MHSA Annual Update Report to MHB Adult System of Care Committee July 18, 2013 Revised: June 21, 2013 1
MHB MHSA Agenda 1. Overview of MHSA Key Performance Measures by Component – CSS / PEI / INN / WET / CFTN 2. MHSA Adult Programs a) Progress Update b) Proposed Changes 3. Next Steps 4. Comments/Questions 2
Performance Measures by MHSA Component 3
MHSA Key Performance Measures by Plan Component Community Services & Prevention & Early Intervention Innovation Workforce Education & Training Capital Facilities & Technology Supports (CSS) (PEI) (INN) (WET) Needs (CFTN) • Reduction of subjective • Reduction of Stigma and • Increase access to underserved • Have a workforce fully • Provide a comprehensive suffering from mental illness Discrimination groups integrated and reflective of the electronic medical record for cultural and ethnic diversity of consumers that can be shared • Increase meaningful use of time • Reduction of Disparities in • Increase the quality of services, consumers and family members in a secure & shared across and capabilities in school, work, Access to Mental Health including better outcomes at all levels of the workforce, service providers (EHR Project) activity Services • Promote interagency including employees, interns, • Create a single data repository • Reduce homelessness and • Reduction of Psycho-Social collaboration and volunteers for all of the MHD information increase safe and permanent Impact of Trauma • Increase access to services • Provide employment (EDW Project) housing • Prevention and Early opportunities and integrated • Provide computer labs and • Increase access to substance Intervention of At-Risk Children, support mechanisms basic PC skills training for abuse treatment Youth and Young Adult throughout the system consumers in established Populations experiencing onset • Increase natural networks of • Enhance staff training and Wellness Centers across the of serious Psychiatric Illness supportive relationships develop opportunities and County (CLC Project) • Reduction and Prevention of • Reduction in multiple foster care career pathways for County and • Enhance the current Mental Suicide Risk placements Community Based Organization Health Department website • Reduction in (CBO) staff (WEB Project) incarceration/juvenile justice • Provide training and educational • Provide a housing and/or bed involvement opportunities in the mental availability database (BHX • Reduction in disparities in health system Project) service access • Create secure, real-time data • Increase in self-help and system of client records consumer/family involvement accessible across agencies to provide a cross agency view of registered consumer’s demographic , service & other information (CHR Project) • Improve access to high risk populations in the downtown & east San Jose service areas; areas with the highest concentration of at-risk youth (Medi-Plex Project) • Improve the current space for Self-Help Center to have a computer training room & several activity rooms which will allow multiple group activities (DTMH Project) 4
MHSA Adult Programs 5
MHSA Adult Program A01 Adult FSP Progress Update According to FY2012 FSP Data: • The total number of Adult FSP consumers served in FY2012 was 222 (1.8% decrease compared to FY2011) • Adult FSP client utilization of Emergency Psychiatric Services (EPS) decreased by 12% compared to FY2011 • Hospital admissions increased by 30%, while • Adult arrests decreased by 8% compared to FY2011 6
MHSA Adult Program A01 Adult FSP Progress Update The Adult FSP program has served a total of 974 Adults from FY2007 to FY2012 (Source Data: Unicare): Adult FSP FY07 FY08 FY09 FY10 FY11 FY12 Total Adult (26-59) 62 111 159 194 226 222 974 7
MHSA Adult Program A01 Adult FSP Progress Update Of the 974 adult consumers who have received FSP services: Unknown Ethnicity 8% Latino African 18% American 7% Native American White 3% 46% Asian/Pacific Other Islander Ethnicity 15% 3% 43.3% (N=421) were from the Underserved Population (Latino, African American, Native American and Asian/Pacific Islander) 8
MHSA Adult Program A01 Adult FSP Progress Update The Adult FSP/IMD Diversion program has served a total of 246 Adults from FY2011 to FY2012 (Source Data: Unicare): FSP/IMD Diversion FY11 FY12 Total Served 99 147 246 9
MHSA Adult Program A01 Adult FSP Progress Update Of the 246 adult consumers who have received FSP/IMD services: Unknown 7% Latino African 21% American 10% Native White American 43% 1% Asian/ Pacific Other Islander 3% 15% 46.7% (N=115) were from the Underserved Population (Latino, African American, Native American and Asian/Pacific Islander) 10
MHSA Adult Program A01 Adult FSP FY2013-14 Proposed Changes Budget Item Residential Recovery Service: • (Hospital/IMD) will decrease from 1 million to 900 in FY14. 11
MHSA Adult Program A02 Adult Behavioral Health Outpatient Services Redesign Progress Update Adult System of Care Redesign, a process to transform and streamline the system, has been completed to improve the effectiveness of services and collaboration with other departments. Services provided through this plan include: • Community Placement Team and 24-Hour Care • MHSA Crisis Residential • MHSA Downtown Mental Health Clinic • Injection/Medication/Case Management Support to Outpatient Clinics & FQHC Staffing • MHSA Adult Redesign • IMD Alternative (Drake House) • Services for Developmentally Disabled Consumers 12
MHSA Adult Program A02 Adult Behavioral Health Outpatient Services Redesign Progress Update Continue.. Community Placement Team and 24-Hour Alternatives: • One of the primary goals of this program is to reduce utilization of high end services by ensuring the consumers who are leaving acute settings receive adequate aftercare. • MHSA funds currently support a County team that is entrusted with coordinating care and services for consumers being discharged from EPS and/or BAP. • To avoid institutions and to avoid discharging clients onto the streets, the Community Placement Team has access to residential and temporary housing programs that are also funded by the MHSA. 13
MHSA Adult Program A02 Adult Behavioral Health Outpatient Services Redesign Progress Update Continue.. MHSA Downtown Mental Health Clinic: • Has three (3) full-time service teams operating Monday through Friday • Aim of the service team is to work with clients suffering from serious mental illness who exhibit severe problems in normal daily functioning; and • To assist individuals within the context of a mutual partnership effort to achieve higher levels of functioning, to develop community and/or family support systems wherever possible 14
MHSA Adult Program A02 Adult Behavioral Health Outpatient Services Redesign Progress Update Continue.. MHSA Crisis Residential (Contract with Momentum): • Goal is to assist individuals to return to the community from acute psychiatric units and locked psychiatric treatment facilities; and • To provide diversion of individuals from admission to acute psychiatric hospitalization and emergency psychiatric services 15
MHSA Adult Program A02 Adult Behavioral Health Outpatient Services Redesign Progress Update Continue.. Injection/Medication/Case Management Support to Outpatient Clinics & FQHC Staffing: • Six (6) FTE’s; • Of these 6 FTE’s, four (4) are located at East Valley FQHC; while two (2) FTE’s are located at Fairoaks FQHC; Rehabilitation Counselors are under Outpatient Specialty Services MHSA Adult Redesign: • Contract Based Organizations (CBOs) have been granted AOA MHSA Redesign contracts: • To provide services to SMI consumers whose level of functioning, symptoms and psychiatric history necessitate service intervention to maintain the individual in community settings 16
MHSA Adult Program A02 Adult Behavioral Health Outpatient Services Redesign Progress Update Continue.. IMD Alternative (Drake House): • Goal is to transition patients from a higher level of care to the most appropriate residential type of facility based on their ability to function independently. This allows consumers to transition to an environment that is less restrictive. • Additionally, goal is to reduce readmission of clients into emergency treatment and acute inpatient hospital settings, preventing homelessness of SMI consumers, providing individuals with stability and a home-like setting and reducing the cost of patient care. Services for Developmentally Disabled Consumers: • Ongoing CSS funds support a CBO-operated program that provides developmentally disabled consumers with integrated treatment and support services 17
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