Transcript Kansas All-Hazards Behavioral Health Program Preparedness, Response, and Recovery For Kansas Communities KAHBH Personnel • Dr.

Kansas All-Hazards
Behavioral Health Program
Preparedness, Response,
and Recovery For
Kansas Communities
KAHBH Personnel
• Dr. Briana S. Nelson Goff, KSU/Family Studies & Human
Services
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Charlie Griffin, KSU/Family Studies & Human Services
Becky Rinehart, SRS Mental Health, Topeka
Stephanie Wick, FSHS MS Student
Anthony Walker, FSHS MS Student
Michael Smith, Psychology Undergraduate Student
Lizette Vargas, BRIDGES & DSP Undergraduate
Student
“Behavioral Health”
Mental Health + Substance Abuse
“It is important to remember that mental health
intervention is a prompt and effective medical response
to a bioterrorism attack. Early detection, successful
management of casualties, and effective treatments
bolster the public’s sense of safety and increase
confidence in our institutions. Because the overriding
goal of terrorism is to change people’s beliefs, sense of
safety, and behaviors, mental health experts are an
essential part of planning and responding.”
Statement from the Conference Transcript:
Responding to Bioterrorism: Individual and Community Needs,
October 19-21, 2001
“Mental Health is the linchpin to an
effective response.“
Statement from April 2005
TOPOFF 3 Exercise
All-Hazards = All-Hazards
Disasters
Bioterrorism
Major Community Crises
State-Level Role of KAHBH
• During a disaster in Kansas, the Kansas Mental
Health Authority through SRS collaborates with
the Kansas Department of Emergency
Management, Local Community Mental Health
Centers, and FEMA in a Presidentially declared
disaster
• FEMA has required each State to develop a crisis
response plan in meeting the mental health and
substance abuse needs at state and local levels,
which are formally integrated into the State
Emergency Operations Plan
• KDHE established a contract with KMHA to provide
funds for 1 year to coordinate the development and
implementation of the All-Hazards Behavioral
Health Plan
– 2nd year began 1/06
• In January 2005, Kansas Department of Social and
Rehabilitation Services, Mental Health Authority,
subcontracted with Kansas State University, School
of Family Studies and Human Services
• The Kansas All-Hazards Behavioral Health
(KAHBH) Project was developed through the
subcontract
Behavioral Health Response to
Presidentially Declared Disaster
Event
City Response
County Response
State Response
Sources of Information
-Red Cros
-KEMA
-Adjutant General’s Office
-Cities
- Newspapers
- New Releases
To Collect Data Per County
-Casualties
-Injured
-Business
-Schools
-Homes
-Homeless
-Power
-Food
-Water
-------------------------------------------Budget
-Staff
KDEM Application
National Disaster
Presidentially
Declared Disaster
KMHA has 14 Days
to Apply for
Immediate Services
Project (ISP)
9 Months
If needed apply for
Regular Services
Program (RSP)
60 Days
1) On-Site Command
2) Local Outreach workers
3) Supplies
FEMA/SAMHSA
Crisis Counseling
Assistance and Training
Program
FEMA Crisis Counseling
Assistance and Training Program
• Robert T. Stafford Disaster
Assistance and Emergency Relief Act
(P.L. 93-288 as amended)
• Interagency Federal Partnership
• Federal-State-Local Partnership
Organizational Partners
in Crisis Counseling Program
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Community Mental Health Agencies
State Mental Health Authority
State Emergency Management Agency
Federal Emergency Management Agency
(Region and Headquarters)
• Center for Mental Health Services
Administrative
Staff
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Community Program Managers
State Disaster Mental Health Coordinator
Governor’s Authorized Representative
FEMA Crisis Counseling Coordinator
FEMA Human Services Officer
Federal Coordinating Officer
FEMA Headquarters Crisis Counseling
Coordinator
• CMHS Project Officer
Disaster Operations
Structure
CCP Organizational Chart:
Small Provider
CCP Organizational Chart:
Large Provider
Examples of Crisis
Counseling Program Services
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Outreach
Screening and Assessment
Counseling
Information and Referral
Public Education
Program
Limitations
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Medications
Hospitalization
Long-term Therapy
Providing Childcare or Transportation
Fundraising activities
Advocacy
Case Management
Crisis Counseling
and “Traditional”
Behavioral Health Practice
“Traditional” Practice
Crisis Counseling
• Primarily Office-Based
• Focus on Diagnosis &
Treatment of Mental Illness
• Attempt to Impact Personality &
Functioning
• Examines Content
• Encourages Insight into Past
Experiences & Influence on
Current Problems
• Psychotherapeutic Focus
• Primarily Home & Community Based
• Assessment of Strengths, Adaptation
& Coping Skills
• Seeks to Restore Pre-Disaster
Functioning
• Accepts Content at Face Value
• Validates Appropriateness of
Reactions and Normalizes
Experience
• Psycho-educational focus
Source: ESDRB Program Guidance, December, 1996
FEMA/CMHS
Crisis Counseling Program
FY 2004 Grant Sites
FEMA 1492 MD
(Hurricane
Isabel))
FEMA 1391 NY
9/11 Terrorism
FEMA 1474 WV
(Floods)
FEMA 1506 SA
(Cyclone)
FEMA 1491 VA
(Hurricane Isabel)
FEMA 1498-CA
(Fires)
FEMA 1475 KY
(Severe Storms)
FEMA 1322 AL
(Tornado)
FEMA 1479 TX
(Hurricane
Claudette)
FEMA 1437 LA
(Flooding)
FEMA 1501 PR
(Storms &
Flooding)
Summary
• The FEMA/CMHS Crisis Counseling
Program works in conjunction with a
number of organizational partners and
administrative staff to provide services
during disasters that differ from
traditional mental health services
KAHBH Purpose
• KAHBH provides State-wide organization
and coordination for behavioral health
response to disaster and other all-hazards
events
• Responsibilities of the KAHBH Project are
outlined in 7 Primary Tasks
Key KAHBH Tasks
• Resource identification and collection
• Training and education
• Development of Annex to KEOP, KAHBH
Plan, and Standard Operating Procedures
• State-wide network recruitment and
coordination
• Preparedness, response, and recovery
activities
KAHBH Trainings
• Core Behavioral Health Training
– Began Dec 2005
– Based on SAMHSA/CMHS Training Manual
– 1.5 day training
• DAY 1 (approx. 8 hours)
• For all participants without CISM or ARC DMH training within the last 5 years
(Mental health and paraprofessionals)
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Module 1: Disaster Classifications and Phases
Module 2: Traumatic Reactions to Disasters
Module 3: Providing Support During Disasters
Module 4: Considerations for Special Populations, Cultural Competence, and Ethical
Issues
• Day 2 (approx. 4)
• For ALL KAHBH Network members
– Module 5: The FEMA/SAMHSA CMHS Crisis Counseling Assistance and Training Program
– Module 6: The KAHBH Program: Preparedness, Response, and Recovery for Kansas
Communities
– Module 7: Behavioral Health and Crisis Response Interventions
– Module 8: KAHBH Community Outreach Teams: Structure, Procedures, and Documents
• Paraprofessional Training
– All nonbehavioral health members/paraprofessionals
– 4 hours training on basic helping skills in crisis
counseling
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The Role of the Helper
Professional and personal boundaries
Ethics, confidentiality, and dual relationships
Communication Skills
Challenges in Helping
Diversity and multicultural awareness as a helper
Helping in Crisis and Grief Situations
• Future Specialty Trainings
– To be based on each community’s needs
– All non-mental health members will receive additional ½ day (4 hours)
training on basic helping skills in crisis counseling
– At least 2 members (1 MH and 1 NMH) from each area will receive
specialized training in the following areas (to be provided online in 2-4
hour trainings):
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Children (under age 18)
Frail Elderly
Developmentally and physically disabled
Severe Mental Illness and People in active Substance Abuse Treatment
People in Correctional Institutions
College Students in dorms/away from home/Families/individuals relocated
People with high traumatic exposure
People in poverty and homeless
Roles of women in community (e.g. new moms, multiple caregivers)
Men and Women
Emergency responders involved in rescue/recovery
Multicultural issues
Farmers/Ranchers/Agricultural Workers/Rural Populations
Other Training
• 2005 All-Hazards Behavioral Health
Symposium: Preparedness,
Response, and Recovery in Kansas
– October 6-7, 2005
– Kansas Highway Patrol Academy in Salina,
KS
KAHBH Network
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10 staff
15 Stakeholders
12 SRS Field Staff
29 CMHC Coordinators
Goal: 200+ KAHBH Network members
KAHBH Stakeholder
Supporting Agencies
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Kansas Department of Health & Environment, Office of Local & Rural Health,
Topeka
SRS Mental Health Authority, Topeka
SRS Health Care Policy, Addiction & Rehabilitation Services, Topeka
Kansas State University, School of Family Studies and Human Services, Manhattan
University of Kansas School of Medicine, Department of Preventive Medicine &
Public Health, Wichita
Lawrence Therapy Services, Lawrence
Mental Health Center of East Central Kansas, Emporia
Regional Prevention Center, Olathe
Mid-America Addiction Technology Transfer Center, Kansas City
COMCARE, Wichita
American Red Cross, Midway Kansas Chapter, Wichita
Wyandot Center, Kansas City
Association of Community Mental Health Centers of Kansas, Inc., Topeka
Center for Counseling & Consultation, Great Bend
Prairie View Behavioral & Mental Health Care, Newton **
Heartland Assessment Center, Roeland Park, KS **
**Resigned due to accepting positions in other states
KAHBH Plan and Standard
Operating Procedures
• The initial Kansas All-Hazards Behavioral Health
Annex has been drafted and submitted to the
Kansas Department of Emergency Management
(KDEM) to be reviewed and accepted into the
Kansas Emergency Operations Plan.
– KDEM acceptance currently is pending
• The State Plan will provide a detailed description of
the behavioral health preparedness, response, and
recovery in Kansas
• Preliminary drafts of the KAHBH Standard
Operating Procedures have been developed and
are to be reviewed by the SRS Contract Manager.
KAHBH
ANNEX
(Submitted to KDEM)
KAHBH
Plan
KAHBH Standard
Operating
Procedures
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Preparedness Activities
Response Activities
Recovery Activities
The goal of KAHBH is to
collaborate and work to
coordinate all behavioral health
services before, during, and
after an all-hazards event in
Kansas.
Organizations Involved in
Disaster Response
• Federal
– SAMHSA—Substance Abuse Mental Health Services Administration
& CMHS—Center for Mental Health Services
– FEMA—Federal Emergency Management Agency
• State
– KDHE—Kansas Dept. of Health and Environment
• KDEM—Kansas Division of Emergency Management
– SRS—Kansas Dept. of Social and Rehabilitation Services
• Local
– Local emergency management agencies
– CMHC—Community Mental Health Centers
– Local professionals and para-professionals (substance abuse
professionals, clergy, doctors/nurses, fire/police department, volunteers,
etc.)
Role of KAHBH
Network Members
• SAMHSA/CMHC Model
• Professionals and paraprofessionals
working in teams
• Based on SRS CMHC Regions
– 27 total areas in Kansas
KAHBH is not:
The KAHBH Program is not:
• American
Red
Cross
Disaster
Mental
• American
Red
Cross
Disaster
Mental
Health
Health Services
Services
(ARC DMHS)
– ARC requires a masters-level licensed mental health professional
– ARC mental health workers are volunteers and do not receive
reimbursement for their services
• Critical Incident Stress Debriefing
• Critical Incident Stress Management (CISM)
– Model developed and approved for use with first responders, but
often is applied to many areas of crisis response, which may not be
appropriate
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Network members
should be:
• Indigenous to the communities they
serve
• Possess varied experience
• Non-traditional methods
• Sensitive to cultural issues
KS Citizens
State
Plan
KDEM
KS Citizens
KS Citizens
KAHBH
State
Plan
KDEM
KS Citizens
KS Citizens
State
Stakeholders
KAHBH
State
Plan
KDEM
KS Citizens
KS Citizens
State
Stakeholders
KAHBH
State
Plan
KDEM
American
Red Cross
KS Citizens
KS Citizens
State
Stakeholders
KAHBH
State
Plan
Education: Trainings,
Universities,
Conferences
KDEM
American
Red Cross
KS Citizens
KS Citizens
State
Stakeholders
KAHBH
State
Plan
Education: Trainings,
Universities,
Conferences
KDEM
Governor’s
Bioterrorism
Coordinating
Council
(SRS Mental Health
Authority rep joined
4/04
American
Red Cross
KS Citizens
KS Citizens
State
Stakeholders
County
Data Bank
KAHBH
State
Plan
Education: Trainings,
Universities,
Conferences
KDEM
Governor’s
Bioterrorism
Coordinating
Council
(SRS Mental Health
Authority rep joined
4/04
American
Red Cross
KS Citizens
KS Citizens
State
Stakeholders
County
Data Bank
KAHBH
State
Plan
Education: Trainings,
Universities,
Conferences
KDEM
KS Train
Governor’s
Bioterrorism
Coordinating
Council
(SRS Mental Health
Authority rep joined
4/04
American
Red Cross
KS Citizens
KS Citizens
State
Stakeholders
Disaster
Exercises
County
Data Bank
KAHBH
State
Plan
Education: Trainings,
Universities,
Conferences
KDEM
KS Train
Governor’s
Bioterrorism
Coordinating
Council
(SRS Mental Health
Authority rep joined
4/04
American
Red Cross
KS Citizens
KS Citizens
State
Stakeholders
Disaster
Exercises
County
Data Bank
KAHBH
State
Plan
Education: Trainings,
Universities,
Conferences
KDEM
KS Train
1st responders/ Critical
Governor’s
Incident Stress
Bioterrorism
Management
Coordinating
Council
(SRS Mental Health
Authority rep joined
4/04
American
Red Cross
KS Citizens
KS Citizens
State
Stakeholders
Disaster
Exercises
County
Data Bank
KAHBH
State
Plan
Education: Trainings,
Universities,
Conferences
KDEM
KS Train
1st responders/ Critical
Governor’s
Incident Stress
Bioterrorism
Management
Coordinating
Council
(SRS Mental Health
Authority rep joined
4/04
American
Red Cross
KS Citizens