HomeMy WebLinkAboutmhab-annual-report-presentation-bos-meeting-2022-2023Mental Health Advisory Board (MHAB)
Annual Report and Recommendations
FY 2022 –2023
Alameda County Board of Supervisors Health Committee
December 11, 2023
Presented by:
Brian Bloom, MHAB Chair
Terry Land, MHAB Vice Chair
Thu Quach, MHAB Adult Committee Co-Chair
The Mental Health Advisory Board (MHAB)
Statutory Authority:
Appointed by the Board of Supervisors, the MHAB is required to:
•Review and evaluate the community’s public mental health needs,services,facilities
and special problems in any facility where mental health services are provided;
•Advise the Board of Supervisors and the County’s Behavioral Health Care Services
Director on any aspect of local mental health program;
•Review any county agreements pursuant to Welfare and Institutions Code Section
5650;
•Review and approve the procedures used to ensure citizen and professional
involvement at all stages of the planning process
•Submit an annual report to the Board of Supervisors on the needs and
performance of the county’s mental health system;and
•Perform such additional duties as assigned by the Board of Supervisors.
Brian Bloom,
Chair
District 4
MHAB Members
Terry Land,
Vice Chair
District 1
Gina Lewis
District 2
Thu Quach
District 2
Warren Cushman
District 3
Ashlee Jemmott
District 3
Alison Voss
District 3
Juliet Leftwich
District 5
Amy Shrago,
Board of
Supervisors
Representative
District 5
Overview of MHAB Activities 2022-2023
•Heard from a variety of behavioral health experts and stakeholders
•Held regular monthly meetings for the Criminal Justice and Adult
Committees
•Served on the Care First,Jail Last Taskforce;Mental Health Services Act
(MHSA)Stakeholder Committee;and the MHSA Budget Stakeholder
Committee
•Conducted two site visits –John George Psychiatric Hospital and Jay
Mahler Recovery Center (crisis residential treatment center)
•Sent two substantive letters to the Board of Supervisors,one expressing
the MHAB’s opposition to the expenditure of $26.6 million of county funds
to build the Mental Health Program and Services Unit at Santa Rita Jail,
and the other providing extensive comments and recommendations
regarding the MHSA FY 2023-26 Three Year Plan.
Annual Report FY 2022-2023: Recommendations Summarized
1.Create a Clear,Publicly-Accessible System Map that Provides an Overview of the System of Care
for the Seriously Mentally Ill (SMI)and those with Substance Abuse Disorders (SUD)
2.Improve Ongoing Continuity of Care for the SMI and SUD Population
3.Increase the Number of and Length of Stay at Crisis Residential Treatment Facilities
4.Continue to Assess the Need for Sub-Acute Treatment Beds
5.Expand the Capacity of and Publish Data Regarding Behavioral Health Court
6.Increase Cultural and Linguistic Responsiveness in Mental Health Services
7.Double-Down on Strategies that Invest in Workforce,Including Recruitment and Retention,and
Expand Providers to Include Lay Counselors
8.Continue to Support Prevention and Early Intervention (PEI)Programs that are Focused on
Reducing Negative Outcomes and Effective at Connecting People with Mental Health Services
Recommendation 5:
Increase Capacity of the Behavioral Health Court (BHC)
•Diverting mentally ill defendants out of jail and into appropriate treatment in non-jail
settings,the BHC reduces recidivism and improves mental health outcomes.
•The County should set a near-term goal of doubling capacity of the BHC.
•The lack of timely assessments contributes to the under-utilization of the BHC.
•The County must study the treatment needs of mentally ill defendants in Santa Rita and
then make the requisite investments in Sub-Acute facilities,Crisis Residential Treatment
(CRT)facilities,and Full Service Partnerships (FSPs),so that the BHC can promptly and
effectively divert mentally ill defendants out of jail and into the appropriate level of care in
the community.(See RAJ Final Report,Recommendation No.40:“Assess the Existing
Inmate Population to Determine Options for Diversion”).
•Need for a “Dual Diagnosis Court”to serve the treatment needs of defendants suffering
from co-occurring disorders.
•A Family Advocate is needed in court who could connect with and help families support
their loved ones who are participating in the BHC.
Recommendation 3:
Increase Capacity of the Crisis Residential Treatment (CRT) Facilities
•CRT facilities are a crucial part of the continuum of behavioral health care as they provide
necessary treatment for a variety of people with mental health challenges,including:
those being diverted from jail,those requiring a “drop-down”from an in-patient acute or
sub-acute facility,and those served by a mobile crisis and/or IHOT team.
•There are currently only 42 CRT beds in the County.
•As many as 42 additional CRT beds may be operational by 2027 through the state’s
BHCIP/CCE grant funding process.
•Even with additional CRT beds in the future,the County must continue to analyze how
many CRT beds are needed to adequately serve the diverse needs of people with
behavioral health challenges.
•Too often,the typical 14-day stay is too short for proper treatment,stabilization,
medication compliance,and meaningful discharge planning.
Recommendation 4:
Assess the Need for Sub-Acute Treatment
Beds and Increase Capacity as Necessary
•The County concurs with the MHAB’s recommendation from last year that the County
“buy back”the 26 beds at Villa Fairmont that are currently purchased by other service
funders.
•The County should be transparent about when these additional beds are purchased
and if there are any obstacles to securing the funding necessary to buy back any of
the 26 beds.
•Additional sub-acute treatment beds may be operational by 2027 due to the state’s
BHCIP/CCE grants awarded for the development of a new forensic Mental Health
Rehabilitation Center (MHRC).
•The County should continue to analyze and assess the need for sub-acute treatment
beds.
Recommendation 1:
Create a Clear, Publicly-Accessible System Map that Provides an Overview
of the System of Care for the SMI and those with SUD
Why?
•ACBH system is incredibly complicated and difficult for consumers,families as well as
providers to decipher and navigate.
•Decentralized and utilizes a variety of outside contractors and facilities.
•Can only see pieces of the puzzle and not the big picture.
What?
•ACBH should create a visual system of care map -from acute,subacute,crisis
residential to outpatient services.
•Help consumers and families to navigate the system.
•Support providers as they seek to coordinate services.
•Visualize capacity,gaps and needs around system of care.
•Support decision-making process for resource allocation and prioritization.
Recommendation 2:
Improve Ongoing Continuity of Care for the SMI and SUD Population
Why?
•Often receive minimal services and cycle in and out of acute psychiatric facilities,jail,
and homelessness.
•Individuals face many challenges,and it’s difficult to navigate the system of care –
including Insurance,housing,transportation,a job or volunteering,and social services.
•Barriers in accessing these services increase likelihood of relapse and cycling in the
system.
What?
•Institute a single point of contact (care coordinator)who proactively reaches out.
•Ensure individual has ongoing access to psychiatric services,medical care,social
services and housing etc.
•Could significantly improve outcomes and prevent cycling.
•Help Alameda County better understand the issues and make targeted improvements.
Recommendation 8:
Continue to Support PEI Programs that are Focused on Reducing Negative
Outcomes and Effective At Connecting People with Mental Health Services
Why?
•MHSA PEI intent:“reducing seven negative outcomes that may result from untreated
mental illness:suicide,incarceration,school failure or dropout,unemployment,prolonged
suffering,homelessness,and removal of children from their homes.”
•Current AC MHSA Plan funds large number of programs.
•Many not focused on connecting people with or providing mental health service.
•Many cite community engagement,social events and general wellness activities as
their goal and accomplishment.
What?
•Recommend development and implementation of more purposeful metrics.
•Include accountability for delivering on mental illness/health aspects of the program goals.
•Continue to prioritize funding for programs that meet this intent.
Recommendation 6:
Increase Cultural & Linguistic Responsiveness
Why?
•Low penetration rate for underserved communities (i.e.,AANHPI,limited English
proficient)
•Culturally and linguistic responsive services -language access,ethnic healing
practices,and bilingual/bicultural providers -can increase penetration rate
What?
•Incentivize bilingual and culturally responsive providers.
•Invest in a culturally and linguistically competent workforce,not just language line.
•Provide payment and reimbursement structures that recognize the culturally and
linguistically competent services.
•Protect funding for CBOs that provide culturally-based prevention programs.
Recommendation 7:
Double-Down on Strategies that Invest in Workforce
Why?
•Recruitment and retention challenging; workforce crisis creates access issues for clients
•Community-based organization (CBO) providers are contracted to provide vast majority
of mental/ behavioral health in the county
What?
•Invest more resources to support CBO –increased funding and flexibility to attract and
retain workforce
•Invest more in lay counselors (trained yet not licensed professionals) to meet demand
and fill gaps
✓Support more of the lay counselor trainings to be more widely available
✓Reimburse at higher rate to allow for more retention of staff
✓Lay counselors more likely to be culturally /linguistically congruent with clients
Questions & Answers