increasing access to behavioral health resources for
TRANSCRIPT
Increasing Access to Behavioral Health Resources for Military and Veteran Children and Families
Webinar
March 12, 2020
Melissa Comeau, Director, Military and Veteran Caregiver Network, American Red Cross
Kelly A. Blasko, Ph.D., Lead, mHealth Clinical Integration,
Connected Health Branch, Clinical Support Division, Medical Affairs, Defense Health Agency
Erika R. Slaton, Associate Director, Military Community Support Programs, Office of the Deputy Assistant Secretary of Defense
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SAMHSA Welcome
Cicely K. Burrows-McElwain, L.C.S.W.-C.Military and Veteran Liaison
National Policy Liaison Branch,
Division of Regional and National Policy/Office of Policy, Planning, and Innovation, SAMHSA
The views, opinions, and content expressed in this presentation do not necessarily reflect the
views, opinions, or policies of the Substance Abuse and Mental Health Services
Administration (SAMHSA), or the U.S. Department of Health and Human Services
(HHS).
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Disclaimer
SAMHSA Background
SAMHSA leads efforts to ensure substance use and mental
health issues among all Americans, including SMVF, are
well understood.
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Since 2008, SAMHSA has partnered with states and territories to strengthen behavioral health systems serving Service Members, Veterans, and their families (SMVF), providing technical assistance (TA) through its SMVF TA Center.
• Strengthening ongoing collaboration among military and civilian stakeholders
• Providing a centralized mechanism for cities, states, and territories to learn, connect, and share
• Increasing awareness of and access to resources and programs that strengthen behavioral healthcare systems for Service Members, Veterans, and their families (SMVF)
• Supporting coordinated responses to the behavioral health needs of SMVF
• Encouraging cities, states, and territories to implement promising, best, and evidence-based practices
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SAMHSA’s SMVF TA Center
Technical Assistance Methods
The SMVF TA Center provides training and technical assistance through activities such as:
• Policy Academies
• Implementation Academies
• Crisis Intercept Mapping
• Webinars
• Learning Communities
• Onsite and virtual expert consultation
• Resource dissemination
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✓ Facilitate information dissemination, resources and tools for increasing connection, engagement, knowledge and skills related to behavioral health resources for military and veteran children and families
✓ Provide an overview of recent expansions to programs and benefits such as TRICARE and specifically related to military and veteran families
✓ Provide an overview of ongoing collaborative efforts and partnerships working to ensure a spectrum of behavioral health services and resources are available in healthcare networks serving SMVF
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Webinar Objectives
✓ Examine how military and civilian behavioral health
care providers can best support SMVF caregivers by
increasing access to best practice programs and
supports
✓ Explore opportunities for public-private collaboration
and partnerships as an option for supporting military
caregivers
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Webinar Objectives (cont’d)
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Our Presenters Today
Kelly A. Blasko, Ph.D.Lead
mHealth Clinical Integration
Connected Health Branch Clinical Support Division
Medical AffairsDefense Health Agency
Erika R. SlatonAssociate Director
Outreach and EngagementMilitary Community Support Programs
Military Community and Family Policy
Office of the Deputy Assistant Secretary of
Defense, DoD
Melissa ComeauDirector
Military and Veteran Caregiver Network
Service to the Armed Forces
American Red Cross
Increasing Access to Behavioral Health Resources for Military and Veteran Children and Families
Webinar
March 12, 2020
Kelly A. Blasko, Ph.D.
Lead
mHealth Clinical Integration
Connected Health Branch
Defense Health Agency
Increasing Behavioral Health Resources for
Military and Veteran Children and Families
Kelly Blasko, Ph.D.mHealth Clinical Integration Lead, Connected Health Branch, Defense Health Agency
March 12, 2020
“Medically Ready Force…Ready Medical Force” 11
Increasing Behavioral Health Resources for Military and Veteran Children and Families
∎Overview
❑TRICARE’s Benefit Change
❑National Defense Authorization Act Fiscal Year 2016
❑DoD Connector Program/Partnering For Readiness (P4R)
❑Qualifying Life Events (QLE) and TRICARE Plan options
“Medically Ready Force…Ready Medical Force” 12
TRICARE’s Benefit Change: A Continuum of Interventions and Increased Access to Behavioral Health
∎ Final Rule, “TRICARE; Mental Health and Substance Use Disorder Treatment,” published in Federal Register on September 2, 2016 (81 FR 61068-61098)❑ Aligned TRICARE’s mental health (MH) and substance use disorder (SUD)
benefit with the principles of mental health parity
❑ Expanded covered MH and SUD treatment under TRICARE purchased care
❑ Streamlined requirements for institutional providers
❑ Eliminated many limits on care
∎ TRICARE manual changes published on June 13, 2017❑ Networks developed to increase access to new provider types
“Medically Ready Force…Ready Medical Force” 13
Plan Ahead: TRICARE Qualifying Life Events (QLE)
∎ TRICARE provides the opportunity to change plans between Prime and Select out
of cycle if a QLE occurs. Beneficiaries may change their TRICARE plan outside of the normal open season (mid-November to mid-December) if a QLE occurs. QLEs include:
https://tricare.mil/LifeEvents/QLE
“Medically Ready Force…Ready Medical Force” 14
Plan Ahead: Loss of TRICARE coverage if separating before retirement
∎TRICARE eligibility ends when the member leaves the service (unless retiring) leading to loss of TRICARE benefits for the member and their family
❑ Temporary health care coverage may be available and acts as a bridge between military health benefits and a new civilian health plan
▪ Transitional Assistance Management Program
▻80 days of premium-free transitional health care benefits after regular TRICARE benefits end
▹ https://tricare.mil/Plans/SpecialPrograms/TAMP
▪ Continued Health Care Benefit Program
▻Gives temporary health coverage for 18-36 months when eligibility for TRICARE ends
▹ https://tricare.mil/Plans/SpecialPrograms/CHCBP
❑ Reservists (and their eligible family members) who are deactivating but remaining in the reserve force may be eligible for TRICARE Reserve Select
“Medically Ready Force…Ready Medical Force” 15
Congressional Requirement: Program for Children at Risk of Mental Health Conditions with Parental Deployment
∎ NDAA 2016, HAC-D Report 114-557 directs SECDEF develop by Fiscal Year (FY) 2017 a program to:❑ Identify children at risk for mental health (MH) conditions related to parental
deployment
❑ Develop tools, education, and guidance for providers and parents
∎ Program Development ❑ Model Adaptation for the DoD Environment
❑ Model Selection and a platform for partnering
“Medically Ready Force…Ready Medical Force” 16
Model Adaptation: Continuum of Interventions in DoD and Community Settings
“Medically Ready Force…Ready Medical Force” 17
Child
Family
Military & Civilian
Community
Culture
INTERVENTIONS Indicated
PreventionSelective
Prevention
Case Identification
Universal Prevention
Standard Treatment: Known Disorders
PositiveDevelopment
Compliance with Long-term Treatment
and After Care
INTERVENTION SETTINGS
Home Acute Inpatient PsychCare/ SUDRF
School
NeighborhoodAgency / Child & Youth Programs
Primary Care Clinic/Embedded
BH/HS OutpatientMental Health/
OBOT
Psychiatric Residential
Treatment Facility
Intensive Outpatient Treatment
Partial Hospital/Opioid Treatment
Program
Adapted from Weisz , Sandler, et al. (2005)
Health Promotion
Institute of Medicine
DoD Connector Program: Prevention and Treatment Programs for Children of Deployers
“Medically Ready Force…Ready Medical Force” 18
INSTITUTE OF MEDICINE, Intervention Spectrum for Psychological Disorders
PREVENTIONSelective - Resources target at-risk children Indicated - Resources target children with current symptoms▪ Child and Family Behavioral Health System (CAFBHS)▪ Child & Youth Military Family Life Counselors/DoD Child & Youth Programs ▪ DoDEA Student Education Services▪ Family Advocacy Program/New Parent Support Program▪ Family Readiness Programs▪ Families Over Coming Under Stress ▪ Military OneSource▪ USCG Work-Life Programs▪ Yellow Ribbon Program
TREATMENT Treatment and Continued Care -Resources for MH/SUD disorders▪ CAFBHS ▪ Services’ military treatment facilities ▪ TRICARE (purchased care):
▪ Outpatient Therapy ▪ Office-Based Opioid Treatment ▪ Intensive Outpatient Program ▪ Partial Hospitalization ▪ Opioid Treatment Program ▪ Residential Treatment Center ▪ Acute Inpatient Psychiatric Facilities▪ SUD Rehabilitation Facilities
Universal - Resources target all▪ AfterDeployment▪ Military Kids Connect ▪ Military OneSource ▪ NDSP-Non-DoDDS Schools▪ PlanMyDeployment ▪ PlanMyMove ▪ Real Warriors
Needs Identification▪ By Providers to Exceptional
Family Member Programs for Assignment/Support Purposes
CONNECTORPROGRAM
Adapted from Weisz , Sandler, et al. (2005)
CONNECTOR PROGRAM PLATFORM: PARTNERING FOR READINESS
PLANNING COMMUNICATION WITH
PARTNERS
PREPARING THE WORKFORCE TO SUPPORT
OUR PEOPLE
DEVELOPING RESOURCES FOR PROVIDERS AND
PARENTS
PARTNERING FOR READINESS
(P4R)
“Medically Ready Force…Ready Medical Force” 19
SHAPING PROCESSES TO SHARE
AND DELIVER SERVICES
PARTNERS: DoD Connector Program/P4R
∎ Building partnerships is a cornerstone for behavioral health prevention and intervention to support military families; more partners are anticipated.
❑ Defense Health Agency (DHA)
❑ DoD Education Activity (DoDEA)
❑ Defense Suicide Prevention Office (DSPO)
❑ Military Community & Family Policy (MC&FP)
❑ MC&FP’s Office of Special Needs and Services’ Exceptional Family Member Programs (EFMP)
❑ Military Family Readiness Council (MFRC)
❑ National Guard-National Guard Bureau (NG-NGB) and Air National Guard (ANG)
❑ Headquarters, Department of the Army (HQDA), Assistant Chief of Staff for Installation Management (ACISM), Child and Youth Programs
❑ Substance Abuse Mental Health Services Administration (SAMHSA)
❑ U.S. Coast Guard (USCG)
“Medically Ready Force…Ready Medical Force” 20
DoD Connector Program: 2017 and 2018 Milestones
∎ 2017
❑ JUL: Military OneSource webisode, “TRICARE Benefits: MH and SUD”
❑ AUG: SAMHSA and P4R conference, Resource Awareness and Sharing
❑ SEP: Articles on child suicide prevention, Health.mil and Exceptional Advocate
❑ DEC: Military Family Readiness Council (MFRC), recommendation to SECDEF
∎ 2018
❑ MAR: MFRC panelists include MH subject matter experts
❑ MAR & JUN: TRICARE behavioral health consultants meetings with P4R member panelists
❑ APR: SAMHSA KSOC-TV webisode, “Addressing the Mental Health Needs of Military Children”
❑ MAY: SAMHSA National Mental Health Awareness Day webisode, “Partnering for Health and Hope Following Trauma”
❑ MAY: Military OneSource Call Center tour for P4R members
❑ JUN & SEP: Child and Adolescent Suicide Prevention Month; DSPO, DoDEA, and DHA
❑ SEP 2018: Suicide Prevention Month
❑ OCT 2018: Prevention of Child and Adolescent Bullying and Cyberbullying
“Medically Ready Force…Ready Medical Force” 21
DoD Connector Program: 2019 and 2020 Milestones
∎ 2019❑ MAY: SAMHSA’s National Children’s Mental Health Awareness Day, “Suicide Prevention: Strategies That Work”
❑ OCT: Mental Health Services in the overseas areas
❑ MONTHLY: P4R TCONS, Hosted by Dr. Kelly Blasko, Military Kids Connect, “Universal Messaging and Programming”
∎ 2020 ❑ MONTHLY: P4R TCONS, Hosted by Dr. Kelly Blasko, Military Kids Connect, “Universal Messaging and
Programming”
❑ MAR: J-7, Clinical Communities Speaker Series: “Children and Youth: Advanced Practices for the Pediatric Health Care Provider”
❑ MAR: SAMHSA webinar: “Increasing Behavioral Health Resources for Military and Veteran Children and Families”
❑ MAY: P4R partners present to SAMHSA’s weeklong webcasts; topics:
▪ Prevention of Prescription and Opioid Drug Misuse
▪ Prevention of Underage Drinking and Alcohol Misuse
▪ Prevention of Illicit Drug Use and Youth Marijuana Use
▪ Prevention of Youth Tobacco Use (E-cigarettes and Vaping);
▪ Prevention of Suicide
❑ JUL: Military Child Education Coalition (MCEC) Pre-Conference Session: “P4R Partners and Military Families”
“Medically Ready Force…Ready Medical Force” 22
Contact Information
Dr. Kelly A. Blasko
Counseling Psychologist
Lead: mHealth Clinical Integration
Connected Health
(c) 253-341-2415
“Medically Ready Force…Ready Medical Force” 23
Supporting Military and Family Where They Serve
Webinar
March 12, 2020
Ms. Erika R. Slaton
Associate Director, Outreach and Engagement
Military Community Support Programs
Military Community & Family Policy
Office of the Deputy Assistant Secretary of Defense
• Discover the range of support provided through Military OneSource
• Understand what non-medical counseling resources are available through MC&FP
• Learn how to access Military OneSource state-based points of contact
• Explore online tools and resources
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Objectives
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Range of Support
Military OneSource offers:• Face-to-face, online, by
phone and video sessions • Short-term, up to 12
sessions, per issue• Available to children and
teens with some guidelines• Can address issues such as:
– Stress management– Marital and communication
issues– Adjustment and deployment
challenges– Parenting skills– Grief or loss
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Confidential Non-medical Counseling
Additional access to non-medical counseling:Military and family life counselors, or MFLCs, and child and youth behavioral MFLCs offer:• Face-to-face counseling and
presentations • Services in a variety of locations:
– Military and family support centers
– Child development centers– School and youth camps– Embedded in military units– Targeted “surge” locations– On-demand events
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Military and Family Life Counseling
Military OneSource provides personalized support designed for expectant parents and parents of children up to age five:• Sessions consist of a variety of
parenting topics, resources, tools and tips– Improving self-care– Developing a routine for your child– Discovering community and
branch-specific resources– Understanding developmental
milestones– Managing challenging behaviors– Single and dual military parents
• Unlimited sessions, available by phone and secure video
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New MilParent Specialty Consultation
State consultants support the total force with emphasis on dispersed military populations. Their role is to:• Provide outreach and education to
military and civilian sectors. • Develop and execute a state support
plan. • Connect active duty, National Guard
and reserve members and families to Federal, state, and local resources and non-profit organizations.
• Integrate community resources into the Military OneSource network of resources available through a 24/7 call center and website.
Request support at: https://supportrequest.militaryonesource.mil/
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State-Based Outreach and Support
MilitaryOneSource.mil provides a 24/7 connection to resources.
Health and Wellness pages feature:
• Articles on healthy living, mental health and health care
• Specific content for wounded warriors and caregivers
• Links to self-care mobile apps and resilience tools
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Online Tools and Resources
Order and download products that cover a range of topics:
• Relationships
• Health and wellness
• Deployment
• Parenting
• Special needs
• Casualty assistance
• Education
• Non-medical counseling
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Educational Materials and Products
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Service members and families have access to Military OneSource as they transition to civilian life:• Supports the Joint Action Plan
required by Executive Order 13822• Ensures that service members and
their families have access to Military OneSource’s suite of services
• Includes Coast Guard members and their families
• Enables Military OneSource outreach to service members who opt-in for contact during the DoD Transition Assistance Program
• Communicates the availability of peer support and non-medical counseling resources
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Military OneSource 365-Day Expansion
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Here’s just a sample of what individuals tell us:• Deployment groups at the school were
very much appreciated. The three MFLCs not only have the skills, but have the heart in working with military kids and their parents.
• Thank you so very much for the great MFLC support during the recent crisis [ in our schools]. I certainly appreciate the flexibility of the MFLC Program to allow [MFLC] to go to school and be available for the kids.
• This is my third time using [Military OneSource] and you have kept my marriage and family together through deployments and everything else.
• Every time I call [Military OneSource], I learn about more resources available. I always wish I knew sooner!
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What They’re Saying
SAMHSA’s mission is to reduce the impact of substance abuse and mental illness on America’s communities.
www.samhsa.gov
1-877-SAMHSA-7 (1-877-726-4727) ● 1-800-487-4889 (TDD)
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Erika R. Slaton
Associate Director, Outreach and Engagement
Military Community Support Programs
Increasing Behavioral Health Resources for Military and Veteran Children and Families
March 12, 2020
Melissa Comeau
Director
Military and Veteran Caregiver Network
American Red Cross
Military caregivers consistently experience worse health outcomes, greater strains in family relationships, and more workplace problems than non-caregivers.
Probable Major Depressive Disorder
38 % post-9/11 and 18.9% pre-9/11
Experience Anxiety
43.1% post-9/11 and 28.7% pre-9/11
https://www.rand.org/pubs/research_reports/RR499z1.html
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What Behavioral Health Challenges Do Military and Veteran Caregivers Face?
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Military and Veteran Caregiver Network
Military and Veteran Caregiver Network
To provide our nation’s military and veteran caregivers from all eras with peer support programs and services
to reduce their isolation and increase their connectedness, engagement, hopefulness, knowledge and skills.
• Reduce caregiver isolation
• Increase caregiver connectedness
• Increase caregiver engagement, hopefulness and
wellbeing
• Increase caregiver knowledge & skills
• Create a network of partner organizations
• Train peer mentors, facilitators & moderators
• Provide one-on-one peer mentoring and peer support
groups (online and community-based)
GOALS OBJECTIVES
OUTCOMES
Connection Engagement Knowledge Skills Hope
MISSION
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The Role of Caregiver Peer Support
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Barriers Impacting Caregivers Searching for Behavioral Health Support
“I don’t know where to go”.
“The services are only for the
Veteran”.
“I don’t want to impact my Service Member’s career”.
“There are no programs for Pre 9/11”.
“I don’t have time”. “We don’t have
the money”.
“ I don’t have any respite”. “There are no
Childcare options”.
“I don’t know what to expect”.
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Searching for Resources
• SAMHSA
• Department of Veterans Affairs Caregiver Support Line 1-855-260-3274
• Hero Care Network
• Cohen Veterans Clinics
• Give An Hour
• Operation Family Caregiver
• Military One Source
• Psych Armor
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Resources Often Recommended by Peers
• https://findtreatment.samhsa.gov/
• https://www.caregiver.va.gov/
• https://www.cohenveteransnetwork.org/
• https://giveanhour.org/
• https://www.operationfamilycaregiver.org/
• https://www.militaryonesource.mil/
• https://psycharmor.org/
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Links to Resources
SAMHSA’s mission is to reduce the impact of substance abuse and mental illness on America’s communities.
www.samhsa.gov
1-877-SAMHSA-7 (1-877-726-4727) ● 1-800-487-4889 (TDD)
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Thank You
https://www.redcross.org/caregivers
Other Key Resources
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Children’s Health Insurance Program101
Division of State Coverage Programs
Children and Adults Health Programs Group
Center for Medicaid and CHIP Services
Where to go for Information on CHIP for Families
• CHIP coverage by state at https://www.insurekidsnow.gov/coverage/index.html
• Frequently Asked Questions at https://www.insurekidsnow.gov/coverage/questions/index.html
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Outreach and Enrollment Resources
• Connecting Kids to Coverage National Campaign– Raises awareness about Medicaid and CHIP and provides outreach
guides and toolkits that can be used to help states, community organizations, schools, health care providers and others organize and conduct successful outreach activities
– Radio and television public service announcements
– Check out www.insurekidsnow.gov for resources!
– Outreach and Enrollment Fundamentals https://www.insurekidsnow.gov/downloads/library/misc/outreach-and-enrollment-fundamentals.pdf
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SAMHSA’s SMVF TA Center E-Newsletter – “Topics in the News”• https://signup.e2ma.net/signup/1820873/1777480/
Military Family Research Institute – Resources and Research• https://www.mfri.purdue.edu/resources-and-research/resources/
VA Special Report on Women Veterans, 2015• https://www.va.gov/vetdata/docs/SpecialReports/Women_Veterans_2015_Final.pdf
SAMHSA’s SMVF TA Center Webinar “Key Transitions: Supporting the
Behavioral Health of Women Veterans”• https://www.youtube.com/watch?v=5UBWzXDQzLA
Children’s Health Insurance Program (CHIP)• www.insurekidsnow.gov
Medicaid or CHIP Enrollment• www.healthcare.gov
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Additional Resources:
Questions?
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Contact SAMHSA’s SMVF TA Center
345 Delaware Avenue
Delmar, NY 12054
Phone: 518-439-7415, ext. 5272
Email: [email protected]
SAMHSA’s mission is to reduce the impact of substance abuse and mental illness on America’s communities.
www.samhsa.gov
1-877-SAMHSA-7 (1-877-726-4727) ● 1-800-487-4889 (TDD)
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Thank You!