M I N U T E S

Mental Health Advisory /Local Alcohol and Drug Planning Committee Lane County BHS, Room 198 2411 MLK, Jr. Blvd., Eugene OR

March 15, 2017 2:30 p.m.

PRESENT: Michele Tantriella-Modell, Vice-Chair; Doug Barrett, Andrea Brown, R. Drake Ewbank, Michael Hejazi, Michael Kwiatkowski, Susanna Sammis, Brenda Sirois, DK Stotler, and Art Zamudio, members; Lucy Zammarelli, Trillium Behavioral Health; Diana Avery, Carla Ayres, Kathy Bootes, Emily Buff Bear, Terry Fields, Elisabeth Maxwell, and Lisa Nichols, staff; Pat Farr, Lane County Commissioner; and Sarah Merkle, National Alliance on Mental Illness (NAMI) of Lane County.

ABSENT: Teresa Kintigh, Chair; Kathleen Daly, José E. Soto-Gates, Lee Anne Wichmann, and Kevin Wiles, members; and Andrea Muzikant, staff.

Available at the table was a Memorandum from the Committee dated March 2, 2017. The subject line was: “Insufficient local secure, acute, and sub-acute beds for youth with mental health and/or developmental disabilities treatment needs”.

1.0 CALL TO ORDER

Michele Tantriella-Modell called the March Mental Health Advisory/Local Alcohol and Drug Planning Committee (MHA/LADPC) meeting to order at 2:35 p.m.

1.1 Introductions

Those present introduced themselves.

1.2 Approval of the February 15, 2017 Minutes

Later in the meeting when a quorum had been met, Diana Avery noted two corrections: Kathy Bootes was added to the list of those PRESENT. Under the list of those ABSENT, R. Drake Ewband was corrected to R. Drake Ewbank.

DK Stotler moved, seconded by Michael Kwiatkowski, to approve the February 15, 2017 Minutes as corrected. The motion passed unanimously, 9:0.

2.0 PUBLIC INPUT

No members of the public wished to address the committee.

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3.1 ADDICTIONS MANAGER’S REPORT

Terry Fields referenced the Lane County Methadone Treatment Program, Annual Report 2016 previously distributed via e-mail. She noted the results, including high consumer satisfaction, were consistent with previous years’ data. When Lisa Nichols asked about expansion of the Methadone Clinic, Ms. Fields estimated the expansion would occur by June. She anticipated forty to fifty people currently on the wait list would be served.

DK Stotler joined the meeting at 2:42 p.m. R. Drake Ewbank arrived shortly thereafter.

Responding to Lucy Zammarelli’s inquiry as to when a Suboxone protocol was to be available, Carla Ayres assured MHA/LADPC members Behavioral Health and Community Health Center staff was working out the details.

When Ms. Stotler asked about outreach to the clinic’s homeless population, Ms. Fields said their peer support specialist provided housing assistance.

3.2 BHS MANAGER’S REPORT

Ms. Ayres said work continued on the transformation project. Multi-discipline teams had been formed, including case managers and peer support specialists. Staff was working with a statistician to develop an algorithm to determine a client’s initial level of need and establish a baseline from which to measure progress. The eight components were based on social determinants of health (e.g., harm to self or others, substance abuse).

Ms. Ayres was also working on an application to the Oregon Health Authority (OHA) for certification to provide outpatient drug treatment services and analyzing proposed legislation, including changes to peer support supervisors, mobile crises services, and acute care.

3.3 DD MANAGER’S REPORT

Ms. Avery said Andrea Muzikant, Developmental Disabilities (DD) Division Manager, was attending a training session. No report was given.

4.0 OLD BUSINESS

4.0.a. Let’s Talk Planning Workgroup

Mr. Kwiatkowski debriefed the work group’s meeting. The focus of the next Let’s Talk Workshop was to assist addictions and behavioral health treatment providers to improve services to individuals with Intellectual Disabilities (ID) and DD. The work group had decided to convene a panel of five presenters, followed by a question and answer period. The workshop was scheduled for Tuesday, June 6, 2017.

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4.0.b. Legislative Update

Ms. Nichols said the Ways and Means Committee had concluded their first round of hearings on OHA’s proposed budget, including funding for mental health programs and the Junction City State Hospital. The second round of hearings was scheduled for the second half of April. The Ways and Means Committee had just started budget hearings on the Department of Human Services (DHS), including the sustainability of the K-plan.

Commissioner Farr arrived at the meeting at 3:00 p.m.

Ms. Nichols reported that no public hearing had been scheduled on House Bill 3063, which established a Mental Health Housing Fund.

Ms. Nichols recognized Commissioner Farr for his efforts with the Board of County Commissioners (BCC) regarding the passage of an ordinance raising the legal age to purchase of possess tobacco products to twenty-one.

Commissioner Farr explained the BCC had eliminated the grandfather clause allowing tobacco purchase and use for those people currently between the ages of 18 and 21. Ms. Zammarelli added nicotine replacement therapy was still available for people under the age of twenty-one.

After Brenda Sirois observed not being able to use tobacco products made it more difficult for some youth in opiate treatment programs, Ms. Stotler remarked long term recovery outcomes improved when people received treatment for both drug and tobacco addiction simultaneously.

Responding to Mr. Ewbank’s question as to why the change in the legal age, Commissioner Farr said the intent was to deter more youth from starting to use tobacco products. He noted the Oregon legislature was considering the same change statewide.

4.0.c. Debrief February 15, 2017 Discussion: Current residential placements, step-down and community reintegration services, local efforts related to the Oregon Performance Plan.

Ms. Avery had invited Kathy Bootes, Lane County Mental Health Specialist, to the March MHA/LADPC meeting in case Committee members had follow-up questions. Ms. Bootes led the Adult Mental Health Initiative (AMHI) aka Choice program.

Michael Hejazi expressed concerns about her work load, given the need for ongoing support to people discharged from the state hospital. He asked if the Choice program served veterans. He also asked if Choice funding followed individuals after discharge from the Oregon State Hospital (OSH).

Ms. Bootes explained she coordinated care through-out the system (be it residential or community services). Her work unit currently served 350 to 400 clients. It was very rare

MINUTES-Mental Health Advisory Committee/ March 15, 2017 Page 3 Local Alcohol & Drug Planning Committee the client was a veteran. Ms. Bootes said that Choice funding did follow eligible clients after discharge from OSH. The vast majority were on Medicaid.

Ms. Zammarelli stressed it was a recovery model. Clients were not clients for life.

When Ms. Stotler asked who provided residential treatment services for those with both Severe and Persistent Mental Illness (SPMI) and addiction, Ms. Zammarelli responded Best Care Treatment Services and Willamette Family Services.

Doug Barrett joined the meeting at 3:15 p.m.

Andrea Brown asked for more information on KEPRO. Had there been significant changes since the OHA awarded KEPRO the statewide contract for authorizing coordinated care for Medicaid patients in July of last year?

Ms. Bootes explained KEPRO set criteria and care standards that had to be met for Medicaid patients. She described positive (e.g., an emphasis on community care) and negative (e.g., extra approval requirements for placement in a secure facility) changes.

When R. Drake Ewbank asked if a person had a choice to stay in the hospital, Ms. Bootes said only if s/he was eligible.

Art Zamudio asked about placement options for those at the state hospital who participated in the peer recovery program.

Ms. Zammarelli explained the peer recovery program had never been implemented at the hospital. However Trillium had expanded the number of Assertive Community Treatment (ACT) teams in the community, including a new one in Junction City. The teams had to demonstrate to the OHA fidelity with the ACT model.

Responding to Ms. Stotler’s question regarding funding for the Choice program, Ms. Bootes said she had not heard the funding was to be reduced from current levels. Ms. Nichols and Ms. Zammarelli concurred.

Ms. Bootes and Ms. Ayres left the meeting at 3:25 p.m.

5.0 NEW BUSINESS

5.0.a. Presentation/Discussion: Behavioral health services scan: Florence/Mapleton

Emily Buff Bear, Lane County Community Health Analyst, distributed the following documents: Strategic Plan, Central Oregon Coast Behavioral Health Network, June 2016; Counseling and Mental Health in Florence; and Support Groups Florence Oregon.

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She reviewed the information on counseling and behavioral health services available in the Florence area: Peace Health Counseling Services, Options Counseling Services, Emergence, Reconnections Counseling, NAMI, and Focus Four. Ms. Buff Bear summarized the situation as one of scarce resources in the area.

When Mr. Kwiatkowski asked about behavioral health services in the schools, Mr. Barrett explained there was one counselor for all the area schools.

Ms. Zammarelli said the Peace Health psychologist was not accepting new clients. Ms. Buff Bear added some telemedicine/Skype sessions were used for short term or emergency counseling services. Trillium funded transportation to Eugene via Lane Transit District’s RideSource program for their members to improve access to behavioral health services. She also noted the behavioral health specialist associated with the Older Adult Behavior Health initiative was in Florence twice a month.

Ms. Nichols described her efforts to boost behavioral health services in Western Lane County. MHA/LADPC members supported her work. They also discussed the need to improve public transportation between Florence and the Eugene/Springfield area.

Mr. Barrett described his work with tribal members. He emphasized the lack of residential treatment facilities. The Native American Rehabilitation Association (NARA) of the Northwest, Inc. planned to open an eighteen-bed youth facility in the Portland area in April. He described several tribal behavioral health programs, highlighting the Canoe Journey. When Ms. Stotler asked about the use of sweat lodges, Mr. Barrett said because they had been improperly used elsewhere resulting in fatalities, sweats are not offered to the general public. He made available four brochures published by the Confederated Tribes of Coos, Lower Umpqua and Siuslaw Indians: Peacegiving; Tribal Court; Tribal Youth Program; and Education Department. He also distributed two handouts on the Canoe Journey: Canoe Journey, The Canoe Journey as a Cultural Best Practice: Alcohol and Drug Free Program; and Canoe Journey, The Canoe Journey as a Cultural Best Practice: Youth Focus Group Responses. He recommended MHA/LADPC members watch the video: http://www.youtube.com/watch?v=WWWHq2_evK8.

When Ms. Buff Bear asked if the Peacekeeping Court was limited to the tribes or if a youth who native-identified was able to be access it, Mr. Barrett said efforts were currently underway to expand the Peacekeeping Court.

6.0 BCC LIAISON REPORT

6.0.a. Commissioner Farr

Commissioner Farr referred to the previously discussed tobacco 21 ordinance. He also described efforts on equity, access, and inclusion. Commissioner Farr said there had been an increase in the number of “no-shows” for appointments at the Community Health Centers because of fear of deportation. Staff was reviewing their policies to see if

MINUTES-Mental Health Advisory Committee/ March 15, 2017 Page 5 Local Alcohol & Drug Planning Committee changes, for example not collecting Social Security Numbers, might allay those fears. When Ms. Stotler observed fear of deportation was also a barrier to drug and alcohol addiction treatment, Commissioner Farr concurred. He said it was also an issue with reporting of domestic violence incidences. Commissioner Farr shared that Lane County Sheriff Byron Trapp was emphatic that those in need of law enforcement help need not fear deportation if they call for assistance. When Ms. Tantriella-Modell asked if the Police Chiefs in Eugene and Springfield were aligned with Sheriff Trapp, Commissioner Farr explained the Eugene City Council had voted that no city resources were to be used for immigration enforcement. The Springfield City Council had not taken council action.

Commissioner Farr also discussed the Housing First initiative. Operation 600 (the goal of creating 600 housing units with support services by 2021) was underway. Plans were proceeding for a facility located near the Lane County Behavioral Health Clinic. He described initial conversations with the organizing group supporting the 2021 World Track and Field Championship to be held in Eugene. They have identified housing for athletes as an issue. Commissioner Farr hoped housing might be built on the Lane Events Center land to initially house athletes participating in the event but then be converted to housing for women and children. He also outlined changes in leadership at Housing and Community Services Agency of Lane County (HACSA) and recognized the accomplishments of the local Saint Vincent DePaul charitable organization. When Mr. Ewbank asked about inclusionary zoning allowances, Commissioner Farr opined the policy change was more accepted in a larger metropolitan area such as Portland.

6.0.b. Andrea Brown

Ms. Brown did not give a report.

Mr. Kwiatkowski announced he had volunteered to partner with Ms. Brown as BCC Liaison from the MHA/LADPC.

7.0 DIRECTOR REPORT

Due to time constraints, Ms. Nichols did not give a report.

8.0 CHAIR REPORT

Ms. Tantriella-Modell passed on the chair report.

9.0 MEMBERS’ ITEMS and ANNOUNCEMENTS

9.0.a. Consumer Council Liaison

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Mr. Ewbank distributed a handout entitled, Consumer/Family Recommendation, Oregon CCBHC Demonstration, detailing nine recommendations adopted by the Consumer Council regarding Oregon’s Certified Community Behavioral Health Clinic (CCBHC) demonstration program. In Lane County, PeaceHealth had been accepted to participate in the program. The recommendations emphasized peer support services and quality and quantity outcome performance measures. When Mr. Ewbank referred to the importance of peer support services, Ms. Stotler observed there were more behavioral health and addiction providers who themselves had experienced those issues than known because the stigma associated with those conditions curtailed personal disclosures. Speaking to the recommendation regarding peer support supervision standards, Ms. Brown said her understanding was that PeaceHealth planned for a clinician to supervise the peer support specialists. Mr. Ewbank noted Recommendation 5 described the specific characteristics needed for meaningful supervision of peer support specialists. Responding to Mr. Zamudio’s question regarding state certification of peer support specialists, Mr. Ewbank said those responsibilities were currently done by ACCBO but the consumer councils were working to provide a different alternative.

9.0.b. Additional Announcements

Mr. Hejazi requested ten minutes at the next MHA/LADPC meeting to present concerns regarding behavioral health services in Lane County. Specifically, he wanted to discuss ways in which the current system made people more vulnerable and perpetuated their problems. He emphasized the situation was worse for veterans.

Ms. Stotler said Laurel Hill Center was hiring ACT team members in order to expand their services into rural communities.

Ms. Zammarelli announced on March 23, 2017 the State was holding a listening session on the integration of alcohol and drug prevention into community health services. She was forwarding the information to Ms. Avery. Pre-registration was required.

Mr. Ewbank promoted the upcoming Lane County Consumer Survivor Advisory Council meeting on March 28, 2016. They were recruiting new members and electing officers. He had forwarded the meeting announcement to Ms. Avery to email to members.

10.0 ITEMS FOR NEXT MEETING

10.1 Information Needed 10.2 Action Items Identified

Due to time constraints, the agenda item was not discussed.

11.0 CLOSE/ADJOURNMENT

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Ms. Tantriella-Modell adjourned the meeting at 4:29 p.m.

(Recorded by Beth Bridges)

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