Care Collaborative March 27, 2018 - North Country Initiative

Care Collaborative March 27, 2018 - North Country Initiative

Care Collaborative March 27, 2018 Lindsay Newvine St. Lawrence County Mental Health Services Coordinator [email protected] (315) 229-3871 Adult SPOA (Single Point of Access) Provides a centralized intake system for referrals to case management, housing, and other supports for individuals with serious mental illness who are having difficulty managing day to day life

Goal is to ensure individuals referred will be matched to the appropriate level of service based on their needs Adult SPOA (Single Point of Access) 18 years and up Diagnosis of a serious mental illness Need ongoing support to live successfully in the community Referral can be found at http:// northcountryinitiative.org/wp-content/upl oads/2017/07/SPOA-Referral-Form-adults. pdf

Adult SPOA (Single Point of Access) Case Management Services Available Assertive Community Treatment (ACT) Team, Delivers comprehensive services to individuals diagnosed with severe mental illness and whose needs have not been well met by traditional service delivery approaches Services offered

On call access 7 days a week Service planning and coordination Family life and social relationship support Housing assistance Wellness Self-Management and Relapse prevention Assistance with ADLs Health Promotion Money Management and Entitlements Integrated Treatment for Substance Abuse

Vocational Opportunities Problem Solving Medication Support Self Help Adult SPOA (Single Point of Access) Case Management Services Available (Cont.) Intensive Health Home Care Management Delivers services to individuals who have SPMI (Serious and Persistent Mental Illness), impairment in functioning, repeated psychiatric hospitalizations, frequent crisis contacts, resistance with treatment Services Offered

Comprehensive Case Management Care Coordination and health promotion Transitional care (from inpatient to community) Individual and Family Support Referrals to community and social supports Adult SPOA (Single Point of Access) Case Management Services Available (Cont.) Health Home Care Management,

https://www.health.ny.gov/health_care/medicaid/program/medicaid_ health_homes / Eligibility Medicaid and Two or More Chronic Conditions or HIV/AIDS, or SPMI and Significant behavioral, medical or social risk factors Care management service model, all caregivers communicate with one another so individuals needs are addressed in a comprehensive manner Services Offered

Comprehensive Care Management Care Coordination and Health Promotion Comprehensive Transitional Care Family Support Referral to Community Supports Adult SPOA (Single Point of Access) Case Management Services Available (Cont.) Supported Housing Case Management Financial and Case Management assistance to adults diagnosed with SPMI in the area of location, procuring and maintaining safe, affordable housing

Services Start up funding for security deposits, first months rent, furniture, appliances Ongoing rental stipends Low level case management needs Seen once or twice a month Adult SPOA (Single Point of Access) Case Management Services Available (Cont.) Peer Support Case Management Step by Step, 1515 Knox St, Ogdensburg (315) 394-0597, http://stepbystep.technologyworks4you.com/

Also have a drop in center which is a safe, nonjudgmental environment where people can be themselves, socialize with others and engage in activities and services of their choice. Adult SPOA (Single Point of Access) Residential Services Available Northwood Manor (Ogdensburg) State Operated Voluntary Community Residence Staff 24/7 For individuals needing assistance and support either following a psychiatric hospitalization or an alternative to hospitalization Eligibility Diagnosis of Mental Illness

Unable to live independently, but has a goal to live independently In need of rehabilitation and guidance in ADLs Capable of self-preservation 18 years and older Adult SPOA (Single Point of Access) Residential Services Available (Cont.) United Helpers Gateway Apartments (Ogdensburg) Housing, Support and Education for people diagnosed with SPMI with the goal of reintegrating into community life Skill training provided in: Medication Management, cooking, cleaning, laundry, self-care skills, budgeting, and others Staffed during the day with on call in the evenings

Eligibility Diagnosis of Mental Illness Unable to live independently, but has a goal to live independently Capable of self-preservation 18 years or older Adult SPOA (Single Point of Access) Residential Services Available (Cont.) North Country Transitional Living Services Community Residence Co-ed apartment style housing with 24/7 staff support located in Gouverneur Residents acquire independent living skills including

medication management, socialization and daily living skills Eligibility Diagnosis of Mental Illness Unable to live independently, but has a goal to live independently 18 years or older Capable of self-preservation Adult SPOA (Single Point of Access) Residential Services Available (Cont.) North Country Transitional Living Services Single Room Occupancy (SRO) Homeless housing immediate goal is to provide shelter and then follow up to ID cause of homelessness and provide assistance to

reverse circumstances One person per bedroom community style living Shared kitchen, living room and bathroom Each room has its own dresser, closet and dorm sized fridge Staffed during normal business hours and on call after hours Residence located in Ogdensburg (Male and Female) and Canton (Male) Eligibility 18 years or older Homeless Adult SPOA (Single Point of Access) Residential Services Available (Cont.) Family Care

Residential service sponsored by OMH Places individuals in need of community placement with persons certified to deliver residential care in their own homes Providers receive training, support and financial reimbursement Eligibility Diagnosis of Mental Illness Unable to Live Independently 18 years or older Adult SPOA (Single Point of Access) Residential Services Available (Cont.) Step by Step, Inc. Housing Program (Ogdensburg)

Peer run service designed to provide an alternative option to traditional residential and supported housing program Transitional housing for individuals re-entering the community from hospitalization or for those who have not benefited from traditional supported housing programs Eligibility Diagnosis of a mental illness 18 years or older Childrens SPOA (Single Point of Access) Process to identify the children most at risk of out of home placements and to connect them to community based programs that will support them and their families.

Goal is to keep children in their home with their families in the most normalized setting as possible. Ensure children and their families are getting the right services in the right amount. Childrens SPOA (Single Point of Access) Who is eligible? Children and youth who reside in SLC Child/youth experiencing serious emotional, behavioral and/or social challenges Risk of hospitalization or out of home placement Child currently hospitalized or in an out of home placement

Referral can be found at http://northcountryinitiative.org/wp-conte nt/uploads/2017/07/SPOA-Referral-Form-c Childrens SPOA (Single Point of Access) Case Management Services Available Home and Community Based Service Waiver Children 5 to 18 who have complex health and mental health needs, must demonstrate evidence of SED (serious emotional disturbance) Has had a hospitalization or is eligible for psychiatric hospitalization Services

Care coordination Respite Family support services Intensive in-home services Crisis response Skill building Childrens SPOA (Single Point of Access) Case Management Services Available (Cont.) Health Home Care Coordination Eligibility

Medicaid and Two or More Chronic Conditions or HIV/AIDS, or SED or Complex Trauma and Significant behavioral, medical or social risk factors Care management service model, all caregivers communicate with one another so individuals needs are addressed in a comprehensive manner Services Offered Comprehensive Care Management

Care Coordination and Health Promotion Comprehensive Transitional Care Family Support Referral to Community Supports Childrens SPOA (Single Point of Access) Case Management Services Available (Cont.) Coordinated Childrens Services Initiative Children under age of 18, at risk of out of home placement or inpatient treatment, family is involved with two or more systems (Mental Health, CSE, Probation, DSS, etc) * No Mental Health Diagnosis Required* Brings the family and providers together in an effort to coordinate services. Services Offered

Case Management Family Support Skill Building Socialization Linkage to community resources Childrens SPOA (Single Point of Access) Case Management Services Available (Cont.) St. Lawrence County Community Services Child and Family Support Team Team consisting of a case manager and licensed therapist

Children ages 4 to 18 and one episode of outpatient and/or inpatient mental health care within past 12 months or have had a mental health evaluation at an ER and is at risk of out of home placement Services Offered Child/Family Therapy Support and collaboration with agencies/schools working with child/family Family Peer Support Case Management Mental Health Clinics St. Lawrence County Mental Health- 80 State Highway 310, Canton, (315) 3862167 Adults and Children St. Lawrence Psychiatric Center

Gouverneur Wellness Center, 28 William St, Gouverneur, (315) 287-2811 Adults and Children Massena Wellness Center, 23 Maple St, Massena, (315) 769-8441 Adults and Children Ogdensburg Wellness Center, 109 Ford St, Ogdensburg (315) 394-0101 Adults Only Children and Youth, 1 Chimney Point Drive, Ogdensburg, (315) 541-2580 Children Only United Helpers Mosaic, 221 Hamilton St, Ogdensburg (315) 541-3042 Adults and Children Claxton Hepburn Wellness Center, 214 King St, Ogdensburg, (315) 713-5720 Adults and Children Canton Potsdam Hospital Behavioral Health Adults and Children Dr. Mariam Asar, 20 Cottage St, Potsdam, (315) 261-5405 Dr. Joshua Frank, 12 Elm St, Potsdam, (315) 261-5420

Substance Abuse Services St. Lawrence County Chemical Dependency Services Gouverneur, 99 West Main St, (315) 386-2189 Canton, 80 SH 310, (315) 386-2189 Ogdensburg, 206 Ford Street, (315) 393-1164 Massena, 21 Harrowgate Commons, (315) 764-0718 Canton Potsdam Hospital Chemical Dependency Services, Outpatient - 12 Elm St, Potsdam (315) 353-2572 Detox 50 Leroy St, Potsdam (315) 261-5969 Seaway Valley Prevention Council 206 Ford St, Ogdensburg, (315) 713-4861 Teen Intervene Counselor Family Support Navigator Peer Support

Horizons Club House (club house for adolescents 12-17) 56-58 Main St, Massena, (315) 705-4203 Crisis Services Reachout of St. Lawrence County 24/7, 365 days a year (315) 265-2422 National Suicide Hotline (800) 273-8255 Office for Persons with Developmental Disabilities Call the Front Door and refer a person via telephone (518) 536-3480 Contact United Helpers (315) 393-3072

x327 Contact CP of the North Country (315) 379-9667 Homelessness Contact Department of Social Services, Adult Protective Services, 6 Judson St, Canton (315) 379-2148 If a child still enrolled in school is deemed homeless or displaced contact childs home district McKinney Vento Liaison Adult/Childrens SPOA Coordinator Lindsay Newvine Financial, Food and Housing Assistance Catholic Charities 716 Caroline St, Ogdensburg (315) 393-2660

Adoption, counseling, financial assistance, parenting education Seaway House, 212 Caroline St, Ogdensburg, (315) 393-3133, http:// www.cathcharities.org/seawayhouse1.html Clubhouse based on psychiatric rehabilitation, promoting individual recovery through the process of skill development. Massena Independent Living Center 156 Center St, Massena, (315) 7649442 STEHP (Solutions to End Homelessness Program) assists households identified as at risk and without assistance would experience homelessness Advocacy Independent Living Skills Training Peer Services Assistive Technology (to live independently at home) Loan Closet (equipment to use on a trial basis) Benefits Advisement Home Health Care

Health Insurance Navigator Financial, Food and Housing Assistance (Cont.) Neighborhood Centers Potsdam 2 Park St, (315) 265-3920 Canton 5 West St, (315) 386-3541 Gouverneur 15 Rock Island, (315) 287-3370 Ogdensburg 330 Ford St, (315) 393-5561 Edwards 183 Main St, (315) 562-3296 or (315) 562-8252 Hammond 30 Lake St, (315) 324-5219 Massena 61 Beach St, )315) 764-0050 Norfolk/Raymondville 287 Brouse Rd, Massena, (315) 3844629 or (315) 769-3915 Richville Food Pantry 209 Main St, (315) 287-0259 or (315) 287-2680 Town of Pierrepont 864 State Highway 68, Canton, (315)

379-0415 Financial, Food and Housing Assistance (Cont.) Helping Hands 5868 State Route 56, Hannawa Falls, (315) 268-0633 Food, Household Items, Financial Assistance Salvation Army Ogdensburg 401 Franklin St, (315) 393-3351 Massena 20 Robinson Road, (315) 769-5154 St. Lawrence County Community Development Program 1 Commerce Lane, Canton, (315) 3861102 Weatherization, housing choice voucher program, personal care

Financial, Food and Housing Assistance (Cont.) St. Lawrence County Department of Social Services Supplemental Nutrition Assistance Program (SNAP), (315) 379-2155 or (800) 649-7565 Home Energy Assistance Program (HEAP), (315) 379-2297 Medical Assistance/Medical Services, (315) 3792701 Program for those who cannot afford to pay for medical care and meet certain financial requirements. Temporary Assistance, (315) 379-2155 Senior Services

St. Lawrence County Office for the Aging, 80 State Highway 310, Canton, (315) 3864730, https:// www.stlawco.org/Departments/Officeforth eAging/OFAServices Nutrition Program, prescription plan, transportation, employment program, inhome services, caregiver support, legal services, health insurance information and counseling Transportation St. Lawrence County Public Transit, 6 Commerce Lane, Canton, (315) 386-2600 http://www.slnysarc.org/public-transit Ogdensburg Public Transportation, (315) 386-2600 http:// www.ogdensburg.org/index.aspx?NID=407

Volunteer Transportation Center, (315) 714-2034 https://volunteertransportationcenter.org/ Child Care St. Lawrence County Department of Social Services, (315) 379-2285 or (315) 229-3127 St. Lawrence Child Care Council, 314 Ford Street, Ogdensburg, (315) 393-6474 or (800) 246-5352 http://www.stlawrencechildcare.org/ Transgender Services The Trevor Project Lifeline (866) 4887386, https://www.thetrevorproject.org/# sm.000zgfb8g9tpf6y10i120xa587scp

Gay and Lesbian National Hotline (888) 843-4564 Stopping the Hate (206) 350-4283 https://www.glbthotline.org/chat.html Other Assistance Programs St. Lawrence County Department of Social Services Disabled Client Assistance Program (DCAP), (315) 379-2146 Assists person receiving assistance to apply for Supplemented Security Income and Social Security Disability. Also assists in filing appeals of denials. One Stop Career Center Employment Assistance, 80 State Highway 310, Canton, (315) 386-3276, www.slconestop.com

St. Lawrence County Department of Social Services Assistance with Burials, (315) 379-2164 Resource Directories North Country Prenatal Perinatal Council, Inc. http://directory.ncppc.org/ https://211cny.com/ https://www.nyconnects.ny.gov/ Seaway Valley Prevention Council http://svpc.net/agency-directory-2/wpbdp_c ategory/st-lawrence /

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