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1 Mental Health Services Act Steering Committee September 14, 2009 Health Care Agency/Behavioral Health Services
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Mental Health Services Act Steering Committee
September 14, 2009
Health Care Agency/Behavioral Health Services
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Welcome
Sharon Browning, Facilitator
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Consumer Perspective
Mary Walker, Family Member
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Local/State Updates
Mark Refowitz, BHS Director
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Anthony Delgado, Program Manager
FSP Data Report
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Full Service Partnership (FSP)Performance Outcomes & Data
Tony Delgado
Keith Erselius
Christina Cordova
Adapted from a presentation from Dave Pilon, Ph.D., CPRP
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People only supportwhat they create:Re-visioning the
Full Service Partnership
Dave Pilon, Ph.D., CPRP
Executive Vice President, MHALA
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Today’s Goals
Reveal my own biases and potential blind spots as Chair of the Data, Accountability and Policy Subcommittee
Begin to establish a framework by which to evaluate FSP performance
Begin to craft a plan to access and use existing FSP (and other) performance data
Begin to establish a process to explore alternative approaches to performance measurement and alternative data elements / measures
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A Brief History of FSPs
Modeled after the successful AB 34/2034 (Primarily Adult) Program
Originally designed to serve “highest need” individuals (51% of MHSA CSS to “unserved, underserved, inappropriately served”)
- Led to dissatisfaction with the two-tiered system
Lack of direction / standards from the State led to much confusion among counties
Recent loosening of State regulations appears to re-define/ expand who can be served by FSPs
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How do we arrive at standards?
Practice vs. Outcomes
The problem with “whatever it takes” (or, How do we measure “culture?”)
Clinician judgment and the need for measurement
What we choose to measure reflects our implicit philosophy
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Recovery is not a Unitary Concept
Many consumers speak of recovery in terms of their own internal experience – often phrased in such terms as “becoming empowered,” “taking charge of their own lives,” “improving their self-esteem,” or “becoming responsible for themselves.”
The mitigation of psychiatric symptoms (or symptom distress) and improvement in functioning.
Identifying and taking on meaningful roles in one’s life.
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Recovery Definition MatrixService Provision/Practices Outcomes
ServiceRecipientPerspective
Recovery Self-Assessment (RSA)“Staff at this agency listen to and follow my choices and preferences.”
Consumer Recovery Outcome System (CROS) “How do I feel about the choices I get about my care?”
Recovery Oriented System Indicators(ROSI) “I do not have enough good service options to choose from.”
Internal Experience of the Client
Consumer Recovery Outcome System (CROS) “I am coping better in my life”
Recovery Measurement Tool (RMT)“I participate in meaningful activities”
Spirituality Index of Well Being (SIWB)“There is not much I can do to make a difference in my life”
ServiceProvider/FamilyMember/SystemPerspective
Fidelity to Specific Practices
Evidence-Based Practices
Clinical Strategies Implementation Scale
Assertive Community Treatment (ACT)
Supported Employment (SE)
Symptom Reduction
Improvement in Functioning
Reductions in Adverse Impact (hospitalization,incarceration, homelessness, mortality)
Improved Quality of Life (Increases in independent living, employment, education rates, more supportive social network)
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GENERIC TREATMENT (EVIDENCE-BASED PRACTICE) LOGIC MODEL
Processes/Interventions
Assertive Community Treatment (ACT)
Medications
Supported Employment
Integrated Dual Diagnosis Treatment
Supported Education
Short-Term (Intermediate) Outcomes
Increased skills and functioning (Behaviors)
“Recovery”, internal experience of empowerment,meaningful roles, self-responsibility, hope (perceptions)
Decreased symptoms and symptom distress (Behaviors and internal experience)
Decreased Substance Abuse (Behaviors)
Input
Mission
Members
Staff
Resources
Long-Term Outcomes
Increased Residential Independence and Stability
Reduced Hospitalization
Reduced Incarceration
Increased Employment
Increased Education
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GENERIC “RECOVERY CULTURE” LOGIC MODEL
Input
Mission
Members
Staff
Stakeholders(Taxpayers)
Resources
Program/System Culture
Welcoming
Charity
Treatment
Rehabilitation
Advocacy
Graduation
Internal (Consumer) Outcomes
Increased skills and functioning
“Recovery” (Empowerment, hope, meaningful roles, self-esteem)
Decreased symptoms
Decreased substance abuse
External (QOL) Outcomes
Increased Residential Independence/Stability
Reduced Hospitalization
Reduced Incarceration
Increased Employment
Increased Education
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What is Culture?
The predominant attitudes and behavior that characterize the functioning of a group or organization.
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Kansas Supported Employment Study
Comparison of “high performing” (31.9%) supported employment programs vs. “low performing” (16.6%) supported employment programs.
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Characteristics of High-Performing Supported Employment Programs
Program leaders emphasize the value of work in people’s lives and the belief that people can work.
Program leaders emphasize strengths-based practices as an explicit part of supported employment work with consumers.
Program leaders use vocational data to guide programming and practice.
Staff do not view stigma against people with psychiatric disabilities as a barrier to consumers’ ability to obtain employment.
Staff perceive that consumers have a desire and motivation to work.
Staff share stories about consumers’ vocational experiences in a way that reflects their belief that consumers have the ability to negotiate and succeed in the work world.
Gowdy, Carlson, and Rapp (2004). Organizational Factors Differentiating High Performing from Low Performing Supported Employment Programs. Psychiatric Rehabilitation Journal, 28,2, 150-156.
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Performance Measurement Issues: A Summary Differences in our assumptions about the ways people
improve / get better / recover
Should we measure “internal” variables (symptoms, ADL skills, increased sobriety) or should we measure “external” variables (increased school performance, increased social support, increased independence, reduced hospitalization)?
Should we measure outcomes or practices (or both)?
Should we measure fidelity to specific practices or the influence of organizational culture (or both)?
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Problems in Existing FSP Performance Measurement Data Where are the data?
Are the data accurate?
Are the data elements useful across all age groups?
Are the data elements appropriate for the “expanded” version of the FSP? Data collection resources at “lower” levels of care may
not be adequate Are the data capable of helping us to improve our
practices (quality improvement)
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Where we go from here?A suggested plan
The data we have How can we best use the FSP (and other) data that we
have been collecting? The Mental Health Planning Council efforts as a
starting point
The data we would like Formation of age-specific groups to arrive at a
consensus about the basic data set that we need given 1) that the existing FSP data are based on an adult
model, and 2) the FSP model has been expanded to a population
that may not be well-served by existing outcome approaches
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Utilizing the FSP Data
Data Analysts at Adult and Older Adult FSPs
The Data Outcomes Committee
The MHSA Newsletter
The MHSA Website
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Adults Enrolled (As of 7/31/09)
Total Adult FSP Enrolled: 551
Total Adult FSP Capacity: 560
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Adult Homelessness (Annualized on 7/31/09)
Pre Enrollment
Post Enrollment
N = 551
• 73.95% Decrease
Number of Days
Homeless*Includes shelters and temporary housing (e.g.) motels
*
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Adult Incarcerations (Annualized on 7/31/09)
Pre Enrollment
Post Enrollment
N = 551
• 84.51% Decrease
• Savings of $1,572,330
Number of Days
Incarcerated*
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Adult Hospitalizations (Annualized on 7/31/09)
Pre Enrollment
Post Enrollment
N = 551
• 52.22% Decrease
• Savings of $2,196,468
Number of Days Hospitalized
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Adult Employment (Annualized on 7/31/09)
Pre Enrollment
Post Enrollment
N = 551
• 12.48% Increase
Number of Days Employed
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Adult Education (Pre and Post Enrollment)
Pre Enrollment*
Post Enrollment
N = 551
• 80.39% Increase
Number of Consumers In School
12 Month History Taken from the PAF
*
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Older Adults Enrolled (As of 7/31/09)
Contracted Slots
Older Adults Currently Enrolled
OASIS
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Older Adult Homelessness (Annualized on 7/31/09)
Pre Enrollment
Post Enrollment
N = 100
• 60.07% Decrease
Number of Days
Homeless*Includes shelters and temporary housing (e.g.) motels
*
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Older Adult Incarcerations (Annualized on 7/31/09)
Pre Enrollment
Post Enrollment
N = 100
• 87.25% Decrease
Number of Days
Incarcerated*
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Older Adult Psychiatric Hospitalizations (Annualized on 7/31/09)
Pre Enrollment
Post Enrollment
N = 100
• 18.33% Decrease
Number of Days Hospitalized
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www.ochealthinfo.com/mhsa
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Karen Roper, Director
O.C. Community Services
Housing
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Orange County’sOrange County’s10 Year Plan to End Homelessness10 Year Plan to End Homelessness
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What is a 10 Year Plan to End What is a 10 Year Plan to End Homelessness?Homelessness?
A Ten Year Plan to End Homelessness is a regional planning A Ten Year Plan to End Homelessness is a regional planning effort that focuses community resources toward clearly effort that focuses community resources toward clearly defined strategies that address the multiple facets of why we defined strategies that address the multiple facets of why we have a homeless problem in our community. have a homeless problem in our community.
This Plan outlines the key goals and strategies necessary to This Plan outlines the key goals and strategies necessary to
successfully eliminate homelessness in Orange County.successfully eliminate homelessness in Orange County.
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Why Create a 10 Year Plan?Why Create a 10 Year Plan?
To remain competitive for Federal SuperNOFA Continuum of To remain competitive for Federal SuperNOFA Continuum of Care funding, the U.S. Department of Housing and Urban Care funding, the U.S. Department of Housing and Urban Development (HUD) strongly encourages counties to develop 10 Development (HUD) strongly encourages counties to develop 10 Year Plans to end chronic homelessness. Year Plans to end chronic homelessness.
Since 1996, Orange County has received $111 million in Since 1996, Orange County has received $111 million in Continuum of Care Homeless Assistance funding. Lack of such Continuum of Care Homeless Assistance funding. Lack of such a plan will eventually threaten continued Federal and State a plan will eventually threaten continued Federal and State funding for homeless assistance.funding for homeless assistance.
Orange County needs to develop a more strategic, focused Orange County needs to develop a more strategic, focused effort to end homelessness. A 10 Year Plan will lead to positive, effort to end homelessness. A 10 Year Plan will lead to positive, systematic changes in the way we address homelessness.systematic changes in the way we address homelessness.
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The County’s overarching goal is to maximize public The County’s overarching goal is to maximize public and privateand private resources to address and improve Orange County’s resources to address and improve Orange County’s system ofsystem of care for at-risk and homeless populations.care for at-risk and homeless populations.
Although the development of the 10 Year Plan is based Although the development of the 10 Year Plan is based upon upon HUD’s requirements for funding and demonstrated bestHUD’s requirements for funding and demonstrated best practices, it is also an opportunity to engage practices, it is also an opportunity to engage stakeholders instakeholders in developing a regional solution to an issue that crosses developing a regional solution to an issue that crosses allall systems and affects all communities.systems and affects all communities.
Why Create a 10 Year Plan?Why Create a 10 Year Plan?
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Homelessness in Orange CountyHomelessness in Orange County
2007 Point In Time Count 2007 Point In Time Count 3,649 homeless persons were identified 3,649 homeless persons were identified inin shelters and on the streetsshelters and on the streets
2009 Point In Time Count2009 Point In Time Count 8,333 homeless persons were identified in 8,333 homeless persons were identified in sheltersshelters and on the streetsand on the streets
Based upon survey data, 21,479 persons Based upon survey data, 21,479 persons experienceexperience homelessness in Orange County over the homelessness in Orange County over the course ofcourse of one yearone year
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Homelessness in Orange CountyHomelessness in Orange County
2008 Client Management Information System Year 2008 Client Management Information System Year End Summary (48% of shelters reporting at year-End Summary (48% of shelters reporting at year-end)end)
5,081 homeless clients and 1,207 at risk clients5,081 homeless clients and 1,207 at risk clients were served by 26 participating agencies.were served by 26 participating agencies.
Each of Orange County’s 34 cities were reported Each of Orange County’s 34 cities were reported asas a last permanent place of residency prior toa last permanent place of residency prior to homelessness.homelessness.
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Overview of Planning StructureOverview of Planning Structure
Working GroupWorking Group:: The 16-person group responsible for providing input to the The 16-person group responsible for providing input to the Plan; receiving, evaluating, and integrating stakeholder and expert input to Plan; receiving, evaluating, and integrating stakeholder and expert input to the 10 Year Plan, and finalizing the 10 Year Plan.the 10 Year Plan, and finalizing the 10 Year Plan.
Stakeholder Comment Group(s)Stakeholder Comment Group(s):: Two Categories- A) A group of Two Categories- A) A group of approximately 25 agencies and individuals established in 2007 who approximately 25 agencies and individuals established in 2007 who responded to a request to be involved in the 10 Year Plan and were known responded to a request to be involved in the 10 Year Plan and were known as the Continuum of Care 10 Year Plan Committee; and B) Other interested as the Continuum of Care 10 Year Plan Committee; and B) Other interested stakeholder groups. These groups will comment on the Working Group’s stakeholder groups. These groups will comment on the Working Group’s work and provide advisory input.work and provide advisory input.
Expert Implementation Group(s):Expert Implementation Group(s): These are groups that may be formed at These are groups that may be formed at the direction and discretion of the Working Group. The participants in these the direction and discretion of the Working Group. The participants in these groups typically may be extremely busy people who would not have the time groups typically may be extremely busy people who would not have the time to participate in a regular series of meetings but could make one meeting to participate in a regular series of meetings but could make one meeting and/or would have valuable information and insights to provide.and/or would have valuable information and insights to provide.
County of Orange Homelessness Planning GroupCounty of Orange Homelessness Planning Group:: This group consists of This group consists of County Department Heads whose agencies are serving the homeless. The County Department Heads whose agencies are serving the homeless. The group has been working since May 2008 to determine where the County can group has been working since May 2008 to determine where the County can provide leadership and resources for the 10 Year Plan.provide leadership and resources for the 10 Year Plan.
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The 10 Year Plan Stakeholder Comment Group was asked to The 10 Year Plan Stakeholder Comment Group was asked to nominate “transformational thinkers” to serve on the 10 Year Plan nominate “transformational thinkers” to serve on the 10 Year Plan Working GroupWorking Group
The 16 Member Working Group was convened in September 2008 to:The 16 Member Working Group was convened in September 2008 to:
Review best practices and other regional plansReview best practices and other regional plans
Discuss the scope of homelessness in Orange CountyDiscuss the scope of homelessness in Orange County
Develop goals and strategies to be included in the 10 Year PlanDevelop goals and strategies to be included in the 10 Year Plan
Compose draft elements of the 10 Year PlanCompose draft elements of the 10 Year Plan
Overview of Planning StructureOverview of Planning Structure
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Plan ComponentsPlan Components
Mission/Vision/ValuesMission/Vision/Values Current Data Current Data
Number of homeless individuals and familiesNumber of homeless individuals and families Current services availableCurrent services available At Risk of HomelessnessAt Risk of Homelessness
Goals, Strategies, and Implementing ActionsGoals, Strategies, and Implementing Actions
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To effectively end homelessness To effectively end homelessness
in Orange County over the next decadein Orange County over the next decade
Mission StatementMission Statement
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A dynamic, A dynamic,
comprehensive system of services, comprehensive system of services,
proportionate to the need, proportionate to the need,
that effectively ends homelessnessthat effectively ends homelessness
Vision Vision
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Orange County’s plan is predicated onOrange County’s plan is predicated on
and reflects the importance of:and reflects the importance of:
Human dignityHuman dignity InnovationInnovation CourageCourage Expectation of success Expectation of success A safe, decent, sanitary housing opportunity for everyoneA safe, decent, sanitary housing opportunity for everyone
ValuesValues
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The Answer toThe Answer to
Homelessness Homelessness
is Housingis Housing
Underlying BeliefUnderlying Belief
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Nine GoalsNine Goals
PreventionPrevention OutreachOutreach Improve emergency shelter and access Improve emergency shelter and access Improve transitional housing Improve transitional housing Permanent housing with supportive servicesPermanent housing with supportive services Ensure individuals and families remain housedEnsure individuals and families remain housed Improve data systems and measure successImprove data systems and measure success Oversight and accountability Oversight and accountability AdvocacyAdvocacy
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Goal 1:Goal 1: Prevent Homelessness Prevent Homelessness to Ensure to Ensure that no one in our community becomes that no one in our community becomes homelesshomeless
Develop regional access centers that will provide prevention assistance for Develop regional access centers that will provide prevention assistance for homeless and at-risk families and individuals, including those affected by homeless and at-risk families and individuals, including those affected by the recent economic downturn:the recent economic downturn:
Anti-eviction servicesAnti-eviction services Rental and utility supportsRental and utility supports Credit counselingCredit counseling Debt managementDebt management Employment servicesEmployment services
Support the development of community resources and housing options for Support the development of community resources and housing options for individuals transitioning out of jails, hospitals, and foster care systemsindividuals transitioning out of jails, hospitals, and foster care systems
Establish a pool of flexible funding that can be used for “whatever it takes” Establish a pool of flexible funding that can be used for “whatever it takes” assistance for those who are at-risk of losing their current housingassistance for those who are at-risk of losing their current housing
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Goal 2: Goal 2: Outreach to those who are homeless Outreach to those who are homeless and at-risk of homelessnessand at-risk of homelessness
ExpandExpand existing regional access centers and develop a 24/7 existing regional access centers and develop a 24/7 coordinated system of outreach to ensure universal coordinated system of outreach to ensure universal assessment, intake, referrals, and transportation to shelters assessment, intake, referrals, and transportation to shelters
Implement new and strengthen existing mobile outreach Implement new and strengthen existing mobile outreach efforts to provide needed health, assessment, and referral efforts to provide needed health, assessment, and referral services in all areas of the Countyservices in all areas of the County
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Goal 3: Goal 3: Improve the efficacy of the Improve the efficacy of the emergency shelter and access systememergency shelter and access system
Continue to support the Armory Program Continue to support the Armory Program until year-round emergency shelter is until year-round emergency shelter is developed developed
Develop a year-round permanent Develop a year-round permanent emergency shelter(s) to replace the emergency shelter(s) to replace the seasonal Armory programseasonal Armory program
Provide a rapid re-housing program for Provide a rapid re-housing program for Emergency Shelter clients, including but not Emergency Shelter clients, including but not limited to move-in expenses, housing limited to move-in expenses, housing subsidies, and case management supportsubsidies, and case management support
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Goal 4: Goal 4: Make strategic improvements in Make strategic improvements in the transitional housing systemthe transitional housing system
Pursue less stringent entrance requirements for Pursue less stringent entrance requirements for obtaining and remaining in transitional housingobtaining and remaining in transitional housing
Provide a rapid re-housing program for clients living in Provide a rapid re-housing program for clients living in transitional housingtransitional housing
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Goal 5: Goal 5: Develop permanent housing Develop permanent housing options linked to a range of supportive options linked to a range of supportive servicesservices
Top priority of the plan is to increase permanent housing Top priority of the plan is to increase permanent housing optionsoptions
Increase Employer Assisted Housing opportunitiesIncrease Employer Assisted Housing opportunities
Adopt a Housing First model for the Adopt a Housing First model for the chronically homelesschronically homeless
Work with Cities and County to limit the Work with Cities and County to limit the barriers to development of affordable housingbarriers to development of affordable housing
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Goal 6: Goal 6: Ensure that people have the right Ensure that people have the right resources, programs, and services to remain resources, programs, and services to remain housedhoused
Grow and enhance aftercare programs for individuals and Grow and enhance aftercare programs for individuals and families that transition from the shelter system into families that transition from the shelter system into permanent housing (including training, job development, permanent housing (including training, job development, budgeting, and/or other life skills)budgeting, and/or other life skills)
Develop a pool of funds that can provide declining rental Develop a pool of funds that can provide declining rental subsidies subsidies
Increase access and coordination of support services Increase access and coordination of support services such as health insurance, childcare, and government such as health insurance, childcare, and government assistanceassistance
Identify and enhance training programs that enable Identify and enhance training programs that enable homeless individuals to find and maintain employmenthomeless individuals to find and maintain employment
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Goal 7: Goal 7: Improve data systems to provide timely, Improve data systems to provide timely, accurate data that can be used to define the need for accurate data that can be used to define the need for housing and related services and to measure outcomeshousing and related services and to measure outcomes
Increase participation in the countywide centralized client Increase participation in the countywide centralized client management information system management information system
Develop a strategy to track client from point of entry to Develop a strategy to track client from point of entry to obtaining permanent housing, and any follow-up services obtaining permanent housing, and any follow-up services provided for at least one year after placement in permanent provided for at least one year after placement in permanent housing housing
Engage local universities to conduct academic research to Engage local universities to conduct academic research to study efficacy of local homeless programs study efficacy of local homeless programs
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Goal 8:Goal 8: Develop the systems and Develop the systems and organizational structures to provide oversight organizational structures to provide oversight and accountabilityand accountability
Establish strategic leadership, communicate best practices, Establish strategic leadership, communicate best practices, monitor outcomes, and report resultsmonitor outcomes, and report results
Create and maintain implementing groups for each of the Create and maintain implementing groups for each of the following goal areas:following goal areas: DataData PreventionPrevention OutreachOutreach Emergency Shelter and Access systemEmergency Shelter and Access system Transitional ShelterTransitional Shelter Permanent HousingPermanent Housing Resource to Remain HousedResource to Remain Housed Advocacy Advocacy
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Goal 9: Goal 9: Advocate for community support, Advocate for community support, social policy, and systemic changes necessary social policy, and systemic changes necessary to succeedto succeed
Educate the public that it is in their best interest, both Educate the public that it is in their best interest, both financially and socially, to end homelessnessfinancially and socially, to end homelessness
Implement a broad program to engage local organizations, Implement a broad program to engage local organizations, faith-based organizations, neighborhood associations, and faith-based organizations, neighborhood associations, and the public in supporting proven solutions to ending the public in supporting proven solutions to ending homelessnesshomelessness
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Prevention
Access Centers/
Multi-Service Centers
Homeless/At Risk
Residential S
ervices
Emergency Shelters/
Year-Round Armory
Transitional (Rapid or
Long Term)
Conventional Process
Permanent Housing
TYPES:
•Supportive with
Services
•Affordable (income- restricted)
•Section 8
•Market Rate
Outreac
h
Orange County’s 10 Year Plan to End Homelessness
Rapid Re-Housing
Process
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General
Public
Agency / Department
Heads
Housing Developers & Service Providers
Business & Civic Leaders
Mayor/County
Executive
Non-profits / foundations
Individuals
experiencing
Homelessness
Faith-based Organizations
Law Enforcement
Officials
Chambers of Commerce
Hospital Administrators
Academia
Librarians
EXAMPLES OF STAKEHOLDERSAS PARTNERS IN THE PLAN
Parks &Recreation
Departments
Federal Agencies
State Government
JudgesJails
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Awareness and advocacyAwareness and advocacy
Feedback and collaborationFeedback and collaboration
Actively engagedActively engaged
Local and countywide perspectivesLocal and countywide perspectives
Support success!Support success!
Stakeholders as Partners in the Plan
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10 Year Plan10 Year Plan Working Group Members Working Group Members
Pam AllisonPam Allison Project Hope SchoolProject Hope School Bonnie BirnbaumBonnie Birnbaum Health Care AgencyHealth Care Agency Helen CameronHelen Cameron HOMES, Inc. HOMES, Inc. Bob CerinceBob Cerince City of AnaheimCity of Anaheim Lucy DunnLucy Dunn Orange County Business CouncilOrange County Business Council Kim GollKim Goll Children and Families CommissionChildren and Families Commission Larry HaynesLarry Haynes Mercy HouseMercy House Lacy KellyLacy Kelly Orange County League of CitiesOrange County League of Cities Scott LarsonScott Larson HomeAid Orange County HomeAid Orange County Dawn LeeDawn Lee OC PartnershipOC Partnership Jennifer Lee-AndersonJennifer Lee-Anderson CLA & AssociatesCLA & Associates Carolyn McInerneyCarolyn McInerney County Executive OfficeCounty Executive Office Cathleen MurphyCathleen Murphy American Family HousingAmerican Family Housing Theresa MurphyTheresa Murphy Precious Life Shelter Precious Life Shelter Karen RoperKaren Roper OC Community ServicesOC Community Services Margie WakehamMargie Wakeham Families ForwardFamilies Forward
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Next StepsNext Steps
Meet with stakeholdersMeet with stakeholders
Refine and edit planRefine and edit plan
Board of Supervisors approvalBoard of Supervisors approval
ImplementImplement
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Patricia Rogers, Division Manager
Crisis Services
Children’s In-Home Crisis Children’s In-Home Crisis Stabilization Program Stabilization Program (By Referral Only)(By Referral Only)
Opened November 2006Opened November 2006 Services Provided 24/7 to Children & Youth to 18 YearsServices Provided 24/7 to Children & Youth to 18 Years Referrals from OD/OC - Serves as Hospital DiversionReferrals from OD/OC - Serves as Hospital Diversion Four Teams Includes Clinician & Family Support Staff Four Teams Includes Clinician & Family Support Staff Can be Step-Down from 24 hr. CareCan be Step-Down from 24 hr. Care Average Stay is 3 Weeks - Can be ExtendedAverage Stay is 3 Weeks - Can be Extended Program to Expand by Two TeamsProgram to Expand by Two Teams
370 Clients Served370 Clients Served
Orange County Child Abuse Prevention Center Orange, CA
Children’s Crisis Residential Program Children’s Crisis Residential Program (By Referral Only)(By Referral Only)
Opened January 2007Opened January 2007 Serves Males/Females, Ages 11-17Serves Males/Females, Ages 11-17
Diversion From In-Patient Diversion From In-Patient Client Does Not Meet Hospital Admission Criteria Client Does Not Meet Hospital Admission Criteria
May be Used as Step-Down ProgramMay be Used as Step-Down Program Average Stay 3 WeeksAverage Stay 3 Weeks
183 Clients Served183 Clients Served
Community Service Programs Inc. Laguna Beach, CA
Transitional Age Youth (TAY) Crisis Transitional Age Youth (TAY) Crisis Residential Program Residential Program (By Referral Only)(By Referral Only)
Opened March 2008Opened March 2008 Serves Males/Females, Ages 18-25 Serves Males/Females, Ages 18-25
Diversion from In-PatientDiversion from In-Patient Client Does Not Meet Hospital Admission Criteria Client Does Not Meet Hospital Admission Criteria
Six-Bed FacilitySix-Bed Facility Step-Down ProgramStep-Down Program Average Stay is 3 WeeksAverage Stay is 3 Weeks
106 Clients Served106 Clients Served
South Coast Children’s Society Costa Mesa, CA
Centralized Assessment Team (CAT) Centralized Assessment Team (CAT)
Currently in Start-Up ProcessCurrently in Start-Up Process Serves Children and Youth, Ages 5-17Serves Children and Youth, Ages 5-17 Provides 24/7 Emergency EvaluationsProvides 24/7 Emergency Evaluations Mobile Response AvailableMobile Response Available Focus on Decreasing Hospitalizations by Diversion to Focus on Decreasing Hospitalizations by Diversion to
an Appropriate Crisis Programan Appropriate Crisis Program Follow-up Aftercare ServicesFollow-up Aftercare Services
1200 Clients to be Served Annually1200 Clients to be Served Annually
MHSA CYS CAT Team
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Greg Masters, LCSW, SCII
Centralized Assessment Team (CAT) Program update
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The team consists of: Licensed Clinical Social Workers Marriage and Family Therapists Mental Health Specialists Behavioral Health Nurses
Centralized Assessment Team
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Who we serve: Any adult who is experiencing a
psychiatric emergency
Hours of Operation: 24/7/365
Centralized Assessment Team
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What we do: Assist police, fire and social service
agencies in response to psychiatric emergencies
Evaluation for psychiatric hospitalization Crisis Intervention Diversion from psychiatric hospitalization
Centralized Assessment Team
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What we do: (cont’d) Provide assessment & consultation to Hospital Emergency Departments Provide education, information and
referral to family members Provide follow-up and linkage to
appropriate services
Centralized Assessment Team
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Psychiatric Emergency Response Team
P.E.R.T.
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P.E.R.T Collaboration
OCMH Provides a trained
clinician who rides with patrol three
days a week
Law Enforcement Provides a team of trained officers for the clinician to ride with
Both agencies provide ongoing training and program evaluations to improve the programWestminster, Orange, Garden Grove, & Sheriff’s Department participate in program
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P.E.R.T. Process
Law Enforcement: Receives a call of a mentally ill subject and
dispatches officers / clinician Officers arrive and evaluate the situation
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P.E.R.T. Process
Clinician: Provides crisis intervention Completes evaluation Initiates involuntary detention as applicable Provide referrals or coordinate admission Provide education, information and referral to
family members
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P.E.R.T. Process
If Clinician not available: Call is documented on a referral form Forwarded to PERT Reviewed to assess appropriate response PERT clinician initiates the planned response PD can also call CAT for immediate response
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P.E.R.T. Program Benefits
Increase efficiency in identifying the needs of the mentally ill individual
Increase police officers knowledge in dealing with the mentally ill population
Prevent unnecessary arrest or hospitalization
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P.E.R.T. Program Benefits
Reduce the number of repeat contacts or calls for service from law enforcement
Shorten the amount of time that police officers spend with the mentally ill individual
PERT also responds to requests from families, churches or businesses
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C.A.T. / P.E.R.T. StatisticsC.A.T. / P.E.R.T. Data FY 08/09
Total Assessments, 5150's & Law Enforcement Referrals
191
178
223
190 188176
198
246
208218 215 210
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64 69 6475
57
74 76 7671
61
76
5259
78 7587
9890
10899 98
114108
0
50
100
150
200
250
Aug-08
Sep-08
Oct-08 Nov-08
Dec-08
Jan-09
Feb-09
Mar-09
Apr-09 May-09
Jun-09
Jul-09
Assessments 5150's PD Referrals
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C.A.T. / P.E.R.T. Statistics
C.A.T. / P.E.R.T. Data FY 08/09Police Referrals - Percent of Calls
25%
36%
31%34%
40%
32%
27%31%
37%33%
28%
36%
27%
33%35%
39%
46%
56%
45% 44%48%
45%
53%51%
0%
10%
20%
30%
40%
50%
60%
Aug-08 Sep-08 Oct-08 Nov-08 Dec-08 Jan-09 Feb-09 Mar-09
Apr-09 May-09
Jun-09 Jul-09
5150's PD Referrals
87
CAT/P.E.R.T. Contact Information
1-866-830-6011
Greg Masters, LCSW, Service Chief - CAT, (714) 480-6778
Linda Molina, Program Manager II - Crisis Recovery Services, (714) 834-6915
Annette Mugrditchian, Division Manager AMHS, (714) 834-5026
88
Annette Mugrditchian, Division Manager
Jayson Benbrook,
County Services Procurement
89
MHSA Program
Kate Pavich, MHSA Coordinator
90
MHSA Updates
FY 08-09 Annual Progress report Spirituality Initiative MHSOAC site visit 9/23/09 MHSA Health Expo 9/24/09 10:00-2:00 at Delhi Center REMHDCO reception 5:00-7:00 pm at Embassy Suites
Santa Ana Recovery Arts 401 S. Tustin
91
Recovery Arts
TAY Art at the MHSOAC site visit 9/23/09 Call for Art/Writing for MHSA On-Line Gallery
http://ochealthinfo.com/mhsa/arts-program.htm MHSA Calendar Art Exhibit next meeting October 5
92
401 S. Tustin Street
93
401 S. Tustin Facility Update
October 6, 1 p.m. at MHSA Office 600 W. Santa Ana Blvd, Ste. 510, SA, CA 92701
Virtual tour of buildings and campus by architect Allen Hibbs
Virtual tour of campus landscaping, gardens and orchard by landscape architect John Hidalgo
Program updates on: Wellness/Peer Support Center Crisis Residential Facility Education and Training Program
94
Kathleen Murray,
Technological Needs Coordinator
Technological Needs
95
Veteran’s Services
Maureen Robles,
Veteran’s Services Coordinator
Building Bridges For OC Veterans
1. Improve coordination between HCA and local VA Medical Center Participate in monthly Mental Health Council meeting
at VA Long Beach Establish monthly clinician meetings between
HCA/BHS and VALB physicians Collaborate with VALB to develop better
demographic data on OC veteran population Develop resource guide for veterans and their
families in OC.
2. Collaborate, plan, participate in Veterans’ Outreach event around Veteran’s Day NAMI Frontline to host event on November 14 at the
Sons of the American Legion on Balboa Peninsula Host booth with OC Veterans Services information
3. Collaborate with local colleges to provide prevention and early intervention services to veterans on campus.
Establish a ‘Drop Zone’ center at Santa Ana City College
to provide resources and education
Explore opportunities with other colleges in OC.
Use surveys and campus focus groups to collect information to identify veteran student issues
4. Network of Care/Veterans Verify and update resource information specific to
Orange County Launch OC version of Network of Care/ Veterans Publicize Network of Care/Veterans to increase
community awareness
5. Participate in regional, state and national groups and organizations to educate and advocate for veterans’ behavioral health services Train behavioral health staff and others about the high
incidence and impact of co-occurring disorders on veterans and their families.
Collaborate with various governmental and non-government groups to identify and problem solve barriers to accessing services as well as gaps in existing services.
6. Explore collaborations with local military bases to develop innovative programs; improve services to veterans, \Active Reservists and CA National Guard
102
Steering Committee CommentsPublic Comments
Sharon Browning, Facilitator
103
Next Steering CommitteeOctober 5, 2009
Delhi Community Center
1 – 4 p.m.
MHSA Calendar Art Exhibit 10:30 a.m. – 12 noon
