mhb adult system of care subcommittee mhsa programs · • 455 workshops, presentations and...

MHB Adult System of Care ySubcommittee

MHSA ProgramsMHSA ProgramsMarch 20, 2014Downtown Mental Health Center

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Downtown Mental Health Center 1075 E. Santa Clara Street, 2nd Floor

Training Room #3Revised: March 19, 2014

AgendagI. MHSA three-year planning process

II. MHSA programs:

a. CSS HO01 Housingg

b. Adult Programs – CSS A01 / CSS A02 / PEI project 3

CalWorksCalWorks

c. CJS Programs – CSS A03 / INN-06 / INN-09

d I d B h i l H l h Di i i MHSA f d d d. Integrated Behavioral Health Division MHSA funded

programs – CSS A04 / PEI Project 4 PCBH / PEI project

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5 Suicide Prevention

MHSA Three-year Planning y gProcess

FY2015 - FY2017

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The County’s MHSA 3-Year Plan The County s MHSA 3 Year Plan Planning Process Structure:

• The Mental Health Board (MHB) and MHB Committee Meetings

• MHSA SLC Members and Stakeholder Community Meetings

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MHSA 3-Year Plan Overview Timeline shared at November 2013 MHSA SLC Meeting:g

Phase IO i t ti

Phase IIDetermine & Prioritize

Phase IIITranslate Priorities to

Phase IVV t Pl & AOrientation Determine & Prioritize

NeedsTranslate Priorities to

Plans Vet Plans & Approve

Nov 2013

•November 19 2013, the MHD ill h ld

Dec 2013 to April 2014

Phase II involves two ti

May 2014 to June 2014

•Incorporate d

July 2014 to Sept 2014

•Commence 30-day bli t i MHD will hold a

MHSA SLC meeting to the launch the County’s MHSA three-year planning process and

actions:

1.Determine Needs2.Prioritize Needs

•Review MHSA

proposed recommendations identified in Phase II into the County’s MHSA 3-year draft

public comment review period of the County’s MHSA 3-year draft plan

After 30-day period:p g prequest for member and stakeholder input on the planning process

programs and outcomes for the five MHSA components; and make recommendations relating to funding

yplan document.

•Review process will be facilitated through the MHB,

•Hold a MHSA SLC Meeting and request members’ endorsement of draft plan

•Go over the MHSOAC’s MHSA three-year (FY15-17) plan instructions

relating to funding and/or program changes

•Review process will be facilitated through the

g ,the MHB Committees and the MHSA SLC group.

•Hold MHB Public Hearing on Draft MHSA Three-Year draft plan

•Request County Board of

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MHB, MHB Committees and MHSA SLC group

q ySupervisors’ Adoption of the County’s Draft Plan

The County’s MHSA 3-Year Plan Ph II D i & P i i i N dPhase II - Determine & Prioritize Needs

County MHD

Review Program Outcomes Data /

Initial Recommendations;

and Request for Input

Share Program Outcomes / Input

1. Gather Data2. Analyze Data3 Draft Initial

and Request for Input at the following MHB

Committees:Adult Sys of CareFamily Adolescent

received at MHB Committee Meetings

to the MHSA Stakeholder Leadership3. Draft Initial

Recommendations

December 2013 /

Family, Adolescent & Children's

MinorityOlder AdultSystem Planning &

Leadership Committee and

request for additional Input

January 2014Syste a g &

Fiscal

February / March 2014

March / April 2014

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MHSA 3-Year Planning (FY15-17)Participation in Mental Health Board Participation in Mental Health Board Subcommittee Meetings:MHB Older Adult Minority Family, Adult System of System Planning Subcommittee:

y y,Adolescents & Children's

yCare

y gand Fiscal

Meeting Date(s): 2/10/2014 2/18/2014 3/13/2014 3/20/2014 4/4/20143/10/2014 3/18/2014

Meeting Time: 9:00 AM ‐ 10:30 AM 12:00 PM ‐ 2:00 PM 2:00 PM ‐ 4:00 PM 9:00 AM ‐ 12:00 PM 9:00 AM ‐ 11:00 AM

Topics: MHSA Older Adult MHSA Consumer MHSA Children and MHSA Adult MHSA TechnologicalTopics: MHSA Older Adult programs and projects

MHSA Consumer and Family programs, Workforce Education and

MHSA Children and Transition Aged Youth (TAY) programs and projects

MHSA Adult, Criminal Justice System, Housing, Integrated Behavioral Health

MHSA Technological Needs (TN) Projects and General Overview of the five MHSA components

Training (WET) plan and projects

and Suicide Prevention programs and projects

M ti L ti D t M t l H lth C t 1075 E S t Cl St t 2 d Fl T i i R #3Meeting Location: Downtown Mental Health Center, 1075 E. Santa Clara Street, 2nd Floor, Training Room #3

MHSA CSS work plan pHO01 - Housing

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CSS HO-01 Housing Options InitiativeGoalsGoalsEnd and prevent homelessness among unserved and underserved men, women, and families who are affected by mental illness, including those with co-occurring disorders.g

Key Strategies1. Increase housing units that are affordable and available to households

earning at or below 30% and or 15% of Area Median Income

2. Implement permanent supportive housing programs to help h h ld bt i d th i t i t h ihouseholds obtain and then maintain permanent housing.

3. Increase services to help households maintain permanent housing.“Step Down Programs”

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- Step Down Programs- Homeless Prevention Programs and Financial Assistance

BackgroundgContextContinuing and worsening affordable housing crisis especially for lower Continuing and worsening affordable housing crisis especially for lower income and special needs populations. Homelessness remains a critical issue for the County

Key Achievements150 units of housing through the MHSA Housing Program & Housing Plus Fund 600+ chronically homeless individuals housed through the Housing 1000 Campaign and the Care Coordination Project Renewed coordination and emphasis on addressing homelessness and the affordable housing crisis (permanent housing, Housing First, Office of Supportive Housing, Collaborative Applicant)

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FY15 & Beyond

CSSCSS1. Redirect $200K from Cold Weather Shelter Program:

• Increase PSH for North County• Increase funding for “Step Down” housing support functionsg p g pp

2. Refocus existing funding to support current priorities:• All non-permanent supportive housing• Align homeless services

3. Increase services to help households maintain permanent housing.

Other MHSA1 WET F d f I t1. WET Funds for Interns2. MHSA Innovation

• Pay for Success• “Step Down”

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• Step Down

Adult Services MHSA funded programs

CSSA01 Ad lt FSP*• CSSA01 Adult FSP*• CSS A02 Adult BH OP Services

Redesign*• PEI P3 CalWorks

* Refer to separate PowerPoint file.p

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PEI Project 3 CalWORKsPEI Project 3 CalWORKsGoalT id C lWORK li t d th i f ili b h i lTo provide CalWORKs clients and their families behavioral health therapy to help improve the quality of their lives through counseling services tailored to their specific g g pneeds.Background

St t d i 1999 th h ll b ti f DADS SSA• Started in 1999 through a collaboration of DADS, SSA and MHD• Behavioral health services (mental health and substanceBehavioral health services (mental health and substance abuse) for clients enrolled in the CalWORKs Welfare-to-Work (WTW) Program• Services provided through AACI, AARS, Catholic Charities, Gardner and County Mental Health at Narvaez 13

PEI Project 3 CalWORKsPEI Project 3 CalWORKsOur Clients87 % Female73 % Between 20 and 44 years old80 % English speaking7 % Vietnamese speaking8 % S i h ki8 % Spanish speaking39 % Hispanic14 % Asian/Pacific Islander14 % Asian/Pacific Islander26 % Caucasian, non-Hispanic7 % African American

Based on Client Satisfaction Survey Results for FY 12

PEI Project 3 CalWORKsPEI Project 3 CalWORKsB th N b FY 13By the Numbers, FY 13• 880 clients served• 567 new clients• 567 new clients• 455 workshops, presentations and screenings• 5,663 outreach contacts,• 2,731 clients screened for behavioral health issues• 97% screening rate• 660 screened clients referred for intake appointments • 24% referral rate at screenings

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PEI Project 3 CalWORKsPEI Project 3 CalWORKsKey Strategies for FY 15-17

• Increase the number of CalWORKs clients served through service expansion that started in FY 14 to include all CalWORKs recipient categoriesCalWORKs recipient categories

• Expand services to South County CalWORKs residents

• Expand workshops and support groups to North and South County CalWORKs Employment Services (CWES) locations

• Expand peer mentor support services

• Recommend continuation of MHSA/Medi-Cal funding as gon-going

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Criminal Justice System (CJS) MHSA funded programs

CSSA03 CJS J il Aft FSP• CSSA03 CJS Jail Aftercare FSP• INN-06 Transitional MH Services

for Newly Released Inmates• INN-09 Re-Entry y

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MENTAL HEALTH DEPARTMENTCRIMINAL JUSTICE SERVICESCRIMINAL JUSTICE SERVICES

The Criminal Justice Services programs serve individuals with multiple incarcerations and involvement with the Criminal Justicemultiple incarcerations and involvement with the Criminal Justice System that are experiencing Mental Illness and substance abuse conditions. The Criminal Justice Services programs include:

E L W ll & R P

Evans Lane Wellness & Recovery ProgramInnVision Shelter NetworkHeaven’s GateHome FirstCommunity SolutionsCatholic CharitiesGardner Health Services Family & Children Services

Evans Lane Wellness & Recovery

EHC LifeBuilders Heaven’s Gate

Transitional Housing

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Access: To provide seamless access to services.The CJS program has served 3 108 unduplicated individuals from 2007 to FY13The CJS program has served 3,108 unduplicated individuals from 2007 to FY13 (Source Data: Unicare). This number has significantly increased from 544 in FY12 to 966 in FY13Engagement: To engage individuals in custody within 5 business days/ those g g g g y yout of custody within 72 hours.Data (Out of Custody) indicate the length of time between “referral date” to “open date” within 72 hours has increased from 48% in FY11 to 71% in FY13.

CJS THUs have increased their ability to fill vacant beds within 48 hours. This has increased from 48% in FY11 to 67% in FY13. Data for out of custody individuals is 89% for FY13.

Meaningful activities: The average client meaningful hours in a day has increased from an average of 2.7 hours in FY 11 to 5.5 hours in FY13.

Program Improvements: (as identified by client surveys) Recovery groups and

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Program Improvements: (as identified by client surveys) Recovery groups and social skills activities have been expanded and transportation is provided to community events.


Serving Individuals with Co-Occurring Disorders: 99% of our population is diagnosed with co-occurring substance use disorderdiagnosed with co occurring substance use disorder.The CJS programs include employees who are certified through California Association of Alcoholism and Drug Abuse Counselors (CAADAC).

G f %Graduation: Evans Lane graduation rate has increased from 19% in FY10 to 34% in FY13.Graduation is defined as meeting treatment goals; stabilized mental health symptoms and substance usage; positive coping skills social support safesymptoms and substance usage; positive coping skills, social support, safe and stable housing, health benefits and access to health care.Basic Capacity:Expand the existing Outpatient contracts.p g p

Homelessness & Housing Support: Expand the existing Housing contracts. Increase the Evans Lane line item of Services/Supplies by $20,000 for the purchasing of bus passes and tokens.

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p g p

Overall recommendation:Continue to fund existing program.

Innovation 6:Transitional Mental Health Services for Newly Released Inmates

Does The Connection to Faith Improve Outcomes?

• Increase the quality of services, including better outcomes• Increase access to underserved groups • Increase access to services

Does The Connection to Faith Improve Outcomes?

• Increase access to services

FBRCs use a self sufficiency matrix tool to measure how well participants see themselves

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FBRCs use a self-sufficiency matrix tool to measure how well participants see themselves meeting their needs in specific areas and their progress towards becoming more self-reliant.

Innovation 6: Transitional Mental Health Services for Newly Released Inmates

Faith Based Resource Centers provide voluntary services and supports at no cost to individuals returning to the community and their families in a

natural community setting – regardless of faith tradition.

B W C C

New BeginningsCathedral Basilica of

St. Joseph

BIBLE WAY CHRISTIAN CENTER2090 OAKLAND ROADSAN JOSE, CA 95131 Recovery Café of San Jose

First Christian Church

CATHEDRAL OF FAITH2315 CANOAS GARDEN SANJOSE, CA 95125 Types of Services:

Celebrate Recovery – 12 Step ProgramCelebrate Recovery 12 Step ProgramLife Skills Classes

Anger ManagementEmployment Prep and Job Connections

Computer Literacy & Education ProgramsFamily Support

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MARANATHA CHRISTIAN CENTER1811 SOUTH 7TH STREETSAN JOSE, CA 95112

Housing Assistance

Innovation 6: Transitional Mental Health Services for Newly Released Inmates2014 Priorities & 2015 Recommendations

Faith Re-Entry Collaborative 2014 Prioritiesy

4th FBRC Employment Housing Faith, Family &Reunification

2015 Faith Based Resource Center Recommendations2015 Faith Based Resource Center Recommendations

Time Limited• Start Date: November 2011• End Date: October 2015End Date: October 2015

• MHD staff to work with FBRC partners to develop transition plans for clients

• MHD will work with FBRC partners to create program recommendations in advance of

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project end date: Oct 2015

• MHD will provide final recommendations to MHB

RE-ENTRY MULTI-AGENCY PILOTINNOVATION PROJECT 9INNOVATION PROJECT 9

The Multi-Agency Assessment Pilot is a Mental Health Service Act Innovation funded project. The Goal of the project is to quickly assess and link clients to services after returning to the community after being in custody. The MAP agencies include Department of Mental Health, Department of Alcohol and Drug Services and the Department of Social Services. This project is designed to serve offenders who have just been released or who are currently beingto serve offenders who have just been released or who are currently being supervised.

The MAP Team offers the following services:

Mental Health Assessment and ReferralMedical Assessment and ReferralTransportation, VTA CertificateDADS/Gateway Assessment and ReferralDADS/Gateway Assessment and ReferralHousing Assessment and ReferralLow Income Health Plan Representative Assessment and ReferralPeer Mentors Assessment and ReferralEligibility Worker Assessment for GA and CalFresh

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Eligibility Worker Assessment for GA and CalFreshDMV discount voucher for California IDBirth Certificate (California only)


Increase access to services: The Re-Entry MAP program has served over 1,358 unduplicated individuals from 2007 to FY13 (Source Data: Unicare). This number has significantly increased from 226 in FY12 to 1132 in FY13.The Re-Entry MAP Team completed 362 assessments/encounters in FY12 and 3 148 in FY133,148 in FY13.

Increase access to services/promoting interagency collaboration:For FY14 (July- September), of the 1,291 individual served by the Re-Entry MAP Team our referral data indicate that the services were distributed asMAP Team, our referral data indicate that the services were distributed as follows: 27% Benefits; 29% DADS; 22% Mental Health; 14% Housing and 11% Medical.

Increase access to underserved groupsIncrease access to underserved groups.There has been some movement in this area. Our data indicates that for FY12, those receiving the majority of our services were Caucasians (60%). Hispanic/Latinos received the existing 40% of our services. However, in FY 13,

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our demographic service delivery data indicated 47% Hispanic/Latino; 33% Caucasians; 20% Black/African American.


The Mental Health Department discontinue funding the DADS clinician effective FY15. We propose DADS to financial support this position ($98,424).

The Mental Health Department discontinue funding the Program EvaluatorThe Mental Health Department discontinue funding the Program Evaluator effective FY15 ($50,000); a total reduction of $148, 424.

Propose expansion of the existing FSP contracts for Outpatient Services.

Propose expansion of the existing Hosing contract.

The continuation of the program in its proposed form as an on-going program.The continuation of the program in its proposed form as an on going program.

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Integrated Behavioral Health (IBH) MHSA funded programs

CSSA04 C t l W ll d U t C • CSSA04 Central Wellness and Urgent Care Services

• PEI P4 Primary Care / BH Integration for • PEI P4 Primary Care / BH Integration for Adults and Older Adults

• PEI P5 Suicide Prevention Strategic Plan• PEI P5 Suicide Prevention Strategic Plan

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Overview: Division of Integrated Behavioral Health and Cross-System

IBH Div. Dir: Sandra Hernandez, LCSW

P4, P5, A04, 5, 0

Cross-system Senior Project Manager Suicide PreventionCross-system Senior Manager:

Mikelle Le, LMFTA04

IBH Senior Manager: Dinh Chu, LCSW

A04, P4

Project Manager, Behavioral Health

IntegrationP4

Suicide Prevention Coordinator:

Evelyn Tirumalai, MPHP5

MHUC, CWBC, Call Center, SACS

Valley Health Center Primary Care

Behavioral Health clinic managers

Primary Care Behavioral Health Contract Clinics,

AACI New Refugees,

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clinic managers g ,PEI AOA Contracts

Key Priorities to guide Recommendations:

Prevention and Early Intervention Services: “lowPrevention and Early Intervention Services: low intensity MH Interventions”Budget realities for MHSA Funds over the nextBudget realities for MHSA Funds over the next three yearsMHSA Key Performance Measures PrioritizationMHSA Key Performance Measures Prioritization

• determined by MHSA Stakeholder Leadership Committee (SLC) in Nov 2013

• Reduction of Stigma and DiscriminationReduction of Stigma and Discrimination• Reduction in Disparities to Access to MH Services• PEI of At-Risk Children, Youth and Young Adult

Populations experiencing onset of serious PsychiatricPopulations experiencing onset of serious Psychiatric Illness

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P4/A04 RecommendationsAO4 These program efforts provide our system the needed support to provide consumers and individuals with emergent needs with critical services and is an alternative to Emergency Psychiatric Services (EPS). P4 This program provides management support to the Primary Care Behavioral Health Program for VHCp g p g pp y g

Programs Initial Recommendations Rationale

County PCBH Behavioral

Maintain Current funding level through FY16-17. •Psychiatrists require the support staff to be most efficient in seeing and treating our 5 000+ clients within the 5 PCBHClient Impact as Result of Proposed

Health Expansion

StaffA04

our 5,000+ clients within the 5 PCBH clinics (identified on following slide).

•4.5 FTE LPTs (Licensed Psychiatric Technicians) monitor vitals, give injections, and provide medication d ti

pRecommendation

• Provide quality care with appropriate staff to ensure clients access to needed medication management services.

education

Integrated

Maintain Current funding level through FY16-17. Due to the significant changes required for collaborative care to really occur, key management positions are needed to ensure ongoing program and system

Client Impact as Result of Proposed RecommendationIntegrated

Behavioral Health (IBH) –

PCBH Staffing

4

ensure ongoing program and system redesign focus.

•Senior Mental Health Program Specialist to over see IBH clinics and PCBH managers.

RecommendationClients will benefit from dedicated management staff who can ensure the development into collaborative care model and clinic level staff who can interact daily with Primary Care Physicians and staff in their efforts to

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P4g

• Health Care Program Manager II for Sunnyvale PCBH to manage Sunnyvale and Milpitas PCBH clinics.

connect patients needing behavioral health services, and who play a key role in ensuring a smooth transfer between PCBH and the Specialty Mental Health System of care.

P4/A04 RecommendationsPrimary Goal of PEI P4- Primary Care/ Behavioral Health Integration for Adults and Older Adults:

Improve underserved population’s access to suitable non stigmatizing and low intensity mental healthImprove underserved population’s access to suitable, non-stigmatizing and low intensity mental health interventions to effectively address the onset of serious psychiatric illness (targeting depressive and anxiety

disorders) and reduce suicide risks among individuals 16 years of age and older.

Program Initial Recommendations Rationale

Primary Care Maintain Current funding level through FY16-17.

Behavioral Health (PCBH) in Valley Health Centers:

Work Plan P4 on

Funding will support many services not billable through PC billing structure, but essential: • Time spent to transfer between

Client Impact as Result of Proposed Recommendation

• Improve access for mild to moderate BH needs andd i di iti i t th iWork Plan P4 on

Primary Care /Behavioral Health (BH) Integration

for Adults & Older

PCBH & Specialty MH systems, • Lite case management activities• Time for providers to

collaborate on shared patients

reducing disparities in access to these services• Decrease prolonged suffering and prevent needs for

higher level of care• Improved quality of life due to increase in

collaboration between Primary Care Physician (PCP)

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Adults and PCBH providers• Reduce Stigma and Discrimination

P4 VHC PCBH UpdatepPrimary Goal of PEI P4- Primary Care/ Behavioral Health Integration for Adults and Older Adults:

Improve underserved population’s access to suitable, non-stigmatizing and low intensity mental health interventions to effectively address the onset of serious psychiatric illness (targeting depressive and anxiety


PEI P4 Program Data/ Update- Work Plan P4 on Primary Care / Behavioral Health (BH) Integrationfor Adults & Older Adults

Total 6,448

32*5 PCBH Centers locations: Valley Health Centers @East Valley, @Sunnyvale, @Milpitas, @Gilroy, @Alexian**Room Charge is billable services

P4 RecommendationsPrimary Goal of PEI P4- Primary Care/ Behavioral Health Integration for Adults and Older Adults:

Improve underserved population’s access to suitable, non-stigmatizing and low intensity mental healthImprove underserved population s access to suitable, non stigmatizing and low intensity mental health interventions to effectively address the onset of serious psychiatric illness (targeting depressive and anxiety


PEI P4 Program Initial Recommendations Rationale

Primary Care (PC)

Maintain Current funding level.

Provide greater flexibility in use of available funds to accommodate the addition of prescribing psychiatrist to the team customize EMR* data reporting tools & BH templates to

• Clinics BH programs still not sustainable based on billings alone.Li it d l f hi t i tPrimary Care (PC)

Behavioral Health (BH) Services:

Population Served:Transition Age

team, customize EMR data reporting tools & BH templates to be more compatible with BH needs (FY 15-16).Between 6/2012-10/31/13

• Clinics are routinely screening for suicidality (< 2% positive)

• Limited supply of psychiatrists available to contractors and these pts.

• Funding prescribing psychiatrists will enhance

Youth (TAY), Adults/Older Adults

(AOA)

patients’ ability to be treated where they most prefer.

• EMR not customized to Behavioral Health needs, limiting patient outcomes

Client Impact as Result of Recommendation

• Those individuals served at these clinics can benefit from continuity of care and collaborative treatment in their clinic.

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g preporting• Expand access to more individuals throughout our County

*Electronic Medical Record

P4 PCBH UpdatepPrimary Goal of PEI P4- Primary Care/ Behavioral Health Integration for Adults and Older Adults:

Improve underserved population’s access to suitable, non-stigmatizing and low intensity mental health interventions to effectively address the onset of serious psychiatric illness (targeting depressive and anxiety

disorders) and reduce suicide risks among individuals 16 years of age and older.PEI P4 Program Data/ Update- Primary Care (PC) Behavioral Health (BH) Services:

Case Finding Activity ofCase-Finding Activity of Homebound OA- 3 clinics screened 2,812 OA PC pts. In 3 clinics- 8% screened were homebound and 13% screened positive for depression

Early Intervention- therapeutic treatment with a licensed behavioral

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health (BH) clinician not a psychiatrist. Prevention- psycho-education provided by either Peer Partner or BH

Clinician

P4 RecommendationsPEI P4

Program Initial Recommendations Rationale/ Data (*all data from 7/11 thru 1/14)

New Refugees are still addressing multiple basic Maintain current funding level-Extending One-Time funds for next two years (or increasing MHSA funds for this purpose), realigning the goal of cost to be split 60% for prevention/ outreach, and 40% of funds for EI.

needs; consequently• Of 333 individuals who received Specialty MH

services • 72% opt for brief MH treatment due to

other essential needs.

New Refugees (NR) Services

,Discuss possible restructuring of MH Services to better meet NR needs.

• 28% receive an average of 5-6 months of treatment, with 69% realizing improvement*.

28% of those referred received Early Client Impact as Result of Recommendation( )Adults,

Older AdultsIntervention services (>60days of treatment).

Outreach and prevention activities are robust and well received, and are a gateway to reducing stigma and increasing awareness of MH i i l t th i d

• Refugees newly settled in SCC, within past 5 years, will continue to receive this needed service

MH services in languages not otherwise served by SCC MHDSCC is in the lead on Refugee P & EI activities• 1,970+ individuals representing 27 countries

benefitted from Prevention & outreach.

• New refugees self-referral rates for mental health services will continue to increase, as they have for the past two years running, decreasing stigma and decreasing long-term

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• 56%* reported increased knowledge about MH resources in SC County

suffering from mental illness.

*As measured by pre and post survey (this is a subset of the 1,970. **As measured by pre and post CAFI XC testing for the 94 New Refugee clients who engage in Specialty Mental Health Services for an average of 5-6 months.

P4 RecommendationsPEI P4

Program Initial Recommendations/ Data/ Update Rationale

Discontinue this PEI program as it does not achieve what was hoped: outreaching and identifying AOA with Early Intervention needs. This was one-time program was implemented prior to the PCBH contracts.

Results show that few people served were PEI client, significant percentage were SMI.

The 8 PCBH clinics are better able to

Adult/Older Adult PEI

identify and serve more of this P&EI population and connect them as needed to higher level of care since approximately 70% of the population seek health care in primary care settings (Regier 1993) including most

ServicesAdults,

Older Adults

care settings (Regier, 1993), including most older Americans. (Bartels et al., 2004) *

No robust additional outreach was possible with the funding levels and small number of i di id l b dindividuals to be served per contract.

All individuals were served, and would continue to be identified and served through existing processes and resources.

Client Impact as Result of Recommendation

Client impact would be neutral if one-time funding were discontinued. All referrals received are through the same

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g pgchannels as Specialty MH referrals. By eliminating this one-time funded program, these individuals would still be served.

*American Psychological Association: https://www.apa.org/about/gr/issues/aging/mental-health.aspx

A04 Recommendations

AO4 This program provides consumers and individuals with emergent needs with critical services and is an alternative to Emergency Psychiatric Services (EPS).

A04 Programs Initial Recommendations Rationale

Maintain Current funding level through FY16-17. • Approximately 400 San Jose

Police Department (sworn and Client Impact as Result of Proposed Recommendation

Law Enforcement

Liaisons (LEL)

p (civilian staff) and California State University (CSU) Campus Law Enforcement staff will be trained with IVST

• Provide continued support to

Clients and their family members will directly benefit from a more informed and better prepared law enforcement trained to de-escalate situations involving mentally ill individuals in (LEL)

A04Provide continued support to MHUC with field assessments and consultations in collaboration with the police and sheriff’s departments

the community.

Interactive Video Simulation Training (IVST) is a powerful training tool that was developed in partnership with our consumer community.

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A04 RecommendationsAO4 This program provides consumers and individuals with emergent mental health needs with critical services and is an alternative to Emergency Psychiatric Services (EPS). Mental Health Urgent Care(MHUC) services include assessment crisis intervention referrals education and medical support(MHUC) services include assessment, crisis intervention, referrals, education, and medical support services. MHUC is available to individuals who walk in for assistance, and works closely with EPS staff. On a limited basis, staff provide mobile crisis response and telephone consultation to the police as they are called to highly emotionally charged situations.

A04 Program Initial Recommendations Rationale

Maintain Current funding level through FY16-17. With the merger of MHD and

Mental Health

gDADS, and the changing health care environment, MHD needs to •Increase timely access to client care

•Re-evaluate workflow to


Overall, continued funding would directly benefit clientsUrgent Care

(MHUC)

Re evaluate workflow to maximize staff scope of work.

•Design client experience survey.•Continue program with plans to integrate with Central Wellness Benefits Center (CWBC)

Ove , co ued u d g wou d d ec y be e c e sthrough:• Increased staffing to enable improved timely access to

care. Addition of a 2nd Lead Clinician to cover hours

currently not being covered by 1st Lead and

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Benefits Center (CWBC).currently not being covered by 1 Lead, and Additional of 1 FTE MD code to cover weekends and

evening hours.

A04 RecommendationsAO4 The Central Wellness and Benefits Center (CWBC) program provides unsponsored mental health consumers assistance in applying for entitlements such as Valley Care, Ability to Pay (APD) Medi-Cal, Medicare and Social Security Insurance (SSI) CWBC provides needed mental health services toMedicare, and Social Security Insurance (SSI). CWBC provides needed mental health services to underserved and uninsured individuals.


Maintain Current funding level through FY16-17.

Uninsured underserved individuals receive assessment, medication management, and minimal time-limited case management, and crisis intervention.

Central Wellness &

Benefits Center

Client Impact as Result of Proposed Recommendation Update

Changes as of 1/1/14:• Recent implementation on 1/1/14 of

(CWBC)A04

the Affordable Care Act (ACA).• Senior Health Representatives are

certified through the state as Certified Benefits Counselors.

• Served 5,011 from FY09 – FY12.

Continued funding for this program would be a benefit to our community. This program is a critical service that affects 2,000 uninsured individuals being served at any given time in need of Specialty Mental Health Services,

ho do not ha e an ins rance

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• Inactive cases are reviewed on a quarterly basis for closure.

who do not have any insurance.

A04 RecommendationsAO4 Integration of the Central Wellness and Benefits Center (CWBC) and Mental Health Urgent Care (MHUC) program will streamline workflows and consolidate staffing that will maximize client access to needed services: assistance in applying for entitlements to unsponsored mental health clients; assessments; crisis intervention; referrals; education; medical support services; and on a limited basis staff providecrisis intervention; referrals; education; medical support services; and on a limited basis, staff provide mobile crisis response and telephone consultation to the police as they are called to highly emotionally charged situations.


Integration of

Maintain Current funding level through FY16-17.

Staff functions and client population have a significant overlap. Consolidation of staff and centralizing the location will enhance flexibility in responding to community needs in a more timely manner therefore improving accessg

Central Wellness &

Benefits Center

(CWBC) and

manner, therefore improving access.


Key ElementsProtective Service Officers (PSO):• Assist clients at Emergency Psychiatric

Services (EPS) who may be on a 5150 hold.(CWBC) and Mental Health

Urgent Care (MHUC)

A04

( ) y• Assist to provide safety for staff, clients, and

visitors.Health Care Program Manager (HCPM) II:• Located in CWBC building.• Provide daily supervision and management

Continued funding for this program would be a benefit to our community. Clients will benefit from increased accessing services in a timely manner that will result from this

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y p gto both programs.

Central Location• At CWBC.• Timeline currently to be determined.

timely manner that will result from this consolidation.

P5 RecommendationsP5 Suicide Prevention Program initiated a county-wide strategic planning process to develop a strategic action plan to prevent suicide. The plan was completed in August 2010 and is now being implemented.

Guided by public health principles of community education, training, capacity building, and population health, the implementation has been designed with one priority in mind: suicide prevention for everyone.PEI P5

Program Initial Recommendations Rationale/ Data

Maintain current funding level through FY 16-17.• Reallocate ongoing funding for C23 position (Suicide –Two CalMHSA grants end June 2014:

Stigma and Discrimination Reduction

P5 Suicide

Prevention Associate) which is partially funded by California MH Services Authority (CalMHSA)-San Francisco Suicide Prevention (SFSP) grant that ends June 2014.

• Reallocate ongoing funds for consultants for Strategies 4,5 to Community Education and Information.

Stigma and Discrimination Reduction (SDR) mini-grant and SFSP grant

–SP will release Community Capacity Building mini-grants for community-based organizations serving at-risk

Prevention:Santa Clara

County Suicide

Prevention

y• Maintain Evaluation Services funding for future Informal

Competitive Process.• Add a MH Community Worker (PT/FT)

g gpopulations identified on the SPSP

–Evaluation of the SPSP can only occur with funding

–A Community Worker would be a Client Impact as Result of RecommendationPrevention Strategic

Plan (SPSP)necessary member of our community capacity building and public awareness campaigns.

–One additional staff is needed to id di t d ti d t i

The community will benefit from • Creation of programs and strategies that help address specific

needs of communities and high-risk clients. • Formation of broader safety net of suicide alert community

members and gatekeepers helping identify and assist clients in

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provide direct and continued support in the community carrying out promotion and awareness activities.

members and gatekeepers helping identify and assist clients in crises sooner and efficiently.

• Community-led prevention efforts specific to funded groups in communities at-risk (i.e. mini-grants)

P5. Suicide Prevention UpdateSt t i Pl I l t tiStrategic Plan ImplementationStarting in 2013, the Suicide Prevention Initiative has moved into the implementation phase. The implementation approach has been designed with one priority in mind: p p pp g p ysuicide prevention for everyone.

SUMMARY OF STRATEGIES, June 2010.Strategy 1: Implement and coordinate suicide prevention and intervention programsStrategy 1: Implement and coordinate suicide prevention and intervention programs and services for targeted high risk populationsStrategy 2: Implement a community education and information campaign to increase public awareness of suicide and suicide preventionStrategy 3: Develop local communication “best practices” to improve media coverage and public dialogue related to suicideStrategy 4: Implement policy and governance advocacy to promote systems change in suicide awareness and preventiong pStrategy 5: Establish a robust data collection and monitoring system to increase the scope and availability of suicide-related data and to evaluate suicide prevention efforts

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Suicide Prevention Strategic Plan I l t ti U d t St t 1Implementation Update: Strategy 1

The following community-based services and strategies are in place to carry out this suicide prevention and intervention strategy:out this suicide prevention and intervention strategy:• Suicide and Crisis Services (SACS) –

Answered 90,863 calls from FY11 – FY13 Expanded Outreach and Education Activities Disseminated SACS information and referrals opportunities Suicide & Crisis Hotline CERTIFIED by the American Association of Suicidology (AAS)

–November 2012 (CalMHSA grant-funded)Next Steps1 ExpandSurvivors of Suicide (SOS) loss support groups1. ExpandSurvivors of Suicide (SOS) loss support groups2. Suicide Attempt Survivors Support Program – Emergency Department collaboration 3. Join National Lifeline4. Adopt a Helpline Management Software to reduce workload, improve service

delivery and advance helpline’s outcomes (e.g. iCarol)y p ( g )

• Santa Clara County Suicide Prevention Speakers’ Bureau Panels• Provided two Assisted Suicide Intervention Skills Training (ASIST) 2-day

Workshops- In collaboration with SJSU ASIST trained professors

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Suicide Prevention Strategic Plan I l t ti U d t St t 2Implementation Update: Strategy 2

The following community-based services and strategies are in place to carry out this community education and public awareness strategy:community education and public awareness strategy:• SACS’s rural outreach initiative (CalMHSA) Ending on June 2014.

• Developed and implemented data tracking system June 2013. • Warm Line Outreach• Enhanced SACS outreach through targeted minority communities• Rural Outreach – Provided outreach in unincorporated areas and South County• Community Outreach Worker (extra-help): April 1, 2014 – December 30, 2014.

• Suicide Prevention Gatekeeper Trainings:p g-Question, Persuade, Refer (QPR) class room and online-safeTALK (suicide alertness for everyone Talk-Ask-Listen-Keepsafe)

• Capacity Building Initiative: -QPR Train-the-Trainer Workshops-safeTALK Train-the-Trainer Workshops

• Community Conversations on Suicide Prevention; SP Speaker’s Bureau (Stigma and Discrimination Reduction, CalMHSA minigrant, ends June 2014).Discrimination Reduction, CalMHSA minigrant, ends June 2014).

• SP Public Awareness Campaign: launching in April 2014• Community Action Building mini-grants (planning phase) 44

Suicide Prevention Strategic Plan Implementation Update: Strategy 3

The following community-based services and strategies are in place to carry out these desired outcomes in communication best practices:

Implementation Update: Strategy 3

• SP Communications Workgroup created to develop the public awareness campaign on suicide prevention

• Training workshops on Best Practices reporting on suicide prevention for reporters, elected officials and school staff (planning phase with SCC VMC Public Information

Implementation Update: Strategy 4

(p g pOfficer)

L d b th S i id P ti O i ht C itt C Ch i d t ff thLed by the Suicide Prevention Oversight Committee Co-Chair and program staff, the program has achieved the following on School-based Suicide Prevention Policies:• 19 Santa Clara County school districts have a suicide prevention policy• 12 of the twenty-one (21) elementary/middle school districts have approved these y ( ) y pp

documents, as have three (3) of the five (5) high school districts and four (4) of the six (6) unified school districts

• Of the districts serving high school students, only the Mt. View – Los Altos High School District has not indicated if they are considering a policy and ARs

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District has not indicated if they are considering a policy and ARs.

Suicide Prevention Strategic Plan

R i d d i t d 2009 2011 D t R t f t id di t ib ti d

gImplementation Update: Strategy 5

• Revised and reprinted 2009-2011 Data Report for county-wide distribution and dissemination at Cities, California Counties, agencies, and the State.

• Compiled and completed the 2012 data entry and initial analysis for a comprehensive 2009-2012 Data Report Executive Summary released December 2013.

• This addendum was included in the Third Annual Suicide Prevention Report, December 2013

Santa Clara County Preliminary Executive Summary2009-2012 Suicide Data2009 2012 Suicide Data

November 8 2013

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November 8, 2013

Additi l I f tiAdditional Information:

•The MHD will be participating in MHB subcommittee meetings in •The MHD will be participating in MHB subcommittee meetings in February and March and invite all to participate in the three-year planning process.

•MHSA Email Distribution List - If you are currently not part of the County’s MHSA email distribution list and would like to be included please send email request to erika lopez@hhs sccgov orgincluded please send email request to [email protected]

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Comments / Questions/ Q

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mhb adult system of care subcommittee mhsa programs · • 455 workshops, presentations and...

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