HomeMy WebLinkAboutMH Provider Meeting Minutes 03-10-17Mental Health Provider Meeting
Human Services Building
Friday, March 10, 2017
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MEETING MINUTES
Welcome & Introductions
Everyone introduced themselves and their agency affiliation.
Provider Announcements and Updates
∾ Mental Health Association
May is Mental Health Awareness Month! The Wellness Conference is May
5th at King Street Church, Art Show is May 19th – 21st at the Chambersburg
Mall and Walk the Walk is May 26th. More information to come!
∾ Occupational Services, Inc.
OSI is celebrating their 60th anniversary this year. There will be an open
house as well as a 60 day gift giveaway over Facebook. More information
will come at the June meeting.
Overview on Hoarding (handout)
Candace Rutherford from Summit Behavioral Health gave a presentation on
hoarding. Handout was provided of slides from Linda Shuman. If anyone is
interested in hoarding and would like to obtain a more in depth basic
understanding, the hoarding training provided by Ms. Shuman is a good
introduction.
Tools used in hoarding (provided in handout) are the Saving Cognitions
Inventory (SCI) and Clutter Image Rating Tool. SCI is a tool used in the midst of
treatment and is used while using Cognitive Behavior Therapy. The Clutter Image
Rating tool is for visually oriented individuals. Pictures are provided of different
levels of hoarding. This is a must needed tool.
Hoarding works best as a team approach; this is the recommended form of
treatment. Teams should involve a partnership with fire departments, Animal
Control, law enforcement, etc. However, the resources for this are not available
in Franklin County nor is the reimbursement for the service.
Candace attended a seminar on hoarding five (5) years ago. After the seminar
she became licensed in this service. Medicare will reimburse for one (1) hour.
However, you are unable to help a hoarder in that time frame. The one (1) hour
would include the service plus travel time. Candace’s average session with an
individual is three (3) to four (4) hours. She takes one case at a time and works
with them until they are at a point where they can come into the office and
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continue sessions. At this point, Candace will then take on another case. There is
a lot of need in the community for this service. There are cases that have
medical conditions. However, the bulletin states that with the licensure that
Candace possesses that it cannot be medically based. Her licensure specializes
in anxiety based disorders. The treatment is cognitive behavior therapy and
exposure therapy. It is treated with some of the same principles as Obsessive
Compulsive Disorder (OCD) along with trauma principles. The individuals that
are hoarding have loss issues. Hoarding and OCD often overlap but the major
difference between the two is people who hoard have emotional attachment
to the objects they have and people with OCD keep objects for rules. Another
commonality between the two is that there is a very big neurological
component. Brain studies and pet scans are being completed to look at centers
of the brain where this is coming from. It is being discovered that there is high
correlation of those with motor accidents and closed head trauma and those
who develop OCD and hoarding.
There is starting to become a division within hoarding, in terms of assessment. This
is the level of squalor (filth). This could potentially be an addition to
measurement scales. There has been language added in the Diagnostic and
Statistical Manual (DSM) of Mental Disorders in regards to level of clutter and
significance of distress.
Candace provided examples of specific cases she has worked on. During the
time of treatment, homework and deadlines were provided to the individuals.
Updates were also a requirement. Before and after pictures were taken of the
hoarding. There were six (6) sessions held.
A contract is a critical piece in this process. The decision has to be the
individual’s. As the worker, you lay out the information but they then decide
what they want to do. There are individuals who hoard but are not committed
to changing it. Each item you touch must go through the cognitive behavioral
and exposure therapy. It is recommended to do the box process – one for sale,
one to keep and one to trash. As you touch items of their possession, you ask
them what it means to them and how it makes them feel.
There are individuals who make their own referrals. The older adults appear to
have family members making referrals for them. The older adults really struggle
with letting go of their things as they don’t want to make the life shift. Their
belongings are safety and security to them. Candace’s cardinal rule is she does
not get involved cleaning out if someone is not working with her. The first session
is done in her office. The first assessment is never completed in the home (this is
not recommended). Additional sessions are held in the office as well.
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Approximately 80% of individuals re-hoard. You have to reinforce the principles
you taught them until they fully get it.
Children’s Services
∾ CASSP Update – Kim Lucas
Representation from CASSP was not present.
∾ TMCA Update – Genevieve Harper
Representation from TMCA was not present.
∾ PerformCare Update – Fawn Farkas
Eye Movement Desensitization and Reprocessing (EMDR) training will be
taking place. The training information was provided to outpatient
providers. PerformCare is sponsoring five (5) clinicians. Once those
clinicians complete the training their names will be released.
County Announcements/Information
∾ Reports due since our last MH Provider Meeting
» Audited Reports (for FY ending June 30th)
» Progress Report on Outcomes in Appendix A
» Internal Quality of Service Survey
» Quarterly Report of Expenditures (October – December)
∾ Reports due prior to our next MH Provider Meeting
» Quarterly Report of Expenditures (January – March)
» Appendix A for upcoming fiscal year
» Budget/Rate Letter for upcoming fiscal year
» Staff Roster for upcoming fiscal year (if appropriate)
» Unit Assumptions for upcoming fiscal year (if appropriate)
» Budget Narratives for upcoming fiscal year (if appropriate)
Contract related documents including budgets are due by Wednesday,
March 15th. Any requests for extensions need to be submitted to and
approved by the program specialists prior.
∾ Psychiatric Admissions Reporting Overview (handout)
Holy Spirit EAC has a bed capacity of three (3). Current census is two (2).
There are two (2) individuals on the waiting list. Franklin/Fulton County
loaned beds to Cumberland/Perry County. We are slowly regaining
access to them and will eventually borrow one (1) of their beds which will
increase the census to four (4).
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Danville State Hospital has a bed capacity of five (5). Current census is
eleven (11). There are no scheduled discharges. Two (2) to three (3)
individuals have been identified as needing nursing home placement.
∾ Sequential Intercept Model Discussion
Intercept Zero level has been added to the Sequential Intercept Model.
We have been put in for the technical assistance grant where Substance
Abuse and Mental Health Services Administration (SAMHSA) will have
individuals come and do mapping for us. If we do not receive the grant,
we will still be moving forward with updating our model in late summer. If
anyone is aware of new programs or services, please let Cori know so she
can update the mapping.
∾ Miscellaneous
MH/ID/EI is sponsoring a free all-day training “Supporting a person with
Post Traumatic Stress Disorder” with David Pitonyak, Ph.D. on Thursday,
May 18th from 9:00 a.m. to 4:00 p.m. at Green Grove Gardens. Continental
breakfast and lunch will be provided. Additional information including
registration will be sent out later this month. CEUs will be available on your
own for a fee.
Franklin County Older Adult Advocacy Team (FCOAAT) Overview (handouts)
Jennifer Wenzel (MH Housing Program Specialist) and Angie Pickel (Link
Coordinator and Aging Ombudsman) gave an overview of the Franklin County
Older Adult Advocacy Team (FCOAAT).
FCOAAT’s primary roles and functions are to bridge the gap between aging
and mental health services, advocacy, consultation and training and
education. Medicare does not pay for a lot of support services and therapies.
There are a lot of individuals in their 60s that have mental health needs. Those
part of the FCOAAT team would like to help individuals develop plans of action
to stop a cycle of going in and out of a hospital or emergency setting.
Eligibility criteria for FCOAAT is 60 years and older, Franklin County resident and
must be experiencing a mental health crisis. Partnering agencies for this
program are Keystone Behavioral Health Crisis Intervention, Mental Health
Association of Franklin & Fulton Counties, Franklin County Area Agency on
Aging, Franklin/Fulton MH/ID/EI, Aging Ombudsman/Link Coordinator, 9-1-1,
TrueNorth Wellness Services, law enforcement, Chambersburg Hospital
Emergency Department, Waynesboro Hospital, and Service Access &
Management. FCOAAT is currently only for Franklin County but it is hoped that
eventually it will be available for Fulton County individuals.
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FCOAAT comes in during and post crisis for individuals. The team will help the
individuals develop a plan to prevent future crisis and work with partnering
agencies to address areas of need. The goal is to avoid individuals coming back
in crisis. Collaboration will be done to assess the individuals. Sometimes there is a
clear mental health component but other times it is biological or dementia. The
team will facilitate access to supports in the community, as well as engaging in
the individual’s personal support system (if they have one).
FCOAAT is not trying to duplicate or replace services. The program is to amplify
what is available and to fill gaps that have been identified. FCOAAT is not a
service that can address dementia related issues as dementia does not meet
program criteria. If someone has been diagnosed with dementia and has a
mental health history then they could be part of FCOAAT.
Referrals to FCOAAT are made by Franklin County Area Agency on Aging (717-
263-2153) and Keystone Behavioral Health Crisis Intervention (717-264-2555). If an
individual is 60 years of age and older and are threatening to harm themselves
or someone else, call crisis. If an individual is in an unsafe living condition or
being abused, call Aging. If you are not sure which one to call, call crisis first.
Once one of these agencies is called, they will do the initial screening to
determine whether to activate FCOAAT. Referrals will be taken starting end of
April, beginning of May. Once the program is ready to begin, information will be
sent out in 211 emails and SRN to notify everyone the team is in place.
If an individual is eligible, the team wants to gather details of the incident, their
history, location of individual and do they have a support person. The team will
look to see if the individual is in recovery, drug and alcohol history, psychotic
symptoms, medical issues, etc. Other agency involvement is checked as well;
are there services in place that are not working, do other agencies need to be
involved, does the person have a case manager, etc. The team will review the
information provided. The immediate focus is on the safety of the individual and
their best well-being. The secondary focus is then to come up with a support
plan to prevent a crisis from happening again. The individual develops goals
and needs. They must invest in these goals. Assistance will be offered to connect
individuals to resources of their choosing and referrals can be made on behalf
of them. Senior Reach (offered by Mental Health Association) will be involved.
The program follows up with the individuals within 48-72 hours. They offer to
continue to provide support on the level the individual would like. A summary
will be sent to Senior Reach so they are aware of what happened and what the
individual’s goals are. Senior Reach will be closing the loop. If elected by the
individual, Senior Reach will continue to do follow up for as long as they would
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like and at the rate they would like. A release of information is completed for the
exchange of information between FCOAAT and other agencies involved.
Anyone can opt out of having support of FCOAAT. It is not a mandatory service.
If another crisis happens for an individual receiving FCOAAT services then the
process would be started again. It is a learning tool that will show what works
and what did not. In the screening tool, individuals’ eligibility is tracked. This is to
help identify gaps for future needs. Various other information will be tracked as
well. The desired outcomes of FCOAAT is to connect individuals to services within
one (1) week of referral, compile baseline to track crisis utilization, track how
long individuals stay engaged in requested services, length of time between
FCOATT referrals and to identify potential service gaps.
The meeting was adjourned.
Next Meeting:
Friday, June 9, 2017 at 10:00 a.m. in the Human Services Building
[425 Franklin Farm Lane, Chambersburg]
Remaining 2017 Meetings:
September 8th December 8th
Minutes by Erin Nye