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The Safety-Net Approach: Weaving a Community-based System-of-Care to Improve Child Mental Outcomes

Award Number: H79SM082987
ORGANIZATION: CENTER FOR MENTAL HEALTH SERVICES
OPDIV: SAMHSA
AWARD CLASS: DISCRETIONARY
AWARD ACTIVITY TYPE: HEALTH SERVICES
PERIOD OF PERFORMANCE START DATE: 09/30/2020
PERIOD OF PERFORMANCE END DATE: 01/31/2025

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The Safety-Net Approach: Weaving a Community-based System-of-Care to Improve Child Mental Outcomes - The Safety-Net project, is intended to disrupt disparities in mental health treatment access for children at-risk for childhood trauma (ACEs) and/or serious emotional disturbance (SED). Safety-Net will use mobile clinical and family support teams to improve mental health outcomes. This clinical innovation, nested in an integrated system-of-care will be piloted for children, ages 3-18 yrs., with SED who receive primary care through Cambridge Health CHA. Massachusetts had the highest rate of child abuse and neglect in the US during 2016 (DHHS, 2017). Approximately, 25% of these children live below the federal poverty level (American Community Survey, 2011-2013). The gateway cities we are targeting in Metro-Boston (Malden and Everett) have 2-3 times the rate for foreign-born residents (43% vs. 15%) compared to the rest of MA, and twice the statewide rate of children at much higher risk for adverse health and mental health outcomes in childhood and beyond. CHA's Children's Health Initiative (CHI) leadership will combine evidence-based interventions from its earlier MHSPY program (family support, care management and shared goals) with new strategies, such as interdisciplinary child mental health evaluation teams, all within primary care. Clinical expertise will be combined with peer-to-peer parent/guardian support for trauma-informed care delivery to both parent and child. All aspects of the care continuum will be provided in a culturally and linguistically competent manner, with child and family-driven care planning. Overall, the program will be sited in two cities, supported by a larger, specialized system of care involving state and local child serving agencies, schools and community-resources. We anticipate serving 248 children and families in total, at approximately 70 children per year. Program goals include: 1) Promote earlier recognition of child mental health needs; 2) Family-driven assessment approach to offset disparities in treatment engagement and outcomes; 3) Facilitate state, local and care planning team coordination and collaboration using SOC principles. Objectives: 1) Assess presence of SED (Serious Emotional Disturbance) via Standardized measures of Clinical Functioning (CGAS and CAFAS) 2) Screen for adverse childhood experiences (ACEs) by use of modified ACE-Q tool, 3) Increase access to child mental health evaluation and treatment using Pre-post measures of patterns of service use of study participants and Assessment of patterns of care for propensity-score weighted comparison group, 4) Improve family care experience, as measured by baseline and follow-up Family Professional Partnership Scale assessments, 5) Improve clinical functioning, as measured by baseline and follow-up CGAS and CAFAS assessments. Safety-Net's goals align with CHA's goals within its Accountable Care Organization contract with MassHealth, thus offering a chance to measure and evaluate outcomes for a customized system-of-care for some of the state's most vulnerable children.


Issue Date FY	Funding FY	Legal Entity Name	Legal Entity Address	Legal Entity City	Legal Entity State	Legal Entity Zip Code	Legal Entity COUNTY	Legal Entity COUNTRY	Assistance Listing	Award Code	Budget Year	Action Date	Action Type	Action Amount

Issue Date FY: 2025 ( Subtotal = -$16,683 )
2025	2023	CAMBRIDGE PUBLIC HEALTH COMMISSION	1493 CAMBRIDGE ST	CAMBRIDGE	MA	02139	MIDDLESEX	USA	Comprehensive Community Mental Health Services for Children with Serious Emotional Disturbances (SED)	001	4	6/10/2025	ADMINISTRATIVE SUPPLEMENT ( + OR - ) (DISCRETIONARY OR BLOCK AWARDS)	-$16,683
2025	2023	CAMBRIDGE PUBLIC HEALTH COMMISSION	1493 CAMBRIDGE ST	CAMBRIDGE	MA	02139	MIDDLESEX	USA	Comprehensive Community Mental Health Services for Children with Serious Emotional Disturbances (SED)	000	4	12/20/2024	ADMINISTRATIVE SUPPLEMENT ( + OR - ) (DISCRETIONARY OR BLOCK AWARDS)	$0
														Subtotal = -$16,683

Issue Date FY: 2024 ( Subtotal = $0 )
2024	2023	CAMBRIDGE PUBLIC HEALTH COMMISSION	1493 CAMBRIDGE ST	CAMBRIDGE	MA	02139	MIDDLESEX	USA	Comprehensive Community Mental Health Services for Children with Serious Emotional Disturbances (SED)	000	4	9/10/2024	ADMINISTRATIVE SUPPLEMENT ( + OR - ) (DISCRETIONARY OR BLOCK AWARDS)	$0
														Subtotal = $0

Issue Date FY: 2023 ( Subtotal = $1,000,000 )
2023	2023	CAMBRIDGE PUBLIC HEALTH COMMISSION	1493 CAMBRIDGE ST	CAMBRIDGE	MA	02139	MIDDLESEX	USA	Comprehensive Community Mental Health Services for Children with Serious Emotional Disturbances (SED)	000	4	8/2/2023	NON-COMPETING CONTINUATION	$1,000,000
														Subtotal = $1,000,000

Issue Date FY: 2022 ( Subtotal = $1,000,000 )
2022	2022	CAMBRIDGE PUBLIC HEALTH COMMISSION	1493 CAMBRIDGE ST	CAMBRIDGE	MA	02139	MIDDLESEX	USA	Comprehensive Community Mental Health Services for Children with Serious Emotional Disturbances (SED)	000	3	7/9/2022	NON-COMPETING CONTINUATION	$1,000,000
														Subtotal = $1,000,000

Issue Date FY: 2021 ( Subtotal = $1,000,000 )
2021	2021	CAMBRIDGE PUBLIC HEALTH COMMISSION	1493 CAMBRIDGE ST	CAMBRIDGE	MA	02139	MIDDLESEX	USA	Comprehensive Community Mental Health Services for Children with Serious Emotional Disturbances (SED)	001	2	7/27/2021	NON-COMPETING CONTINUATION	$1,000,000
2021	2020	CAMBRIDGE PUBLIC HEALTH COMMISSION	1493 CAMBRIDGE ST	CAMBRIDGE	MA	02139	MIDDLESEX	USA	Comprehensive Community Mental Health Services for Children with Serious Emotional Disturbances (SED)	000	1	7/9/2021	ADMINISTRATIVE SUPPLEMENT ( + OR - ) (DISCRETIONARY OR BLOCK AWARDS)	$0
														Subtotal = $1,000,000

Issue Date FY: 2020 ( Subtotal = $1,000,000 )
2020	2020	CAMBRIDGE PUBLIC HEALTH COMMISSION	1493 CAMBRIDGE ST	CAMBRIDGE	MA	02139	MIDDLESEX	USA	Comprehensive Community Mental Health Services for Children with Serious Emotional Disturbances (SED)	000	1	9/15/2020	NEW	$1,000,000
														Subtotal = $1,000,000

Grand Total All Awards = $3,983,317

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The Safety-Net Approach: Weaving a Community-based System-of-Care to Improve Child Mental Outcomes

Award Number: H79SM082987

ORGANIZATION: CENTER FOR MENTAL HEALTH SERVICES

OPDIV: SAMHSA

AWARD CLASS: DISCRETIONARY

AWARD ACTIVITY TYPE: HEALTH SERVICES

PERIOD OF PERFORMANCE START DATE: 09/30/2020

PERIOD OF PERFORMANCE END DATE: 01/31/2025

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