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 DIRECTOR'S REPORT

The value stream mapping team.

A team representing all parts of the Behavioral Health Services Division participated in a joint, week-long Value Stream Mapping event the week of Feb. 24 to consider how to improve consumer access to our programs.

Behavioral Health's inaugural session focused on how consumers access our services, with an eye toward developing a seamless, integrated access system that ensures that all the needs of our clients are met when they contact us.

"The group started off not necessarily understanding each others system of care or even knowing one another," said Homeless Youth Program Manager Molly Henricks, but the process allowed them to "create one integrated vision of how consumers could access the system of care with just one phone call."  

Participants learned how to apply value-mapping principles to the relevant processes in their programs' services, and surveyed consumers and staff to learn about their experiences with existing procedures.

It's the same process that Contra Costa Regional Medical Center & Health Centers and other divisions of Contra Costa Health Services have used to learn how to deliver better and more efficient service.

The team identified technological challenges, capacity issues and organizational challenges that, if addressed, will more effectively meet the needs of consumers. Its recommendations included cross-disciplinary training for staff, development of a front-end triage process, creation of shared resource databases and a single Behavioral Health access line.

Future events are planned to follow up on the findings.

The Behavioral Health Executive Team invites its community based stakeholders and Behavioral Health line staff to help shape the division's efforts to integrate into a seamless system of care at a pair of Service Planning Integration & Implementation Plan Design (SPIID) Team meetings March 12 in Concord.

Meeting participants will contribute to key decision points and information needs for implementing integrated service in Contra Costa's behavioral health system of care.

Due to space restrictions, we've divided the meetings. The focus of the morning meeting will be children, teens and young adults, with adults and older adults in the afternoon. Participants are welcome to attend both meetings.

Follow this link to RSVP. Please direct any questions to Jeff Crandall at  jeff.crandall@homebaseccc.org.

AODS Director Haven Fearn addresses the media on March 5.

Representatives from health departments around the Bay Area, including Alcohol and Other Drug Services Director Haven Fearn, participated in a media event at Contra Costa Regional Medical Center (CCRMC) earlier this month to kick off a new statewide health campaign.

The Healthy Stores for a Healthy Community campaign is a collaboration of health departments in California, nonprofits and community groups. The 10-year campaign aims to improve the health of Californians through changes in the retail environment to educate people about how in-store product marketing influences consumption of unhealthy products such as alcohol, tobacco and junk food.

At the March 5 press event at CCRMC -one of 13 regional press conferences around the state-recently collected data was released showing that alcohol, tobacco and sugary drinks are still being promoted to youth. According to the survey data, nearly 85% of stores in Contra Costa that sell alcohol sold "alcopops," highly potent, sweetened alcoholic drinks available in single bottles or cans that often resemble energy drinks popular with youth. A 24-ounce alcopop can contain as much alcohol as four or more standard drinks.  

Haven told reporters about the problem of underage drinking in the county and the importance of working with merchants to reduce alcohol consumption by youth.

The purpose of Utilization Review is to review and approve requests for mental health services as well as ensure that our consumers receive quality care, meet medical and service necessity criteria, and that we are compliant with all county, state and federal regulations.

Based on the circumstances, the UR team may also provide service authorization while the client is still in treatment (concurrent review) or upon review of services or treatments that have already been provided (retrospective review).  

Within the System of Care, the UR Team conducts three types of reviews: Level I, II and III.   The Contra Costa Mental Health Plan (CCMHP) is now also conducting a fourth type of review, Quality of Care.

The Level I - Authorization (compliance) Review is to review and "authorize" requests for services (mental health, case management, or medication support services, day treatment or TBS).    

The Level II - Compliance Review is a more in-depth review of the medical record to ensure compliance with the CCMHP's documentation standards.

The Level III - Centralized UR is to assess compliance, cost effectiveness, quality of care, quality of services and identify training and process improvement activities within a single clinic or organization.

Quality of Care Review is twofold. Reviewers determine whether quality care is being delivered at the appropriate level and consumers' mental health needs are being met. Reviewers ensure that resources are being optimally utilized (minimize duplication) by verifying that coordination between multiple providers is evident.

Consumers gave high ratings to Contra Costa's mental health services in a recent, state-mandated poll.

The California Department of Health Care Services requires all counties in the state survey its mental health consumers to obtain feedback about the quality of services provided using the Mental Health Statistical Improvement Project survey instrument. Surveys were administered to our consumers at each of the county clinics and by contract service providers in August 2013.

The results were detailed in a February 2014 report intended to inform decision-making within Behavioral Health Services' system of care.

Consumers using a 1-to-5 scale indicated a high level of satisfaction with their service providers and the behavioral health services received. Adult consumers gave an average satisfaction score of 4.2, youth an average of 4.4.

In an open-ended part of the survey, many consumers expressed appreciation for services, timeliness, staff support, and the impact that the services have had on their lives. They also offered recommendations for improving services.

The county received 882 surveys, an 84% increase from last year. Follow this link to read sample MHSIP surveys. For more information, contact mhresearch@hsd.cccounty.us. 

Participants learn how to identify affordable housing, how to understand rental agreements and work with landlords, credit and money management, and how to keep a home once secured. While participants engage in the workshops, shelter staff helps each of them to develop individualized housing-search plans.

The Portland Housing Center began working on a housing readiness curriculum in 1998 for renters having difficulties finding housing due to their rental history, poor credit or their criminal background. The result is the Ready to Rent curriculum. 

In keeping with Behavioral Health's vision for integrated service delivery, the Homeless Program will soon bring these workshops to the El Portal Adult Mental Health Clinic. A housing specialist on site will identify and support homeless consumers in accessing shelter and permanent housing. 

For more information, contact Program Manager Arturo Castillo at Arturo.castillo@hsd.cccounty.us

The Mental Health Services program will hold a series of community meetings this month to share the findings of our needs assessment and results of our focus groups in preparation for drafting our Mental Health Services Act (MHSA) Three-Year Program and Expenditure Plan.

At these sessions we will present Contra Costa's prioritized mental health needs, as developed through consumer and family member focus groups, and discuss strategies for closing service gaps. Contributions from the community are welcome, and also vital to the process.

We will hold three forums in East, Central and West Contra Costa County. The agenda for each is the same, so we encourage participants to attend the one most convenient for them, and to spread the word with the attached fliers.

For more information, write Warren Hayes at Warren.Hayes@hsd.cccounty.us. To RSVP for a forum, contact Anita Kumar at akumar@resourcedevelopment.net or 510-488-4345, extension 125.

The first forum is Wednesday, March 19, from 3 p.m. to 5 p.m. at the Department of Conservation and Development, 30 Muir Road, Martinez. Click here for a flier.

The second is Tuesday, March 25, from 3 p.m. to 5 p.m. at the Ambrose Center, 3105 Willow Pass Road in Bay Point. Click here for a flier.

The third is Wednesday, March 26, from 3 p.m. to 5 p.m. at the RYSE Center, 205 41st Street in Richmond. Click here for a flier. 

Hope House, a crisis residential facility

Mental health consumers who are discharging from the hospital or long-term locked facilities will soon benefit from a new housing option in Hope House, an unlocked but highly structured residential program on the hillside above Contra Costa Regional Medical Center in Martinez.

This 16-bed facility is intended to support consumers during periods of crisis, and to avoid hospitalization. The care offered by Hope House will encourage successful transitioning back into the community, providing round-the-clock service to consumers who are 18 or older. 

Services will be recovery-focused and evidence-based, and will include a peer-provider component. The program will be co-occurring capable and use an outcome-driven approach to providing services.

Mental Health Services Act (MHSA) funding was used to build Hope House, which is located at 300 Ilene Street in Martinez. Behavioral Health Services is in the process of contracting with Telecare Corporation to be the service provider at the facility. Telecare serves adults, older adults, and adolescents, particularly those who may require intensive, recovery-centered mental health programs.

The building has been constructed and interior details and furnishings are in progress. An open house is expected very soon, so stay tuned!

For more information contact Erin McCarty at Erin.Mccarty@hsd.cccounty.us  

Daniel Montiel was a student winner of a poster contest to stop underage drinking.

Two years after Alcohol and Other Drugs Services (AODS) received a federal grant to combat youth drinking in Walnut Creek and Antioch, the program has developed a multi-faceted prevention program with help from local law enforcement.

The program, funded through a 2012 Strategic Prevention Framework State Incentive Grant from the Federal Substance Abuse and Mental Health Services Administration (SAMHSA), works to improve community prevention efforts through evidence-based strategies to reduce excessive drinking among 12- to 25-year-olds in those communities.

AODS contracts with the Center for Human Development to coordinate grant activities. In 2013, the program supported more than 25 enforcement operations in partnership with local police, including decoy operations, party patrols, DUI checkpoints and saturation patrols. The grant will continue to support these strategies in Antioch and Walnut Creek through the summer of 2015.

The program also supports these enforcement strategies through the use of community message boards in Antioch, recruiting and training college students to participate in its activities, and a student-produced video about DUI enforcement shared on participating campuses during the morning announcements.

SURVEY HIGHLIGHTS SUCCESS OF SHELTER PLUS CARE PROGRAM

A recent survey shows that consumers using the Shelter Plus Care Program had positive experiences with it.
 

More than 100 participants responded to the November survey about the program, which provides permanent housing and support services to homeless people living with disabilities in Contra Costa County. Topics included quality of housing, knowledge of support services and interactions with program staff.

A large majority indicated that they knew about and used services such as case management and mental health services, and felt their apartments were safe and decent. Click here for a detailed summary of survey results. "This program has allowed me to be self-sufficient, and a better parent. I can focus on my child without worry about having a home," shared one respondent.

Many of those surveyed also inquired about other housing options. In response, the Homeless Program provided all Shelter Plus Care residents with affordable housing resources and answers to their most frequently asked questions, which are available here. 

By ensuring the long-term housing stability and success of formerly homeless individuals and families, Shelter Plus Care remains a vital resource within the Homeless Program continuum of care.

• 1/2 aji limo or habanero chile, seeded and halved lengthwise
• 1 pound fluke, flounder or halibut, cut into 1/2-inch cubes
• 1 small red onion, quartered and thinly sliced, divided (Julienne)
• 1/2 of stand picked Cilantro leaves
• Juice of 22 limes (make sure you don't squeeze all the way to avoid getting the bitter pith of the lime)
• 4 small pieces of sea urchin (optional)
• 1/2 TB garlic paste or puree
• Salt and pepper to taste

Preparation:
Thoroughly wash the onion, then soak them in a bowl of water with 4 cubes of ice for about 20 minutes to crisp them.

Cut the chile into fine slices, avoiding the seeds.

Gently chop the cilantro leaves.

Cut the fish into cubes about 2 centimeters on a side. Remember the fish is delicate; use a sharp knife.

Place the cubes into a chilled bowl and gently toss it with the salt and pepper. Gently add the garlic, onions and sea urchin.

Finally, add the lime juice and toss twice.

Let the mixture sit about 40 seconds, then check the seasoning and add the cilantro.

Source: Erin McCarty