Wednesday, January 15, 2025
1/15/2025
The Milwaukee County Behavioral Health Division (BHD) submits this application for $3,996,143 (over four years) to enhance crisis treatment services by implementing a new Assisted Outpatient Treatment (AOT) program using the Assertive Community Treatment (ACT) model for individuals with severe mental illness (SMI), high utilization rates of acute adult inpatient services (AIS), and under involuntary commitment for treatment. Services will be delivered in the geographic catchment area of Milwaukee County with a population of 952,085 and encompassing areas of extreme poverty and high racial segregation. The projected number of unique consumers to be served through the AOT program are 30 consumers per year; 120 consumers throughout the lifetime of the project. The focus population is predominantly African American with diagnoses of Schizophrenia and Other Psychotic Disorders, unemployed, undereducated, on Medicare or Medicaid, and requiring four times longer average lengths of stay than their national counterparts. Strategies and interventions include: the implementation of an AOT program that provides access to, and continuity of care with, a full fidelity ACT team for civilly committed SMI consumers; full fidelity ACT Team staffing and services; training for ACT team members, AOT Implementation Team, ACT Stakeholder Advisory Board, and consumer advocates in AOT and ACT evidence-based practices (EBP) such as Enhanced Illness Management and Recovery (psychosocial rehabilitation intervention that combines Illness Management and Recovery and Integrated Dual Disorder Treatment, Social/Natural Supports), Family Psychoeducation, and Cognitive Behavioral Therapy; rigorous AOT program evaluation and ACT model fidelity; and sustainable funding streams and the role of Managed Care, Medicaid, and other insurance programs to ensure AOT program continuation when federal funding ends. Project goals: enhance crisis treatment services for individuals unable to adhere to treatment and who cycle repeatedly from tenuous stability to psychiatric crisis; provide more effective and comprehensive EBP services for individuals with complex clinical and social needs; and sustain the AOT program through ongoing EBP training for the ACT Team, third party revenue, and mentorship. Measurable objectives are to: create the foundation for AOT Program implementation using a full fidelity ACT Team Model; establish and operate a formal AOT program to motivate and engage individuals with SMI who struggle with voluntary treatment adherence; train in core ACT services and educate stakeholders and community on the AOT process the ACT model; admit 4 consumers with an AOT Court Order to the full fidelity ACT Team per month; monitor and assess ACT fidelity; provide ongoing training and consultation in intensive skills (secondary ACT services) and complementary EBPs; and build access to core ACT and secondary services for individuals with SMI in Milwaukee County. Anticipated outcomes include fewer psychiatric hospitalizations, increase in medication adherence, cost savings from less readmissions, decrease in harmful behaviors, reduced likelihood to perpetrate violence, and fewer arrests and incarceration among AOT participants.
HHS’ Tracking Accountability in Government Grants System (TAGGS) website provides access to detailed descriptions of grants, loans, aggregated direct payments and other types of financial assistance awarded by the HHS Operating Divisions (OPDIVs) and the Office of the Secretary Staff Divisions (STAFFDIVs).