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December 8, 2015

SAMHSA Division of Grant Review

1 Choke Cherry Road Rockville, MD 20857

240-276-1199

support@grants.gov

To the Substance Abuse and Mental Health Services Administration Division of Grant Review,

The Jewish Child Care Association (JCCA) is one of the oldest and most trusted treatment centers in the state of New York. For over 100 years, the JCCA has aided the community with:

foster care, special needs populations, childhood education, community outreach programs, mental health rehabilitation, and adoptions.

As part of the Human Resources team, I am writing to inform your administration of the expansion we are spearheading. As of January 2017, we would like to expand and improve the existing adoption program by adding a higher level of psychologist and therapist intervention to improve the quality of life for the adoptees and their families, especially during the first six years post-adoption.

This new plan includes extensive psychological testing, medical tracking, private and group therapy sessions, psychiatrist intervention, and medicinal therapy (as needed). In order to appropriately implement this program, we will need a comprehensive grant of $150,000 over a six-year period.

Our end goal is to provide a stronger and more accountable network of support during the first six post-adoption years. During this time, patients will gain more advantageous ways to cope with adversity, as well as become more secure in their emotional and psychological self- awareness.

Attached is the JCCA’s grant proposal for our six-year plan. Thank you for your consideration and please do not hesitate to contact me if you have any further questions or comments. I look forward to hearing from you in the near future.

Sincerely,

Sara West

JCCA Human Resources Department 1075 Broadway

Pleasantville, NY 10570

914-238-7899

swest@jccany.org

The Jewish Child Care Association’s Communi ty Mental Health Services Block Grant Proposal

Sara West

Pace University

December 8, 2015

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T ABLE OF C ON TENTS

T ABLE OF C ONTENTS

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E XECUTIVE S UMMARY

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O RGANIZATIONAL I NFORMATION

2

N EED D ESCRIPTION

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W ORK P LAN

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E VALUATION ..............................................................................................................................

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B UDGET

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R EFERENCES

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1

E XECUTIVE S UMMARY

The Jewish Child Care Association’s (JCCA) core belief is to, “meet the child welfare and

mental health needs of all children and their families in the New York metropolitan area” (JCCA,

2013). This practice is carried out through various avenues including, early childhood

intervention, foster care, and the domestic and international adoptions. By expanding the level

of our involvement, we can ensure a better future for our patients.

The following in-depth grant proposal will outline the adjustments and additions that need to be

made to the current adoption program in order to increase our ability to care for the adoptees and

their families. This report includes: a description of the JCCA and our work; a look at the need

and importance of expanding the current adoption program; a realistic work plan of what can be

done to improve the therapy curriculum; a six-year timeline of the speculative program; a

sensible budget outline; and an evaluation of the assistance and impact this program will have on

the patients’ lives.

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O RGANIZATION AL I NF ORMATION

The Jewish Child Care Association (JCCA) of Westchester County is the chief family

psychiatric care facility for at-risk children, youth, and young adults in Westchester County. The

JCCA aids in a variety of services that range from child rearing and personal psychiatric health

assistance to family counseling and even monetary and emotional support during the adoption

process. The JCCA is dedicated to working with families to “build on their strengths, preserve

the family when possible, and help create new families when necessary, so that all children may

thrive by having a sense of family, culture, and community” (JCCA, 2013).

When the JCCA was founded in 1822, they started by raising just $300, which was used to

“ameliorate the condition of the unfortunate of the same faith” (JCCA, 2013). A little over 50

years later, in 1874, the JCCA helped immigrants acclimate to the Westchester area by providing

asylum to displaced homeless children. During this time, the JCCA raised approximately $110

per child, to help cover each child’s costs. Throughout the 1960s, the JCCA became the premier

youth center and provided “innovative, coed, therapeutic residential treatment program for 40

older adolescents, ages 16 to 21” (JCCA, 2013).

Over the years, the JCCA has continued to be an influential piece of the Westchester community

and they have networked with dozens of other organizations including (but not limited to): Forest

Hills; the Brooklyn Child and Adolescent Guidance Center; Kew Garden Hills Youth Center; the

Juvenile Justice Programs in Brownsville; and the Ametz Adoption Program (JCCA, 2013).

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N EED D ESCRIPTION

Adoptions, whether domestic or international, can be expensive, daunting, and difficult.

However, the JCCA has a highly trained staff of professionals who are ready to help the adopting

family every step of the way. The staff can answer questions about how the family matching

occurs; with preparing the new house and room for the adoptive child; and counseling.

Building the strengths of the family means improving the family dynamics through psychiatric

counseling for the individual and the family unit. According to About Kids Health, adopted

children have a higher risk of developing mental and emotional health disorders (About Kids

Health, n.d.), which can put a damper on how quickly the child is adopted. No family wants to

adopt a child who is going to have moderate-to-severe (or even mild) psychiatric and/or

emotional problems. And sometimes these problems remain dormant until years after the

adoption has gone through.

This problem could be more quickly identified and remedied if the JCCA was able to help the

families by having the potential adoptee children tested for psychiatric disorders and

disturbances. However, The Minnesota Multiphasic Personality Inventory-2 (MMPI-2), the

standard in psychiatric testing, initially costs $500 to take, per test, per person (PsychCorp,

2015). In addition, many insurance programs will only justify paying for part of an MMPI (if

any of the charge at all) (PsychCorp, 2015), which can leave the family in a tough spot because

they are not able to afford the testing. The JCCA can give some monetary support to these

families, however, not to each adopting family and prior adoptive families.

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The Mental Health Block Grant (MHBG) from the Substance Abuse and Mental Health Services

Administration (SAMHSA) would help to pay for post-adoption mental health intervention

programs such as therapy for the families, play therapy for the children, and psychiatric

appointments with doctors to observe and maintain care while the patients undergo treatment.

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W ORK P LAN

The JCCA plans to increase the adoptee’s quality of life. They are hoping these life changes will

be met within three years of starting therapy with trained therapists and counseling with trained

psychiatrists. This is an achievable goal because the JCCA staff will focus on the individual’s

progress in solo therapy, as well as the family and their well being by providing group family

therapy. The results are the most important part of the JCCA’s plan, because if they are able to

remold behavior, they can better the family unit and the individual’s life and future.

There are several methods the JCCA is proposing to create these results. After the adoptees have

their initial MMPI-2 screening test, they will undergo intensive individual therapy sessions with

a designated therapy professional. The JCCA has a staff of play therapists, psychotherapists, and

behavioral therapists, whom are all eager to help these children to better cope with their

surroundings. The child’s MMPI-2 scores will determine what type of therapy (or combination

of therapy) they will have. In addition, a chief psychiatrist will oversee all patients’ cases. This

is vital because the children need to be under a doctor’s care at all time, but also helpful in case

the children need additional intervention through medications.

As for the family units, they will undergo therapy as well, but as a whole. A couple times a

month, the family will attend group therapy sessions with a specialized family therapist who will

help the family to get used to the new arrangement and any new personality traits. After several

months of family therapy, depending on how quickly the family progresses, they will be allowed

to attend group therapy sessions with other families who are under the same stresses and are

living in similar situations.

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An example treatment plan would be as follows:

Example One-Year Timeline and Treatment Plan

  • - January: family one begins official adoption process (note: all required paperwork and official documents have been signed and turned in to the appropriate parties prior to this)

  • - February: JCCA, adoption organization, and family finalize paperwork

  • - March: the child is adopted

o

Early March: the child is brought home for the first time

o

Mid-March: family two begins official adoption process

o

End of March: the child will take The Minnesota Multiphasic Personality

Inventory-2 (MMPI-2) for the first time

  • § Several days later: a psychiatrist will go over the child’s results with the family, the child, and a therapist and create a treatment plan

  • - April: treatment plan goes into effect under a psychiatrist’s supervision

o

Depending on the child’s test results, the child would begin seeing a therapist

once a week for the next three months, before being re-evaluated

o

Per the doctor’s request, the child may be put on an additional treatment plan

which may include medications

o

The family unit will also see a therapist, under a psychiatrist’s supervision, at

least twice a month for three months, and then will also be re-evaluated

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  • - May: the child will continually see the therapist once a week, before any changes are to be made to the current treatment plan

o

End of May: family three begins official adoption process

  • - June: the child will meet with the psychiatrist to talk about how therapy is going with the therapist and how they feel about their medications

o

The family will continue therapy twice a month for three months, before any

changes are made to the current treatment plan

  • - July: the child continue the therapy and treatment plan as scheduled

o

The family will continue the treatment plan as scheduled

  • - August: the child will meet with the psychiatrist for a re-evaluation of any possible changes in direction of therapy and or medication treatments

o

The family will begin to attend a group therapy session with other families who

are experience the same situations for the next three months

o

Mid-August: family four begins official adoption process

  • - September: the child will continue the current treatment plan

o

The family will continue the current treatment plan

  • - October: the child will see the psychiatrist for a check-up and to make sure things are going smoothly for both the therapeutic and the medication treatment plans

o

The family will continue the current treatment plan of group therapy

o

End of October: family five begins official adoption process

  • - November: the child will continue the current treatment plan

o

The family will continue the current treatment plan

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  • - December: the child will meet with the psychiatrist to discuss any possible changes in the treatment plan

o

The family will meet with the psychiatrist to talk about how family therapy

sessions were

o

The family will slowly stop attending group family therapy sessions

  • - Every 12 months that treatment continues: the JCCA’s psychiatrist will re-distribute an MMPI-2 to the adopted child

o

The JCCA will record, track, and compare the child’s progress to a the child’s

own previous scores; to a baseline; and to the general public

  • - For three years: the adopted child will be under the therapeutic and medical supervision and observation of the JCCA

  • - After three years: it is up to the family and/or the individual to decide if they want to continue treatment at the JCCA; seek private care; or discontinue treatment all together

  • - Every two and a half months: a new adopted child and their family will be admitted to the JCCA’s program for treatment

o

The JCCA’s goal is to admit and process at least five adoptees and their families

per year for six years, for a total of 30 rehabilitated individuals and their families

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E VALUATIO N

The JCCA’s success can be measured both qualitatively and quantitatively throughout the

treatment plan process.

Qualitatively, the progress can be measured by the increase (or decrease) in the child’s coping

skills, emotional control, and family interaction. The therapist and psychiatrist can gather this

information through stories that the family relays to them as well as first-hand during their

interactive therapy and psychiatric sessions with the child. Additional people the child may

interact with, i.e. church teachers, school teachers, and even bus drivers or teacher’s aides, can

also give their opinions on the child’s social growth and progress.

Quantitatively, the child can be observed through the MMPI results. The child will be taking the

MMPI examination a minimum of five times throughout their three year treatment program,

which will give ample results to compare to the baseline MMPI scores from the child’s initial

intake. The JCCA hopes that the child will decrease in any hyperactivity and social ineptness,

and will increase in social awareness and ability to interact in a health manner.

If the child is put on medications, the progress can also be quantitatively measured through blood

test results. For example, if the child is on a psychotropic drug, like Lithium, the drug levels will

build up in the blood stream, allowing the doctors to track the levels of ups and downs children

may have during their treatment.

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B UDGET

Because the JCCA is expanding on a program, the budget will need to expand as well. The

JCCA is hoping help at least five adoptees and their families with psychiatric and therapeutic

rehabilitation per year. To start this program, the JCCA is asking for six years’ support, which in

turn would provide 30 individuals and their families with services. Altogether, the estimated

cost would be $150,000 to run the program for six-year trial period. Over this span, the JCCA

would be able to positively impact over 30 lives.

The JCCA already has the proper facilities for individual and group therapy treatments. In

addition, the JCCA has the appropriate staff. However, the JCCA will need to increase staff pay

to the psychiatrists and therapists who participate and take on more clients. There will be an

allotted $70,000 cushion to reimburse the staff of therapists, psychiatrists, and lab technicians

that give their services.

The building is already intact and paid for, so there will not be a significant increase in utilities.

Yet, there may be an increase in supplies needed for the new treatment plans. For example, each

MMPI-2 test starts at $160 just to obtain the test. Then, the JCCA will have to pay for the results

of the test. If each adoptee takes the test a minimum of five times during their three year

treatment program, there must be an allotted $800-$1,000 per child for proper accommodations

while under the care of the JCCA.

Other expenses will include extra toys and play things for play therapy sessions. Also, the JCCA

will need extra materials for psychotherapy and behavior therapy sessions, such as workbooks

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and pamphlets for both the staff and the patients. It is estimated that each patient and their

family will require an additional $500 per three-year stay, in additional therapy materials.

Finally, there will be lab costs for any blood tests and other tests necessary to maintain and

manage medication therapy. The type of medication will dictate which tests will need to be run

and how often these tests will be done. However, a safe rough estimate would be about $1,000

per child per three-year treatment plan.

The remaining $11,000 will be used towards any miscellaneous expenses such as: snacks for the

break room or basic office supplies. The remainder of the grant can also be saved for any

emergency expenses such as: ambulance fees, emergency room visits, or unscheduled blood

work testing.

FISCAL BREAKDOWN

Miscellaneous

7% Staff Salary Therapy Lab Costs Materials Materials Testing Retainer 47% 20% 16% 10%
7%
Staff Salary
Therapy
Lab Costs
Materials
Materials
Testing
Retainer
47%
20%
16%
10%

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R EFERENCES

About Kids Health. (2014-2015). Mental health of adopted children: risks and protective

factors. Retrieved November 12, 2015 from

http://www.aboutkidshealth.ca/en/news/newsandfeatures/pages/mental-health-of-

adopted-children-risks-and-protective-factors.aspx

JCCA. (2013). Our mission. Retrieved November 19, 2015 from

http://www.jccany.org/site/PageServer?pagename=about_mission

JCCA. (2013). The history of JCCA. Retrieved November 19, 2015 from

http://www.jccany.org/site/PageServer?pagename=about_history1

Park, Madison. (April 14, 2010). Adopted children at greater risk for mental health disorders.

Retrieved November 12, 2015 from

http://www.cnn.com/2010/HEALTH/04/13/children.adoption.mental.health/

PsychCorp. (2015). Clinical Psychology: MMPI. Retrieved December 2, 2015 from

http://www.pearsonclinical.com/psychology/products/100000718/minnesota-multiphasic-

personality-inventory-2-adult-clinical-system-revised-4th-edition-interpretive-

reports.html#tab-pricing

SAMHSA. (2015, September 29). Substance abuse and mental health block grants. Retrieved

November 12, 2015 from http://www.samhsa.gov/grants/block-grants

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SAMHSA. (2015, August 13). Grants fact sheet. Retrieved November 12, 2015 from

http://www.samhsa.gov/grants/grants-fact-sheet

SAMHSA. (2014, March 5). Community mental health services block grant. Retrieved

November 12, 2015 from http://www.samhsa.gov/grants/block-grants/mhbg

Texas Adoption Resource Exchange. (n.d.). Requirements for foster/adopt families. Retrieved

December 2, 2015 from

https://www.dfps.state.tx.us/Adoption_and_Foster_Care/Get_Started/requirements.asp

The Long-Term Effects of Abuse and Neglect in Early Childhood. (n.d.). [Infographic].

Retrieved November 12, 2015 from

http://www.thehome.org/images/content/pagebuilder/earlychildhood_infographic.jpg