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HomeMy WebLinkAboutMH Provider Meeting Minutes 06-21-19 Mental Health Provider Meeting Friday, June 21, 2019 MH 1 6/21/19 MEETING MINUTES Welcome & Introduction Everyone introduced themselves and their agency affiliation. Provider Announcements & Updates ≠ Mental Health Association (MHA) MHA’s new CEO, Beth Palmatier, will be starting on Monday, June 24th. MHA has a new Peer Specialist Program for youth and young adults. The service description is for individuals 14 years of age and older. MHA has hired Peer Specialists that only work with youth and young adults. If you would like to make a referral or have any questions, contact Victoria Craig. Save the date – Christmas in July is July 19th. Save the dates for all upcoming events for next year will be coming out. Walk the Walk has changed dates for 2020. Usually it took place the Friday before Memorial week; it will now be the Friday after. ≠ Pennsylvania Counseling Services (PCS) PCS has an official move date to their new building – July 12th. The new address will be 50 Black Avenue, Chambersburg. PCS will be open for business at their new location on Monday, July 15th. Information will be sent out. The new location is literally around the back of the current building PCS is located in; the back of the M&T Bank building on Main Street. PCS has two (2) Certified Recovery Specialists and a Care Navigator working with the Substance Abuse programs. They have the ability to work with anyone in the community pertaining to recovery and substance use for an array of things such as navigating through barriers or obstacles. The staff will work with the local Drug & Alcohol program to be a recovery vendor to provide services such as education, planning and support, community support network and linking to services. This service will take place on the 1st floor of the above mentioned address (outpatient services are on the 2nd floor). New program information for Lighthouse Recovery will be sent out. ≠ Healthy Franklin County Mental Health Task Force Healthy Franklin County Mental Health Task Force is conducting an employer survey of existing mental health occupations and associated educational requirements. The task force will use the results to promote the mental health field in Franklin County with the goal of creating a local workforce that is qualified to meet the demands of local employers in the mental health sector. Please complete the survey by June 30, 2019. Visit www.healthyfranklincounty.org to learn more about efforts to improve the health and well- being of all Franklin County residents. Please be honest when completing the survey. Provide information pertaining to what staffing needs you have, qualifications, trainings, etc. Input from providers is needed. ≠ Summit Behavioral Health / WellSpan Behavioral Health As of July 1st, all outpatient satellite offices are changing from Summit Behavioral Health to WellSpan Behavioral Health. Originally, Philhaven was going to be added to the new name. Mental Health Provider Meeting MH 2 6/21/19 However, that is not the case. Signs will change mid-July/early August to reflect the name change. Email addresses will be changing from summithealth.org to wellspan.org. Emails sent to the summithealth.org email addresses will transfer to the new email addresses. On July 8th, a new Child and Adolescent Psychiatrist, Dr. Nathan Lee will be starting. He will be in the outpatient office full time and will be rebuilding the child and adolescent case load. Providers can start to make referrals now. Summit (WellSpan) is interviewing several Nurse Practitioner (NP) students who are finishing school in the fall. These individuals were nurses on the unit who went into NP school. They were offered the position and have accepted. They will be starting outpatient in the fall when completing their degree. They will complete the necessary credentialing then build their caseload. This will allow for openings to take psychiatric evaluations. Summit (WellSpan) will be changing their Medi-tech computer system to Epic. The new system will connect them to multiple other hospital systems nationwide. Children’s Services ≠ CASSP Update No update at this time. ≠ TMCA Update No update at this time. ≠ PerformCare Update PerformCare is having another Claims Training on August 7th. The training is a webinar with a morning and afternoon option. A link was sent out to register. If you did not receive it please contact Kourtney Griggs. Supporting Individuals Transitioning to Employment Success (SITES) Supporting Individuals Transitioning to Employment Success (SITES) program opened on July 2, 2018; almost one year ago! Yesterday, individuals in the program helped Keith Bowers prepare for open house. Michelle Lane is the Director of SITES; Keith Bowers is a full time employee; and there are three (3) other part time employees that are at the facility three (3) times a week. In order to participate in the SITES program, individuals must have a mental health diagnosis, post high school (18 years and older), be supported by Service Access & Management (SAM) and be looking for employment. Individuals need to have soft skills. The SITES program is open four (4) days a week: Monday – Thursday, 8:30 a.m. to 2:30 p.m. located at their Industrial Drive location (off Route 11). The program is a stepping stone towards community employment. Keith discussed the cycles of employment and how individuals often lack social skills and life skills to become independent. SITES is designed to be a 6-18 month program to assist individuals with life, social and job skills. SITES can have up to six (6) individuals per a day in the program. The program has room to grow. If you know of anyone who may be interested and meets the above criteria, they must be referred through SAM. SITES can help with some transportation but individuals must live within a five (5) mile radius due to limited funding. Individuals may also use Rabbit Transit or they can self-transport. Mental Health Provider Meeting MH 3 6/21/19 From the time the individuals arrive until the time they leave there is sit down classroom time. It is structured to be a social environment as it is a skill they need to learn. Individuals need to learn to agree to disagree. In this time, individuals can talk about anything in the newspaper or on the smart board (such as CNN). This is to hold a healthy discussion about the topics. Handout was provided on SITES educational focus. Focuses include personal life skills, self- advocacy, job skills, cognitive & critical thinking skills, creative arts, and social skills at work and at home. Please refer to the handout to have an overview of what is included in each focus. The focuses are not done daily but each one is touched on every week. Of the focuses, job skills are the biggest one. Individuals have to set goals and one of them has to be competitive integrated employment. Social skills are also a big part of SITES. It involves learning to get along at work and at home as well as understand emotions, how to manage them and power of positive attitudes. Provider Spotlight – TrueNorth Wellness Services Erin Glenn, Director of Franklin/Fulton Services, presented on TrueNorth Wellness Services. TrueNorth Wellness Services is spread throughout South Central PA. Erin oversees the programs offered in Franklin and Fulton counties. Those services include: Crisis Intervention (Fulton) – a 24/7 service that is housed at the Fulton County Medical Center. Crisis workers go mobile to providers, schools and probation. They do not go in homes due to there only being one worker on per shift. They are able to go with police, if necessary. A lot of individuals in crisis come through the emergency room due to presenting with physical symptoms before the crisis symptoms. However, individuals do not need to come through the ER if they choose not to as crisis has a safe room. This room is attached to the crisis workers’ office and includes a couch, chair, bathroom, table, etc. for a comforting environment to those in crisis. Outpatient (Fulton) – therapy is provided for individuals, families, psychiatry, and adolescent psychiatry through telepsych. There is a therapist who is Eye Movement Desensitization and Reprocessing (EMDR) certified for trauma. This same therapist is also Target trained. Therapist will be going through the Mindfulness Cognitive Behavioral Therapy (CBT) training next week which is another evidence-based therapy that will be rolling out. TrueNorth provides psych evaluations out of the Franklin County jail. Dr. Cinda Liggon will go to the jail on Saturdays to see individuals who will be getting released. She will complete an evaluation to figure out what type of services they need to get involved in upon their release. In addition, evaluations are done via telepsychiatry through the Bedford County Jail. This is for individuals who are court ordered for an evaluation. Fulton County now utilizes the Bedford County Jail to house inmates instead of the Franklin County Jail. Community Outreach (Fulton) – this is a program specific to the community. A partnership is established with probation where a therapist is present one day a week to complete screenings on individuals with depression, drug and alcohol, and anxiety. They assess their needs and give recommendations to the probation officers (PO). The therapist then completes follow up and provides mental health consultation with the PO. The consultation is to discuss caseloads and stresses so that the therapist can provide advice and support. ≠ In addition, a crisis worker goes to TriState Community Health Center weekly, on Tuesdays, to meet with individuals TriState has referred for mental health assistance. These Mental Health Provider Meeting MH 4 6/21/19 individuals are not in crisis but the doctor feels there may be risk. The individual is seen to determine their needs and to make the necessary referrals for services. Residential (Franklin) – this facility has 16 individuals who are living in individual apartments. An office is located on the property that is staffed 24/7 to provide support to them. There is a lot of programming done with the individuals to assess their hygiene, cooking, cleaning, etc. Visits are conducted by staff to check in. Staff provide rides to appointments as well as have fun outings. Peer Support (Franklin & Fulton) – this is currently for adults only. TrueNorth is working with the Mental Health Association to become youth trained. A staff member was just hired who will become youth trained in the fall. Starting in October, peer support will branch out to the youth population. Currently, TrueNorth has outpatient services in two (2) schools. So the hope is to make the link with the youth population to have a team of support. Base Service Unit (Fulton) – intakes are completed on individuals who need County funding or case management services. The assessments determine the level of care that is needed (ACM, RC or ICM). If the individual is ACM then they stay with TrueNorth services. If they are RC or ICM, TrueNorth works with SAM to obtain a case manager and take over the case. If anyone has any questions about TrueNorth Wellness Services please reach out to Erin Glenn (eglenn@truenorthwellness.org). ----- If your agency would like to be in the spotlight, please contact Jim. There is availability for Provider Spotlight at the September and December Provider Meetings. Community Resource Spotlight – Women in Need Brittany Leach, Training & Education Specialist, presented on Women in Need (WIN). Women in Need (WIN) works with individuals experiencing trauma. If you are interested in having brochures and posters dropped off at your facility, please let Brittany know. WIN is the local domestic violence and rape center for Franklin and Fulton counties. WIN helps both men and women. The main focus is to help individuals affected by domestic violence and/or sexual assault. There is a 24/7 crisis hotline available that is staffed by WIN staff or trained volunteers. The staff talk to the individuals and assess their needs. The situation can be handled over the phone or the individual can be brought to the WIN office. WIN has an emergency shelter that not only houses women and children but takes individuals who are fleeing a domestic violence situation and need a safe house. The shelter is often at full capacity. The facility has been completing rebuilt. Originally, it was a safe house with an undisclosed location. It is now a secure house. There are security doors, lights, etc. to make sure individuals are secure. If anyone wants a tour, reach out to WIN to arrange that. It is set up like suites. This secure house has also provided the ability to house male and transgender individuals. WIN does not provide mental health counseling but provides counseling specific to domestic violence and sexual violence. They assist the individual in finding resources. If WIN finds the individual has a need that they cannot address, they refer out to other agencies. WIN helps with Mental Health Provider Meeting MH 5 6/21/19 legal advocacy. For example: with protection from abuse (PFA) orders, WIN can help with the paperwork processing part but they cannot grant the protection order. WIN has attorneys that will take the case and take the individual in front of the judge. In addition, WIN explains other court processes to help individuals understand what the judge means when they say certain statements. WIN recently obtained funding for Transitional Housing program. It has been going well and there has been some success with it. This service is not one that is advertised. The program has specific requirements such as must have a job, be a current client of WIN, etc. WIN encourages providers to contact them if they have an individual who is looking to relocate from a domestic violence situation. WIN is an emergency agency. Individuals come to WIN for help with domestic violence prevention. Brittany’s role is to focus on preventing domestic violence. She provides training and education at schools and in the community. She is trying to expand her work and is focused on working with communities to see what their needs are. This helps build policies and training for what others need. Right now, Brittany is working on sexual harassment policies and developing training. She is trying to create safe environments. WIN provides some sort of assistance for all domestic violence but, depending on the funding, it may be specific to intimate partner violence only. For a child or parent being abused, WIN can provide counseling or case management but they cannot help them file a protection from abuse order. Individuals can still call WIN so they can work with them to make necessary referrals. County Announcements/Information ≠ Reports due since our last MH Provider Meeting  Appendix A for upcoming fiscal year  Budget Packets (to include Budget/Rate Letter, Staff Roster, Unit Assumptions and Budget Narrative for upcoming fiscal year – if appropriate) ≠ Reports due prior to our next MH Provider Meeting  Audited Financial Report (calendar year ending December 31st)  Audit Engagement/Extension Letter (FY ending June 30th)  Progress Report on Outcomes in Appendix A  Quarterly Report of Expenditures (April – June)  Salary Review (FY ending June 30th)  Property Purchased/Property Leased Report (FY ending June 30th)  Fixed Assets Purchased with MH/IDD/EI Funds (FY ending June 30th) ≠ Psychiatric Admissions Reporting Overview The report provided is comparing first quarter of 2018 to 2019. The first quarter has been much lower. If anyone has any questions, please contact Jim Gilbert. There is currently no one on the waiting list to go to the state hospital. Discussion took place on what impacts length of stay. Sometimes this may be a result of demographics. Historically, there were several individuals being admitted to inpatient frequently but have since been placed appropriately. Service Access & Management (SAM) is trying to be more aggressive with discharge planning as well as trying to facilitate a smooth transition to decrease the possibility of individuals returning to inpatient. Mental Health Provider Meeting MH 6 6/21/19 Chambersburg Hospital has had individuals staying longer due to housing needs which is a huge factor. The hospital has also re-vamped and improved their discharge planning and follow through. From day one of inpatient, hospital staff are looking at what the individual’s needs are to get out of the inpatient unit. Staff is trying to get individuals a mental health follow up appointment within seven (7) days of discharge. The referral process begins at day one of admission so that by the time an individual is discharged they are being seen. The purpose is to avoid running out of medication as well as being able to touch base with a mental health professional. It is taking individuals longer and longer to be admitted to Danville State Hospital due to full capacity. Since there is not an Extended Acute Care (EAC), individuals are on the Behavioral Health Units (BHUs) longer than normal awaiting admission at Danville. However, in the interim, the BHUs are stabilizing the individuals and those individuals end up not needing to go to Danville. Providers present noted that collaboration with outside providers and the community is helpful to make referrals. This includes receiving updates from providers and being aware of new programs. Any time outpatient providers have availability, please notify Chambersburg Hospital, Crisis and SAM. ≠ Staff Burnout and Well-Being Update The burnout and well-being project is a collaboration between Mental Health and Shippensburg University Psychology Department. Dr. Kim Weikel presented on the data collected. This data is just the beginning level data analysis. Please review the handout for additional information. In the first phase, accomplishments included establishment of a workplace well-being workgroup and data collection. An online survey was conducted. Dr. Weikel thanked those who participated. There were 69 participants who responded to the demographics portion of the survey; 54 went on to respond to the burnout inventory; and 44 who completed the survey in its entirety. The Maslach Burnout Inventory is a gold standard in the field. It has three (3) scales – emotional exhaustion (which is a core feature for burnout), depersonalization and personal accomplishment. Some view depersonalization as consequence of emotional exhaustion. For human services, it has to do with detaching oneself from their work or their consumers. Personal accomplishment pertains to sense of confidence in your work and sense of making a difference. There are 7430 individuals employed in mental health per normative database. However, there are many others in human services. Dr. Weikel did a comparison with just mental health professionals. Emotional exhaustion is higher in Franklin County than in normative data. Depersonalization is seminal in Franklin County when compared to others. Personal accomplishment is significantly higher in Franklin County than others. For those completing the survey, half were Administrators and half were staff who work with consumers. Personal accomplishment is related to burnout; the stronger the personal accomplishment the lower the burnout. Mental Health Provider Meeting MH 7 6/21/19 Dr. Weikel looked at percentages of individuals who have high emotional exhaustion. In Maslach’s workgroup, he looks at the top 30%. Dr. Weikel finds it meaningful to look at the standard deviated cut as it pertains to those above the mean (outside the average). There were 14 individuals (or 26%) who completed the survey that reported higher emotional exhaustion than the average mental health professional. The Areas of Work Life Inventory was purchased. It is a Maslach companion instrument. The survey looks at things pertaining to work environment. There are six (6) scales – workload congruency (amount of work is congruent with the amount of time); control (you can make a difference in policy); reward (praise, etc.); community (co-worker/supervisor relationships); fairness (resources are distributed and promotions are made); and values (whether employees values are consistent with the agency’s). In correlation with emotional exhaustion, workload congruency, control, reward and community phases are correlated with burnout levels for mental health professionals. The strongest correlation is workload congruency. With reward, the more the sense the work is rewarded, the lower level of burnout. This is something the workgroup can work on. The importance of the workgroup – there are many things correlated with signs of burnout that can be worked on within the workgroup. A beginning workgroup was established but it needs more participation. There was a handful of individuals who said they would be interested in attending; all are invited! Contributions made by the workgroup were important to the survey. There was strong opinion that there must be paper and pen versus online surveys. However, when this option was proposed at Shippensburg University, the committee wanted one method of administration so online was chosen. Dr. Weikel felt there were a number of agencies that did not participate due to this. If your agency would like to complete the survey by pen and paper please contact Jim. The completed information can then be added into the results. Participants in the workgroup were interested in turnover as it relates to burnout. At the last minute before the survey was ready, two (2) questions were added about burnout intent. One question was “how likely are you to look for a new job in the field of mental health within the next year” and “how likely are you to look for a new job outside the field of mental health within the next year.” Results showed that 30% were likely to look for a new job within the next year; only 10% were likely or very likely to leave the field of mental health. With the results of those (2) questions, it is interesting how it related to indicators of burnout. The individuals who were experiencing emotional exhaustion and a low sense of personal accomplishment were “most likely to find a new job outside the mental health field.” Those who were likely to look for a different job but in the mental health field had different indicators. It was not so much burnout but what is going on within the agency. This did not pertain to workload. It was related to sense of control, reward for work done, community (relationships with others), sense of fairness and congruency of values. The next workshop is scheduled for June 27th from 9:00 a.m. to noon at the Mental Health Association (478 Grant Street, Chambersburg). Dr. Weikel noted that there has been lower participation in self-care workshops. Training was offered on borderline personality disorder and it had a large turnout. There is research that suggests that training is correlated with lower burnout. There has been discussion about offering training at the university around other topics. For some, receiving training can help with sense of accomplishment. If anyone has any thoughts regarding training, please let Jim know. Mental Health Provider Meeting MH 8 6/21/19 Questions/Comments from providers: Was data on level of care collected? – yes; however, the largest response received was under the title “other.” This meaning we were not capturing the positions of those who completed the survey. One workgroup talked about explaining different levels of care.  Dr. Weikel noted that those who consider themselves peers use their own experience with mental health to work with individuals and have a higher sense of personal accomplishment. Providers would like to see break down of demographics to tell us what resources they have outside of work. – Demographic information was asked. It was not brought to the provider meeting as the Shippensburg Board wants to make sure it is kept confidential. However, some of the demographic information may be shared. If a larger data base is retrieved, Dr. Weikel would feel more comfortable reporting demographic information. For workgroups, therapists are booked a month or more out with appointments. They need a way longer notice than a week or two in order to attend other meetings (roughly a three month notice). In addition, CEUs are needed in order for them to attend. ≠ Department of Human Services Electronic Provider Enrollment Application As of July 1st, provider enrollments will be done through the portal electronically. This is for providers who bill through the state as well as any provider that is contracted with the County. Cori will attempt to assist providers with this, if needed, but she will no longer submit the application. She will still provide an attestation form for providers stating that they are contracted with the County to provide a certain procedure code. ≠ Keystone Service Systems Forensic SCR Keystone Service Systems purchased a home on Ragged Edge Road for a forensic specialized community residence which will be an eight (8) bed facility. The purchase was approved and settlement took place. The architect went out to do a walk through. Keystone is currently waiting on drawings to be returned. Once this is done, the contractors will complete their necessary renovations. The last update received is potential admitting will take place in late July/early August. The meeting was adjourned. Next Meeting: Friday, September 20, 2019 starting at 10:00 a.m. in the Human Services Building [425 Franklin Farm Lane, Chambersburg] Remaining 2019 Meeting: December 20th