Onondaga County Integrated Mental Health System of Care - The Onondaga County Integrated Mental Health Services System of Care ('OCIMHSOC') will address the disparities of youth aged 0 to 21 facing multiple diagnoses of Serious Emotional Disturbance (SED), including autism and/or developmental, physical, or emotional disabilities within Onondaga County. A particular focus is placed on those entwined with the child welfare and juvenile justice systems, aiming to instate an organized community-based care system for children and youth grappling with serious emotional disturbances and co-occurring developmental disorders. The unduplicated number of individuals to be served is 27 youth annually (15 in year one), 96 over the duration of the grant. The identified outcomes for this project are to reduce the number of and length of stay for hospitalizations and out of home placements for the target population and will be met though the following: (1) development of universal identification, assessment, referral, and linkages process for youth and families experiencing SED and developmental disability challenges; (2) provide access to intensive evidence-based services (e.g. START Model) that this population is traditionally barred from due to eligibility complexities; (3) adaption/enhancement of behavioral health services and system to specifically engage youth and families in culturally competent and trauma informed treatment practices that provide services focused on the whole child; and (4) support families in gaining skills necessary to address the needs of youth experiencing SED/IDD. Children and youth in Onondaga County grappling with both serious emotional disturbances and intellectual or developmental disabilities ('SED/IDD'), face an increased risk of experiencing hospitalizations and out-of-home placements, both within and outside the foster care and/or juvenile justice systems. Complicated administrative regulations and eligibility requirements across four large state systems - Office of Mental Health (OMH), Office for People with Developmental Disabilities (OPWDD), Department of Health (DOH) and Office of Children and Family Services (OCFS) - hinder efficient access, eligibility determination, and treatment delivery. The NYS OPWDD system has the expertise and services but significantly limits access to services with time intensive, complicated and restrictive eligibility processes; for instance, youth in foster care or youth with high levels of functioning are not eligible for services through the OPWDD system. In addition, the NYS mental health systems have a history of not serving individuals with developmental challenges due to traditional clinical approaches not being adapted to meet the population's needs. These factors hinder consistent access to adequate care and effective interventions and services for youth resulting in increased severity of needs, reduced youth functionality and increased caregiver frustration. This often leads caregivers to seek hospitalization or out-of-home placement to address their child's needs, or it could result in the youth facing criminal justice involvement and being placed in detention. In the past six months, the Onondaga County System of Care Complex Case meeting has problem solved on six different cases of youth with SED/IDD who were/are stuck, for months at a time, in a hospital emergency room, inpatient unit, detention or were disrupting from a foster care residential facility. Of the 80 youth in residential foster care, approximately 30% percent are youth with SED/IDD (24 youth). On average, 20% to 25% of youth served in intensive mental health services are youth experiencing SED/IDD. Successful structures are already in place for program administration, governance, strategic planning, engagement of community stakeholders, cross-system service development, and evaluation. Those existing structures would be refocused to support the target population and scope of OCIMHSOC.
