Sherry Shamblin PCC-S Testimony to State Finance Committee

Tri-County Mental Health and Counseling Services, Inc.

90 Hospital Drive                   

Athens, OH 45701

Athens Clinic: 740-592-3091

Administration:  740-594-5045

Fax#:  740-594-5642

TDD#:  740-593-3344

House Finance and Appropriations Committee

Sherry Shamblin, PCC-S and Early Childhood Mental Health Consultant

Tri-County Mental Health and Counseling Services and Integrating Professionals for Appalachian Children

March 26, 2009

Good morning Chairman Sykes, Ranking Member Amstutz, and members of the House Finance and Appropriations Committee.   My name is Sherry Shamblin and I am the Early Childhood Mental Health Consultant for Tri-County Mental Health and Counseling serving Athens, Hocking, Vinton, and Washington Counties.  I am also a founding board member for Integrating Professionals for Appalachian Children (IPAC), a rural health network in Southeastern Ohio focused on better identification, assessment, and treatment for young children.  Thank you for the opportunity to testify today.

Others will highlight for you the amazing work that has been done in Ohio by the Early Childhood Mental Health Initiative funded through the Ohio Department of Mental Health since 2000.  They will point out that this program served more than 31,000 children, childcare providers, and families in the last fiscal year. Other speakers will make you fully aware that the estimated impact of the proposed $350,000 reduction in early childhood mental health consultation funding would result in 23 fewer consultants and a reduction in services for 2924 fewer children, 805 families, 132 early childhood programs and 229 classrooms.

It has been a tough morning with hard personal stories caused by our state’s economic challenges.  But I’d like to let you know about an economic success: a situation where a very small state investment has led to exponential growth in services and funding.  I feel compelled to tell you with pride and excitement what the Early Childhood Mental Health Initiative has helped build for young children and families in Southeastern Ohio over the last 9 years.  As an ECMH consultant, my work has been funded solely by Initiative dollars.  Before the ECMHI, my agency, which is the major community mental health provider in our area, did not serve children under the age of 4.  I was the only mental health provider in our four counties to have experience and expertise in young children.  The Southern Consortium for Children, a collaborative of four Alcohol, Drug Addiction and Mental Health Services (ADAMHS) Boards, wrote our original proposal for a ten-county area and continues to administer the grant for our region.  The early years of our project focused on providing consultation services to our Head Start program.  Through that experience, I saw first hand the impact of delivering early screening, assessment, and treatment outside the mental health clinic and in the community where young children live and learn.  These early successes created an awareness of the vast opportunity to infuse mental health into every child-serving agency in our region.  But I was only one person and funded for only $48,000 a year.  It was clear that I would need help! This vision has compelled me to spend the last five years increasing our region’s ability to provide mental health services in natural settings for young children by building capacity through work force development and increasing expertise. These efforts have resulted in a regional peer supervision group and a specialized ECMH internship program through Ohio University.  I have been able to create an early childhood division within my agency that now has three people, in addition to myself.  Although these providers are funded with a mix of Medicaid and a variety of grants, by funding me, the ECMHI built that program.

The Initiative has also served as a springboard for the development of Integrating Professionals for Appalachian Children (IPAC).  This non-profit, rural health network serves as a model for collaboration in our state by creating a strong community-university partnership between local agencies and Ohio University, including their College of Osteopathic Medicine.  Working together we have been able to leverage funding from additional state and federal resources on behalf of young children and families in our region. We have taken the ECMH consultation program into private childcare centers in three counties.  A second project aims to integrate mental health services into primary care settings.  This effort has placed a mental health provider in 4 primary care sites, including an early childhood counselor in the area’s largest pediatric practice.  Finally, IPAC has created our region’s first interdisciplinary assessment team so that young children can obtain an appropriate developmental assessment.  These efforts have broadened the ECMH consultation and treatment agenda far beyond early care and education and have placed it within the greater public health agenda identified by this state and by our current president. Prior to this Initiative, mental health services for young children were housed in a system that pathologized young children and made services available to only a few who qualified for a mental health diagnosis.  Through this initiative, we have been able to strengthen the mental health and well-being of all young children in our area so that they enter school ready to learn and ready to succeed. 

It has been one of the greatest joys of my life to be part of the growth in early childhood mental health services in Ohio.  But during these tight economic times, this committee is charged with funding programs that are a wise investment of taxpayer dollars.  I can assure you that the Early Childhood Mental Health Initiative is a worthwhile investment! 

  1. The ECMHI is a worthy investment because it has led to increased access to services for young children.  Prior to the ECMHI, TCMHC served (0) children under 4 years of age.  In 2009, 2650 children in Southeastern Ohio will receive early screening, assessment, or treatment services as a result of the Initiative’s presence in our region.
  2. The ECMHI is a worthy investment because it has led to increased funding to serve young children.  Over the last 9 years, an investment of $436,500 in the Early Childhood Mental Health Initiative has helped generate an additional $428,750 for early childhood mental health services in Southeastern Ohio.  In April 2009, through IPAC, the ECMHI at TCMHC is positioned to receive funding from an Outreach Grant  given by the National Office of Rural Health.  This  would bring an additional $540,000 across 3 years into Southeastern Ohio and would expand Early Childhood Mental Health Consultation into our public preschools.

Chairman Sykes and other committee members, I know of few tax payer investments that will yield this type of return!  For almost every dollar that the state initiative invested in me as a consultant, I have helped match it with an additional dollar to serve the mental health needs of young children in my area.  This increased funding has quadrupled the size of the early childhood mental health workforce in our agency.  This increased workforce has helped increase the number of children served in this age range from 0 to 2650.  

It is with this proven track record that I strongly urge this committee to include an additional $350,000 per year for the Early Childhood Mental Health Consultation Program in order to meet the 2009 level of funding at $2.5 million per year.  I also urge you to put the Early Childhood Behavioral Health Treatment Program into permanent language, and increase funding to $5 million over the biennium.  These measures are necessary to meet the needs of all children in our state and to provide services, which are not reimbursable by third party payee sources.

This funding is essential to help children like Nathan, a child served by the Initiative last year.  At age 4, Nathan was the oldest of five children, which included a set of twins.  His father, who was a long-haul trucker, had just gotten custody of his children following major physical abuse to Nathan by his mother’s boyfriend.  Nathan had Post Traumatic Stress Disorder, but his teachers didn’t know that at the time.  They knew that he never sat still.  They knew that when he got angry, he hurt other children, had up-ended a water table, and had almost broken a teacher’s nose.  His father knew that Nathan never slept, had terrible nightmares, and fought bedtime tooth-and-nail.

By the time I was called into consult and provide treatment, the teachers were scared of Nathan and wanted him out of their class.  His father was at his wits’ end and afraid that he couldn’t care for Nathan.

As the consultant, I worked to develop a safety net of care for Nathan.  He and his father started participating in parent-child therapy sessions to help Nathan develop a sense of security.  His father and I worked on strategies that he could use to soothe and calm Nathan at home.  His teachers were taught similar strategies they could use at school.  The team developed a simple behavior chart with a daily schedule that would, not only reward Nathan for staying calm at school, but would also serve as a daily communication tool between the teachers and Nathan’s father.  The center manager and I helped the staff develop a safety plan to manage his behaviors when he lost control.  Because caring for Nathan required excessive energy, the family was linked with respite services.  

Slowly, these strategies began to have some effect.  The staff began to work together and became committed to keeping Nathan in their program.  His father began to feel capable and connected to his son.  Through the hard work of everyone, Nathan was able to stay in his home and in his center.  He made friends and began to enjoy going to school.

Nathan is near the end of his kindergarten year.  I hear that he is doing pretty well.  I like to think that it’s because of the safety net of care that our team created for him.  Nathan’s story is not unique.  Often an ECMH consultant becomes a pivot person to help a child’s caregivers work as a team to fully meet a child’s needs.  Please help other children in Ohio have access to this same safety net.  This can only happen if the Early Childhood Mental Health Services are fully funded and accessible to all children in Ohio.

Thank you and I would be happy to answer any questions you might have at this time.

Services provided through contract with the Alcohol, Drug Addiction and Mental Health Services Board of Athens, Hocking and Vinton Counties