IMPERIAL COUNTY MENTAL HEALTH BOARD

Transcription

1 IMPERIAL COUNTY MENTAL HEALTH BOARD ANNUAL REPORT FY Advocating local mental health needs while strengthening program development and operation.

2 Imperial County Mental Health Board Members and District Map A Foreword from the Chair 5 Introduction to the MHB Annual Report FY 16/17 7 About our Members 8 Member Leaving the Board During the Past Year 13 Welcome to our Newest MHB Member 13 Legislative Mandates for FY 16/17 14 Mental Health Board Annual Highlights 16 Expansion of Services 16 Outreach and Collaborative Efforts 17 World Mental Health Day 18 California Mental Health Planning Council Data Notebook Mental Health Awareness Month 19 California Association of Local Behavioral Health Boards/Commissions (CALBHB/C) MHB Employee Recognition Program: PACE Awards 20 Monthly Updates 21 MHB Monthly Meeting Attendance 22 MHB Committees 24 Committee Meetings Attended by MHB Members 26 MHB Committee Reports 27 Adult and Older Adult Services Committee 27 Children Services Committee 27 Transitional Age Youth Committee 27 Board Applicant Committee 27 California Mental Health Planning Council (CMHPC) Data Notebook Mental Health Board Annual Report 28 Nominating Committee 28 Performance, Achievement, Caring and Excellence (PACE) Award 2 P A G E

3 ICBHS Highlights and Program Updates 29 Administrative Services 29 Center for Clinical Training 30 Children and Adolescent Outpatient Services 31 Youth and Young Adult Services 32 Adult and Older Adult Services 33 Crisis and Engagement Services 35 Statistical Information 36 Total Clients Served 37 Medi-Cal Beneficiaries Served 38 Outcome Measures 39 Revenue and Expenses 40 Mental Health Board Goals for FY 17/18 41 Recommendations to the Board of Supervisors 41 Appendix 42 Appendix A: Evidence-Based Treatment Practices & Outcome Evaluation Tool Description and Updates Appendix B: Imperial County Mental Health Population Appendix C: Site Maps and Summary 44 Appendix D: Trainings Provided to Outside Agencies Appendix E: Outreach and Engagement Activities P A G E

4 IMPERIAL COUNTY MENTAL HEALTH BOARD MEMBER REPRESENTATION BY DISTRICT AND SUPERVISOR District 1 Supervisor John Renison Glenn Sarot Mohammed Asiad District 4 Supervisor Ryan Kelley Kurt Leptich Vacancy Orlando Espino District 2 Supervisor Luis A. Plancarte Nancy Rhodes District 5 Supervisor Ray Castillo Bertha Morris Benny Benavidez, Chair District 3 Supervisor Michael W. Kelley Harold Walk Pamela Mills-Morita, Vice Chair Board of Supervisors Representative Supervisor Ray Castillo 4 P A G E

5 A FOREWORD FROM THE CHAIR On behalf of the Imperial County MHB, I am pleased to present this year s annual MHB Report to the Imperial County Board of Supervisors and the CA Association of Local MHB and Commissions. As members of the Mental Health Board (MHB), it is our duty to serve as liaisons to the community to work towards providing superior services and minimizing stigma. Our goal as a board is to be responsive to community concerns and seek to initiate processes within the department to address these concerns. We strive to incorporate quality mental health standards in our role within the community. In order to meet these standards, the board relies on its committees to allow members to familiarize themselves with programs, services and staff of Imperial County Behavioral Health Services (ICBHS). ICBHS and the MHB take a team approach to develop and implement problem-solving solutions to make services more compatible with the mental health needs of the community we serve. The MHB itself has seen quite a bit of change this past year. We have said good-bye to two long-standing members who have retired from the MHB, Bertha Morris and Glenn Sarot. Both carried a wealth of knowledge and compassion for our community and they will be greatly missed. We welcomed our newest member, Orlando Espino. We look forward to working with Mr. Espino and hearing his ideas. Our board members continue to take an increased interest in participating in various trainings and recognize the importance of having a hands-on approach to being involved in the planning process with the department. Through education and involvement, the board has been able to provide constructive feedback on behalf of consumers to improve services. This past year, ICBHS also said good-bye to a spectacular leader and Director, Michael Horn, who retired from the agency in September. Upon retiring, Mr. Horn was presented with the SPACE Awards presented by Dr. Mohamed Asiad and the California Association of Local Mental Health Boards and Commission for his outstanding leadership and commitment to the community as the Director of ICBHS. We welcomed our new Director, Andrea Kuhlen. Ms. Kuhlen has not missed a step and under her leadership, the agency has continued to strive to reach the goals it has set out to accomplish over the years. The transition for Ms. Kuhlen and other new management staff has been smooth and easy. As Chair of the MHB, I am proud of the department s collaborative efforts to improve relations with local law enforcement agencies, the county jail, probation department and juvenile Hall. Improving relations with these agencies has worked leaps and bounds in improving the department s ability to reach a specialized client base. 5 P A G E

6 ICBHS also continues to expand services to outlying areas of the community in order to make services readily accessible to anyone who needs them. This year is no exception with the opening of two new clinics, the Children s Clinics in Brawley and the Adult Anxiety and Depression Clinic in Calexico. The new clinics are designed to provide a warm welcoming environment for clients, allowing them to seek treatment in a professional manner that is conducive to comfort and well-being. The department is continuing to work towards additional expansion and additional sites are currently under construction with plans to open additional sites for the Wellness Center in Brawley, and for Children and Youth and Young Adult programs in Calexico during fiscal year Additional building re-models for Adult Services, Children Services and Crisis and Engagement Services are also underway to design the clinics to better meet the needs of client care. Open House Celebration for the Adult Anxiety and Depression Clinic in Calexico held on March 9, 2017 With the expansion of services, the department has also been expanding its workforce and now employs over 500 employees. This level of growth could often cause and agency to feel growing pains, but the department has been able to grow with grace. The fundamental foundation for client success is treatment based on Evidenced Based Practices. ICBHS treats patients using appropriate Evidenced Based Practice models and diligently ensures that all treatment staff members are properly trained in these areas. It is my hope that the following pages will further explain the goals that the MHB and ICBHS have been working on this past year. They will demonstrate the outstanding effort put forth by the department staff and the high quality services provided. On behalf of the MHB, I would like to thank the Imperial County Board of Supervisors for their support of the Behavioral Health Department. This department has a big vision, with huge plans and goals and your support is what allows the department to achieve their goals. It has been quite a journey, but I truly believe that as the vision comes to fruition, the positive impact that this department has had on the community is palpable. 6 P A G E

7 INTRODUCTION TO THE MHB ANNUAL REPORT FOR FY 16/17 Our current Mental Health Board consists of ten (10) members; nine (9) members are appointed in equal numbers by the Board of Supervisors and one (1) member who shall be appointed by the Chair of the Board of Supervisors to represent the Board of Supervisors. One (1) vacancy exists. Recruitment efforts are made by advertising the vacancies at local clinics and newspapers. Interested parties are given the Bylaws for their review along with an interest survey for them to compete. Upon completion, surveys are screened to verify they meet residency requirements and membership categories by the Mental Health Boards Applicant Review Committee. The Mental Health Board must comply with Welfare & Institution Code 5604(a) which requires: 1) membership reflect the ethnic diversity of the client population in the county; and 2) membership shall be consumers, parents, spouse, sibling, or adult children of consumers, who are receiving or have received mental health services. The role and function of the board is to review and evaluate the community's mental health needs, services, and special problems; review any county agreements entered into pursuant to Section 5650; advise the governing body and the local mental health director as to any aspect of the local mental health program; review and approve the procedures used to ensure citizen and professional involvement at all stages of the planning process; submit an annual report to the governing body on the needs and performance of the county's mental health system; review and make recommendations on applicants for the appointment of a local director of mental health services; review and comment on the county's performance outcome data and communicate its findings to the State Mental Health Commission; Perform other duties or functions as may be transferred to the Mental Health Board by the Board of Supervisor; assess the impact of the realignment of services from the state to the county, on services delivered to clients and on the local community. The Mental Health Board of Imperial County, as a part of its state mandate, is asked to submit an annual report to the governing body on the needs and performance of the county s mental health system. Our intention is to produce a report that would also create a common understanding of the Mental Health Board s role and responsibilities along with an overview of the work we have done and the goals we have accomplished. 7 P A G E

8 ABOUT OUR MEMBERS Chair of the Board Benny Benavidez District 2 ~ Supervisor Luis A. Plancarte Mr. Benavidez started his career at Imperial County Probation as a Juvenile Hall Officer in the 1970's. In this assignment, he started early in working towards offender rehabilitation and used his knowledge to be a good counselor. In the 1980's, he transitioned to the service of Probation Officer and worked Investigations and Supervision. His supervision style was geared towards treatment; he ensured that all offenders had specific case plans geared towards their individual risks and needs. In the 1990's, Mr. Benavidez transferred his knowledge to the Department of Corrections. During this time in that agency, he quickly went up the ranks and performed several different tasks geared towards transitioning the prison populations towards the community services that would help them be successful, including prosocial skill development, housing, and employment assistance. He concluded his career with that agency in 2011 as a Parole Administrator and was instrumental in changing the organizational culture to a treatment model that we now know as the California Department of Corrections and Rehabilitation. Mr. Benavidez possesses a degree in Criminal Justice Administration from San Diego State University and continues to be a Correctional Science instructor for Imperial Valley College. He has been married for 36 years and is a father to two wonderful children, who also follow in the family tradition of public service. Vice Chair of the Board Pamela Mills-Morita District 3 ~ Supervisor Michael W. Kelley Pamela Mills-Morita came to the Imperial Valley as a child when her father became stationed at the Naval Air Facility in El Centro. In 1978 she returned to the Imperial Valley upon accepting a job as a speech therapist with El Centro School District. Ms. Mills-Morita retired in July 2014 from a 34 year career as a speech pathologist. Pamela obtained her degree from Texas Women's University and completed her graduate work in Speech Pathology at Northern Arizona University in Flagstaff, Az. This is her seventh year serving on the Mental Health Board. 8 P A G E

9 Glenn Sarot, Ed. D District 1 ~ Supervisor John Renison Glenn Sarot moved to Brawley, California in 1972 to teach Special Education at Brawley Union High School. He then was selected to serve as Administrator of Imperial County SELPA from 1989 to During this time he served as Chair of the California State Association of Special Education Local Plan Administrators, as well as Imperial County Mental Health Board member and chair (several times) from 1994 to present. Upon his retirement from Imperial County SELPA, he served as an Education Consultant to the San Diego/Imperial County Regional Center and ended his career as an Educator as Calexico Unified School Districts Director of Special Education and Student Services in He earned a Master s Degree in Counselor Education with emphasis in Special Education from the University of San Diego and was awarded an earned Doctorate in Administration from Northern Arizona University. He has extensive background working with the special needs population. He is a strong advocate for children and youth with special education needs and their families. Nancy Lee Rhodes District 2 ~Supervisor Luis A. Plancarte Mrs. Rhodes relocated to the Imperial County 23 years ago with her husband and family with the sole purpose to start Court Appointed Special Advocates (CASA) program in Imperial County. In 1994, she started the non-profit agency, CASA, as the Executive Director. CASA of Imperial County serves foster children in the dependency system. After fourteen years, Nancy retired from CASA and then within eighteen months found a rewarding volunteer job. She volunteers with the El Centro Police Department in their CIPS (Community in Police Service) volunteer program. She and her husband recently started a non-profit organization called Burning Bush International which supports and assists the poor in Uganda. Mrs. Rhodes has served on the Mental Health Board since P A G E

10 Dr. Mohammed Asiad District 1 ~ Supervisor John Renison Dr. Asiad is a graduate of the American University of the Caribbean School of Medicine. He attended Old Church Hospital, Romford Essex County East London in England for clinical medicine. He graduated from California State University San Diego with a Master s in Education, and he completed a Master s in Business Management from Northern Arizona University. He attended California State University Stanislaus and received his Bachelors in Biology. He completed his A.S. degree in Pre-Medicine from Merced College. He is married with six beautiful children. Dr. Asiad served on many boards. He served on El Centro Police Advisory Board for six years, the Calexico planning commission for four years and is now on the Calexico Street Naming Committee. Most recently, Dr. Asiad was elected as an Alternate Regional Director to represent the Southern Region for the California Associations of Local Mental Health Boards and Commissions. He is active politically in the community. Orlando Espino District 1 ~ Supervisor John Renison Mr. Espino is a lifelong resident of Calexico and is a graduate of Calexico high School. He is also a veteran of the United States Marine Corps and holds a Bachelor of Arts degree in Political Science from the University of California, Riverside. In keeping with his drive to serve in public service, Mr. Espino began a career in law enforcement and has been involved in countless investigations targeting and dismantling local criminal street gangs and international criminal organizations. Mr. Espino is also a member of the Calexico Rotary Club and is currently pursuing a Master s Degree from Arizona State University. Mr. Espino is also married and has two young children. 10 P A G E

11 Harold Walk District 3 ~ Supervisor Michael W. Kelley Mr. Walk is employed by the Imperial Irrigation District as supervisor of the Real Estate Section. He was raised on a farm in Imperial Valley and is a graduate of Cal Poly, Pomona with a bachelor s degree in Agricultural Economics. Mr. Walk has an extensive background in commercial banking, finance and real estate. Current community activities include serving as vice-chairman of the Imperial Valley College Foundation, and member of The Rustlers social club. Former activities include being chairman of the El Centro Planning Commission, Joint Strike Fighter Committee, and Vice Chairman of El Centro Elementary School District Citizens Oversight Committee. Mr. Walk has two adult children: a daughter Kelsey, with a doctorate in Physical Therapy and son, Bryan, with a bachelor s degree in Economics.. Kurt Leptich District 4 ~ Supervisor Ryan Kelley Mr. Leptich is the Senior Director of the Special Education Department for the Imperial County Office of Education. He has called Imperial County home since Mr. Leptich finds great happiness with his wife of 30+ years along with their two adult daughters. Personal affiliations include the El Centro Kiwanis Club, Valley Baptist Church and the Salvation Army. His passions include spending time with a large extended family, rebuilding antique automobiles and working around his house. Bertha Morris District 5 ~ Supervisor Ray Castillo Bertha Morris is a retired Assistant Director of Behavioral Health Services and has served on the Mental Health Board since She has a Bachelor s of Science degree from the University of Phoenix. She was elected California Senior Legislative Assembly Member of Imperial County in 2005 and re-elected in Bertha is the past chair of The Area Agency on Aging and the past President of the El Centro Regional Medical Hospital Board and has served on numerous other boards and task forces. 11 P A G E

12 Ray Castillo, District 5 Supervisor Representative of the Board of Supervisors Raymond Ray Castillo is a lifelong resident whose grandparents first came to the Imperial Valley in Mr. Castillo was elected to the Imperial County Board of Supervisors, District 5, in November In the 5 th District, Castillo represents the communities of El Centro, Brawley, Holtville, Winterhaven and Palo Verde. Prior to Mr. Castillo s election on to the Board of Supervisors, he had been elected to the El Centro City Council and subsequently appointed as Mayor from 2003 to Castillo graduated from CUHS in 1967, IVC in 1973 and SDSU Calexico in His law enforcement career spans back 35 years, working with the Holtville Police Department, Imperial County Probation Department, US Customs and the California Department of Corrections, where he retired in July Mr. Castillo is married to Gloria, has five grown children; Angie, Teresa, Louisa, Michelle and Raymond Jr. and fifteen grandchildren. 12 P A G E

13 MEMBERS LEAVING THE BOARD DURING THE PAST YEAR Glenn Sarot was appointed to the Mental Health Board on October 7, 2005, by Board of Supervisor District Representative for the 5 th District. As a former Administrator of Imperial County SELPA from 1989 to 2008, Glenn brought a wealth of experience and knowledge related to the needs of children and youth with special education needs and their families. Over the years, Glenn has been one of the MHBs most passionate advocates. Glenn was recognized for his dedication and service on the board and presented with a plaque of appreciation at the Board of Supervisor Meeting on September 19, Bertha Morris was appointed to the Mental Health Board on May 17, 2005, by Board of Supervisor District Representative for the 5 th District. As a former Assistant Director of Behavioral Health, Bertha brought a level of expertise and knowledge of the mental health system. Bertha was recognized for her dedication and service on the board and presented with a plaque of appreciation at the Board of Supervisor Meeting on September 19, WELCOME TO OUR NEWEST MHB MEMBER Please join us in welcoming our newest member of the board, Orlando Espino. Mr. Espino was appointed to the Mental Health Board on November 8, 2016 under District 1 Supervisor John Renison. With a background in military service and law enforcement, Mr. Espino will bring a new level of knowledge and expereince to the table. We look forward to working with Mr. Espino. 13 P A G E

14 LEGISLATIVE MANDATES FOR FY 16/17 Imperial County s Mental Health Board Met the Legislative Mandates in FY 16/17 SOURCE: California Welfare and Institutions Code Powers and Duties of California Mental Health Boards Action Taken by Imperial County MHB FY 16/17 Review and evaluate the community s mental health needs, services, facilities and special problems. Board members attended monthly MHB meetings (including committee and liaison appointments). Board members reviewed and evaluated mental health facilities and services through scheduled site visits. MHB held a public hearing to review and comment on the Mental Health Services Act (MHSA) Annual Plan Update Fiscal Year (FY) Review any county agreements entered into pursuant to Section The agreement entered into between the state agency Department of Health Care Services (DHCS) and ICBHS was executed on August 9, Advise the governing body and the local mental health director as to any mental health program. Board members made contact with members of the community and often brought concerns and requests to the monthly MHB meetings. The MHB Chair met with the Behavioral Health Director on a monthly basis. MHB members advocated with individual Supervisors. Review and approve the procedures used to ensure citizen and professional involvement at all stages of the planning process. The public was routinely invited to participate in all monthly MHB meetings. MHB Members participated in the MHSA Steering Committee meetings. 14 P A G E

15 SOURCE: California Welfare and Institutions Code Powers and Duties of California Mental Health Boards Action Taken by Imperial County MHB FY 16/17 Submit an annual report to the governing body on the needs and performance of the county s mental health systems. The presentation of the MHB Annual Report for FY 15/16 was provided to the Imperial County Board of Supervisors on August 30, Review and make recommendations on the applicants for the appointment of a local Director of Mental Health Services. The board shall be included in the selection process prior to the vote of the governing body. Review and comment on the county s performance outcome data and communicate its findings to the California Mental Health Planning Council. The Board of Supervisors appointed Andrea Kuhlen as Director of ICBHS on October 11, The MHB completed the California Mental Health Planning Council s 2016 Data Notebook questionnaire. The Data Notebook focused on children, youth and transitional age youth (TAY) Programs, findings were submitted on March 24, Perform other duties or functions as may be transferred to the Mental Health Board by the Board of Supervisors. The County Board of Supervisors did not transfer any additional duties or authority to the MHB during FY 16/17. Assess the impact of the realignment of services from the state to county, on services delivered to clients and on the local community. The MHB and the department have assessed the need for MH services throughout the County of Imperial and have worked to expand services to outlying areas. 15 P A G E

16 MENTAL HEALTH BOARD ANNUAL HIGHLIGHTS Mental Health Board (MHB) members received regular updates on the department s effort to improve access, timeliness, quality, and outcomes, in the delivery of services for those suffering from severe and persistent mental illness (refer page 21 for an outline of updates received). Information from these updates leads the MHB and ICBHS to engage in a productive dialogue in which the MHB members are able to provide meaningful, community-based insights. The MHB members also serve on various committees (refer page 24 for an overview of MHB Committees). The active committees allow the MHB to accomplish more specialized tasks, along with providing an arena to review departmental processes and report on findings. The input received from MHB members influences the course of the department s plans and operations. The MHB works closely with ICBHS staff to implement a philosophy of care and understanding. This philosophy has led to the department s transformation into a Trauma- Informed Agency and continued efforts to implement Evidence Based Practices (EBP s). Both help fight stigma attached to mental illness (refer to Appendix A for full list of EBP s provided). Expansion of Services ICBHS has continued working to expand services throughout the County as there is still an unmet need for services in our community (refer to Appendix B for an overview of Imperial County s Mental Health Population). The MHB supports expansion efforts by advocating on the behalf of ICBHS to the Board of Supervisors. They have helped to expedite the process of opening new clinics and have justified the need additional buildings and staff to provide services to outlying areas. They reach out and educate community members by providing information related to services provided at ICBHS. These efforts have resulted in a department that currently employs 13 full time psychiatrists, 367 full time and 150 extra help staff members. The MHB is proud to announce the opening of two (2) additional clinics this past year, the Children Services Clinic in Brawley and the Adult Services Anxiety and Depression Clinic in Calexico. (refer to Appendix C for ICBHS Site Map and Summary). Additionally, ICBHS will be expanding further due to taking part in the Drug Medi-Cal Organized Delivery System (DMC-ODS) Waiver. ICBHS agreed to opt in and participate in this program which will test a new paradigm for the organized delivery of health care services for Medicaid eligible individuals with a substance use disorder. With the implementation of this waiver, there will be a need to hire additional staff and secure additional regionalized buildings to meet the demands of the various required services. The 16 P A G E

17 ICBHS DMC-ODS Implementation Plan has been approved by the Department of Health Care Services and the Fiscal Plan has been submitted and is pending revisions for approval. It is anticipated that initial implementation begin in FY 17/18. Outreach and Collaborative Efforts The MHB has continually encouraged the department to improve collaborative efforts and relationships with outside agencies, including local law enforcement agencies, hospitals, school districts, County Jail and Probation staff as reflected below: Crisis Intervention Team Training (CIT) was held for local law enforcement to increase awareness into mental health and strengthen the collaboration with ICBHS. Protocols between local emergency departments and ICBHS were drafted to enhance the working relationship and contiuum of care when treating 5150 individuals in the community. Quarterly meetings between ICBHS, emergency departments and law enforcement were held to review progress in collaborative efforts and problem solve obstacles. Mental health staff were stationed at alternative education sites and the County Jail to conduct Intake Assessments and implement the Moral Reconation Therapy (MRT) model with the goal of decreasing recidivism. ICBHS staff were stationed at the Imperial County Jail to provide mental health screening, education, and linkage to inmates who were determined to benefit from mental health treatment. One ICBHS Psychiatric Social Worker Intern and one Mental Health Counselor Intern began providing therapuetic services at the County Jail on a voluntary part-time basis. Initial plans were done to hire a permanent full-time Psychiatric Social Worker to be stationed at the County Jail. ICBHS worked closely with Probation staff to develop the Suicide Prevention Plan and participated in a Suicide Assessment Training and follow up consultation alongside Probation staff. The ICBHS mental health staff continued to provide assessment, medication support, collaterol, and linkage services to youth in Juvenile Hall who also met criteria for a mental health disorder. Tai Chi classes were offered at Juvenile Hall to youth with a mental health disoder to assist in affect regulation, awareness, and physical fitness. As an additional effort to meet this request, ICBHS staff focused on outreach efforts to the community to educate and reduce stigma attached to mental illness. ICBHS offered multiple trainings to staff and outside agencies to bring awareness to the community and to provide tools to agencies to assist with providing quality care to mental health clients throughout the 17 P A G E

18 community (refer to Appendix D for a list of trainings provided). These trainings allowed the outside agencies to acquire a better understanding of how to work with individuals suffering from Mental Illness and facilitated in establishing awareness of the services that ICBHS has to offer and the role the department plays in the community. ICBHS also participated in approximately 378 outreach activities throughout the year providing outreach to a total of 9,931 individuals with 308 individuals being engaged into the ICBHS system (refer to Appendix E for the full list of outreach activities). Additional outreach efforts include the weekly wellness radio show in both English and Spanish. The radio show is broadcast on KXO and KROP, available on demand and by podcast. The ICBHS website, continues to provide user friendly access to information regarding services provided by Behavioral Health Services. World Mental Health Day World Mental Health Day was on October 10, 2016 and was recognized by the department and brought to the attention of the community by submitting a Proclamation to the Board of Supervisors on October 4, California Mental Health Planning Council Data Notebook The MHB completed the California Mental Health Planning Council s (CMHPC) 2016 Data Notebook questionnaire with reference to data from the external quality review organizations. The Data Notebook focused on children, youth and transitional age youth (TAY) programs. An Ad-Hoc Committee was formed and committee members worked closely with ICBHS staff to answer a series of questions provided by the CMHPC. The Data Notebook assisted the MHB in meeting our legal mandates to review performance data for mental health services provided by ICBHS, and report on performance and functioning as an educational source on behavioral health data for local boards. Questions related to the following categories were included in the Data Notebook: Access to Services Outreach and Engagement Timely Follow Up Services after Child/Youth Psychiatric Hospitalization Vulnerable Groups with Specialized Mental Health Needs Foster Children and Youth Lesbian, Gay, Bisexual, Transgender and Questioning Youth (LGBTQ) Children and Youth Affected by Substance Abuse Disorders Justice System-Involved Youth with Behavioral Health Needs Mental Health Service Act Programs Help Children and Youth Recover Prevention and Early Intervention (PEI) Programs and Services Prevention of Suicide and Suicide Attempts Early Identification of Risks for First-Break Psychosis Full Service Partnership (FSP) Programs for Children and Youth Outcomes Data for Children and Youth (TAY) in FSP Programs 18 P A G E

19 Findings showed that ICBHS is overall, meeting the needs of youth in the community as the department was able to respond to each category in a positive manner and provide information about available programs to meet the needs of the target population. Areas that were identified as needing further program development included retention of TAY clients, strategies to engage foster youth, programs that are designed and directed specifically to LGBTQ youth and programs or services designed to improve family acceptance of LGBTQ youth, programs specifically targeted to preventing suicide in children and youth under the age of 16 years old. The completed Data Notebook was submitted to the CMHPC on March 24, Mental Health Awareness Month The month of May was Mental Health Awareness Month, which the department recognized and brought to the attention of the community by submitting a Proclamation to the Board of Supervisors on May 2, 2017 and by placing green ribbons throughout the community. Through education and outreach, the department continually works towards forming an alliance with the community to lower the existing mental health stigma so that those who might benefit from treatment seek treatment. ICBHS Staff celebrate Mental Health Awareness Month - May 2017 California Association of Local Behavioral Health Boards/Commissions (CALBHB/C) Theresa Comstock, President of the CALBHB/C and Steven Dambeck, Acting Director of CALBHB/C attended the monthly Imperial County MHB meeting on June 20, She presented information outlining the responsibilities of the local MHB and emphasized that advocacy is a significant role. The MHB is expected to advocate for the community and mental health services by sharing recommendations to the appointed Board of Supervisors. By taking a hands-on approach to advocacy, the MHB will be able to identify areas that may need further evaluation or discussion at the State level. The presentation was beneficial for the MHB members as many of the members have expressed the desire to be more involved on the local and state level. 19 P A G E

20 MHB Employee Recognition Program: PACE Awards The MHB continued to recognize staff for their accomplishments and hard work throughout FY 2016/2017 by presenting them with the Employee Recognition Program Performance, Achievement, Caring and Excellence (PACE) Awards. This year s awards were presented to recipients at each Quarterly Full Staff Meeting. The Administrative Services Human Resources Unit was recognized in July The Crisis and Engagement Services Mental Health Workers were recognized in October The Youth and Young Adult Services Substance Abuse Counselors were recognized in January The Children Services Nursing Staff were recognized in April The Recognition Program met the goal of allowing the Mental Health Board Members to be more visible within the department. Administrative Services Human Resources Unit July 2016 Crisis and Engagement Services Mental Health Workers October 2016 Youth and Young Adult Services Substance Abuse Counselors January 2017 Children Services Nursing Staff April P A G E

21 MONTHLY UPDATES As part of our regular Mental Health Board meetings, the Board received monthly updates on the following topics: MHSA Plan Updates Community Service and Supports (CSS) Full Service Partnerships (FSP) Adult and Older Adult Services Youth and Young Adult Services Wellness Center Programs Outreach and Engagement Programs Transitional Engagement Supportive Services Program (TESS) Prevention Early Intervention (PEI) Incredible Years Early Intervention Trauma-Focused Cognitive Behavioral Therapy Statewide Prevention and Early Intervention Projects First Steps to Success Capital Facilities and Technology Needs (CFTN) Workforce Education Training (WET) MHSA Funding Summary Presentations MHSA Three-Year Program & Expenditure Plan for FY through FY Moral Reconation Therapy (MRT) Aggression Replacement Training (ART) Suicide Risk Training Quality Improvement Work Plan Motivational Interviewing Other Updates Adult and Older Adult Services Youth and Young Adults Services Updates Children Services Updates Crisis Engagement Services Updates Mental Health Awareness and Outreach Efforts Anti-Stigma Advertisement Campaign Updates Expansion of Services Updates (Building and Staffing Needs) Crisis and Engagement Services Expansion Plan Drug Medi-Cal Organized-Delivery System Updates Crisis Intervention Training Updates Doctor/Staffing Needs-Psychiatrist Recruitment Efforts California External Quality Review Oversight (EQRO) Findings Department of Health Care Services Review Findings Budgets and Contracted Services Updates Crisis Intervention Training MHB Annual Report Updates PACE Award Budgets and Contracted Services Updates Evidenced Based Practice and Trauma-Informed Care Updates CA Mental Health Board and Commissions Updates (meetings and mandates) Site Visit Updates California Mental Health Planning Council Data Notebook Updates 21 P A G E

22 MHB MONTHLY MEETINGS Meeting Dates July 19, 2016 September 20, 2016 October 18, 2016 November 15, 2016 January 17, 2017 February 21, 2017 March 21, 2017 April 18, 2017 MHB Monthly Meetings Board Member Attendance Dr. Mohamed Asiad Benny Benavidez Kurt Leptich Pamela Mills-Morita Glenn Sarot Benny Benavidez Kurt Leptich Pamela Mills-Morita Bertha Morris Nancy Rhodes Glenn Sarot Dr. Mohamed Asiad Benny Benavidez Ray Castillo Kurt Leptich Pamela Mills-Morita Nancy Rhodes Dr. Mohamed Asiad Benny Benavidez Ray Castillo Kurt Leptich Pamela Mills-Morita Bertha Morris Nancy Rhodes Harold Walk Benny Benavidez Orlando Espino Kurt Leptich Pamela Mills-Morita Dr. Mohamed Asiad Benny Benavidez Kurt Leptich Pamela Mills-Morita Harold Walk Dr. Mohamed Asiad Benny Benavidez Orlando Espino Pamela Mills-Morita Bertha Morris Nancy Rhodes Harold Walk Dr. Mohamed Asiad Benny Benavidez Bertha Morris Nancy Rhodes Harold Walk 22 P A G E

23 May 16, 2017 June 20, 2017 MHB Monthly Meetings Dr. Mohamed Asiad Benny Benavidez Ray Castillo Orlando Espino Kurt Leptich Pamela Mills-Morita Dr. Mohamed Asiad Benny Benavidez Ray Castillo Orlando Espino Kurt Leptich Pamela Mills-Morita Nancy Rhodes Harold Walk 23 P A G E

24 MHB COMMITTEES (*) Ad Hoc Committee Children s Committee Description Board Members on Committee Ages 0-16 Kurt Leptich Represent the special needs of Nancy Rhodes children; evaluate and make Dr. Mohammed Asiad recommendations for children mental health services. Transitional Age Youth Committee Description Ages Represent the needs of at-risk young people who are in transition from state custody or foster care. Description Ages 25-Older Represent special needs of adults/older adults; evaluate and make recommendation for adult/older adult mental health needs. Description Review applications and recommend appointees to the County Supervisors for their approval. *County Supervisors reserve the rights to recommend perspective members to the MHB directly. Board Members on Committee Benny Benavidez Orlando Espino Adult/Older Adult Committee Board Members on Committee Harold Walk Pamela Mills-Morita Dr. Mohammed Asiad Board Applicant Review Committee Board Members on Committee Harold Walk Benny Benavidez Annual Report/Data Notebook Committee* Description Board Members on Committee Submit reports to the Governing Pamela Mills-Morita Body on the needs and Harold Walk performance of the County s Nancy Rhodes mental health system. Benny Benavidez Description Each October the MHB Chair shall appoint three Board Members to the committee who shall select a slate of officers and obtain verbal indication of willingness from the nominated individuals to serve. The Chair of the committee shall report the results to the MHB at November s meeting. Nominating Committee* Board Members on Committee Dr. Mohammed Asiad Harold Walk Kurt Leptich 24 P A G E

25 Performance, Achievement, Caring and Excellence (PACE) Award Committee Description Board Members on Committee Develop and implement an award Pamela Mills-Morita system to allow the MHB to Dr. Mohammed Asiad acknowledge staff members within Kurt Leptich the department who display the values outlined in their day to day attitude, work ethic and in their ability to serve the community with compassion. 25 P A G E

26 COMMITTEE MEETINGS ATTENDED BY MHB MEMBERS (*) Ad Hoc Committee California Mental Health Planning Council Data Notebook* Meeting Dates Board Member Attendance February 7, 2017 Benny Benavidez February 16, 2017 Pamela Mills-Morita March 2, 2017 Harold Walk California Association of Local MHB and Commissions Meeting Dates October Folsom, CA January San Diego, CA April 2017 Redding, CA June 2017 Irvine, CA Board Member Attendance Dr. Mohammed Asiad Dr. Mohammed Asiad Dr. Mohammed Asiad Dr. Mohammed Asiad Benny Benavidez Mental Health Board Annual Report FY * Meeting Dates Board Member Attendance August 10, 2017 Benny Benavidez August 31, 2017 Pamela Mills-Morita September 8, 2017 Harold Walk September 14, 2017 MHB Member Site Visits Adult and Older Adult Services Meeting Dates Board Member Attendance October 24, 2016 Pamela Mills-Morita Bertha Morris Harold Walk October 25, 2016 Dr. Mohamed Asiad MHB Member Site Visits Transitional Age Youth (TAY) Meeting Dates Board Member Attendance October 24, 2016 Benny Benavidez MHSA Steering Committee Meeting Meeting Dates Board Member Attendance Kurt Leptich September 19, 2016 December 19, 2016 March 20, 2017 April 10, 2017 June 19, 2017 Nominating Committee* Meeting Dates Board Member Attendance October 18, 2016 Dr. Mohammed Asiad Harold Walk Kurt Leptich Performance, Achievement, Caring and Excellence (PACE) Award Meeting Dates Board Member Attendance July 6, 2016 Dr. Mohammed Asiad October 5, 2016 Kurt Leptich January 4, 2017 Pamela Mills-Morita April 5, P A G E

27 MHB COMMITTEE REPORTS Adult and Older Adult Services Committee The committee met to conduct the site visit of the department s adult service programs was conducted on October 24, Subcommittee members in attendance included Pamela Mills-Morita, Bertha Morris and Harold Walk. Dr. Mohamed Asiad conducted his site visit separately on October 25, The visit included a guided tour of the Adult Outpatient Clinics and Wellness Centers led by John Grass, Deputy Director of ICBHS. The sub-committee reviewed and received information regarding the intake process and services provided to the public. Specialty cases in forensics and conservatorship were also reviewed. They also received a schedule of activities and services provided by the Wellness Centers. Children Services Committee The committee planned to meet to conduct the annual site visit of the department s children services programs on October 24, This meeting was cancelled, with the intent to reschedule at a later date. Transitional Age Youth (TAY) Services Committee The committee met to conduct the annual site visit of the department s transitional age youth (TAY) programs was conducted on October 24, Board Chair Benny Benavidez was in attendance. The visit included a guided tour of the Youth and Young Adult Outpatient Clinic located at 1295 State Street in El Centro led by Cindy Guz, Deputy Director of ICBHS. Mr. Benavidez was surprised to discover that the services provided to this age group (14-25) includes a wide-range of programs that he did not realize were available. He did notice the quarters are tight for staff and clients at this particular location, as the department is still working on obtaining new buildings to accommodate the expansion of services. Mr. Benavidez was also provided a tour of the Equine Therapy Center (Horse Therapy) and was impressed by the center s experience in dealing with troubled youth. Board Applicant Committee This committee meets on an as needed basis to review, evaluate and make recommendations regarding MHB Applicants to the Board of Supervisors for appointment. There was no need for these committees to meet during California Mental Health Planning Council (CMHPC) Data Notebook The MHB completed the California Mental Health Planning Council s (CMHPC) 2016 Data Notebook questionnaire with reference to data from the external quality review organizations. The Data Notebook focused on children, youth and transitional age youth (TAY) programs. An Ad-Hoc Committee was formed and committee members worked closely with ICBHS staff to answer a series of questions provided by the CMHPC. The Data Notebook assisted the MHB in meeting our legal mandates to review performance data for mental health services provided by ICBHS, and report on performance and functioning as 27 P A G E

28 an educational source on behavioral health data for local boards. Finding were provided to the MHB members for review and approval for submission during the monthly MHB meeting held March 21, The finalized Data Notebook was submitted to the CMHPC on March 24, 2017 (refer to the Mental Health Board Highlights, page 19 for more details regarding the outcome of the Data Notebook). Mental Health Board Annual Report The MHB Ad Hoc Committee, along with management staff from ICBHS meets to review and complete the Annual Mental Health Board Annual Report. Finding are provided to the MHB members for review and approval for submission during the monthly MHB meeting The finalized Annual Report is presented to the Board of Supervisors and Submitted to the California Association of Local MHB and Commissions. Nominating Committee The Ad Hoc Committee met during the monthly MHB meeting held on October 18, 2016 to select the slate of officers. The committee presented their recommendations to the MHB members at the monthly MHB meeting held on November 15, 2017 at which time the Board followed the recommendation of the committee and voted the existing officers continue in their role, Benny Benavidez as Chair and Pamela Mills-Morita as Vice-Chair. Performance, Achievement, Caring and Excellence (PACE) Award The committee meets at the regularly scheduled monthly meetings one month prior to the ICBHS full staff meeting to review and approve the department s nomination. They meet again on a quarterly basis at the ICBHS Full Staff meetings to present the PACE Award to the selected recipients. 28 P A G E

29 IMPERIAL COUNTY BEHAVIORAL HEALTH SERVICES HIGHLIGHTS AND PROGRAM UPDATES The Imperial County Behavioral Health Services Strategic Plan is a collection of goals that are developed based on feedback from division retreats. Each division of the department develops its own goals in order to achieve desired outcomes for the department. The different divisions include Administration, the Center for Clinical Training, Children Services, Youth and Young Adult Services, Adult Services, and Crisis and Engagement Services. The purpose of the plan is to accomplish the following tasks: Clarify the outcomes that ICBHS wants to achieve Select strategies that will enable ICBHS to achieve those outcomes Identify ways to measure progress. The plan is established by compiling feedback and input gathered from ICBHS staff and Mental Health Board members during division retreats. Staff members and MHB members are very important in the strategic planning process because they are directly connected with the clients and community affected by and benefiting from the department s programs and services. Progress on developed goals is monitored and adjusted as needed throughout the year. Updates are provided to staff on a regular basis and accomplishments from the previous year are presented. Administration The purpose of the Administration Units is to provide administrative assistance in support of departmental operations. Goal 1: Teamwork All Access and Benefit Workers have been cross-trained and have developed electronic forms. The Accounting, Payroll and Purchasing Units have completed their crosstraining goals. Quality Management and Fiscal staff worked to update the Provider Handbook. Information Systems worked to implement OrderConnect to allow the doctors to electronically prescribe all medications including controlled substances. Information Systems and Medical Records worked to upgrade the software used to scan client documents into the Electronic Health Record (EHR). Quality Management conducted monitoring activities to ensure the department is compliant with contractual and regulatory requirements. 29 P A G E

30 Access and Quality Assurance worked closely with the Substance Abuse Disorder Clinics in the development of the Drug Medi-Cal Organized Delivery System Waiver Implementation Plan. Goal 2: Customer Service Access staff provides clients with their PIN and information to access the consumer portal MyHealthPointe. The Accounting Unit transitioned to electronic distribution of monthly financial reports. Information Systems continued to adopt new modules and technologies to allow the full transition to an EHR. Priority lists have been established and are reviewed at the clinician Workstation Steering Committee meetings. Projects and priority are discussed by management during the meetings in order to ensure that the needs of the agency are being met. Systems Technology installed computer equipment and network access to new clinics. Quality Management worked to improve access and delivery of mental health and substance abuse disorder services while assuring that services are community-based, beneficiary directed, age appropriate, culturally competent and process and outcome focused. Goal 3: Communication The Access Unit provides a quarterly training for the Universal Method to Determine Ability to Pay (UMDAP) process. The Fiscal Unit provides training to outside providers on how to enter services into the EHR. ICBHS transitioned to an environment which is hosted by Netsmart, improving security and system back up. In order to stay compliant with the HIPAA Security Rule, online trainings have been provided to staff to complete. Managed Care units began preparing for the department s triennial audit conducted by the California Department of Health Care Services (DHCS). The audit is scheduled for FY Center for Clinical Training Goal 1: Provide leadership and training to the development to partner agencies Various trainings were provided to partner agencies throughout the year to increase their knowledge and skills in mental health awareness. (refer to Appendix D) 30 P A G E

31 Collaborative efforts were initiated to increase awareness in suicide risk assessment and intervention. The first community agency to receive the two-day training of Applied Suicide Intervention Skills (ASIST) was the Calexico Unified School District. Similar plans have been initiated with other Imperial Valley school districts and county agencies. Goal 2: Enrich behavioral health awareness through outreach activities A series of events were held to commemorate Mental Health Awareness Month Initial planning, coordination, and advertising was completed for the first annual World Mental Health Day Summit scheduled for October This summit is a collaborative effort between ICBHS and Imperial Valley College (IVC). Children and Adolescents Outpatient Services Goal 1: Implementation of a Parenting Program The Incredible Years model has been implemented as an intervention to provide parenting skills to parents with school-age children diagnosed with ADHD or other mental health disorders. Through the contract with the Child Abuse Prevention (CAP) Council, a total of 70 groups have been held in the community. Through ICBHS Children and Adolescents Outpatient Services, there have been 3 groups held. Future training for the Incredible Years-Parent and Babies Program has been coordinated tor ICBHS and CAP Council staff to attend in October This will allow for the target population of this model to be expanded from 2 to 8 year olds to 0-8 year olds. A total of 30 Mental Health Rehabilitation Technicians/Specialists were trained on a parenting model designed to be used with parents or caregivers of children up to the age of 18 with special challenges. The Parents Reach, Achieve, and excel through Empowerment Strategies (PRAXES) model will be provided by trained staff to parents during home visits. Goal 2: Enhancement of Services to increase the Penetration Rate Provide a more child-friendly environment at the outpatient clinics: In May 2015 a new clinic was opened in Brawley. During the remodel, the recommendations of the committee were incorporated in the selection of the wall colors and child friendly decorations and materials. The plan is to replicate this as the department moves into new facilities. Increase child/parent engagement by providing more personalized services: A pilot program started in February 2016 by having the intake therapist contact the parent prior to the child s initial appointment to explain the intake process and answer questions. The goal in this was to de-mystify and de-stigmatize mental health treatment. Also, a total of 69 outreach efforts to schools and agencies in Imperial County were conducted reaching 911 students, parents, teachers, and community members to increase recognition of early signs of mental illness, 31 P A G E

32 access and linkage to mental health treatment, anti-stigma and antidiscrimination regarding mental illness. Become a Trauma-Informed agency: Training on trauma-informed care was provided to ICBHS staff in Consultation calls have been held with Lynne Marsenich, LCSW, trainer, to assist in structuring activities and trainings and support of becoming a Trauma-Informed System of Care Implement interventions that would target young children who were identified as having some of the lowest penetration rates Goal 3: Extend Hours of Operation Surveys were conducted during 2016 with parents during three different times of the year to obtain a good representation of clients. Surveys were conducted in different months, different cities, and targeted individuals that had missed past appointments. The goal was to determine if different office hours would increase their attendance to appointments. Results of the survey indicate that the majority of parents are satisfied with current hours of operation. Based on the results of the survey which indicate that the majority of parents are satisfied with current clinic hours and on the current show rate to appointments, Children and Adolescents Outpatient Services will continue to evaluate parents satisfaction with hours of operation and show rates to appointments. Youth and Young Adult Services Goal 1: Increase Access and Engagement for Youth in the Community A clinician has been assigned part-time to the El Centro Alternative Education School to conduct intake assessments for students. The intake assessment can be conducted at the school or the individual s place of residence. ICBHS and the Probation Department have developed joint protocols for the treatment of youth with mental health needs while in Juvenile Hall and upon discharge. This includes a Suicide Prevention Plan which provides direction to staff to identify and respond to a minor in custody who is experiencing potential for suicide behavior, onsite assessment, education and treatment. Collaboration with the local LGBT Resource Center and LGBT Coalition of the Desert including participation in and outreach during their collaborative meetings and community events. Moral Reconation Therapy (MRT) groups are conducted at two alternative education schools to assist youth in developing awareness on the impact of skillful decision making. Contracting with a Tai Chi instructor has allowed ICBHS to provide classes to minors at Juvenile Hall resulting in minors receiving physical fitness and learning relaxation, mindfulness and self-control techniques. 32 P A G E

33 Goal 2: Increase Collaboration with Community Partners to Improve Coordination of Care Monthly consultation calls with Dr. Lisa Boesky, an expert in the field of suicide prevention ensures that Suicide Prevention Plan is appropriately implemented and that staff properly trained on prevention and intervention. ICBHS and Probation staff continues to participate in monthly consultation calls. ICBHS includes the Probation Department at departmental trainings such as Applied Suicide Intervention Skills and Non-Violent Crisis Intervention to increase knowledge and understanding on proper interventions when working with youth who present problem behaviors or are at risk of suicide. Presentations about services were provided at agencies respective monthly staff meetings. This has resulted in an increase in the number of referrals to and from these community agencies. Goal 3: Become a Trauma Informed Agency Training on Trauma-Informed care was provided to ICBH staff in Consultation calls have been held with Lynne Marsenich, LCSW, trainer, to assist in structuring activities and trainings in support of becoming a Trauma-Informed System of Care. Trauma Informed care has been established as a standing agenda item on all clinician meetings with the intent of education and maintaining a focus on trauma related issues that occur during the course of treatment. Adult and Older Adult Services Goal 1: Implementation of the CBT for Anxiety Treatment Model (CBT-AT) Adult Services therapists were trained to provide this model to their clients on January CBT-AT is a therapy model used for adult clients with an anxiety related diagnosis. To date, Adult Services Therapists have provided this model to 32 clients who met the criteria at the various Adult clinics. In June 2017 a booster training was provided to the Clinicians who participated in the first training. Goal 2: Implementation of multiple strategies to reduce no shows, enhance engagement and increase productivity Individuals with intake assessment appointments are contacted by therapists prior to the appointment to reduce fears and doubts regarding mental health services, engage individuals and eliminate barriers to attending appointment. Mental Health Rehabilitation Technicians (MHRT) assigned to cases worked in collaboration with the therapist in engaging the client to services. 33 P A G E

34 Psychotherapy appointments and follow up nursing appointment no shows are contacted by assigned staff to explore barriers to attending appointments and explore strategies to alleviate these barriers. Therapists contact clients in between sessions to ask how interventions implemented in sessions have helped, follow up on questions, and remind the client of their next appointment. Nurses explore possible referrals to Mental Health Rehabilitation Services to help clients with linkage to services and mental health services that would assist client with other issues that may be contributing to their lack of compliance to our services. Goal 3: Improve the use of technology ICBHS rolled out a web based client centered services called MyHealthPointe. This service allows clients to see their appointments, prescriptions and lab results from the comfort of their home or mobile device. As of August 2017 there are a total of 118 Adult clients enrolled in this service. Goal 4: Expansion of adult and older adult services sites Adult Services has been working towards the fulfillment of plans to expand service capacity through the hiring of new Staff, expanding existing clinic sites and establishing additional clinics. A new and larger location for the Adult El Centro Anxiety and Depression Clinic opened on January 11, 2016 and the MHSA FSP/ Anxiety and Depression clinic opened in Calexico on March Goal 5: Expansion of Wellness Center services The Wellness Centers provided services to an average of 325 consumers at both sites (Brawley and El Centro) and continued to partner with outside agencies to offer consumers educational classes and pre-employment, job readiness, and employment training, as well as assist them in obtaining a high school diploma or GED. Consumers also have access to computers and the internet to aid them in completing school assignments (i.e. research, homework, and projects). The Fitness program has expanded to include a contract with 413 Gym that focuses on cardio, strength training, conditioning, and nutrition education for the male consumers Goal 6: Approval of the Drug Medi-Cal Organized Delivery System (DMC-ODS) Waiver Plan: The ICBHS Implementation Plan was approved by the Department of Health Care Services (DHCS) and CMS in April A County fiscal plan was also developed and submitted to DHCS, which includes projections of expenses, units of service, number of beneficiaries, 34 P A G E

35 revenue, and a methodology to establish interim rates for DMC-ODS services to ensure the proper balance of revenue and expenditures. Crisis and Engagement Services Goal 1: Expedite linkage of Transitional Engagement Supportive Services (TESS) clients to ICBHS outpatient clinics. An increase in positions has allowed for an expansion of services for individuals who have experienced a mental health crisis and / or are being released from the criminal justice system to access mental health services in a timely manner. This has resulted in an increase in the total number of linkages to outpatient mental health treatment evidenced by the number of individuals referred to Children Services, Youth and Young Adult Services, and Adult Services totaling 328 from July 2016 to June 30, Goal 2: Establish evidence-based practices to increase relationships with community agencies. In collaboration with the California Institute for Behavioral Health Solutions (CIBHS), ICBHS successfully facilitated two additional Crisis Intervention Team (CIT) trainings with a total of 61 participants from local law enforcement and emergency departments. ICBHS is also working in developing a Memorandum of Understanding (MOU) which is fundamental to maintain a collaborative and working relationship with law enforcement and local hospitals. Goal 3: Increase the number of beds at the crisis desk and contract with out of county hospitals. ICBHS is in the process of executing an MOU with Rady s Children Hospital San Diego (RCHSD) that will implement the New Mobile Crisis Support Team to provide interactive and mobile clinical support system under the Investment Mental Health Wellness Grant Program. (Mental Health Wellness Grant, 2016) This will involve CES nurses, clinicians, and MHRTs and MHRSs providing services in the emergency room and expedite services, while avoiding unnecessary inpatient hospitalization. This enhancement will provide CES with additional non-inpatient hospital capacity at RCHSD inpatient unit for clients in need of crisis services in periods of peak demand. 35 P A G E

36 STATISTICAL INFORMATION Statistical and demographic information about the Medi-Cal and non-medi-cal individuals served by Imperial County Behavioral Health Services are presented in pages 37 through 40. Information to be found in this section is as follows: Page 37: Provides an overview of the demographics including race/ethnicity, age, gender, spoken language and location of residence for all clients served by the MHP, as well as for Medi-Cal beneficiaries. This data includes Medi-Cal beneficiaries and Non-Medi-Cal clients Page 38: Provides an overview of the demographics including race/ethnicity, age, gender, spoken language and location of residence for Medi-Cal beneficiaries only. Page 39: Provides an overview of Outcome Measures for the MHP including inpatient admission trends, inpatient bed days and consumer satisfaction. Page 40: Provides an overview of the revenue and expenses for the MHP for FY 16/17. Definition: the term unduplicated is used to indicate that each individual is counted one time only, regardless of how many programs they have received services from or the number of episodes opened in a given period of time. In this case, the given time frame is FY 16/ P A G E

37 TOTAL CLIENTS SERVED The total number of unduplicated individuals provided services during FY 16/17 was 7,683. these clients served were Medi-Cal beneficiaries (6,759). A total of 88% of Figure 1 Percent of Total Clients Served by Race/Ethnicity White 12% Other, 1% Alaskan/ Native American, 1% Asian/ Pacific Islander 1% Black 3% Figure 2 Percent of Total Clients Served by Age % % Hispanic 82% % % Figure 3 Percent of Total Clients Served by Gender Figure 4 Percent of Total Clients Served by Language Female 47% Spanish; 36% Other / Not Reported 1% Male 53% English; 63% Figure 5 Percent of Total Clients Served by City/District District 3 Other 2% 1% Imperial 8% District 5 4% District 2 5% District 4 6% Brawley 19% El Centro 33% District 1/ Calexico 22% 37 P A G E

38 MEDI-CAL BENEFICIERIES SERVED Figure 6 Percent of Medi-Cal Beneficiaries Served by Race/Ethnicity Figure 7 Percent Medi-Cal Beneficiaries Served by Age White 11% Other 1% Alaskan/ Native American 1% Black 3% Asian/ Pacific Islander 1% % % % Hispanic 83% % Figure 8 Percent of Medi-Cal Beneficiaries Served by Gender Figure 9 - Percent of Medi-Cal Beneficiaries Served by Language Female 47% Spanish 37% Other/ Not Reported 1% Male 53% English 62% Figure 10 Percent Medi-Cal Beneficiaries Served by City/District Brawley - 20% Other - 2% District 1/ Calexico - 22% District 2-5% District 4-7% El Centro - 33% District 5-3% District 3-8% 38 P A G E

39 OUTCOME MEASURES Inpatient Admissions Trends An analysis of hospital admissions for Medi- Cal beneficiaries during calendar years 2015 and 2016 show that hospital admissions decreased by 37 individuals. The most significant decreases were in March, April, November and December of The month of January showed the greatest increase in Admissions Jan Feb Mar Apr May June July Aug Sept Oct Nov Dec Number of Admissions = Number of Admissions = 117 Inpatient Bed Days An analysis of inpatient bed days for Medi- Cal beneficiaries during calendar years 2015 and 2016 show that bed days were higher in January and again during September and November There were 208 more bed days in 2015 than in The average number of days per admission in 2015 was 7.2 days compared to 7.8 days in There was an increase of.6 bed days per individual in Bed Days Jan Feb Mar Apr May June July Aug Sept Oct Nov Dec Number of Bed Days = Number of Bed Days = FY Consumer Satisfaction During FY 16-17, the MHP replaced the Consumer Satisfaction Survey with the Statewide Consumer Perception Survey (CPS). The CPS is conducted twice a year. The MHP administered the CPS during Fall 2016 and Spring Ad of the date of this report the data from these survey periods have not been made available by the California Institute for Behavioral Solutions (CIBHS). 39 P A G E

40 REVENUE SOURCES FY 16/ % 1.15% 3.90% 6.77% 13.77% 27.13% Federal Medi-Cal State Aid - MHSA Prop. 63 Reim for Services Provided Federal Medi-Cal $19,346, State Aid/MHSA $16,418, Reim/Services Provided $13,848, BH Subaccount $9,816, State/Realignment $4,825, BH Subaccount State Aid/OCJP $2,782, % 23.03% State Aid- Realignment State Aid OCJP FFP-MHP Admin. Other Behavioral Health FFP-MHP Admin. $3,433, Other Behavioral Health $817, Total $71,288, EXPENSES FY 16/ % 1.07% 3.86% 6.66% 0.44% 1.38% Salaries & Benefits Professional Servcices General Expenses Salaries & Benefits $32,251, Professional Services $19,760, General Expenses $4,093, Rent & Utilities $2,368, Travel & Training $658, Rent & Utilities Intra/Inter Transfers $1,172, Travel & Training Communication $270, Equipment $850, Intra/Inter Transfers Total $61,424, % 52.51% Communication Equipment 40 P A G E

41 MENTAL HEALTH BOARD GOALS FOR FY 17/18 During the coming year, the Board will continue to raise awareness surrounding the role of the Mental Health Board to meet the following goals: Act as a forum for consumers, families and other stakeholders about the needs and services for the mentally ill in Imperial County by scheduling MHB meetings in communities throughout Imperial County. Review and evaluate information about the delivery of care provided by Imperial County Behavioral Health Services for the mentally ill to ensure services are efficiently and effectively delivered and are accessible individuals throughout Imperial County. Continue to provide input to the Director and Mental Health staff for planning programs, contracts and budgets prior to final decisions. Continue to make specific recommendations to assist the Board of Supervisors to make decisions concerning mental health services. Continue to provide to the Board of Supervisors an annual report about the mental health program. Continue to provide opportunities for board members to expand their knowledge and expertise related to mental health through participation in conferences, trainings, department retreats, and site visitations. Identify and participate in Board development and trainings offered by the California Institute of Mental Health (CIMH). The Mental Health Board would like to thank the Imperial County Behavioral Health Services staff for their dedication and hard work over the past year. RECOMMENDATIONS TO THE BOARD OF SUPERVISORS Based on data gathered from meetings, presentations and site visits during FY , the MHB recommends the following initiatives in order to enhance the continuum of care for mental health services in Imperial County: Expansion of Substance Use Disorders (SUD) Services Establishment of residential services and Sober Living facilities Continuation of essential trainings to improve collaboration and treatment services 41 P A G E

42 APPENDIX A EVIDENCE-BASED TREATMENT PRACTICES & OUTCOME EVALUATION TOOL DESCRIPTIONS AND UPDATES Treatment Model ( * ) Model Introduced FY Children 0-12 years Age Served by TX Model YAYA years Adults 26 + years CES See Supervisor District Map Page 4 Supervisor District Focus of Treatment ADHD Multimodal Treatment X ADHD X X X X X Aggression Replacement Training Disruptive X X (ART) Behaviors X X X X X The Behavior Code X Behavior X X X X X Cognitive Behavioral Therapy Depression X X X (CBT) and Behavior X X X X X Cognitive Behavioral Therapy for Anxiety and X Anxiety (CBT-AT) * Behavior X X X X X Cognitive Behavioral Therapy for Depression X Depression (CBT-DT) X X X X X Cognitive Processing Therapy PTSD X X (CPT) X X X X X Coping Cat X Anxiety X X X X X First Steps to Success (FSS) X Behavior X X X Functional Family Therapy (FFT) X X Family Relationships X X X X X Incredible Years X Parenting X X X X X Interpersonal Psycho-Therapy (IPT) X X X Depression X X X X X Moral Reconation Therapy (MRT) X X X Behavior X X X X X Motivational Interviewing X X X Engagement X X X X X Portland Identification and Early Intervention (PIER) Model X X Psychosis X X X X X Parents Reach, Achieve, excel Through Empowerment Strategies (PRAXES) * X Parenting X X X X X Trauma-Focused Cognitive PTSD/ X X Behavioral Therapy (TF-CBT) Depression X X X X X Cognitive Behavioral Therapy for Anxiety (CBT-AT) CBT-AT helps clients modify dysfunctional beliefs that help improve their overall mood and behaviors. It also involves a cognitive conceptualization of the disorder and of the particular client. CBT-AT uses a variety of helpful techniques and strategies to challenge unhelpful patterns of thinking that trigger or increase anxiety related symptoms. Parents Reach, Achieve, and excel through Empowerment Strategies (PRAXES) PRAXES is a parenting model designed to be used with parents or caregivers of children up to the age of 18 with special challenges. These interventions are provided individually to parents during home visits. 42 P A G E

43 APPENDIX B IMPERIAL COUNTY MENTAL HEALTH POPULATION The number of individuals who suffer from Mental Illness represented in the charts below is based on the National Alliance on Mental Health (NAMI) Mental Health by Numbers Statistical Data, which states that approximately 1 in 5 adults in the U.S million or 18.5% - experiences mental illness in a given year. The number of total Medi-Cal Beneficiaries for Imperial County is just under 50% based on the Department of Health Care Services Medi-Cal Quick Stats. During FY , ICBHS served a total of 7,683 clients, representing 23% of the total population of individuals who statistically suffer from Mental Illness in Imperial County. Of the 7,683 clients served, 6,759 were Medi-Cal beneficiaries, representing 41% of the Medi-Cal beneficiaries in Imperial County who statistically suffer from mental illness. Total Clients Served Total Population of Imperial County (180,191) Potential Clients and Number Served FY (23%) Total Population of Individuals who suffer from Mental Illness in Imperial County (33,335) Total Clients Served for FY (7,683) Medi-Cal Clients Served Number of Medi-Cal Beneficiaries in Imperial County (90,096) Potential Medi-Cal Clients and Number Served FY (41%) Number of Medi-Cal Beneficiaries that suffer from Mental Illness (16,668) Total Number of Medi- Cal Cleints Served FY (6,759) 43 P A G E

44 APPENDIX C 44 P A G E

45 APPENDIX C 45 P A G E

46 APPENDIX C 46 P A G E

47 APPENDIX C 47 P A G E