NorthKey

503 Farrell Drive
Covington, KY 41012
859-578-3204
http://www.northkey.org

Project Title
Adolescent Substance Abuse Planning
Grant Description
To complete a needs assessment and develop a plan to enhance adolescent substance abuse treatment services in eight Northern Kentucky counties
Focus Area
Substance Use Disorders
Region Served
Boone, Campbell, Gallatin, Grant, Kenton, and Pendleton Counties, KY
Award Amount
$131,575
Year Awarded
2000
Grant Duration
18 months
Results The planning process was led by a consultant and included participation by more than 300 individuals. A steering team of 20 professional leaders met monthly to direct the project. A project team of 43 other individuals (representing a variety of disciplines, agencies, and geographical locations) met for three full-day work sessions over the course of the project to provide input for the finished products: a needs assessment, a strategic plan for the region, and a business plan for an adolescent service. Focus groups, key informant surveys and interviews, and local, state, and national incidence data were used to determine the needs of the area.

NorthKey was able to meet its goal and all the objectives related to this grant. A needs assessment of adolescent substance abuse treatment in an eight-county area was completed. A strategic plan was developed with prioritized items and detailed implementation steps. A business plan for a regional adolescent substance abuse collaborative and for an intensive outpatient program in Pendleton County were presented to the Foundation as part of an application for start-up funds.

A recovering ninth grader who was interviewed during the needs assessment said, "It may sound trite, but it will take an entire community working together to change the culture in which drug and alcohol use by teens is the norm." This view was echoed by many during the planning process and is evident in the strategic plan that was developed by NorthKey.

Other findings include the following:

  • Based on the 1998 Kentucky Adolescent Household Survey, approximately 15.5% of adolescents in Northern Kentucky need substance abuse treatment.
  • Only 10% of those Northern Kentucky adolescents in need of substance abuse treatment services are receiving them.
  • The eight counties served have the highest median family income and the lowest percent of people living in poverty of all the regions in the state.
  • Three (Campbell, Pendleton, and Kenton) of the eight counties are in the top 10 counties in Kentucky for yearly juvenile alcohol and other drug offenses.

The needs assessment and strategic plan were used by the Mental Health Association of Northern Kentucky to obtain a $200,000 grant from the Kentucky Agency for Substance Abuse Policy.

The use of a skilled planner was the primary facilitator of this project. The size and diversity of the region would have been daunting without expert consultation. Other facilitators included:

  • workshops and dinners with an adolescent substance abuse expert to kick off the project;
  • involvement of a broad, diverse group of community members in the process;
  • community planning efforts that helped set the stage for group planning;
  • use of a common survey in the past year by three urban counties to assess adolescent incidence and trends; and collaboration.

Barriers to the process included short team-building time because of the need to accomplish so much.

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Project Title
Adolescent Substance Abuse Treatment Start-Up
Grant Description
To provide adolescent substance abusers in Pendleton County access to an intensive outpatient treatment program
Focus Area
Substance Use Disorders
Region Served
Pendleton County, KY
Award Amount
$315,300
Year Awarded
2001
Grant Duration
36 months

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Project Title
Building Family and Community Relations
Grant Description
To develop additional treatment resources for services to justice system-involved youth in Northern Kentucky
Focus Area
Other Health
Region Served
Boone, Campbell, and Kenton Counties, KY
Award Amount
$286,622
Year Awarded
2003
Grant Duration
36 months
Results
 NorthKey hired and arranged for Functional Family Therapy (FFT) training for 2 therapists and a clinical coordinator; installed FFT software; and developed policies and procedures in collaboration with the Department of Juvenile Justice.

The first FFT treatment began in April 2004. Over the grant period, NorthKey opened 104 FFT cases. Of these cases, 51 youth and their families completed treatment.

NorthKey tracked outcomes for all youth who completed the FFT program.

NorthKey had several discussions with state officials to try to alter the Medicaid payment approach in order to cover intensive programs such as FFT. However, none of these discussions resulted in any change. Therefore, NorthKey had to bill under the traditional Medicaid payment system which was not enough to cover the costs of the FFT program. As a result, the FFT program was discontinued after grant funds ended.

NorthKey collected outcome data on the 51 youth who completed treatment:

  • Behavioral health status – 46 of 51 (92%) demonstrated behavior improvement
  • Symptom improvement – 42 of 42 (100%) self-rated improvement in symptoms
  • Aggressive behavior – 42 of 51 (82%) displayed a decrease in aggressive behavior
  • School attendance – in cases where school attendance was noted as a problem, FFT therapy had no impact on improving school attendance
  • Recidivism – 16 of 16 (100%) with juvenile justice involvement did not re-offend during the treatment period
  • Family Functioning – 47 of 51 (92%) showed improvement in family functioning
  • Out-of-home placement – 50 of 51 (98%) remained in their homes
  • Cost – the FFT program generated $87,270 in payer revenue, but this was not enough to offset the cost of the program. The traditional payer system only paid for 2 hours of billable time per client per week. When combined with the low caseload per therapist, this was an insufficient income rate to sustain the service.

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Project Title
Crisis Intervention Team
Grant Description
To implement a police-based crisis intervention team to divert those with severe mental illnesses into treatment
Focus Area
Joint Substance Use Disorders / Severe Mental Illness
Region Served
Boone, Campbell, and Kenton Counties, KY
Award Amount
$249,165
Year Awarded
2006
Grant Duration
36 months

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Project Title
Evidence Based Practices in the Treatment of Adolescent Substance Use Disorders
Grant Description
To conduct a feasibility study and assessment of the organization's ability to implement an evidence-based practice
Focus Area
Substance Use Disorders
Region Served
Boone, Campbell, Carroll, Gallatin, Grant, Kenton, Owen, and Pendleton Counties, KY
Award Amount
$43,400
Year Awarded
2005
Grant Duration
13 months

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Project Title
Grant County Inmate Transition Program
Grant Description
To assist offenders with substance use disorders and severe mental illnesses reenter the community after incarceration.
Focus Area
Joint Substance Use Disorders/ Severe Mental Illness
Region Served
Grant County, KY
Award Amount
$272,900
Year Awarded
2007
Grant Duration
36 months

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Project Title
Improving School-Based Mental and Behavioral Health Services
Grant Description
To improve the coordination and delivery of school-based mental health services
Focus Area
School-Aged Child Healthcare
Region Served
Boone, Campbell, Gallatin, Grant, Kenton, and Pendleton Counties, KY
Award Amount
$208,652
Year Awarded
2000
Grant Duration
24 months
Results The Advisory Council’s major objectives of the strategic plan are to:
  • develop service delivery systems involving the collaboration and coordination of multi-disciplinary providers;
  • provide on-going advocacy for school-based mental health services;
  • assess and evaluate the level of mental health care delivered through school-based services; and
  • serve as a resource for and educate families and school personnel regarding the roles of mental health professionals, parents, and teachers in healthy child development.

The Advisory Council is comprised of school-based services administrators representing the three largest social service/mental health organizations; school district superintendents (representing a rural and a suburban/urban district); a parent with years of advocacy experience for children with severe emotional disorders and academic problems; and service providers from public, independent, and private school programs. Under the direction of the Project Director, this newly titled Northern Kentucky School-Based Mental Health Collaborative has adopted as its mission "to improve school-based services through collaborative efforts, with an ultimate vision that every student will be mentally healthy."

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Project Title
Improving Mental and Behavioral Health Services for School Children
Grant Description
To improve access to mental and behavioral health services in Northern Kentucky
Focus Area
School-Aged Child Healthcare
Region Served
Boone, Campbell, Gallatin, Grant, Kenton, and Pendleton Counties, KY
Award Amount
$87,898
Year Awarded
2002
Grant Duration
12 months
Results
  • An Adivisory Council and a Steering Committee, which were established prior to this grant with members from mental health providers, community leaders and school personnel, continued to meet throughout the last year to steer the planning effort.
  • The Advisory Council identified and reviewed school-based services models. The Council selected a model to implement in Northern Kentucky and applied for a Substance Abuse and Mental Health Services Administration (SAMHSA) grant for implementation funds.
  • Lastly, the project coordinator collected data on the amount of services being provided in Northern Kentucky. The number of providers in the schools decreased from the previous year, but hours and children seen actually increased. The number of students receiving services in schools increased. The number of students receiving services in schools increased from 647 to 867 and the number of hours increased from 6,331 to 8,145.

The collaborative partners continued to informed each other and interested parties about the needs of this population. However, no new additional funding was identified.

The Mental Health Association of Northern Kentucky and the Public Relations Resource Officer with the Northern Kentucky Regional Board regularly update their websites with information regarding availability and types of services offered in the region. In addition, a regional Mental Health Awareness Committee has been established.

The Advisory Council is committed to continuing its work, but does not see new services being available without outside funding.

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Project Title
Northern Kentucky Youth Substance Abuse Treatment Collaborative
Grant Description
To build a regional partnership and care system for reducing substance abuse in 8 counties in Northern Kentucky
Focus Area
Substance Use Disorders
Region Served
Boone, Campbell, Carroll, Gallatin, Grant, Kenton, Owen, and Pendleton Counties, KY
Award Amount
$101,100
Year Awarded
2001
Grant Duration
36 months
Results The grantee hired the staff, established meetings, and designed reporting mechanisms.

The YSAT Collaborative met monthly over the three years with involvement of over 30 individuals from eight counties.  The partners completed most of the work plan activities, adding new activities and deleting unnecessary ones in response to changing opportunities within Kentucky.

The Collaborative developed guidelines and policies for sustaining itself but decided not to charge dues.  They submitted 50 proposals to various foundations and state agencies in order to fund activities of the Collaborative, both during and after Health Foundation funding.  Only two of these proposals provided funding for the project: The Kentucky Agency for Substance Abuse Policy provided 50% of the funds ($50,700) needed to support the collaborative for the first 18 months; and The Northern Kentucky Health Department provided $20,000 to the Collaborative for its last year.  NorthKey is sustaining the Collaborative through June 2006.

  • Services in the region now include intensive outpatient programs in four counties and outpatient services in eight counties.  No residential treatment programs are offered currently, but NorthKey is examining the possibility of offering residential services within its children’s psychiatric program. 
  • YSAT partners submitted six collaborative proposals to increase or improve adolescent services.  Two of these were funded, including a federal grant to improve school-based services for co-occurring disorders. Two proposals are still being reviewed and two were rejected by the funding entities.  YSAT partners submitted four proposals related to improving adolescent treatment services to The Health Foundation during the project period. The Foundation funded all four.
  • Collaborative partners improved coordination by sharing policies and procedures at meetings and trainings.  During the last year, YSAT partners worked together to evaluate the drop in referrals to early intervention programs.  YSAT solutions succeeded in increasing referrals for two of the programs.  The goal for the coming year is to increase referrals for two other programs.
  • The Collaborative held  27 group awareness presentations. YSAT staff did not give pre/post tests for 21 of the presentations because of the nature of the audience or the setting.  Attendees at presentations who completed pre/post tests increased their knowledge of substance use disorders.  YSAT has tried to involve the Northern Kentucky Chamber of Commerce in their activities to no avail.  YSAT continues its efforts to talk to this group.
  • YSAT partners report to varied agencies with different data required in different formats.  As a result, the Collaborative partners were unable to achieve this objective.  Instead they began sharing information monthly on their agencies which improved the communication between agencies in the region.
  • The YSAT Collaborative held 12 provider educational events with 487 people attending. Attendees’ evaluations reported increased knowledge. Thirty-two people attended the final event, a community-wide training Finding Help for Our Youth.  In the last year of the grant the YSAT Collaborative received two awards: The Robert Straus Award for Outstanding Service in the Field of Community Organizations from the Kentucky Division of Substance Abuse and the Community Group Impact Award from the Northern Kentucky United Community Awards.
  • The number of youth served in the region yearly increased by 61% (from 540 in 2001 to 868 in 2004).

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Project Title
NorthKey Strategic Planning for Mental Health and Substance Abuse
Grant Description
To establish a community needs assessment process which leads to the development of services to achieve clinical excellence in mental health and substance abuse systems in eight Kentucky counties
Focus Area
Substance Use Disorders
Region Served
Boone, Campbell, Carroll, Gallatin, Grant, Kenton, Owen, and Pendleton Counties, KY
Award Amount
$193,635
Year Awarded
1999
Grant Duration
12 months
Results The planning grant received by the NorthKey Community Care is a multi-phased project which allows for an effective assessment of the mental health, substance abuse and mental retardation service needs in the eight northern counties of Kentucky. The project funded by this grant consists of establishing a thorough and replicable process to identify the needs of the region; developing a regional data base from the needs assessment data collected; establishing an internet access to this database; and undertaking a strategic planning process with the Regional Board to prioritize the needs identified in the eight northern counties of Kentucky. Finally, the Regional Board will develop a realistic plan to address the needs targeted as priorities. This grant will have an immediate and lasting impact on the region by strengthening the process for data collection and establishing a replicable process for the maintenance of current needs assessment data. The added feature of storing the data collected from the needs assessment in a database that is accessible through an internet connection allows for the data to be accessible to the entire region of mental health providers and planners. It will serve as a resource for planning to enhance the existing service continuum and meet the growing demands for services in the region.

The collection and aggregation of needs assessment data will occur until mid-summer by utilizing existing information and feedback from key informants representing a cross section of the community. This information gathering is projected to include individual interviews, focus groups, and the use of a survey instrument to gather information from service providers, consumers, business leaders, community leaders, advocacy groups, state agencies, and others. The grant helps support the initial development of the survey items, the database, the web site, and helps establish linkages for each community. The continuing support of the data collection process, maintenance of the database, and maintenance of the web site will be continued by the Regional Board.

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Project Title
Planning for Adults in the Criminal Justice System with Mental Illness and Substance Use Disorders
Grant Description
To conduct a needs assessment and determine best practice interventions for adults with mental illnesses or substance use disorders involved in the criminal justice system in eight Northern Kentucky counties
Focus Area
Joint Substance Abuse/Severe Mental Illness\Criminal Justice
Region Served
Boone, Campbell, Carroll, Gallatin, Grant, Kenton, Owen, and Pendleton Counties, KY
Award Amount
$55,300
Year Awarded
2004
Grant Duration
12 months
Results A true collaborative team was not developed.  However, information was gathered from over 150 stakeholders through a variety of methods. Site visits and meetings were conducted with clinicians, judges, jailers and other criminal justice personnel in both urban and rural counties.  Although an overall team was not formed because of scheduling difficulties, telephone calls and emails were regularly made with contacts to seek input and keep those contacts involved in the planning process.

Data was gathered about the rural and urban jail population through surveys and focus groups.  Surveys were administered to a cross section of deputy jailers.  Sixty-two percent of the deputy jailers felt that there were mentally ill inmates who should never have been arrested.  The deputies also believed they were not adequately training to deal with the inmates with mental illness.  Inmates with mental health or substance abuse disorders were surveyed.  Approximately one-third said they had been told by a doctor or therapist that they had a mental illness.  A total of 69% thought they had a problem with alcohol or drugs, and 48% wanted to talk with a doctor because they felt depressed. Jail-based and community focus groups were held in both urban and rural counties.  Information gathered from these meetings clarified that different programming options would be needed for urban and rural counties.

A full review of the literature was included in the final report. Interventions studied were Crisis Intervention Teams (CIT), mental health and drug courts, institutional treatment and reentry programs.

Grant County was interested in considering reentry options for those inmates exiting the jail. The other rural counties could not come to a consensus regarding what interventions would be helpful. For the urban counties of Boone, Campbell and Kenton, CIT was determined to be the most appropriate model.

Plans were developed for both rural and urban areas.  CIT for the urban counties was deemed to be of the highest priority and most ready for implementation.  The planning team continues to work on the Grant County reentry project.

A business plan was completed for the CIT project, and one is projected for the Grant County reentry project.

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Project Title
Seven Challenges Program Implementation
Grant Description
To implement the Seven Challenges Program for the treatment of adolescents with substance use disorders
Focus Area
Substance Use Disorders
Region Served
Campbell, Grant, and Kenton Counties, KY
Award Amount
$55,000
Year Awarded
2006
Grant Duration
12 months

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Project Title
Supported Community Housing for Persons with Severe Mental Illness
Grant Description
To provide supportive services to people with severe mental illnesses living in permanent community housing in three Kentucky counties
Focus Area