california department of corrections and rehabilitation release planning continuity of mental health...

California Department of California Department of Corrections and RehabilitationCorrections and Rehabilitation

RELEASE PLANNINGRELEASE PLANNING

CONTINUITY OFCONTINUITY OF

MENTAL HEALTHMENTAL HEALTH

ANDAND

MEDICAL CAREMEDICAL CARE

California Department of California Department of Corrections and RehabilitationCorrections and Rehabilitation

Presented byPresented by

The CDCRThe CDCR

Division of Correctional Health Care ServicesDivision of Correctional Health Care Services

Benefit EntitlementsBenefit Entitlements

Uses contracted staff within prisons to apply Uses contracted staff within prisons to apply for federal and state benefit entitlements for federal and state benefit entitlements prior to inmate’s return to the community prior to inmate’s return to the community

Benefits applied for:Benefits applied for: Social SecuritySocial Security Medi-CalMedi-Cal Veterans benefitsVeterans benefits

Division of Adult Parole OperationsDivision of Adult Parole Operations


Prioritize inmates by acuity and need

1. Long-term medical care and inpatient mental health care.

2. Board & care/assisted living, in-home health care, and hospice.

3. Chronic illness requiring life sustaining assistance (i.e., dialysis, continuous oxygen).



Prioritize inmates by acuity and need

4. Inmates with mental illness designated Enhanced Outpatient Program (EOP) or above

5. HIV/AIDS (if qualified)

6. Developmentally disabled or other qualifying disabilities

7. Inmates with mental illness designated Correctional Clinical Case Management System (CCCMS)



CCurrent funding do not allow applications for benefits for all potentially eligible releasing inmates

So, focus remains on first four priorities of which not all receive the service



Transitional period of offender realignment and budget reductions

Efforts will continue to provide benefit application assistance to releasing inmates within criteria 1-4, regardless of parole supervision status



Funding and staffing levels may change from FY to FY

If level services changes counties will be notified

Counties should consider alternatives to the CDCR benefits program



For additional information on the Division of Adult Parole Operations’ Transitional Case Management Program, please contact:

Patricia Lujan(916) 323-0152

[email protected].


Benefit EntitlementsBenefit Entitlements Additional Efforts Additional Efforts

California Correctional Health Care Services

Implementing program to obtain Medi-Cal eligibility for inmates receiving inpatient medical treatment outside of the prisons

May result in increase of inmates releasing with Medi-Cal established which can continue upon release from prison

Patient Information SharingPatient Information Sharing

Will attempt to obtain signed authorization

to release information from inmates as part of release planning for continuity of care

Not all inmates will sign a release


Both the California Medical

Instrumentation Association (CMIA) and the federal Health Insurance Portability and Accountability Act (HIPAA) provide for the privacy and security of protected health information.


CMIA and HIPAA permit the use and

disclosure of protected health information by health care providers without an authorization by the individual to whom the information pertains when that information is used or disclosed for treatment, payment or health care operations.

Patient Information SharingPatient Information Sharing HIPAA

Covered entity may obtain the consent of an individual to use or disclose protected health information

Consent is not required by the individual whose medical information is being disclosed to another health care provider for treatment


HIPAA

Arrangement for the continuity of care is a form of treatment.

HIPAA defines “treatment” to mean, “the provision, coordination, or management of health care and related services by one or more health care providers”


CMIA

CMIA does not define treatment but authorizes use or disclosure of medical information for each of the purposes in the HIPAA definition of treatment


An inmate’s refusal to sign an

authorization is not a barrier to the disclosure of his or her medical information from provider to provider to arrange for treatment

Community Based Medical and Community Based Medical and Mental Health CareMental Health Care

Release PlanningRelease Planning

Planning and preparation for release of inmates who need continued mental health or medical care is essential to successful transition to the community



CCDCR staff attempt to arrange community-based care prior to an inmate-patient’s release when inmate: Needs acute or sub acute care Is unable to arrange for care due to disability Needs dialysis Is unable to handle Activities of Daily Living


Release Planning Release Planning

For all AB109/PRCS mental health and dental related questions contact:

DCHCS Operations – Mental health and dental questions only:

Email: [email protected]

Phone: (916) 324-9482, Pamela Michel



For all AB109/PRCS medical related questions contact:

CCHCS Field Operations – Medical questions only:

Email: [email protected]

Phone: (916) 648-8281


Release Planning

All questions will be logged and forwarded

to appropriate personnel for timely response

Transitional Protocol WorkgroupTransitional Protocol Workgroup Mental Health and Medical Mental Health and Medical

SubcommitteesSubcommittees The CDCR Office of Communications and

External Affairs established Transitional Protocol Workgroup

Co-hosted by the California State Association of Counties


SubcommitteesSubcommittees Representatives from several organizations

Various CDCR Divisions California Correctional Health Care Services California Hospital Association California Mental Health Directors Association Chief Probation Officers of California County Counsels County Health Executives Public Guardians County Welfare Directors Association


SubcommitteesSubcommittees Purpose:

To bring together stakeholders to determine information needs, notification timelines, and treatment coordination roles for inmates releasing to post release community supervision


SubcommitteesSubcommittees

Bi-weekly meetings Held in CDCR headquarters, Sacramento Conference call-in available


SubcommitteesSubcommittees

For additional information or to request to be part of the process, please contact Thy Vuong, at (916) 327-0277 or [email protected].

Division of Correctional Health Care Division of Correctional Health Care Services Mental Health Pre-Release Services Mental Health Pre-Release

WorkgroupWorkgroup

Goals:

Redesign prison-based mental health pre-release process/services to be more effective

Meet the needs of counties in linking high risk, high need inmates to care

Focus on inmates in EOP or higher levels of care

Increase involvement of families to increase success of inmates


WorkgroupWorkgroup Participants:

DCHCS Pre-Release Programs

California Mental Health Directors Association

Chief Probation Officers of California

NAMI (National Alliance on Mental Illness)

Other interested stakeholders


WorkgroupWorkgroup

To participate contact:

Michael Morrison [email protected] 916-323-6299

Accessing Health Records InformationAccessing Health Records InformationAfter Release from PrisonAfter Release from Prison

After release from prison, inmate-patient

Unit Health Records are stored and managed at the California Correctional Health Care Services’ Health Records Center


Requests for inmate health records after release

from prison: Mail request to:

Health Records Center P.O. Box 942883 Sacramento, CA 94283

Fax Request to: (916) 229-0002


All requests should include an

Authorization for Release of Information, which can be accessed at http://www.cphcs.ca.gov/docs/resources/CDCRForm7385.pdf.


For additional information on requesting

Health Records after an inmate’s release from prison, please contact:

The California Correctional Health CareServices’ Health Records Center

(916) 229-0475

CDCR’s Mental Health ProgramCDCR’s Mental Health Program

Provide services to inmates with serious mental

illness or those meeting medical necessity criteria

Interdisciplinary treatment teams Psychiatrists Psychologists Licensed Social Workers Recreational Therapists Psychiatric Technicians


Four Basic Levels of Care

Correctional Clinical Case Management System (CCCMS)

Stable/functioning in the general population or Administrative Segregation

Exhibit symptom control or are in partial remission Assessment by a mental health clinician Treatment team - primary clinician, psychiatrist, and

correctional counselor Primary clinician contact no less than every 90 days Seen annually by treatment team If prescribed medication are seen by psychiatrist at least

every 90 days



Enhanced Outpatient Program (EOP) Acute onset/significant decompensation and unable to function in

the prison general population Inability to program in work, education, etc. Dysfunctional or disruptive social interaction or impairment in the

activities of daily living Need structured therapeutic living environment but do not require

inpatient care Initial clinical assessment and treatment team every 90 days Weekly clinical contact with primary clinician in individual or group Individual clinical contact at least every other week At least ten hours per week of structured therapeutic activities Seen by a psychiatrist at least once per month



Mental Health Crisis Bed (MHCB) - Short term (less than 10 day) inpatient treatment

Marked impairment/dysfunction requiring 24 hour nursing care, danger to others due to serious mental disorder or danger to self

Pre-admission screening by a psychiatrist or licensed psychologist Admission note, initial mental health assessment to begin initial

treatment planning, nursing assessment, and physical examination in first 24 hours

Treatment team meets within 72 hours of admission and at least every 7 days

Daily assessment and monitoring by the primary clinician. Evaluation by a psychiatrist at least twice a week Twenty-four hour nursing care Brief intensive therapy as needed Rehabilitation therapy activities as needed Aftercare planning



Acute Care or Intermediate Care Facility (ICF) CDCR/DMH Memorandum of Understanding

for inpatient psychiatric care. Provide care to patients whose conditions

cannot be successfully treated in the outpatient setting or in short term MHCB placements

MENTAL HEALTH POPULATION AND MENTAL HEALTH POPULATION AND PERCENTAGES AS OF AUGUST 24, 2011PERCENTAGES AS OF AUGUST 24, 2011

Total Mental Health Inmate Population 37,200

% of Overall CDCR Inmate Population 23.1%

MENTAL HEALTH POPULATION AND MENTAL HEALTH POPULATION AND PERCENTAGES AS OF AUGUST 24, 2011 PERCENTAGES AS OF AUGUST 24, 2011

FEMALE % Female MH Pop

% Female CDCR Pop

Total 3,251 34.1%

CCCMS 3,032 93.3% 31.8%

EOP 167 5.1% 1.7%

PSU 19 0.6% 0.2%

MHCB 18 0.6% 0.2%

DMH APP/ICF 15 0.5% 0.2%

MENTAL HEALTH POPULATION AND MENTAL HEALTH POPULATION AND PERCENTAGES AS OF AUGUST 24, 2011 PERCENTAGES AS OF AUGUST 24, 2011

MALE % Male MH Pop

% Male CDCR Pop

Total 33,949 22.4%

CCCMS 27,637 81.4% 18.2%

EOP 4,795 14.1% 3.2%

PSU 356 1.0% 0.2%

MHCB 345 1.0% 0.2%

DMH ICF 609 1.8% 0.4%

DMH APP 207 0.6% 0.1%

Questions?Questions?

california department of corrections and rehabilitation release planning continuity of mental health...

Documents

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increase of inmates

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