies 9 Months If needed apply for Regular Services Program (RSP) Sources of Information -Red Cros -KEMA -Adjutant General’s Office -Cities - Newspapers - New Releases To Collect Data Per County -Casualties -Injured -Business -Schools -Homes -Homeless -Power -Food -Water Budget -Staff KMHA has 14 Days to Apply for Immediate Services Project (ISP) Behavioral Health Response to Presidentially Declared Disaster

FEMA/SAMHSA Crisis Counseling Assistance and Training Program

FEMA Crisis Counseling Assistance and Training Program Robert T. Stafford Disaster Assistance and Emergency Relief Act (P.L as amended) Interagency Federal Partnership Federal-State-Local Partnership

Organizational Partners in Crisis Counseling Program Community Mental Health Agencies State Mental Health Authority State Emergency Management Agency Federal Emergency Management Agency (Region and Headquarters) Center for Mental Health Services

Administrative Staff Community Program Managers State Disaster Mental Health Coordinator Governor’s Authorized Representative FEMA Crisis Counseling Coordinator FEMA Human Services Officer Federal Coordinating Officer FEMA Headquarters Crisis Counseling Coordinator CMHS Project Officer

Disaster Operations Structure

CCP Organizational Chart: Small Provider

CCP Organizational Chart: Large Provider

Examples of Crisis Counseling Program Services Outreach Screening and Assessment Counseling Information and Referral Public Education

Program Limitations Medications Hospitalization Long-term Therapy Providing Childcare or Transportation Fundraising activities Advocacy Case Management

Crisis Counseling and “Traditional” Behavioral Health Practice Primarily Office-Based Focus on Diagnosis & Treatment of Mental Illness Attempt to Impact Personality & Functioning Examines Content Encourages Insight into Past Experiences & Influence on Current Problems Psychotherapeutic Focus Primarily Home & Community Based Assessment of Strengths, Adaptation & Coping Skills Seeks to Restore Pre-Disaster Functioning Accepts Content at Face Value Validates Appropriateness of Reactions and Normalizes Experience Psycho-educational focus “Traditional” PracticeCrisis Counseling Source: ESDRB Program Guidance, December, 1996

FEMA/CMHS Crisis Counseling Program FY 2004 Grant Sites FEMA/CMHS Crisis Counseling Program FY 2004 Grant Sites FEMA 1479 TX (Hurricane Claudette) FEMA 1479 TX (Hurricane Claudette) FEMA 1437 LA (Flooding) FEMA 1437 LA (Flooding) FEMA 1492 MD (Hurricane Isabel)) FEMA 1391 NY 9/11 Terrorism FEMA 1391 NY 9/11 Terrorism FEMA 1474 WV (Floods) FEMA 1474 WV (Floods) FEMA 1506 SA (Cyclone) FEMA 1491 VA (Hurricane Isabel) FEMA 1498-CA (Fires) FEMA 1498-CA (Fires) FEMA 1475 KY (Severe Storms) FEMA 1475 KY (Severe Storms) FEMA 1501 PR (Storms & Flooding) FEMA 1501 PR (Storms & Flooding) FEMA 1322 AL (Tornado)

Summary The FEMA/CMHS Crisis Counseling Program works in conjunction with a number of organizational partners and administrative staff to provide services during disasters that differ from traditional mental health services

KAHBH Purpose KAHBH provides State-wide organization and coordination for behavioral health response to disaster and other all-hazards events Responsibilities of the KAHBH Project are outlined in 7 Primary Tasks

Key KAHBH Tasks Resource identification and collection Training and education Development of Annex to KEOP, KAHBH Plan, and Standard Operating Procedures State-wide network recruitment and coordination Preparedness, response, and recovery activities

KAHBH Trainings Core Behavioral Health Training –Began Dec 2005 –Based on SAMHSA/CMHS Training Manual –1.5 day training DAY 1 (approx. 8 hours) For all participants without CISM or ARC DMH training within the last 5 years (Mental health and paraprofessionals) –Module 1: Disaster Classifications and Phases –Module 2: Traumatic Reactions to Disasters –Module 3: Providing Support During Disasters –Module 4: Considerations for Special Populations, Cultural Competence, and Ethical Issues Day 2 (approx. 4) For ALL KAHBH Network members –Module 5: The FEMA/SAMHSA CMHS Crisis Counseling Assistance and Training Program –Module 6: The KAHBH Program: Preparedness, Response, and Recovery for Kansas Communities –Module 7: Behavioral Health and Crisis Response Interventions –Module 8: KAHBH Community Outreach Teams: Structure, Procedures, and Documents

Paraprofessional Training –All nonbehavioral health members/paraprofessionals –4 hours training on basic helping skills in crisis counseling The Role of the Helper Professional and personal boundaries Ethics, confidentiality, and dual relationships Communication Skills Challenges in Helping Diversity and multicultural awareness as a helper Helping in Crisis and Grief Situations

Future Specialty Trainings –To be based on each community’s needs –All non-mental health members will receive additional ½ day (4 hours) training on basic helping skills in crisis counseling –At least 2 members (1 MH and 1 NMH) from each area will receive specialized training in the following areas (to be provided online in 2-4 hour trainings): Children (under age 18) Frail Elderly Developmentally and physically disabled Severe Mental Illness and People in active Substance Abuse Treatment People in Correctional Institutions College Students in dorms/away from home/Families/individuals relocated People with high traumatic exposure People in poverty and homeless Roles of women in community (e.g. new moms, multiple caregivers) Men and Women Emergency responders involved in rescue/recovery Multicultural issues Farmers/Ranchers/Agricultural Workers/Rural Populations

Other Training 2005 All-Hazards Behavioral Health Symposium: Preparedness, Response, and Recovery in Kansas –October 6-7, 2005 –Kansas Highway Patrol Academy in Salina, KS

KAHBH Network 10 staff 15 Stakeholders 12 SRS Field Staff 29 CMHC Coordinators Goal: 200+ KAHBH Network members

KAHBH Stakeholder Supporting Agencies Kansas Department of Health & Environment, Office of Local & Rural Health, Topeka SRS Mental Health Authority, Topeka SRS Health Care Policy, Addiction & Rehabilitation Services, Topeka Kansas State University, School of Family Studies and Human Services, Manhattan University of Kansas School of Medicine, Department of Preventive Medicine & Public Health, Wichita Lawrence Therapy Services, Lawrence Mental Health Center of East Central Kansas, Emporia Regional Prevention Center, Olathe Mid-America Addiction Technology Transfer Center, Kansas City COMCARE, Wichita American Red Cross, Midway Kansas Chapter, Wichita Wyandot Center, Kansas City Association of Community Mental Health Centers of Kansas, Inc., Topeka Center for Counseling & Consultation, Great Bend Prairie View Behavioral & Mental Health Care, Newton ** Heartland Assessment Center, Roeland Park, KS ** **Resigned due to accepting positions in other states

KAHBH Plan and Standard Operating Procedures The initial Kansas All-Hazards Behavioral Health Annex has been drafted and submitted to the Kansas Department of Emergency Management (KDEM) to be reviewed and accepted into the Kansas Emergency Operations Plan. –KDEM acceptance currently is pending The State Plan will provide a detailed description of the behavioral health preparedness, response, and recovery in Kansas Preliminary drafts of the KAHBH Standard Operating Procedures have been developed and are to be reviewed by the SRS Contract Manager.

Preparedness Activities Response Activities Recovery Activities

The goal of KAHBH is to collaborate and work to coordinate all behavioral health services before, during, and after an all-hazards event in Kansas.

Organizations Involved in Disaster Response Federal –SAMHSA— Substance Abuse Mental Health Services Administration & CMHS— Center for Mental Health Services –FEMA— Federal Emergency Management Agency State –KDHE—Kansas Dept. of Health and Environment KDEM— Kansas Division of Emergency Management –SRS—Kansas Dept. of Social and Rehabilitation Services Local –Local emergency management agencies –CMHC— Community Mental Health Centers –Local professionals and para-professionals (substance abuse professionals, clergy, doctors/nurses, fire/police department, volunteers, etc.)

Role of KAHBH Network Members SAMHSA/CMHC Model Professionals and paraprofessionals working in teams Based on SRS CMHC Regions –27 total areas in Kansas

KAHBH is not: American Red Cross Disaster Mental Health Services Critical Incident Stress Debriefing

Network members should be: Indigenous to the communities they serve Possess varied experience Non-traditional methods Sensitive to cultural issues

KDEM KS Citizens State Plan

KDEM KS Citizens State Plan KAHBH

KDEM KS Citizens State Plan KAHBH State Stakeholders

KDEM KS Citizens State Plan KAHBH State Stakeholders American Red Cross

KDEM KS Citizens State Plan KAHBH State Stakeholders American Red Cross Education: Trainings, Universities, Conferences

KDEM KS Citizens State Plan KAHBH State Stakeholders Education: Trainings, Universities, Conferences American Red Cross Governor’s Bioterrorism Coordinating Council (SRS Mental Health Authority rep joined 4/04

KDEM KS Citizens State Plan KAHBH State Stakeholders Education: Trainings, Universities, Conferences American Red Cross Governor’s Bioterrorism Coordinating Council (SRS Mental Health Authority rep joined 4/04 County Data Bank

KDEM KS Citizens State Plan KAHBH State Stakeholders Education: Trainings, Universities, Conferences American Red Cross Governor’s Bioterrorism Coordinating Council (SRS Mental Health Authority rep joined 4/04 County Data Bank KS Train

KDEM KS Citizens State Plan KAHBH State Stakeholders Education: Trainings, Universities, Conferences American Red Cross Governor’s Bioterrorism Coordinating Council (SRS Mental Health Authority rep joined 4/04 County Data Bank KS Train Disaster Exercises

KDEM KS Citizens State Plan KAHBH State Stakeholders Education: Trainings, Universities, Conferences American Red Cross Governor’s Bioterrorism Coordinating Council (SRS Mental Health Authority rep joined 4/04 County Data Bank KS Train Disaster Exercises 1 st responders/ Critical Incident Stress Management

KDEM KS Citizens State Plan KAHBH State Stakeholders Education: Trainings, Universities, Conferences American Red Cross Governor’s Bioterrorism Coordinating Council (SRS Mental Health Authority rep joined 4/04 County Data Bank KS Train Disaster Exercises 1 st responders/ Critical Incident Stress Management