SHASTA COUNTY MENTAL HEALTH, ALCOHOL AND DRUG ADVISORY BOARD

Transcription

1 SHASTA COUNTY MENTAL HEALTH, ALCOHOL AND DRUG ADVISORY BOARD Annual Report to the Shasta County Board of Supervisors January December 2011 The mission of the Shasta County Mental Health, Alcohol and Drug Advisory Board (MHADAB) is to inform and educate the public on alcohol, drugs, and mental health issues as well as to advise Shasta County Mental Health, Alcohol and Drug Services (SCMHADS) on program development, availability of services, and planning efforts established by Welfare and Institutions Code Section , which includes the following responsibilities: 1. Review and evaluate the community s mental health, alcohol and/or drug treatment needs, services and special problems as related to the above. 2. Review performance contracts. 3. Advise the Board of Supervisors (BOS), the County Director of Mental Health Services (Director), and the County Alcohol and Drug Program Administrator (Administrator) as to any aspect of the County of Shasta s mental health, alcohol and drug treatment and prevention services. 4. Ensure citizen, consumer and professional involvement in the SCMHADS delivery planning efforts. 5. Submit an annual report to the BOS on the needs, challenges and performance of the County of Shasta s mental health, alcohol and drug treatment and prevention services. 6. Review, interview and make recommendations on applicants for appointment of the Director and Administrator. 7. Review and comment on the County of Shasta s performance outcome data and communicate its findings to the State of California Mental Health Planning Council and/or other appropriate entities. 8. Assess the impact of the realignment of services from the State of California on mental health services delivered to clients and within the Shasta County community. 9. Review draft Mental Health Services Act (Proposition 63, General Election of November 2004) plans and annual updates, make recommendations to the Director regarding the plans and updates, and make recommendations to the County Mental Health Department for revisions, as needed (per Welfare and Institutions Code Section 5848(b)). 10. Conduct public hearings on draft Mental Health Services Act (MHSA) plans, annual updates and other matters as appropriate. Page 1

2 Introduction Mental Health, Alcohol and Drug services in Shasta County face two distinct realities. On one hand we have inadequate resources and allocations, leading to severely limited services for a population growing in numbers and need. Substance abuse treatment has taken some deep cuts in recent years and suffered from the elimination of Proposition 36. The Department braced for a possible influx of criminal offenders scheduled to be released from state prison per AB 109 who would need services. On the other hand, the Mental Health Services Act funding supports several new programs to serve the housing, crisis, aging adult, and mental illness preventive needs in our community. Because of these complicated challenges and opportunities, serving on the Mental Health, Alcohol and Drug Advisory Board is always interesting and challenging. We received reports on new and innovative ways to understand and/or address the problems that plague us like child abuse, healthcare reform, a workforce in need of training, an outdated building, and the aging clients with multiple health issues. We also saw increased community dialogue on the topics of suicide and discrimination against people living with mental illness. We are dealing with complex issues that demand complex approaches, and we are still considering ways to effectively address them. With healthcare reform on the horizon and a new focus on preventing mental illness and addiction, the delivery of mental health and alcohol and drug services may look very different in the next few years. One thing is certain, change is constant Membership Enormous appreciation goes to the members of the board, staff and Board of Supervisor representative Mr. David Kehoe for your participation, work and interest in mental health and alcohol and drug issues in Shasta County. Dianna Branch Interested citizen Dana Brooks, MFT Redding Rancheria Cheryl Ann Chinn Interested citizen Larry DeNayer Retired Postal Service Georgia Dukes Interested citizen Dave Honey Good News Rescue Mission David Kehoe Shasta County Board of Supervisors Samuel Major State Comp Insurance Fund Richard Myers Foothill High School Marie Ann Quiros American Indian Education Center Sara Steinbeiss Student Lowell Streiker, Vice Chair Author / Retired Minister Sandra Tary, Chair Semi Retired School Counselor Redding School District Steven Trujillo Barista Don Van Buskirk Sheriff s Office Page 2

3 Special Highlights Triple P Positive Parenting Program The Positive Parenting Program (Triple P ) is an internationally recognized evidence based parenting program developed by Professor Matt Sanders and colleagues at the University of Queensland, Department of Psychology, in Australia. The program is designed to help parents deal with social, emotional and behavioral problems that are inherent in childhood. What makes this program unique is that it offers multiple levels of intervention that range from the general to the specific. Shasta County Health and Human Services is implementing Triple P as part of its Mental Health Services Act (MHSA) Prevention and Early Intervention (PEI) efforts. During MHSA s stakeholder input process, community members ranked children and youth in stressed families as the #1 population to work with in preventing mental illness, and with upwards of 1400 children a year being served through HHSA s Child Protective Services system the need for early intervention for this population was clear. To date, we have trained 197 practitioners to deliver various levels of Triple P throughout the county to more than 661 children and their families. Practitioners range from paraprofessionals in schools and community based organizations to licensed professionals in private practice. Joy Garcia, MHSA PEI Coordinator Page 3

4 Alcohol and Drug Prevention Activities Shasta County receives funding to support substance abuse prevention activities. Current activities cover underage drinking, prescription drug abuse and medical marijuana. Alcohol is the leading factor in the most common causes of death among people aged years. An underage drinking campaign aims to decrease this situation in Shasta County, and has designed the thinkagainshasta.info web site to educate and inform parents about this problem and what they can do to help. Kathey Kakiuchi, Public Health Manager Psychiatric Hospitalizations In response to a newspaper article titled Long Waits, Few Options for Patients on the lack of mental health treatment services in Shasta County, HHSA Director Marta McKenzie presented on the changes that have occurred locally since the closure of the County s psychiatric hospital. While acute psychiatric treatment costs have remained stable, Crisis Stabilization Services and Crisis Residential and Recovery Center services have been added. In addition, the number of acute psychiatric hospital admissions has been cut in half, while the length of stay has more than doubled, perhaps indicating a more selective process for psychiatric hospital admission than existed when the facility was locally available. And a higher proportion of County inpatient resources are being spent on long term residential care. A request for proposals to fund a local psychiatric facility is being released this year. Marta McKenzie, Health and Human Services Agency (HHSA) Director Approval of Innovation Plan The Mental Health Services Act funding for innovative projects will focus on mentally ill offenders and on peer supported pre crisis intervention team efforts. These projects were approved unanimously by the MHADAB. Jamie Hannigan, MHSA Manager Endorsement of the Health and Human Services Agency Strategic Plan The Health and Human Services Agency Strategic Plan was endorsed by the MHADAB. The plan contains six main goals: (1) decrease the use of tobacco, alcohol and other drugs, (2) prevent adverse childhood experiences, (3) promote mental well being, (4) empower independence and selfsufficiency, (5) increase accessibility of services and (6) build organizational capacity to provide highquality services. Donnell Ewert, Public Health Director Page 4

5 Adverse Childhood Experiences (ACE) Research indicates there is a relationship between certain early childhood experiences and health as an adult. The adverse experiences linked to ill health later in life include several forms of child abuse and neglect, and/or various household dysfunctions like domestic violence, parental separation, or an incarcerated, substance abusing or mentally ill household member. It is believed that these early traumatic experiences result in emotional impairment which leads to the adoption of risky behaviors which in turn lead to disease and ill health. Among the many linked health outcomes, those most relevant to mental health and substance use issues include a high correlation to suicide attempts, the use of psychotropic medications, smoking, alcohol and drug abuse, depression, etc. With the support of some MHSA PEI funding, a community collaborative made up of representatives from Head Start, Shasta County Office of Education, First 5 Shasta, Women s Refuge, Probation, Child Abuse Prevention Coordinating Council, Youth Violence Prevention Coordinating Council and Northern Valley Catholic Social Service (NVCSS) and others will address ACE. Andrew Deckert, MD, MPH Public Health Officer Special Meetings Healthcare Reform Catholic Healthcare West North State President Jon Halfhide gave an hour long presentation on the implications of healthcare reform on healthcare delivery in Shasta County. This was a joint meeting held Page 5

6 with the Shasta County Public Health Advisory Board and the In home Supportive Services Advisory Committee. Tour of the Shasta County Jail The MHADAB received an informative overview of mental health services delivered at the jail through a contract with the California Forensic Medical Group (CMFG) that include Medication management and counseling. Tour of the Good News Rescue Mission The MHADAB held a special meeting at the Good News Rescue Mission. The board was given a tour and was introduced to the many programs available to the chronically homeless, drug and alcohol addicted, and the homeless mentally ill of Shasta County. Page 6

7 Department Committee Reports Community Education The Community Education Committee works to promote mental wellness, increase community awareness of mental health, and end the stigma surrounding mental illness and substance abuse. The HHSA Community Relations/Education Division supported the committee this year. They helped plan activities for May s Mental Health Month such as the Mental Health Resource Fair, A News Café Book Club, and Second Saturday Art Hop exhibit, as well as Mental Illness Awareness Week in October. They also developed a Speakers Bureau, gave input into the youth focused Anti stigma and Discrimination Media Campaign and the Brave Faces Photo Gallery. They met regularly at the Second Home Wellness Center, but moved to the Redding Library after a few months. Client Services The purpose of the Client Services Committee is to highlight employment, transportation and housing needs and resources for consumers of mental health services. Consumers are invited and encouraged to attend, as the meeting is for their benefit. Mental Health Services Act Advisory (MHSAA) The MHSA Advisory Committee provides input and guidance for the planning, implementation and oversight of MHSA funded activities and programs. MHADAB member Sara Steinbeiss serves as the chair. The topics of interest included: Older Adult Gatekeeper Program Suicide Prevention Destigmatization of mental illness Triple P TF CBT Trauma Focused Cognitive Behavioral Therapy Workforce Education and Treatment (WET) Consumer/Family Member MHSA Volunteer Program Capital Facilities Project Innovation Plan Approval Suicide Prevention Workgroup A local collaboration of public and private agencies and concerned community members focused on reducing the number of suicides in Shasta County. This workgroup developed a work plan, with goals that included community assessment, community education and peer support. To this end, it created a three part community assessment that included sections on suicide data, community perception and community response. It organized activities for Suicide Prevention Week in September and participated in statewide and regional suicide prevention planning efforts. It created and distributed educational information about firearms safety and suicide prevention to Shasta County firearms dealers, target Page 7

8 shooting ranges and sporting goods stores. Information about prevention, intervention and postvention was shared with the community, both in person (at places like health fairs) and online (website and Facebook page). The group also works to promote existing resources for grief and loss. Approximately 70 certificates and/or pins were presented to community members and organizations who are working to promote protective factors in the community. A new work plan is in progress and should be complete by January Page 8

9 Services Mental health services within the Health and Human Services Agency are a piece of a countyadministered specialty mental health system. As such, we follow state requirements to serve a target population of only those adults with serious mental illness (SMI) and youth with serious emotional disturbances (SED). We also serve youth with serious emotional disturbances. In both populations, we are required to serve clients in the least restrictive setting available. For adults, a mental illness is considered serious when it substantially interferes with basic daily skills (like eating and bathing), living skills (like managing money or maintaining a household) and forming relationships and interacting with other people. For youth under 18, SED is defined as a mental health problem that causes the child to behave contrary to expected developmental norms. An estimated five percent of U.S. adults have a severe mental illness such as schizophrenia, bipolar disease or major depression, although this estimate of disease prevalence does not necessarily translate into serious and persistent functional impairment. As resources allow, mental health services may include assessing mental health issues, prescription medication management, therapy, crisis intervention and services to support stability in housing, income, health care, etc.. While these services might not seem directly linked to mental health, unmet personal needs can complicate the ability of a person with mental illness to effectively manage their illness. Crisis Crisis Services are provided for persons who are experiencing a mental health crisis or psychiatric emergency, including individuals who present at the local emergency room on an involuntary mental health hold. 23 hour Crisis Stabilization Services (CSS) are available for youth, adults, and older adults. Crisis Residential Recovery Center (CRRC) services are available for adults and older adults. Services are available 24/7 and include telephone crisis services. Crisis Stabilization Services (CSS) provides 23 hour stabilization services, including psychiatric medication support. The Crisis Residential Recovery Center (CRRC), provides residential services for up to 30 days, and permits individuals to move from crisis into a short term transitional housing situation. The 23 hour Crisis Stabilization Unit, in tandem with the Crisis Residential and Recovery Center, serves clients in crisis with a goal to reduce the need for acute psychiatric hospitalizations and allows individuals to receive treatment within our community. This in turn promotes more meaningful support by friends and family and has a positive impact on their recovery. Page 9

10 Services Acute Psychiatric Hospitalization and Long term Care The local mental health program is required by statute to provide 24/7 treatment services that includes psychiatric hospitalization when appropriate. As psychiatric hospitals are in short supply, the County contracts with several psychiatric and acute general hospitals, as well as free standing psychiatric health facilities to meet this need for County residents. Patients experiencing a psychiatric crisis are evaluated, and if necessary, appropriate arrangements for hospitalization and transportation to/from the psychiatric hospital are made. For the most functionally impaired mentally ill county residents, arrangements for intermediate or long term residential care are made by the County. In some cases, clients are assisted in board and care or assisted living facilities, in other cases institutes for mental disease (IMD) or the state psychiatric hospital. Outpatient (Youth and Adult) The services provided to these patients in fiscal year included 4,971 mental health assessments and treatment plans, 42,818 treatment progress notes, and 9,828 face to face visits. Eligible clients must meet the target population and services must follow a treatment plan. Because the target population includes those with serious mental illness, medication supports are often part of the treatment plan. In , 30,189 prescriptions were filled and 11,245 medication support visits occurred. Care of serious mentally ill people has historically focused on returning the patient to a more normal level of social functioning through therapeutic interventions and medication supports. Increasingly, treatment methods have broadened to include social rehabilitative services such as case management that can assist with housing, employment and other aspects of improved social well being. Treatment providers have also broadened to include personal service coordinators, employment counselors, peers and family members. Depending on the needs of the client, these additional services should contribute to a successful recovery. Alcohol and Drug Outpatient services are specifically designed for the treatment of substance use disorders and include counseling, education, and crisis intervention and referral services. There are also outpatient services for teenagers and people with mental health problems, and payment can be made on a sliding scale or with Drug Medi Cal. The majority of outpatient services are contracted through Right Roads Recovery Programs and Empire Recovery Center. The Behavioral Health Team provides screening, counseling and therapy for people with alcohol and drug problems as well as mental health problems, as part of CalWORKs participation. These County staff provide these services to help eliminate barriers to employment. Page 10

11 Services The Perinatal Program is for women who are pregnant or have a young child and have a substance abuse problem. Through this program, they can receive day treatment, counseling, parenting skills classes and more. An on site child care co op and transportation is available, and payment can be made on a sliding scale or with Medi Cal. Though services are primarily by County staff, there are also limited residential services available through a contract with Visions of the Cross. Co occuring Disorders Many clients have co occurring disorders, which means they struggle simultaneously with mental health challenges, substance use disorders, and/or other medical conditions. Shasta County increasingly assesses and treats people with co occurring disorders through team staffing and/or dually trained staff. Traditional treatment programs often treat one condition at a time, but as dual recovery becomes the standard, patients outcomes are expected to improve. Integration of Mental Health with Primary Care Recent national reports indicate that seriously mentally ill people die 25 years younger than the general population due to inadequately treated medical conditions. This is because many people with serious mental illness have problems following recommendations for their health care and/or disease management. In addition, risky behaviors such as smoking and substance abuse contribute to shortened life spans.. To counteract this problem, many mental health systems across the country, including Shasta County, are beginning to integrate mental health and primary care and improve the channels of communication between them. We have formal partnerships funded through MHSA resources with four federally qualified health centers (FQHC) in Shasta County including Hill Country Community Clinic, Mountain Valleys Health Centers, Shasta Community Health Center and Shingletown Medical Clinic. Chronic diseases and conditions such as diabetes, hyperthyroidism, dementia, and cancer can lead to different forms of mental illness. Optimum treatment of chronic diseases should include mental health counseling and other supports. Primary care physicians occupy a setting where mental health can be routinely assessed in both children and adults. Adding behavioral health evaluations to routine physical examinations may reduce the anxiety and stigma associated with mental illness, and result in more routine integrated treatment for mental and physical health conditions. While full integration isn t yet fully realized, personal service coordinators or case managers who coordinate mental health and primary care can make a difference. They arrange follow up medical appointments, ensure medication availability and compliance, and make sure other supports to meet social, vocational and educational needs are provided. Page 11

12 Services Patients Rights Patients Rights is mandated by the Welfare and Institutions Code Section This code is designed to protect the rights of people receiving mental health services in California. Shasta County Mental Health has a Patients Rights Advocate on staff that is responsible for training and educating people about mental health law and patients rights. In 2011, the advocate helped 1,346 clients with numerous issues, including problems with a payee, change of provider, access to service and billing issues. The Patients' Rights Advocate also monitors mental health facilities, services and programs for compliance with statutory and regulatory patients' rights provisions. In addition, they work closely with the California Office of Patients' Rights. For more information, call (530) Page 12

13 Funding and Expenses Funding While there may be some modest variation among counties, California s public mental health system is largely funded by the revenue sources listed below. Medi Cal revenues included in the narrative are service related and do not include Administration or Utilization Review. Specific Shasta County amounts are: o o o o o Realignment (from sales tax and vehicle license fees) provided $ 5.4 million in 2010/2011. This number has declined by $900,000 since These funds are used to match federal Medi cal and EPSDT funds (FFP below), and support the care provided to persons who are uninsured. County General Fund provides $266,778 per year. By statute, the county must allocate this amount in order to receive Realignment funds. Medi Cal Federal Financial Participation (FFP) pays for half of all claimable mental health services provided to Medi Cal beneficiaries ($6 million in 2010/2011). Medi Cal Managed Care was reduced from $1.1 million to $611,889 in 2010/2011. With this state funding, counties in California agree to provide or contract for mental health services for the Medi Cal eligible mentally ill population. Early Periodic Screening, Diagnosis and Treatment (EPSDT) ($2,419,044 million in 2010/11) is the Medi cal program that provides mental health services for eligible low income youth. Page 13

14 o The Mental Health Services Act provides approximately $5 million per year Funds come from a 1 percent tax on people with incomes more than $1 million. The funds are used to expand California s public mental health system. o Substance Abuse Prevention & Treatment (SAPT) Federal Block Grant $1,399,752 used to provide services for both Alcohol and Drug and Perinatal clients, drug testing, and prevention services that are not otherwise claimable to Medi Cal. o State General Fund $287,913 used to match Federal Medi Cal FFP, and to provide drug and alcohol services to clients who do not have Medi Cal. o Drug Medi Cal $169,476 Federal FFP funding for allowable services to Medi Cal clients o Drug Court $248,843 State funding to provide services as a diversion from regular court forconvicted adult felons. Includes drug testing, etc. o CalWorks $673,776 Services provided to CalWorks recipients for whom substance abuse or mental health issues are barriers to employment Expenses The majority of funding is used to provide client services. Salary and benefit expenses make up less than half of the county s mental health budget, with some additional funding dedicated to contracting with providers to care for mentally ill patients. A portion of the budget is used to provide crisis care as well as hospitalize people with severe psychiatric problems or to provide longer term residential care. The total cost of inpatient care for people with acute emergency psychiatric problems and long term residential care has remained fairly steady at around $4 million per year and includes: o o o Acute psychiatric care at hospitals that provide short term care with the goal of stabilizing the acute psychiatric condition and linking the patient to community services and supports when they re released. This responsibility is sometimes complicated by persons who have both medical and psychiatric challenges that require a facility that can meet both needs. Long term residential care in Institutes of Mental Disease (IMD) which provide residential care for people with severe and debilitating mental illness in a secure environment. Most of these clients are under LPS conservatorship because they struggle to make decisions for their own care. Approximately conserved Shasta County residents are served in IMDs at any given point in time, which has been a fairly consistent number over the last decade. The cost for this care is entirely funded through Realignment. Federal regulations prevent Medi Cal reimbursement for this type of locked facility. The annual cost of this care has averaged about $1.6 million since State hospitals care for the most serious mentally ill with criminal backgrounds and/or those with significant medical needs in addition to their serious mental illness. Expenditures on housing county residents at state hospitals have varied from $75,000 to $469,365 in the past 8 years, (an average of $ 253,867). Four Shasta County residents received this care in 2010/2011. Page 14

15 Shasta County Contracted Service Providers Provider Services Provided City Alcohol and Drug Providers Cascade Circle, Inc ADP DUI Provider Oversight Redding Empire Recovery Center ADP Residential and Outpatient Shasta Lake City Treatment Redding Right Road Recovery Programs, Inc. Outpatient Treatment Anderson Visions of the Cross ADP Residential Treatment Redding Wright Education Services, A Licensed ADP DUI Provider Oversight Redding Clinical Social Worker Children s Providers Cascade Counseling Center, Inc Triple P Redding Charis Youth Center Residential Facility Grass Valley Edgewood Center for Children and Residential Facility San Francisco Families Enterprise Elementary School District Triple P Redding Families First, Inc. Residential Facility Campbell Family Dynamic Resource Center Triple P Redding Fred Finch Children's Home Residential Facility Oakland Hill Country Community Clinic (FQHC) Triple P Round Mountain Milhous Children's Services Residential Facility Nevada City and Oakland Northern Valley Catholic Social Service Non Residential Mental Health Redding Services Organizational Provider Remi Vista, Inc. Non Residential Mental Health Redding Services Organizational Provider Right Road Recovery Programs, Inc. Triple P Anderson Summitview Child & Family Services, Inc. Residential Facility Diamond Springs Youth for Change Residential Facility Triple P Paradise Redding Youth Violence Prevention Council of Triple P Redding Shasta County Value Options, Inc. Other Admin Services Colorado Springs, CO Organization for foster youth Wright Education Services Triple P Redding Victor Community Support Services Non Residential Mental Health Redding Services Organizational Provider Victor Treatment Centers, Inc., for Victor Youth Services Residential Facility Redding Adult/Older Adult Providers Hill Country Community Clinic (FQHC) Circle of Friends Wellness and Recovery Center, Mental Health Round Mountain Burney Services LeBrun Residential Care Facility Residential Facility Older Adults Redding Page 15

16 Mountain Valleys Health Centers (FQHC) Integrated Mental Health Services Burney Northern Valley Catholic Social Service Wellness & Recovery Center Redding Compass Care Older Adult Gatekeeper Program Redding Sail House Residential Facility Older Adults Willow Glen Care Center Residential Facility Older Adults Yuba City Hospitals El Dorado County Placerville John Muir Behavioral Health Concord North Valley Behavioral Health Yuba City St. Helena Hospital & St. Helena Hospital St. Helena/Vallejo Center for Behavioral Sutter Health Sacramento Sierra Region, Sacramento dba Sutter Center BHC Heritage Oaks Sacramento BHC Sierra Vista Sacramento Sutter Yuba Mental Health Services Yuba City Federally Qualified Health Centers (FQHC) Shasta Community Health Center (FQHC) Integrated Mental Health Services Redding Hill Country Community Clinic (FQHC) Triple P, Circle of Friends Wellness Round Mountain and Recovery Center, Integrated Mental Health Services Mountain Valleys Health Centers (FQHC) Integrated Mental Health Services Burney Fall River Mills Shingletown Medical Clinic (FQHC) Integrated Mental Health Services Shingletown Institutes of Mental Disease (IMD) Crestwood Behavioral Health, Inc. Sacramento Helios Healthcare, LLC Stockton Vista Pacifica Enterprises, Inc. Riverside Other Nwangburuka, Okechukwu Nkem Psychiatrist (HPSA) Doctors Managed Care Network Provider Sacramento Page 16

17 Hope and Challenge: Mental Health Services Act The Mental Health Services Act (MHSA) represents new funding to develop a more comprehensive system of community based mental health services and supports. It addresses a broad continuum of prevention, early intervention, and service needs including the necessary infrastructure, technology, and training elements to effectively support this system. There are five fundamental concepts that govern MHSA: Cultural Competency Wellness, Recovery, and Resiliency Community Collaboration Client and Family Driven Mental Health System Integrated Service Experience The MHSA is divided into five overarching categories that promote orderly implementation. The California Department of Mental Health planned for sequential phases of development for each of the following: Community Services and Supports (CSS) Prevention and Early Intervention (PEI) Workforce Education and Training (WET) Capital Facilities and Technological Needs (CF/TN) Innovation (INN) Community Services and Supports Plan approval: March 2006 Programs 1. Client and Family Operated Services 2. STAR (Shasta Triumph and Recovery) Intensive Case Management and Services 3. Rural Health Initiative 4. Older Adult Services 5. Crisis Services Activities include Full Service Partnerships (FSP), Federally Qualified Healthcare Center rural and integrated care (FQHC Hill Country, Shasta Community, Mountains Valley, Shingletown), crisis services (23 hour Crisis Stabilization Services and up to 30 day Crisis Residential Recovery Center), wellness centers, and permanent housing. Prevention and Early Intervention Plan Approval: November 2009 Programs 1. Children and Youth in Stressed Families 2. Older Adults 3. Individuals Experiencing the Onset of Serious Psychiatric Illness 4. Stigma and Discrimination Page 17

18 5. Suicide Prevention Activities include Trauma Focused Cognitive Behavioral Therapy, Triple P Positive Parenting Program, Older Adult Gatekeeper Program, Adverse Childhood Experiences prevention collaboration, evidencebased practices regarding first break and early onset, Stigma/Discrimination and Suicide Prevention media campaign, and the Suicide Prevention Workgroup. Workforce Education and Training Plan Approval: November 2009 Programs: 1. Comprehensive Training Plan 2. Consumer and Family Member Volunteer Program 3. Psychosocial Rehabilitation Program 4. Marriage and Family Therapist/Master of Social Work Internships Activities include internship programs for both employees and non employees, training for individuals working within the public mental health field, and a career ladder MHSA Volunteer Program. Capital Facilities and Technology Plan Approval: December 2010/January 2011 Programs: 1. Capital Facilities Project 2. Technological Needs Project The Capital Facilities Project includes a lobby re design and various upgrades to the main county owned mental health facility. The Technological Needs Project includes the purchase of software and hardware necessary to support our Electronic Health Records system. Innovation Plan Approval: March 2011 Programs: 1. Community Intervention Pre Crisis Team (CIPT) 2. Mentally Ill Offender Program (MIOP) CIPT activities include a 24/7 community based team including peer members to provide services and support to consumers and their families who are experiencing circumstances which, without intervention, could escalate into a crisis. The MIOP provides peer based services to individuals with mental illness and possible substance use disorders that have been released from a correctional facility. Page 18

19 The future As our board completes the Annual Report for 2011, it has become clear that we must gain a greater understanding of the many mental health and alcohol /drug use programs and opportunities offered through the HHSA. We have begun that process in 2012 as we have embarked on a journey of learning and exploring existing programs within the system. One such program is AB109, the public safety realignment program. AB109 will supply us with valuable information such as: a. What is the number of inmates being released to Shasta County? b. What percentage is homeless? c. What percentage is mentally ill? AB109 is just one of the many topics the board will take on to gain a greater understanding of all that Mental Health provides. The topics we have settled on for 2012 include: Psychiatric Health Facility (PHF), AB 109, Managed Care Plan, Youth Mental Health System of Care, Adult Mental Health System of Care, External Quality Review Organization (EQRO), Public Guardianship/Conservatorship/LPS, Evidence based Practices and the MHSA Annual update. MHADAB Priorities In order to insure the MHADAB meets the requirements of the California Welfare and Institutions Code, the following priorities have been set: 1. Provide a forum for clients, family members and other community members about the needs and quality of service for mentally ill people and those diagnosed with substance use disorders. 2. Promote outreach and education about mental health and substance abuse issues and services. 3. Monitor the progress of the implementation of the MHSA, convene public hearings regarding MHSA plans and receive updates and progress reports regarding ongoing MHSA funded programs. 4. Collaborate with the National Alliance on Mental Illness (NAMI) Shasta County and other community organizations in support of services for those diagnosed with mental illness and substance dependence. 5. Work with the HHSA Director, Alcohol and Drug Administrator, and the Adult and Children s Services Directors to learn about the range of services provided. Page 19