I. Welcome and Introductions Chair Gorodezky called the meeting to order at 1:02 PM, followed by self introductions.

Transcription

1 County of Santa Barbara Mental Health Commission 300 North San Antonio Road, Bldg. 3, Santa Barbara, CA Meeting Minutes January 20, :00 p.m. to 4:30 p.m. Santa Barbara, CA Commission Members Present: James Rohde, 3 rd District; Jan Winter, 1 st District; Ann Eldridge, 5 th District, Alternate; Charles Huffines, 5 th District, Vice Chair; Michael Gorodezky, 2 nd District, Chair; Tom Franklin, 3 rd District, Alternate; Wayne Mellinger, 1 st District, Alternate; Manny Casas, PhD., 1 st District; Alicia Journey, 2 nd District. Commission Members Absent: Lisa Morinini, 4 th District, Alternate; Sandra Brown, 4 th District; Michelle Brenner, 2 nd District, Alternate; Ken Bonner, 5 th District; Thomas Urbanske, 4 th District (excused). ADMHS Staff: Karen Campos, Office Professional Senior; Alice Gleghorn PhD, ADMHS Director; Sara Bazan, Santa Barbara Children s Clinic Team Supervisor; Tammy Summers, Quality Care Management (QCM) Coordinator. Guests: Pia Barker, with Aegis Treatment Center; Kit McMillion, unknown affiliation. I. Welcome and Introductions Chair Gorodezky called the meeting to order at 1:02 PM, followed by self introductions. II. Establish Quorum: Yes III. Approve Meeting Minutes for December 16, 2015 Motion was made by Commissioner Rohde to approve the December 16, 2015 minutes with one amendment, page 2, correct Commissioner Huffines last name. Commissioner Huffines seconded. Meeting minutes approved with the mentioned amendment. No oppositions. Motion carried. Minutes approved. IV. Announcements by Chairperson Chair Gorodezky reminded the Commission that on February 6 th the training on best practices of Mental Health Commissions and Boards will be held at the Solvang Senior Center from 10:00 am to 2:00 pm. Commissioner Mellinger and Dr. Casas shared that they may not be able to attend. Action item: Karen to send an reminder to the Commission. Chair Gorodezky shared that he attended the last Advisory Board on Alcohol and Drugs meeting and wanted to share that there was a brief discussion on possibly recommending that their meeting be combined with the Mental Health Commission in the future. A committee was formed to look into how other counties are doing it. More details to come as they develop. Also, he shares that yesterday at the Board of Supervisors (BOS) meeting the CEO made a recommendation for the Sheriff s Department to give back SB 82 funds they had been granted as it did not seem feasible to rewrite the grant proposal and relocate the funds as previously requested by the Sheriff. Many people spoke in favor of using the money for a new residential drug treatment diversion program to keep people out of jail. 3 to 2 supervisors voted in in support of CEO s recommendation to return the money, however each made it clear that they were not against the idea of a residential treatment program, however agreed that it was not feasible to relocate the funds. Dr. Casas asked for clarification of the original purpose of the proposal. Chair Gorodezky explains that the Sheriff was planning on using the money to build a new jail with many mental health components. However, when consultants gave the cost analysis to build, the board did not approve. At that point the Sheriff asked for permission to rewrite the grant so that the money would not be lost. Dr. Gleghorn announced that the Capital Facilities Presentation to the BOS has a tentative date of March 8, V. Public Comment none.

2 VI. Presentations Mental Health Services Act Plan 15/16 Update no update this month. Directors Report Director, Dr. Gleghorn provided a handout with her monthly report which highlights the following along with other items not included in the report: JSA Health Tele psychiatry was contracted to cover tele psychiatry for the newly opened Crisis Stabilization Unit (CSU) in Santa Barbara, the only current downfall is that there is a process to schedule a doctor to meet with the client. Overall, Tele psychiatry is working well. Also, the CSU and the Psychiatric Health Facility are sharing staff so that they can collaborate coverage and cross train staff. The ultimate goal is to have acute and crisis services organized under one umbrella, rotation of staff is a goal so that everyone better understands the cycle of the system. Dr. Casas asked how he could get more information on tele psychiatry as he would like to better understand what the client interaction is like with a doctor on a screen. Who can he contact? Dr. Gleghorn explained the process. Dr. Gorodezky shares that this technique is actually fairly big internationally. Dr. Gleghorn is happy to announce that all paperwork has been signed for the purchase of the CSU North. It is a very big, barn like building with giant high ceilings and lots of tile. Currently there is a dirt lot where there is plans to create a driveway and have it fully fenced for safe drop-off and pick up. Targeted open date is the end of June. Building located off of Broadway St. Dr. Gleghorn reports that the new Deputy Director of Behavioral Health has been hired, Doctor Pam Fisher will begin February 16, Dr. Fisher will be the clinical advisor and liaison for Contracts, she will also have special projects and will be leading integration as well. Also, briefly went over how the organizational chart has been reorganized. Dr. Gleghorn agreed to share a copy of the organizational chart with the Commission at a future meeting. Commissioner Eldridge asked if exit interviews are being conducted when people leave the Department, specifically psychiatrists. She asks because two Transitional Behavioral Health (TBH) doctors left the department after a short time. Dr. Gleghorn shares that the two doctors that she is referring to left as they got into private practice, others have retired and want to establish a retirement base and come work for ADMHS part time for a short period. The goal has been to target fresh out of school folks who have a lot of debt, an incentive is now being offered for civil service psychiatrist, and hopefully this will attract more doctors who stay long term. Also looking to hire Physician Assistants and Nurse Practitioners. The U.S Department of Health and Human Services (HHS) issued a summary of 2015 accomplishments in behavioral health where six 2015 focus areas are highlighted. Details available in the handout. The California Consortium of Addiction Programs and Professionals (CCAPP) are issuing a new credential for peer support specialists. Professional certification will be available for mental health and substance use disorders (SUD). ADMHS develops community trauma response team. Thirteen staff members were on call to assist individuals impacted by the mass shooting in San Bernardino on December 2nd. Efforts are now underway to broaden and formalize the department s community trauma response team. Dr. Gleghorn shares that with parts of the nation experiencing an opioid epidemic, the U.S Congress has ended a three year decade ban on federal funding for needle exchanges. This will allow drug users to get free sterile needles to prevent the spread of disease. County Alcohol and Drug Program (ADP) has responded to the prescription drug and heroin epidemic and rise in overdose deaths locally and beyond. Staff members attended a six- hour overdose Prevention and Reversal training. County ADP is also working with the Sheriff s department to purchase additional naloxone kits to be distributed to targeted individuals and agencies to address and reverse overdose.

3 Dr. Casas shares concern that Santa Barbara Police Department (SBPD) staff rarely attends the Crisis Intervention Team (CIT) yearly training hosted by ADMHS. Dr. Gleghorn comments that the Chief has been a presenter at the training and there has been attendance from his team at the trainings. Also, guest Pia Barker commented that in a recent meeting with SBPD they shared that they will have weekly trainings on how to manage crisis and invite mental health providers and those who can help train their officers in mental health. The initiative started this week and plans to run until end of April. Dr. Casas and the Commission were very pleased to hear the news. Director Report available upon request. Assertive Community Treatment (ACT) Fidelity Findings Tammy Summers, Quality Care Management (QCM) Coordinator presented recent ACT fidelity reviews recently conducted on the three ACT programs in Santa Barbara County. Ms. Summers explains that the Tools for Measurement TMACT model was used to do the reviews. This model has 47 items with a 5 point scale. TM ACT is based on DACTS (Dartmouth Assertive Community Treatment Scale), however it has refinements in measurement and evolution of the model. The TM ACT model emphasizes the importance of recovery oriented services as the focus of care. Hospital-level services are to be provided by ACT teams in the community to prevent a hospitalizations.tm ACT is arranged with the following 6 scales; operations and structure, core team, specialist team, core practices, evidence based practices and person centered planning and practices. Ms. Summers explains that two reviewers, including her visited each ACT site (Santa Maria, Lompoc and Santa Barbara). Scores were determined independently, then averaged for the final rating. Santa Maria ACT rated highest in person centered practices, lowest in operations and structures and core practices. Review rating was Lompoc ACT rated highest in person centered practices, lowest in evidence based practices. Review rating was Santa Barbara ACT rated highest in person centered practices, lowest in operations and structures. Total rating was 3.45 Some of the challenges that were identified in all three ACT programs were not enough staff, alternative work schedules, no clear understanding of fidelity model or its value, lack of tools, not working on an ACT level rotation of staff, scheduling challenges, low staff morale, not having a full time psychiatrist, not structured as an ACT model. Recommendations include review funding/staffing patterns, develop action plan and meeting schedule, ACT fidelity model training, track improvement, fidelity monitoring, implement a certification process, ongoing support and reporting to leadership. Commissioner Winter shared that she has a family member that withdrew from one of the ACT programs, her understanding is that most of ACT services are delivered in the community not in the office. She also shares that family members constantly complain because there is minimal effort from case workers to reach out to clients/gain trust back. Data reviewed indicates that Santa Barbara community services were below the other two ACT programs and they are not offering as many services. Dr. Gleghorn shares that most clinicians did not have laptops to take out on the field therefore documentation was low. Recently they were all assigned a laptop to take out in the field and have facilitated improvement in documentation. Commissioner Eldridge asked about training of staff, Ms. Summers shares that the ACT teams need to be trained in the components of the ACT model, they have great case workers but they simply have not been properly trained. Dr. Gleghorn shares that staff have been sent to recent trainings as it was noted that full service partnership was not clear to staff when she came on board. Commissioner Mellinger applauds Ms. Summers for her work. He suggests that word is spread on how ACT teams should operate. The commission thanked Ms. Summers for her report. Handout available upon request.

4 Santa Barbara Children s Clinic Services Dr. Gleghorn shares that she is thrilled to have Sarah Bazan leading the Santa Barbara Childrens Clinic, she joined the Department 4 months ago. Ms. Bazan introduces herself and shares that she is passionate about mental health services for children. She worked for Child Abuse Listening and Mediation (CALM) for 10 years, however she feels wonderful to be part of the bigger picture with ADMHS. As Supervisor of the clinic she oversees the different teams within the clinic and also the contracts with County Based Organizations (CBO S) as they refer back and forth. Ms. Bazan gave a brief overview of the different programs and services offered by the clinic. The CORE team see s clients mainly in the clinic and as referrals come through they refer based on qualification. They offer individual and family services. For 0 to 5 years of age, they contract with CALM, their Great Beginnings program is designed for high risk families who have young children or who are expecting. The objective is to reach children very early in age and help parents attach with their children by teaching them positive parenting practices. For 6 to 18 years of age, ADMHS also contracts with CALM to provide intensive home services. Also, the SPIRT program is housed in the clinic which is a wraparound service which involves the parent(s), a partner and team facilitator to treat complexity in family system. The SPIRT team is on call 24-7 to deal with crisis calls. Transitional Age Youth (TAY) works with youth who are starting to have psychotic disorders. This team goes out into the field and works with the youth at risk and helps them get through school and stay on track with their life. Through planned field trips they encourage them to socialize with others. Currently there are about 50 clients that belong to this group. Again, prevention and early intervention is key. New Heights Program treats severe and persistence illness. Casa Pacifica, a contracted CBO offers three programs. SAFTY program has a 24/7 crisis line for children who are in danger or are a threat to others. One of SAFTY s programs, Proactive is an eight week program where they work directly with suicidal kids. Therapeutic Behavioral Services (TBS) is a 4 to 6 month intensive program for kids that are in danger of being taken out of home. Staff spends a few hours with them, at least 4 to 5 times a week. This is not supposed to be standalone program because it does not provide therapy. Kids are constantly reassessed to see where they are in the recovery process, age limit for TBS is 18 may be possible to go up to 21. Katie A, there is a designated coordinator that manages referrals and services for children that go through the foster system as they all need to be assessed. In response to early intervention questions commissioners had, Ms. Bazan shares that she attends the Regional Partnership Meeting which is a group of local agencies that get together, including schools, to collaborate for early intervention and have a smooth referral systems that everyone is aware of. Dr. Casas shares that historically, the issue of who was going to pay for services prevented services to be provided to kids. Commissioner Winter asked if there is a child identified that is disturbed and turns out parents have mental health issues do you guys work with the adult case workers? Ms. Bazan responds yes, they collaborate with their case worker to help the family. Commission thanked Sara Bazan for her presentation.

5 VII. Commission Business a. Mental Health Commission Liaison Reports Advisory Board on Alcohol and Drugs - Commissioner Rohde shares that he is part of the committee looking into combining both commissions. b. Correspondence National Alliance on Mental Illness Letter - Action item: vote in support of NAMI s letter with recommendations to the Board of Supervisors regarding key indicators. Dr. Gleghorn clarified that many of the data requested in the NAMI letter is not obtained by ADMHS and does not want to give false hope that ADMHS will be able to provide the requested data. Chair Gorodezky comments that the request is going to the Board not ADMHS. Chair Gorodezky refers the Commission to the letter included in their packets from Advocacy Group, NAMI. He went over the 4 highlighted points. Commissioner Solomon comments on point number 3 shouldn t we track how many people in general, not just ADMHS. Chair Gorodezky agrees and makes recommendation to NAMI s public policy to change number 3 to include all those with mental health issues not just ADMHS clients. He then proceeds to pose the question, does the commission want to endorse the letter in support of the concept of the metrics listed? Motion to endorse the concept of the NAMI letter was made by Commissioner Eldridge. Commissioner Huffines seconded. No oppositions. Motion carried. Dr. Casas recommends that the Board is not only asked to provide the data but also asked to identify the means to collect the data requested and to subsequently take action to collect it. c. Action item: Discussion and vote to consider cancellation of the February Mental Health Commission Meeting due to the Boards and Commissions Training on February 6, After brief discussion the commission agreed to meet in the month of February, however they would like to push back the executive meeting so that it takes place after the training. Commissioner Mellinger suggested having a shorter meeting in February. No vote was taken. d. Other Business none. e. Adjournment Commissioner Solomon made a motion to adjourn the meeting. Commissioner Rohde seconded. No oppositions. Motion carried. Meeting adjourned 4:20 p.m.