NH Department of Education(NHDOE), Bureau of Special Education Presentation by McKenzie Harrington-Bacote January 30,

During the summer of 2013 the U.S. Department of Health and Human Services’ Substance Abuse and Mental Health Services Administration (SAMHSA) released the Safe Schools and Healthy Students State Planning Grant Request for Applications (RFA) The NH Department of Education (NHDOE), in conjunction with the NH Department of Health and Human Services’ Bureau of Behavioral Health (BBH), the Laconia, Concord, and Rochester School Districts, submitted an application for this RFA titled NH Communities for Children. 2

Since 1999, the US Department of Health and Human Services, Education, and Justice have collaborated on the SS/HS Initiative. This grant program provided funding to local education agencies (LEAs) that worked in partnership with local law enforcement and juvenile justice, social service and mental health agencies, and other community organizations to plan and implement comprehensive and coordinated programs, policies, and services delivery systems that promoted the mental health of students, enhanced academic achievement, prevented violence and substance use, and created safe and respectful school climates. This is the first funding opportunity for SS/HS in four years and was prompted by the shootings that occurred in Sandyhook, CT. 3

SAMHSA’s Intent SAMHA’s Expectation The purpose of the SS/HS State Program is to create safe and supportive schools and communities by bringing the SS/HS model to scale at the state/tribe level by building partnerships among educational, behavioral health, and criminal/justice systems. By implementing this program, SAMHSA expects to achieve an increase in the number of children and youth who have access to behavioral health services; a decrease in the number of students who abuse substances; an increase in supports for early childhood development; improvements in school climate; and a reduction in the number of students who are exposed to violence. 4

SAMHSA required two state agencies to partner together for the submission of this grant, with a lead agency and a co-lead agency overseeing the work. SAMSHA required that each state select three (3), and no more or no less than 3, Local Education Agencies (LEAs) to partner with for the life of the grant. The 3 LEAs had to be selected prior to grant submission and the selection had to be based on student and community populations and district- wide data linked to the SS/HS elements. 5

Population Demographics (Concord & Laconia have the 2 nd and 3 rd largest refugee populations in NH) Free and Reduced School Lunch Eligibility Data Median Household Income Data Persons below the poverty line Data Gaps in Early Childhood Programs Gaps in Promoting Mental, Emotional & Behavioral Health Gaps in Connecting Family, Schools & Communities PBIS readiness in LEA schools Youth Risk Behavior Survey Results School Suspension Data Bullying and Harassment Data 6

All US States and Tribal Nations were eligible to apply SAMHSA received thirty-three (33) applications across the country, including NH’s grant proposal SAMHSA awarded seven (7) states a Safe Schools & Healthy Students State Planning Grant SAMHSA awarded $56.9 million to seven (7) states over four years in FY 13 to support safe schools and healthy students SS/HS Grant Awardees 1. New Hampshire 2. Connecticut 3. Nevada 4. Ohio 5. Pennsylvania 6. Michigan 7. Wisconsin 7

New Hampshire’s Department of Education (NHDOE) was awarded a four-year grant, beginning on October 1, 2013 for a total amount of $8.6 million over the life of the grant. Annually: 25% of the funding will be distributed to each of the three (3) LEAs = 75% total 10% will fund the required outside evaluator for the project 15% of the funding will go to the NHDOE and NH DHHS’ Bureau of Behavioral Health 8

Integrates 3 components: 9 1. The Five SS/HS Elements which comprise the core content areas to be addressed 2. Strategic Approaches which are the roadmap that ensures success in planning and implementation 3. Guiding Principals which are the values that connect the content and program areas of the SS/HS Framework with best practices for planning and implementation

Addressing each of the following elements in the grant was a requirement: 1. Promoting Early Social and Emotional Learning and Development 2. Promoting Mental, Emotional, and Behavioral Health 3. Connecting Families, Schools, and Communities 4. Preventing Behavioral Health Problems (including Substance Use) 5. Creating Safe and Violence Free Schools 10

11 Element One is intended to assist children (0–5) with the development of social and emotional skills that will lay the foundation for future healthy interpersonal relationships, association with nonviolent peers, and improved academic achievement. Because younger children are not yet enrolled in school, access to families and children and toddlers may be complex. For this reason, proposed activities should include ways to overcome barriers in identifying and serving children and families in need of services.

12 Element Two is intended to support enhanced integration, coordination, and resource sharing of mental, emotional, and behavioral services. SS/HS requires a partnership between schools and public mental health entities so that students and families can benefit from increased access to school- based universal prevention and early intervention services as well as the delivery of more intensive community-based mental health services.

13 Element Three is intended to link families, schools, and communities together to increase and improve the quality of their engagement in planning and implementing programs and activities that assist students. Integrated programs and services that link schools, families, and their communities improve school climate, provide family services and support, increase parents' skills, and connect families and students with others in the school and in the community.

14 Element Four is intended to address the prevention and reduction of risk factors associated with behavioral health problems, including substance use, in coordination with broader environmental strategies that address change not only at the individual, classroom, and school levels, but also at the family and community levels. SS/HS programs are expected to draw from the existing body of research on effective practices and strategies for reducing risk factors associated with behavioral health problems which can prevent substance use, and other risky behaviors, among children and youth. Such practices and strategies may include a combination of proven school-wide approaches that focus on universal prevention and target the whole school; selective interventions targeted at children and youth who show signs of potential drug involvement; or indicated interventions for youth already engaging in drug use.

15 Element Five is intended to identify and address issues, conditions, behaviors, and structures that contribute to unsafe school environments and violence in schools. The level of disruptive and aggressive behaviors of students and how schools respond to such behaviors is directly related to the potential for violence in a school.

GRANT PROPOSAL IS COMPRISED OF SIX OVERARCHING GOALS THAT EACH ADDRESS ONE OR MORE OF THE SS/HS ELEMENTS EACH GOAL CONTAINS MULTIPLE OBJECTIVES THAT OUTLINE MAJOR ACTIVITIES TO TAKE PLACE THAT WILL MEET THE OVERALL GRANT GOAL STATE LEVEL MANAGEMENT TEAM AND LEA LEVEL CORE MANAGEMENT TEAMS DEVELOPED 16

17 Create and sustain safe and supportive schools and communities and improve the social, emotional, and behavioral health outcomes for all children and youth by developing and sustaining a formal state- level collaborative cross-agency structure for identifying needs, implementing evidence-based practices, sharing and targeting data and resources, changing policy, and implementing cross-discipline professional development (Elements 1, 2, 3, 4 & 5).

Build an effective State Level Team and Core Management Teams in each LEA 18 Disaggregate statewide education and behavioral health data Use National Standards for Culturally & Linguistically Appropriate Services Identify & Target Resources Build a data collection & reporting system (evaluator) Use Realizing the Promise of the Whole-School Approach to Children’s Mental Health: A Practical Guide for Schools (SAMHSA 2012) to guide planning and collaboration efforts Conduct a needs assessment and environmental scan Develop the comprehensive plan

19 Substantially improve the social and emotional skills and preparedness for long-term educational success of young children, birth through five years, by facilitating cross-sector collaboration in each LEA among parents/caregivers and professionals serving expectant families and young children from birth through 3 rd grade and their families (Element 1).

Identify one Head Start & one Child Care Program in each LEA 20 Identify all early childhood programs in each LEA Promote participation in Watch Me Grow Train staff in screening & assessment of young children & their families in the areas of mental health well-being and trauma symptoms Create & implement LEA plan for cross- sector educational activities on evidence- based early mental health related interventions/practices Hire Early Childhood Coordinator at each LEA

21 Substantially improve the mental, emotional, and behavioral health of children and youth through early identification of needs and matching interventions to need by implementing of a continuum of positive, evidence-based behavioral health practices within a multi-tiered framework. This goal includes substantial reductions in school violence, bullying, behavior problems, suspensions, substance abuse and punitive/exclusionary discipline practices (Elements 2, 3 & 5).

Develop & Install Interconnected Systems Framework in each school in each LEA 22 Develop a LEA-level health workgroup that is responsible for assessing the behavioral health needs of the school’s population & developing formal agreements with local and regional providers Identify each school’s current level of PBIS implementation and development of a plan for implementation or improvement Identify existing data sources and the need for enhanced data systems (such as SWIS) Screen all students for emotional, behavioral, and substance abuse needs. Develop & deliver marketing, communication, & outreach campaigns that educate the community about mental health risk factors for behavioral health problems including substance use.

23 Schools are not typically equipped to identify or address the wide range of social or emotional needs of all their students. The Interconnected Systems Framework will provide a structured process for school staffs and community behavioral health providers to work together through the school’s multi-tiered PBIS framework. At the school-wide level, community experts in early childhood, mental health, and substance abuse treatment will be part of the school’s Universal Team to develop social/emotional expectations and behavior support for all students/children in the school. This may include student groups, parent trainings, presentations, and staff training. At the secondary level, community experts and providers work with the school’s Tier 2 (Behavior Support) Team to implement screening protocols, and develop interventions for students with specific emotional or behavioral support needs (such as a social skills group or group for students with anxiety disorders). Finally, at the tertiary level, individual services are provided in collaboration with community providers and families for students with the greatest social/emotional needs including individualized behavior supports, therapies, and wraparound planning.

24 The ISF structure is based upon the same principles as PBIS: Collaborative models Data-based Decision-making Strengths-based, positive social skills development Community-based, focus on community inclusion Family, student driven

Substantially improve the behavioral health outcomes and reduce the need for intensive treatment, out-of-home placement, hospitalization, or incarceration of children and youth in each region through partnership with the local community mental health center and NH’s System of Care, which will provide individualized wrap- around and evidence-based interventions for the highest-need children, youth & their families/caregivers (Element 2). 25

Provide wraparound and person-centered planning 26 LEA behavioral workgroup identifies children and youth who are at imminent risk of out-of-district, out-of-home placements or significant emotional or behavioral supports using education data and state Child Welfare screening process. Develop contract (0r modify) with the mental health center & other regional behavioral health providers to address specific high-need behavioral health concerns Establish formal relationship with regional juvenile justice office staff Provide or coordinate intensive level evidence- based treatment services (chosen from SAMHSA website list) for the highest need children, youth and families

27 Substantially improve the engagement of families and youth in decision-making at the policy, practice and individual levels by including and supporting family members and youth as members of the State Management Team, Core Management Teams, and individual child/family wraparound teams (Element 3).

Engage, involve, and strengthen the assets of family members, other caregivers, and youth. 28 Develop strong family involvement in decisions and implementation of state, LEA and regional work. Provide training in cultural competence and Systems of Care for all project staff and team members. Connect parents to school community through NH Connections programs at the NH Parent Information Center Develop youth leadership in every school through NH YouthMove Hold 2 school-wide events annually focused on diversity and cultural differences

Substantially reduce risk factors and strengthen protective factors at the individual, family and community level to reduce the prevalence of alcohol and other drug misuse among school aged children (Element 4). 29

Hire Student Assistance Program (SAP) Counselors at each LEA 30 Implement Project SUCCESS in middle and high schools (addressing lack of coordination of services as risk factors) & deliver prevention curriculum to middle and high school students Design and deliver culturally competent, incentivized parent education and outreach opportunities and materials with community-based partners that educate parents on risks of youth substance misuse and effective parent strategies Provide school based prevention and early intervention Develop & disseminate behavioral health & substance misuse information & messaging that challenge risk factors and strengthen protective factors through existing school and community channels Recruit and retain youth in resiliency programming during out-of-school time (e.g. afterschool programs)

Assessment Phase (includes Needs Assessment, Environmental Scan and Comprehensive Plan) Year 1 Implement -ation Phase (Comprehens ive Plan) Year 2 Implement -ation Phase (Comprehens ive Plan) Year 3 Implement - ation Phase (Comprehensi ve Plan) Year 4 31

Funding for Year 1 is restricted to essential staff for planning activities and development of comprehensive plan. Staff to be hired during Year 1: NHDOE Project Coordinator, BBH Project Co-Coordinator, LEA Project Managers RFP for contracted Evaluator SAMHSA does not allow funding during Year 1 for staff and partners who will be implementing the comprehensive plan’s activities Year 2 – 4: Implementation Phases Implementation of the State and LEA comprehensive plan Funding not restricted by SAMHSA and all required staff and partners will be funded Staff to be hired: NHDOE Educational Information Dissemination Coordinator, Early Childhood Coordinator at each LEA, Student Assistant Program (SAP) Counselors at each LEA (others as based on LEA needs) Partners to be funded at each LEA: such as but not limited to, Mental Health Centers, Family Organizations, PBIS and ISF partners, refugee and homeless partners, 32

Improve alignment, integration, and effectiveness of systems level efforts Identify gaps in existing services and assessing resource capacity, Identify risk and protective factors Strengthen existing partnerships and identify new and expanded opportunities for local and state level org partnerships Build support between program partners and other public and private partners ACTIVITIES: COMPLETE NEEDS ASSESSMENT AND ENVIRONMENTAL SCAN TO DEVELOP COMPREHENSIVE PLAN (INCLUDES STATE LEVEL AND EACH LEA LEVEL) 33

35 SS/HS ElementsIndicators (The required GPRA indicators are in bold italics) 1. Promoting Early Childhood Social & Emotional Learning & Development Number and rate of children enrolled in early childhood education programs (Example). 2. Promoting Mental, Emotional, and Behavioral Health Total number of students who received school-based mental health services Percentage of mental health service referrals for students which resulted in mental health services being provided in the community 3. Connecting Families, Schools and Communities Number of school, community, and family initiatives that promote safe student academic, recreational, and social environments (Example). 4. Preventing Behavioral Health Problems (including substance use) Percentage of students who report consuming alcohol on one or more occasions during the past 30 days 5. Creating Safe and Violence Free Schools Percentage of students who reported being in a physical fight on school property during the current school year. Percentage of students who did not go to school on one or more days during the past 30 days because they felt unsafe at school or on their way to and from school.

Quantitative data such as numbers, rates, and statistics (includes primary and secondary sources) Qualitative data through focus groups, interviews, and observations Data source for each shared indicator must be identified  Example: a good data source tied to indicators on adolescent substance use would be the most recent Youth Risk Behavior Surveillance System (YRBSS) survey 35

36 NH DHHS (number of recipients of Medicaid and Food Stamp Program Participants) County Health Rankings County Health Calculator Police Records Chamber of Commerce Data School districts NHDOE (district profiles, etc.) State and national surveys, such as Behavioral Risk Factor Survey, National Survey of Children’s Health, YRBSS, Health and Nutrition Examination Survey, etc.

37 Collaborative effort between project partners at both the state and community levels. The SMT and CMTs should take the following steps as part of the process: 1. Compile data on the risk and protective factors related to each of the five SS/HS Elements 2. Define the target populations and sub-populations 3. Select at least one shared indicator for each of the five SS/HS Elements (can have as many indicators as desired) 4. Locate data sources for each of the Indicators

ENVIRONMENTAL SCAN SHOULD IDENTIFY SYSTEMS, PROGRAMS, AND SERVICES THAT EXISTED PRIOR TO THE SS/HS STATE PROGRAM (NOT THOSE THAT WILL BE ADDED TO THE COMPREHENSIVE PLAN). THE ENVIRONMENTAL SCANNING PROCESS IS SIMILAR TO STATE AND COMMUNITY LEVEL NEEDS ASSESSMENT PROCESS. IT SHOULD FOCUS ON DESCRIBING THE AVAILABLE RESOURCES AT THE STATE AND WITHIN THE THREE COMMUNITIES THAT ADDRESS THE SHARED INDICATORS FOR THE SPECIFIED POPULATION. AFTER GATHERING DATA FOR THE NEEDS ASSESSMENT, THE ENVIRONMENTAL SCAN SHOULD BE CONDUCTED TO DETERMINE TYPES OF RESOURCES THAT ARE CURRENTLY ADDRESSING THE NEED. 38

39 Document existing resources, services & systems Describe how existing resources and services align with the enhanced National CLAS standards Describe funding streams supporting the existing resources Identify existing policies and procedures Identify technology resources Describe systems change and integration activities

40 Use multiple methods to scan to get a true picture of the availability of existing resources to address needs: Direct observation Questionnaires Consultation with persons in key positions, and/or with specific knowledge Review of relevant policies Interviews Focus Group

Last step of the needs assessment and environmental scanning process is to assess gaps in services and infrastructure. Where and how services related to the shared indicators can be created or enhanced Assess what types of systems or infrastructure developments are needed to address the shared indicators 41

42 Questions to be considered: What needs of children and youth are going unmet? What available programs, supports, and services are designed to meet these needs? Are there any major problems not being addressed by a service, program or activity? Are the children and youth at greatest risk receiving prevention programs, services, and supports? If not, why not?

43 Questions to be considered, continued: Are there duplicative services, programs, and supports attempting to address the same problem? If so, which are more effective and which are less so? Are those who are implementing the separate programs coordinating their efforts in any way? Are there documented policies and procedures for addressing behavioral health disparities? Is there a blending of funding across these various programs and efforts?

44 Other considerations include: Community-level coordination issues, including changes in state policies and regulations that can facilitate the blending of funding Regional and/or statewide work force development issues Mechanisms available to share lessons learned with others in the state and across communities (example: utilize IRB process with evaluators to ensure publication of success and challenges of SS/HS model and provide model for NH SS/HS model expansion across the state)

NH will work with our SAMHSA Project Officer and our Resource Specialist (AIR) to use the needs assessment and environmental scan information to complete the SS/HS Framework Grid Tool. NH will work with the Project Officer to develop our Comprehensive Plan. The comprehensive plan should be a direct response to address the highest priority needs and gaps. The comprehensive plan also presents the SS/HS State Program’s vision for how best practices in infrastructure reform and service delivery can most effectively meet the identified needs. 45

PROJECT DIRECTOR: McKenzie Harrington-Bacote, NH Department of Education PROJECT CO-DIRECTOR: Michele Harlan, NH DHHS, Bureau of Behavioral Health 46