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HomeMy WebLinkAboutMH Provider Meeting Minutes 03-12-21Mental Health Provider Meeting Friday, March 12, 2021 MH 1 3/12/21 MEETING MINUTES Welcome & Introduction This meeting was held via Google Meet. Jim Gilbert confirmed the attendance of providers that were present. Provider Announcements & Updates ≠ AHEDD – Sarah Marshall AHEDD staff has been out in the community more as referrals and services increase. ≠ Keystone Behavioral Health – Kelly Goshen Keystone Behavioral Health is currently recruiting for a psychiatrist and a Licensed Clinical Social Worker (LCSW) therapist. Keystone Crisis is in the process of getting certified to work with the National Suicide Prevention Lifeline. The Office of Mental Health and Substance Abuse Services (OMHSAS) has chosen Keystone Crisis to participate with the 988 line. The co-responders continue to go out into the community. Jenn Ewing recently received positive feedback from a Chambersburg Police Department sergeant for her management of a situation. Keystone Behavioral Health currently has a very long waiting list for therapists. Referrals should be sent to other outpatient providers at this time. ≠ Occupational Services, Inc. (OSI) – Gabby Snider and Michelle Powell OSI reopened on March 1st and is almost halfway through its reopening phases. A few individuals decided not to return so OSI is currently accepting new referrals for all of its MH programs. Supported Employment had an influx of referrals in February. There are four (4) new clients being served. Of the new clients, two (2) are currently working after being placed in the community. Pre-Employment Transition Services (Pre-ETS) students will resume work at South Mountain Creamery on March 17th. Supporting Individuals Transitional to Employment Success (SITES) Vocational Program has been serving three (3) clients two (2) days per week. These clients have been focusing on vocational skills while volunteering at a food pantry and with Civitan candy boxes that are located in local restaurants/businesses. SITES will add an extra day of programming each week starting March 24th to accommodate a new referral and a client that is returning from a leave of absence. As of this date, SITES will be operating on Tuesdays, Wednesdays, and Thursdays. ≠ Pennsylvania Counseling Services (PCS) – Janelle Ward PCS has had a recent increase in referrals and intakes for MH services. Mental Health Provider Meeting MH 2 3/12/21 Michelle Hurd, Director of Social Work (DSW), retired in December. PCS has recently hired Julia Jones, Licensed Professional Counselor (LPC). Julia has experience working with children/adolescents and has been assisting with intakes. ≠ Service Access & Management (SAM), Inc. – Michael Rodriguez SAM recently sent a letter to providers to remind them that referrals are being accepted electronically through a specified link. Individuals can also refer themselves for SAM’s services. Providers should include the individual’s psychological evaluation and contact/insurance information in order to expedite the referral process. ≠ The Meadows Psychiatric Center – Jesse Dzubak The Meadows’ new Young Adult Program will be opening on March 22nd. This program will serve individuals that are between the ages of eighteen (18) and twenty-four (24). The Meadows has three (3) new doctors on its Adult Unit: Dr. Dodson, Dr. Ting, and Dr. Crowley. ≠ Healthy Communities Partnership (HCP) – Karen Johnston HCP’s next Freedom from Smoking class sessions will be starting on March 22nd and March 23rd. This seven (7) to eight (8) week course will be offered virtually. All course supplies are free including the nicotine replacement products. Interested individuals may register for the course through HCP’s website (https://www.hcpfranklinpa.org/) or by contacting Karen Johnston. Standing Agenda Items ≠ Child Adolescent Service System Program (CASSP) Update – Kim Lucas, CASSP Coordinator If providers have any questions, comments, or concerns related to CASSP, please reach out to Kim. ≠ Tuscarora Manage Care Alliance (TMCA) Update – Brad Coccagna, Quality Specialist No update at this time. ≠ PerformCare Update – Kourtney Griggs, Account Executive No update at this time. ≠ Community Resource Spotlight: Franklin County Jail – Michelle Weller, Deputy Warden of Inmate Services and Melyssa Flud, Director of Specialized Services Michelle and Melyssa provided an overview of the Franklin County Jail’s treatment services and operations. Jail Overview The Franklin County Jail holds both male and female offenders that are either sentenced or un-sentenced. The offenders have been charged with different types of crimes ranging from non-support to criminal homicide. Sentences can be up to two (2) years but the average length of stay is seventy-two (72) days. The current recidivism rate based on a three (3) year window is 40% for those who come back with a new charge or 53% for those who come back for another reason (i.e. probation violation). Mental Health Provider Meeting MH 3 3/12/21 Jail Staff Administration consists of the Warden and Deputy Wardens of Inmate Services, Inmate Security, and Inmate Records. The Custody Department follows a chain of command that goes from Deputy Warden down to the Major to the Captain to the Lieutenants and finally to the Line Officers. The Jail contracts with Summit for food services and with GTL for maintenance. Breakdown of Treatment Staff The Treatment Department has Directors of Specialized Services, Inmate Management, and Inmate Programs. There are six (6) Correctional Treatment Specialists that are assigned to each housing unit and act as unit managers. They are responsible for their unit’s case management and all of its programming . The Education Department has a General Educational Development (GED) Program. The Jail is a certified GED testing site. Prior to the COVID-19 pandemic, inmates were able to prepare for and take the GED test on-site. The Jail partners with the Lincoln Intermediate Unit (LIU) for its High School Program. A teacher is available to meet with inmates that are ages twenty (20) and under throughout the school year. The Religious Program has a chaplain on-site five (5) days per week to provide group and individual services to inmates. The Volunteer Program offers various services to inmates such as Bible study, Narcotics Anonymous (NA), and Alcoholics Anonymous (AA). Prior to the COVID-19 pandemic, the Jail had approximately 120 active volunteers. The Jail contracts with PrimeCare for medical services which include physical health, mental health, dental, and treatment groups. PrimeCare also oversees the Jail to Community/Medication Assisted Treatment (MAT) Program. Intake Process A series of screenings is done whenever an individual is brought to the Jail for booking to ensure that they receive the appropriate housing/classification and treatments. During this process, the individual’s background and current needs are assessed through the completion of a triage form and jail/medical intakes. Information from these screenings is used to make the following housing and status determinations: detox protocol, suicide watch, and segregation status assignment. An objective housing/classification screening is done during booking which gathers information on criminal/institutional history and any stabilizing factors like age, employment, or education. This information is used to determine whether the individual should be sent to a minimum, medium, or maximum status unit after clearing quarantine. Mental Health Provider Meeting MH 4 3/12/21 Inmates can be assigned to a worker cadre unit that completes tasks as part of the laundry, kitchen, County maintenance, and outside work details. There are also groups of inmates that clean common areas (i.e. hallways, lobby, and visitation areas). The Jail has an in-house Work Release Program which is supervised by Adult Probation. Inmates are screened to ensure that they meet classification and sentencing requirements to work outside of the Jail at community employment. This program is currently suspended due to COVID-19 with no projected return date. Treatment Model Correctional Treatment Specialists facilitate the Jail’s treatment model which is overseen by the Directors. A Risk-need-responsivity approach is used to assess/determine the inmate’s needs and to assign programming accordingly. The Jail uses the following assessments to identify needs:  Texas Christian University (TCU) – measures drug/alcohol use within the last twelve (12) months  Risk Screen Tool (RST) – measures recidivism factors (i.e. risks of coming back to the Jail and inappropriate behaviors while incarcerated)  Ohio Risk Assessment System (ORAS) – measures areas of concern such as employment, drug/alcohol use, and family/social relationships An Individual Treatment Plan (ITP) is developed and discussed with each inmate to inform them about which programs are recommended to be completed while at the Jail. Although all programs are voluntary, the inmate’s level of participation is discussed with Adult Probation at the time of their release. Program Curriculum The Jail offers Drug and Alcohol Groups. These groups do not provide licensed treatment but instead focus on basic drug/alcohol education and relapse prevention. There is a Certified Addictions Counselor on staff that leads each group and meets with inmates individually as needed. The Trauma Affect Regulation: Guide for Education and Therapy (TARGET) Program addresses each inmate’s history of trauma in a safe way without damaging their overall progress. The Jail has been a licensed TARGET provider for over three (3) years. Inmates are often able to continue their involvement with the TARGET Program at a community provider upon release. Other programs in the Jail curriculum include High School/GED, Healthy Living/Parenting, Succeeding Under Supervision/Job Skills, Stress and Anger Management, Victim Impact , Mental Health Wellness/Trauma Groups, Sex Offender Treatment (satisfies court order requirement), and Grief and Loss. The Jail to Community/MAT Program originally offered Vivitrol injections to inmates that would be going out of the Jail for drug and alcohol counseling with a community provider. Inmates have been prevented from going out to counseling appointments since the start of the COVID-19 pandemic. The Mental Health Team now provides this counseling in-house. There had been an issue with Vivitrol injections being diverted so the Jail has mostly switched to using Suboxone strips instead. Mental Health Provider Meeting MH 5 3/12/21 Non-Jail staff are also involved with program curriculum. The Jail contracts with Peerstar for Peer Support services. Peer Specialists have not been coming in person to meet with inmates in recent months due to visitation restrictions from Peerstar and/or the Jail that were related to COVID-19. Efforts are currently underway to restart Peer Support Services at the Jail. Religious volunteers coordinate the Jail’s Twelve (12) Step Programs (i.e. NA, AA, Celebrate Recovery). Franklin/Fulton Drug and Alcohol staff conducts Operation Save a Life training for the Jail. The Jail works with outside providers and other County agencies on a Case Review Task Force. This group meets to discuss individuals that are having a difficult time returning to the community. Case Review Task Force Meetings will be restarting soon. Keystone Navigators meet with inmates that are soon to be released from the Jail to assist them with setting up Medical Assistance or other types of insurance. The Navigators will often help inmates complete their COMPASS PA application. Specialized Services The Director of Specialized Services coordinates outpatient competency evaluations for the criminal court system, psychiatric evaluations with Dr. Liggon, and drug and alcohol assessments. The Director also makes referrals to SAM, Inc. for individuals that need case management/housing and meet the Serious Mental Illness (SMI) criteria. Discharge Planning Re-entry Committee The Discharge Planning Re-entry Committee includes representatives from the Jail, Pre- Release, the CARE Program, and the Single County Authority (SCA)/Drug and Alcohol. This committee discusses inmates that are scheduled for release within the next three (3) weeks while considering their program participation, behavior, home plan, and parole recommendation or denial. Discharge PrimeCare staff provides a three (3) day supply of all prescribed medications to individuals that are being discharged from the Jail. They will also call in a thirty (30) day prescription of mental health medications and others as needed to either Chambers Apothecary in Chambersburg or Savage Family Pharmacy in Waynesboro. Various re-entry brochures and outpatient guides are provided to discharged individuals which feature helpful referral information that can be used upon returning to the community. Jail staff will transport an individual to Keystone Crisis at the Chambersburg Hospital if PrimeCare determines that they meet the appropriate criteria at the time of discharge. Transports can also be made to other locations requested by the discharged individual (i.e. bus stop, train station, Salvation Army). Mental Health Provider Meeting MH 6 3/12/21 304 Process The Jail follows a process to involuntarily commit inmates to the Forensic Unit of Torrance State Hospital through a 304(c) petition. PrimeCare staff will usually initiate the petition when an inmate’s current mental health needs exceed what the Jail can provide and a transfer to Torrance State Hospital is determined to be the best option for stabilizing them. The Director of Specialized Services coordinates with a Mental Health Review Officer (MHRO) and the inmate’s attorney to schedule a 304 (c) hearing. PrimeCare mental health clinicians and psychiatrists present their observations of the inmate’s behaviors during the hearing. If the MHRO recommends an involuntary commitment and a judge signs off on the resulting court order, the inmate will be transferred to Torrance State Hospital. A different process is followed when Jail staff determines that an individual being discharged needs an involuntary commitment. In this situation, a 302 petition is initiated and the State Police transport the individual to Chambersburg Hospital for an emergency psychiatric evaluation. COVID-19 Response Inmates are put on quarantine for up to twenty-one (21) days after being committed to the Jail. PrimeCare staff will monitor new inmates for COVID-19 symptoms and treat them as positive until proven otherwise. If an inmate receives a positive COVID-19 test, their quarantine will continue. If an inmate receives a negative COVID-19 test, they will be cleared for general population. The Jail’s day space time schedules have been modified so that inmates can come out in cohort groups to ensure social distancing. Each cohort group’s recreation activities occur within a two (2) to three (3) hour window. In-person social visitations and Volunteer Programs at the Jail have been suspended. All staff and inmates are required to wear masks. Staff is required to answer screening questions and have their temperature taken prior to entering the facility. Any staff that have a high temperature reading or exhibit other symptoms must be tested and receive a negative result before they can return. Questions? Jim inquired about the current census and whether any Fulton County residents are still being housed at the Jail. Michelle confirmed that the current census is 375 and that Fulton County residents have not been housed at the Jail for several years due to an overall increase in population. Barry Munch asked if the Jail would be able to accommodate any virtual Peer Support services. Melyssa explained that the Jail does not have adequate staff resources to accommodate virtual services at this time. Michelle noted that staff has been handling an increase in requests for professional in-person visitation and video conferencing appointments from outside providers, other County agencies, and the court system. Mental Health Provider Meeting MH 7 3/12/21 ≠ Provider Spotlight: Laurel Life Services (Folium) – Dee Santiago , Supervisor of Administrative Services Program Overview The umbrella organization for Laurel Life Services is Folium, Inc. Prior to its rebranding in 2017, the umbrella corporation had been Manito since 1979. Folium is now the administrative organization and Laurel Life Services continues to be the name of the behavioral health programming branch. The Brown’s Mill Center Alternative Education and Alternative High School programs have been rebranded as Affinity Education Solutions. Bill services are still provided in the Chambersburg area. The Alternative Education program has downsized over the years and is limited in functioning this year due to COVID-19 with a small group of students at the Brown’s Mill campus. The Alternative High School program is currently serving thirteen (13) individuals from the Shippensburg School District at the Brown’s Mill campus. Rolling Hills Rolling Hills is the name of the van transportation service provided by Folium. Rolling Hills is currently transporting approximately 120 individuals per day in Franklin County who require specialized transportation to programs within or outside of the public school setting. Mill Road Adventures Mill Road Adventures is an adventure based and team building operation. The Brown’s Mill location includes the Alpine Tower and other climbing initiatives. The mobile program offers team building exercises facilitated by Mill Road Adventures staff for individual teams or organizations at their location. Behavioral Health Programs The largest component of Folium is Laurel Life’s Behavioral Health programs. The most recent data for individuals served was updated in January 2021. Outpatient Counseling Services at the Phoenix Drive and Brown’s Mill locations are serving approximately 590 individuals each month. This number also includes the Greencastle, Waynesboro, and Chambersburg School District satellite clinic locations. Within the Outpatient Program, psychiatric services are being provided to children, adolescents and adults. The psychiatric services are provided by Dr. Dana Crites, MD and Suzanne Siroki, PMHNP- BC. There are eight (8) licensed professional counselors, one (1) licensed clinical social worker, and other master’s level clinicians providing Outpatient Therapy services. Parent Child Interactive Therapy is provided at the Phoenix Drive location. A number of therapists are trauma-informed trained and a few therapists are certified in Trauma Focused Cognitive Behavioral therapy. One (1) therapist is currently finishing their certification in EMDR (Eye Movement Desensitization and Reprocessing) Treatment and one (1) therapist is working on certification as a Registered Play Therapist. There has been an increase in referrals to Laurel Life’s outpatient practices. Referrals are being accepted at this time but there could be a long wait depending on the insurance Mental Health Provider Meeting MH 8 3/12/21 coverage and the needs of the individual. Laurel Life is credentialed to work with multiple primary insurance providers. Managed Care and Fee for Service are also accepted. Family Based Mental Health Laurel Life is a Family Based Mental Health provider for Franklin and Fulton Counties. Three (3) teams of therapists work with families in the two (2) counties. Laurel Life is also one of the agencies that hold a contract with Franklin/Fulton MH/IDD/EI. Family Based served approximately twenty-two (22) individuals/families in January and new referrals are currently being accepted. Intensive Behavioral Health Services (IBHS) This is Laurel Life’s first year of licensure as an IBHS provider. IBHS is the rebranding/renaming of Behavioral Health Rehabilitation Services (BHRS) which were formerly known as Wraparound. The two (2) forms of IBHS services are individual services and specified Applied Behavior Analysis (ABA). Approximately 100 individuals will receive these services in Franklin and Fulton Counties. There are two (2) board certified Behavior Analysts, five (5) ABA qualified Behavior Consultants, and eight (8) Behavioral Health Technicians within the IBHS program. They will be providing both individual services and ABA treatment. Girls, Inc. Laurel Life has a contract with Girls, Inc. in the Hagerstown, MD area. Psycho-educational treatment is provided to identified youth in an after school program. The program serves approximately 100 girls on a monthly basis. The program includes life skills training, psycho-education, coping strategies, and skill teaching. Transition Classroom Program Transition Classroom Programs are created as a contract with individual school districts to provide trauma-informed care programming. Laurel Life provides a teacher, behavioral coach, therapist, and a transition coordinator to each classroom. The goal is to provide treatment, planning, and education focused on identified students. These students are either at risk for out of district placement or returning from residential foster care outside of the district/county for a possible inpatient stay. The goal is to ease them back to regular educational programming within the district. Laurel Life utilizes treatment planning and collaborates with parents/schools to help students transition back to the regular educational programming. There is currently a transition classroom at two (2) schools in Franklin County: Waynesboro Area Middle School and Fairview Elementary School (Waynesboro Area School District). Laurel Life staff typically works with ten (10) to eleven (11) students in the classrooms on a daily basis for either full or partial days. National Certification Laurel Life’s entire agency has been nationally certified as a trauma informed-care program. This is based on early screening/assessment within all of programs and nurturing a trauma- informed and responsive workforce. The staff receives several initial and yearly trainings on trauma-informed care and practices. The overall goal is to create, promote, and maintain Mental Health Provider Meeting MH 9 3/12/21 safe environments for staff and families served by the agency either in-home or at an office location. COVID-19 Response Laurel Life has worked diligently to promote its COVID-19 wellness policies and procedures. These measures include pre-screening for staff as well as consumers to mitigate risk. In the past four (4) to six (6) months, 95% of IBHS and Family Based services have been provided within the homes. Protocols have been put into place to ensure that staff and families experience safe in-person programming. The percentage of Outpatient services being offered in-person or via telehealth has varied depending on the month. The consumer’s comfort level and ability to feel safe during appointments at the office continues to be the most important consideration when deciding between in-person and telehealth options. Laurel Life has strictly followed the Centers for Disease Control and Prevention (CDC) and OHMSAS safety guidelines on protective barriers/approaches while working with individuals during in-person IBHS and Family Based sessions. Virtual brochures were sent out with this meeting’s agenda for the Outpatient, IBHS, ABA, Family Based, and Transition Classrooms Programs. The information can be shared with any interested consumers and agencies in the community. Laurel Life encourages inquiries from community members and welcomes the opportunity to collaborate in ways that will improve its services. County Announcements/Information ≠ Reports due since our last MH Provider Meeting:  Audited Financial Reports (for FY ending June 30th)  Audit Engagement/Extension Letter (for calendar year ending December 31st)  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: Contract Season FY 21-22  Quarterly Report of Expenditures (January – March)  Appendix A for upcoming fiscal year (including measurable outcomes/goals if encumbrance is at least $50,000)  Budget Packets (to include Budget/Rate Letter, Staff Roster, Unit Assumptions, Budget Narrative for upcoming fiscal if appropriate) ≠ Contract Signers and Recipients – Erin Nye An email will be sent to contracted providers in the next couple of weeks requesting updated contact information for their designated contract signers and other staff that should receive a copy of the contract. It is important that providers respond to this email in order to keep MH/IDD/EI’s records up to date and facilitate the electronic approval process for contracts. ≠ Human Services Block Grant Mini-grants – Erin Nye The Human Services Block Grant Mini-grant application was released on March 12th. This is a one-time grant opportunity for up to $15,000 per application. Providers may submit more than one application if they offer multiple programs/services. The Mini-grant application packet includes an overview of the funding and guidelines for qualifying programs in the Mental Health Provider Meeting MH 10 3/12/21 following areas: Mental Health, Intellectual and Developmental Disabilities, Homeless Assistance, Substance Use Disorder, and Human Services Development Fund. Mini-grant applications must be submitted to Glenda Helman (gshelman@franklincountypa.gov) and Stacie Horvath (smhorvath@franklincountypa.gov) by 12:00 p.m. on March 26th. A review process will determine which applications are recommended for consideration during an upcoming Public Block Grant Meeting. Providers may reference the County website and Facebook page for more information about the Mini- grant or to download an application packet. ≠ Psychiatric Admissions Reporting Overview (handout): Comparing October – December 2020 with October – December 2019 This report also includes a 2020 calendar year review of actual utilization at Danville State Hospital. A slight re-formatting of the report has occurred in light of SAM, Inc.‘s recent transition to Blended Case Management (BCM). Entries that would have been listed as Intensive Case Management (ICM) or Resource Coordination (RC) on former reports have been combined under BCM. ≠ Certified Clinical Trauma Professional (CCTP) Training Course and Block Grant Reminders – Jim Gilbert on behalf of Cori Seilhamer Providers have until May to complete the CCTP training course. Providers should share any strengths/needs in regard to the Block Grant with Cori. The meeting was adjourned. Next Meeting: Friday, June 11, 2021 starting at 10:00 a.m. in the Human Services Building with a call-in option or via Google Meet 2021 Meetings: September 10th December 10th Minutes by Dan Rhodes