MHSA Annual Update Report to MHB Adult System of Care Committee - - PowerPoint PPT Presentation
MHSA Annual Update Report to MHB Adult System of Care Committee July 18, 2013 Revised: June 21, 2013 1 MHB MHSA Agenda 1. Overview of MHSA Key Performance Measures by Component CSS / PEI / INN / WET / CFTN 2. MHSA Adult Programs a)
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Revised: June 21, 2013
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MHSA Key Performance Measures by Plan Component
Community Services & Supports (CSS) Prevention & Early Intervention (PEI) Innovation (INN) Workforce Education & Training (WET) Capital Facilities & Technology Needs (CFTN)
suffering from mental illness
and capabilities in school, work, activity
increase safe and permanent housing
abuse treatment
supportive relationships
placements
incarceration/juvenile justice involvement
service access
consumer/family involvement
Discrimination
Access to Mental Health Services
Impact of Trauma
Intervention of At-Risk Children, Youth and Young Adult Populations experiencing onset
Suicide Risk
groups
including better outcomes
collaboration
integrated and reflective of the cultural and ethnic diversity of consumers and family members at all levels of the workforce, including employees, interns, and volunteers
support mechanisms throughout the system
develop opportunities and career pathways for County and Community Based Organization (CBO) staff
health system
electronic medical record for consumers that can be shared in a secure & shared across service providers (EHR Project)
for all of the MHD information (EDW Project)
basic PC skills training for consumers in established Wellness Centers across the County (CLC Project)
Health Department website (WEB Project)
availability database (BHX Project)
system of client records accessible across agencies to provide a cross agency view of registered consumer’s demographic , service & other information (CHR Project)
populations in the downtown & east San Jose service areas; areas with the highest concentration of at-risk youth (Medi-Plex Project)
Self-Help Center to have a computer training room & several activity rooms which will allow multiple group activities (DTMH Project)
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FY2012 was 222 (1.8% decrease compared to FY2011)
Services (EPS) decreased by 12% compared to FY2011
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Adult FSP FY07 FY08 FY09 FY10 FY11 FY12 Total Adult (26-59) 62 111 159 194 226 222 974
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Of the 974 adult consumers who have received FSP services: 43.3% (N=421) were from the Underserved Population (Latino, African American, Native American and Asian/Pacific Islander)
Latino 18% African American 7% Native American 3% Asian/Pacific Islander 15% Other Ethnicity 3% White 46% Unknown Ethnicity 8%
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The Adult FSP/IMD Diversion program has served a total of 246 Adults from FY2011 to FY2012 (Source Data: Unicare):
FSP/IMD Diversion FY11 FY12 Total Served 99 147 246
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Of the 246 adult consumers who have received FSP/IMD services: 46.7% (N=115) were from the Underserved Population (Latino, African American, Native American and Asian/Pacific Islander)
Latino 21% African American 10% Native American 1% Asian/ Pacific Islander 15% Other 3% White 43% Unknown 7%
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Budget Item Residential Recovery Service:
FY14.
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Adult System of Care Redesign, a process to transform and streamline the system, has been completed to improve the effectiveness of services and collaboration with other departments. Services provided through this plan include:
Clinics & FQHC Staffing
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Community Placement Team and 24-Hour Alternatives:
utilization of high end services by ensuring the consumers who are leaving acute settings receive adequate aftercare.
entrusted with coordinating care and services for consumers being discharged from EPS and/or BAP.
the streets, the Community Placement Team has access to residential and temporary housing programs that are also funded by the MHSA.
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MHSA Downtown Mental Health Clinic:
through Friday
from serious mental illness who exhibit severe problems in normal daily functioning; and
partnership effort to achieve higher levels of functioning, to develop community and/or family support systems wherever possible
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MHSA Crisis Residential (Contract with Momentum):
from acute psychiatric units and locked psychiatric treatment facilities; and
acute psychiatric hospitalization and emergency psychiatric services
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Injection/Medication/Case Management Support to Outpatient Clinics & FQHC Staffing:
two (2) FTE’s are located at Fairoaks FQHC; Rehabilitation Counselors are under Outpatient Specialty Services
MHSA Adult Redesign:
Redesign contracts:
symptoms and psychiatric history necessitate service intervention to maintain the individual in community settings
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IMD Alternative (Drake House):
appropriate residential type of facility based on their ability to function independently. This allows consumers to transition to an environment that is less restrictive.
emergency treatment and acute inpatient hospital settings, preventing homelessness of SMI consumers, providing individuals with stability and a home-like setting and reducing the cost of patient care.
Services for Developmentally Disabled Consumers:
provides developmentally disabled consumers with integrated treatment and support services
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The redesign has resulted in new measurement system currently implemented to assess stages of recovery, level of functioning/impairment and level of risk;
stage of recovery, enabling the system of care to provide highly efficient, person-centered and culturally competent services Training is also a critical part of the A02 plan:
(DADS) is providing MHD staff training in Substance Use Disorders & interventions, enhancing MHD staff’s competency to address both mental health and substance use issues experienced by consumers.
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Additional collaboration underway is:
Smoking Cessation courses to consumers that want to quit smoking;
improve the “mental health competency” of law enforcement personnel who respond to community crises that involve mental health consumers;
most CBOs are also employing peers and family members.
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Center (CC)#4488 to (CC)#4320;
sustained & integrated into A02 Work plan due to positive results of two (2) year project;
part of MHSA Downtown MH Clinic staff and two (2) positions are part of Community Placement staff;
$98,334;
funding allocated for this project.
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served in FY2012 was 271 (13.4% increase compared to FY2011)
Emergency Psychiatric Services (EPS) decreased by 118% compared to FY2011
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The Criminal Justice FSP program has served 1,209 adults from FY2007 to FY2012 (Source Data: Unicare):
CJS FSP FY07 FY08 FY09 FY10 FY11 FY12 Total CJS Served 45 179 235 242 237 271 1,209
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Of the 1,209 adult consumers who have received CJ-FSP services:
58.8% (N=711) were from the Underserved Population (Latino, African American, Native American and Asian/Pacific Islander)
Latino 28% African American 16% Native American 5% Asian/ Pacific Islander 10% Mixed 1% Other 4% White 32% Unknown 4%
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The Criminal Justice Aftercare program has served 773 adults from FY2007 to FY2012 (Source Data: Unicare): Of the 1,209 adult consumers who have received CJ-FSP services:
Native American and Asian/Pacific Islander)
CJS Aftercare FY08 FY09 FY10 FY11 FY12 Total CJS Served 127 173 158 161 154 773
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Of the 1,209 adult consumers who have received CJ-FSP services: 46.7% (N=361) were from the Underserved Population (Latino, African American, Native American and Asian/Pacific Islander) Latino 31% African American 9% Native American 3% Asian/Pacific Islander 3% Mixed 1% Other 4% White 44% Unknown 5%
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No proposed changes for FY2014.
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Urgent Care Results: Fiscal Year 2009 to 2012 Data Source: Unicare (Ucode: U-777)
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Age Group FY09 FY10 FY11 FY12 All Fiscal Year Total All Fiscal Year Total % Child & Youth (0-15) 18 36 46 40 140 2.00% Transition Age Youth (16-25) 187 384 301 365 1237 17.30% Adult (26-59) 740 1477 1346 1805 5368 75.30% Older Adult (60+) 43 101 100 144 388 5.40% Total 988 1998 1793 2354 7133 100.00%
Urgent Care Results: Fiscal Year 2009 to 2012 Data Source: Unicare (Ucode: U-777)
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Ethnicity FY09 FY10 FY11 FY12 All Fiscal Year Total All Fiscal Year Total % Asian/Pacific Islander 94 221 220 203 738 10.30% Black/African American 62 160 127 154 503 7.10% Hispanic 294 565 542 695 2096 29.40% Mixed Race 1 8 6 6 21 0.30% Native American 14 21 20 41 96 1.30% Other 30 69 57 79 235 3.30% Unknown 77 126 153 313 669 9.40% White 416 828 668 863 2775 38.90%
Total 988 1998 1793 2354 7133 100.00%
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MHSAC FY07 FY08 FY09 FY10 FY11 FY12 All Fiscal Year Total Child & Youth (0-15) 1 1 Transition Age Youth (16-25) 59 93 88 65 2 307 Adult (26-59) 3 739 821 742 737 42 3084 Older Adult (60+) 96 92 107 97 5 397 Total 3 894 1006 937 900 49 3789
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Ethnicity FY07 FY08 FY09 FY10 FY11 FY12 All Fiscal Year Total All Fiscal Year Total %
Asian/Pacific Island 1 175 177 200 183 12 748 19.70% Black/African American 56 61 60 44 1 222 5.90% Hispanic 222 238 253 204 9 926 24.40% Mixed Race 3 5 1 1 10 0.30% Native American 8 11 7 7 1 34 0.90% Other Race 34 42 35 31 5 147 3.90% Unknown 23 79 85 90 5 282 7.40% White 2 373 393 296 340 16 1420 37.50% Total 3 894 1006 937 900 49 3789 100.00%
from 900 consumers to 49 consumers as MHSAC staff consolidated in to the CWBC program.
contract provider with CWBC receiving at minimum 50% of all referrals I any given month & at least 50% of all Level I referrals a month
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program serves individuals who will be eligible for Medi-Cal in 2014 and is part of the new Health Care Reform legislation.), Medi-Cal, SSI, Medicare, Medicare Part-D, Minor Consent Medi-Cal, LIS (Low Income Subsidy).
care (MHUC) to Call Center. All referrals from MHUC are now considered a transfer.
transfers are see within 14 days .
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Numbers Served at CWBC
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Age Group FY07 FY08 FY09 FY10 FY11 FY12 All Fiscal Year Total All Fiscal Year Total % Transition Age Youth 34 173 196 237 640 12.80% Adult (26-59) 214 1026 1248 1643 4131 82.40% Older Adult (60+) 14 56 73 97 240 4.80% Total 262 1255 1517 1977 5011 100.00%
Numbers Served at CWBC
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Ethnicity FY07 FY08 FY09 FY10 FY11 FY12 All Fiscal Year Total All Fiscal Year Total % Asian/Pacific Island 40 244 257 275 816 16.30% Black/African American 14 65 85 102 266 5.30% Hispanic 79 405 471 634 1589 31.70% Missing 1 1 0.00% Mixed Race 2 2 2 6 0.10% Native American 2 9 12 21 44 0.90% Other Race 16 52 66 84 218 4.40% Unknown 9 40 78 156 283 5.60% White 102 438 545 703 1788 35.70% Total 262 1255 1517 1977 5011 100.00%
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have obtained PSH
management and are in the process of locating housing
“Encampment Strategy
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The Cal WORKS Health Alliance provides:
Welfare-to-Work (WTW) program to help them deal with mental health & substance abuse issues;
Services, Employment Services Division but is managed by MHD;
small number of transitional housing beds;
behavioral health issues;
education programs to provide onsite individual counseling, support groups, &educational forums for Cal Works consumers
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No proposed changes for FY2014
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(aged 16+) identified & treated Jul-Dec
was the first time they had access to Behavioral Health (BH) services through their primary care clinics.
primary care.
IMPACT in FY 14
clinical skills training for IMPACT
primary diagnosis for pts in PC, present in many, but not primary
to MH Services
Safety-Net providers to the underserved
Suicide Risk
screening, suicidality is addressed with every screen
*Contractor Data is only approximate given that there were steep learning curves with the implementation of new Electronic Medical Records
and launch of BH services one month apart from each other and data entry errors and omissions.
present in many
Adult Populations experiencing onset of serious Psychiatric Illness
Behavioral Health contractors were aged 16-25, none experiencing first break
experience suicidal thoughts at time of screening
*Contractor Data is only approximate given that there were steep learning curves with the implementation of new Electronic Medical Records and
launch of BH services one month apart from each other and data entry errors and omissions. ** VMC Data is an estimate until such a time as EMR is launched (Oct 2013) to track this systematically.
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Effective June 2013- all of the PEI P4 contracts (New Refugees, PEI Short-Doyle, and Primary Care Behavioral Health) will be consolidated under one contract monitor from the current four contract monitors. Effective FY 13-14- all contractor PEI P4 data will be analyzed and consolidated by Decision Support: a) quicker analysis across all three vendors, b) easier segregation of patient data across multiple metrics, and c) by individual contractor. (Currently each contractor provides only aggregate data to SCCMHD) An additional $1.0 million in one-time MHSA Funds will be continued in VMC in FY 14. IMPACT Training and technical assistance will continue into FY13- expanding from 8 clinics to 10 clinics (4 community clinics; 6 VMC)
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The Suicide Prevention Program addresses the following Key Performance Measures:
UPDATE
Supervisors
Resource Center (SPRC) Safe Reporting Guidelines
Persuade-Refer (QPR) was finalized
Network’s Regional Workshop. The theme was Strengthen Your Role in Suicide Prevention
suicide deaths in Santa Clara County from 2009-2011. 2012
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and speakers bureaus throughout California to achieve three goals: 1) incorporate SDR messages into speaker presentations; 2) increase the number of presentations/events on a quarterly basis; 3) provide stipend funds to individuals speaking about mental illness and SDR
Stigma and Discrimination Reduction messages. Nine speakers are currently active (N=11 attended training).
Executive Summary report with expected dissemination date on Suicide Prevention Week, September 9-13, 2013.
implementing a Suicide Prevention public awareness and promotion campaign, among other functions, is formed.
2012 2013
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brochure with contact information for prevention, intervention and post- intervention resources in Santa Clara County. Dissemination is on-going. Plan to translate into to other languages.
gatekeeper workshops in the community. This was part of the SP’s community capacity building focus to expand and provide suicide prevention tools to agencies/communities throughout Santa Clara County. N=54 new instructors were certified by the QPR Institute.
to help with various implementation strategies (10 week program)
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Next Steps
implement key suicide prevention strategies in high-risk and at-risk communities based on a community capacity building/public health approach.
staff and teachers for up to 36 participants
staff and teachers for up to 36 participants
Training to clinicians, social workers and other mental health advocates throughout the county for up to 90 individuals
first public awareness and promotion campaign by increasing crisis line awareness and knowledge through digital mall advertisements, buses and increasing SACS ethnic print media and radio promotion.
2013
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Summary
through face-to-face trainings.
started, started and completed)
that suicide is preventable through Community Education Campaign (CEC).
Prevention Policies to date.
death reports provided by the SCC Coroner’s Office of all recorded suicide deaths for FY 2009-2011.
weave suicide prevention into their existing activities, was launched, adding to the pre-existing Suicide Prevention Oversight Committee and Data Workgroup, which were convened last fiscal year.
2012- 2013
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members met in May 2013. Suicide Prevention plans were discussed at the May 2013 meeting and resulted in the following proposed one-time additions to the following budget line items:
Education and Information program budget line item in FY14 to:
buses, digital mall advertisement, and expansion of ethnic media outreach;
brand (SCC Suicide Prevention) and marketing tools in multiple languages (Spanish, Vietnamese, Tagalog, Chinese and English);
profit agency to administer and manager the over 50 trained QPR instructor pool.
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program budget in FY14 to:
attitudes regarding suicide prevention and crisis
program budget line item in FY14. Additional funds needed for strategies four and five of PEI P5. Strategy Four is to implement policy and governance advocacy to promote systems change in suicide awareness while strategy five addresses data collection.
in one-time funds based on the changes noted above.
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SACS addresses the following Key Performance Measure:
UPDATE
CalMHSA to enhance Suicide and Crisis Services of Santa Clara County (SACS) hotline and enhance regional suicide prevention capacity through 3 core functions: targeted outreach of the Hotline services to core demographic groups of county residents, ensure that SACS meets American Association of Suicidology accreditation standards (FY 13 activity), and
Intervention Alliance (BASCIA). MHD has been collaborating, supporting, and attending quarterly training/conferences held by BASCIA.
2011 2012
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Conference, which was held April 24 – 27, 2013, in Austin, Texas. SACS hotline clinical supervisor and a Suicide Prevention associate attended the conference.
a collaborative effort to aggressively recruit bilingual SACS volunteers to better serve the entire community.
enables us to gather caller’s demographic information, document/record types and number of calls we received, and generate statistical reports.
amount of $39,500. The augmentation was to implement a bilingual
increase follow up calls to individuals who are at high risk for suicide.
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Next Steps
promote SACS hotline and its services on 6 ethnic community newspapers including the El Observador and La-Oferta bilingual Spanish newspapers, Vietnam Daily News and Cali Today of the Vietnamese newspapers, Sing Tao Daily Chinese newspaper, and the Asian Journal that focus on the Filipino community. SACS hotline promotion is for the period of July 2013 to June 2014. A total of $38,000 was allocated from CalMHSA grant to advertise on these six ethnic community newspapers.
to procure a web-based software solutions that has the capacity to manage SACS hotline’s caller data, comply with AAS Accreditation’s technology requirements, provides us abilities to generate data and reports to predict trends and support best practices, and ability to enhance features such as Live-Chat and Text.
bilingual Spanish position. The hired individual will provide community outreach services to the Latino community. The goal is to increase the number of calls from Latino residents to the crisis line. This position is a 14 month funded position – May 2013 – June 30, 2014.
2013
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Summary
2012.
training and referral services. We also establish partnership with these agencies through Memorandum of Understandings (MOUs).
raise awareness in ethnic communities including the Latino, Asian, and African American community. Since July 1, 2012, SACS provided a total of 11 presentations to these ethnic communities.
unincorporated areas throughout the County as well as the Southern part of the County such as Morgan Hill and Gilroy areas.
Asian Pacific Islander, African American, LGBTQ , seniors, as well as Transitional Age Youth population. Since July 1, 2012, we provided a total of 9 presentations to these specific communities.
2011- 2013
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Summary
Support Group.
Assessment/Crisis Intervention presentations to high school teachers and staff as well as self care presentations for students. These services were provided to 7 high schools in San Jose area.
handles the 24-hour crisis hotline. Out of the total, 16 of the volunteers have master’s degree in either social work or counseling
County residents that we are able to retain these highly qualified volunteers who can provide great quality services to our callers.
2011- 2013
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Study period for this project began July 01, 2011 & will terminate June 30, 2013:
instrument was adjusted to meet DSM-IV-TR criteria & staff were trained on use of this new tool;
clients, as well as the 10 existing clients;
indicates that significantly more individuals with autism had one (1) or more lifetime episodic disorder;
using the SAPPA show higher rates of episodic psychiatric disorders than control group assessed with the standard approach
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suffered episodic psychiatric disorders, compared to one (1) in five (5) of the consumers in the random control group from FY2012 and diagnoses were determined at a faster rate;
consumers have occurred to date;
insurance who also had Medi-Cal/Medicare benefits & who otherwise would not have been eligible for this specialized treatment
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closing the gap in our lack of understanding and awareness regarding individuals with Classic Autism and co-occurring mental disorders;
challenge (average satisfaction 7.1 against the 7.3 – 8.0 in other areas).;
interaction with the therapist with average scoring between 8.9 and 8.5; approximately 56% of the clients gave the therapist the highest scoring of 40/40;
17 consumers involved in the project show a general improvement in the well-being of the consumers;
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The INN-03 Project scheduled to terminate on June 30, 2013 will be sustained and integrated into the A02 Adult Behavioral Outpatient Services Redesign work plan due to the positive results of this two year project.
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The MHD has worked over the past several months with local faith
defined and approved by initial group of approximately 20 faith
include:
The partners have agreed on a structure and co-chairs. Work groups are being launched to outline specific deliverables for FY13.
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Activities to-date:
based resource centers located in different geographic areas
Good Samaritan and Mission Possible;
faith collaborative partners, including the three (3) faith based resource centers, over 30 individuals are registered and trained.
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Total number of individuals served at the FBRC (as of April 2013): 89
Race/Ethnicity:
Housing Status
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Past Release Status
Current and Past Church Affiliation:
10 Most Immediate Needs as reported by program participants:
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fourth faith based resource center will be identified in early FY14, to provide targeted services in the core downtown area of the City of San Jose.
culturally competent services and supports to Hispanic individuals and their families identified in the downtown area.
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From September 01, 2011 through May 31, 2013 there were 3,844 mental health calls to San Jose Police Department:
received
received by the Post-Crisis Intervention Team (PCIT),
were linked to ongoing mental health services and 171 opted
longer needed; PCIT staff were unable to contact 53 consumers.
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According to the contract between San Jose State University (SJSU) and Santa Clara County Mental Health Department (SCCMHD) the final report is due in November 2013. This project is scheduled to terminate as of June 30, 2013 and will not continue in FY2014. This project encountered several challenges:
individuals on a 5150 Hold & having them transported to Emergency Psychiatric Services (EPS) for an evaluation.
changes occurring within the San Jose Police Department that included staff reduction of officers & change in leadership which made it difficult to achieve “buy in” to the project.
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repeat callers, however that type of information is not tracked by SJPD & could not be measured;
either already connected to MH or had had prior involvement with MH;
total number of referrals received during two (2) year project does not merit continuation of project as it is presently design.
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This project will conclude its operation as of June 30, 2013.
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January 2014. Initial evaluations indicate that over 90% of attending
emergencies.
now in post-production)
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Work is under way to design and test an outcomes “dashboard” to track pilot progress in addressing consumer needs in multiple functional domains:
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The Re-Entry index is designed to evaluate risk in eight domains:
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MAP Results Based on 17 Months Data (October 2011 – March 2013):
released
were completed.
services through Evans Lane Outpatient Program, Community Solutions, Gardner and Catholic Charities FSP
Program, of which 14 clients are currently residing at Evans Lane.
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The MAP Team has worked with the following evaluation staff to identify set of achievements for this population to tracked as part of a broader Re-Entry Initiative:
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Currently, two (2) tools are used to track pilot progress in addressing client needs in multiple functional domains:
Department to determine supervision plans, and
The MAP Team & Probation Department have developed a new referral form which is ready for implementation. Once the referral form has been implemented, probation officers will utilize this form to make referrals to MAP Team.
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MHD proposes to adjustments in FY14 which includes:
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July 2013 August 2013 September 2013 October 2013
MHB Committee meetings in July to discuss progress updates and preliminary plans for Draft FY2013-14 MHSA Annual Update.
meeting on July 29, 2013 to go over preliminary plans for Draft FY2013-14 MHSA Annual Update.
14 MHSA Annual Update Plan on August 2, 2013 for the required 30-day public comment/review
be posted on the SCCMHD website. http://www.sccgov.or g/sites/mhd/MHSA/ Pages/default.aspx
the end of the required 30-day public review comment period – End of Business Day.
MHSA SLC meeting. SLC to vote on Draft FY2013-14 MHSA Annual Update Plan.
MHB Public Hearing to vote on Draft FY2013-14 MHSA Annual Update Plan.
the County Board of Supervisor (BOS) to adopt Draft FY2013-14 MHSA Annual Update Plan as endorsed / approved by MHB and MHSA SLC tentatively Scheduled October 2013 TBD. 82
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