The NAMI-Department of Veterans Affairs / Family-to-Family Partnership

Susan J. McCutcheon, RN, EdDDirector, Family Services, Women’s Mental

Health and Military Sexual TraumaOffice of Mental Health ServicesDepartment of Veterans Affairs

July 7, 2009

Uniform Mental Health Services in VA Medical Centers and Clinics

Family Services

Uniform Mental Health Services in VA Medical Centers and Clinics

Minimal clinical requirements for VHA Mental Health Services:

• Providers discuss family involvement with patient at least yearly & at inpatient discharge

• Treatment plan to identify family contact or reason for lack of contact

• Providers must seek consent from veterans to contact families in the future, as necessary

Uniform Mental Health Services in VA Medical Centers and Clinics

Minimal clinical requirements for VHA Mental Health Services:

• Family consultation, family education or family psychoeducation for veterans with serious mental illness must be provided at VA Medical centers and very large CBOCs

• Opportunities for these family services must be available to all veterans with serious mental illness on site, by telemental health, or with community providers through sharing arrangements, contracting, or non-VA fee basis care

Family Education (FE)

Family Education (FE)

Family Education (FE)

Treatment team provides factual information necessary to support the veteran and partner

Offered in many formats, regularly scheduled and conducted over time including:

By professionals (e.g., SAFE Program)

By trained family members (e.g., NAMI Family-to-Family Education Program)

Family Education (FE)

VHA-NAMI Memorandum of Understanding

Family-to-Family Education (FFEP)

VHA – NAMI Memorandum of Understanding

Offer NAMI Family-to-Family Education Program (FFEP) in: At least one VHA facility in each state During a two year period starting June 2008

Collaborative effort between the VA and NAMI on national, state and local levels

Selected VHA facility and local NAMI affiliate will then serve as model to continue this partnership throughout all networks

VHA – NAMI Memorandum of Understanding

• The first VHA FFEP classes were held Fall’08

• Currently planning VHA FFEP classes for Late Winter/Early Spring’09

• Any VAMC can partner with their local NAMI affiliate to offer FFEP in their facility outside of the MOU

VHA – NAMI Memorandum of Understanding

VHA OMHS shall:

• Identify VHA facility most likely to succeed and serve as a model for the rest of the state

• Identify VHA employee as the FFEP POC

• Ensure the VHA facility collaborates with local Vet Center

• Participate in monthly VHA FFEP POC Conference Calls

VHA – NAMI Memorandum of Understanding

VHA OMHS shall:

• Ensure the selected VHA selected facility informs veterans and staff about FFEP

• Assist with enrolling families into FFEP

• Reproduce the FFEP Manual and Handouts

• Reserve an appropriate meeting space for the FFEP with Adequate parking

• Develop PTSD “Take Home Packet”

VHA – NAMI Memorandum of Understanding

NAMI Shall:

• Identify a NAMI affiliate POC to work with the VHA FFEP POC at the selected facility in the state

• Ensure that a representative from the NAMI Education Dept participate in planning and communication among and between states and VHA sites in the project

VHA – NAMI Memorandum of Understanding

NAMI Shall:

• Ensure that there are FFEP teachers for the selected VHA site

• Ensure that a NAMI affiliate POC assists VHA in informing veterans & VA staff of availability of FFEP

• If VA family enrollment does not meet the minimum required number for a FFEP, assist with recruitment/ enrollment of community family members to fill class

VHA – NAMI Memorandum of Understanding

Other Considerations:

• Matching a motivated VHA facility with a NAMI affiliate with appropriate resources to teach FFEP will be a mutual decision between VHA OMHS and NAMI

• The process for enrolling family members into the FFEP will be a local decision based on the established practice of the NAMI affiliate

VHA – NAMI Memorandum of Understanding

Other Considerations:

• VHA has an extensive Community Residential Care Program – veterans residing in group homes

• Frequently these placements are long term and the group home sponsor becomes part of the veteran’s “family”

• When such a relationship exists, the group home sponsor may enroll in the FFEP

VHA-NAMI MOU:Designated Sites

STATE VAMC CITY STATE VAMC CITYAlabama Tuskegee Hawaii Honolulu

Alaska Anchorage Idaho Boise

Arizona Phoenix Illinois Chicago/Hines

Arkansas Little Rock Illinois Marion/Ft. Wayne

California San Francisco Indiana Indianapolis

California Long Beach Iowa Des Moines/Knoxville

Colorado Denver/Pueblo Kansas Topeka

Connecticut West Haven Kentucky Louisville

Delaware Wilmington Louisiana New Orleans

Florida Tampa Louisiana Alexandria

Georgia Atlanta Maine Togus

Completed Fall 2008 Completed Spring/Summer 2009

VHA-NAMI MOU:Designated Sites (con’t)

STATE VAMC CITY STATE VAMC CITYMaryland Baltimore New Mexico Albuquerque

Massachusetts Bedford New York Syracuse

Michigan Detroit New York New York Harbor

Minnesota Minneapolis North Carolina Durham

Mississippi Biloxi North Dakota Fargo

Missouri St. Louis Ohio Columbus

Montana Ft. Harrison Oklahoma Muskogee

Nebraska Omaha Oregon Portland

Nevada Las Vegas Pennsylvania Pittsburgh

New Hampshire Manchester Puerto Rico San Juan

New Jersey Lyons Rhode Island Providence

Completed Fall 2008 Completed Spring/Summer 2009

VHA-NAMI MOU: Designated Sites (con’t)

STATE VAMC CITY STATE VAMC CITYSouth Carolina Columbia Virginia Salem

South Dakota Sioux Falls Washington DC

Tennessee Mountain Home Washington Seattle/Puget Sound

Texas Dallas West Virginia Clarksburg

Texas Amarillo West Virginia Martinsburg

Texas Houston Wisconsin Madison

Utah Salt Lake City Wyoming Cheyenne

Vermont White River Junction

Wyoming Sheridan

Completed Fall 2008 Completed Spring/Summer 2009

Completed InitiativeInitiative In Process

Not Completed

San Francisco

Long Beach

New York Harbor

Syracuse

Dallas

Amarillo

Houston

NOLA

Alexandria

Sheridan

Cheyenne

Marion

Chicago/Hines

Clarksburg

Martinsburg

Legal Implications

Family Services

Definition of Family

Family

According to federal law, eligible individuals who may be provided family services for immediate family members are:

• Members of the immediate family

• Guardian of a veteran

• Individual in whose household such veteran certifies an intention to live

PL 110-387 Veterans’ Mental Health and Other Care Improvement Act of 2008

Sec 301 amends 38 USC 1782

Adds marriage and family counseling to services for family members of all veterans eligible for VA care

Rescinds prior stipulation that services which include family members for veterans receiving non-service connected treatment are contingent on initiation during an inpatient stay

Training Initiatives

Family Services

Training for Family Services by End of FY2008

Family Psychoeducation (FPE), Behavioral Family Therapy (BFT), or Multiple Family Group Therapy (MFGT) 133 staff trained in care provision 15 staff trained to be BFT or MFGT trainers

Family Consultation 15 Staff trained in care provision

35 Local Recovery Coordinators trained as Network Family Education Consultants to facilitate implementation of: SAFE Program NAMI Family-to-Family Education Program

Ongoing Initiatives / Next Steps

Meeting requirements of UMHSP:

• Providers discussing family involvement with patient yearly and at inpatient discharge

• Treatment plan to identify family contact or reason for lack of contact

• Further dissemination of family education, family consultation and family psychoeducation models

Compliance with PL 110-387

Thank you for supporting Veterans!

For additional information or questions

Contact Susan J. McCutcheon at susan.mccutcheon@va.gov