1. How to find the money to keep on doing what you want to do

2.  Multi-Jurisdictional  Four Counties in Rural Nebraska  Agriculturally based  Four cows to every person  50,922 pop. in 2,200 sq miles  Prior to 1990 -Caucasian  Now about 15% Hispanic/Latino

3. Goals:  Reduce disparities in availability of outpatient Behavioral Health (BH) services  Complete integrated BH evaluations for CPS  Provide BH services & evaluations to EDN HFN  Screen Primary Care patients for DSM IV BH issues  Evaluate effectiveness of BH integration

4.  1,372 Unduplicated Users  523 Non-English Speaking  Served 55 children <13  173 Teens 13-17  1,114 Adults  30 Eldery  4,443 encounters  Provided access for 2,800 persons  Provided four new services to our area

5.  80 percent of 1,372 received a discount based on income  429 had some type of public insurance Medicaid or Medicare  655 persons paid out of pocket for the service  288 persons had private insurance

6.  Social Worker  Psychologist  Licensed Mental Health Therapist  Psychiatric Nurse Practitioner  Interpreter  Van Driver

7.  1,365 BH patients visits in 2006  1,145 BH patients visits in 2007  2,731 BH patients visits in 2008  2,587 BH patients visits in 2009 from Jan-June

8. Sustainability should be a journey, not a destination. Planning should be with and through our communities The shift needs to be in how we think about funding and viewing your grant from a business model. Shift to long-term funding.

9. FROMTO Needs Assets and Resources Focus on the AgencyFocus on the Community Operational PlanningStrategic Planning Focus on Short-term FundingFocus on Long-Term Funding

10.  What sources of income could potentially fund the program?  Medicaid  Medicare  Private Insurance  Sliding fee payments  Contracts for EAP  Contracts with the court  Social Security Administration Disability Determinations)  State contracts via Regional Mental Health Centers  Long-Term Grants  Tele-health contracts

11.  How do other programs similar to ours fund themselves?  What can you learn to help keep your doors open?  Who has an interest in seeing a program like ours funded? How can we get them to invest in our program?  Who is affected when the system breaks down  Who can we partner with to make this work?  Consortium Meetings

12.  Who are your indirect customers?  Medical Community  Law Enforcement  Homeless Shelters  In-patient treatment  Housing  Hospitals  Community Businesses  Schools

13.  Find out what they need and get the attention of the community.  Newspaper  Radio  Face book & Twitter  Reports to Key Stakeholders  Don’t just focus on your agency, focus on the problem and potential solutions  Become the “expert” in the area on your topic  Keep your stories timely – find angles that interest other people

14.  Need to get your stories out into the Community  E-mail  Community Annual Report  Key Stakeholders James enrolled in job core and got specialized training and was ready to find a job when the economy crashed. This month James felt hopeless and tried to commit suicide. James was able to see a mental health practitioner and get the help he needed to get back on his feet to continue to search for a job and he is hopeful that the economy will get better soon.

15.  Once you learn where the funding sources may be you need to line up so that you fit their needs not the other way around.  Become proficient as an agency  Learn more about billing efficiencies – set target goals for the year and month  Understand what third party payors pay and why, make sure you are coding correctly  Provide materials to key stakeholders

16.  State Grant for the Uninsured  Learned that state funds were given out only every three years  List for bidders conference  Education on what is required to submit a successful application  Learned that to get state funds the organization had to be accredited – took us 10 months to do this but we succeeded.

17.  Community Health Center Funding  Court Evaluations  Social Security Disability Evaluations  Contracts for Services with Private Companies  Managed Care Preferred Provider  Preferred Provider with private Pay Insurance

18.  Look at funding a new way each source is only one part of what you need.  Short term funding is the starter blocks for any program  Sustainablie Long Term funding is what will make the final product work.

19. If you fail to plan you plan to fail Rebecca J. Rayman Good Neighbor Community Health Center Columbus, NE 68601