I. Welcome and Call to Order. Review/ Approval of Minutes from last meeting

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1 Dallas County Behavioral Health Leadership Team Thursday, September 12, 2013 Henry Wade Juvenile Justice Center 2600 Lone Star Drive, Dallas, TX Room 203 A at 9:30 11:30 a.m. I. Welcome and Call to Order II. III. IV. Review/ Approval of Minutes from last meeting Changes to BHLT Membership Primary Care Physicians Dr. Sue Bornstien School Liaison Dr. Michael Ayoob Recommendations for BHLT Action Adoption of Resolution for New Membership Adoption of Resolution for DSRIP Milestone Reporting V. Reports from and Charges to BHLT Committees Clinical Operations Team FACT BHSC CSP Governance Committee Legislative Committee (Thank you letters sent) VI. VII. NTBHA Update Update on Pending Issues In Jail Competency Restoration Pilot VIII. Public Comments IX. Adjournment Page 1

2 Dallas County Behavioral Health Leadership Team Meeting Notes Thursday, August 8, 2013 Welcome and Call to Order, Commissioner Price: The meeting was called to order by Commissioner John Wiley Price at 9:36 AM. Review/Approval of Minutes: The minutes from the BHLT meeting held on July 11, 2013 were made a part of the packet. There was a motion made to accept the minutes as printed. The motion was seconded and approved. Commissioner Price commended Parkland Hospital for successfully passing a key government survey conducted by Centers for Medicare and Medicaid Services (CMS). Parkland will no longer have to operate under a systems improvement agreement, which went into effect Sept. 27, Sharon Phillips with Parkland stated that she feels confident that the structures in place will help them sustain their current status. Recommendations for BHLT Action: Ron Stretcher directed the committee s attention to a handout that was in addition to the packet for this meeting. The handout consisted of the letters generated for the Senators and State Representatives thanking them for their support during this legislative session regarding additional funding for the mental health community. There was some discussion regarding who should sign, and what letterhead should be used. The consensus of the committee was to use the BHLT letterhead and to have Commissioners Price and Daniel to sign. Duane Steele will coordinate with Janie Metzinger to ensure the letters are completed and delivered. Reports from and Charges to BHLT Committees: Clinical Operations Team Sherry Cusumano reported that the Adult Clinical Operations Team (ACOT) and Families Adolescents Children s Team (FACT) have both been restored to individually address the charges from the BHLT. The minutes from the meetings held on July 17, 2013 and July 30, 2013 were made a part of the packet for this meeting. ACOT is working on the issues with repeat or chronic offenders, the new crisis services project, and access to shelters for women of domestic violence. There will be a small workgroup meeting on August 29, 2013 to begin to address domestic violence shelter options. Ms. Cusumano stated that Mike Faenza of Metro Dallas Homeless Alliance (MDHA) spoke about the importance of an integrated intake process to determine how many consumers are being turned away. Ron Stretcher added that MDHA manages about $15 million a year for the providers that receive funding for continuum of care (COC) from the U.S. Department of Housing and Urban Development Page 2 Behavioral Health Leadership Team Minutes from August 8, 2013 Page 1 of 3

3 (HUD). He stated that now HUD is requiring recipients of this funding to establish a coordinated intake system to continue to be competitive applicants for the funding. Establishing this intake system will cost, causing some funding to be diverted. Jane LeVieux explained that FACT is working on the issues surrounding the increasing demand for psychiatric crisis beds for children and adolescents. The workgroup is looking at the services that are currently available and focusing on midlevel service care like day treatment, intensive outpatient care, partial hospitalization, and working with the school district. FACT is scheduled to meet again on August 26, 2013 at 4 PM. Mr. Stretcher mentioned that he noticed that in the FACT meeting there was some discussion about Metrocare s DSRIP projects. He stated that some of Metrocare s projects are designed to focus on the adolescent population. Dr. John Burruss, Metrocare s CEO, stated that he was optimistic about there being funding in the State s budget to support re-establishing the Wellness Recovery Action Plan (WRAP) teams. However, it does not appear that the funding required will be included in the next biennium, so these types of adolescent services have been added to their DSRIP project. This sparked discussion regarding the State s budget. Alex Smith with NTBHA stated that a preliminary review of the budget seemed to indicate that the anticipated $6 million that was earmarked for the NorthSTAR (NS) system may not be coming. A number of the service providers believed that this would be additional funding infused into the system. Liam Mulvaney with LifeNet stated that during a meeting with ValueOptions (VO), the service providers were informed that not only may the additional funding not be available, but there may be a cut in funding. Mr. Stretcher reported that NTBHA has invited the Department of State Health Services (DSHS) to send a representative to the August 14, 2013 meeting to explain how the budget will affect the NS region. Dr. Akin Akinlawon, Medical Director for VO echoed the concerns of the committee in regard to the uncertainty of how DSHS will allocate the $6 million. Mr. Stretcher expressed the frustration felt as a result of the limited coordination and communication between VO and NTBHA. BHSC Judge Wade reported that the Behavioral Health Steering Committee (BHSC) had their last meeting on June 20, The committee did not meet in July due to a number of members attending a national drug court conference. Judge Wade also reported that three of the County s specialty courts have entered into an agreement with DOORS originally known as Dallas One-Stop Optimized Reentry System. DOORS has agreed to provide a dedicated case manager to each of the three courts to assist in identifying reentry services. BHLT CSP Governance Committee Ron Stretcher reported that the committee last met on August 6, 2013 and the agenda packet from that meeting has been made a part of the packet for this meeting. He stated that the Policy Page 3 Behavioral Health Leadership Team Minutes from August 8, 2013 Page 2 of 3

4 Analyst for the Crisis Service project, Ms. Charlene Randolph, has been hired and is expected to start on August 26, The search for the Administrative Assistant is still underway. Adapt and Transicare have also hired staff to work on this project. Stephanie Denton with Adapt Community Solutions (ACS) has been onsite at the Frank Crowley Courts Building meeting with the Pre-Trail and Jail Diversion Units, the Public Defenders and District Attorney s Offices and Judge Wade s Misdemeanor Jail Diversion Court working through the discovery and learning process. Mr. Stretcher stated that contract negotiation between ACS, Transicare and the County are underway to resolve concerns surrounding indemnification. Once these negotiations have been resolved, the project will golive. Mr. Stretcher introduced Bill Harris, CEO of HarrisLOGIC Inc. who will be providing Stella, the safety net information exchange data base that will be implemented as part of the Crisis Services project. NTBHA Update: Alex Smith reported that NTBHA did respond and post information on the penalty and incentive projects in process. Brittony McNaughton reported that NTBHA is currently working on the local area service plan for Some on-site surveys have been conducted and an online survey tool will be released early next week. Information about how to access the online survey will be distributed via . Legislative Update: Janie Metzinger reported that the Regional Legislative Steering Committee is continuing to review bills that passed and those that did not and using that information to determine where their focus should be. Public Comments: Ron Stretcher reported on the status of Senate Bill (SB) 1475 regarding in jail competency restoration. The bill allows funding to establish a pilot program in the jail to attempt to restore competency within the County jail as opposed to sending the inmate to the State Hospital. The Sheriff s Department and Parkland Hospital s mental health jail staff has met with DSHS to determine if this is a pilot Dallas County wants to participate in. Sharon Philips with Parkland Hospital inquired as to if Parkland would be allowed to provide the services as opposed to Liberty Healthcare. Mr. Stretcher responded that this is one of the topics being discussed. Alex Smith commented on NTBHA s attempts to access the additional 1115 waiver opportunities using VO s general revenue. He stated that there has been no movement in regard to this issue. Dr. Akinlawon with VO stated that he would look into this and report back to the committee. Chester McGee with the Association of Persons Affected by Addiction (APAA) reported that APAA will be seeking national accreditation from CAPRSS - Council on Accreditation for Peer Recovery Support Services. He thanked everyone for their support, love and dedication to recovery support services. Commissioner Price extended his customary thank you from those that are unable to express their thanks. Adjournment: A motion was made, seconded and approved to adjourn the meeting at 10:26 AM. Page 4 Behavioral Health Leadership Team Minutes from August 8, 2013 Page 3 of 3

5 Dallas County Behavioral Health Leadership Team Rev 9/13 Advocates Initial Representative Current Representative Mental Health America 1 Janie Metzinger Janie Metzinger NAMI Dallas 1 Ashley Zugelter Marsha Rodgers NAMI Dallas Southern Sector 1 Anna Leggett-Walker Anna Leggett-Walker Child/Family 1 Vanita Halliburton Vanita Halliburton Consumer 1 Dedra Medford Dedra Medford Category Subtotal 5 Proposed Representative County/City Jail Behavioral Health Services 1 Waseem Ahmed Waseem Ahmed City of Dallas 1 New Seat Norman Seals Sheriff Department 1 David Mitchell Alice King CSCD (Adult Probation) 1 Teresa May-Williams Dr. Dori L. Hilker Juvenile Department 1 Desiree Fleming Dr. Terry Smith Judicial Representative 1 New Seat Kristin Wade District Attorney 1 Durrand Hill Renee Brezeale Public Defender 1 Lynn Richardson Lynn Richardson Metro Dallas Homeless Alliance 1 Mike Faenza Mike Faenza Dallas Housing Authority 1 Brooke Etie Open Law Enforcement 1 Herb Cotner Herb Cotner Dallas County Health & Human Services 1 Zach Thompson Open School Liaison 1 New Seat Dr. Mike Ayoob Category Subtotal 13 Residential Facilities Parkland 2 Josh Floren Sharon Phillips / Dr. Chris Carson Green Oaks 1 Tom Collins Tom Collins Timberlawn 1 Craig Nuckles Craig Nuckles Terrell State Hospital 1 Joe Finch Joe Finch Chemical Dependency Residential Center 1 Doug Denton Doug Denton Veterans Affairs (VA) 1 New Seat Tammy Wood Category Subtotal 7 Outpatient Providers Alcohol and Other Drug (AOD) -(Residential/OP) 1 Rebecca Crowell Rebecca Crowell The Bridge 1 Jay Dunn Jay Dunn SPN - Adult 1 Liam Mulvaney Liam Mulvaney SPN-Child Adolescent 1 Michelle Weaver Michelle Weaver SPN - Crisis 1 Preston Looper Preston Looper Peer/Non-Clinical 1 Joe Powell Joe Powell Non-SPN Crisis 1 Ken Medlock Ken Medlock Re-Entry 1 Michael Lee Christina Crain Adult Clinical Operations Team 1 Renee Brezeale Child/Adolescent Clinical Operations Team 1 Summer Frederick Jane LeVieux Parkland COPC 1 Jacqualane Stephens Jacqualane Stephens Psychiatrist Leadership Organization 1 Judith Hunter Judith Hunter Psychiatry Residency 1 Adam Brenner Adam Brenner Mental Retardation/Developmental Delay 1 James Baker John Burruss Underserved Populations 1 Norma Westurn Norma Westurn Primary Care Physicians 1 Vacant Dr. Sue S. Bornstein Category Subtotal 16 Payers/Funders Commissioners Court 1 Ron Stretcher Ron Stretcher Meadows Foundation 1 New Seat Cindy Patrick NTBHA 1 Alex Smith Alex Smith NTBHA Chair 1 New Seat Dr. Richard Scotch Value Options 1 Eric Hunter Kenneth Meyer Category Subtotal 5 Membership Total 46 Page 5

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7 Michael L. Ayoob, Ed.D Sweetwood Drive Dallas, Texas Home: Cell: EXPERIENCE Counselor November 9, 1998 to June 27, 2013 Dallas Independent School District Multiple Careers Magnet Center 4528 Rusk Ave., Dallas, Texas Program management for vocational training program for students with special needs Develop and implement school counseling and guidance plan Facilitate the teaching of guidance related curriculum Guides students through the development of educational plans, career awareness, and transition from school to careers Counseling with individual students with presenting needs/concerns; and, small groups Consultation with teachers, parents, students, and school personnel Coordination of all Admission, Review, and Dismissal (ARD) committees Coordinate building testing program Coordinate school-wide initiative for functional vocational assessment: Career Assessment and Cluster Exploration (C.A.C.E.) Additional responsibilities as assigned by the principal Chair Student Support Team (SST) Conduct staff development training related to Functional Vocational Assessment and Transition Focused Planning Conducted district-wide staff development: Solution Focused Brief Counseling in the School Setting Member of Campus Instructional Leadership Team (CILT); coordinate and conduct staff development training sessions for school staff; participate in the development of the Campus Improvement Plan (CIP) Counselor of the year for Alternative Programs (2007) Counseling Instructor September, 1978 to November 6, 1998 Dallas Independent School District School of Education and Social Services at Townview Magnet Center 1201 East Eighth Street, Dallas, Texas Developed and taught Core Counseling curriculum based on To Be a Therapist by Jerry Lewis, M.D. Attended the seminar To Be a Therapist conducted by Jerry Lewis, M.D. at the Timberlawn Psychiatric Foundation, Dallas, Texas (1978) Teacher technologist ( ) to interface with District s technology department and our school to implement application of available computer hardware and software technology as well as provide ongoing support to faculty Effective in teaching individual and group counseling skills Page 7

8 Chair of student support system committee Teacher of the year (1995) Coordinated school-wide symposiums: March, 1994 and March, 1995 Workshop trainer and leader for faculty and students for prevention of drug and alcohol abuse Conducted Connections support group for students at-risk Allied Youth Sponsor Conducted parent effectiveness workshops Conducted group leadership training workshops (district wide) Therapist / Supervisor September, 1988 to May, 2008 (part time) Counseling Institute of Texas 705 West Avenue B., Suite 200, Garland, Texas In clinical practice providing marital and family therapy, individual and group therapy to clients of the agency Supervising student-interns working toward masters and doctoral level degrees from area universities Case Manager / Therapist September, 1996 to May, 2000 (part time) Dallas Independent School District Youth and Family Centers 6006 Reiger, Dallas, Texas Provide case management / therapeutic services to students and families of Youth and Family Services Centers and coordinate services with Dallas Metro Care and Parkland Hospital Therapist / Supervisor September, 1981 to 1988 (part time) Galaxy Center 603 West Main, Suite 202, Garland, Texas In clinical practice providing marital and family therapy, individual and group therapy to clients of the agency Supervising student-interns working toward masters and doctoral level degrees from area universities English Teacher September, 1973 to 1978 Dallas Independent School District English teacher, to students in grades 8-12 in various schools (Pinkston High School, Spence Middle School, South Oak Cliff Ninth Grade Center) Video / Audio Production Technician September, 1972 to May, 1973 Texas Instruments Corporation Dallas, Texas Developed and distributed video and audio productions for training purposes to company employees Page 8

9 EDUCATION Texas A&M at Commerce 1990 Department of Counseling and Guidance Commerce, Texas Doctor of Education Major in Counseling, Minor in Psychology Area of emphasis in marriage and family therapy Doctoral Dissertation: Family Functioning in Mother-Only Families With An Unmarried Pregnant Adolescent University of North Texas 1975 Department of Counseling and Guidance Denton, Texas Master of Education Major in Counseling, Minor in Psychology St. Louis University 1971 English Department St. Louis, Missouri Bachelor of Arts Major in English, Minor in Philosophy CERTIFICATIONS / LICENSES / AFFILITIATIONS Secondary Teaching Certification issued in 1972 Texas Counseling Certification issued in 1977 Texas Licensed Professional Counselor (LPC: License 1920) issued in 1982 Texas Approved Licensed Professional Counselor (LPC) Supervisor (1986 to 2004) in Good Standing Visiting Teacher Certification issued in 1991 Texas Licensed Marriage and Family Therapist (LMFT: License ) issued in 1992 Texas Approved Licensed Marriage and Family Therapy (LMFT) Supervisor Clinical Member of the American Association for Marriage and Family Therapy (AAMFT) [#13226] ( ) in Good Standing Approved Supervisor of the American Association for Marriage and Family Therapy (AAMFT) ( ) in Good Standing Related Activity: Presenter; Supervision: Structure and Process, Texas Association for Marriage and Family Therapy (TAMFT) Conference [2 hr. workshop] Houston, Texas January, 2004 Presenter; Solution Focused Brief Therapy in the High School Setting, Dallas Independent School District Staff Development [7 hrs.] Dallas, Texas June 10, 2004 Presenter; 5-hr. Approved Supervisor Refresher Course, Texas Association for Marriage and Family Therapy (TAMFT) Conference [Institute] Dallas, Texas January 27, 2005 Presenter; 5-hr. Approved Supervisor Refresher Course, Holiday Inn Select Dallas-Love Field Dallas, Texas September 10, 2005 Presenter, 5-hr. Approved Supervisor Refresher Course, George Mason University, Fairfax Campus Fairfax, Virginia June 10, 2006 Presented workshops in Microsoft Word, Excel, and Power Point as Teacher Technologist to School Staff Townview Magnet Center, Dallas, Texas Fall, 1996 References Available Upon Request Page 9

10 REFERENCES Cheryl Humphrey, Ed.D., Principal Multiple Careers Magnet Center 4528 Rusk Avenue Dallas, Texas Sherri Vault, Counselor Supervisor Dallas I.S.D., Counseling Services 3700 Ross Ave Ruth Woodward, Principal Education and Social Services Magnet at Yvonne Ewell Townview Center 1201 E. Eighth St., Suite 111 Dallas, Texas Maria Molett, Executive Director Counseling Institute of Texas 705 W. Ave. B., Suite 200 Garland, Texas Skylar Woods, Center Manager Youth and Family Center, Woodrow Wilson High School 100 South Glasgow Drive Dallas, Texas Page 10

11 RESOLUTION DALLAS COUNTY BEHAVIORAL HEALTH LEADERSHIP TEAM RESOULTION NO: DATE: September 12, 2013 STATE OF TEXAS } COUNTY OF DALLAS } BE IT REMEMBERED at a regular meeting of the Dallas County Behavioral Health Leadership Team held on the 12 th day of September, 2013, the following Resolution was adopted: WHEREAS, WHEREAS, WHEREAS, WHEREAS, WHEREAS, On January 4, 2011 Dallas County Commissioners Court was briefed to establish the Behavioral Health Leadership Team (BHLT); and the Dallas County BHLT was comprised of key stakeholders and organizations throughout the county, including the Dallas County Hospital District.; and the body was made up of five (5) Advocates, twelve (12) County/City organizations, seven (7) Residential Facilities, sixteen (16) Outpatient Providers, and five (5) Payers/Funders; and in the two years since the BHLT s inception, a number of membership seats have become vacant and additional stakeholder groups have been identified for representation in the BHLT; and the BHLT recommends the following changes and additions to the BHLT membership: Primary Care Physician Sue S. Bornstein School Liaison Dr. Michael Ayoob IT IS THEREFORE RESOLVED that the Dallas County Behavioral Health Leadership Team appoints the above listed individuals as active members of the BHLT. DONE IN OPEN MEETING this the 12 th day of September, John Wiley Price Dr. Theresa Daniel Commissioner District #3 Commissioner District #1 Dallas County Dallas County Page 11

12 RESOLUTION DALLAS COUNTY BEHAVIORAL HEALTH LEADERSHIP TEAM RESOULTION NO: DATE: September 12, 2013 STATE OF TEXAS } COUNTY OF DALLAS } BE IT REMEMBERED at a regular meeting of the Dallas County Behavioral Health Leadership Team held on the 12 th day of September 2013,the following Resolution was adopted: WHEREAS, WHEREAS, WHEREAS, WHEREAS, on February 14, 2013 the Dallas County Behavioral Health Leadership Team endorsed the 1115 Healthcare Transformation Waiver DSRIP Project, and development of Behavioral Health Crisis Stabilization Services as alternatives to hospitalization; and the Dallas County Behavioral Health Leadership Team is the governing body for the DSRIP project through a standing committee known as the Crisis Services Project (CSP) Governance Committee; and the CSP Governance Committee is responsible for the submission of required reporting on metrics and milestones; and functioning as the reporting entity, the CSP Governance Committee reported on the following milestones and submitted supporting documents on August 30, 2013: Conduct stakeholder meetings Mapping and gap analysis of current crisis system Written implementation plan for needed crisis services Operational protocols and clinical guidelines for crisis services IT IS THEREFORE RESOLVED that the Dallas County Behavioral Health Leadership Team endorses the submission of this required report on metrics and milestones. DONE IN OPEN MEETING this the 12 th day of September, John Wiley Price Dr. Theresa Daniel Commissioner District #3 Commissioner District #1 Dallas County Dallas County Page 12

13 Adult Clinical Ops Team, Committee of the Dallas BHLT Minutes August 8, 2013 at 1:30pm at Three Forest Welcome : Sherry Cusumano chaired the meeting and welcomed the committee members. She stated that regular meetings would be held until the issues being addressed were resolved and reported back to Commissioner Price and the BHLT. It was determined by the committee to hold the meeting at 8am before BHLT until further notice. There needs to be a Value Options representative involved in this meeting in the future. They ve been notified of the meetings and invited but haven t responded. Will continue to invite VO to participate. Attendees: Ron Stretcher, John Burruss, Brittony McNaughton, Herb Cotner, Meera Rao Bette, Dave Hogan, Yancy Flemming, Liam Mulvaney, Ron Cowart, and Janie Metzinger. Subjects of Discussion: 3 Groups of People were discussed: Chronically Homeless Recycling to the ER s/dv Women who cannot get shelter and IED populations: These people need to be reviewed by ValueOptions (Helen White?)and find out why they keep falling out of the system. The AOT Judge (Judge Peyton) is an integral part of the system for it to work. The Black Robe affect does work for some of this population Being able to use some new money for care between ACT and Package 3 is important. Currently there is a huge drop off when someone leaves the ACT Team and move to Package 3; we don t go in the community to find them to get them re engaged. We can t provide services that we are not compensated for. Ron Stretcher urged that we need to have meaningful discussion on the structure of the managed care operation set up and what the community wants and values. Need to help this population in the civil process rather than a criminal process Need to get the top 5 people who are dropping out of the system and recidivating from each SPN and the City of Dallas Crisis Intervention Team (who has a list of all APOWWs done by the City of Dallas) and do an analysis of what has happened to them, i.e. hospitalizations, jail, are they homeless/not homeless, etc. All agreed to bring their top 5. Look at a process and move towards a solution How well are the SPN s utilizing each other to help these people? Are we utilizing services outside the SPN s, i.e., Salvation Army? Does Forensic Diversion work? We need to be realistic on what to expect on how to help the people in our system. Margie Balfour had the top 200 (Sherry will contact Margie to see if we can engage her in this process) What does Green Oaks need? Transicare doing PAT with Green Oaks? Sherry will get with Gail Barnes. Utilize Kyle with VO to help us with gathering Data In regards to DV shelters, Sherry, Ron and Mike will meet with Paige Flink Look at complexities of homeless, mental health, domestic violence. We create operational flaws by leaving some of these groups out Awareness is Key For IED population that s going to require DSHS working with DADS somehow; need a funding stream to pay for treatment of these individuals with developmental disorders and SMI. Neither agency accepts responsibility when those disorders are co occurring. Janie reports that there will be a COMI meeting of this topic. So we re going to on faith build a bunch of programs utilizing IGT for the DSRIP waiver in an attempt to get additional funding. Really, we need Medicaid expansion due to the fleeting opportunity of the waiver. If you have an aggressive client with IED issues it will take weeks; not days. The system has seemed to evolve at a certain point. We would be happy to consider any new change to that. We will try and develop programs to help these people. Is Scott B./Transicare still the SPA and does he still have access to all of the data? Ron says he does and he will be reaching out to Scott about this in the future when their contract with the County is final. They do some PATS team. Page 13

14 Crisis Services Update: Trying to get contracts completed; very long process through an RFP. It s going to take a lot of work to get it started. Complex Case Conferences with Value Options. You have the provider, care manager..we need VO in the meeting via Conference Call. Action Plan: Follow up discussion planned in 1 month to review high utilizers from each SPN. Follow up discussion regarding meeting with Domestic Violence Shelter staff. Page 14

15 Behavioral Health Steering Committee Thursday August 15, 2013 Minutes for August 15, 8:30 am Judge Kristen Wade was not in attendance. Chief Public Defender Lynn Richardson opened the meeting and introductions were made. Courtney Heard, Program Specialist for DSHS, was on hand for an overview of the Dallas County Outpatient Restoration Program. Last month s minutes were approved with one correction. The previous minutes stated CATS/Probation was not getting the appropriate number of referrals. Gerald Crumpton, Probation, advised that it is actually the DDC that is not getting the appropriate number of referrals. Dr. Hunter provided a detailed explanation of the DSRIP Projects. Dallas Metrocare has 7 DSRIP programs; several of those will be utilized to assist people with mental illness and learning disabilities. Also included are a family preservation program, a psychiatric based behavior day program, an IDD program, and a primary care integration program. The projects are still in development; Dr. Hunter will inform the committee of the procedure to make referrals to the appropriate program. Dr. Hunter requested the committees support; the committee agreed to submit a resolution on Dallas Metrocare s behalf Waiver Ron Stretcher, Director of Criminal Justice, reported the contract will be presented to the commissioner s court by August 27, 2013; the program is also expected to start this day. Discussion ensued regarding the service providers roles in relation to this project, whether or not the county is duplicating services and will consumers get the same level of services. SPN Reports: Lifenet Crystal Garland reported 9 active participants in misdemeanor jail diversion, 8 active participants in ATLAS, and 3 in jail. ABC Carolyn Lennox reported they have 5 participants in ATLAS, 6 in STARR court, 3 in OCR and 2 clients participating in misdemeanor jail diversion. Metrocare Page 15 Behavioral Health Steering Committee Minutes from August 15, 2013 Page 1 of 2

16 Katrina Lowery reported 35 participants in Atlas, 42 in Post DDRTC, 22 in STAC, 38 in misdemeanor, 49 in DDRTC, 46 in FDU and 120 in ICM. The Bridge The Bridge received 9 judicial re-entry referrals and 2 jail discharges. Probation Probation had 62 referrals and completed 53 assessments; 14 defendants were discharged. Probation has 20 beds available for DDC and is accepting referrals. State Hospital There are 11 defendants waiting on a bed, 205 defendants at the hospital and 68 cases back from the state hospital waiting to be resolved. ANNOUNCEMENTS: 9:31 am Page 16 Behavioral Health Steering Committee Minutes from August 15, 2013 Page 2 of 2

17 Dallas County Crisis Services Project BHLT Governance Committee Meeting September 3, 2013 Attendees: Ron Stretcher, Lisa Ciminelli, Gail Berlin, Stephanie Denton, Melanie Lippmann, Mani Alavi, Charlene Randolph, Paul Scott, Preston Looper, Scott Black, Ken Medlock, Margaret Balfour, Doug Denton, Liam Mulvaney, John Bennett, Daniel Byrd, Duane Steele, Lynn Richardson The meeting was called to order by Ron Stretcher, Director of Dallas County s Criminal Justice Department, at 3:30 PM. Committee Membership and Charter: Ron Stretcher presented the notes from the previous governance meeting held on August 6, The notes were reviewed and approved with no revisions Waiver and Crisis Services Project Update: Mr. Stretcher updated the committee on the status of the contract with Adapt and Transicare. All issues regarding the Transicare contract have been resolved. The contract was approved by Dallas County Commissioners Court and services will begin 9/3/2013. Transicare has hired one Licensed Professional of the Healing Arts (LPHA). A staff roster will be provided. Transicare also has two vehicles in operation. The contract with Adapt (ACS) is almost finalized and should be approved soon. Two new employees have been identified and will start soon. A staff roster will be provided. Stephanie Denton, ACS Clinical Director for the Crisis Service Project, will create a document detailing the work and outcomes of discovery sessions with the District Attorneys Office and City Detention Center. Charlene Randolph, Policy Analyst for the Crisis Services Project, was introduced. The search is still underway for the appropriate candidate to fill the Administrative Coordinator position. Gail Berlin, CEO Value Options of Texas, Inc., was introduced. Discussions with Dr. North regarding contract for program evaluation will begin soon. IGT Status: The report was submitted on four of the six DY2 milestones 8/31/2013. Ron Stretcher reviewed the metrics and supporting documents in the reporting template. The team was asked to review the document and provide feedback. Mr. Stretcher anticipates that HHHS may have questions regarding the Needs Assessment document. The upcoming discovery documentation detailing the work between ACS, the District Attorneys Office and City Detention Center may be helpful in answering those questions. Page 17 Page 1

18 CMS/HHSC/Anchor Information: Preston Looper, Scott Black, and Duane Steele shared information from the last RHP9 anchor meeting. Phase 2 feedback (Quality Patient Impact) is coming in September or October. We will be evaluated on how well indigent clients are served and how our program compares to others. The score is determined by a regression analysis; however, we do not yet know what variables are being used in the equation. Our score will directly affect the amount of money received in Phases 4 and 5. Parkland has purchased a Project Management Tool, which will be made available to all RHP9 providers for free. All new three year project proposals are due in Oct. We are not proposing any new projects. The RHP9 meetings will be held every 1 st Wednesday of month. Approval of Metrics Reporting for August & October 2013 Report Opportunity: Stakeholder s meetings 8/31 Mapping and gap analysis 8/31 Writing implementation plan 8/31 Developing operation protocols 8/31 Hiring and training of staff 10/31 Begin providing services 10/31 Next Priorities for Services: The Bridge The Bridge has implemented new procedures for dealing with client flow. Union Gospel has modified their hours for dropping off and picking up clients from The Bridge. Their new hours are 8 am 5 pm. Their buses now leave no later than 5 pm. These changes have helped control the flow of clients and decrease the interference in morning activities of clients staying at The Bridge. In order to combat the problem of clients being dropped off between 10 pm 12 am, The Bridge staff now confiscates the client s badge and holds it until the client provides proof that they stayed at least one night in a shelter. The number of clients coming into The Bridge during late nights has decreased from approximately 125 to 30 people per night. A meeting will be scheduled at The Bridge to talk about challenges, the discharge process and after hours response to crisis. Parkland Hospital Parkland has begun coordinating the Care Navigation Services under their 1115 Waiver program. This program will target persons coming into the ER and COPC who are at risk of returning to the ER. Those clients will be allowed to participate in the peer based project. Parkland will pilot the program now and will begin implementation in one year. The Care Navigation s team meets monthly and a CSP representative, Charlene Randolph, will receive an invitation to attend. Scott Black Page 2 Page 18

19 requested a contact for Jacqueline Stephens to address concerns regarding Parkland access. Baylor CSP will invite a representative from Baylor Hospital to our meetings to talk about what they are doing in their 1115 Waiver projects. Public Defender Chief Public Defender, Lynn Richardson, said that the District Attorneys Office (DA) is most interested in coordinating with CSP on cases in which clients are classified as low risk (i.e. chemical dependent, prostitutes). The DA is less likely to coordinate on cases in which the client is considered a threat to society (i.e. kidnapping, murder) because of potential blame if the client hurts someone else. However, the DA will consider those high risk clients on a case by case basis. Ms. Richardson did applaud the efforts of the DA to support the CSP project and considers their willingness to cooperate a win. Scott Black did have some questions regarding clients who may not be as truthful during the evaluation because of fear of extra charges. Ms. Richardson believes there is a clause in the public defender paperwork that states clients will not receive extra charges for anything admitted during the evaluation. Charlene Randolph will check to ensure this is accurate. Housing & Services: Doug Denton, from Seidler House, reported that renovations on twelve housing units are going well. In particular, ten of them are almost ready for occupation. Mr. Denton and Scott Black will talk about how Transicare may be able to refer clients to Seidler House. Liam Mulvaney reported that boarding homes may also be available to CSP clients. Ron Stretcher stated that The Cottages Project is slow moving and that attorneys are currently working to resolve contract issues. Next Steps/Action Items: New staff members will be hired and trained. ACS and Transicare beginning to work on site. Begin serving 150 clients. Report on remaining two metrics and milestones Reach out to Baylor Hospital. ACS will develop a diagram showing outcome of discussions with DA and City Detention Center Create a system for tracking clients and their progress Next meeting: October 1, 2013 Meeting Adjourned at 5:31 PM Page 19 Page 3

20 Crisis Services Project Status Report and Next Steps September 3, 2013 Staffing Charlene Randolph began work as the Project Analyst on The Administrative Coordinator position was officially reposted and remains to be filled. Implementation Activities Mental health workroom has been established at Frank Crowley Court Building for ADAPT and Transicare staff IGT Status DYI IGT of $314,447 submitted and match of $772,598 received Set up as an escrow account grant in Dallas County system; funds flow to dedicated account DY2 details below Next DY2 IGT submission date is DY3: can report metrics and request match and Metrics and Milestones for DY : DY2 reporting for completed metrics was submitted for milestones 1 4 HHSC and CMS have 30 days to review and approve each milestone/ metric reported on in DY2. If more information is needed, we have 15 days to supply additional information. Submitted DY2 reporting template is attached Updated Status on metrics attached : submit IGT for metrics reported as complete through : receive IGT match from submission : required DY2 reporting on milestones : submit IGT for metrics reported as complete on : receive IGT match for metrics reported as complete on $4,002,565 total funds available for DY2 Contracts Status Commissioners Court approved Transicare contract 9/3/2013. Anchor Information RHP 9 Performing Provider Meeting (please see attached) Next RHP9 Performance Provider Meeting will be on 9 4 1:30 3pm and Recur the first Wednesday of Each Month from 1:30 to 3:00 pm Page 20

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