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Reinvestment Grant#RFA06H16G51 Working Draft At SEFBHN, our staff and all contracted provider agencies utilize the most current and appropriate tools and techniques when engaging with the mentally ill population involved in the criminal justice system,with specific SEFBHN administered trainings and monitored requirements for criminogenic assessments and motivational interviewing in order to most effectively identify the higher-risk individuals while concurrently determining the most appropriate dosage and intensity of services. SEFBHN will ensure the delivery of these services through a Care Coordinator, directly employed by SEFBHN, who will coordinate with the IRCMHC staff and the team directly funded by this grant to include the Program Manager, Licensed Therapist, Care Manager and Certified Peer Specialists, employed by contracted provider agencies; all of whom will be supported by the greater SEFBHN management and staff. SEFBHN trains and monitors all contracted provider agencies with regard to their required implementation and fidelity to the appropriate Evidence- Based Practices (EBPs). The key EBPs to be utilized in fulfillment of this grant are: Sequential Intercept Model; Brief Jail Mental Health Screen (BJMHS); the Wellness Recovery Action Plan (WRAP); and, Cognitive Behavioral Therapy(CBT). For a complete listing of EBPs that will be utilized by the contracted provider agencies in fulfillment of this grant, please see Appendix B. During the post-crisis or post-release transition periods, the consumer is at higher risk of decompensation and engaging in behaviors which may require law enforcement intervention. Immediate access to social services, which SEFBHN will initiate during the transition period, is critical to stabilize this population and set them on a path for recovery and wellness. Applying a detailed analysis of the consumer's assessment, a Care Manager will work directly with the consumer in a client-centered approach to establish a treatment plan. Components of this plan will include the following services, as deemed appropriate: mental health and substance abuse treatment, recovery orientated support groups, medical screening, WHAM, vocational training, family counseling, anger management, peer support, WRAP, SOAR enrollment in social security disability and other relevant assistance benefits. Creating recovery-oriented, supportive therapeutic opportunities is essential for the success of the program participants and SEFBHN will ensure availability and access to these opportunities. The Care Manager acts as liaison for the consumer, families and other related agencies involved in the transition process; provides information and support; assists consumers in completing various forms and obtaining documents for transition, training, education and employment; provides interventions when necessary; conducts a variety of risk/needs assessments with consumer; and, participates in collaborative meetings with staff and agencies to provide information and recommendations. Certified Peer Specialists assist individuals to successfully transition back into the community following crises or incarceration. The Certified Peer Specialist engages the individual while still incarcerated or they can travel out in the field with the MCT, initiating contact and establishing rapport. They participate in discharge planning and assist the person in identifying community-based services and support needs while also helping them to build self-directed recovery tools, such as a Wellness Recovery Action Plan (WRAP). They then continue to actively provide support as the consumer transitions back into society. The SEFBHN Care Coordinator will maintain responsibility for all aspects of the SEFBHN Care Coordination Program, ensuring grant and contract compliance, data entry, evaluation measures and the collaborative coordination of care with our network of Page 19 of 33