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HomeMy WebLinkAbout2021-03-02 BHAC MINUTES1 Behavioral Health Advisory Committee (Mental Health-Substance Use Disorders) Minutes March 2, 2021 3:00-5:00 PM FINAL I. Call to Order/ Introductions Board Members: X Heidi Eisenhour-Chair ABSENT- EXCUSED Ariel Speser—Vice Chair X Patricia Beathard X David Fortino X Patrick Johnson X Sheila Westerman ABSENT- EXCUSED Anne Dean X Chris Ashcraft ABSENT- EXCUSED Jill Buhler-Rienstra Staff: Vicki Kirkpatrick, Anna Mc Enery, Yuko Umeda Guests: Jolene Krone, Lori Fleming, Lily Haight, Joe Nole, Leah Russell, Richard Davies, Jud Haynes, Veronica Shaw, Whitney Friddle, Troy Surber, Lisa Thomas, Tanya Barnett, Brian Gleason, James Kennedy, Amanda Tjemsland, Heather McRae- Wolf, Gabbie Caudill, Brian Richardson, Denise Banker II. Approval and/or modification of the draft Agenda of May 4, 2021/(Enclosure) Staff Mc Enery noted a modification for DBH listed under Vendor Reports. This reports will be moved to the May meeting because Jim Novelli is unable to attend. Member Fortino (M)/Member Westerman (S)/ Approved with noted modification. Review/Adoption of Draft Minutes of November 10, 2020, Special December 29, 2020 Member Fortino (M)/Member Westerman (S)/ Approved with no changes. III. Public Comments Richard Davies, Public Defender, and member of the Drug Court team thanked the Committee for an opportunity to speak and express his thoughts. In 2017, Drug Court admitted 33 individuals and in 2018, Drug Court admitted 37 individuals. Admissions to Drug Court, have declined to 13 in 2019 and to ten in 2020. At present, there are only 15 individuals in Drug Court and that will be reduced to 9 or 10 because of the recent WA State Supreme Court decision. Mr. Davies is hoping for an opportunity to “tune-up” the Jefferson County Drug Court Policy Manual that was written in 2003, by implementing objective evidence- based practices. Mr. Davies believes that the current admission criteria is too subjective and ends up excluding the high risk, high need clients that would benefit most from Drug Court. He also believes it is a missed opportunity for clients’ families and for our community. 2 Mr. Davies believes a comprehensive review of the Jefferson County Drug Court Program is needed. To get the ball rolling, he has reached out the National Association of Drug Court Professionals (NADCP), to provide Zoom technical assistance and training. NADCP training and assistance is free; they are willing to help reevaluate our Drug Court Manual and admission procedures. Mr. Davies is asking the BHAC for support to help achieve an evidence-based Drug Court program, by encouraging others on the team to buy into this review. Mr. Davies asked the BHAC to please add a Drug Court update to the next meeting agenda. Prosecutor James Kennedy noted that the Drug Court Manual is going to be discussed at the Drug Court team meeting tomorrow. Mr. Davies explained that the original Manual was drafted in 2003, which is almost twenty years ago. A lot of work has been done in the way of evidence-based practices for Drug Courts. Mr. Davies said that he and Prosecutor Kennedy have developed some amendments, but he realized they need assistance in putting together a Drug Court Program that is evidence-based. Patrick Johnson expressed his support of the Drug Court Program and that it should be directed at high-risk users. He said would like to see the BHAC endorse an invitation to NADCP to assist the local Drug Court. Staff Vicki Kirkpatrick added that she had gone through a NADCP review process when she worked in Mason County. NADCP’s advice helped to improve Drug Court standards, so that they could maintain fidelity. Member Sheila Westerman expressed support and great interest in having the Drug Court issue be put on the BHAC May agenda. However, she expressed concern that the time between this meeting and the May meeting, may be too long to wait for forward momentum. Guest Joe Nole asked how the new law regarding drug possession will impact the numbers in Drug Court and the ability to get an individual into Drug Court. Prosecutor Kennedy explained that the law will impact the numbers initially, an individual does not have to be a possession of drugs to get in to Drug Court. But, they do need to have a drug problem; a diagnosable substance abuse disorder and there needs to be a nexus to the crime that is committed. Guest Lori Fleming shared that the Behavioral Health Consortium is focused on improving and developing the Behavioral Health system. She would like the Drug Court team to feel welcome to that table; for assistance and support. A motion was made that the BHAC endorse the Drug Court team to invite NADCP to be involved in updating the Jefferson County Drug Court Manual and assist in creating an evidence-based Drug Court Program. Commissioner Eisenhour/(M), Member Westerman/(S), and the motion passed with unanimous approval. 3 IV. BUDGET Staff Veronica Shaw explained the 2021 Budget Tracking Spreadsheet & Sales Tax Projection. Highlights:  The carry-over into 2021 is $532,944.  Actual expenditures in January were $54,532, pending a few invoices.  Revenue for January was a 3.25% increase to original budget.  Reserves are 10% of the total revenue budget.  The Committee decided there needed to be an additional Emergency Fund reserve of $50,000.  The Emergency Fund reserve was reduced this year, for additional school based mental health services, under MCS Counseling.  Considering COVID, sales tax revenue is doing quite well. V. VENDOR REPORTS OlyCAP/Transitional Housing Leah Russell reported that she has been managing the OlyCAP Transitional Housing Cabins for two years. There are eight-two bedroom cabins, that are available as emergency housing to single adults and families who are clean and sober. The cabins are for homeless; people funded by 1/10th of 1% grant and people who are the most vulnerable. Most referrals come from therapeutic courts, Department of Corrections and IOP programs. Housing is also prioritized for people fleeing domestic violence and receiving mental health services. OlyCAP is the continuum of care agency for Jefferson County. Individuals in need of housing can go through OlyCAP to determine eligibility. They are assigned a cabin and a case manager who works with them to create a stability plan. The individual focuses on staying sober and staying in compliance with other programs they are involved with. The goal is to get them into stable employment and stable housing. Case Management programs at OlyCAP: Foundational Community Support Program is through Amerigroup. It provides intensive case management for complex needs. There is no funding for this program but can be funded through partnering. Housing and Recovery through Peer Services is a program for participants who get a letter from their substance abuse/mental health counselor stating that they need housing; the program can provide short term and long-term rental assistance. The Crossroads Program –helps families who have been homeless for at least a year, have someone in the household with a disability, and/or a substance use disorder. This program can find housing for up to two years. The Youth Homeless Demonstration Program – which provides housing for young adults 18-24 4 An increased need has occurred in families with children. Twelve households have maintained employment during COVID and three households with children have gained subsidized housing. Some goals Leah Russell is working on for the Transitional Housing Program:  To begin a rental fee for residents who are employed. This could allow opportunities for tenants to make them feel like the space is “theirs”.  Begin designating houses specifically for the Therapeutic Courts, thus allowing the Courts to make direct referrals into the Cabins themselves.  Updating rules, policies, and procedures to reflect the changes from the last year. Member Johnson asked if there were any disqualifying issues for applicants to get into housing at the Cabins? Leah responded that any violent charges in the last two years would disqualify them. However, she would advocate with the Prosecutor for the client in Therapeutic Courts. Member Westerman asked what happens when a family reaches the 2-year cut off without securing housing. Leah said that, fortunately, this has not happened yet. She went on to explain that the technical rule for being homeless is under two years, so if a household reaches the two-year mark, they are no longer eligible for the services provided through this program. VI. PRESENTATIONS a. Update- Washington State Residential Substance Abuse Treatment (RSAT) Jail-Based Program and Aftercare Services for Jefferson County David Fortino reported that they have started the Residential Substance Abuse Treatment, (RSAT) program at the Jail. They have had two weeks of services and presently there ten males and two females in the program. Generally, RSAT will max out at ten, but due to delays in getting the program started, the State has made extra funds available for the program. Staff Mc Enery asked how RSAT is being separated out in the Jail. David Fortino explained that this is a challenge right now. Ideally, they would have the inmates participating in RSAT, separated in another cell block. But, since the County moved to Phase II, booking restrictions have been lifted and they are housing 20 to 25 inmates now. The RSAT program is held 5 days a week, approximately 40 hours a week and is currently being held in the indoor recreation area. The scheduling of all Jail program needs – court, etc., means RSAT does not a set schedule of Monday through Frida, from 8-5. But, they are working to meet the hours. When an inmate leaves, they will participate in the aftercare services part of RSAT. 5 Gabbie Caudill explained that there is a Case Manager who will be working with each individual after they are no longer incarcerated; the Case Manager will manage transportation and any other after care services they need. Sheriff Nole shared that initially, he thought the new Navigator could support the inmates at the Jail, but they will already have their own Case Manager through the RSAT Jail program. Member Westerman asked about the eligibility criteria for the Jail RSAT program. David Fortino explained that a risk needs assessment is given, space availability is looked at and then Jail management also looks at eligibility. b. One-Tenth Online (OTO) Data Platform Update Amanda Tjemsland, Kitsap County Epidemiologist, shared the Kitsap County online platform, that can be used for annual reports and other tools. The hope is to create County specific data, to show the community how the 1/10th of 1% funding is being expended. Amanda and Staff Mc Enery have started the evaluation meetings with the Vendors and Staff invited Commissioner Eisenhour to participate. Commissioner Eisenhour noted there’s a difference and some variance among the Vendors, when answering the questions about the data evaluation tools. It’s important to get feedback from Vendors. This will help to inform the Committee about next steps and improvements that can be made going forward. Staff Mc Enery noted a question that came up for her when meeting with the Vendors. How can we create and support more trauma informed spaces for our agencies and community? Staff Mc Enery reached out to Minnie Whalen, the Director of the Clallam Resistance Project to investigate this matter further. The Clallam Resistance Project said they are willing to support trauma informed education for our Vendors. Staff Mc Enery will follow up with the Committee. Amanda has suggested that she could take data from the 2019 Annual Report for Jefferson County and add that to the dashboard to share at future meeting. This would help the Committee see what the dashboard could look like and might help inform additional needs. c. Medicaid vs. Medicare/What is Funded for People on Medicare/What is no longer being funded since MCO’s took over/ Jolene Kron- Deputy Administrator/Clinical Director Salish BH-ASO Jolene Kron shared that in January 2021, Behavioral Health Organizations transitioned and no longer provided the full spectrum of care. Now, their primary scope only includes Medicaid coverage in some crisis situations. Jolene explained that Medicare is for older adults and for individuals under the age of 19, who became disabled and have conditions that would allow them to have coverage under their parents’ employment history. Medicaid is a needs- based program, that covers individuals based solely on financial eligibility and resources. 6 When the January 2021 transition happened for Medicaid, it covered individuals going under Managed Care Organizations, (MCO’s). There were significant changes made to non-Medicaid services. Gaps created by the change to Managed Care:  BH-ASO, as the funder for non-Medicaid services for mental health outpatient services across the region, was no longer able to provide those services. This happened in the fall of 2020.  As of January 2021, further reductions saw impacts in residential funding, withdrawal management, and long-term residential programs no longer being funded. Jolene shared the possibility, that due to COVID there may be additional funds for some of the programs; perhaps an RFP in the spring. Patrick Johnson asked what motivated the state to go the MCO route? Jolene answered that four or five plans in Washington State are for profit. Managed Care has been a move nationally. The idea is consistency in care and healthcare savings. Staff Vicki Kirkpatrick added that part of Healthcare Reform created the Regional Communities of Health. Part of their goal was to integrate Managed Care, by bringing together substance use disorders, mental health and physical health. The thinking is, it doesn’t make sense to separate the head from the rest of the body. d. Update-Status of the New Navigator Position & RFP /Sheriff Nole Sheriff Nole said that the RFP has been emailed out and a notice will go into the PDN tomorrow. All responses are due back by March 15th. Staff Mc Enery noted that she had talked with the RFP Panel of the BHAC; members; they would be interested in helping the Sheriff’s Office review and evaluate the Navigator proposals. Commissioner Eisenhour recommended that a Mental Health Professional be a part of the RFP Review team as well. VII. STAFF UPDATES/ a. Update about WA State’s Proposal to Regionalize Local Public Health Districts-Vicki Kirkpatrick 1. Comprehensive Public Health Districts, replacing current Local Health Jurisdictions through creation of: HB 1152 Staff Kirkpatrick shared legislation from the Governor that arose out of the COVID response. The legislation proposes eliminating local Health Departments that have a minimum population of 250,000 and creating Regional Health Departments. In essence, it will take local control from County Boards of Health and create Regional Boards. 7 The initial legislation has already gone through some significant changes. Right now, local Health Departments have not been eliminated, but it adds a new layer of very costly Regional Public Health Districts. Our local Commissioner, Kate Dean and Public Health Officer, Tom Locke are on a group that represents many organizations in both Jefferson and Clallam Counties. The work is focusing on legislation that it does not take away local control. Vicki said this is a work in progress and we should expect change that will potentially impact the future of local Public Health. But, it will be better than what was suggested in the initial legislation. Public Health Departments want to review what transpired during the COVID response. To look at what worked, what didn’t work and determine where there were gaps; so there can be a more holistic approach in the case of a future pandemic. VIII. Public Comments-There were no public comments. IX. Adjournment of Meeting 5 pm Future Agenda Items: I. Law Enforcement Assisted Diversion (LEAD) Workshop Update/Ariel Speser & Anna Mc Enery II. Update- New Navigator Position with the Sheriff’s Office III. Update Mental Health Field Response Team Meetings IV. Washington State Residential Substance Abuse Treatment (RSAT) Jail-Based Program and Aftercare Services Grant for Jefferson County - /David Fortino V. DBH/ New 1/10th of 1% Funded Service called Wrap Around Case Manager for clients with Medicare or who are Uninsured/Jim Novelli-Executive Director The Service was recently awarded 1/10th of 1% funding Below is a quote from their recent RFP.  “DBH seeks to provide access to mental health services to individuals not funded by Medicare, private insurers and those who are uninsured. Our proposal outlines the gap in coverage for these services. We will be utilizing a wrap- around approach for services billed as a case rate per month per individual. This project will target those individuals who are generally high utilizers of services. The 1/10th of 1% funds would assist in reducing the gap in coverage.” Next BH Advisory Committee MTG- Tuesday May 4, 2021