County of San Diego Behavioral Health Division. Cultural Competence Resource Team

Transcription

1 County of San Diego Behavioral Health Division Adult/Older Adult Systems of Care 3255 Camino Del Rio South San Diego, CA Cultural Competence Resource Team Friday, June 6, 2014 Minutes + = Members in Attendance = Absent E = Excused Organization 1/3 Member Behavioral Health Services + Piedad Garcia Behavioral Health Services QI Tabatha Lang Behavioral Health Services QI + Liz Miles Behavioral Health Services + Kristina Maxwell Behavioral Health Services Cecily Thornton-Stearns Behavioral Health Services + Lauren Chin Behavioral Health Services ADS/Children s MH + Wendy Maramba Behavioral Health Services + Betsy Knight Behavioral Health Services + Toroshinia Kennedy Behavioral Health Services CYF Edith Mohler Consultant, Trauma Informed Care + Dawn Griffin BHETA 1 Kellie Scott BHETA + Minola Clark Manson CASRC + Celeste Hunter Deaf Community Services Cindi Cassady Exodus Recovery Tamara Stark Harmonious Solutions Patrice Baker Harmonium Terry Maxson HHSA + Nancy Rodriguez HSRC + Rick Heller Mental Health America Laura Andrews Mental Health America Tondra Lolin Mental Health Board John Sturm MHS, Inc. Fahimeh Peifer Native American + Leon Altamirano Optum Health Bindu Khurana Recovery Innovations + Mercedes Webber The Knowledge Center Jennifer Burnett UPAC + Dixie Galapon Veterans Courage to Call Shun Miller

2 Additional Attendees: Shane Padamada, CASRC Hector Martinez, Mental Health America Kathy Tomasic, The Knowledge Center County of San Diego Behavioral Health Services Staff in Attendance Karen Crie, Dasha Dahdouh Welcome & Introductions The meeting was called to order at 10:10 a.m. by Piedad Garcia. Review and Approval of the Friday, May 2, 2014 minutes Motion to approve May 2, 2014 minutes was made and seconded. Minutes were approved as written. Chair s Report Piedad Garcia The July 4, 2014 CCRT meeting falls on a County holiday and will go dark. The group consensus was to meet next on August 1, Over the past few months BHS staff has been working on amendments to 136 contracts, adding Live Well, San Diego!, Trauma Informed Care and Faith Based language. In addition, they have been working on a new budget for the next fiscal year, Requests for Proposals (RFPs) and Sole Source Committees (SSC). Contractors are advised to submit their budgets two weeks before the end of the fiscal year. The new Purchasing & Contracting Director, Jack Pellegrino, will not sign retroactive contracts. Internal budget discussions for FY will take place this fall. Virginia West and Cecily Thornton-Stearns of BHS recently attended a Faith Based conference in Los Angeles. Central and North Inland Faith Based Councils are reviewing the bylaws. Innovations proposed programs include five more plans in the Adult System of Care: 1. Urban Beats 2. IMHIP 3. Peer Transitions 4. Ramp Up 2 Work 5. Faith Based The proposed Innovations programs will be released to the Mental Health Board for a 30 day public review input before sending to the OAC and BOS for approval. A teleconference with the OAC provided valuable feedback. Work plans include two for children and five for adults, totaling 25 million dollars for the next few years. BHS has established a Design Team for the 6 AOD Regional Recovery Centers (RRC) that will be reprocured in FY All will be subject to the RFP process, including the Drug Court, Re-entry Court and the Behavioral Health Court. Design Teams help define best practices consistent with Substance Abuse and Mental Health Services Administration (SAMHSA) guidelines and National Standards. An RRC Industry Day is being planned in September and will provide an opportunity to provide feedback on 2

3 what BHS is proposing. The use of medications, in particular Medication Assisted Treatment such as Vivitrol and Naltrexone, in the recovery centers are new interventions are being considered. Dr. Dawn Griffin asked about billing for case managers, How will the State of California fare when and if peer/family support partners become a part of the legislation for Medi-Cal billing? Will they be able to fill that role, as they often do, and be identified as such? Case manager is a term providers give to people whether they are a peer or not. In the Peer Assisted Treatment Program under Innovations there will be peer case managers, or Health Navigators. Case management is not paid by Drug Medi-Cal. The County will have to identify funding for case management under Realignment for RRC. Action Item(s): none QI Update Tabatha Lang A requirement of the State is the Performance Improvement Project (PIP) which requires one clinical and one non-clinical component. o For the non-clinical component, BHS has proposed to work with one of the WET subcommittees for the development of Peers in Our System, Family Support Partners and Advancement Career Ladders. o Another workgroup will be formed around looking at suicide of clients that were discharged within 90 days from our system. These two PIPs are awaiting approval at the State. Discharge planning and outpatient treatment is sparse in the outpatient sector. Case management discharge planning will become tighter because of the conservatorship. Dr. Leon Altamirano stated that suicides within 90 days have been a big concern due to changes related to Skilled Nursing Facilities (SNFs) and AB109. Further discussion is needed with community clinics and hospital partners to work on closing the gaps in follow up primary care. Liz Miles reported that the Culturally Competent Program Annual Self-Evaluation (CC-PAS) draft was reviewed. A total of 242 programs responded to the survey, which included 20 questions: o 154 clinical (15 ADS and 139 MHS programs). o 88 non-clinical (42 ADS and 46 MHS programs). This was the first year the survey was sent to the ADS programs; however, the results will be compared to the previous year by clinical and non-clinical program responses. A breakdown between clinical and non-clinical programs was included for the third year. This is the first year trends could be seen with the non-clinical programs. There were 20 questions with responses were assigned a score (5 points for Met Standard, 3 points for Partially Met Standard, 1 point for Standard Not Met) and summed up for each program. The highest possible score was 100 points (if a program responded Met Standard on all 20 Standards). Non-clinical programs results on are located on Page 2 of the Culturally Competent Program Annual Self Evaluation (CC-PAS) May 2014 DRAFT document. o Non-Clinical Programs CC-PAS: Scores range from 28-to100, out of a possible 100. The average score for Non-Clinical Programs 80.5 compared to 77.8 in % (8.1% in 2013) of non-clinical programs reported that they met all cultural competence standards on the CC-PAS. 43.2% (25.8% in 2013) of non-clinical programs reported that they met or partially met all cultural competence standards on the CC-PAS. 3

4 The most unmet standard among non-clinical programs was, The program conducted a survey amongst its clients to determine if the program s clinical services are perceived as being culturally competent. (32 programs, 36.4%). A total of 36% of Non-Clinical Programs scored points. The program managers perception is they are culturally competent. Out of all standards that haven t been met the most, the following standard is the most applicable to non-clinical programs: The program conducted a survey amongst its clients to determine if the program s clinical services are perceived as being culturally competent. (18 programs, 20.4%). o Clinical Programs CC-PAS: Scores ranged from 56 to 100, out of a possible 100. The average score was 89.2 (87.1 in 2013). 10.4% (5.4% in 2013) of clinical programs reported that they met or partially met all cultural competence standards on the CC-PAS. The most unmet standard among clinical programs was, The program conducted a survey amongst its clients to determine if the program s clinical services are perceived as being culturally competent (20 programs, 13.0%). The second most unmet CC-PAS standard among clinical programs was, The program has conducted a survey amongst its clients to determine if the program is perceived as being culturally competent. (19 programs, 12.3%). o The four Clinical Competency Domains are Standard Guidelines and Procedures, Clients and Community, Staff Competencies and Training and Evaluation and Data Collection. The Cultural Competence Domain where the most clinical programs (10 or more) requested technical assistance were Staff Competencies and Training. The two Cultural Competence Domains where the most non-clinical programs (8 or more) requested technical assistance were Standard Guidelines and Procedures and Staff Competencies and Training. o Non-clinical is non-direct services, as perceived by the program manager. Some clarity was requested so that results are cleaner. Going forward, it will become more evident when further detail is provided and with communication. o Next steps in the CC-PAS administration include: Disseminating results to interested parties and stakeholders such as San Diego County Behavioral Health leadership, CCRT and the Behavioral Health Services Training and Education Committee (BHSTEC). o Next steps in the CC-PAS analysis and review include: Continue tracking trends in technical assistance needs and CC-PAS scores. Linking the CC-PAS with other cultural competence measures and information for a snapshot of cultural competence. Narratives, scores and responses on the California Brief Multi- Cultural Survey (which identifies individual training needs in the delivery of culturally competent behavioral health services) and submitted Cultural Competence Plans will be used in conjunction with the CC-PAS to measure system wide cultural competence and cultural competency strengths and areas for improvement. Action Item(s): BHS program monitors to discuss their programs, define technical assistance and address technical assistance requests with each of the programs and facilitate the process. 4

5 Committee Updates Education and Training Kristina Maxwell o Will be looking at site visits in o Looking at requests for technical assistance. o Jenny Burnett has been creating a short online training as an introduction to Cultural Competency, what tools are available and where they can be found. It is being considered making this an annual training or at least a part of orientation for those starting work with the County. It may be available to BHS staff and BHS providers. o Piedad Garcia suggested that the workgroup review CC-PAS and work on developing the definition of Technical Assistance and what tools can be used. o Committee will meet today to review final recommendations which were discussed in May and provide final draft recommendations by the end of June. Children s Update Wendy Maramba o Working on contract amendments and budget. o Yael Koenig was appointed as the new Assistant Deputy Director (ADD) for Children s Mental Health. Ad Hoc Membership In suspense. Action Item(s): Kristina Maxwell will review and provide final draft recommendations by end of June to the group via . Policy and Program Workgroup Tabatha Lang A Draft Cultural Competence Handbook was distributed and reviewed with the group. In addition, it will be disseminated to councils for their review. It will be posted on the Technical Resources Library (TRL) after approval by all the appropriate parties as well as in the provider manual. Piedad recommended it be disseminated to CEO s as well so they know what the requirements are. CLAS Standards will be included in training. Method of presenting the CLAS Standards can include e-learning, web based, and face to face training. A brief presentation could be disseminated more broadly to generate awareness. In-depth training can also be provided. Discussion ensued regarding hybrid methods of dissemination of training, coaching and supervision. Action Item(s): none MHSA Plan Update Adrienne Yancey Toroshinia Kennedy provided a summary update. o The 3 Year Plan is being completed and will go before the Mental Health Board for their review on June 19, In September, the plan will go before the Board of Supervisors (BOS) for approval of proposed Innovation, WET funding and other components. The final 3 Year Plan will be submitted to the Mental Health Oversight & Accountability Commission (MHOAC) in October for their review. It is hoped that their input and approval will be received in December so the programs can be effective by July 1, Upon approval by the BOS, the RFP process for the 7 Innovations programs can begin in November, contingent upon availability of funds and OAC 5

6 o approval. The County sent a letter to CalMHSA of Statewide PEI programs recommending funding allocations of 3% (or $650,000) for the Student Mental Health Initiative. Of that amount, it is recommended that $100,000 be allocated for the chat feature of the Access and Crisis line. Optum is looking to contribute funding to cover usage of the Access and Crisis line by the private sector. Each Mind Matters is being integrated into local PEI campaign. Action Item(s): none CRDP Disparities Reports Lead Workgroup Update Leads for CCRT Disparities Reports The workgroup met last Friday with a focus on the African American committee recommendations. Through discussion, opportunities to better serve the African American community were identified and expanded upon. The goal of the CRDP Leads Workgroup is to review the CCRT Chair s selected recommendations from each of the five plans CRDP Subgroup committee recommendations. Each subgroup lead reviewed the Chari s recommendations and provided input on which were already being accomplished, which were feasible, and which should be placed on hold. The Leads workgroup already discussed the input for the API, African American and Native American recommendations. Still pending is discussion around the Latino and LGBTQ recommendations. The finished product will be provided to the CCRT to review. Piedad requested a volunteer to address the Latino recommendations. Dr. Leon Altamirano offered to participate and provide input for the Latino recommendations. Kristina Maxwell will work with Dixie Galapon, Minola Clark Manson and Piedad Garcia to develop the final report to submit to the CCRT. The draft should be sent in mid-july. Action Item: Draft recommendation should be sent in mid-july. Announcements The plan on an Agency level for Trauma Informed Care training and education is still being developed. Dr. Dawn Griffin, consultant, spoke about working on next year s implementation schedule. A plan will be developed by the Dr. Griffin, an advisory board as well as national experts and members of the Agency Executive Team. Next Meeting: Friday, August 1, :00-11:30 AM La Jolla Room Behavioral Health Services 3255 Camino Del Rio South, San Diego, CA

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