Kansas All-Hazards Behavioral Health Program

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Kansas All-Hazards Behavioral Health Program

• Preparedness, Response,
• and Recovery For
• Kansas Communities

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KAHBH Personnel

• Dr. Briana S. Nelson Goff, KSU/Family Studies
  Human Services
• Charlie Griffin, KSU/Family Studies Human
  Services
• Becky Rinehart, SRS Mental Health, Topeka
• Stephanie Wick, Operations Manager
• Michael Smith, Graduate Student Assistant
• Lizette Vargas, BRIDGES DSP Undergraduate
  Student Assistant

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• Behavioral Health
• Mental Health Substance Abuse

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• 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 publics
  sense of safety and increase confidence in our
  institutions. Because the overriding goal of
  terrorism is to change peoples 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

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• Mental Health is the linchpin to an effective
  response.
• Statement from April 2005
• TOPOFF 3 Exercise

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• All-Hazards All-Hazards
• Disasters
• Bioterrorism
• Major Community Crises

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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 recommended 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 Response Plan

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• 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

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Behavioral Health Response to Presidentially
Declared Disaster
Sources of Information -Red
Cros -KEMA -Adjutant Generals Office -Cities
- Newspapers - New Releases To Collect
Data Per County -Casualties -Injured -Business -Sc
hools -Homes -Homeless -Power -Food -Water -------
------------------------------------ -Budget -Staf
f
Event
9 Months If needed apply for Regular
Services Program (RSP)
City Response
County Response
60 Days 1) On-Site Command 2) Local
Outreach workers 3) Supplies
State Response
KDEM Application National Disaster
KMHA has 14 Days to Apply for Immediate
Services Project (ISP)
Presidentially Declared Disaster
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FEMA/SAMHSA Crisis Counseling Assistance and
Training Program
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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

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Organizational Partners in Crisis Counseling
Program

• Community Mental Health Agencies
• State Mental Health Authority
• State Emergency Management Agency
• Federal Emergency Management Agency (Region and
  Headquarters)
• Center for Mental Health Services

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Administrative Staff

• Community Program Managers
• State Disaster Mental Health Coordinator
• Governors Authorized Representative
• FEMA Crisis Counseling Coordinator
• FEMA Human Services Officer
• Federal Coordinating Officer
• FEMA Headquarters Crisis Counseling Coordinator
• CMHS Project Officer

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Disaster Operations Structure
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CCP Organizational Chart Small Provider
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CCP Organizational Chart Large Provider
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Examples of Crisis Counseling Program Services

• Outreach
• Screening and Assessment
• Counseling
• Information and Referral
• Public Education

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Program Limitations

• Medications
• Hospitalization
• Long-term Therapy
• Providing Childcare or Transportation
• Fundraising activities
• Advocacy
• Case Management

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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
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FEMA/CMHS Crisis Counseling ProgramFY 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 1501 PR (Storms Flooding)
FEMA 1322 AL (Tornado)
FEMA 1437 LA (Flooding)
FEMA 1479 TX (Hurricane Claudette)
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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

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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

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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

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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)
• 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

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• Paraprofessional Training
• All nonbehavioral health members/paraprofessionals
  
• 4 hours training on basic helping skills in
  crisis counseling
• 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

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• Future Specialty Trainings
• To be based on each communitys 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)
• 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

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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

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KAHBH Network

• 10 staff
• 15 Stakeholders
• 12 SRS Field Staff
• 29 CMHC Coordinators
• Goal 200 KAHBH Network members

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KAHBH Stakeholder Supporting Agencies

• 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

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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.

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(No Transcript)
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• Preparedness Activities
• Response Activities
• Recovery Activities

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• 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.

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Organizations Involved in Disaster Response

• Federal
• SAMHSASubstance Abuse Mental Health Services
  Administration CMHSCenter for Mental Health
  Services
• FEMAFederal Emergency Management Agency
• State
• KDHEKansas Dept. of Health and Environment
• KDEMKansas Division of Emergency Management
• SRSKansas Dept. of Social and Rehabilitation
  Services
• Local
• Local emergency management agencies
• CMHCCommunity Mental Health Centers
• Local professionals and para-professionals
  (substance abuse professionals, clergy,
  doctors/nurses, fire/police department,
  volunteers, etc.)

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Role of KAHBH Network Members

• SAMHSA/CMHC Model
• Professionals and paraprofessionals working in
  teams
• Based on SRS CMHC Regions
• 27 total areas in Kansas

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KAHBH is not

• American Red Cross Disaster Mental Health
  Services
• Critical Incident Stress Debriefing

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Network members should be

• Indigenous to the communities they serve
• Possess varied experience
• Non-traditional methods
• Sensitive to cultural issues

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KS Citizens

KDEM
State Plan
KS Citizens
39
KS Citizens

KAHBH
KDEM
State Plan
KS Citizens
40
KS Citizens
State Stakeholders

KAHBH
KDEM
State Plan
KS Citizens
41
KS Citizens

State Stakeholders
KAHBH
KDEM
State Plan
American Red Cross
KS Citizens
42
KS Citizens
State Stakeholders

KAHBH
KDEM
State Plan
Education Trainings, Universities, Conferences
American Red Cross
KS Citizens
43
KS Citizens
State Stakeholders

KAHBH
KDEM
State Plan
Education Trainings, Universities, Conferences
Governors Bioterrorism Coordinating Council (SRS
Mental Health Authority rep joined
4/04
American Red Cross
KS Citizens
44
KS Citizens
State Stakeholders

County Data Bank
KAHBH
KDEM
State Plan
Education Trainings, Universities, Conferences
Governors Bioterrorism Coordinating Council (SRS
Mental Health Authority rep joined
4/04
American Red Cross
KS Citizens
45
KS Citizens
State Stakeholders

County Data Bank
KAHBH
KDEM
State Plan
Education Trainings, Universities, Conferences
KS Train
Governors Bioterrorism Coordinating Council (SRS
Mental Health Authority rep joined
4/04
American Red Cross
KS Citizens
46
KS Citizens
State Stakeholders
Disaster Exercises

County Data Bank
KAHBH
KDEM
State Plan
Education Trainings, Universities, Conferences
KS Train
Governors Bioterrorism Coordinating Council (SRS
Mental Health Authority rep joined
4/04
American Red Cross
KS Citizens
47
KS Citizens
State Stakeholders
Disaster Exercises

County Data Bank
KAHBH
KDEM
State Plan
Education Trainings, Universities, Conferences
KS Train
1st responders/ Critical Incident Stress
Management
Governors Bioterrorism Coordinating Council (SRS
Mental Health Authority rep joined
4/04
American Red Cross
KS Citizens
48
KS Citizens
State Stakeholders
Disaster Exercises

County Data Bank
KAHBH
KDEM
State Plan
Education Trainings, Universities, Conferences
KS Train
1st responders/ Critical Incident Stress
Management
Governors Bioterrorism Coordinating Council (SRS
Mental Health Authority rep joined
4/04
American Red Cross
KS Citizens