HomeMy WebLinkAbout2021-11-09 BHAC MINUTES1
Behavioral Health Advisory Committee
(Mental Health-Substance Use Disorders)
MINUTES
November 9, 2021
3:00-5:00 PM
FINAL
I. Call to Order/ Introductions
_X__ Heidi Eisenhour-Chair
_X__ Ariel Speser-Vice Chair
_X__ Chris Ashcraft
_X _ Patricia Beathard
_X__ Jill Buhler-Rienstra
_X__ Anne Dean
_X__ David Fortino
_X__ Patrick Johnson
Excused - Sheila Westerman
Staff: Anna Mc Enery & Veronica Shaw
Guests: Whitney Friddle, Heather McRaey-Woolf, Lori Fleming, Joe Nole, Pam
Gozora, Mike Schleckser, Brian Richardson, Gabby Caudill, Kimberly Gorman,
Amanda Tjemsland, Ciela Meyer, Tanya Barnett, Jean Scarborough
II. Approval and/or modification of the draft Agenda of November 9,
2021/(Enclosure) Member Speser(M), Member Johnson (S), Approved
unanimously
III. Review/Adoption of draft Minutes of September 7, 2021 & October 28, 2021
Member Buhler-Rienstra (M), Member Fortino (S), Adopted unanimously
IV. Public Comments
None
V. BUDGET/ Veronica Shaw
a. 2021 Budget Tracking Spreadsheet & Sales Tax Projection
Good news, the revenue continues to come in higher than anticipated. At end of
October the number was $585,000 against the projected number of $383,000.
That was $103,000 over what was anticipated in sales tax.
There are some Vendors who will not spend all that was awarded to them.
Staff Shaw reported that the committee recently agreed to award mental health
funds to each School District. Commissioner Eisenhour explained that there was a
gap in the contract for School-based Mental Health Services; so the committee
voted to provide some interim funding to the schools.
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Staff Shaw reported that she had been informed by Anna Mc Enery that contracts
would be in place shortly.
Expenditures are at currently 61% of the total budget
At the end of December, if everything goes as planned, cash on hand will be at
$535,681.
Member Patrick Johnson asked what the parameters of the reserve account are.
Staff Shaw reported that the actual reserve has to be 10% of the total revenue. If
November and December come in as anticipated we will most likely see the
reserve go up to $69,000.
VI. Presentations-UPDATES
a. 1/10th of 1% Evaluation Report- 2020/Amanda Tjemsland/Kitsap County
Epidemiologist
Amanda Tjemsland shared the1/10th of 1% report on the screen and gave an
overview and explanation of what was shown in the report:
The first few pages were an overview of the entire County. A note about the
impact of COVID on the numbers for 2020 was added as an explainer.
A count of individuals served by each program was given and then overall
numbers.
A map showing which zip codes had the most served.
Budgets for each of the programs.
Summaries of each of the programs taking information from the written responses
and outlining numbers served and successes for 2020.
Each program has a page dedicated to their program.
All of the school districts have a combined page for mental health services as well
as Therapeutic Courts having a combined page.
Overall, Amanda Tjemsland reported that most programs saw a decrease in the
numbers of individuals served, most likely due to COVID and their access to
programs.
Commissioner Eisenhour noted that it seems the numbers of programs offered have
actually increased significantly in the past few years. Staff McEnery responded that
this is true, and it is due to so many agencies and programs really stepping up in the
past few years.
The report shows the most served zip codes are around Port Townsend; 98368 and
98339. It also showed that about 14% of the people served have reported being
homeless at some point during their services.
Member Johnson asked if the most served zip codes could be pulled by ages, to
reflect more accurately the actual users, as Port Townsend has a higher aging
population, if just looking at the population numbers. Amanda Tjemsland responded
that perhaps showing population percentages by age, per zip code could be helpful.
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Member Trish Beathard noted that it might also be important to consider poverty
levels which may skew the statistics as well. The intention, she said, is not to increase
workload, but if there were a way to show this easily it could be helpful in analysis.
Amanda Tjemsland shared that when providing data about schools, she looks at the
size of the school, compares it to how many are being served and then shows the
percentage. It would be possible to do something like that for the 1/10th data.
Summaries by Program:
Jumping Mouse:
They transitioned to telehealth at the end of 2020, but in March they started to see a
select group of clients in person. Jumping Mouse had a decrease in kids and
caregivers served, so the data shows a decrease in the average number of sessions per
quarter.
In 2020, Jumping Mouse noted that 86% of the children served, either completed or
continued their services. This statistic has remained consistent, as they don't have
many children drop out of services.
Jumping Mouse Brinnon:
They transitioned to telehealth, but the Brinnon School District was able to provide
outdoor facilities. So, Jumping Mouse was able to provide some in- person services
and saw an increase in kids and caregivers served. The Jumping Mouse Program at
BSD started small, but they're growing each year.
In 2020, Jumping Mouse noted that 100% of the children served at the Brinnon
School District, either completed or continued their services.
Nurse Family Partnership:
Services were able to transition to telehealth. But this transition made it more difficult
to discuss more sensitive issues like ACES. (A number of programs were unable to
collect ACES and more sensitive information for their evaluations this year.) Overall,
the pandemic led to a decrease in referrals to the program.
However, in 2020 100% of families who no longer needed services completed the
program, there was no dropping out.
School-based Mental Health Services:
School-based Mental Health Services also transitioned to a virtual format and the
2019/2020 and the 2020/2021 school years were impacted. For the 2020/2021 school
year, the number of students accessing services decreased at Chimacum, Port
Townsend and Quilcene Districts, but increased at Brinnon.
As schools began to open up in 2021, the average number of visits were shown to
increase too, as March and June had the highest number of visits. Services are picking
back up, which is great.
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Recovery Café:
Due to the pandemic, construction was delayed for the Recovery Café, but they began
to provide virtual check-ins and virtual trainings with their members. They did face
barriers when trying to reach individuals without access to Wi-Fi. Amanda Tjemsland
noted that she continually saw this trend when individuals served didn’t have access
to the internet. Trying to reach individuals during the pandemic became difficult. This
difficulty, was written more in the responses than specific numbers, but this was a
recurring issue and it was seen particularly in the Courts.
In 2020, the Recovery Cafe begin accepting members when they opened to the
public, and in its first year 31 members joined. The number of recovery circles held in
2020, was six times the number held in 2018.
Behavioral Health Court:
The Behavioral Health Court also transitioned to a virtual platform and struggled to
reach participants without access to Wi-Fi. Amanda Tjemsland said the Court
increased the number of times they would reach out to participants. In 2020, the
Behavioral Health Court had an increase in individuals served from 26 to 29, and they
graduated six of their participants.
Jail Assessment Program:
Amanda Tjemsland reported, due to the pandemic, the jail implemented restrictions to
limit inmate exposure to the virus. This limited the program's ability to access and
coordinate inmates. Consequently, this led to a decrease in the average number of
assessments completed and the number of individuals served. However, Amanda
pointed out, 100% of the clients referred to outpatient and medically assisted
treatment attended.
Gabby Caudill requested that the numbers from the Jail for 2016, 2017 and 2018 be
revisited because there seem to be some inaccuracies. Amanda Tjemsland said she
would look into it.
Drug Court Program:
Amanda Tjemsland reported that Drug Court also transitioned to telehealth and
provided Court via Zoom. Some participants did choose to remain in Drug Court
until they could participate in an in-person graduation. As a result, this extended the
amount of time people participated in Drug Court and there was a decrease in the
number of actual individuals served. Even so, in 2020, 15 Drug Court participants
graduated.
Family Therapeutic Court:
Family Therapeutic Court also transitioned to telehealth and provided Court via
Zoom. There was an increase in number of individuals served, and Tjemsland
reported that this number has remained consistent over the past five years. In 2020
100% of those participating graduated.
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Police Navigator Program:
Amanda Tjemsland reported that this program was able to continue to work with the
police department, despite the pandemic. This is the second year of the program and
the number of contacts increased dramatically, from 62 to 289.
Functional Family Therapy and Juvenile Family Court:
Due to schools transitioning to the virtual format, Amanda Tjemsland said there were
no truancy referrals, and as a result there were very limited referrals to this court.
Tjemsland reported that they were able to transition to telehealth, but because of the
lack of referrals, they started to reach out to former clients to see if they needed
additional help during this time. They saw a decrease in their clients, but were still
able to graduate 75% of their participants within 12 sessions, which is their goal.
Discovery Behavioral Health – Transitional Housing Program:
Unfortunately, Tjemsland said, due to the Pandemic the individuals in this program
transitioned to having weekly phone calls with their case managers and it was noted
that this transition made it more difficult for them to discuss sensitive issues with
their clients. The pandemic exacerbated existing problems and their clients
experienced more relapses than they normally have had in the past. In 2020 the
number of individuals served by this program decreased, but of those who were
discharged 67% were leaving to permanent housing.
OlyCAP Housing Program:
This program was forced to transition to a more limited intake and case management
format to reduce in their in-person contact. Amanda Tjemsland shared that prior to
the eviction moratorium, OlyCAP was going to initiate a rental payment program
where clients were going to pay 30% of their income to rent, but that was put on hold
with the eviction moratorium. In 2020, the number of individuals served decreased
slightly, but of those discharged, 55% went to permanent housing.
Amanda Tjemsland asked if there were questions or additional information anyone
would like from the report.
Staff Mc Enery said that she was curious about the numbers for the Navigator
program and asked Jud Haynes for some feedback. She noted the Navigator had 62
contacts in 2019 but then it went up to 289 in 2020.
Jud Haynes responded that it did start off slowly in 2019 because the official start was
not until April or May. By the time 2020 came along, things were rolling. He was not
only contacting unsheltered individuals, but also doing a lot of co-response work with
people in housing or apartments. Haynes said that initially the idea was to work with
unsheltered individuals, but the work has actually shifted to people where housing
isn't the issue, other behavioral health related issues are.
Jud Haynes said that he isn’t carrying a caseload of 150 people. He currently has
frequent contact with eight or nine individuals on a weekly basis; so that's
manageable.
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Member Patrick Johnson noted that the self-referral number is high for the job and
asked Haynes if he might elaborate. Jud explained, when he or an officer provide his
contact information, those individuals are just calling him directly, instead of going
through dispatch. Sheriff Nole said that from his standpoint, self-referrals are a large
part of a successful Navigator program. This frees up deputies or police officers and
those individuals get to talk to someone who has more expertise in that area.
Amanda Tjemsland asked that feedback be emailed to her. She also requested, if
anyone has additional data needs or ideas for other ways to present this information in
a future report, to send feedback.
Staff Mc Enery said that the version of the report that was presented today, will be
sent to everyone following the meeting, along with all summaries.
b. 1/10th of 1% Funding/School-based Mental Health Services 2021/2023
Commissioner Eisenhour, Anna Mc Enery & Ciela Meyer, MA – OESD
Behavioral Health Coordinator
Staff Mc Enery shared the news that OESD #114 (Olympic Educational Service
District) has been contracted to provide services for school-based mental health
services for all four of our schools.
Staff Mc Enery explained that the rate for counselors has increased, which we
understand and support. This Committee approved a budget of $167,246 for school
based mental health counseling for a two-year period for all four school districts. Due
to the higher pay rate per counselor, we need an additional $31,892 for the two year
period, bringing the total to $199,138. (That amount does not include the 1/10th
emergency reserve funding, which was accessed to provide counseling services for
each school district in the interim.)
In 2021/2022, we will be able to provide counseling days as follows: one day in
Brinnon, one day in Quilcene, two days in Chimacum, and two days in Port
Townsend. However, Staff Mc Enery noted, because the daily counseling rate and
clinical oversight rate is almost double what it was, in 2022/2023, we will only be
able to provide one day of counseling per week, per school. That means Chimacum
and Port Townsend will go from two days a week to one day per week.
Staff Mc Enery noted, if there is additional tax dollars in the future, we can revisit the
funding because it is a two-year contract. But, she cautioned the need to look at
funding equity across all of the Vendors and noted we are spending a total of
$219,000 for the two-year period on school-based mental health.
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Staff Mc Enery introduced Ciela Meyer who comes to us from OESD #114 (Olympic
Educational Service District) as a Behavioral Health Coordinator. In her role, Ciela is
a liaison with school districts and supports increased access to behavioral
health/counseling services. Ciela’s position is mandated through the legislature.
Ciela Meyer expressed her appreciation to the Committee. She reported that now that
students are back in school, she is seeing increased behavioral health needs and
behaviors that need to be addressed because students have been in isolation or in
semi-isolation for a period of months. She anticipates this will also be seen in the
larger community.
Ciela went on to say, based on the level of need for behavioral health services, in our
state and across the nation, the ability to fill counseling positions is getting more
challenging. Counseling staff are able to ask for higher rates or are choosing to do
private or individual therapy. Consequently, the OESD is choosing to work with MCS
to maintain the counselors that are in place. If the OESD is not able to fill a position,
they are open to working with other agencies and will reach out to other individual
licensed mental health providers.
At the present time, the OESD #114 is required to work with and receive supervision
from a licensed facility because they aren’t currently licensed as a mental health
treatment provider. There are other OESD’s in the state that are licensed and that's
something that OESD #114 is looking into for the future.
Commissioner Eisenhour added that a goal of getting OESD #114 involved was to
have them manage these contracts and provide stability to our school districts.
Commissioner Eisenhour noted that OESD already works with our districts every
day, they know them; so it feels like a more thoughtful, holistic approach to providing
these behavioral health services.
Commissioner Eisenhour expressed her appreciation for Staff Mc Enery's leadership,
her steadiness as a staff to this Committee and for working on these issues. Also, she
thanked Kristin Schutte and Ciela Meyer from the OESD #114, for stepping up and
working through the process in a very compassionate way.
Staff Mc Enery shared that the OESD #114 provides a similar service with the 1/10 of
1% funding for all Kitsap school districts.
The request for the additional funding for school-based mental health services was
defined again at the request of Commissioner Eisenhour by Staff Mc Enery.
Staff Mc Enery stated, due to the increase of counseling rates, an additional amount
of $31,892 of 1/10 of 1 % funds would need to be approved and voted on by this
committee, for school-based mental health services. The original approved amount
was $167,246; the new request is for a total of $199,138, for the years of 2021 to
2023. Commissioner Eisenhour asked for the motion. Member Johnson (M) to
approve the additional funding and Member Buhler-Rienstra (S) to approve. The
Motion passed unanimously.
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VII. VENDOR REPORTS/ 25 Minutes
a. Jumping Mouse/ Brinnon School District-Mental Health Program-
(Imbedded Model)
Kimberly Gorman, the new Executive Director for Jumping Mouse introduced herself
and shared that she has been at Jumping Mouse for the last three months. She was in
in education for 20 years before that. Gorman said, as an educator looking at school-
based programs, she feels it is significant to see what Jumping Mouse is doing.
Gorman sees the ripple effect of not only serving a child, but serving their family and
then the whole community. She pointed out that the educators in Brinnon, the
paraprofessionals, the teachers, are all involved in helping the kiddos as well. It's a
holistic approach; she is honored to have been a part of for the last three months and
hopefully for a very, very long time.
Jean Scarboro, the Clinical Director for Jumping Mouse, shared about the Jumping
Mouse program in the Brinnon schools. It’s their fourth year of working in the
Brinnon School. This program was actually initiated by Staff McEnery and this
Committee, who came to Jumping Mouse in 2018, with possible funding and a
request to serve the Brinnon School District. The same therapist has been working at
the Brinnon School for four years, working with eight students. Additionally, they
provide groups for teachers and paraprofessionals; this program has been incredibly
well received and valued by participating school staff.
Jean shared that the Jumping Mouse program at the Brinnon School, is always a work
in progress. They have been trying to provide a trauma informed perspective to
support kids at school, who might be showing up with symptoms of trauma, which
can look like so many different things. Jean said it’s an ongoing conversation on how
to create space, in order to support and to understand each child individually.
Jean shared a very difficult and meaningful story of a young child she had worked
with in therapy at Jumping Mouse. After she had shared the story of this child, she
reminded the Committee that childhood trauma can be such a dehumanizing and
devaluing experience. Jean went on to express her gratitude for Jumping Mouse,
where the whole model is to really value the full humanity of each child they work
with. Where each child can even learn how to love the path that they've taken to
survive and defend themselves. Where there is the opportunity to really show each
child, they are worthy of care and worthy of being seen.
Jean Scarboro brought the story back to their work at the Brinnon School.
Brinnon is a place that has a lot of ACEs, a lot of intergenerational trauma and is
under resourced. Jean said we all know that Brinnon and all areas of our community
deserve more resources. All children and families are worthy of our care.
VIII. PUBLIC COMMENTS
Tanya Barnett said as a Mom whose kiddo has been through Jumping Mouse and as a
community member, she would like to express her heartfelt gratitude for Jean
Scarboro and for everyone at Jumping Mouse.
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IX. ADJOURNMENT
Commissioner Eisenhour adjourned the meeting.
Potential - Future Agenda Items:
a. Presentation from the New Family Resource Navigator Program- YMCA of Jefferson
County-/Tanya M. Barnett
b. Update- Drug Court/ Richard Davies- Public Defenders Office & James Kennedy-
Prosecutor’s Office Update- Mental Health Field Response Team Meetings
c. Update- Washington State Residential Substance Abuse Treatment (RSAT) Jail-Based
Program and Aftercare Services for Jefferson County - /David Fortino & Gabbie Caudill
d. Continued Updates on (HB 1310) & the Sheriff’s Dept. Navigator Program
e. Discussion-Allocating Additional Sales Tax Funding, (for the existing Vendors) at a
future 2022 BHAC Meeting
f. Vendor Presentations--DBH/ Transitional Housing & Wrap Around Case Management
& Drug Court/Family Therapeutic Court
BH ADVISORY COMMITTEE MTGs: 2022- Held on Tuesdays @ 3PM to 5PM on Zoom
January 4, 2022
March 1, 2022
May 3, 2022
July 5, 2022
September 6, 2022
November 1, 2022
MENTAL HEALTH FIELD RESPONSE TEAM MEETINGS: 2022- Held on Thursdays @
1:30PM to 2:45PM on Zoom
January 27, 2022
March 31, 2022
May 26, 2022
September 29, 2022