H79SM080948

Assertive Community Treatment - Assisted by a Stakeholder's Advisory Group, Los Angeles Centers for Alcohol and Drug Abuse (L.A. CADA), will establish a high-fidelity, field-based Assertive Community Treatment (ACT) program in L.A. County.

We will accept up to six admissions a month for a static capacity of 100 participants. A recovery-oriented package of integrated, individualized, and time-unlimited services will provide consumers with approximately four face-to-face contacts per week and four family contacts per month, as well as 24/7 crisis intervention.

A diverse multidisciplinary team will deliver ACT services, meeting daily to review consumer progress and plan the treatment day. Participants will be referred from the L.A. County Department of Mental Health (DMH), local law enforcement, and L.A. CADA treatment programs.

L.A. CADA will serve adult men and women (age 18+) with severe and persistent primary mental illness (SMI) and secondary co-occurring substance use disorders (SUD), including veterans. This group has not been well-served by traditional services and are at highest risk for trauma, relapse, mortality, and morbidity due to chronic incarceration, hospitalization, and homelessness. Our consumers are of very low income and predominantly persons of color (17% African American; 61% Latino; 8% other; 14% white). They report being subject to racial discrimination, as well as cultural fear and family bias regarding mental illness - barriers that separate them from treatment.

Among the ACT "feeder" programs operated by L.A. CADA is our new 10-30-day DMH-funded crisis residential treatment program for persons with SMI (opening January 2019 in Santa Fe Springs, CA). Our service group will also include gay and transgender inmates with SMI released to probation from L.A. CADA's unique treatment program within Men's Central Jail in Los Angeles, as well as consumers with SMI who have been released from our locked state detention treatment facility: the Custody-to-Community Reentry Treatment Program for Women. Our service group is characterized by functional disability, social isolation, medications non-compliance, health problems (including HIV), and overuse of emergency services and mental health hospitals.

The ACT model has proven effective in helping similar people with continuous high service needs to reduce hospitalizations, retain housing, and remain connected to recovery, healthcare, and social services. Moreover, ACT can empower our consumers to achieve their own recovery and successful community integration.

With 10 million diverse residents (72% persons of color), Los Angeles County is an urban area with few ACT programs, especially programs designed to competently serve people of color. Here and throughout California, 10-12% of all ER visits are a result of mental health emergencies, often compounded by substance use (the primary reason for ER visits in L.A. County is prescription drug overdose). Our service area includes 74 critical census tracts designated by HRSA with a shortage of mental health providers. In addition, California has only 17 psychiatric beds per 100,000 residents when mental health specialists recommend a minimum of 50 psychiatric beds per 100,000.

An estimated 25% of all L.A. County inmates have a mental illness - double the number in 2016. And the L.A. County 2017 homeless count found that 30% of our homeless population have a mental illness and 18% have a substance use disorder (with homelessness here up a staggering 23% in one year over 2016). Clearly, evidence-based ACT programs are needed in L.A. County.

Los Angeles Center For Alcohol & Drug Abuse

SAMHSA WAS GIVEN THE AUTHORITY TO ADDRESS PRIORITY SUBSTANCE ABUSE TREATMENT, PREVENTION AND MENTAL HEALTH NEEDS OF REGIONAL AND NATIONAL SIGNIFICANCE THROUGH ASSISTANCE (GRANTS AND COOPERATIVE AGREEMENTS) TO STATES, POLITICAL SUBDIVISIONS OF STATES, INDIAN TRIBES AND TRIBAL ORGANIZATIONS, AND OTHER PUBLIC OR NONPROFIT PRIVATE ENTITIES. UNDER THESE SECTIONS, CSAT, CMHS AND CSAP SEEK TO EXPAND THE AVAILABILITY OF EFFECTIVE SUBSTANCE ABUSE TREATMENT AND RECOVERY SERVICES AVAILABLE TO AMERICANS TO IMPROVE THE LIVES OF THOSE AFFECTED BY ALCOHOL AND DRUG ADDITIONS, AND TO REDUCE THE IMPACT OF ALCOHOL AND DRUG ABUSE ON INDIVIDUALS, FAMILIES, COMMUNITIES AND SOCIETIES AND TO ADDRESS PRIORITY MENTAL HEALTH NEEDS OF REGIONAL AND NATIONAL SIGNIFICANCE AND ASSIST CHILDREN IN DEALING WITH VIOLENCE AND TRAUMATIC EVENTS THROUGH BY FUNDING GRANT AND COOPERATIVE AGREEMENT PROJECTS. GRANTS AND COOPERATIVE AGREEMENTS MAY BE FOR (1) KNOWLEDGE AND DEVELOPMENT AND APPLICATION PROJECTS FOR TREATMENT AND REHABILITATION AND THE CONDUCT OR SUPPORT OF EVALUATIONS OF SUCH PROJECTS, (2) TRAINING AND TECHNICAL ASSISTANCE, (3) TARGETED CAPACITY RESPONSE PROGRAMS (4) SYSTEMS CHANGE GRANTS INCLUDING STATEWIDE FAMILY NETWORK GRANTS AND CLIENT-ORIENTED AND CONSUMER RUN SELF-HELP ACTIVITIES AND (5) PROGRAMS TO FOSTER HEALTH AND DEVELOPMENT OF CHILDREN, (6) COORDINATION AND INTEGRATION OF PRIMARY CARE SERVICES INTO PUBLICLY-FUNDED COMMUNITY MENTAL HEALTH CENTERS AND OTHER COMMUNITY-BASED BEHAVIORAL HEALTH SETTINGS

93.243 - Substance Abuse and Mental Health Services Projects of Regional and National Significance

Division of Grants Management [HHS - SAMHSA]

Santa Fe Springs, California 90670 United States

Single Zip Code

Assertive Community Treatment Grants (Short Title: ACT) (SM-18-013)

Amendment Since initial award the total obligations have increased 406% from $678,000 to $3,428,706.