+ Melissa Hall Leah Straley Melissa Hall. + Don Miller Steve Tess Don Miller. + Mary Benson Recovery Innovations

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1 County of San Diego Behavioral Health Services Administration Adult Behavioral Health Systems of Care BHS Adult Council La Jolla Room 3255 Camino Del Rio South San Diego, CA Tuesday, 10:00 11:00 am Minutes + = Members in Attendance / = Absent / E = Excused * Council Co-Chairs Constituency Council Member Alternate MHSA Advocacy-CCHEA Mary Jo O Brien Lindsey Advocacy-Jewish Family Services Advocacy-Mental Health America Winthrop Healthy Living Member Mary Jo O Brien + Melissa Hall Leah Straley Melissa Hall Advocacy-NAMI San Diego Shannon Jaccard Brandi Marcre Shannon Jaccard Advocacy-NAMI-North Coastal E Liz Kruidenier Eric Revere Liz Kruidenier Alcohol and Drug Services Angela Rowe Case Management + Debbie Malcarne Rebecca Fisher Debbie CCRT Community Community College District Steve Cooper Malcarne Shannon Jaccard Co-occurring Disorder/CADRE + Diego Rogers Rosalind Corbett Diego Rogers Employment Service Solutions + Juan Medina Kay Masaryk + Don Miller Steve Tess Don Miller Fee for Service San Diego Psychological Association Hospital Partners Angela Carrillo Karen Rose Long Term Care + David Armstrong Joyce Mental Health Board Bob Hebbler Mental Health Coalition Tamara Stark Thompson Mental Health Contractor Assn. E Dixie Galapon Gary Hubbard David Armstrong MHS Housing Council Jane Fyer Jane Fyer Primary Health Care + Nicole Howard* Marty Adelman Nicole Howard* Quality Improvement Stephanie Hansen Steve Jones Recovery Innovations + Mary Benson Recovery Innovations + Jeffrey Najarian* San Diego Regional Center for Peggie Webb the Developmentally Disabled Sheriff Elene Bratton Elene Bratton TAY + Cara Evans Ellen Frudakis Cara Evans Murray Murray Underserved Communities Holly Younghans Tashia Petty Veterans Services Stephanie Hansen Ellen Frudakis

2 Page 2 Behavioral Health Services Staff: Karen Crie Adult BHS SOC, Betsy Knight, Adult/Older Adult BHS SOC, Shelly Tregembo, County BHS Adrienne Yancey, MHSA Other Attendees: Aaron Weislogel, BHETA Alicia Devine, DCS Raeann Miller, UCSD Welcome and Introductions The meeting was called to order at 10:00 by Jeff Najarian, Co-Chair. Members were welcomed and introductions were made. Public Input None. Action Item(s): None. Review and Approval of the July 15, 2014 minutes Motion to approve the July 15, 2014 minutes was made by Diego Rogers. Motion was seconded by Juan Medina and minutes were approved with a correction noted. Action Item(s): None Behavioral Health Director s Report Alfredo Aguirre/Piedad Garcia Piedad Garcia reported Alcohol & Drug staff is implementing the emergency regulations for Drug Medi-Cal which became effective on June 26, 2014 and are in place through December 31, 2014 for permanent implementation as of January 1, The Federal government is investigating California s lack of competence in delivering alcohol and drug services at the State level (resulting in fraud). Regional Recovery Centers are moving forward in implementing the new regulations. Proposed implementation of the 1115 Waiver also known as the California Drug Medi-Cal Waiver is being assessed across counties which will enhance the alcohol and drug system of care. Counties can opt in or opt out. San Diego County is analyzing costs related to opting in. Children, pregnant women, methadone treatment are included. The MHSA 3 Year Plan and the Operational Budget will be aligned. Action Item: none MHSA Update Adrienne Yancey Adrienne reported a replacement for Toroshinia Kennedy s vacated Contract Analyst position on the MHSA Coordination Team should be available by early September. The MHSA 3 Year Plan has gone before the Mental Health Board for the Public Hearing. The Joint Mental

3 Page 3 Health Board and Alcohol and Drug Advisory Board will take action on the Board Letter on September 4, On September 16, 2014 the Board of Supervisors (BOS) will hear the 3 Year Plan and if approved at that point, the Plan will be forwarded to the MHSOAC for their approval of the Innovation component. MHSAOAC no longer has oversight for the Counties work plans, except for the Innovations component. The Little Hoover Commission has started a study of MHSA. As part of their study, they will explore whether the existing oversight mechanisms are adequate to ensure money generated through HHSA is spent in the most cost effective manner and services are provided in accordance with recommended best practices. They will also consider whether additional opportunities exist to improve oversight of these funds. The Commission will also examine how the state is monitoring the outcomes of its investment. There will be a hearing on September 23, MHSAOAC has put out draft regulations on PEI and Innovation. The hearing on PEI was at the end of July On August 28, 2014 the staff will put forward the recommended regulations based on the public hearing and the Commission will vote on that. The Draft Proposed Innovative Project Regulations will be available for public comment one more time before the PEI component goes into place. CBHDA Letter to the MHSOAC dated August 15, 2014 was provided to the group. The key item is the opportunity for counties to be able to utilize established behavioral health practices that are proven to work successfully elsewhere and implement them, as part of their innovations. Currently that is not allowed. After the hearing, they will go through the process of taking recommendations and a final draft of Regulations for Innovations will come out in September 2014 before going before the administrative law entity. Action Item: none Tobacco Cessation (BHS Update) Piedad Garcia Piedad Garcia will present to the BHS Executive Team an implementation plan based on recommendations by the Adult Council. Several steps will be addressed in the implementation plan covering system, program and practice levels in addition to getting concurrence from the Contractors Association. o Nicole Howard added that with regards to the outpatient program, if someone is ready to make a quit attempt there should be a way to capitalize on that moment and prescribe then rather than wait for primary care to get back to them. Literature is clear that even if the option of NRT was not available, advice was offered over time from a clinician and it was assessed at every visit whether they are ready to quit, that in itself is an intervention. o Per Diego Rogers, the CADRE Executive Committee received the Tobacco Cessation Workgroup recommendations and has passed and approved the Tobacco Cessation Plan. It will be presented to the CADRE Quarterly meeting on October 1, It was suggested that an be sent ahead of the meeting to advise the group of plans to present the Tobacco Cessation Plan at October s meeting. By October we will have assigned programs, data, etc. and Piedad may be able to give a one pager for the CADRE meeting. Action Item: Next month Piedad Garcia will present an implementation grid. (CORS, QI, Clinical Directors Office, CADRE, etc. should be a group effort).

4 Page 4 MHSA Workgroup Status Elene Bratton Preliminary notes on Adult Council future funding priorities (if future funding were to become available) from the MHSA 3 Year Program and Expenditure Plan for FY to FY were presented by Nicole Howard on behalf of Elene Bratton: Referenced in the plan is a list of future funding priorities (located on pages 9 and 10 of the 349 page 3 Year Plan report). At a previous meeting, the Adult Council voted on for each category what the Council thought was the most important of the priorities to provide additional feedback to the BHS Administration from the Adult Council. Debbie Malcarne suggested that the top three vote getters be reported and not necessarily how many votes were cast. Since Innovations is already funded, Debbie Malcarne recommended that they be omitted from the list. Action Item: Draft of Adult Council Priorities to be finalized and brought back to the Adult Council at a future meeting before being presented to BHS Administration. Consumer Committee/Recovery Innovations Mary Benson Recovery Innovations Peer Liaisons will host, Pleasure Unwoven, a DVD presentation, with the latest neuroscientific information about recovery and addiction on August 26, 2014 from 1:00 pm to 3:00 pm at the Health Services Complex, 3851 Rosecrans Street, San Diego, CA The August 2014 Peers Linking Peers Recovery Innovations newsletter was provided to the group by Mary Benson. Mary Benson brought forward a concern that the need for housing is great. Piedad Garcia reported BHS staff is working on several angles of housing development, such as for Transition Age Youth, Independent Living Home, an ILF in a Ranch setting and development of 6-7 short term transition beds for homeless females. Alfredo Aguirre is pursuing additional funding for development of affordable housing. A presentation on the Strategic Housing Plan will be added to the Adult Council agenda in September or October. This could possibly be part of the September or October agenda. The 5 Year Strategic Housing Plan was presented to the Mental Health Board last month. The 25 Cities Project for reducing homelessness is in the first phase, with multiple providers participating. Action Item: Put Housing topic on the September or October agenda. Announcements CADRE quarterly meeting will be held on Wednesday, October 1, It is recommended that people interested in the Geriatric Series training offered through BHETA confirm their registration in LMS prior to attending the class. It will be a full class and due to a glitch in the system there is no way to know in advance who is registered and who thinks they are registered but whose registration is not confirmed. Adjournment The Adult Council meeting was adjourned at 10:55 am. Next Adult Council Meeting: Tuesday, September 16, :00-11:00 am La Jolla Room BHS Administration 3255 Camino Del Rio South, San Diego, CA 92108

5 Page 5 Healthy Living Workgroup Diego Rogers (Tobacco Cessation) The Healthy Living Workgroup will not meet in September MHSA Workgroup - Elene Bratton MHSA Workgroup will not meet in September