Saturday, April 27, 2024
4/27/2024
This proposed System of Care, CREATE (Co-designing Rich Environments for All to Thrive Everyday), will address three priority populations of children identified by SAMHSA--children and youth with special health care needs (CYSHCN), those transitioning from pediatric to adult care (HCT), and LGBTQ+ children and youth (C&Y). They represent a third of US children, are at high risk for SEDs, and are disproportionately represented by minority and low-income families. Escalating structural, institutional, and societal discrimination confront these children generating profound inequities. Political assaults in Florida and across the country against minority and LGBTQ+ C&Y are driving these inequities. In response, CREATE will combine evidence-based SOC principles, with those of Population Health and Child Rights, to establish a model SOC that integrates clinical care, community systems development, and policy generation as a strategy to advance health equity among these marginalized C&Y at-risk for SED. Two-hundred C&Y will be served in Year 1, with subsequent annual increases of 200 C&Y resulting in 2000 served. With respect to CYSHCN, 30% to 60% experience mental and behavioral health conditions. Twenty-five percent of HCT youth have at least one psychiatric diagnosis. Among LGBTQ+ C&Y in Jacksonville, 43% seriously considered suicide, 35% planned a suicide, and 30% attempted it. The Goals of CREATE include, To: 1) Integrate SOC, Population Health, and Child rights principles into a SOC capable of addressing the unique needs of these C&Y, 2) Implement evidence-based mental-behavioral practices that respond to the needs of these C&Y, 3) Address public and private sector policies, laws, and practices that contribute to inequities in care and outcomes, 4) Evaluate process and outcomes using a variety of methods, including rights and equity-based metrics, and 5) Disseminate results and ensure sustainability. In Years 1&2, CREATE will work with C&Y in the University of Florida Bower Lyman Center that cares for 2000+ C&Y with complex medical conditions, and with JASMYN, a community-based organization serving 1100+ LGBTQ+ youth. . Two Mental-Behavioral teams consisting of a LCSW, Wraparound prepared Care Coordinator, and Family Advocate will be embedded in the two venues. They will be responsible for assessing, diagnosing, referring into the SOC and f/u of C&Y and parents and siblings manifesting SED requiring care. Parent Advocates will provide support for families and ensure they are involved in all components of planning, implementing, and evaluating CREATE. A Youth Advocate will be embedded in JASMYN to serve as a peer support for LGBTQ+ youth. Both Parent and Youth Advocates will engage in outreach into the community. In Years 3&4, the teams will expand their work into community-based pediatric practices and agencies. Community-based Participatory and Child Rights-based Approaches will be implemented to ensure youth and parents are engaged in all components of CREATE. A Collaborative Care model will be used to train pediatricians on psychiatric med-management and mental-behavioral health approaches to their patients. Access to a psychiatrist will be assured through the Collaborative Care model. Mental-Behavioral Health providers will be trained to respond to the unique needs of these C&Y. Rigorous health systems and evaluation research will contribute to the evaluation of processes and outcomes for goals and objectives and QI. Evaluation of all components of CREATE will involve all stakeholders, including parents and youth. Child rights and equity-based metrics will be utilized. Sustainability strategies include training 100+ multidisciplinary residents and fellows and practicing pediatricians. Financial sustainability will be negotiated with UF and JASMYN. The results of the Project will be disseminated through multiple academic and professional portals.
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).
