1

Mental Health Services Act

Steering Committee Meeting

August 4, 2008

2

Sharon Browning

Welcome

3

William Gonzalez

Consumer Perspective

4

Mary Hale

Local / State Updates

5

Kate Pavich

MHSA Updates / Capital Facilities

6

Capital Facilities-Technological Needs

Component Proposal was submitted to DMH on 7/17.

DMH review team has completed the administrative process and will be moving our proposal on to the next level of review and approval. DMH will send “points of clarification” by 9/17/08. Proposal will be approved after all questions are answered.

7

401 S. Tustin Renovation Architect and selected consultants have begun

validation study Civil Engineer has begun topographic research A Geotechnical Engineer has begun site

investigation Hazardous Material crew has begun fieldwork Conditional Use Permit for a residential

psychiatric facility was verified

8

Architecture and Planning

Alexander + Hibbs AIA, INC.1200 N. Jefferson St. Suite AAnaheim, CA 92807Tel:  (714) 630-3686Fax: (714) 630-3687www.alexanderandhibbs.com

9

401 S. Tustin Programming

Mission Statements have been drafted for the Crisis Residential Program, Wellness /Peer Support Center and Vocational Training Program

Request for Proposal for the Wellness Center was released on 7/16

10

401 S. Tustin Programming Space requirements for all three programs

were reviewed Discussed ways to incorporate “green”

activities into the project which will be constructed as energy efficient/ environmentally friendly as possible

HCA staff and architects toured a children’s crisis residential program and Transitional Age Youth program to develop design ideas and recommendations

11

DMH Information Notice 08-21

Funding Augmentation $28,308,300 increased to $37,202,800

Request for Capital Facilities

Pre-Development Funds

12

PEI Review

CSS / PEI – Orange County

PEI Roundtable 7/28/08 - 7/29/08

13

Resilience – A Key Element in PEI

Valuable model to evaluate how programs will engage the resilient nature of the folks we are hoping to serve and how will protective factors critical to health be employed in these programs. These protective factors are:

14

Caring Relationships

Consistently “being there” Showing compassion, interest, and

acceptance Listening to what is expressed Having patience Being trustworthy

15

Setting High Expectations

Expressing belief in people’s resilience Showing respect, firm guidance and

support Providing structure Remaining strengths-focused Reframing

16

Meaningful Participation

Creating a safe place for expression, inclusion and choices

Allowing everyone to have a voice Participant-driven Caring for others Peer Support

17

Protective Factors

These protective factors should be at the heart of our PEI efforts whether it’s community collaboration, individual/family driven programs, systems change, recovery programs, evidence based practices, or cultural competence

18

“Bringing Young People to the Policy Table”

19

Prevention Question:

“How can the education, foster care and juvenile justice systems be improved to support young people’s own efforts to maintain their mental health?”

20

Youth Recommendations

#1 Long-Term Relationships with Adults

#2 Make Meds Make Sense

#3 Confidentiality

21

Youth Recommendations:

#4 Culturally Positive Environments

#5 Youth Voice

22

Intervention Question:

“What kind of interventions change the mentality of young people who have experienced trauma, so they don’t repeat the abuse and self-abuse they learned as coping tools?”

23

Youth Recommendations:

#1 Cultivate Personal Interests

#2 Fix the Situation, Not Just the Kid

#3 Good Information

24

Youth Recommendations:

#4 Avoid Labels and Stigma

#5 Role Models

25

Young People Matter

“Kids can walk around trouble if there is someplace to walk to, and someone to walk with.”

Tito in Urban Sanctuaries(Milbery, McLaughlin et. al)

26

Listening

“I believe all any of us really wants is to feel truly and deeply heard, seen, acknowledged, and allowed to be ourselves.”

Jon Wilson

Hope Magazine (#40) 2003

27

Kimari Phillips

PEI Community Survey Updates

28

Survey Dissemination Mailed over 3,000 surveys to OC

organizations and community members

Handed out over 5,000 surveys throughout OC at meetings, clinics, community based organizations, etc.

E-mailed announcements regarding the online surveys (including a hyperlink for easy access)

29

390 Organizational Surveys Received72.6% Print (n = 283)

27.4% Online (n = 107)

1,564 Community Surveys Received81.5% Print (n = 1,275)

18.5% Online (n = 289)

Community Survey Language84.7% English (n = 1,325)

11.7% Spanish (n = 183)

3.6% Vietnamese (n = 56)

30

Information Gathered from Organizational Providers in OC

Types of organizations serving OC community (potential PEI partners)

Types of PEI services provided by respondents Percent of annual budget allocated to PEI Resources needed by OC providers to deliver

PEI services Satisfaction with amount & accessibility of PEI

services in OC Opinions regarding:

Priority goals/needs for PEI in OC How OC can best deliver PEI services to

underserved populations

31

Information Gathered from OC Community (Residents/MH Consumers)

Demographic info (age, gender, race/ethnicity, annual household income, home ZIP code)

Satisfaction with amount & accessibility of PEI services in OC

Opinions regarding: Populations in greatest need of PEI in OC Priority PEI issues in OC communities Most effective settings for identifying OC

residents with a need for PEI services Best approaches for addressing PEI in OC

32

Race/Ethnicity of Community Respondents (n=1,514)

1.4% 0.9%

50.2%

12.2%

26.9%

3.5%5.0%

0%

10%

20%

30%

40%

50%

60%

White

/Cau

casi

an

Hispan

ic/L

atin

o

Asian

Black

/Afri

can A

mer

ican

Amer

Indi

an/N

ativ

e Am

er

Pacifi

c Is

land

er

OTHER / M

ULTIPLE

33

Community Respondents’

Average Age (n=1,476)

43.5 years (15-91 yrs)

Gender (n=1,531)

66.8% Female33.1% Male

34

AverageAnnual Household Income (n=1,429)

38.0%

32.0%

17.1%

12.9%

< $25,000 $25,000-$74,999 $75,000-$124,999 $125,000+

35

There are enough existing PEI resources and services.(n=382 provider & n=1,512 community responses, averages=1.72 & 2.25on a 5-point scale, where 1=Strongly Disagree, 5=Strongly Agree)

0%

10%

20%

30%

40%

50%

60%

70%

StronglyDisagree

SomewhatDisagree

NeitherAgree NorDisagree

SomewhatAgree

StronglyAgree

Organizational

Community

36

There is enough information available about how to find and access existing PEI resources and services.(n=387 provider & n=1,527 community responses, averages=1.86 & 2.29 on a 5-point scale, where 1=Strongly Disagree, 5=Strongly Agree)

0%

10%

20%

30%

40%

50%

StronglyDisagree

SomewhatDisagree

NeitherAgree NorDisagree

SomewhatAgree

StronglyAgree

Organizational

Community

37

Community Opinions Regarding Priority Populations for PEI in OC(n > 1,500, averages on a 5-point scale, where 1=Very Low Need, 5=Very High Need)

High to Very High Need for PEI

4.44.2 4.1 4.1

0

1

2

3

4

5

Risk for Suicide Serious Signs of MI Facing Trauma Youth in StressedFamilies

38

Community Opinions Regarding Priority Populations for PEI in OC (n > 1,500, averages on a 5-point scale, where 1=Very Low Need, 5=Very High Need)

Moderate to High Need for PEI

3.98 3.97 3.92 3.75

0

1

2

3

4

5

Family History ofMI &/or SA

Underserved byMH Svcs

Risk of SchoolFailure

Risk of Arrest/Jail

39

(slide 1 of 2) Opinions Regarding Priority PEI Goals/Needs

REDUCTION OF…

0%

10%

20%

30%

40%

50%

Organizational

Community

40

(slide 2 of 2) Opinions Regarding Priority PEI Goals/Needs

REDUCTION OF…

0%

10%

20%

30%

40%

50%

MH S

tigm

a

Arrest

& J

ail

Remov

al of C

hildr

en

Unem

ploy

men

t

Milit

ary

Vet P

robs

OTHER: S

A, Und

svd,

Srs

Organizational

Community

41

Other Written PEI Goals/Needs

Dual Diagnosis/Substance Abuse (16.8%): eg, substance abuse/addiction; problems due to prenatal drug

exposure; self medicating; rehab Underserved & Lack of Services/Access (14.5%):

eg, access to care/Rx at low/reasonable cost; more bilingual/bicultural staff; working poor; eligibility for SSI/SSDI, Medi-Cal/Medicare, MSI, Mental Health

Seniors/Older Adults (13%): eg, elder neglect/abuse; senior homeless; isolated at risk elderly;

lack of services for elderly; stigma particularly affects older adults

42

Community Opinions Regarding Effective Settings for Identifying OC Residents Needing PEI Services

30.6%

44.1%

36.6%

34.3%

26.0%

48.7%

0%

10%

20%

30%

40%

50%

60%

Schools DoctorOffices &

Clinics

SocialServices

Healthcare:Hospitals,

SNF

CommunityBased Orgs

LawEnforcement

& Legal

43

Community Opinions Regarding Effective Settings for Identifying OC Residents Needing PEI Services

12.2%

1.5%

7.5% 6.6% 6.2%

0%

10%

20%

30%

40%

50%

60%

Un/employmentCtrs

In-home Faith-based Orgs Workplaces OTHER:Neighborhood,

Media

44

Community Opinions RegardingBest Strategies for Addressing PEI in OC

39.3% 38.2%

9.1%

46.5% 45.7%

3.6%

0%

10%

20%

30%

40%

50%

60%

Early

Scr

eenin

g, Dx,

Tx

Train

ing fo

r Pro

fess

ional

s

I & R

@ D

iver

se S

ettin

gs

Paren

t Educ

/ Suppor

t Svc

s

Work

-bas

ed P

rogr

ams

OTHER: Colla

b, Housi

ng, P

H

45

Other Written PEI Strategies

Collaboration & Expanded Services (31.6%): eg, connect with Prop 10 services particularly with/for 0-5 yrs of age;

locate better funding for existing programs; use more Spanish speaking staff; more clinics; support non-profit orgs

Housing & Placement for Recovery/Homeless (22.8%): eg, implementation of AB 1421; additional facilities - inpatient and

outpatient - for treatment; do not turn people with mental issues out on street; homeless outreach; long term care in SNF

Public Education & Media Campaigns (19.3%): eg, increase public awareness via media (newspapers, bus stops, TV,

radio, Internet “pop-ups,” MySpace, YouTube, etc); advertisements; public mailings; life skills training

46

Community Suggestions for Expansion of PEI

At the Provider Level:1. Expanded MH Services

(78.0% of suggestions)

2. Priority PEI Settings (67.6%)

Schools, Residential Tx/ Rehab, Resource Centers, Doctor Offices/Clinics

3. Priority PEI Populations (52.7%)

Children & Youth, Substance Abusers, Homeless, Seniors/Older Adults

4. Professional Training (49.7%)

5. Early Identification of MH Problems (43.2%)

To Meet Consumer Needs:1. Community Programs

(53.9% of suggestions)

2. Family/Caregiver Resources (34.9%)

3. Public Knowledge (29.2%)

4. Counseling Resources (27.0%)

5. Culturally Competent Resources (19.4%)

6. Access to Services (19.1%)

7. Crisis Management (17.0%)

47

Organizational Suggestions for Expansion of PEIAt the Provider Level:1. Expanded MH Services

(45.6% of suggestions)2. Priority PEI Settings

(44.2%) Schools, Resource Centers,

Doctor Offices/Clinics, Faith Based Organizations

3. Priority PEI Populations (38.8%)

Children, Transitional Age Youth, Seniors/Older Adults, Homeless

4. Early Identification of MH Problems (22.4%)

5. Professional Training (19.0%)

To Meet Consumer Needs:1. Access to Services (46.3%

of suggestions)

2. Community Programs (23.8%)

3. Family/Caregiver Resources (20.4%)

4. Culturally Competent Resources (14.3%)

5. Counseling Resources (11.6%)

6. Public Knowledge (11.6%)

7. Crisis Management (6.1%)

48

COMBINED Suggestions for Expansion of PEIAt the Provider Level:1. Expanded MH Services

(71.4% of suggestions)2. Priority PEI Settings

(62.9%) Schools, Resource Centers,

Doctor Offices/Clinics, Residential Tx/Rehab

3. Priority PEI Populations (49.9%)

Children & Youth, Substance Abusers, Homeless, Seniors/Older Adults

4. Professional Training (43.5%)

5. Early Identification of MH Problems (39.0%)

To Meet Consumer Needs:1. Community Programs

(47.8% of suggestions)2. Family/Caregiver

Resources (32.0%)

3. Public Knowledge (25.7%)

4. Access to Services (24.6%)

5. Counseling Resources (23.9%)

6. Culturally Competent Resources (18.4%)

7. Crisis Management (14.8%)

49

For more information regarding methods used for data collection, preliminary analyses, or this summary of results …

Contact:Kimari Phillips, MA, CHESResearch Analyst, OC Health Care AgencyOffice of Quality Mgmt – Planning & Research

714-834-7402kphillips@ochca.com

50

Alan Albright

PEI Sub-Committee Meetings

51