2021-2022 Mental Health Application

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2021-2022 Mental Health ApplicationPart I: Youth Mental Health Awareness Training PlanPart II: Mental Health Assistance Allocation Plan(Insert District Name)Deadline for submission to ShareFileon or before August 1, 2021

2021-2022 Mental Health ApplicationPurposeThe purpose of the combined mental health application is to streamline and merge two programs into one application. TheYouth Mental Health Awareness Training (YMHAT) Plan and the Mental Health Assistance Allocation (MHAA) Plan areto provide supplemental funding to districts so schools can establish, expand and/or improve mental health care,awareness and training and offer a continuum of services. These allocations are appropriated annually to serve studentsand families through resources designed to foster quality mental health. This application is separated into two primarysections: Part I includes the YMHAT Plan and Part II includes the MHAAPPart I. Youth Mental Health Awareness Training PlanIn accordance with section (s.) 1012.584, Florida Statutes (F.S.), the YMHAT allocation is to assist districts withproviding an evidence-based youth mental health awareness and assistance training program to help school personnelidentify and understand the signs of emotional disturbance, mental illness and substance use disorders, and provide suchpersonnel with the skills to help a person who is developing or experiencing an emotional disturbance, mental health orsubstance use problem.Part II. Mental Health Assistance Allocation PlanIn accordance with s. 1011.62(16), F.S., the MHAA Plan allocation is to assist districts in establishing or expandingschool-based mental health care; training educators and other school staff in detecting and responding to mental healthissues; and connecting children, youth and families who may experience behavioral health issues with appropriateservices.Submission Process and DeadlineThe application must be submitted to the Florida Department of Education (FDOE) ShareFile bythe deadline August 1, 2021.There are two submission options for charter schools: Option 1: District submission includes charter schools in both parts of the application. Option 2: Charter school(s) submit a separate application from the district.Part I. Youth Mental Health Awareness Training PlanYMHAT Objective: provide an evidence-based youth mental health awareness and assistance training program to helpschool personnel identify and understand the signs of emotional disturbance, mental illness and substance use disorders,and provide such personnel with the skills to help a person who is developing or experiencing an emotional disturbance,mental health or substance use problem.Page 2

2021-2022 Mental Health ApplicationPart I. Youth Mental Health Awareness Training Plan and Projected BudgetSection A: YMHAT Training Plan1. What is the percentage of employees currently trained and certified in Youth Mental Health First Aid (YMHFA)?There are% of employees trained and certified as of2. Explain the training goal(s) for the upcoming 2021-2022 school year.3. In addition, the annual goal for the 2021-2022 school year is to train:% of employees as of(date)4. Explain the training goal(s) for the next 3-5 years.5. What is the procedure for training new personnel to the district?6. Explain how the district will utilize the following three YMHAT programs: YMHFA YMHFA Recertification Kognito At-Risk Modules (at all three levels: elementary, middle, high school)Page 3 (date)

2021-2022 Mental Health ApplicationSection B: YHHAT Projected BudgetCategoriesDetailed Description, number of activitieswithin each categoryCost Per/EachTotal ProjectedBudget byCategory1. Stipends(Detailed # ofpersonnel and stipendcost per person)2. Materials(Detail # of units xindividual unit cost,plus shipping)3. National Council(YMHFA) Training(Detailed description ofeach training activity toinclude # of personneland individual trainingcosts)4. Additional KognitoModules (Provide thename of trainingmodule and cost)TOTAL 2021-2022 BUDGET: 0.005. Additional narrative (optional):Page 4

2021-2022 Mental Health ApplicationPart II. Mental Health Assistance Allocation Plan s. 1011.62 (16), F.S.Section A: MHAA Plan AssurancesThe district assures One hundred percent of state funds are used to expand school-based mental health care; train educators andother school staff in detecting and responding to mental health issues; and connect children, youth and familieswith appropriate behavioral health services.Mental health assistance allocation funds do not supplant other funding sources or increase salaries or providestaff bonuses or incentives.Maximizing the use of other sources of funding to provide school-based mental health services (e.g., Medicaidreimbursement, third-party payments and grants).Collaboration with FDOE to disseminate mental health information and resources to students and familiesThe district website includes local contacts, information and resources for mental health services for studentsand families.Includes a system for tracking the number of students at high risk for mental health or co-occurring substanceuse disorders who received mental health screenings or assessments; the number of students referred to schoolbased mental health services providers; the number of students referred to community-based mental healthservices providers; the number of students who received school-based interventions, services or assistance; andthe number of students who received community-based interventions, services or assistance.A school board policy or procedure has been established for Students referred for a mental health screening assessed within 15 calendar days of referral.School-based mental health services initiated within 15 calendar days of identification and assessment.Community-based mental health services initiated within 30 calendar days of referral coordinating mentalhealth services with a student’s primary mental health care provider and other mental health providers involvedin student care.Assisting a mental health services provider or a behavioral health provider as described in s. 1011.62, F.S.,respectively, or a school resource officer or school safety officer who has completed mental health crisisintervention training in attempting to verbally de-escalate a student’s crisis situation before initiating aninvoluntary examination pursuant to s. 394.463, F.S. Procedures include must include strategies to de-escalatea crisis situation for a student with a developmental disability as that term is defined in s. 393.063, F.S.The requirement that in a student crisis situation, the school or law enforcement personnel must make areasonable attempt to contact a mental health professional who may initiate an involuntaryexamination pursuant to s. 394.463, F.S., unless the child poses an imminent danger to self or others beforeinitiating an involuntary examination pursuant to s. 394.463, F.S. Such contact may be in person or usingtelehealth, as defined in s. 456.47, F.S. The mental health professional may be available to the schooldistrict either by contracts or interagency agreements with the managing entity, one or more local communitybehavioral health providers, or the local mobile response team, or be a direct or contracted school districtemployee.Page 5

2021-2022 Mental Health ApplicationSection B: Planned OutcomesIdentify one or two specific and measurable outcomes for your district’s plan to achieve through the 2021-2022evidence-based mental health program.Section C: District Program ImplementationPlease include the following in this section:1. Evidence-Based Program (EBP) and DescriptionName and provide the essential elements of the EBP you will be implementing through a Multi-Tiered System ofSupports (MTSS) using one or more of the preferred EBP/Practices found in Blue Menu of Evidence-BasedPsychosocial Interventions for Youth and the SAMHSA Evidence-Based Practices Resource Center.Describe the key EBP components that will be implemented as well as any related activities, curricula,programs, services, policies and strategies.*If you will be using another EBP other than those provided above please explain using the same formatlisted.2. EBP ImplementationThis should include: Explain how your district will implement evidence-based mental health services for students to improve theearly identification of social, emotional, behavioral problems or substance use disorders, as well as thelikelihood of at-risk students developing social, emotional, behavioral problems, depression, anxietydisorders, suicidal tendencies and how these will assist students dealing with trauma and violence. Explain how the supports will deliver evidence-based mental health care assessment, diagnosis, intervention,treatment and recovery services to students with one or more mental health or co-occurring substance abusediagnoses and to students at high risk of such diagnoses.3. Outcome Measures Provide the outcome measures of your EBPs and how each aligns with your overall annual program goals inSection 2.4. Multi-tiered System of Support (MTSS) Identify the tier(s) of the EBP being implemented.Appendix ExamplesPage 6

2021-2022 Mental Health ApplicationTable 1: District Program Implementation1.EBP and DescriptionPage 7 2.EBP Implementation3.Outcome Measures4.MTSS1 2 3

2021-2022 Mental Health Application1.EBP and DescriptionAdditional narrative may be added herePage 8 2.EBP Implementation3.Outcome Measures4.MTSS1 2 3

2021-2022 Mental Health ApplicationSection D: Direct EmploymentTable 2: MHAA Plan Direct EmploymentPositionCurrent Ratio as ofAugust 1, 20212021-2022 Proposed Ratio byJune 30, 2022School CounselorSchool Social WorkerSchool PsychologistOther Licensed Mental Health ProviderDirect employment policy, roles and responsibilitiesDescriptionExplain how direct employment of school-basedmental health services providers (school psychologists,school social workers, school counselors and otherlicensed mental health professionals) will reduce staffto-student ratios.Describe your district’s established policies andprocedures to increase the amount of time studentservices personnel spend providing direct mental healthservices (e.g., review and revision of staffingallocations based on school or student mental healthassistance needs.Describe the role of school based mental healthproviders and community-based partners in theimplementation of your evidence based mental healthprogram.List the contracts or interagency agreements with local behavioral health providers or Community Action Team(CAT) services and specify the type of behavioral health services being provided on or off the school campus.Table 3: MHAA Plan Contracts or Interagency Agreements and Services ProvidedMental Health Provider:Page 9 Agency:Services Provided:Funding Source:

2021-2022 Mental Health ApplicationSection E: Planned ExpendituresTable 4: MHAA Planned ExpendituresAllocation Expenditure SummaryTotalUnexpended Mental Health Assistance Allocation funds from previous fiscal years:School district expenditures for mental health services provided by staff who are employees ofthe school district:School district expenditures for mental health services provided by contract-based collaborativeefforts or partnerships with community-based mental health program agencies or providers:Other expenditures (see below):Total MHAA expenditures: 0.00 0.00Other expenditures (specify details such as type, supplies, training and amount):Type: Narrative description with detailed costTotal Other Expenditures:Page 10 Total Amount 0.00

2021-2022 Mental Health ApplicationDistrict CertificationThis application certifies that the School Board approved the district’s Mental HealthAssistance Allocation Plan, which outlines the local program and planned expenditures to establish or expand schoolbased mental health care consistent with the statutory requirements for the mental health assistance allocation inaccordance with section 1011.62(16), F.S.School (MSID) NumberCharter School NameNote: Charter schools not listed above will be included in the school district youth mental health awareness plan andmental health assistance allocation plan. If you have more Charter schools to add, please list them on a separate sheet.Signature of District SuperintendentPrinted Name of District SuperintendentBoard Approval DatePage 11

2021-2022 Mental Health ApplicationCharter School CertificationThis application certifies that the Charter School Governing Board approved the school’sMental Health Assistance Allocation Plan, which outlines the program and planned expenditures to establish or expandschool-based mental health care consistent with the statutory requirements for the mental health assistance allocation inaccordance with section 1011.62(16), F.S.Charter School Administrator Signature:Printed Name of Charter School AdministratorGoverning Board Approval Date:Page 12

2021-2022 Mental Health ApplicationAPPENDIXPage 13

2021-2022 Mental Health ApplicationResources for Program Implementation1. Evidence-Based Program and DescriptionThis is a three-module series about implementing evidence-based programs. The modules in this series are as follows:Module 1: Selecting Evidenced-Based Programs for School Settings, which covers using data to inform EBPselection, engaging stakeholders, assessing and building readiness, and reviewing and selecting EBPs; Module 2:Preparing to Implement Evidence-Based Programs in School Settings, which covers creating an implementation planand team, understanding fidelity and adaptations, building staff and organizational competencies, and schedulingimplementation; and Module 3: Implementing Evidenced-Based Programs in School Settings, which coversexecuting implementation, collecting data and monitoring progress, overcoming barriers and challenges, and planningfor sustainability.Below is a series of interactive, self-paced learning modules on selecting, preparing for and implementing EBPs inschool settings. Selecting Evidence-Based Programs for School SettingsPreparing to Implement Evidence-Based Programs in School SettingsImplementing Evidence-Based Programs in School SettingsSince the publication of Module 1, SAMHSA has phased out the NREPP website. In April 2018, SAMHSA launchedthe Evidence-Based Practices Resource Center that aims to provide communities, clinicians, policy makers and othersin the field with the information and tools they need to incorporate evidence-based practices into their communities orclinical settings. Selecting Evidence-Based ProgramsEvidence-Based Module Series2. Assessment ResourcesThe SHAPE System Screening and Assessment Library includes instruments appropriate for use in school mentalhealth. Search for the screening or assessment tools that fit your school(s) by focus area (academic, school climate orsocial/emotional/behavioral), assessment purpose, student age, language, reporter and cost. The Center for SchoolMental Health team has carefully reviewed every measure to provide a brief summary of each with direct links tocopies of the instrument and scoring information. Page 14 School Mental Health Screening PlaybookDesrochers, J., & Houck, G. (2013). Depression in Children and Adolescents: Guidelines for School Practice.Handout H: Mental Health Screening in Schools

2021-2022 Mental Health Application3. EBP/Practice Implementation for Co-Occurring Mental Health or Substance Use DiagnosesCo-Occurring Mental Health or Substance Use Diagnoses Treatment Considerations for Youth and Young Adultswith Serious Emotional Disturbances and Serious Mental Illnesses and Co-Occurring Substance UseBlue Prints This interactive search enables you to identify Blueprints – certified interventions based on specificcriteria – and browse through a wide range of interventions that match those criteria. Select only a few criteria ofimportance, as the number of interventions may be reduced by selecting multiple items ACROSS categories orincreased by selecting multiple items WITHIN categories.Model and Model Plus programs are listed separately from promising programs. This is because only Model andModel Plus programs have demonstrated efficacy for changing outcomes over time and are recommended for largescale implementation. Promising programs show promise of efficacy but require follow-up research before beingrecommended for large-scale adoption.Table 5: District Program Implementation Examples1.EBP and DescriptionExample 1Bounce BackBounce Back based onthe Cognitive BehavioralIntervention for Trauma in Schools(CBITS) is comprised of 10 onehour group sessions, two to threeindividual sessions and one tothree parent education sessions thatlast over a three-month period.Group sessions are typically heldduring school hours and cover arange of topics such as relaxationtraining, cognitive restructuring,social problem solving, positiveactivities, trauma-focusedintervention strategies andemotional regulation and copingskills.These topics and methods derivefrom established successfulinterventions for children withpost-traumatic stress disorder(PTSD), including a gradualapproach of anxiety-provokingsituations and a modified traumanarratives approach.Page 15 2.EBP Implementation3.Outcome MeasuresSchool Social Workers and Family Improve:Therapists will administer thePost-traumatic stress symptomssessions to students ages 5-11.(parent and child reported),Students will learn to identifyanxiety symptoms (childfeelings, and their links to thoughts reported), emotional regulationand actions, using published(parent reported) andstorybooks to relate concepts andemotional/behavioral problemsconnect engagement activities and (parent reported).create personal storybooks as anIn terms of risk and protectiveage-appropriate concrete traumafactors, improve on measures ofnarrative. Student participationwill be encouraged with games and social adjustment (childreported).activities specific to age groupsand with “courage cards” tailoredto each student. Group sessions arevery structured and include agendasetting; review of activityassignments; introduction of newtopics through games, stories andexperiential activities; andassigning activities for the nextgroup meeting. Group sessions aresmall, with only four to sixstudents all in the same age range.The School Social Worker andFamily Therapist review the skillsthe children are learning in BounceBack, with the student’s parent.4.MTSS1 2 3X

2021-2022 Mental Health Application1.EBP and Description2.EBP Implementation3.Outcome Measures4.MTSS1 2 3Parents can support the childrenpracticing the skills at home.The School Social Worker andFamily Therapist will help eachchild develop a “My Story” traumanarrative. Near the end of theprogram, the School SocialWorker and Family Therapistmeets with the parent and child toshare the child’s story.The Bounce Back program is atrauma-informed equitableprogram; appropriate for childrenand families of diverse ethnic andsocial backgrounds.Example 2Support for Students Exposed toTrauma (SSET)A school-based group interventionfor students who have beenexposed to traumatic events andare suffering from symptoms ofPTSD.SSET is delivered in an easy-touse lesson plan format that is idealfor educators. Teachers andSchool Counselors will use SSETas a non-clinical adaptation of theCBITS Program.Teachers and School Counselorswill teach many cognitive andbehavioral skills, such as socialproblem solving, psychoeducationand relaxation.The program consists of 10 45minute lessons designed to bedelivered during one class period.These lessons focus on: Page 16 common reactions totraumarelaxation techniquescoping strategieslearning to approachdifficult situationsdeveloping a traumanarrativeproblem solvingThrough the use of thisevidence-based program, middleschool students ages 10-14 willlearn to deal with real-lifeproblems and stressors andincrease levels of peer andparent supportTo increase skill-buildingtechniques to reduce currentproblems with: anxiety or nervousnesswithdrawal or isolationdepressed moodacting out in schoolimpulsive or riskybehaviorX X

2021-2022 Mental Health Application1.EBP and DescriptionPage 17 2.EBP Implementation3.Outcome Measures4.MTSS1 2 3

2021-2022 Mental Health Application1.EBP and DescriptionPage 18 2.EBP Implementation3.Outcome Measures4.MTSS1 2 3

2021-2022 Mental Health Application1.EBP and DescriptionPage 19 2.EBP Implementation3.Outcome Measures4.MTSS1 2 3

2021-2022 Mental Health Application1.EBP and DescriptionPage 20 2.EBP Implementation3.Outcome Measures4.MTSS1 2 3

2021-2022 Mental Health Application1.EBP and DescriptionPage 21 2.EBP Implementation3.Outcome Measures4.MTSS1 2 3

Communityed-bas mental health services initiated within 30 calendar days of referral coordinating mental health services with a student's primary mental health care provider and other mental health providers involved in student care. Assisting a mental health services provider or a behavioral health provider as described in s. 1011.62, F.S.,

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