Mental Health Services Act:
2013-2014 Annual Update to the Three-Year Program and Expenditure Plan
MARCH 25, 2013
Santa Cruz County Mental Health & Substance Abuse Services: MHSA Annual Update
Table of Contents Page
Letter From The Mental Health Services Act Coordinator 2 MHSA County Compliance Certification 3 MHSA County Fiscal Accountability Certification 4 Description Of Stakeholder Process 5 Mental Health Services Act (MHSA) Programs 7
Community Services And Supports (CSS) 8 CSS Program #1: Community Gate 8 CSS Program #2: Probation Gate 11 CSS Program #3: Child Welfare Services Gate 13 CSS Program #4: Education Gate 16 CSS Program #5: Special Focus: Family Partnerships 18 CSS Program #6: Enhanced Crisis Response 21 CSS Program #7: Consumer, Peer, & Family Services 26 CSS Program #8: Community Support Services 29 Community Services And Supports: Housing 38
Prevention & Early Intervention (PEI) 40 PEI Project #1: Early Intervention Services For Children 40 PEI Project #2: Culture Specific Parent Education & Support 48 PEI Project #3: Early Onset Intervention Services For Transition Age Youth & Adults 51 PEI Project #4: Early Intervention Services For Older Adults 58
Innovative Projects- “INN” 61
Workforce Education & Training – “WET” 65 WET Program #1: Workforce, Education and Training Coordination & The Training Academy 65 WET Program #2: Consumer “Culture” Trainings 66 WET Program #3: Family “Culture” Trainings 67 WET Program #4: High School Outreach 67 WET Program #5: Entry Level Employment Preparation 67 WET Program #6: Public Mental Health Internship Program 69 Information Technology 70 Capital Facilities 72 MHSA Budget Summary 73 Attachments 74 Acronyms Used In This Report 75 Cultural Competence & MH Outreach 76 Aptos Blue Revision 103 Trainings 2011-2012 107 Trainings 2012-2013 120
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Santa Cruz County Mental Health & Substance Abuse Services: MHSA Annual Update
Description of Stakeholder Process a) A description of the local stakeholder process including date(s) of the meeting(s) The County works closely with the Mental Health Board (which includes consumers, family members and other advocates), meets regularly with the various mental health contract agency representatives, and until January, 2009 met monthly with the Santa Cruz County Mental Health Services Act Steering Committee. The MHSA Steering Committee oversaw the community planning process for each of the MHSA components. (Note: the MHSA Steering Committee membership was selected with the intention of having a cross section of member representatives, including mental health providers, employment, social services, law enforcement, consumers, and family members, as well as representatives from diverse geographical and ethnic/racial/cultural populations.) The MHSA Steering committee members elected to disband, as their primary function of launching each MHSA component was accomplished. Oversight of MHSA activities has been returned to the Mental Health Board, and they receive regular updates about MHSA activities.
Aside from the extensive Community Services and Supports (CSS) Planning Process, the County has conducted planning processes for the CSS Housing component, the Workforce Education & Training Component, the Prevention & Early Intervention Component, Innovative Projects Component, and the Capital Facilities & Information Technology Components. Although consumers and family members participate in the workgroups, the County also had focus groups with consumers in both North and South County, with NAMI family members, with Spanish speaking family members, with transition age youth, seniors, and veterans.
The County held a Town Hall meeting on January 31, 2013 from 6 to 8 p.m. in a central location in Santa Cruz County (Aptos), specifically to obtain stakeholder input on the MHSA services. The MHSA components and their requirements were reviewed, and the County and Contractors provided an overview of the programs. Stakeholders included: education (9%), social service agencies (3%), providers of services (52%), veterans (2%), providers of alcohol and drug services (2%), consumers (27%), family members (2%), and “other” (3%), including one member of the Board of Supervisors. We invited health care organizations and representatives from law enforcement, but other than the Health Services Agency Director, and the former Health Services Agency Director, they were not in attendance. (The Health Services Director oversees Mental Health & Substance Abuse Services, Public Health, and the County medical clinics.) We had a translator attend so that persons that speak our threshold language (Spanish) could participate.
The feedback from the community stakeholders fell largely in these areas: the County and Contractors are providing a large variety of programs; there is a lot of collaboration in the provision of services; the MHSA has benefited the various community partners, and more importantly have made a difference in the lives of many. Many consumers spoke up at the Town Hall meeting, and shared the impact the services have had, with some going as far as saying that specific programs changed, and even saved, their life!
5 Santa Cruz County Mental Health & Substance Abuse Services: MHSA Annual Update b) A general description of the stakeholders who participated in the planning process and that the stakeholders who participated met the criteria established in section 3200.270 The County works closely with the Local Mental Health Board, contract agency representatives, family members, NAMI, consumers, the Mental Health Client Action Network (MHCAN), the Mariposa Wellness Center, agencies representing underserved communities (the Diversity Center, Queer Youth Task Force, Barrios Unidos, Migrant Head Start), community based agencies (such as Santa Cruz Community Counseling Center, Front Street Inc., Pajaro Valley Prevention & Student Assistance, Family Services), and educational institutions, social services, probation, juvenile detention, county jail, law enforcement, community resource centers, employment and health.
c) The dates of the 30 day review process The draft plan of the MHSA update was available for review and comment from February 15, 2013 to March 20, 2013
d) Methods used by the county to circulate for the purpose of public comment the draft of the annual update to representatives of the stakeholders interests, and any other interested party who requested a copy of the draft plan. The draft plan was distributed to the Local Mental Health Board, contractors, and to other stakeholders. It was also posted on our Internet site, and made available in hard copy to anyone who requested it. We placed ads in our local newspapers to inform the community at large of its availability.
e) Date of the Public hearing held by the local Mental Health Board: The Public Hearing was held on March 21, 2013. f) Substantive Feedback: Contractors provided minor feedback about the draft plan, and asked for revisions which included a better description of services provided by one agency, additional impact statements for another, and revised target numbers for 2013-2014 for the third contractor. Comments at the Public Hearing were all positive, and indicated that it was “comprehensive” and that the County did “a great job” in developing the document. One contractor expressed her gratitude for the MHSA funds received that help the agency support the clients’ recovery.
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III. Mental Health Services Act (MHSA) Programs In 2004 California passed Proposition 63, known as the Mental Health Services Act.
Three components of MHSA focus on direct clinical services: • Community Services and Supports (CSS), • Prevention and Early Intervention (PEI), and • Innovative Programs (INN).
Three focus on infrastructure: • Workforce Education and Training (WET), • Capital Facilities, and • Information Technology.
MHSA funds are to be used to establish new services, or to expand services. Direct client services are not allowed in infrastructure components. Below is a list of MHSA services in Santa Cruz County. Throughout this document you will see specific examples of notable community impact resulting from MHSA; these are in italics. (Note: all names and identifying factors have been changed to protect the confidentiality of the individuals.)
Description of county demographics such as size of the county, threshold languages, unique characteristics, etc. The population in Santa Cruz County is 262,382 according to 2010 estimates. This is an increase of 2.7% from the 2000 census. In Santa Cruz, the breakdown of the population by race is approximately 59.6% White (Not of Latino origin), 32% Latinos, 1.1% African-Americans, .9% are American Indian and Alaskan Native persons, and 4.2% Asian. Eleven percent (11.1%) of the population is over 65 years old. The primary language in Santa Cruz County is English, with 29.9% of households speaking a language other than English. The threshold language in Santa Cruz is Spanish. Half of the population (50.1%) is female.
The county’s own data from FY 10-11 shows that of the 5,183 unduplicated clients served, 3,268 (63%) were white and 1,473 (29%) were Latino. According to EQRO data for 2010, the penetration rate for Latinos is 3.95%, compared with 10.34% for Whites, African –Americans 14.87%, Asian/Pacific Islander 5.58%, and Native American 12.72%. The statewide penetration rates are: Latinos 3.47%, Whites 10.21%, African-Americans 10.04%, Asian/Pacific Islanders 3.99%, and Native Americans 9.77%
Cost Per Person Served: The approximate cost for children served in the CSS programs is $4,475, and in PEI programs is $634. The approximate cost for adults in the CSS programs is $4,212, in PEI programs $460, and in INN $4,651.
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COMMUNITY SERVICES AND SUPPORTS (CSS) This component is to provide services and supports for children and youth who have been diagnosed with or may have serious emotional disorders, and adults and older adults who have been diagnosed with or may have serious and persistent mental illness.
CSS Program #1: Community Gate Purpose: The services of this program are designed to create expanded community-linked screening/assessment and treatment of children/youth suspected of having serious emotional disturbances—but who are not referred from our System of Care public partner agencies (Probation, Child Welfare, Education).
The Community Gate is designed to address the mental health needs of children/youth in the Community at risk of hospitalization, placement, and related factors. These services include assessment, individual, group, and family therapy with the goal of improved mental health functioning and maintaining youth in the community.
Community Gate services focus on ensuring timely access to Medi-Cal beneficiaries of appropriate mental health services and supports. This results in keeping youth hospitalization rates down, as well as helping to keep at risk youth out of deeper involvement with Probation, Child Welfare, and Special Education, including ensuring alternatives to residential care.
Target Population: children/youth suspected of having serious emotional disturbances, Particular attention is paid to addressing the needs of Latino youth and families, as well as serving Transition-age youth. Services are offered to males and females, and are primarily in English and Spanish.
Providers: The staff from Santa Cruz Community Counseling Center (Youth Services), Family Services, and Santa Cruz County Mental Health & Substance Abuse Services provide the services in this work plan.
Number of individuals to be served in 2013-2014: The unduplicated numbers of individuals to be served by program are: Santa Cruz Community Counseling Center: 100 Family Services: 150 Santa Cruz County Mental Health & Substance Abuse Services: 110
Were there any challenges or barriers in the program? If so, what are the strategies to mitigate? With 7,000 Healthy Families beneficiaries shifting to Medi-Cal this year, the Community Gate county and contract clinical resources will work to ensure timely access, triage, assessment and appropriate levels of treatment. We will also use the year to continue planning for improved health care referral/linkages as health care reform proceeds.
8 Santa Cruz County Mental Health & Substance Abuse Services: MHSA Annual Update
Are there any new, changed or discontinued programs? No.
Performance Outcomes (specify time period): The number of people served in 2011-2012 is 325. The numbers of people served in quarter 1 (July 1, 2012 to September 30, 2012) and in quarter 2 (October 1, 2012 to December 31, 2012) by program are below. The numbers in the table are: Quarter 1/Quarter 2. (Note: These numbers represent an unduplicated client count.) Agency Reporting SCCCC Unduplicated Total Served 77/87 Age Group Children 0-17 TAY 16-25 Adults 26-59 Older Adults 60+ 32/49 33/29 12/9 Race/Ethnicity White Latino Other 4/6 71/79 2/2 Primary Language English Spanish Other 68/73 9/14 Culture Veterans LGBTQ Other
Agency Reporting Family Services Unduplicated Total Served 86/87 Age Group Children 0-17 TAY 16-25 Adults 26-59 Older Adults 60+ 76/78 10/9 Race/Ethnicity White Latino Other 44/39 38/43 4/5 Primary Language English Spanish Other 76/59 10/28 Culture Veterans LGBTQ Other
Agency Reporting MHSAS Unduplicated Total Served 85/86 Age Group Children 0-17 TAY 16-25 Adults 26-59 Older Adults 60+ 68/70 17/16 Race/Ethnicity White Latino Other 27/27 42/43 16/16
Primary Language English Spanish Other 72/67 12/18 1 Culture Veterans LGBTQ Other
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Community Impact "Damien" is a 15 y/o boy who came in through our Community Gate. Shortly after intake, he revealed suicidal ideation and required three hospitalizations in a short period. He was given TBS services and did so much better that it was ended after 6 months. He was also given a different therapist provide Family Therapy, specifically Triple P - Positive Parenting Program, so that his relationship with his individual counselor would not be affected. He has not been hospitalized for over 6 months now. He is no longer actively suicidal and he and his family are making progress in therapy.
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CSS Program #2: Probation Gate Purpose: The Probation Gate is designed to address the mental health needs (including assessment, individual, group, and family therapy) of youth involved with, or at risk of involvement, with the Juvenile Probation system. This program is also designed to increase dual diagnosis (mental health/substance abuse) services to these individuals. The System of Care goal (shared with Probation) is keeping youth safely at home, rather than in prolonged stays of residential placement or incarcerated in juvenile hall. We have noted that providing more access to mental health services for at-risk youth in the community via our contract providers BEFORE the youth become more deeply involved in the juvenile justice system has helped to keep juvenile rates of incarceration low.
To achieve our goal we have increased dual diagnosis (mental health/substance abuse) services for youth that are: • Identified by Juvenile Hall screening tools (i.e., MAYSI) with mental health and substance abuse needs that are released back into the community. • In the community and have multiple risk factors for probation involvement (with a primary focus on Latino youth). . Services to Transition-age youth (TAY) in the Probation population (particularly as they age out of the juvenile probation system). . Services to Probation youth with high mental health needs, but low criminality.
These community based services help provide alternatives to residential levels of care, including minimizing lengths of stay in juvenile hall and keeping bed days low.
Target Population: youth and families involved with the Juvenile Probation system or at risk of involvement. This includes Transition-age youth aging out of the system with particular attention paid to addressing the needs of Latino youth and families.
Providers: The staff from PajaroValley Prevention & Student Assistance, and Santa Cruz Community Counseling Center provide the services in this work plan.
Number of individuals to be served in 2013-2014: The unduplicated numbers of individuals to be served by program are: Pajaro Valley Prevention & Student Assistance: 45 Santa Cruz Community Counseling Center: 180
Were there any challenges or barriers in the program? If so, what are the strategies to mitigate? Given the Probation department’s commitment to detention reform and community alternatives, there is a lot of pressure to ensure adequate access for court wards and at-risk youth to mental health services. We will continue to work with Probation and community referral sources to ensure adequate supports for youth to help prevent deeper involvement with the juvenile justice system.
Are there any new, changed or discontinued programs? No.
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Performance Outcomes (specify time period): The number of people served in 2011-2012 is 244. . The numbers of people served in quarter 1 (July 1, 2012 to September 30, 2012) and in quarter 2 (October 1, 2012 to December 31, 2012) by program are below. The numbers in the table are: Quarter 1/Quarter 2. (Note: These numbers represent an unduplicated client count.) Agency Reporting PVPSA Unduplicated Total Served 29/18 Age Group Children 0-17 TAY 16-25 Adults 26-59 Older Adults 60+ 29/18 Race/Ethnicity White Latino Other 29/18 Primary Language English Spanish Other 21/13 8/5 Culture Veterans LGBTQ Other
Agency Reporting SCCCC Unduplicated Total Served 86/77 Age Group Children 0-17 TAY 16-25 Adults 26-59 Older Adults 60+ 50/49 29/22 7/6 Race/Ethnicity White Latino Other 34/31 22/37 10/9 Primary Language English Spanish Other 83/72 3/5 Culture Veterans LGBTQ Other
Community Impact A male high school student was expelled and placed on probation for sexual harassment and inappropriate touching of female students. He had many anger issues and poor boundaries around female students. He was also a special education student with some developmental delays. Attending counseling and meeting his probation terms were the requirements for transferring to a new high school.
He began working with a male therapist from PVPSA. In the process of therapy he disclosed that his uncle had molested him when he was younger. After many years of having no contact with the uncle, he had unexpected contact with him. This contact and the memories of his abuse triggered the inappropriate behaviors at school. Through the process of treatment and strong support from his family, he developed a clear understanding of the probation terms and made a commitment to make a clean start at the new school. After about a year of working with the therapist he had no recurrence of the inappropriate behaviors at the new high school. He set strong boundaries and rules for himself. He maintained age appropriate behaviors with female students with whom he interacted. He completed his probation terms, completed therapy, remains in school and is doing quite well.
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CSS Program #3: Child Welfare Services Gate Purpose: The Child Welfare Gate goals were designed to address the mental health needs of children/youth in the Child Welfare system. We have seen a significant rise in the number of younger foster children served in the 2-10 year old range, and particularly in the targeted 0-5-age range. To address these needs we will continue to provide: • Consultation services for parents (with children in the CPS system) who have both mental health and substance abuse issues. • Services to Transition age youth (18-21 years old) who are leaving foster care to live on their own (as well as other youth with SED turning 18). • Provide increased services, including expanded services for the 0 to 5-child population. These services include assessment, counseling, family therapy and crisis intervention. • Services for general foster children/youth treatment with a community-based agency, as well as county clinical capacity.
By ensuring comprehensive screening and assessment for foster children, we are assisting in family reunification and permanency planning for court dependents, helping them perform better in school, minimize hospitalization, and keep children in lowest level of care safely possible.
Target Population: Children, youth and families involved with Child Welfare Services, as well as Transition-age youth (particularly those aging out of foster care, but not limited to this population). Particular attention will be paid to addressing the needs of Latino youth and families. Services are offered to males and females, and are primarily in English and Spanish.
Providers: The staff from Parent Center, Santa Cruz Community Counseling Center, and Santa Cruz County Mental Health & Substance Abuse Services provide the services in this work plan.
Number of individuals to be served in 2013-2014: The unduplicated numbers of individuals to be served by program are: Parent Center: 30 Santa Cruz Community Counseling Center: 25 Santa Cruz County Mental Health & Substance Abuse Services: 230
Were there any challenges or barriers in the program? If so, what are the strategies to mitigate? The Katie A. lawsuit settlement will bring some new treatment planning and service modalities to our work with foster children, including the specific sub-class of individuals named in the lawsuit. However as a long-standing Children’s System of Care county, we are already serving most foster children and will be able to work closely with Child Welfare to make needed adjustments in focus and service mix in order to comply with specific Katie A requirements.
Are there any new, changed or discontinued programs? No.
Performance Outcomes (specify time period): The number of people served in 2011-2012 is 251. The numbers of people served in quarter 1 (July 1, 2012 to September 30, 2012) and in
13 Santa Cruz County Mental Health & Substance Abuse Services: MHSA Annual Update quarter 2 (October 1, 2012 to December 31, 2012) by program are below. The numbers in the table are: Quarter 1/Quarter 2. (Note: These numbers represent an unduplicated client count.)
Agency Reporting Parent Center Unduplicated Total Served 12/10 Age Group Children 0-17 TAY 16-25 Adults 26-59 Older Adults 60+ 11/10 1/0 Race/Ethnicity White Latino Other 5/2 6/8 Primary Language English Spanish Other 9/4 2/6 Culture Veterans LGBTQ Other
Agency Reporting SCCCC Unduplicated Total Served 3/2 Age Group Children 0-17 TAY 16-25 Adults 26-59 Older Adults 60+ 2/1 1/1 Race/Ethnicity White Latino Other 1/1 1/1 Primary Language English Spanish Other 2/2 Culture Veterans LGBTQ Other
Agency Reporting SCCCC- THPP, ILSP Unduplicated Total Served 11/12 Age Group Children 0-17 TAY 16-25 Adults 26-59 Older Adults 60+
Race/Ethnicity White Latino Other 3/4 6/6 2/2 Primary Language English Spanish Other 10/11 1/1 Culture Veterans LGBTQ Other 1/0 0/1
Agency Reporting MHSAS Unduplicated Total Served 131/87 Age Group Children 0-17 TAY 16-25 Adults 26-59 Older Adults 60+ 93/87 38/0 Race/Ethnicity White Latino Other 70/48 31/20 30/19 Primary Language English Spanish Other 122/67 9/18 0/1 Culture Veterans LGBTQ Other
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Community Impact: MHSAS A 17 yr old refugee from war-torn Syria requested services from CMH for services. He was suffering from post traumatic stress disorder after witnessing two friends executed by rebel forces. Due to attempts by the rebels to enlist him into their army his parents snuck him out of the country. Currently, he lives in Santa Cruz with relatives. Client suffered from reoccurring nightmares about the shooting incident, sadness, daily worrying about his family, and difficulty sleeping. After almost a year in treatment client, now 18, reports a significant decrease in symptoms. He is working for his uncle, is taking an English class through Adult Ed, and works out at the gym. His family was forced out of Syria and now live in Jordan.
Community Impact: Parent Center A 7 year old Latina girl has been coming to the Parents Center for individual therapy for about 10 months. She was referred for counseling because she was in out of home care (due to her mother’s failure to protect) and had: loss of appetite, extreme sadness, chronic worries, highly fearful and was failing academically and socially. She had all of the symptoms of Post Traumatic Stress Disorder. We have been providing individual and family therapy to help her process her feelings and gain an understanding of what occurred that is unrelated to her being loved by her family. Although she will not return home, her symptoms have greatly reduced, her joy has returned and she is happy in her new home with her Grandmother who was included in our services. Her extended family is now allowing her to visit with one of her birth parents and have communication with her other parent that was deported. All services were provided bilingually from a licensed eligible Latina therapist.
Community Impact: SCCCC, Independent Living Skills “ILP is one of the most amazing and helpful programs. It’s not easy to get out of foster care and then take care of yourself. But, ILP has been there every step of the way, helping and encouraging me to keep making positive changes in my life. Without them, I wouldn’t be where I am today, not by a long shot. I will always be grateful and appreciative for ILP, forever.”
Community Impact: SCCCC, Independent Living Skills “I’ve been in ILP for the last three years. Throughout that whole time I had several different counselor’s that were very helpful. ILP provided me resources that I was able to take advantage of. Fro example, when I wanted to start college my counselor provided me with all the information I needed to get started without me even setting foot on campus. Then, my ILP counselor helped me fill out my registration and get me signed up for financial aid. ILP helped me also with other things in my life that helped me mature and improve my decision making in life. I appreciate all the help that I received from ILP. This program really helped me become responsible and aware of how hard it is to live on your own, and for that I’m grateful.”
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CSS Program #4: Education Gate Purpose: This program is designed to create school-linked screening/assessment and treatment of children/youth suspected of having serious emotional disturbances. In addition, specific dual diagnosis (mental health/substance abuse) service capacity has been created and targeted to students referred from Santa Cruz County's local schools, particularly those not referred through Special Education.
The Education Gate goal is to address the mental health needs of children/youth in Education system at risk of school failure by • Providing mental health services to children/youth with serious emotional disturbance (SED) at school sites, particularly at the County Office of Education’s alternative schools. • Providing consultation and training of school staff in mental health issues regarding screening and service needs of students with SED
Targeting specific referral and linkage relationships with the County Office of Education’s Alternative School programs has helped target at-risk students not eligible for special education services, but still in need of mental health supports.
Education Gate services are particularly helpful in reaching out to our local Alternative Schools students who don’t qualify for special education services and are at risk of escalation into Probation and Child Welfare services.
Target Population: Children/youth in Education system at risk of school failure. Particular attention will be paid to addressing the needs of Latino youth and families. Transition-age youth will also be served. Services are offered to males and females, and are primarily in English and Spanish.
Providers: The services in this work plan are provided by Santa Cruz County Mental Health & Substance Abuse Services staff.
Number of individuals to be served in 2013-2014: The unduplicated number of individuals to be served by program is: Santa Cruz County Mental Health & Substance Abuse Services: 10
Were there any challenges or barriers in the program? If so, what are the strategies to mitigate? The North SELPA has taken back responsibility for Educationally Related Mental Health Services (ERMHS), while the Pajaro SELPA has continued to contract with us to provide mental health services to their eligible special education pupils. We are concerned about reductions in North SELPA services to students, and will need to carefully screen and assess new referrals through our MHSA Education Gate (and Community Gate) to ensure timely access for appropriate referrals to us, as well as assist families/districts in ensuring appropriate continued ERMHS services for North SELPA students through other appropriate vendors.
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Are there any new, changed or discontinued programs? No. ERMHS was not an MHSA funded program, so those changes are external to our organization.
Performance Outcomes (specify time period): The number of people served in 2011-2012 is 11. The numbers of people served in quarter 1 (July 1, 2012 to September 30, 2012) and in quarter 2 (October 1, 2012 to December 31, 2012) by program are below. The numbers in the table are: Quarter 1/Quarter 2. (Note: These numbers represent an unduplicated client count.)
Agency Reporting MHSAS Unduplicated Total Served 22/3 Age Group Children 0-17 TAY 16-25 Adults 26-59 Older Adults 60+ 11/0 11/3 Race/Ethnicity White Latino Other 7/1 12/1 3/1 Primary Language English Spanish Other 17/3 4/0 1/0 Culture Veterans LGBTQ Other
Community Impact: MHSAS We received a referral over three years ago for Jason (not his real name) from his school. Thirteen then, he was identified by his teacher as having difficulty paying attention in class, coming to school in dirty clothes, and seeming anxious. Both his brother and sister were already in treatment with our agency at that time. During the assessment interviews, Jason’s mother stated that he had anger issues because of the domestic violence he had witnessed, as well as PTSD. His mother had serious substance abuse issues, and Jason was noted to have an anxious mood and significant constriction of affect, with a need to protect mother from any criticism. The family had experienced periods of homelessness and now lived in condemned housing. The father came to visit infrequently and mother reported that she was dying.
In the past three years, Jason has continued to attend school, and is now more congruent about his anger with his mother around her insistence that she is dying. Father has returned to the family home, which Jason likes, but is nervous about the potential for domestic violence. Jason has so far resisted the pressure to join a gang, and instead spends his time sewing satchels, which he sells to teachers and assists in teaching the sewing class at his high school. He has started using marijuana as a coping strategy, but is also more open about his feelings. His therapist continues to work with him to find healthy alternatives to drugs and repression of feelings to deal with the real problems of living in poverty with substance abusing parents, an older brother who bullies him, and boundary issues such as when mother invites friends to sleep in his bedroom.
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CSS Program #5: Special Focus: Family Partnerships Purpose: This MHSA contract is designed to expand Family and Youth Partnership activities provided by parents, and youth, who are or have been served by our Children's Interagency System of Care, to support, outreach, education, and services to parent and youth services in our System of Care. Family partners have become increasingly integrated parts of our interagency Wraparound teams serving youth on probation at-risk of group home placement.
The support, outreach, education, and services include: • Community-based agency contract to provide parent and youth services in our System of Care, and • Capacity for youth and family advocacy by contracting for these services with a community bases agency. Emphasis is on youth-partnership activities.
Having family partners integrated into our Wraparound teams has provided invaluable peer resources for these families. It has helped parents navigate the juvenile justice, court, and health service systems and provided a peer-family advocacy voice. Similarly, the youth partnership program at SCCCC has made significant progress in reaching out to LGBTQ youth throught the STRANGE program and Diversity Center activities.
Target Population: Families and youth involved in our Children’s Mental Health System of Care in need of family and youth partnership activities. Services are offered to males and females, and are primarily Caucasian or Latino, and speak English and/or Spanish.
Providers: The staff from SCCCC (Youth Services) and Volunteer Center- Family Partnerships provide the services in this work plan.
Number of individuals to be served in 2013-2014: The unduplicated numbers of individuals to be served by program are: Santa Cruz Community Counseling Center: 220 Volunteer Center/Family Partnerships: 20
Were there any challenges or barriers in the program? If so, what are the strategies to mitigate? Contractor recruitment of qualified family partners, particularly with Spanish-speaking skills, has been uneven. While this is not unique to these organizations, and is indeed a statewide issue, we need to continue to work with contractors to maximize outreach and training/support functions for family and youth partners.
Are there any new, changed or discontinued programs? No.
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Performance Outcomes (specify time period): The number of people served in 2011-2012 is 25 youth and families, and 164 youth in outreach. The numbers of people served in quarter 1 (July 1, 2012 to September 30, 2012) and in quarter 2 (October 1, 2012 to December 31, 2012) by program are below. The numbers in the table are: Quarter 1/Quarter 2. (Note: These numbers represent an unduplicated client count.)
Agency Reporting SCCCC Unduplicated Total Served 17/ 20 Age Group Children 0-17 TAY 16-25 Adults 26-59 Older Adults 60+ 9/15 8/5 Race/Ethnicity White Latino Other Unknown 3/6 3/4 4/7 7/3 Primary Language English Spanish Other 17/20 Culture Veterans LGBTQ Other 14/16
Agency Reporting Volunteer Center/Family Partnership Unduplicated Total Served 2/6 Age Group Children 0-17 TAY 16-25 Adults 26-59 Older Adults 60+ 1/1 1/5 Race/Ethnicity White Latino Other Unknown 1/0 0/6 1/0 Primary Language English Spanish Other 2/4 0/2 Culture Veterans LGBTQ Other
Community Impact: Youth Services One of our recent successes came on National Day of Silence, a day on which students nation- wide take a vow of silence to call attention to the silence that many LGBTQ students are forced into through anti-LGBTQ bullying and harassment. Our program supported 8 participating middle schools and high schools with over 150 total student participants. This event supports LGBTQ youth in a number of ways. Students who are not out about their sexual orientation or gender identity are able to see a widespread display of support for LGBTQ students. The student organizers of the event at each school gain valuable leadership and event planning experience that can boost their sense of accomplishment and self worth.”
Community Impact: Family Partnership For the last few years our Program has been working with a youth who has had significant problems with emotional regulation as we all serious challenges with focusing and impulsiveness. This youth and his mother were homeless for several months and living out of their car. As a result of these challenges this youth displayed uncontrollable outbursts in school, had significant challenges focusing and was highly disruptive. While this child was receiving
19 Santa Cruz County Mental Health & Substance Abuse Services: MHSA Annual Update special education services, he was so far behind in reading that his teachers had little hope he would ever be able to read at grade level. His mother was unable to get him to complete homework at home and often spent a great deal of time simply trying to help her son calm down enough to be able to focus.
Our program was able to provide support and education to this client’s mother around consistent parental responses such as setting clear limits and consequences. As a result of this support, this youth has made remarkable improvements. In addition, his mother has learned to disengage from power struggles and how to adapt her parenting style to minimize the potential for negative attention seeking behaviors. This youth is now in his first year of middle school and has had no major behavioral issues in school or at home. His reading has improved significantly and he now uses strategies that help him focus and concentrate as well as strategies to manage difficult emotions. Last, as a result of Family Partnership services, this youth’s mother has become a stronger advocate and can now effectively communicate with school staff regarding her son’s health and well being at IEP meetings.
20 Santa Cruz County Mental Health & Substance Abuse Services: MHSA Annual Update
CSS Program #6: Enhanced Crisis Response Purpose: This work plan provides enhanced 24/7 supports to adults experiencing significant impact to their level of functioning in their home or community placement to maintain functioning in their living situation, or (2) in need or at risk of psychiatric hospitalization but are able to be safely treated on a voluntary basis in a lower level of care, or (3) individuals being inappropriately treated at a higher level of care or incarceration and able to step down from psychiatric hospitalization or locked skilled nursing facility to a lower level of care in the community.
The Santa Cruz County Mental Health and Substance Abuse Program is committed to a person- centered recovery vision as it’s guiding principles and values; central to this is the notion that every individual should receive services in the least restrictive setting possible. We enable individuals to avoid or minimize the disruption and trauma of psychiatric hospitalization and/or incarceration while maintaining their safety in a supportive, safe, and comfortable environment. Additionally, we provide individualized attention and a “compassionate presence” for individuals in need on a 24/7 basis.
To accomplish the above, we provide the following services: 1. Transition House. This serves as a crisis residential program to enhance the capacity of voluntary alternatives to acute psychiatric hospitalization, and its primary function is hospital diversion. Individuals are referred directly from the community, from the Psychiatric Emergency Service at the Behavioral Health unit and as “step-down” from the inpatient unit. The “step down” intention is to reduce the length of time an individual spends in locked care and provide a safe environment to continue to recover prior to returning to the community. 2. Enhanced Support Service (ESS). This team assists adult Full Service Partnerships and other System of Care consumers maintain the least restrictive care by providing intensive wrap around services. Aggressive supports are provided to individuals experiencing crisis in the community to allow individuals to stay in the least restrictive environment safe for the situation. This service continues to allow individuals to recover from a crisis in the community, preventing unnecessary hospitalizations or escalated treatment services. 3. El Dorado Center (EDC). This is an intensive treatment program to transfer individuals from locked care into the community. The treatment is guided by recovery oriented and strength based principles. Staff collaborates with residents in identifying their strengths, skills and areas they want to improve upon as they continue the healing process in preparation for transitioning back to community living. 4. River Street Shelter. This is an emergency shelter for homeless adult men and women. The shelter is a clean and sober environment where residents can begin or continue the process of rebuilding their lives, maintaining sobriety, and reconnecting with the community as they move towards ending homelessness. River Street Shelter staff provides expertise and specialized services for individuals with psychiatric disabilities and substance abuse challenges. Staff works individually with residents to assist them in connecting with community resources for obtaining benefits, physical health services, employment, and housing. Specialized counseling is available for those residents with mental health and substance abuse issues, to support them in maintaining psychiatric stability and achieving individualized goals.
21 Santa Cruz County Mental Health & Substance Abuse Services: MHSA Annual Update
5. Specialty Staffing. The focus is to link individuals to services in the community to avoid hospital utilization, if possible. One staff person functions as a “re-entry specialist” for the Adult Wrap team, and the others provide Crisis Response at out walk-in service at Access.
Target Population: Individuals 18 and older diagnosed with a serious mental illness at high risk of crisis. Clients are primarily White or Latino, male or female, and speak English and/or Spanish.
Providers: • For Transition House: Santa Cruz Community Counseling Center • For Enhanced Support Service (ESS) team: Santa Cruz Community Counseling Center • For El Dorado Center (EDC): Santa Cruz Community Counseling Center • River Street Shelter: Santa Cruz Community Counseling Center • For Specialty Staffing: Santa Cruz County Mental Health & Substance Abuse Services
Number of individuals to be served in 2013-2014: The unduplicated numbers of individuals to be served by program are: SCCCC-Transition House: 200 SCCCC-Enhanced Support Services Team: 100 SCCCC- El Dorado Center: 80 SCCCC- River Street Shelter: 200 SC MHSAS: 100
Were there any challenges or barriers in the program? If so, what are the strategies to mitigate? The above programs continue to provide intensive support services to individuals in crisis. The only potential challenges noted in the past period relate to program capacity issues. With budget cuts affecting other community programs, the residential facilities in this category, Transition House, El Dorado Center and River Street Shelter have individuals staying longer as subsequent placements are full. Consumer flow through services is affected.
We are carefully monitoring the utilization of these facilities and developing alternative plans for individuals ready to “step down from this intensive level of care.
Are there any new, changed or discontinued programs? No. Although, River Street Shelter was previously in CSS work plan #8, but more appropriately fits in this work plan.
Performance Outcomes (specify time period): The number of people served in 2011-2012 is approximately 357. The numbers of people served in quarter 1 (July 1, 2012 to September 30, 2012) and in quarter 2 (October 1, 2012 to December 31, 2012) by program are below. The numbers in the table are: Quarter 1/Quarter 2. (Note: These numbers represent an unduplicated client count.)
22 Santa Cruz County Mental Health & Substance Abuse Services: MHSA Annual Update
Agency Reporting SCCCC- Transition House Unduplicated Total Served 38/38 Age Group Children 0-17 TAY 16-25 Adults 26-59 Older Adults 60+ 0/0 2/3 33/33 3/2 Race/Ethnicity White Latino Other 20/28 5/5 13/5 Primary Language English Spanish Other Not collected Not collected Culture Veterans LGBTQ Other Not collected Not collected
System Development Quarter 1: SCCCC/Transition House Number of individuals/families targeted Number of individuals actually served 38*/38 *Note: this represents 55% of the clients served at Transition House. T-House is funded by fees, a Federal Grant, MHSA CSS and Medi-Cal FFP. MHSA represents 55% of T-House funding. The total number of individuals served was 60.
Agency Reporting SCCCC- Enhance Crisis Support (ESS) Unduplicated Total Served 28/28 Age Group Children 0-17 TAY 16-25 Adults 26-59 Older Adults 60+ 0/1 22/22 6/5 Race/Ethnicity White Latino Other Not collected Not collected Primary Language English Spanish Other Not collected Not collected Culture Veterans LGBTQ Other Not collected Not collected
System Development Quarter 1: SCCCC/ESS Team Number of individuals/families targeted Number of individuals actually served 28*/28 *Note: this represents 51% of the clients served at CSS Enhanced Support Services Team. The Enhanced Support Services Team is funded by MHSA CSS and Medi-Cal FFP. MHSA represents 51% of the Enhanced Support Services Team funding. The total number of individuals served was 55.
23 Santa Cruz County Mental Health & Substance Abuse Services: MHSA Annual Update
Agency Reporting SCCCC- El Dorado Center Unduplicated Total Served 29/21 Age Group Children 0-17 TAY 16-25 Adults 26-59 Older Adults 60+ 4/1 23/14 2/6 Race/Ethnicity White Latino Other 12/16 3/2 14/3 Primary Language English Spanish Other Not collected Not collected Culture Veterans LGBTQ Other Not collected Not collected
System Development Quarter 1- El Dorado Center Number of individuals/families targeted Number of individuals actually served 29*/21 *Note: this represents 49% of the clients served at El Dorado. El Dorado is funded by MHSA CSS and Medi-Cal FFP. MHSA represents 49% of the El Dorado funding. The total number of individuals served was 60.
Agency Reporting SCCCC- River Street Shelter Unduplicated Total Served 19/17 Age Group Children 0-17 TAY 16-25 Adults 26-59 Older Adults 60+ 1/1 16/15 2/1 Race/Ethnicity White Latino Other 11/10 2/3 6/4 Primary Language English Spanish Other Not tracked Not tracked Culture Veterans LGBTQ Other Not tracked Not tracked
System Development Quarter 1- River Street Shelter Number of individuals/families targeted Number of individuals actually served 19* *Note: this represents 10% of the clients served by the River Street Shelter. The River Street Shelter is funded by MHSA CSS Medi-Cal FFP, a Federal grant, H.S.A. County General funds, HSD, the City of Santa Cruz and United Way. MHSA represents 10% of the Shelter funding. The total number of individuals served was 186.
24 Santa Cruz County Mental Health & Substance Abuse Services: MHSA Annual Update
Agency Reporting MHSAS Unduplicated Total Served 13/30 Age Group Children 0-17 TAY 16-25 Adults 26-59 Older Adults 60+ 13/28 0/2 Race/Ethnicity White Latino Other 12/23 0/4 1/3 Primary Language English Spanish Other 13/29 0/1 Culture Veterans LGBTQ Other
Family Partnerships MHSAS Number of Transition Age Youth (16-25) targeted Number of Transition Age Youth actually served Number of Adults (26-59) targeted Number of Adults actually served 13/28 Number of Older Adults (60+) targeted Number of Older Adults actually served 0/2
Community Impact The collective impact of these programs and is illustrated in the success of the consumers on the Formatted Adult Wrap Around team. Individuals were identified that had been in locked care over 12 months. A number of these individuals had been in acute inpatient and locked care settings for up to 40 months. These individuals were initially placed at El Dorado Center in the intensive treatment program for individuals returning from locked care. At El Dorado Center, they received daily supports for living in the community, taking medications, developing independent living skills and strategies for wellness. While at El Dorado Center, the case management staff from the Adult Wrap Around team meet with clients multiple days per week to develop plans for living in the community, either in Adult Residential Facilities or Supported Housing environments. They focus on pro-social activities and community integration for activities. Once the individual moves on the community placement, the Wrap team continues the intensive wrap around services of monitoring medication, community activities, crisis intervention and support services to encourage success in the community. Of the 25 individuals on the wrap team last year, only 3 returned to a higher level of care.
25 Santa Cruz County Mental Health & Substance Abuse Services: MHSA Annual Update
CSS Program #7: Consumer, Peer, & Family Services Purpose: To provide countywide access to culturally competent, recovery-oriented, peer-to- peer, community mentoring, and consumer-operated services. This plan includes 1. The Wellness Center. This is located in Santa Cruz at the Mental Health Client Action Network (MHCAN) self-help center. It is a client-owned and operated site that offers a menu of services for persons in the early stages of mental illness to “graduates” of mental health services, including peer support and TAY Academy. 2. Mariposa. This Wellness Center is located Watsonville. Mariposa Offers a variety of activities and support services for adult mental health consumers and their families, as well as for outreach activities. Activities include employment services, therapy, groups, and medication management. 3. Peer supports. Consumers work with the teams to build relationships with consumers and address isolation and socialization issues.
Target Population: The priority population for these services includes transition age youth, adults and older adults, males and females, with serious mental illness. The target population for this program is primarily White or Latino, and speaks English and/or Spanish.
Providers: • For North county Wellness: Mental Health Consumer Action Network • For Mariposa: Community Connection/Volunteer Center • For Peer Supports: Santa Cruz County Mental Health & Substance Abuse Services
Number of individuals to be served in 2013-2014: The unduplicated numbers of individuals to be served by program are: • MHCAN: 550 • Mariposa: 150 • Adult Peer Support: 25 • Older Adult Peer Support: 15
Were there any challenges or barriers in the program? If so, what are the strategies to mitigate? No.
Are there any new, changed or discontinued programs? No.
Performance Outcomes (specify time period): The number of people served in 2011-2012 is approximately 784. The numbers of people served in quarter 1 (July 1, 2012 to September 30, 2012) and in quarter 2 (October 1, 2012 to December 31, 2012) by program are below. The numbers in the table are: Quarter 1/Quarter 2. (Note: These numbers represent an unduplicated client count.)
26 Santa Cruz County Mental Health & Substance Abuse Services: MHSA Annual Update
Agency Reporting MHCAN Unduplicated Total Served 604/596 Age Group Children 0-17 TAY 16-25 Adults 26-59 Older Adults 60+ 3/4 42/51 321/324 238/217 Race/Ethnicity White Latino Other
Primary Language English Spanish Other
Culture Veterans LGBTQ Other
Agency Reporting MHCAN Full Service Partnerships Quarter 1 Number of Transition Age Youth (16-25) targeted Number of Transition Age Youth actually served 42/51 Number of Adults (26-59) targeted Number of Adults actually served 321/324 Number of Older Adults (60+) targeted Number of Older Adults actually served 238/217
Agency Reporting Volunteer Center/Community Connection Unduplicated Total Served 144/121 Age Group Children 0-17 TAY 16-25 Adults 26-59 Older Adults 60+ 13/12 125/103 6/6 Race/Ethnicity White Latino Other 88/72 32/60 15/11 Primary Language English Spanish Other 129/83 6/58 0/2/0 Culture Veterans LGBTQ Other 2/0 4/0
Agency Reporting Volunteer Center/Community Connection System Development Quarter 1 Number of individuals/families targeted Number of individuals actually served 17/22 Full Service Partnerships Quarter 1 Number of Transition Age Youth (16-25) targeted Number of Transition Age Youth actually served 5/6 Number of Adults (26-59) targeted Number of Adults actually served 11/15 Number of Older Adults (60+) targeted Number of Older Adults actually served 1/1
27 Santa Cruz County Mental Health & Substance Abuse Services: MHSA Annual Update
Agency Reporting MHSAS Unduplicated Total Served 13/13 Age Group Children 0-17 TAY 16-25 Adults 26-59 Older Adults 60+ 13/13 Race/Ethnicity White Latino Other
Primary Language English Spanish Other
Culture Veterans LGBTQ Other
Community Impact: Mariposa I am very thankful to be a part of the Mariposa Center. Words cannot explain how much it has helped my life. Mariposa is a big part of my recovery plan. I come to Mariposa every day and participate in all the wonderful groups. We have schizophrenia, bipolar, healthy relationship, mindfulness, DRA and peer-to-peer groups. Staff at Mariposa are awesome; they are very caring and it has been very helpful to me.
I had the opportunity to volunteer and work myself up from a client to a staff member. Currently I am a program aide for the Avenues program. I love my job so much; it has been a great experience to be able to work with such great people. I am thankful and exited to get out of bed today and every day. I have 2 years 2 months clean and sober, and for a chronic relapse it is a miracle. I owe it all to coming to the Mariposa and changing my life.
Community Impact: Mariposa I am representing Mariposa Wellness Center, which is a place where I can go during the day. Everybody there knows me and each other and are always friendly. If it weren’t for Mariposa I would probably be on the streets. I personally think that my life is now going in the right direction. At Mariposa Center we have a lot of groups, such as bipolar class, DRA groups, cooking class, etc. I really learn a lot about mental illness, and how to cope with it myself. Being around friends here lets me know I am not alone and that there is always hope for me and my friends.
28 Santa Cruz County Mental Health & Substance Abuse Services: MHSA Annual Update
CSS Program #8: Community Support Services Purpose: The services and strategies in this work plan are designed to advance recovery goals for all consumers to live independently and be to engaged in meaningful work and learning activities. Participants will be enrolled in Full Service Partnership (FSP) Teams. FSPs are “partnerships” between clients and clinicians that include opportunities for clinical care, housing, employment, and 24/7 service availability of staff.
To accomplish the above, the Recovery Team and South County Adult Team have been restructured to now provide intensive wrap around services to prevent acute hospitalizations and assist in getting people out of higher levels of care. These teams will focus more on “crisis” as their priority and when time allows provide an additional array of recovery-oriented supports that include linkage to housing, employment and education. One team Supervisor will carry a small caseload and one position will be staffed as a Clinic Nurse 1 or 2 to provide medical case management services.
The Housing Support Team provides services and supports to adults living independently in order to help them maintain their housing and mental health stability. The team consists of County Housing Coordinator and an occupational therapist, Front Street staff (housing case management, OT, RN, and peer counselor), Community Connection staff (employment specialist and peer counselor), and SCCCC case managers.
The supportive employment activities include the development of employment options for clients, competitive and non-competitive alternatives, and volunteer opportunities to help consumers in their recovery.
We also provide Adult care facility beds with providing 24/7 care, bi-lingual, bi-cultural services. The Board and Care facilities include Wheelock, Willowbrook, and Front Street. Opal Cliffs provides an adult residential setting to provide intensive supervision and support to individuals returning from Locked Care settings to prepare to re-integrate into housing and community services.
Target Population: The priority population for these services includes transition age youth, adults, and older adults with serious mental illness. The target population for this program is primarily White or Latino, and speaks English and/or Spanish.
Providers: The staff from Front Street, SCCCC, Volunteer Center/Community Connection and Santa Cruz County Mental Health & Substance Abuse Services provide the services in this work plan. • Front Street provides: Supported Housing, Wheelock (Residential), Wheelock (Outpatient), Willowbrook, and Housing /Property Management. • SCCCC provides Housing Support • Volunteer Center/Community Connection provides Housing Support/Employment and Peer Support. • Santa Cruz County Mental Health & Substance Abuse Services staff provides case management services.
29 Santa Cruz County Mental Health & Substance Abuse Services: MHSA Annual Update
Number of individuals to be served in 2013-2014: The unduplicated numbers of individuals to be served by program are: Front Street- Supported Housing: 100 Front Street- Wheelock (Residential & Outpatient): 23 Front Street- Willowbrook: 53 Front Street- Housing/Property Management: 42 Front Street- Opal Cliff: 10 Santa Cruz Community Counseling Center- Supported Housing: 150 Volunteer Center/Community Connection-Housing Support (employment): 30 Volunteer Center/Community Connection-Opportunity Connection: 65 Santa Cruz County Mental Health & Substance Abuse Services: 130
Were there any challenges or barriers in the program? If so, what are the strategies to mitigate? There has been an increase of complex medical problems among our consumers. We need more medical staff to address this issue, so we are adding a nurse.
Are there any new, changed or discontinued programs? Yes. We are adding Opal Cliffs, which is an adult residential setting to provide intensive supervision and support to individuals returning from Locked Care settings to prepare to re- integrate into housing and community services. Additionally, we used to include River Street Shelter in this work plan, but it is now included in work plan #6.
Performance Outcomes (specify time period): The number of people served in 2011-2012 is approximately 247. The numbers of people served in quarter 1 (July 1, 2012 to September 30, 2012) and in quarter 2 (October 1, 2012 to December 31, 2012) by program are below. The numbers in the table are: Quarter 1/Quarter 2. (Note: These numbers represent an unduplicated client count.) Agency Reporting Front Street Inc- Housing Support Unduplicated Total Served 90/93 Age Group Children 0-17 TAY 16-25 Adults 26-59 Older Adults 60+ 6/6 69/66 15/21 Race/Ethnicity White Latino Other 72/74 7/6 11/13 Primary Language English Spanish Other 86/86 3/3 1/2 Culture Veterans LGBTQ Other 3/5 5/1
Full Service Partnerships Quarter 1- Front Street Housing Support Number of Transition Age Youth (16-25) targeted Number of Transition Age Youth actually served 6/6 Number of Adults (26-59) targeted Number of Adults actually served 69/66 Number of Older Adults (60+) targeted Number of Older Adults actually served 15/21
30 Santa Cruz County Mental Health & Substance Abuse Services: MHSA Annual Update
Agency Reporting Front Street Inc- Wheelock (outpatient) Unduplicated Total Served 16/16 Age Group Children 0-17 TAY 16-25 Adults 26-59 Older Adults 60+ 3/3 10/9 4/4 Race/Ethnicity White Latino Other 8/7 4/5 4/4 Primary Language English Spanish Other 14/14 2/2 Culture Veterans LGBTQ Other 2/0 2/2
Full Service Partnerships Front Street- Wheelock (out patient) Number of Transition Age Youth (16-25) targeted Number of Transition Age Youth actually served 3/3 Number of Adults (26-59) targeted Number of Adults actually served 10/9 Number of Older Adults (60+) targeted Number of Older Adults actually served 3/4
Agency Reporting Front Street Inc- Wheelock (residential) Unduplicated Total Served 16/16 Age Group Children 0-17 TAY 16-25 Adults 26-59 Older Adults 60+ 3/3 10/9 4/4 Race/Ethnicity White Latino Other 8/7 4/5 4/4 Primary Language English Spanish Other 14/14 2/2 Culture Veterans LGBTQ Other 2/0 2/2
Full Service Partnerships Front Street- Wheelock (residential) Number of Transition Age Youth (16-25) targeted Number of Transition Age Youth actually served 3/3 Number of Adults (26-59) targeted Number of Adults actually served 10/9 Number of Older Adults (60+) targeted Number of Older Adults actually served 3/4
31 Santa Cruz County Mental Health & Substance Abuse Services: MHSA Annual Update
Agency Reporting Front Street Inc- Willowbrook Unduplicated Total Served 39/40 Age Group Children 0-17 TAY 16-25 Adults 26-59 Older Adults 60+ 28/25 11/12 Race/Ethnicity White Latino Other 31/32 5/5 3/3 Primary Language English Spanish Other 32/33 5/5 2/2 Culture Veterans LGBTQ Other 2/3 3/2
Full Service Partnerships Front St- Willowbrook Number of Transition Age Youth (16-25) targeted Number of Transition Age Youth actually served 0/0 Number of Adults (26-59) targeted Number of Adults actually served 28/28 Number of Older Adults (60+) targeted Number of Older Adults actually served 11/12
Agency Reporting Front Street- Housing/Property Management Unduplicated Total Served 48/3 Age Group Children 0-17 TAY 16-25 Adults 26-59 Older Adults 60+ 47/3 1/0 Race/Ethnicity White Latino Other Unknown 48 Primary Language English Spanish Other Unknown 48/3 Culture Veterans LGBTQ Other
Full Service Partnerships Front Street Housing Property Management Number of Transition Age Youth (16-25) targeted Number of Transition Age Youth actually served 0/0 Number of Adults (26-59) targeted Number of Adults actually served 47/3 Number of Older Adults (60+) targeted Number of Older Adults actually served 1/0
32 Santa Cruz County Mental Health & Substance Abuse Services: MHSA Annual Update
Agency Reporting SCCCC- Supported Housing Team Unduplicated Total Served 67*/64 Age Group Children 0-17 TAY 16-25 Adults 26-59 Older Adults 60+ 1/2 54/49 12/13 Race/Ethnicity White Latino Other Not tracked Not tracked Primary Language English Spanish Other Not tracked Not tracked Culture Veterans LGBTQ Other Not tracked Not tracked
System Development Quarter 1- SCCCC Supportive Housing Team Number of individuals/families targeted Number of individuals actually served 67*/64 *Note: this represents 51% of the clients served by CSS Supported Housing Staff. The Supported Housing Program is funded by MHSA CSS and Medi-Cal FFP. MHSA represents 51% of Supported Housing funding. The total number of individuals served was 131.
Agency Reporting Community Connection- Housing Support (employment) Unduplicated Total Served 82/92 Age Group Children 0-17 TAY 16-25 Adults 26-59 Older Adults 60+ 3/1 77/90 2/1 Race/Ethnicity White Latino Other 62/71 11/12 7/9 Primary Language English Spanish Other 79/91 1/1 Culture Veterans LGBTQ Other 1/1 2/2
Full Service Partnerships CC: Housing Support (employment) Number of Transition Age Youth (16-25) targeted Number of Transition Age Youth actually served 3/1 Number of Adults (26-59) targeted Number of Adults actually served 77/90 Number of Older Adults (60+) targeted Number of Older Adults actually served 2/0
33 Santa Cruz County Mental Health & Substance Abuse Services: MHSA Annual Update
Agency Reporting Santa Cruz County Mental Health & Substance Abuse Program Outreach Unduplicated Total Served 32/32 Age Group Children 0-17 TAY 16-25 Adults 26-59 Older Adults 60+ 0/14 32/18 Race/Ethnicity White Latino Other ?/24 ?/3 ?/1 Primary Language English Spanish Other ?/30 ?/2 Culture Veterans LGBTQ Other
Agency Reporting Santa Cruz County Mental Health & Substance Abuse Program Staffing Support Unduplicated Total Served 481/454 Age Group Children 0-17 TAY 16-25 Adults 26-59 Older Adults 60+ 39/41 335/313 107/100 Race/Ethnicity White Latino Other 313/290 96/95 72/46 Primary Language English Spanish Other 419/394 41/40 21/20 Culture Veterans LGBTQ Other
Community Impact: SCCCC/Supportive Housing Team Christian was a homeless man for a period of at least two years. He became very ill and at that time was taken to DBHU for three weeks. Upon his discharge from DBHU, it was decided that Christian should be placed in a Board and Care facility in order for him to have his needs met. Christian moved into Stanford House on 12/02/10 after having stayed at the same Board and Care facility for 11 years. At the beginning of his stay, he was very quiet and pleasant. He was not yet familiar with taking care of his activities of daily living in terms of shopping, cooking, laundry and other simple chores.
The CSS Housing Support team provided independent skills building; use of laundry facilities, teach him how to do things like clean the sink and empty the dishwasher. The occupational therapist from County Mental Health also worked with Christian regularly on cooking skills and other basic tasks. Every other week a counselor from the CSS Housing Support team taught a cooking class and Christian was a regular participant.
34 Santa Cruz County Mental Health & Substance Abuse Services: MHSA Annual Update
Soon, Christian got a bicycle and began learning the area in order to transport himself around town. Christian began volunteer work at the Soup Kitchen, which he enjoyed very much. He was a reliable and appreciated part of the Soup kitchen from that point on. Christian stayed at Stanford House for nearly one year.
On 11/10/11, a room opened up at Van Ness, a permanent supported housing opportunity that the team felt Christian was ready for. Christian resides at Van Ness to this day. He continues to volunteer at the Soup Kitchen, consistently contributing to the Santa Cruz community. Christian recently was able to get himself a kitten, which he loves very much and gives good care to. The CSS Housing Team, County Housing Team and MMP are all thrilled with Christian’s progress over the past 27 months and have every reason to expect that he will continue to progress even further.
Community Impact: Front Street “Front Street housing helped me through tough times. It helped me when nothing else seemed to work. I followed through with their guidance, and I have become more independent. It is a successful program.” (Testimonial at Town Hall meeting)
Community Impact: Front Street As recently as a year and a half ago M was experiencing symptoms that had caused her to lose her housing and become homeless for a period. She also did damage to her relationships with her two sons as a result of the behavior caused by her symptoms. She ended up being placed in locked care against her will, something she still has bad memories of. She was able to transition to a board and care facility and from there into supported housing, where she has been doing well for almost a year. She has been volunteering her time to help at other facilities and feels a strong desire to help others who are not currently as successful as her. She has been working with a therapist on many issues, and with her therapist’s help has made great progress in repairing her relationships with her children.
Community Impact: Front Street CD – Has been in our supported housing (2 bedroom) since funding began and recently moved into a one-bedroom unit with SC4 housing. This is truly remarkable as he has a TBI, which significantly impaired short-term memory and has had to work very hard to overcome this challenge along with his mental health symptoms, which include depression. He spent many years at residential treatment centers, and then moved to social rehabs prior to Supported Housing, always with keeping his eye on his goals despite challenges and setbacks. He is currently enrolled in classes at Cabrillo and working toward getting his certificate in Human Services, he also volunteers at second story and is a peer counselor. He is happy to be living in his own one bedroom unit, as this has been a goal of his for a long time. He remains open to our team during this huge transition to support him with developing new routines and changes in his environment. He will continue receiving housing support through SC4 and will no doubt reach his educational goals and continue to contribute to the mental health community as he pursues his dreams.
35 Santa Cruz County Mental Health & Substance Abuse Services: MHSA Annual Update
Community Impact: Community Connection I began hearing voices in the third grade, at a time when I couldn’t talk about it, so I turned to alcohol. Ten years ago I started getting help and was in and out of hospitals, often suicidal. My last hope was going to Community Connection. They saved my life! I love my family, and I love Community Connection.
Community Impact: Front Street, Willowbrook Mary came to Willowbrook in 2012, after having lost independent housing as a result of symptoms of mental illness. She was at WRC for a short amount of time, but while she was here, she utilized all her resources (attending group therapy, attending other onsite groups, meeting with her coordinator, volunteering at EDC). She managed to maintain good interpersonal skills while living in the women’s cottage despite challenging personalities of housemates. Mary was referred to the Front Street Inc Housing Support Team when an apartment became available near Willowbrook Residential. She successfully made the move to supported housing. She continues to do well in that setting and has become a positive peer mentor for the Willowbrook residents.
Community Impact: Wheelock When Debbie was first admitted to Wheelock almost three years ago. She was under conservatorship and severely impacted by the symptoms of Schizophrenia. Her ongoing paranoia estranged her from being able to fulfill any social norms and prevented her from understanding the hardships of reality. With a few years of therapeutic education and a boost of self confidence, Debbie has made almost a complete 180 in her recovery. Today she is able to manage her personal hygiene and is fully committed to improving her independent living skills. Late last year she successully terminated her conservatorship, a remarkable personal achievement. She maintains focus on her long term goals and remians engaged in her recovery program. Debbie tackled her struggles by following a structured schedule as she pursues an active role in her community (e.g. volunteering and taking part in community resource center activities). Debbie went from being critically afraid of public transportation to a frequent consumer of the transit system. She maintains a serious relationship with her long term boyfriend and is now able to put her needs before his. We are all so proud of her ongoing improvements and continue to encourage her to do her best. Debbie still faces challenges today, but she is learning every day how to live with and manage her symptoms.
Community Impact: Community Connection D.B was referred from the Transition Team for Housing Support Team to assist in finding her a volunteer job. She was very shy and withdrawn when she first became a part of Housing Support Team's program. The staff met with her a few times to assess what kind of volunteer job she wanted to do and what job would best suit her skills and interests. In our meetings we discussed what factors were important to consider when looking for a volunteer job in the community. D.B. wanted to volunteer somewhere that was close to home, and a job where she could work quietly by herself if she was having symptoms yet also have the choice to interact with staff or volunteers, if she was feeling social.
Before making the placement, staff took her down to Jacobs Heart to take a tour of the building and meet some of the volunteers and staff who worked there. After which, the Housing staff
36 Santa Cruz County Mental Health & Substance Abuse Services: MHSA Annual Update supported D.B. in filling out a volunteer application and provided interview training as well as transportation to her interview with Jacobs Heart.
Since then a successful placement was made for her with Jacobs Heart in Watsonville. She reports that she enjoys volunteering at Jacobs Heart, making greeting cards for children with cancer. D.B enjoys the benefit of getting to interact with the other volunteers and staff if she wants to, or just sitting quietly and making greeting cards and not interacting with anyone, if she is having some symptoms. She has successfully maintained her volunteer job for the entire second quarter.
Community Impact: Community Connection " I am thankful for the support I have received. I've been able to work as an In Home Support staff, and I'm volunteering." -C
37 Santa Cruz County Mental Health & Substance Abuse Services: MHSA Annual Update
COMMUNITY SERVICES AND SUPPORTS: HOUSING This component is to offer permanent supportive housing to the target population, with no limit on length of stay. The target population is defined as very low-income adults, 18 yrs of age and older, with serious mental illness, and who do not have stable permanent housing, have a recent history of homelessness, or are at risk for homelessness.
Nuevo Sol located in Santa Cruz has 2 units for adults 18 and over who were chronically homeless. These units are accessed through our partnership with Homeless Persons Health Project. Nuevo Sol was the first project in the State to use the Governor's Homeless Initiative funding, tied to MHSA for services and also the capitalized subsidy reserve.
The County has developed housing on Bay Avenue Apartments, Capitola. The Bay Avenue project provides five MHSA units for seniors 60 years and older, at risk of homelessness. “Aptos Blue” has been approved by DMH and CALHFA and is under construction for an additional 5 units for adults. County staff continues to work with the Planning Department staff to identify a site in the Live Oak area to provide an additional 5-6 units adult housing. These units will be owned and operated by a local non-profit Santa Cruz Community Counseling Center in partnership with the County MHSA and a property management agency. All referrals and supports to MHSA housing come from a FSP team.
A program requirement for these services is that persons be without stable housing or at risk of becoming homeless. The Housing Support team has worked intensively to both educate the client and mitigate any problem issues that might lead to eviction notices with the property manager.
In order to ensure that the potential tenants have appropriate skills and supports for independent housing, the County has developed these General Screening and Evaluation Requirements: 1. The applicant(s) must be able to demonstrate that his/her conduct and skills in present or prior housing has been such that the admission to the property would not negatively affect the health, safety, or welfare of other residents, or the physical environment, or financial stability of the property. 2. Positive identification with a picture will be required for all adult applicants (photocopy may be kept on file). Eligible applicants without picture identification will be supported by County Mental Health or other service providers to obtain one. For purposes of the application, a receipt from the DMV showing an application for an ID will be sufficient. If deferred, the final picture identification will be required at the time of move-in. 3. A complete and accurate Application for Housing that lists a current and at least one previous rental reference, with phone numbers will be required (incomplete applications will be returned to the applicant). Applicants must provide at least 2 years residency history. Applications must include date of birth of all applicants to be considered complete. Requests for Consideration will be considered for MHSA applicants whose disability may result in insufficient or negative references. 4. A history of good housekeeping habits. 5. A history of cooperation with management regarding house rules and regulations; abiding by lease terms; and care of property.
38 Santa Cruz County Mental Health & Substance Abuse Services: MHSA Annual Update
6. Each applicant family must agree to pay the rent required by the program under which the applicant is qualified. 7. A history of cooperation in completing or providing the appropriate information to qualify an individual/family for determining eligibility in affordable housing and to cooperate with the Community Manager. 8. Any applicant that acts inappropriately towards property management staff or is obviously impaired by alcohol or drugs, uses obscene or otherwise offensive language, or makes derogatory remarks to staff, may be disqualified 9. Applicants must agree that their rental unit will be their only residence. When applicants are undergoing income limit tests, they are required to reveal all assets they own including real estate. They are allowed to own real estate, whether they are retaining it for investment purposes as with any other asset, or have the property listed for sale. However, they may never use this real estate as a residence while they live in an affordable housing unit.
Other Screening Criteria include: 1. Income / Assets 2. Credit and Rental History 3. Criminal Background 4. Student Status
Community Impact Jane, aged 63 year, came in to her psychiatrist appointment in August 2010 complaining of increasing voices, stressed by the imminent loss of her housing. She had been sharing a roach infested residential motel room with a friend, but he had gone into long term nursing care, and she was unable to pay the rent alone. The MHSA housing support team helped her move into a sub-acute residential treatment program to stabilize her symptoms and began to make plans. There are few if any affordable housing options in Santa Cruz for someone on an SSI income of $845 per month. Without MHSA housing, it is not clear where Jane would have gone. The MHSA housing team supported her through the application process, helping her to gather the needed documents, complete the application forms, and attend the appointments with property management. Once her application was approved, the housing team helped her arrange security deposit assistance from the Housing Authority. In October 2010, Jane moved into her new one- bedroom apartment, furnished with donated furniture the housing team helped arrange and move in. This has been her home for almost two and a half years now, and housing support has helped with a variety of problems, including lost keys, late rent, and a bed bug infestation brought in by a visitor. MHSA housing and support services have made a difference for this disabled senior, keeping her safely housed and in recovery, rather than homeless and struggling with her illness.
39 Santa Cruz County Mental Health & Substance Abuse Services: MHSA Annual Update
PREVENTION & EARLY INTERVENTION - PEI The intent of this component is to engage persons prior to the development of serious mental illness or serious emotional disturbances, or in the case of early intervention, to alleviate the need for additional mental health treatment and/or to transition to extended mental health treatment.
The County’s PEI Plan has four major projects.
PEI Project #1: Early Intervention Services for Children Purpose: To serve children and youth from stressed families, onset of mental illness, and trauma exposed children and their families. Of particular concern are families needing parental/supervision skills affected by substance use/abuse, and/or are exposed to violence, abuse, and /or neglect. The desire is to decrease the negative impact of these factors by offering mental health services to youth and their families.
PEI Project #1 has three strategies: 1. 0-5 Screening and Early Intervention: Provides multi-disciplinary team assessments for foster children 0-5. Dominican clinic is up and running, with PEI supported mental health services as well as in-kind and contracted services for Stanford University specialist time from a developmental psychologist and a pediatrician. 2. Countywide Parent Education and Support: • The Positive Parenting Program (Triple P) has rolled out multiple levels of community training and is providing a wide array of groups and consultations. • A part of this second strategy is the Side-by-Side program for early mental health consultation to day care providers, which has been proceeding well. • Additionally, we provide Primary Care Outreach & Consultation, which has helped improve screening and referrals for mental health services, and improve the training/guidance for physicians and health care professions regarding mental health issues. 3. School-based Prevention and Early Intervention: • Our contract with Barrios Unidos provides violence prevention services with a unique cultural focus. • The County Office of Education provided services ranging from direct support to students through the Prevention Intervention Program (PIP), Positive Behavioral Interventions and Support (PBIS) program, Gay Straight Alliances, Suicide Prevention and Queer Youth Scene to School Staff support via Triangle Speakers, NAMI (National Alliance for the Mentally Ill), Staff support Warm Line and PBIS training. In addition, parents through all districts received Positive Discipline support from the Live Oak Family Resource Center. • Seven Challenges is a program that prevents further escalation of mental health issues among youth with co-occurring mental health and substance se disorders. It assists youth in evaluating the motivation behind and the impact of substance use in order to make wise decisions about future behavior.
40 Santa Cruz County Mental Health & Substance Abuse Services: MHSA Annual Update
The various PEI projects in this section have had a tremendous impact on the community given the wide range of approaches that include schools, cultural organizations, and evidence-based practices such as Triple P and PBIS that touch the lives of many more families than individual treatment services can. Each of these PEI strategies has made a significant impact on local children, youth and families.
Target Population: This project area addresses three priority populations: children and youth from stressed families, onset of mental illness, and trauma exposed children and their families. This project also addresses disparities in access to services by including a focus on the needs of Latino children/families, as well as lesbian, gay, bisexual, transsexual, and questioning (LGBT) youth and their families.
Providers: The services in this component are provided by staff from First 5, SCCCC, Barrios Unidos, County Office of Education, Pajaro Valley Prevention & Student Assistance, and Santa Cruz County Mental Health & Substance Abuse Services. Some of these agencies collaborate on the strategies listed above. • First 5 provides Triple P, Side by Side • SCCCC provides Side by Side, Seven Challenges, and school-based services • Barrios Unidos provides violence prevention in the school-based prevention & early intervention strategy • County Office of Education provides services in the school-based prevention & early intervention, and has subcontracted with NAMI, the Diversity Center, the Live Oak Resource Center, Positive Behavioral Interventions & Support, and SCCCC to provide the services. • Pajaro Valley Prevention & Student Assistance provides school based prevention & early intervention services, and Seven Challenges • Santa Cruz County Mental Health & Substance Abuse Services provides 0 to 5 early intervention services, and primary care outreach/consultation.
Number of individuals to be served in 2013-2014: The unduplicated numbers of individuals to be served by program are: First 5- Triple P: 3400 youth, 1900 parents First 5 & SCCCC- Side by Side: 20 SCCCC- Seven Challenges: 30 SCCCC- Familias Fuertes: 17 Barrios Unidos: 300 County Office of Education: • Live Oak Community Resource Center: 75 parents • Diversity Center: 25 triangle panels in Santa County schools (reaching 750 students) • Positive Behavioral Interventions & Support: 15 teachers • Youth Services: 84 students, 21 parents, 13 teachers and 4 principals. Pajaro Valley Prevention & Student Assistance, Seven Challenges: 40 Santa Cruz County Mental Health & Substance Abuse Services- 0-5: 100 Santa Cruz County Mental Health & Substance Abuse Services- primary care outreach: 400
41 Santa Cruz County Mental Health & Substance Abuse Services: MHSA Annual Update
Were there any challenges or barriers in the program? If so, what are the strategies to mitigate? In the coming year, the 0-5 clinic housed at the Dominican Rehabilitation facility may need to be re-located to a new site. We will work closely with them and Stanford University to help facilitate a smooth transition in any way we can. Regarding primary care outreach, we will continue to work with various health care sites to ensure adequate clinic space in which to see referred children/youth and their parent/guardians. Finally we want to continue to encourage more school districts to work with the County Office of Education in PBIS implementation so that eventually it will be utilized in as many school sites as possible.
Are there any new, changed or discontinued programs? No.
Performance Outcomes (specify time period): These numbers represent an unduplicated client count of persons served in quarter 1 (July 1, 2012 to September 30, 2012) and in quarter 2 (October 1, 2012 to December 31, 2012). The numbers in the table are: Quarter 1/Quarter 2.
Agency Reporting MHSAS: 0-5 screening Unduplicated Total Served 20/51 Age Group Children 0-17 TAY 16-25 Adults 26-59 Older Adults 60+ 20/51 Race/Ethnicity White Latino Other Multi 7/28 11/12 0/2 2/9 Primary Language English Spanish Other 15/44 5/7 Culture Veterans LGBTQ Other
Agency Reporting First 5: Triple P Unduplicated Total Served 349/418 Age Group Children 0-17 TAY 16-25 Adults 26-59 Older Adults 60+ 203/241 146/177 Race/Ethnicity White Latino Other Unknown 72/96 197/224 80/5 76/93 Primary Language English Spanish Other 181/242 168/176 Culture Veterans LGBTQ Other Not collected Info not collected
42 Santa Cruz County Mental Health & Substance Abuse Services: MHSA Annual Update
Agency Reporting First 5: Side by Side Unduplicated Total Served 11/10 Age Group Children 0-17 TAY 16-25 Adults 26-59 Older Adults 60+ 11/10 Race/Ethnicity White Latino Other 1/3 10/7 Primary Language English Spanish Other 3/5 8/5 Culture Veterans LGBTQ Other Not collected Not collected
Agency Reporting MHSAS: Primary Care Outreach Unduplicated Total Served 139/68 Age Group Children 0-17 TAY 16-25 Adults 26-59 Older Adults 60+ 75/55 10/13 Race/Ethnicity White Latino Other 6/10 74/56 5/2 Primary Language English Spanish Other 41/40 44/28 Culture Veterans LGBTQ Other N/A 1/0
Agency Reporting Barrios Unidos Unduplicated Total Served 300/335 Age Group Children 0-17 TAY 16-25 Adults 26-59 Older Adults 60+ 300/? Race/Ethnicity White Latino Other 60/? 230/? 10/? Primary Language English Spanish Other 230/? 70/? Culture Veterans LGBTQ Other 11/? Barrios client counts are a result of blended funding, not solely MHSA (22% PEI).
Agency Reporting NAMI (under COE) Unduplicated Total Served 0/0 Age Group Children 0-17 TAY 16-25 Adults 26-59 Older Adults 60+
Race/Ethnicity White Latino Other
Primary Language English Spanish Other
Culture Veterans LGBTQ Other
43 Santa Cruz County Mental Health & Substance Abuse Services: MHSA Annual Update
Agency Reporting Live Oak Family Resource Center (under COE) Unduplicated Total Served 7/52 Age Group Children 0-17 TAY 16-25 Adults 26-59 Older Adults 60+ 1/31 3/1 3/19 0/1 Race/Ethnicity White Latino Other 1/34 6/16 0/2 Primary Language English Spanish Other 2/39 1/13 Culture Veterans LGBTQ Other SARB referred 1/2
Agency Reporting Diversity Center (under COE) Unduplicated Total Served 145/320 Age Group Children 0-17 TAY 16-25 Adults 26-59 Older Adults 60+ 145/213 0/67 0/40 Race/Ethnicity White Latino Other Other 108/107 24/173 13/40 Primary Language English Spanish Other 145/284 0/36 Culture Veterans LGBTQ Other 88/118
Agency Reporting Positive Behavioral Interventions Program (via COE) Unduplicated Total Served 15/0 Age Group Children 0-17 TAY 16-25 Adults 26-59 Older Adults 60+
Race/Ethnicity White Latino Other 14/0 1/0 Primary Language English Spanish Other 15/0 Culture Veterans LGBTQ Other
Agency Reporting SCCCC (under COE) Unduplicated Total Served 12/14 Age Group Children 0-17 TAY 16-25 Adults 26-59 Older Adults 60+ 6/10 6/4 Race/Ethnicity White Latino Other 2/4 2/3 8/9 Primary Language English Spanish Other 12/14 Culture Veterans LGBTQ Other 9/11
44 Santa Cruz County Mental Health & Substance Abuse Services: MHSA Annual Update
Agency Reporting SCCCC: Seven Challenges Unduplicated Total Served 7/4 Age Group Children 0-17 TAY 16-25 Adults 26-59 Older Adults 60+ 5/3 2/1 Race/Ethnicity White Latino Other 7/4 Primary Language English Spanish Other 7/4 Culture Veterans LGBTQ Other
Agency Reporting SCCCC- Familias Fuertes Unduplicated Total Served 14/22 Age Group Children 0-17 TAY 16-25 Adults 26-59 Older Adults 60+ 8/13 6/9 Race/Ethnicity White Latino Other 14/22 Primary Language English Spanish Other 14/22 Culture Veterans LGBTQ Other
Agency Reporting PVPSA: Seven Challenges Unduplicated Total Served 20/41 Age Group Children 0-17 TAY 16-25 Adults 26-59 Older Adults 60+ 20/41 Race/Ethnicity White Latino Other 20/41 Primary Language English Spanish Other 13/34 7/7 Culture Veterans LGBTQ Other
Community Impact: 0-5 Dominican Clinic Juan was placed into foster care for the 2nd time when he was 5 years old. He had been witness to extreme domestic violence, had been physically abused and he had experienced significant neglect as a result of his parents drug abuse. He was referred to Children’s Mental Health and began receiving mental health treatment right away. He demonstrated significant anxiety, had difficulty sleeping, difficulty concentrating, and talked about some of the traumas he had experienced. He missed his parents, and was having challenges adjusting to living in his foster home. His mental health treatment included supporting him in his foster home, working with him individually, and with his family, and supporting him in his educational setting. He was also referred to our Dominican Interdisciplinary Child Development Program (DICDP) for a
45 Santa Cruz County Mental Health & Substance Abuse Services: MHSA Annual Update psychological assessment. His mental health clinician worked with the developmental psychologist who provided developmental and cognitive testing to assess for any unmet needs Juan might have.
The testing results indicated that Juan should be eligible for special education services due to his cognitive functioning. Juan’s mother was provided with a letter addressed to Juan’s school requesting an eligibility assessment to ensure that Juan received the support he needed at school to ensure his success. Unfortunately, Juan’s mother was not willing to provide the school with that letter, as she did not want her son to receive special education services. Juan’s mental health therapist worked with Juan’s mother and with his social worker to support Juan in receiving the educational support he needed. Juan’s mother was ultimately unable to reunify with Juan and he was placed in an adoptive home. Juan’s mental health counselor was able to talk with the adoptive parent educating her on Juan’s educational needs, and she was very interested in following up with the request for Juan to receive educational support at school. Juan’s mental health counselor consulted with the DICDP psychologist, who was happy to write an addendum to her report requesting that the school provide the eligibility assessment for Juan.
We are happy to report that Juan received the eligibility assessment at school and is now receiving the special education support he needs to be successful at school. Juan is happily living in a loving home, and his adoption will be finalized soon. He is still receiving mental health therapy, and has made significant progress in his treatment. He is no longer feeling as anxious and he is building a loving and caring relationship with his new family.
Community Impact: Barrios Unidos At fifteen years old, Mario was all too familiar with Juvenile Hall and the gang culture that permeated his life. Mario has participated at Barrios Unidos programs through the Educational Outreach Program and the Beach Flats Youth Group program for over seven months now and has made huge improvements in his life. He is enrolled and doing well in school with an almost perfect attendance record. Most importantly, Mario has had a completely clean track record with the juvenile system since he started participating in Barrios Unidos programs.
Community Impact: Diversity Center (Under COE) “This Spring we received a request from one of our South County middle schools for support around their first openly transgender student. Our staff met with the schoolteachers and administrators to provide education on the topic. Together we helped craft a plan to keep the student physically and emotionally safe while at school. The plan includes a Triangle Speakers panel and implementation of a GSA. The transgender student has since expressed that she feels much safer at school and really appreciates that school staff are treating her more appropriately. Her academic performance has also improved markedly. This success story is important for the many other students struggling with LGBT issues at her school who now have access to more resources.”
Community Impact: Live Oak Family Resource Center – Positive Discipline (Under COE) “One particular success this year was our partnership this year (driven and supported by our MHSA partnership) with Del Mar Elementary to provide a Positive Discipline class targeted to Spanish speaking Del Mar parents and held at Del Mar School. Del Mar did special targeted
46 Santa Cruz County Mental Health & Substance Abuse Services: MHSA Annual Update outreach to families with special challenges…” The following is a comment from one of the parents in this class: “My entire family has benefited. We are learning how to live better as a family and with others.”
Community Impact: Triple P “Gina” began receiving in-depth individual Triple P sessions because of concerns that her 3- year old daughter, “Amanda,” regularly threw tantrums and was aggressive with mom, grandma, cousins, and even her 3-month old sister. At times, Amanda would also go to her grandmother, who would end up giving in. Amanda had also regressed in her potty training and was having accidents several times each day, despite only having occasional accidents at night several months earlier.
Through the Triple P assessment process, Gina revealed that her parenting style tended to be lax, and her anxiety level was really high. The Triple P practitioner taught Gina some Triple P parenting strategies to help strengthen her relationship with Amanda, such as spending quality time together and providing descriptive praise for the things that Amanda did well. Gina also learned Triple P strategies for giving calm, clear instructions and following up with logical consequences if needed.
Gina is now nine weeks into the program, and her confidence has skyrocketed. She is able to use the Triple P strategies consistently, and Amanda can now calm herself down. Amanda no longer goes to her grandma when throwing tantrums, and Gina feels that her family now sees her as a competent parent because she is able to set appropriate limits and follow through. Gina and Amanda also spend more quality time together baking cupcakes, playing at bath time, and making jewelry together. And Gina is ecstatic that the news skills and confidence that both she and Amanda have gained has resulted in tremendous improvements in Amanda’s potty training…and there is now much less laundry to do.
47 Santa Cruz County Mental Health & Substance Abuse Services: MHSA Annual Update
PEI Project #2: Culture Specific Parent Education & Support Purpose: To decrease the risk of violence, suicide, and other traumas that children and youth age 0 – 17 may be exposed to by providing education, skills-based training, early intervention and treatment referrals to parents, families, and children, that are in need of parental/supervision skills, are affected by substance abuse, and/or are exposed to violence, abuse, or neglect.
We have chosen Cara Y Corazón, Jóven Noble and Xinatchli. Cara Y Corazón is a culturally based family strengthening and community mobilization approach that assists parents and other members of the extended family to raise and educate their children from a positive bicultural base. Jóven Noble is a youth leadership development program for boys, and Xínatchli is a youth leadership development program for girls.
Target Population: This project parents, teen boys, and teen girls from stressed families, and trauma exposed.
Provider: Santa Cruz County Mental Health & Substance Abuse Services oversees and coordinates the implementation of this program, and contracts with individual facilitators to carry out the Cara Y Corazón, Jóven Noble and Xinatchli groups. We will also be contracting with the Youth Resource Bank for use of incentives, day care and related programmatic expenses.
Number of individuals to be served in 2013-2014: The unduplicated numbers of individuals to be served by program are: Cara y Corazón: 200 Jóven Noble: 80 Xinatchli: 80
Were there any challenges or barriers in the program? If so, what are the strategies to mitigate? Requests for service temporarily outstripped program capacity. The program has trained additional facilitators to keep up with the demand. Start-up of new Jóven Noble and Xinatchli groups was temporarily suspended pending clarification of needs for additional program evaluation data. The programs will collect additional evaluation data in 12/13 and 13/14.
Are there any new, changed or discontinued programs? No.
Performance Outcomes (specify time period): A study of 54 Cara Y Corazon families demonstrated significant pre-post improvements and positive trends in family and partner relationship quality; parenting and child development; social supports; use of community resources; and cultural pride. In 12/13 and 13/14, the program will be expanding the program evaluation of both Cara Y Corazon and Jóven Noble to increase the sample size and refine the evaluation instruments.
48 Santa Cruz County Mental Health & Substance Abuse Services: MHSA Annual Update
These numbers represent an unduplicated client count of persons served in quarter 1 (July 1, 2012 to September 30, 2012) and in quarter 2 (October 1, 2012 to December 31, 2012). The numbers in the table are: Quarter 1/Quarter 2.
Agency Reporting MHSAS: Cara y Corazón Unduplicated Total Served 175/175 Age Group Children 0-17 TAY 16-25 Adults 26-59 Older Adults 60+ 10/15 30/15 60/96 15/20 Race/Ethnicity White Latino Other 52/27 74/145 Primary Language English Spanish Other 58/32 68/140 Culture Veterans LGBTQ Other
In fiscal year 2011-2012, Cara y Corzón served 200 families.
Agency Reporting MHSAS: Jóven Noble Unduplicated Total Served 0 Age Group Children 0-17 TAY 16-25 Adults 26-59 Older Adults 60+
Race/Ethnicity White Latino Other
Primary Language English Spanish Other
Culture Veterans LGBTQ Other
In fiscal year 2011-2012, Jóven Noble served 80 people.
Agency Reporting MHSAS: Xinatchli Unduplicated Total Served 0 Age Group Children 0-17 TAY 16-25 Adults 26-59 Older Adults 60+
Race/Ethnicity White Latino Other
Primary Language English Spanish Other
Culture Veterans LGBTQ Other
In fiscal year 2011-2012, Xinatchli served 80 people.
Community Impact: Cara y Corazón I am a recent graduate of Cara y Corazón curriculum in November 2012. I attended all 8 sessions with great interest from an instructor, Jaime Molina, whose approach to the teachings and presentation was with incredible open heart. Maestro Molina spoke his truth with the
49 Santa Cruz County Mental Health & Substance Abuse Services: MHSA Annual Update wisdom and ease of an elder. I entered Cara y Corazón familiar with La Cultura Cura teachings introduced by Jerry Tello, but it was in the Cara y Corazón classes where I became reconnected with my Ancestors, healed in a meaningful way after years of holding on to old hurts. I truly learned and was able to let go and forgive what was in the past to live fully in the present with grace. Maestro Jaime Molina modeled “palabra” showing me how to honor myself and to be present when I speak my truth. My sacred ways from my Ancestors, once forgotten were supported in Cara y Corazón and I completed that course transformed as a whole sacred being. Gratitude for the blessings and healings brought forth by Cara y Corazón curriculum, the people and their palabra, sharing their hearts/stories, and being my teachers on my journey of awakening to being present and whole hearted as a spiritual being in this human body.
Community Impact: Xinatchli Para mi fue una experiencia muy bonita. El compartir con mi hija cosas nuevas, el aprender como mejorar la relacion entre madre e hija fue algo maravilloso. Mi hija esta muy contenta con el programa. Dice que quiere volver a participar en el proximo. Espero que lo sigan dando por que es algo muy positivo para las jovensitas y muy bueno para nosotros los padres. Gracias por teneles paciencia y enseñarles lo mejor.
Translation: This was a beautiful experience for me. To be able to share new things with my daughter and to learn how to improve out mother-daughter relationship was wonderful. My daughter is very happy with the program. She says that she wants to participate in the next one. I hope that you keep providing these because it is a very positive thing for our daughters, and good for us parents. Thank you for your patience and for teaching them better skills.
Community Impact: Jóven Noble “Jóven Noble me ha dado mucha saviduría y me a ayudado a ganar la confiansa y respeto de mis maestros y otros adultos importantes en mi vida. Me ha ayudado a entender que nuestros padres hacen mucho por nosotros y quieren ver que nosotros salgamos adelante, y que nuestras accíones reflejan en la persona que todos ven en nosotros.”
Translation: “ Jóven Noble has given me much wisdom and has helped me gain the trust and respect of my teachers and other important adults in my life. It has helped me to understand that our parents do so much for us, and want to see us get ahead in our lives and that our actions reflect who we truly are.”
50 Santa Cruz County Mental Health & Substance Abuse Services: MHSA Annual Update
PEI Project #3: Early Onset Intervention Services for Transition Age Youth & Adults Purpose: This project provides intensive treatment and education for family members when individuals are developing early signs of possible serious mental illness. Through consultation, training and direct service delivery, a broad menu of services will be offered by Peer Counselors, Family Advocates, and Licensed counselors and psychiatrists to transition age youth and their families.
PEI Project #3 has three proposed strategies: 1. Early Onset Intervention Services utilizing licensed mental health clinicians, psychiatry, Peer and Family Advocates, Peer Respite, and Employment Services for Individuals • Employment Services: To offer assistance with finding employment • Family Advocacy for Adults: to answer calls from concerned individuals or family members, and provide information and referrals. • Early Intervention Services: to provide information, referrals, and support about serious mental illness. • Serial Inebriate Project: to avoid further penetration into the mental health system for persons with co-occurring mental health and substance abuse disorders by offering alternatives to jail and higher levels of care. • Mental Health Stabilization Beds: to avoid further penetration into the mental health system for persons with co-occurring mental health and substance abuse disorders by offering alternatives to jail and higher levels of care. 2. Veterans’ advocacy and service coordination: the Veteran Advocate position is responsible for brokering federal, state, and local programs to the Veterans in the community. The focus is on providing needed services regardless of the Veteran’s discharge or benefit status. The position has also functioned as a unifying agent for service collaboration among the various Veteran service providers. 3. Suicide Prevention services: to provide educational presentations, grief support, and the suicide hotline. The Suicide Crisis Line is available 24 hours, 7 days per week for those who are suicidal or in crisis, as well as for community members who are grieving the loss of a loved one to suicide, are concerned about the safety of another person, or are looking for assistance with finding community resources. Outreach presentations and trainings (which help to reduce stigma, raise awareness, and promote help seeking) are provided regularly throughout the County to a range of different at risk groups, stakeholders, and service providers for various populations (including domestic violence prevention, professional and peer mental health support organizations, etc.). One focus of community outreach activities continues to be reaching groups who are higher at risk than in the general population – for example, survivors of suicide loss are up to forty times more likely to die of suicide than others. 4. Peer Respite: to avoid continued utilization of locked psychiatric hospitalizations and/or sub acute programs. Utilizes 100% peer staffing that promotes problem solving, personal choice, non-coercive supports, linkage with employment, education, health and other resources in the community. Promotes maintaining ones independence in the community. Offers a home like setting in the community for up to 6 guests who are
51 Santa Cruz County Mental Health & Substance Abuse Services: MHSA Annual Update
experiencing increased symptoms and challenges that if unsupported could result in a hospitalization.
Target Population: This program addresses transition age youth and adults who are trauma exposed and are experiencing (or at risk of experiencing) the onset of serious mental illness. This project also addresses disparities in access to mental health services by including a focus on the needs of Latino youth as well as Lesbian, gay, bisexual, transsexual (LGBT) individuals and their families.
Providers: the services in this work plan are provided by the staff from Volunteer Center/Community Connection, SCCCC, Janus, Family Services, and Santa Cruz County Mental Health & Substance Abuse Services. We will also be contracting with SCCCC for flex funds to provide essential living items and incentives for care for the Veterans program and money management program.
• Volunteer Center/Community Connection provides employment assistance • SCCCC Janus, Sobriety Works and New Life Community Services provide the Serial Inebriate services • SCCCC new program that will provide Peer Respite Support • Janus provides the Mental Health Stabilization Beds • Family Services provides the Suicide Prevention Services • Santa Cruz County Mental Health & Substance Abuse Services provides family advocacy and early intervention services, and the Veterans Advocate program (by contract)
Number of individuals to be served in 2013-2014: The unduplicated numbers of individuals to be served by program are: Volunteer Center/Community Connection: 30 SCCCC, Janus, Sobriety Works and New Life Community Services - Serial Inebriate: 35 Janus- Mental health stabilization beds: 30 MHSAS- Family Advocacy (Calls): 200 MHSAS- Early Intervention Services: 40 Family Services/Suicide Prevention: 2,200 Veterans Advocate: 56 Peer Respite: 75
Were there any challenges or barriers in the program? If so, what are the strategies to mitigate? None.
Are there any new, changed or discontinued programs? The Peer Respite Support is a new program. Consumers want a range of alternatives to hospitalization including funding peer respite and a range of wrap around supports.
52 Santa Cruz County Mental Health & Substance Abuse Services: MHSA Annual Update
Performance Outcomes (specify time period): These numbers represent an unduplicated client count of persons served in quarter 1 (July 1, 2012 to September 30, 2012) and in quarter 2 (October 1, 2012 to December 31, 2012). The numbers in the table are: Quarter 1/Quarter 2
Agency Reporting Volunteer Center/Community Connection Unduplicated Total Served 32/6 Age Group Children 0-17 TAY 16-25 Adults 26-59 Older Adults 60+ 20/4 8/2 4/0 Race/Ethnicity White Latino Other 25/5 3/1 4/0 Primary Language English Spanish Other 32/6 Culture Veterans LGBTQ Other 2/2 2/0
Agency Reporting SCCCC- Serial Inebriate Unduplicated Total Served 9/11 Age Group Children 0-17 TAY 16-25 Adults 26-59 Older Adults 60+ 0 0 9/11 0 Race/Ethnicity White Latino Other 6/8 1/1 2/2 Primary Language English Spanish Other 8/11 1/0 Culture Veterans LGBTQ Other
Serial Inebriate Project: A study of 41 Serial Inebriate Project participants showed substantial reductions in criminal justice and health utilization and costs when comparing the one year prior to SIP enrollment with the one year after SIP enrollment, including a 46% reduction in ambulance runs and emergency department visits, a 57% reduction in jail bookings, and a 7% increase in jail days.
Agency Reporting Janus Unduplicated Total Served 16/6 Age Group Children 0-17 TAY 16-25 Adults 26-59 Older Adults 60+ 0 4/2 12/4 0 Race/Ethnicity White Latino Other 15/6 1/0 Primary Language English Spanish Other 16/6 Culture Veterans LGBTQ Other
53 Santa Cruz County Mental Health & Substance Abuse Services: MHSA Annual Update
Agency Reporting MHSAS- Family Advocacy Calls Total calls 39 /39
Agency Reporting MHSAS- Early Intervention Services Unduplicated Total Served 17/10 Age Group Children 0-17 TAY 16-25 Adults 26-59 Older Adults 60+ 13/8 4/2 Race/Ethnicity White Latino Other 9/4 4/3 4/3 Primary Language English Spanish Other 17/10 Culture Veterans LGBTQ Other
Agency Reporting Veteran Advocate (Dean Kaufman) Unduplicated Total Served 46/56 Age Group Children 0-17 TAY 16-25 Adults 26-59 Older Adults 60+ 25/30 21/26 Race/Ethnicity White Latino African Other American 36/43 5/10 4/3 1/0 Primary Language English Spanish Other 41/56 5/0 Culture Veterans LGBTQ Other 46/56
Agency Reporting Family Services Agency/Suicide Prevention Services Unduplicated Total Served 754/799 Age Group Children 0-17 TAY 16-25 Adults 26-59 Older Adults 60+ 401/551 72/22 234/212 47/14 Race/Ethnicity White Latino African Other American 336/374 377/358 17/4 24/43 Primary Language English Spanish Other 536/616 218/183 Culture Veterans LGBTQ 0/1 0/4
Community Impact: Veteran’s Advocate Sam is a homeless veteran who is struggling with major depressive disorder, and anxiety disorder. This vet served two terms in the Navy as a hull mechanic on an aircraft carrier. He was able to complete his first term of four years honorably, but received an “Other Than Honorable” discharge a year into his second enlistment. He was bullied by other sailors and had other family issues that compounded his ability to perform his duties. Due to the nature of his discharge
54 Santa Cruz County Mental Health & Substance Abuse Services: MHSA Annual Update nobody had bothered to help him with his claim. I was able to work with the VSO, County MH, local volunteers, and file his claim. It was somewhat discouraging, but we gathered evidence from many years of treatment and current diagnosis from a local volunteer retired Psychiatrist. After a year in decision his claim was granted at 100% service connection ($2673 per month), and he now has the income he needs to live a quality life for the first time in over 15 years. He was granted a fiduciary payee who handles all of his bills so that he can now maintain: permanent housing, good personal hygiene, clothing, food and all other essential needs. In addition he has the ability to care for himself and has gained the confidence he had been lacking since he left the Navy.
Community Impact: Community Connection DS was referred through NAMI to our PEI Employment program. DS was a student in a southern California University when his symptoms of bipolar disorder forced him to return home. Through the PEI program, DS was able to enroll at Cabrillo College, connected with the Disabled Student Services at Cabrillo, complete a resume, connected with the Department of Rehabilitation, and then begin the application process to enroll at SJSU in the fall to pursue a degree in Kinesiology. In addition, through the support of PEI staff, DS has learned how to advocate for himself with his mental health providers and his academic counselors. DS has begun to volunteer at a local high school as an assistant to the track coach.
Community Impact: Community Connection "I think it is wonderful that you have these programs for us. It's remarkable that people pull together like you guys do. You make life easier for us, and for that I am very appreciative. Thank You." -S Community Impact: Serial Inebriate Program Serial Inebriate Project: A homeless man used to sleep on the front porch of the SIP office where the SIP Coordinator, Michael Wiley, would engage him in conversation from time to time. He told him that at one time, he had a family and a job installing sprinkler systems until he was injured. Even though he could no longer work, his employer gave him a large sum of money to help him survive. Eventually, he ran out of money, and his family life disintegrated. He became homeless and took up drinking, rapidly spiraling into alcoholism. He later disclosed that he hit "bottom" on that same porch, thinking to himself, "This is how I am going to die. Michael will find me here dead and have to call the police." Shortly after this, he was arrested for drunk in public and sentenced to the SIP program. He was formally interviewed and referred to treatment. Grateful for a chance at a better life, he grabbed hold of recovery and has never let go. After 28 days of residential treatment, he stayed in a sober living house and has been clean and sober for over one year. The Coordinator referred him to Project Home Base (PHB), and his PHB Coordinator eventually got him into permanent housing. He drops by the SIP office now and then to let the SIP Coordinator know how he is doing. He is very active in his 12-step recovery and has the opportunity to get surgery on his old injury. Every time he visits, he voices his gratitude for the gift of life he received.
Community Impact: Mental Health Stabilization Beds Sam came to the Janus residential substance abuse treatment program after a stay at the mental health inpatient unit and Crisis House. He had a co-occurring diagnosis of bipolar disorder and suffered from almost debilitating anxiety. During his treatment stay at Janus he voluntarily
55 Santa Cruz County Mental Health & Substance Abuse Services: MHSA Annual Update returned to the inpatient unit for mental health stabilization, but returned to Janus after a couple of days. He once believed that he could not manage his mental health symptoms without using substances. Since he completed the program, he's taking medications as prescribed, and living at the Loft shelter. He has re-established his relationship with his significant other and their baby, who live at the Rebele family shelter next door.
Community Impact: Suicide Prevention Family Service Agency of the Central Coast personnel recently provided training for staff and volunteers from a local non-profit organization that serves at risk young people. Though the training focused on recognizing and responding to suicidality in their clients, one of the attendees approached the presenter at the end and shared that she had lost her husband to suicide recently. The presenter arranged for them to speak in private. She explained that it had been a very difficult and painful experience, and that she had felt unable to talk about it with anyone, and felt as though she needed to reassure everyone she was “fine,” even though she wasn’t. She said that, after hearing the presentation, she felt more empowered to be open about what she was going through (the presenter helped her identify someone she felt she could share this with and reminded her that the Suicide Crisis Line is available for her to call and talk anytime as well). She realized the importance of getting support for herself and talking with her students about where to turn for help if they ever feel this way, “So, hopefully, they won’t have to go through the same isolation [that I felt].” The presenter also gave her the information for our Survivors of Suicide support groups and some other local resources for getting support after loss. She thanked him and said that she would call soon for herself and her family.
Community Impact: Suicide Prevention (Quotes from high school students (on anonymous question cards) after youth presentations) “You guys are really nice and made this less scary to learn about – I enjoyed hearing what you had to say. I have had thoughts about this before but know that I wouldn’t do it – you helped me feel better about what I went through. I have called your line before and it helped me – they let me just say what I was feeling and helped me figure out how to talk to my mom about it. Thank you!”
“I really enjoyed learning about this. It changed what I thought about suicide and suicidal people. I guess I want to understand more how they think and feel and how to help them.” “Thank you for coming to our class and talking about this. Everything you said was right. I tried to kill myself last year because I was depressed and I was taking drugs. I am glad it didn’t work, but I think more kids need to hear this and know they can reach out and try to find help. A lot of people feel this way.”
Community Impact: Early Intervention Services (MHSAS) YA, a Israeli American was referred to PEI - TAY services by Bill Roesch, NP, to initiate PEI services by providing therapy only. Client was resistant to MH services and had experienced trouble in the past forming relationships with service providers. Client carried a diagnosis of bipolar and even with meds suffered from extreme fluctuations in mood each lasting several months. Her depressions were evidenced by long periods of anhedonia, isolation, hypersomnia, and hopelessness. Her manias were evidenced by periods of extremely high energy leading to risky behaviors, racing thoughts, grandiose ideas, little sleep, agitation, loss of natural
56 Santa Cruz County Mental Health & Substance Abuse Services: MHSA Annual Update inhibitions, anger, inability to organize activity in goal directed manner, and disregard for social mores. During this time, she was hospitalized three times but has not been hospitalized in the last nine months.
Over time client accepted more PEI services including educational supports via PEI Career Services at Community Connections, case management supports and medication management supports. Her family was also supported through PEI services and family dynamics were addressed to allow for client to increasingly become more responsible for herself and for managing her illness and her ILS. With support this client returned to the local community college to pursue her interest in art.
This has led to where client is now, currently living independently without supports, family relationships are without the conflict that had characterized them previously, and client has transferred to a BA program at San Jose State where she is working towards her degree in computer animation.
57 Santa Cruz County Mental Health & Substance Abuse Services: MHSA Annual Update
PEI Project #4: Early Intervention Services for Older Adults Purpose: This prevention strategy addresses the high rates of depression, isolation and suicides of Older Adults in Santa Cruz County. Strategies are aimed at identifying older adults at risk of trauma-induced mental illness, depression, anxiety, suicidal ideation, and late onset mental illness, as well as undiagnosed and misdiagnosed seniors. This group has been identified as an underserved population, often due to senior’s isolation and challenges in accessing appropriate care.
PEI Project #4 has three proposed strategies: 1. Field Based Mental Health Training and Assessment Services: to provide mental health assessment and short-term services to older adults where they reside 2. Senior services and outreach: this includes brief therapy for seniors at risk, and outreach (and peer companions) for isolated seniors. 3. Warm Line: Provides quick telephone screening and referrals to senior resources for persons seeking service for older adults.
Target Population: Older adults (age 60 and above) at risk.
Providers: the services in this work plan are provided by Family Services Agency, Senior Council, the Senior Network Resource Center, and Santa Cruz County Mental Health & Substance Abuse Services. We will also be contracting with SCCCC for flex funds to provide essential living items and incentives for care for the Older Adult Services.
• Family Services provides brief therapy and senior outreach • Senior Council provides outreach and peer companions • Senior Network Resource Center provides the warm line • Santa Cruz County Mental Health & Substance Abuse Services provides trainings to service providers, outreach to seniors, and early intervention services.
Number of individuals to be served in 2013-2014: The unduplicated numbers of individuals to be served by program are: Family Services- brief therapy: 50 Family Services- senior outreach: 18 Senior Council: 40 Senior Network Resource Center: 100 SCMHSAS: 28
Were there any challenges or barriers in the program? If so, what are the strategies to mitigate? No.
Are there any new, changed or discontinued programs? We will increase Sr. Companion services by adding an additional Peer Companion.
58 Santa Cruz County Mental Health & Substance Abuse Services: MHSA Annual Update
Performance Outcomes (specify time period): These numbers represent an unduplicated client count of persons served in quarter 1 (July 1, 2012 to September 30, 2012) and in quarter 2 (October 1, 2012 to December 31, 2012). The numbers in the table are: Quarter 1/Quarter 2.
Family Services Agency Renaissance Program (Brief Therapy) Unduplicated Total Served 41/20 Age Group Children 0-17 TAY 16-25 Adults 26-59 Older Adults 60+ 17/8 24/12 Race/Ethnicity White Latino Other 33/15 8/4 0/1 Primary Language English Spanish Other 39 2 Culture Veterans LGBTQ Other
Family Services Agency Senior Outreach Program Unduplicated Total Served 10/5 Age Group Children 0-17 TAY 16-25 Adults 26-59 Older Adults 60+ 10/5 Race/Ethnicity White Latino Other 5/3 2/2 3/0 Primary Language English Spanish Other 8/4 2/1 Culture Veterans LGBTQ Other 2/0
Agency Reporting Senior Council Unduplicated Total Served 34/ 18 Age Group Children 0-17 TAY 16-25 Adults 26-59 Older Adults 60+ 34/18 Race/Ethnicity White Latino Other 31/15 1/1 2/2 Primary Language English Spanish Other 32/16 1/1 0/1 Culture Veterans LGBTQ Other
59 Santa Cruz County Mental Health & Substance Abuse Services: MHSA Annual Update
Agency Reporting Senior Network Resource Center Unduplicated Total Served 6 (+ 26 mental health information only calls)/3 + 25 calls Age Group Children 0-17 TAY 16-25 Adults 26-59 Older Adults 60+ 6/3 Race/Ethnicity White Latino Other 6/2 Primary Language English Spanish Other 6 Culture Veterans LGBTQ Other 0
Unduplicated Total Served MHSAS Age Group Children 0-17 TAY 16-25 Adults 26-59 Older Adults 60+ 19/15 Race/Ethnicity White Latino Other 17/14 2/1 Primary Language English Spanish Other 18/14 1/1 Culture Veterans LGBTQ Other
Community Impact "Nancy" was referred to the older adult PEI program by her landlord. Her landlord called to report that Nancy was in desperate need of medical care, however refused to leave her apartment. Nancy has not left her apartment in over 20 years. She pays her neighbors to grocery shop for her and to take out her garbage. I was able to identify the support and physical assistance that Nancy needed in order to feel safe going to the ER and she agreed to go with me. After working with Nancy for a short time, her medical situation was stabilized and I was able to introduce her to a Senior Companion. The Senior Companion and I were successful in assisting this client to obtain a primary care physician and begin to get regular medical care. We also assisted the client with a successful move, as living on the second floor of her apartment complex was contributing to her severe anxiety and agoraphobia. After working with the PEI program, Nancy now has regular medical and dental care, is grocery shopping with the assistance of a companion, passed her housing inspection and reports improved quality of life.
60 Santa Cruz County Mental Health & Substance Abuse Services: MHSA Annual Update
INNOVATIVE PROJECTS- “INN” Purpose: The intent of this component is to increase access to underserved groups; to increase the quality of services, including better outcomes; to promote interagency collaboration; and/or to increase access to services. The County’s work plan name is “Avenues: Work First for Individuals with co-occurring disorders”.
“Avenues: Work First for Individuals with Co-Occurring Disorders” is a “Work First” approach as a core treatment modality for co-occurring disorders. The innovation is to engage people in active work related activities as an alternative to traditional mental health and/or substance abuse treatment modalities, rather than focusing primarily on the individuals’ symptoms. It is designed after a philosophy and model known as “Housing First.” The Housing First approach centers on providing homeless people with housing quickly and then providing services as needed. In this proposal we will take a similar approach emphasizing work as a motivating and protective factor. This innovative program expects to have more positive outcomes by offering “natural” activities, e.g., work or career paths that will provide individual incentives for success. These incentives are person centered, designed by each participant based on their own self described goals.
Referrals for Avenues: Work First for Individuals with Co-Occurring Disorders come from Santa Cruz County Mental Health Full Service Partnership (FSP) Teams, the jail, court, probation, proposition 36, hospitals, sub-acute settings, supported mental health housing and shelters
Staff include a certified alcohol and drug counselor, licensed therapist, Community Navigators, employment specialists, and a psychiatrist. Adjunct services will include alternative treatments, such as acupuncture, yoga, and mindfulness based stress reduction offered at the Wellness Centers.
Community Navigators are peers in their own recovery as positive role models and support counselors who have “been there and know what it’s like,” and offer support and guidance. “Casa Pacific” is a residential program for those individuals struggling to maintain sobriety and need a supervised setting to stay clean and sober.
Individuals are referred to appropriate resources, substance abuse treatment, or other services, as needed and appropriate. Close coordination is maintained with the FSP’s while someone is utilizing these services. Individuals are able to continue with “Work First” activities even after referred elsewhere.
Target population: Transition age youth and adults. This includes persons with severe and chronic mental illness; persons who abuse alcohol and drugs whose mental health issues interfere with their ability to achieve stable recovery and put them at risk of homelessness, jail and/or hospitalization;
Providers: The Volunteer Center/Community Connection (employment preparation), Santa Cruz Community Counseling Center (Casa Pacific), Mental Health Client Action Network (Dual Recovery Support and Acupuncture), facilitator by contract (Mindfulness Recovery), and the Community Action Board- Community Restoration Project (Work Crew).
61 Santa Cruz County Mental Health & Substance Abuse Services: MHSA Annual Update
Number of individuals to be served in 2013-2014: The unduplicated numbers of individuals to be served by program are: Volunteer Center/Community Connection: 45 SCCCC: 30 MHCAN: 45 Mindfulness Recovery: 45 CAB/Work Crew: 37
Were there any challenges or barriers in the program? If so, what are the strategies to mitigate? No
Are there any new, changed or discontinued programs? No.
Performance Outcomes (specify time period): These numbers represent an unduplicated client count of persons served in Quarter 1: July 1, 2012-September 30, 2012:
Agency Reporting Volunteer Center/Community Connection Unduplicated Total Served 41/11 Age Group Children 0-17 TAY 16-25 Adults 26-59 Older Adults 60+ 41 Race/Ethnicity White Latino Other 21/10 14/1 6 Primary Language English Spanish Other 40/11 1/0 Culture Veterans LGBTQ Other 0 0
Agency Reporting SCCCC Unduplicated Total Served 9/9 Age Group Children 0-17 TAY 16-25 Adults 26-59 Older Adults 60+ 2/2 6/7 1/0 Race/Ethnicity White Latino Other 5/5 3/3 1/1 Primary Language English Spanish Other Not collected Not collected Culture Veterans LGBTQ Other Not collected Not collected
62 Santa Cruz County Mental Health & Substance Abuse Services: MHSA Annual Update
Agency Reporting CAB Unduplicated Total Served 22/16 Age Group Children 0-17 TAY 16-25 Adults 26-59 Older Adults 60+ 5/5 16/10 1/1 Race/Ethnicity White Latino Other 11/7 10/9 1/0 Primary Language English Spanish Other Not reported Not reported Culture Veterans LGBTQ Male Female 19/15 3/1 Total community service hours performed 1,175/560
Agency Reporting Mindfulness Recovery Unduplicated Total Served 41/40 Age Group Children 0-17 TAY 16-25 Adults 26-59 Older Adults 60+ 21/20 11/9 10/11 Race/Ethnicity White Latino Other
Primary Language English Spanish Other
Culture Veterans LGBTQ Other
Agency Reporting MHCAN Unduplicated Total Served 36/80 Age Group Children 0-17 TAY 16-25 Adults 26-59 Older Adults 60+ 0 11/9 18/48 7/23 Race/Ethnicity White Latino Other 9/32 11/33 16/15 Primary Language English Spanish Other 36/61 9/16 0/3 Culture Veterans LGBTQ Other 7/7 4/11
Community Impact: Casa Pacific Tom is a 29-year-old male, who spent the last ten years using drugs and isolating in his family home, until he was arrested after threatening someone with a sword. S was sentenced to 6 months at Casa Pacific dual diagnosis treatment program. Since entering the program Tom has been engaged, he doesn’t just participate in program, he gets involved and takes charge of his own treatment and wellness, taking advantage of every opportunity he has. Tom’s plan is to move into independent housing and is using his time to learn all the skills that it will take for him to be successful. He has been sober for 8 months. Tom sees his psychiatrist and his PCP regularly and takes care of all of his medical needs. He has learned to plan meals and how to cook, a skill he did not have previously. He enjoys this so much that when he visits his family he cooks for them. As Tom grows and learns new skills, he challenges the program to grow and
63 Santa Cruz County Mental Health & Substance Abuse Services: MHSA Annual Update continue to support him in his goals. Because of Tom, Casa Pacific is developing a grocery shopping skills group (to enhance the menu planning and cooking groups), budgeting group, and more independent medication management, so that when S moves into housing it will be a seamless transition. Tom’s family is impressed with his progress and comments on how enjoyable and social Tom is, as well as being a great cook. Tom is proud of himself, and is pleased with all the progress that he has made in the last several months with the assistance and support of Casa Pacific.
Community Impact: Community Connection Through the Avenues program and continued commitment to wellness and recovery, Steve has been able to do something that has eluded him his entire adult life; stay clean, sober and out of jail. “I have been clean for 22 months”, he says with a large smile on his face. “I live in a studio behind my mom’s house by the beach and am taking guitar classes at Cabrillo”. The Avenues program referred Steve to College Connection to help him with registering for classes at Cabrillo College. Steve has been a role model for the rest of the program participants in showing that it is possible for participants to live independently, maintain stability with their mental health, and stay sober on their road to recovery.
64 Santa Cruz County Mental Health & Substance Abuse Services: MHSA Annual Update
WORKFORCE EDUCATION & TRAINING – “WET” This infrastructure component is designed to strengthen the public mental health workforce both by training and educating current staff (including concepts of recovery and resiliency), and to address occupation shortages in the public mental health profession by a variety of means. (Note: Infrastructure programs do not allow the County to hire staff to provide services.)
The workforce assessment conducted in 2007 revealed that the greatest shortfall throughout the Public mental health system in Santa Cruz County is licensed clinicians, especially bilingual (Spanish) speaking clinicians. Also noted were shortages in LVN/licensed psychiatric technicians, occupation therapists, employment supports, and consumer and family supports. Furthermore, the workforce does not reflect the ethnic diversity of the community; there is a serious shortage of Latino/a staff throughout the public mental health system, as well as a shortage of Spanish speaking staff. (Spanish is our threshold language.) There are no positions designated for consumer and family member experience at the County and only a few at contract agencies.
The MHSA Coordinator and two other county staff worked effectively with county personnel to make changes in the hiring criteria that now recognize and award certain considerations for personal and/or lived experience, and special skills for persons applying to entry level county positions. We added language to inform applicants ‘credit’ would be given for lived experience as a consumer, or family member, as well as credit for obtaining a Human Services Credential and/or a consumer peer-training certificate for positions for community mental health aide. Additionally, the Senior/Mental Health Client Specialist classification was changed to give "credit" to applicants for experience related to county mental health work, rather than solely based on years of experience. Furthermore, the county made a concerted effort to hire qualified bilingual bicultural staff. However, Santa Cruz had to lay off staff during the economic downturn, and in a two-year period, 7 persons were laid off and all of them were bilingual.
The County is now able to hire staff back and recruit for new bilingual staff. Through these new recruitments we hope to expand our bilingual capacity in psychiatry, clinical care, case management, and in workforce supports. It is our goal to achieve this using loan forgiveness, national recruitments, and focused outreach to organizations linked to professionals of color and to family and consumer organizations. There has been an expansion of consumer positions in the non-profit contract programs and in consumer run programs. In addition a position and resources have been dedicated to support and supervision of interns and extensive training options for best practices in MH and SUD treatment.
Here are the County’s WET programs:
WET Program #1: Workforce, Education and Training Coordination & The Training Academy Purpose: To implement and coordinate the Santa Cruz County WET plan and to create a well-run welcoming environment for all training audiences.
We established a Workforce Education & Training (“WET”) Task Force with representatives from children’s mental health, adult mental health, alcohol & drug services, community based
65 Santa Cruz County Mental Health & Substance Abuse Services: MHSA Annual Update agencies, consumers, families and community college. The WET Task Force oversees the Training Academy, including creating and/or contracting for trainings that are needed, and assessment of the trainings provided.
In order to increase the quality and success of educating and training the public mental health workforce to better serve unserved and underserved populations, the Training Academy has offered trainings to multiple audiences. The overarching goal is to increase skills in order to improve public mental health services. Trainings reflect the needs identified in the assessment of paid public mental health (County and Contractor) staff, volunteers, consumers and family members. All training courses include evaluation, and results are used to contribute toward decision-making regarding future trainings.
The Academy offers workshops and on-going classes of varying sizes, areas of focus and depth and support for pertinent application of knowledge gained. The Workforce Education & Training Task Force (WET-TF) advises the WET Coordinator regarding the assessment tool to be used to evaluate training needs, effectiveness of the trainings, and establishment of priorities based on the five fundamental MHSA concepts (consumer and family driven, community collaboration, recovery/resiliency strength-based services, integrated services, and culturally competency).
The WET Task Force also serves as our “Cultural Competence Committee” overseeing not only the Cultural Competence Trainings, but also addressing issues of integrating cultural competence practicing through out the work force, including how to create welcoming environments for our consumers and families. (See appendix for list of trainings offered.)
The Training Academy has the following goals:
1. To regularly offer orientations (or overviews) of the public mental health system to consumers, family members, new employees, potential employees, interns, and community members. 2. To offer trainings on how to create a respectful, welcoming, and “customer service” attitude towards consumers and families. 3. To develop the skill sets of consumers and family members to participate more effectively in treatment and recovery. 4. The WET-TF will ensure involvement of consumers and families, as both participants and trainers at educational events. 5. Offer training modules on topics as a broad overview to be accessible to a larger audience and to progress to more skilled, in-depth techniques. 6. To utilize local education providers to deliver in-service education where doing so will result in cost savings through leveraging existing public investments in education.
WET Program #2: Consumer “Culture” Trainings Purpose: To educate providers about the important role that consumers play in their wellness and recovery, and to foster consumer involvement and participation in primary clinical decision- making.
66 Santa Cruz County Mental Health & Substance Abuse Services: MHSA Annual Update
To support our commitment of creating a public mental health system that truly understands the consumer’s needs and perspectives, the MHSA Coordinator contracts and/or partners with persons and/or organizations to provide educational services to public mental health. This is an integral part of the Training Academy. The goal is to educate providers about the important role that consumers play in their wellness and recovery, and to foster consumer involvement and participation in primary clinical decision-making.
WET Program #3: Family “Culture” Trainings Purpose: To educate the providers about the important role that families can play in wellness and recovery, and to foster family involvement and participation in primary clinical decision-making.
To support our commitment of creating a public mental health system that truly understands the family’s needs and perspectives, the MHSA Coordinator contracts and/or partners with persons and/or organizations to provide educational services to public mental health. This is an integral part of The Training Academy. The goal is to educate providers about the important role that families can play in wellness and recovery, and to foster family involvement and participation in primary clinical decision-making. We have established a collaborative partnership with NAMI of Santa Cruz to provide an educational program for mental health service providers co-taught by consumers and family members. Additionally, we have supported “What Is NAMI?” trainings to educate staff about NAMI.
WET Program #4: High School Outreach Purpose: To foster knowledge and create interest in mental health as a career path amongst high school students, with a focus on bilingual (Spanish) and bicultural students.
The public mental health system needs to conduct targeted ‘outreach’ to high school students to provide information about mental illness, resources and to promote the idea of employment in public mental health. One way to accomplish this is by partnering with existing ROP programs currently in the local high schools. The Workforce Needs Assessment for Santa Cruz County reflects that there is a lack of sufficient mental health providers. Outreach focuses on Spanish speaking communities. Additionally, the local community colleges have been encouraged to target this same population in order to inform the students about the application process and supports available for students interested in pursuing higher education.
See appendix for complete list of outreach activities.
WET Program #5: Entry Level Employment Preparation Purpose: To develop an entry-level preparation program (for consumers and family members and the general public) for services in the public mental health sector which incorporates the five fundamental elements of MHSA (consumer and family driven services, community
67 Santa Cruz County Mental Health & Substance Abuse Services: MHSA Annual Update collaboration, recovery/resiliency strength-based, integrated services, and culturally competent services) into the courses offered.
The goal of this program was to develop an entry-level preparation program (for consumers and family members and the general public) for services in the public mental health sector, which incorporates the five fundamental elements of MHSA (consumer and family driven services, community collaboration, recovery/resiliency strength-based, integrated services, and culturally competent services) into the courses offered.
In order to achieve our objectives we have adapted the Community Mental Health Aide position to encourage consumer and family members to apply, and revised the application review in order to give "credit" for lived experience as a consumer, or family member, as well as credit for obtaining a Human Services Credential and/or a consumer peer training certificate. We have a strong collaboration with Cabrillo College certificate program, to support consumers expressing interest in working in public mental health. This program also supports the Cabrillo “College Connection” program. In the first quarter of 2012-2013 (July 1, 2012 to September 30, 2012), 21 students were served. The target number of students to serve in fiscal year 2013-2014 is 25.
Agency Reporting Community Connection- College Connection Unduplicated Total Served 21/20 Age Group Children 0-17 TAY 16-25 Adults 26-59 Older Adults 60+ 2/1 19/19 Race/Ethnicity White Latino Other 18/17 2/2 1/1 Primary Language English Spanish Other 21/20 Culture Veterans LGBTQ Other 1/0
The major challenge of this program has been that we have not been able to hire new clinicians or mental health aides due to budgetary constraints.
Community Impact: “Carl” Carl was diagnosed as schizophrenic and also has a traumatic brain injury (TBI). He is not only challenged with managing his psychiatric symptoms but also with managing extremely poor short-term memory due to his TBI. The College Connection staff were able to successfully register him for classes that are appropriate for his mental health capacity. We also developed a plan for the transportation to/from Cabrillo, a system to track all assignments and expectations of his classes, by writing EVERYTHING down in an organizer. He checks this organizer several times a day. He meets with me to help manage psychiatric symptoms and maintain self-care plan. He attended classes on a regular basis, which built his confidence and self-esteem. He successfully completed 2 Kinesiology classes and English 110 for Fall 2012.
"With the help of Lisa and the College Connection program, I was able to graduate with a Human Services certificate." -J
68 Santa Cruz County Mental Health & Substance Abuse Services: MHSA Annual Update
WET Program #6: Public Mental Health Internship Program
Purpose: To create a more cohesive internship program for trainees at county mental health, and to foster greater support for registered interns on licensure track.
The goal of this program is to create a more cohesive internship program for trainees at county mental health, and to foster greater support for registered interns on licensure track. We have established a single point of contact for educational institutions regarding internship placements within the County. We provide and coordinate group supervision for all trainees placed within the public mental health sector. We provide license track education & support to all public mental health registered interns for license examination preparation, and offer funds for public mental health employees for purchase of license exam preparation materials and/or test fees.
One of the benefits of the funding for WET has been that it has allowed Santa Cruz County Mental Health and Substance Abuse Service to encourage unlicensed staff to pursue their MFT or LCSW licenses by:
1) Reimbursing County and contract employees for AATBs and Gerry Grossman workshops and materials and other related expenses 2) Offering in-house license preparation/support groups 3) Providing weekly individual and group supervision
The outcome of this is that in fiscal year 2011-2012 seven people passed their first exam, and seven passed all their exams and became licensed. The net result is a more professional staff and increased overall morale.
69 Santa Cruz County Mental Health & Substance Abuse Services: MHSA Annual Update
INFORMATION TECHNOLOGY Funds and guidelines for Capital Facilities and Information Technology were packaged together by the State Department of Mental Health. (Note: Infrastructure programs do not allow the County to hire staff to provide services.)
The Information Technology funds are to be used to: . Modernize and transform clinical and administrative information systems to improve quality of care, operational efficiency and cost effectiveness, and . Increase consumer and family empowerment by providing the tools for secure consumer and family access to health information within a wide variety of public and private settings.
We have two primary information technology needs: 1. To increase consumer and family empowerment. Access to knowledge is a human right. Every client will be tech literate and have Internet access to increase communication between each other and all the supports that promote recovery, wellness, resiliency, and social inclusion. Our goal is to have computer access for consumers in housing and kiosks at existing clinic sites, and to provide technical support and training (for consumers and staff). We will begin with the addition of six terminals at sites in both Santa Cruz and Watsonville, and available to both children, adult and family members. Security issues will be addressed by posting signs in English and Spanish stating: “This is a public computer. For your security we advise that you take these steps: 1. Do not save your logon information. 2.Do not leave the computer unattended with sensitive information on the screen. 3. Delete your temporary files and your history. 4. Do not enter sensitive information on public computers.”
2. To modernize and transform clinical administrative systems. Our goal is to improve overall functionality and user-friendliness for both clinical and administrative work processes. We need to have one cohesive system with intuitive functionality where it would only be necessary to enter information one time and have that information populate fields as needed. The system must support fiscal, billing, administrative work processes, and include an electronic health record. Ideally a patient portal is needed as well. Strong billing processes, including automated eligibility and exception reports, are needed to effectively manage accounts payable and accounts receivable, and also provide necessary reporting tools for cost reports and budgeting activities. It also needs to include robust caseload and clinical management tools, as well as encourage and allow client access, interaction and participation. It should facilitate person-centered treatment planning, and ease of information sharing of documentation across service providers in the system of care.
Briefly, we plan to purchase an upgrade of our existing practice management system. Insyst will be upgraded to the new system Share Care. Share Care does have an Electronic Health Record, but before a final commitment is make to use Share Care for the Electronic Health record, Santa Cruz wants to confirm the capacities of Netsmart, and Elysium to link with both the Share Care practice management and the OCHIN/Epic clinic product. Vendors ECHO and OCHIN are collaborating to coordinate our health record across systems. The first stage of this project is the practice management, including billing, reporting and utilization. The second stage is the
70 Santa Cruz County Mental Health & Substance Abuse Services: MHSA Annual Update development of the electronic health record. The third stage is the collaboration between primary health and behavioral health.
We are on track for the first phase (project management) of this project. This phase lays the foundation for the second phase (the development of the electronic health record). We are in negotiations for the exact price per license and determining the number of licenses we will need. After reviewing our EHR options we anticipate that this will be implemented (and we will begin using electronic health records) in fiscal year 2013-2014. We plan on being able to connect to primary care services, following “meaningful use” guidelines to allow for coordinated care (such as medications and prescriptions). By the end of fiscal year 2013-14 our staff will be entering progress notes, service plans, prescriptions and labs into the electronic health record.
One of the challenges we found in implementing the first and second phases is that we lack the administrative capacity to both negotiate and implement at the same time. Our administrative have diligently set priorities and we are reaching our benchmarks. As you know with health reform and changes to MediCal, the challenge is staying current with changes and doing new implementation at the same time.
71 Santa Cruz County Mental Health & Substance Abuse Services: MHSA Annual Update
CAPITAL FACILITIES Funds and guidelines for Capital Facilities and Information Technology were packaged together by the State Department of Mental Health. (Note: Infrastructure programs do not allow the County to hire staff to provide services.) Our stakeholders chose to spend the majority of funds in the Information Technology projects.
The purpose of Capital Facilities is to acquire, develop or renovate buildings for service delivery for mental health clients or their families, and/or for MHSA administrative offices. Capital Facilities funds cannot be used for housing. We used these funds to renovate county-owned buildings. In South County renovated the building that was previously the County Court house. The previous location of mental health services was privately owned, and the rent was steadily increasing. With the re-location of the Court system the County decided to move the mental health service site to the County-owned site. Renovation includes making ADA changes such as grading the ramp into the building, improving doorway widths, and other changes that may not yet be identified.
Projects that have yet to be completed in South County include the installation of two counters outside the reception windows for a horizontal barrier for client use. One counter will be at the American Disabilities Act height requirement and the other counter at a higher height. In the North County renovation includes upgrading existing reception by expanding existing window opening on existing wall, installing secure fire rated, electronically operated secure window (door) system, and installing new counters. Additionally, the County buildings have poor ventilation, so we will also be modifying to improve air quality and circulation. The challenge to completing these upgrades has been due to a number of other Health Service Agencies projects.
72 Santa Cruz County Mental Health & Substance Abuse Services: MHSA Annual Update
IV. MHSA FUNDING SUMMARY: 2013-2014
County: Santa Cruz Date: 2/14/13 CSS WET CFTN PEI INN
A. Estimated FY 2013/14Funding 1. Estimated Unspent $424,349 $226,826 $941,070 $564,480 $318,768 Funds from Prior Fiscal Years
2. Estimated New FY $6,540,292 $1,613,635 $431,400 2013/14Funding
3. Estimated $6,964,641 $226,826 $941,070 $2,178,115 $750,168 Available Funding for FY 2013/14
B. Estimated FY $6,964,641 $226,826 $941,070 $2,178,115 $750,168 2013/14Expenditures
Estimated Local Prudent Reserve Balance 1. Estimated Local Prudent Reserve Balance on $3,387,556 June 30, 2013 2. Contributions to the Local Prudent Reserve in $0 FY 2013/14 3. Distributions from Local Prudent Reserve in FY $0 2013/14 4. Estimated Local Prudent Reserve Balance on $3,387,556 June 30, 2014.
Community Services & Supports Expenditures By Type Of Service Full Service Partnerships $3,324,970 General System Development $2,369,839 Outreach and Engagement $450,241 Administration $819,591
Prevention & Early Intervention Expenditures by Program 1. Early Intervention Services for Children $684,411 2. Culture Specific Parent Education & Support $112,155 3. Early Onset Intervention Services for Transition Age Youth & Adults $835,348 4. Early Intervention Services for Older Adults $171,953 Administration $374,248
Innovation Expenditures by Program 1. Avenues: Work First for Individuals with Co-Occurring Disorders $750,168
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Attachments
74 Santa Cruz County Mental Health & Substance Abuse Services: MHSA Annual Update
ACRONYMS USED IN THIS REPORT
CAB Community Action Board COE County Office of Education CSS Community Services & Supports DBHU Dominican Behavioral Health Unit FSA Family Service Agency of the Central Coast FSP Full Service Partnership INN Innovative Project MH Mental Health MHCAN Mental Health Client Action Network MHSA Mental Health Services Act MHSAS (Santa Cruz County) Mental Health & Substance Abuse Services NAMI National Alliance on Mental Illness PEI Prevention & Early Intervention PVPSA Pajaro Valley Prevention & Student Assistance Agency SCCCC Santa Cruz Community Counseling Center SUD Substance Use Disorder
75 Santa Cruz County Mental Health & Substance Abuse Services: MHSA Annual Update
MHSA Housing Program Rental Application
Section D: Supportive Services Plan Instructions
1. Submit the MHSA Supportive Services Information, Section D, Items D.1 through D.16, as listed on the Application Index & Checklist.
2. Enter required information into the box marked "Response".
3. Items D1 through D9 must be circulated for public comment and local review for 30 days prior to submission.
76 Santa Cruz County Mental Health & Substance Abuse Services: MHSA Annual Update
Item D.1 Development Summary Form (Attachment B) Instructions: Complete and submit the Development Summary Form (Attachment B) RENTAL HOUSING DEVELOPMENT SUMMARY FORM
County Mental Health Department: County of Santa Cruz Health Services Agency
Name of Development: Aptos Blue Apartments
Site Address: 7839 Soquel Drive
City: Aptos State: CA Zip: 95003
Development Sponsor: MidPen Housing Corporation
Development Developer: Mid-Peninsula The Farm, Inc.
Primary Service Provider: County of Santa Cruz Health Services Agency
New Construction Acquisition/Rehabilitation of an existing structure
Type of Building: Apartment Single Family BConilddiomi nium HOther
Total Development MHSA Total Number of Units: 40 Total Number of MHSA Un its: 5 Total Cost of $23,175,000 Amount of MHSA Funds $1,062,430 Development: Requested: Capital: $500,000 Capitalized Operating $562,430 Subsidies:
Other Rental Subsidy Sources (if applicable): None
Target Population (please check all that apply):
Child (w/family) Transition-Age Youth Adult X Older Adults
County Contact
Name and Title: Jim Straubinger
Agency or Department Address: 1400 Emeline Avenue., Building K, Santa Cruz, CA 95060
Agency or Department Phone: 831.454.4951
Agency or Department Email: [email protected]
77 Santa Cruz County Mental Health & Substance Abuse Services: MHSA Annual Update
Item D.2 Development Description
The Development Description should provide a narrative (approximately two pages) that includes: 1. Name and location of the proposed housing development; 2. Service goals of the development; 3. Characteristics of tenants to be served; 4. Type of housing to be provided (new construction or acquisition/rehab.); 5. How the building(s) in which housing and services will be provided will meet the housing and service needs of the MHSA tenants (location, building type, layout, features, etc.);
6. Name of primary service provider, property manager, and other development partners; and, 7. Summary of the anticipated sources of development financing. (Name sources only, do not include dollar amounts.)
Response:
Aptos Blue is located at 7839 Soquel Drive in Aptos, an unincorporated community in Santa Cruz County. Aptos Blue will consist of 40 newly constructed apartments in two and three story “tuckunder” buildings. There will be six residential buildings on the property and a mix of studios, one-bedroom, two-bedroom and three-bedroom units. In addition, an existing single family home on the property will be renovated into community space, which will include leasing and services offices, a computer lab, a kitchen and community gathering space. Adjacent to the community space will be landscaped open space, consisting of an informal orchard of fruit trees, a central green and a tot lot. Adjacent to the open space will be common laundry rooms. The units at Aptos Blue will all be fully equipped. Residents will have their own private bathroom and full kitchen as well as private open space either in a balcony or a patio. There will be adequate space for services to be provided in the tenants’ units. In addition, the community facilities will be available for services. There will be private offices that can be accessed as well as larger community space, depending on the type of services being delivered. Five of the 40 units will be set aside for MHSA-eligible tenants. The service goals of the MHSA units at Aptos Blue are to provide affordable housing and to offer integrated, client- centered, multi-disciplinary support services, individualized with the participation of each MHSA tenant. The goal of services is to support wellness, recovery, resiliency, and housing stability. The MHSA housing program at Aptos Blue will serve adults 18 years of age and over.
The goal criteria for the five units of housing are:
1. To assist a qualified individual who has a diagnosis of psychiatric disability including depression or anxiety disorders with permanent supportive housing to avoid homelessness. 2. The individual was not recently discharged from an acute hospital or crisis unit. 3. The individual has been assessed by mental health clinician and deemed to be alert, oriented, calm and cooperative.
78 Santa Cruz County Mental Health & Substance Abuse Services: MHSA Annual Update
4. The individual is mentally stable and receiving outpatient behavioral health services. 5. The individual is able to care for themselves with support and live independently. They must demonstrate conduct and skills in prior living situations that the admission to independent housing would not negatively affect the health, safety or welfare of themselves or other residents, they physical environment or the financial stability of the property. 6. All tenants living in the housing unit shall be in compliance with the MidPen Housing’s resident selection criteria, including credit check, criminal history, background check and prior housing experiences.
Many individuals on SSI have regular housing crises in the regular rental marketplace, which usually requires $1000, or more for a single unit. SSI can range from $695 per month to $1300 thus presenting constant financial challenges. For this reason many of the county clients live with their families until the parents age makes this no longer possible. The individuals served can be expected to have special needs linked to their disability, including physical health issues, a lack of support systems, credit problems, and housing history that present barriers to other rental housing. The County of Santa Cruz Health Services Agency will be the primary service provider for MHSA clients and will provide treatment and case management supports in the residents’ units, at the community space onsite and at locations offsite as needed. Access to in-home support services is also common for those with mobility and physical impairments. The County provides services to MHSA clients through their Full Service Partnership treatment teams who will be the primary service providers to MHSA clients at Aptos Blue. The general process for service assessment and team support is described below. Initially, MHSA clients will work with the Access Team, who does intake and assessment of eligible clients. Once a client has completed the intake process and developed a care plan, they will be referred to one of the full service care management teams. Teams include a physician, nurse practitioner, therapy, rehabilitation, and case management supports. In addition to these teams, there is a mobile Mental Health Housing Support Team, which includes County staff as well as contract agency partners. The Mental Health Housing Support Team provides support to the MHSA program in addition to the core treatment programs provided by the other teams. This extra support includes the MHSA Housing Coordinator and an occupational therapist as well as other contract partners who bring complimentary services and are available nights and weekends to meet client needs in housing. This overall group of teams and staff are referred to as the County’s System of Care. Independent housing is needed for individuals who have completed transitional housing rehabilitation and support services, those whose parents can no longer provide a living situation, those who have lost their market rent housing due to financial problems. All clients recommended for independent housing have skills to allow them to make this level of housing a success and have additional supports to insure this. County supported housing has been a successful avenue for many to live independently.
In addition, Mid-Peninsula Resident Services Corporation will provide other service programs on-site that will be open to all residents of Aptos Blue. Service programs will include things like computer literacy training, ESL classes, nutritional classes, homework clubs and more.
79 Santa Cruz County Mental Health & Substance Abuse Services: MHSA Annual Update
MHSA clients as well as their families will be invited to all the service programs offered to the residents at Aptos Blue. The Property Manager will be Mid-Peninsula Property Management Corporation, who will provide property management and assist with scheduling and outreach for any on-site programs provided by the County Full Service Partnership teams or MidPen Resident Services Corporation. Mid-Peninsula Property Management Corporation, MidPen Resident Services Corporation as well as the owner and developer of Aptos Blue are affiliates of Mid-Peninsula Housing Corporation, one of the largest and most successful non- profit developers of affordable housing in Northern California. Since 1970, they have been working to provide quality housing to low-income families and individuals. Mid-Pen has extensive experience financing, building and operating affordable housing and has worked with many populations with special needs and disabilities. For Aptos Blue, MidPen plans to use a combination of funding from the County of Santa Cruz Redevelopment Agency (low-income housing funds), the State Department of Housing and Community Development (federal HOME funds), MHSA funds and the Low Income Housing Tax Credit (federal tax credits awarded by the California State Treasurer).
Item D.3 Consistency with the Three-Year Program and Expenditure Plan
Describe how the proposed housing development is consistent with the sponsoring county mental health department's approved Three-Year Program and Expenditure Plan. Provide specific information regarding how the development meets the priorities and goals identified in the Three-Year Program and Expenditure Plan.
Response:
D.1 Consistency with Three-Year Program and Expenditure Plan
MidPen Housing Corporation, a non-profit housing development corporation, is proposing to construct 40 new affordable family rental apartments in the unincorporated community of Aptos in Santa Cruz County. MidPen has obtained funding commitments from the Redevelopment Agency of Santa Cruz County and State HOME and requested that the County of Santa Cruz allocate MHSA funding to the project, which would involve setting aside 5 of the 40 units for MHSA eligible adults. Funds include construction and support. The proposed project is consistent with Santa Cruz County Mental Health’s Community Services and Support (CSS) Plan that was developed with broad community stakeholder participation and that was approved by the County of Santa Cruz Board of Supervisors and the State Department of Mental Health. Increasing housing capacity in a range of options was consistently identified as a priority for all planning committees--Housing, Adult System of Care, Youth, and Older Adults. The Housing and Supports Committee prioritized the need to create permanent supportive housing with an emphasis on single units, both scattered throughout a particular development as well as in dedicated developments. The committee emphasized the importance of providing housing opportunities throughout the County.
80 Santa Cruz County Mental Health & Substance Abuse Services: MHSA Annual Update
Aptos Blue brings together the Redevelopment Agency of the County of Santa Cruz (“RDA”), County Mental Health, and MidPen Housing Corporation (“MidPen”). The project will be the third project and an important element of the MHSA housing program in that it will provide five new permanent supportive housing units for MHSA eligible adults. The location in Aptos is ideal for the target population as it is close to shopping and public transit and is an area that is underserved for permanent supportive housing. The permanent supportive housing units in the project build on the successes already achieved at Nuevo Sol and Bay Avenue Senior Apartments. Nuevo Sol utilized MHSA one-time funds and the Governor’s Homeless Initiative resources to provide permanent supportive housing with integrated services for people with psychiatric disabilities who have been homeless and are at risk of becoming homeless without subsidized affordable housing. Bay Avenue utilized MHSA funds, Tax Credits and HOME funds to further the CSS Plan by increasing access for Older Adults to an array of integrated services that support their ability to reside in their community of choice and reduce the negative effects of having a psychiatric disability. Aptos Blue further supports that Plan, building on the groundwork set by prior projects to provide Supportive, affordable housing for adults in Aptos.
81 Santa Cruz County Mental Health & Substance Abuse Services: MHSA Annual Update
Item D.4 Description of Target Population to be Served
Describe the MHSA Rental Housing Program target population to be served in the development. Include a description of the following:
1. Age group, i.e., adults, older adults, children, transition-aged youth; 2. The anticipated income level of the MHSA tenants; and, 3. A description of the anticipated special needs of the target population to be served, e.g., physical disabilities, chronic illness, prior housing status, etc.
Response:
The MHSA housing program at Aptos Blue will serve adults 18 years of age and over.
The goal criteria for the five units of housing are:
1. To assist a qualified individual who has a diagnosis of psychiatric disability including depression or anxiety disorders with permanent supportive housing to avoid homelessness. 2. The individual was not recently discharged from an acute hospital or crisis unit. 3. The individual has been assessed by mental health clinician and deemed to be alert, oriented, calm and cooperative. 4. The individual is mentally stable and receiving outpatient behavioral health services. 5. The individual is able to care for themselves with support and live independently. They must demonstrate conduct and skills in prior living situations that the admission to independent housing would not negatively affect the health, safety or welfare of themselves or other residents, they physical environment or the financial stability of the property. 6. All tenants living in the housing unit shall be in compliance with the MidPen Housing’s resident selection criteria, including credit check, criminal history, background check and prior housing experiences.
People in the MHSA target population often lack support systems, lack money management skills, and have poor credit. Individuals will be receiving Social Security Income, which ranges from $695 to $1300 per month depending on work history. Occupancy will be specifically limited to those whose income does not exceed 30% of the area median income. In addition to the MHSA units, there will be 35 units available to qualified low income families and individuals.
82 Santa Cruz County Mental Health & Substance Abuse Services: MHSA Annual Update
Item D.5 Tenant Eligibility Certification
The county mental health department is responsible for certifying the eligibility of individuals, applying for tenancy in an MHSA unit, for compliance with the target population criteria. Submit a narrative description of the following:
1. How an individual applies to the county to become certified as eligible for an MHSA unit; 2. How certification of eligibility will be documented, provided to the individual applicant, and maintained by the county; and, 3. How certification of eligibility will be provided to the property manager/development.
Response:
1. How an individual applies to the county to become certified as eligible for an MHSA unit Santa Cruz County’s MHSA Housing Program is an integral part of our mental health services. All individuals receiving services are eligible for housing at an appropriate level of care, including MHSA funded housing. If an individual is not currently getting services but would like to access MHSA housing units and services, they would be first screened by the Access Team to determine that they qualify. Once this screening has occurred the person may request housing from our various housing options and levels of care.
The goal criteria for the five units of housing are:
1. To assist a qualified individual who has a diagnosis of psychiatric disability including depression or anxiety disorders with permanent supportive housing to avoid homelessness. 2. The individual was not recently discharged from an acute hospital or crisis unit. 3. The individual has been assessed by mental health clinician and deemed to be alert, oriented, calm and cooperative. 4. The individual is mentally stable and receiving outpatient behavioral health services. 5. The individual is able to care for themselves with support and live independently. They must demonstrate conduct and skills in prior living situations that the admission to independent housing would not negatively affect the health, safety or welfare of themselves or other residents, they physical environment or the financial stability of the property. 6. All tenants living in the housing unit shall be in compliance with the MidPen Housing’s resident selection criteria, including credit check, criminal history, background check and prior housing experiences.
Access to housing is either through a mental health housing support team or may be requested directly through the MHSA Housing Coordinator. The Division of Mental Health Clinician or its designee will assess applicants to ensure the above goal criteria are met. Those clients who are MHSA Housing program-eligible will be certified and mental health
83 Santa Cruz County Mental Health & Substance Abuse Services: MHSA Annual Update
disability will be documented. Upon receipt of the application for certification, County staff will ensure that all the information is complete and/or request the referral source or the applicant to either explain the incomplete information or provide the missing information. 1. Certification of Diagnoses County Mental Health will verify and certify the applicant has a qualifying disability by: a. Accessing Santa Cruz County Mental Health held records of diagnoses or other Santa Cruz County contracted mental health service programs, b. Arranging for assessment and diagnosis by a licensed mental health clinician through its own staff where there is no documented history in County Mental Health records, or c. Accepting a diagnosis provided by a treatment center or institution referring the applicant to the MHSA program.
2. Certification of Status a. To certify homeless risk status County Mental Health will obtain written verification from the staff of a transitional housing facility, a family who can no longer provide housing or temporary housing site designed to provide temporary living accommodations. If unable to obtain third-party verification, the applicant or supportive services program staff may prepare a short statement about the person’s previous living situation for the applicant to sign. b. to certify an applicant’s status as at-risk-of-homelessness, County Mental Health will obtain written verification of transitional housing settings, family, or Residential care facilities. Imminent risk of homelessness can be certified by a Santa Cruz County Mental Health service provider when the individual and/or their family is at imminent risk of homelessness and needs affordable supported housing. 2. How certification of eligibility will be documented, provided to the individual applicant, and maintained by the county Santa Cruz County Mental Health will determine and certify eligibility for MHSA applicants as detailed above. The County MHSA Housing Coordinator or designee will maintain a list of certified eligible applicants and inform them of their eligibility in writing. 3. How certification of eligibility will be provided to the property manager/development When a new unit in the MHSA Housing program is being rented up, or when existing units are expected to become vacant, the property manager will notify the MHSA Housing Coordinator of an available unit. The MHSA Housing Coordinator will then check the existing MHSA waiting list, notify the service teams of the type and size of unit that is available and request additional referrals of MHSA eligible consumers who would be a good match to the community. In the event that multiple potential residents are interested who qualify and are at comparable risk of homelessness, they will be referred to property management who will process applications on a first qualified first offered basis.
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Item D.6 Tenant Selection Plan
Provide a tenant selection plan, specific to the proposed development, that describes the following: 1. How prospective tenants will be referred to and selected for MHSA units in the development;
2. The tenant application process; 3. The procedure for maintaining the wait list; 4. The process for screening and evaluating the eligibility of the prospective MHSA tenants; 5. The criteria that will be used to determine a prospective MHSA tenant's eligibility for occupancy in the development; 6. The appeals process for individuals who are denied tenancy in an MHSA unit; and, 7. The reasonable accommodations policies and protocols.
NOTE: The Department's approval of the MHSA Housing Program Application does not ensure that the Tenant Certification/Referral Process is compliant with local, state and federal fair housing laws. Please seek legal counsel to ensure that the Tenant Certification/Referral Process complies with fair housing laws.
Response:
The MHSA Tenant Selection Plan for Aptos Blue reflects the shared values and mission to provide person centered supportive services and affordable housing. The selection process is based on the premise that all people have a right to housing, that Santa Cruz County is committed to ending homelessness and that applicants will be treated fairly and with dignity and respect. The Aptos Blue MHSA Tenant Selection Plan has been developed through collaboration with the Santa Cruz County Division of Mental Health (County Mental Health), the lead supportive services provider; the MidPen Property Management Corporation (MidPen Management), the property manager; and MidPen Housing Corporation (MidPen), the project developer. 1. How prospective tenants will be referred to and selected for MHSA units in the development Applicants who qualify and express interest in Aptos Blue will be referred to MidPen Management. The partners involved with Aptos Blue acknowledge the multiple processes involved and that navigating this process may be very challenging for the MHSA applicant. To that end the service providers are committed to assisting the applicant, if he/she so wishes, throughout and during each process. Potential tenants for the five MHSA-funded units must be referred to MidPen Management through the County MHSA Housing Coordinator or designee. This is to insure they have appropriate skills and supports for independent housing. Any person who contacts the project directly will be directed by the property management staff to contact the MHSA Housing Coordinator for certification of eligibility and subsequent referral to the project. County Mental Health, the MHSA service provider at this project, will work with other providers in the community to identify eligible applicants. County Mental Health will use culturally competent efforts to reach out to and engage members of the target population, including those among unserved or underserved ethnic communities and other minority populations, and will utilize a variety of proven outreach strategies to recruit residents for the permanent supportive housing. All referrals will be persons who are determined eligible to
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receive services through the County’s System of Care, and they will have had an assessment by the Access Team to ensure that they meet the eligibility requirements. In addition to accepting individuals reached through direct outreach methods, County Mental Health will accept referrals from the mental health service teams including our contract providers doing transitional housing. Referrals may also come directly from the Access Team and from psychiatrists and therapists who are seeing clients not currently served by a team. Referrals to the System of Care may come from other service providers or the broader community. Examples may include Adult Protective Services, a doctor’s office, a concerned family member or an individual seeking assistance from County Mental Health. Other sources of referrals will include but not be limited to local shelters, food programs and other nonprofit and government agencies that provide outreach and services to low income individuals and local veterans’ agencies; religious organizations; ethnically and linguistically diverse community-based organizations; and self-referrals. Referrals who are not currently served by county mental health services will need to be assessed by Mental Health Access Team to ensure that they meet the program requirements and that they meet the Aptos Blue criteria. 2. The tenant application process Applicants must complete an Application for Housing. Application packets will be provided to the County so that services staff may assist prospective tenants with completing their application. Along with the application, the forms for a Request for Consideration will be provided. The Request for Consideration process is more fully described in part 6 of this section and allows prospective residents consideration for negative or absent references, criminal backgrounds and other circumstances that might otherwise be cause for denial of an Application. When an appropriate unit becomes available, management schedules an orientation. At the orientation, applicant will be required to pay by Money Order or County Mental Health Department check the screening fee for each adult household member. There are several parts to an application; each part must be completed. The application cannot be accepted unless it is complete. Applicants must designate the number of bedrooms requested and may request more than one unit type provided the household meets the occupancy standards. The application must be signed and dated by all adult members for the application to be considered. During the initial Lease-Up, Applications may be accepted at a temporary leasing office; at all other times Applications should be submitted to the Property Leasing office onsite. 3. The procedure for maintaining the wait list Property management will not keep a waiting list for the MHSA units. When a new unit in the MHSA Housing program is being rented up, or when existing units are expected to become vacant, the property manager will notify MHSA Housing Coordinator of an available unit. MHSA Housing Coordinator will then notify the service teams of the type and size of unit that is available and request referrals of MHSA eligible consumers who would be a good match to the community. In the event that multiple potential residents are interested who qualify and are at comparable risk of homelessness, they will be referred to property management on a first qualified first offered basis. The MHSA Housing Coordinator will work with the Property Management staff to prevent long-term vacancies of MHSA units, by maintaining a waitlist of potential tenants sufficient to find a qualified applicant within a reasonable timeframe from notice of a pending vacant unit. 4. The process for screening and evaluating the eligibility of prospective MHSA tenants
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General Screening and Evaluation Requirements: 1. The applicant(s) must be able to demonstrate that his/her conduct and skills in present or prior housing has been such that the admission to the property would not negatively affect the health, safety, or welfare of other residents, or the physical environment, or financial stability of the property. 2. Positive identification with a picture will be required for all adult applicants (photocopy may be kept on file). Eligible applicants without picture identification will be supported by County Mental Health or other service providers to obtain one. For purposes of the application, a receipt from the DMV showing an application for an ID will be sufficient. If deferred, the final picture identification will be required at the time of move-in. 3. A complete and accurate Application for Housing that lists a current and at least one previous rental reference, with phone numbers will be required(incomplete applications will be returned to the applicant). Applicants must provide at least 2 years residency history. Applications must include date of birth of all applicants to be considered complete. Requests for Consideration will be considered for MHSA applicants whose disability may result in insufficient or negative references. 4. A history of good housekeeping habits. 5. A history of cooperation with management regarding house rules and regulations; abiding by lease terms; and care of property. 6. Each applicant family must agree to pay the rent required by the program under which the applicant is qualified. 7. A history of cooperation in completing or providing the appropriate information to qualify an individual/family for determining eligibility in affordable housing and to cooperate with the Community Manager. 8. Any applicant that acts inappropriately towards property management staff or is obviously impaired by alcohol or drugs, uses obscene or otherwise offensive language, or makes derogatory remarks to staff, may be disqualified 9. Applicants must agree that their rental unit will be their only residence. When applicants are undergoing income limit tests, they are required to reveal all assets they own including real estate. They are allowed to own real estate, whether they are retaining it for investment purposes as with any other asset, or have the property listed for sale. However, they may never use this real estate as a residence while they live in an affordable housing unit. Other Screening Criteria: 1. Income / Assets 2. Credit and Rental History 3. Criminal Background 4. Student Status 5. The criteria that will be used to determine a prospective MHSA tenant's eligibility for occupancy in the development Consistent with the CSS Plan and the MHSA definition of target population and the restrictions of the project, eligible tenants must be adults 18 years of age and over and have a diagnosed psychiatric disability, and many will also have medical problems. Special consideration will be given to the underserved populations and communities. • Santa Cruz County’s MHSA Housing staff will provide documentation for qualifying mental
87 Santa Cruz County Mental Health & Substance Abuse Services: MHSA Annual Update
illness and risk of becoming homeless. The documentation process for mental illness may include verifying an eligible diagnosis through access to County-held records of diagnoses or other mental health service programs. If there is no documented history in the County records, County Mental Health will arrange for assessment and diagnosis by a clinician or psychiatrist through its own staff. Potential tenants status of risk of homelessness will be verified by the County MHSA Housing Coordinator, who will obtain written verification from the staff of a transitional housing facility, other shelter designed to provide temporary living accommodations, or family no longer able to house a disabled family member. In the rare event that third-party verification cannot be found, the applicant or supportive services program staff may prepare a short statement about the person’s previous living situation for the applicant to sign. 6. The appeals process for individuals who are denied tenants in an MHSA unit MidPen Management works to prevent unnecessary denials by allowing applicants to include a “Request for Consideration” with their initial application for tenancy. The process for submitting a Request for Consideration is outlined below: Applicants who believe their application may be denied for negative credit or criminal background history due to extenuating circumstances are encouraged to complete a Request for Consideration Form. This form will ask applicants to specify why they are requesting the consideration, and to explain how they have previously corrected any previous behaviors to the above, what supportive services they are participating in, if any, financial assistance, and/or rehabilitation/social services programs they have completed and/or participate in. Should the applicant be selected for an intake interview, they will also be interviewed by the Considerations Committee regarding their Request for Consideration. This process may require applicant(s) to have separate interviews with property management and resident services. A decision will be made as to whether or not MidPen Management can/will accept the application based on the reasons stated in the request. The decision will be made based on recommendations made by a representative from the Owner/Management Company and resident services. The goal of this process is to determine if individuals that may have otherwise been denied can successfully reside and benefit from this affordable housing community. Upon completion of the Consideration Committee process, applicants will receive notification within a timely manner of its decision as to whether they can proceed with the application process. 7. The reasonable accommodations policies and protocols MidPen management is committed to making Aptos Blue readily accessible and usable by individuals with handicaps. MidPen Management will consider any request by or on behalf of a handicapped resident or applicant for: A reasonable accommodation requesting a change in its rules and/or policies; or A reasonable modification relating to alteration of the common areas or an individual unit. Any such request must be made in writing to the Director of Compliance/Section 504 Coordinator located at Mid-Peninsula Housing, 303 Vintage Park; Suite #250, Foster City, CA 94404. If it is not possible to make the request in writing, the MidPen Management staff will assist the person making the request and provide the necessary information. In most instances, MidPen Management will allow a handicapped person to have an assistance animal, which is related to, and necessary for the handicapped person to enjoy
88 Santa Cruz County Mental Health & Substance Abuse Services: MHSA Annual Update
the benefits of the housing. A particular assistance animal may be rejected if: The animal poses a direct threat to the health or safety of others that cannot be reduced or eliminated by a reasonable accommodation; the animal would cause substantial physical damage to the property of others; The presence of the animal would pose an undue financial and administrative burden to the apartment community owner; The presence of the assistance animal would fundamentally alter the nature of the services provided by the apartment community. NOTE: No fees or additional security deposit will be imposed as a condition of allowing an assistance animal. NOTE: At Aptos Blue, no cats will be allowed pursuant to a conservation easement on the property that protects the adjacent Aptos Creek habitat and wildlife. If a request for a reasonable accommodation or reasonable modification(s) is granted, the cost to perform the accommodation or modification(s) will be the responsibility of MidPen unless the request will impose an undue financial and administrative burden on the apartment community; or fundamentally alter the nature of the services provided by the apartment community. Auxiliary Aids to Ensure Effective Communication: The property will seek to effectively communicate with applicants, residents, and members of the public who are individuals with handicaps or disabilities. The use of auxiliary aides will be implemented when necessary. MidPen Management asks for 7 days notice in order to make any service, meeting, interview, appointment, or any business accessible. Requests for auxiliary aids may include visual alarms, tactile signs, visual doorbells, readers, interpreters, large print or Braille applications, leases, and other information/communications, recordings of such information, and a community room television that provides closed captioning services.
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Item D.7 Supportive Services Plan
NOTE: A tenant's participation in supportive services may not be a condition of occupancy in MHSA units.
Describe the development's approach to providing supportive services to MHSA tenants. The following information should be provided:
1. A description of the anticipated needs of the MHSA tenants; 2. The supportive service provider's initial and ongoing process for assessing the supportive service needs of the MHSA tenants; 3. A description of each service to be made available to the MHSA tenants, to include where and how the service will be delivered, the frequency of the service delivery and identification of the service provider. A description of the available services and supports should include, but not be limited to:
a) Mental health services
b) Physical health services (including prevention programs) c) Employment/vocational services d) Educational opportunities and linkages e) Substance abuse services if needed f) Budget and financial training g) Assistance in obtaining and maintaining benefits/entitlements h) Linkage to community-based services and resources 4. Indicate whether or not there will be an onsite service coordinator, and include the ratio of onsite staff to MHSA tenants. If there is no onsite service coordination, provide a description of service coordination for the development; 5. A description of how services will support wellness, recovery and resiliency. It is anticipated that the supportive services plan for the development will include services that are facilitated by peers and/or consumers. If this is not part of your service delivery approach, please provide an explanation; 6. A description of how the MHSA tenants will be engaged in supportive services and community life. Include strategies and specific methods for engaging tenants in supportive services and the frequency of contact between supportive services staff and MHSA tenants. This description should also include the identification of staff (the responsible service provider) and specific strategies for working with MHSA tenants to maintain housing stability and plans for handling crisis intervention;
7. If the Development is housing for homeless youth, provide a description of services to be provided to meet the unique needs of the population including engagement strategies and peer involvement. In addition, provide a description of how transition-aged youth MHSA tenants will be assisted in transitioning to other permanent housing once they reach 25 years of age;
8. Supportive services must be culturally and linguistically competent. Describe how services will meet this requirement including, when necessary, how services will be provided to MHSA tenants who do not speak English and how communication between the property manager and the non-English speaking MHSA tenants will be facilitated;
90 Santa Cruz County Mental Health & Substance Abuse Services: MHSA Annual Update
9. Describe the process to ensure effective communication between the service provider and the property manager regarding the status of MHSA tenants in the development and any other issues regarding the development, including but not limited to regularly scheduled meetings and the identification of a single point of contact for communication and coordination of supportive services; and, 10. If proposing to develop Shared Housing units within a Rental Housing Development, describe the plan for developing “house rules” and provide a copy of any rules that may be in place at initial rent-up; (Please label and attach as "House Rules".)
Response:
The supportive services plan is intended to support the individual in maintaining tenancy and to promote wellness, mental health, stability and resiliency. Services are individualized, strength-based, flexible, consumer-driven and voluntary. There is a broad range of services depending on the individuals needs. Description of Services: Supportive services provided to residents in MHSA-funded units will be coordinated by the Mental Health and Substance Abuse Services division of the County of Santa Cruz Health Services Agency (County Mental Health). Service coordinators will take an individualized approach to assessment of tenants’ strengths, needs and goals. Service plans will be developed in partnership with the tenant and will be consumer directed, utilizing a strengths based, and “whatever-it-takes” approach. The multidisciplinary staff will include service coordinators, peers counselors, psychiatrists, licensed social workers and occupational therapists, a vocational specialist, and licensed medication support staff. A range of services will be offered to all MHSA-eligible tenants. The range of supportive services program will include move-in support; needs/strengths assessment; assistance with food and clothing and furnishings as needed; individual treatment/service planning; assistance in accessing mainstream benefits if not already in place, such as Social Security, MediCal, a primary care physician, assistive devices, In-Home Supportive Services (IHSS) for housing keeping and assistance with home care; independent living skills development; transportation assistance; money management and financial education; health assessment, treatment and referral; addiction disorder treatment; employment services and opportunities; mobile support services as needed; leadership development; community building; and any other services as needed. Services will occur primarily on-site and occur with a frequency that is individually determined, but no less than weekly. Supportive services staff will also assist tenants in accessing County and other outside services as appropriate to meet all of a resident’s needs. Support and Assistance to Maintain Housing Stability, Wellness, Recovery and Resiliency Employing a whatever-it-takes approach allows staff to identify what is needed to support the tenant in maintaining his/her housing. Initial needs often include the establishment of a steady income and assessment of physical and mental health with treatment access. When indicated, applications for financial and health care benefits will begin as soon as possible. The full range of services described above will be offered. A strengths-based approach that encourages and supports choice, empowerment and focuses on the strengths of the individual has proven successful in mental health, stability in housing, fostering resiliency and the promotion of overall wellness. Based on the tenants’ wishes, employment opportunities and supports will be made available, including assistance with preparing for
91 Santa Cruz County Mental Health & Substance Abuse Services: MHSA Annual Update
and attending interviews, job coaching and any other items that will be important for the tenant to be successful. Educational supports will also be made available including tuition and financial assistance with books and supplies. In supporting tenancy retention, service staff will be available 24/7 to respond to needs for urgent support or other tenant issues requiring this level of support. Staff will be working with the tenant and property management staff if behaviors have been identified that might place the tenant at risk for potential eviction will proactively support both the tenant and property management. Tenant Engagement: Frequent, consistent service coordinator contact will support tenants in their transition into independent housing. Recognizing the challenges of this transition, the types and frequency of contact will be determined by where tenants are in their mental health. Examples include frequent social worker or nurse contacts to establish a supportive and trusting relationship, to providing support to individuals by accompanying them to medical and other appointments. Peer support staff will be critical links in assisting tenants to maintain housing. Service coordinators will also encourage consumers to participate in community programs such as the Wellness Center offered through the Mental Health Client Action Network (MHCAN). Finally, a strong working relationship between the service provider and property management is crucial to supporting the MHSA clients in maintaining tenancy. This relationship is described below. Service Provider(s) and Property Management Relationship: A critical element of supporting tenants in maintaining housing is the communication and relationship between service providers and property management staff. For tenants in MHSA-eligible units at Aptos Blue, County Mental Health will act as the lead service provider but many others may be available to meet needs of the tenant. A County Housing Coordinator will provide a single point of contact for communications between County Mental Health and property management staff. The roles of property owner, property manager and service provider will be clearly established in a Memorandum of Understanding signed by all parties. Regular meetings between property management and County Mental Health staff will be held, initially on a monthly basis and subsequently as needed. Release of Information forms will be presented to each client for signature in order to allow for maximum sharing of information. To address urgent housing issues, an interactive Problems/Issues form that provides space for the property manager’s description of the issue and County Mental Health staff response with strategies for resolution will be shared by email. The form is for informational purposes only; no confidential material will be shared. If tenant behaviors such as noise place an individual at risk for eviction, property management staff will communicate with the Housing Coordinator and the issue will be discussed at a service team meeting. With a clear delineation of roles and responsibilities between service providers and property management, the goal of such communications will be to support housing retention for tenants.
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Item D.8 Supportive Services Chart (Attachment C)
Submit the Supportive Services Chart (Attachment C). The Chart must list all services that will be provided to MHSA tenants, including any in-kind services essential to the success of the Supportive Services Plan.
Attachment C Supportive Services Chart
List all the services to be provided to MHSA tenants in the MHSA Rental Housing Development, including any in- kind services essential to the success of your Supportive Services Plan. Add additional lines to the Supportive Services Chart as needed. Supportive Service Target Population Service Provider(s) Service Location Indicate where the
service is to be provided List each service separately Name the target - onsite or offsite. For (e.g., case management, population(s) that will be List the name of the proposed offsite services, indicate mental health services, receiving the supportive service provider. the means by which substance abuse services, etc.) service listed. residents will access the service. All tenants of MHSA- Santa Cruz County Mental 1 Needs/Strengths On/off-site financed units Health Coordinators
Service All tenants of MHSA- Santa Cruz County Mental 2 On/off-site Integration/Coordination financed units Health Coordinators All tenants of MHSA- Mental Health Santa Cruz County Mental On-site/off-site 3 financed units, as Counseling Support Health Coordinators as needed needed Santa Cruz County Mental Housing Retention All tenants of MHSA- 4 Health Services Coordinators On-site Services financed units and peer facilitators Santa Cruz County Mental Community All tenants of MHSA- Health Service Coordinator, 5 Building/Social On-site financed units MidPen Resident Services and Integration Support peers All tenants of MHSA- Santa Cruz County Mental
financed units with Health Service Coordinator; Substance Abuse On-site / off-site 6 substance abuse County substance abuse Counseling if needed as needed disorders, including co- programs; referral to treatment occurring disorders programs as needed Santa Cruz County Mental
Medical Care All tenants of MHSA- Health Service Coordinators; On-site / off-site 7 Access/Coordination financed units community safety net clinics; as needed primary care providers Santa Cruz County Mental Health Services Coordinators;
All tenants of MHSA- Department of Rehabilitation On-site / off-site 8 Employment Support financed units Co-Op; Community as needed Connection; Volunteer Center; Grey Bears Dientes Dental Clinic; HPHP Dental Care All tenants of MHSA- 9 Health Care for the Homeless Off-site Access/Coordination financed units Oral Health Program
93 Santa Cruz County Mental Health & Substance Abuse Services: MHSA Annual Update
Transportation All tenants of MHSA- Santa Cruz County Mental 10 Off-site Assistance financed units Health Service Coordinators All tenants of MHSA- Santa Cruz County Mental 11 Benefits Advocacy Off-site financed units Health Benefits Unit Community Support Services Money All tenants of MHSA- Money Management Program 12 Management/Budgeting financed units, as Off-site though Santa Cruz Community Skills needed Counseling Center
Primary Service Santa Cruz County Health Services Agency-Mental Health and Provider: Substance Abuse Services (COUNTY MENTAL HEALTH)
(Indicate the primary service provider, i.e., entity responsible for providing services to the tenants of the MHSA Housing Program units, and for overall implementation of the Supportive Services Plan, including coordination between multiple service providers where applicable.)
94 Santa Cruz County Mental Health & Substance Abuse Services: MHSA Annual Update
Item D.9 Design Considerations for Meeting the Needs of the MHSA Tenants
Describe the following: 1 Physical space, including common areas, outdoor areas, landscaping, physical access to the property, security; 2 Supportive services space (if any), including any quiet area on site for tenants to meet service staff; 3 How the MHSA units will be designed to provide appropriate accommodations for physically disabled MHSA tenants, if appropriate.
Response: Physical space: Aptos Blue is a garden style development consisting of seven buildings, six of which will contain residences and the seventh of which contains the community space. The community space will including a full kitchen and open dining and living areas available for the enjoyment of all residents as well as leasing and services office and a computer lab. The buildings are loosely configured around a central green that opens onto the community building. The central green will be landscaped with seating and gathering areas for residents as well as a tot lot for children. There will also be an “orchard” of apple trees around the community building with additional seating and gathering space for residents. Aptos Rancho Road is street that will be used to enter the property and it is accessed off of Soquel Drive which is major bus route and a service rich corridor. There is a sidewalk all along Aptos Rancho Road, and the street slopes somewhat steeply down to the property from Soquel Drive. A full-scale grocery store, pharmacy, library and park are all within easy walking distance of the property. In addition, there are numerous restaurants, a movie theatre and other services available very close by. There are no specific plans for special security provisions at the property at this time. This is generally a very safe and quiet neighborhood. However, MidPen has implemented both gated driveways as well as security camera surveillance at many of its properties and may implement one or both of these measures here if it is deemed appropriate. Supportive Services Space: The community space will be housed in a renovated 2-story home and there will be private offices on the first and second floors that will be available for private meetings when needed. How MHSA units will be designed for the physically disabled: All ground floor units will be adaptable for persons with physical disabilities. MidPen will adapt units at its own cost as needed to accommodate residents with physical disabilities.
95 Santa Cruz County Mental Health & Substance Abuse Services: MHSA Annual Update
Item D.10 Summary and Analysis of Stakeholder Input
Submit documentation of the 30-day Local Review Process, including: 1. Dates of the 30-day public review and comment period;
2. A description of the methods used to circulate Items D.1 through D.9 for the purpose of public comment; and, 3. A summary and analysis of any comments received, and a description of any changes made as a result of public comment.
Response:
A corrected document will be posted March 12, 2013 to April 13, 2013
96 Santa Cruz County Mental Health & Substance Abuse Services: MHSA Annual Update
Item D.11 DMH Outcome Reporting Requirements (Attachment D)
This form must be completed by the County Mental Health Department, verifying the County's commitment to comply with outcome reporting requirements for the MHSA Rental Housing tenants.
97 Santa Cruz County Mental Health & Substance Abuse Services: MHSA Annual Update
Item D.12 County Mental Health Sponsorship and Services Verification Form (Attachment E)
This form must be completed by the County Mental Health Department, verifying the County's commitment to provide supportive services to this development.
98 Santa Cruz County Mental Health & Substance Abuse Services: MHSA Annual Update
Item D.13 Primary Service Provider Experience Serving Target Population
The primary service provider must demonstrate that they have experience in successfully delivering services to tenants with serious mental illness. Describe general experience, and if applicable, identify and describe all developments in which the primary service provider has provided supportive services to tenants with serious mental illness. For each development, include the following:
1. Name of the development; 2. Number of units targeted to tenants with serious mental illness; 3. Services provided; and 4. Period of time during which the primary service provider delivered services to the developments' tenants.
NOTE: If the County Mental Health Department has not designated a primary service provider at the time of the initial application submittal, the County will be considered the primary service provider. An updated submission reflecting the final identification of a service provider along with the proposed provider's experience and qualifications must be submitted for approval not less than 120 days prior to initial rent-up.
Response:
99 Santa Cruz County Mental Health & Substance Abuse Services: MHSA Annual Update
Item D.14 County Fair Housing Certification (Attachment F)
This form must be completed by the County Mental Health Department, certifying the County's compliance with local, state, and federal fair housing laws.
100 Santa Cruz County Mental Health & Substance Abuse Services: MHSA Annual Update
Item D.15 Draft Memorandum of Understanding
If available at time of application, submit a draft of the Memorandum of Understanding (MOU) between the borrower, the primary service provider(s), the property management agent, and the County Mental Health Department. The MOU should document the following:
1. The roles and responsibilities of each partner; 2. Each partner's willingness to enter into a contract to carry out those roles and responsibilities (including provision of supportive services and property management services); 3. How all reporting requirements will be met; 4. How privacy and confidentiality requirements will be met; and, 5. Procedures for ongoing communication and decision-making between the property management agent and the primary service provider to assist MHSA tenants in maintaining housing stability.
NOTE: A fully executed MOU acceptable to CalHFA and DMH must be submitted not less than 120 days prior to initial rent-up.
101 Santa Cruz County Mental Health & Substance Abuse Services: MHSA Annual Update
Item D.16 Supportive Services Budget Form and Budget Narrative (Attachment G)
Complete the Supportive Services Budget Form and Budget Narrative (Attachment G). The budget must depict both the expenses and sources of revenue for the costs associated with the delivery of supportive services to the development. Additionally provide a budget narrative that includes the staffing ratio for the Supportive Services Plan.
NOTE: Both of these items must be submitted for approval not less.
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Santa Cruz County Mental Health & Substance Abuse Services: MHSA Annual Update- Draft for Public Review
Cultural Competence and MH Outreach Events in Santa Cruz County 9-1-11- to - 10-15-12 Date Event Attendance Ethnicity Age Gender Language L C A O Child TA Adult Senior F M E S O Y 9-7-11 Watsonville High School parent meeting 55 40 10 5 20 20 20 15 30 25 15 40 Presentation to cover an overview of the Culturally specific family strengthening curriculum. 9-7-11 Branciforte Jr. High School parent 25 25 15 20 5 20 5 25 meeting. Presentation to cover an overview of the Culturally specific family-strengthening curriculum. 9-9-11 UCSC Cafeteria Staff workshop. 125 90 25 10 20 95 10 70 55 35 90 Training presentation for Spanish Speaking cafeteria staff on the importance of physical and emotional health and how these may contribute to stress and/or depression 10-3-11 Sun Street Center AOD Residential. 20 10 10 15 5 20 15 5 Presentation to cover an overview of the Culturally specific family-strengthening curriculum. 10-14-11 Migrant Parent Institute. 60 50 10 25 15 30 10 30 25 10 50 Parent workshop to create awareness, education, and assist parents how to identify if a loved one is experiencing stress, depression, and/or AOD problems 10-15-11 Harbor High School Latino Role Models. 200 145 50 5 50 100 70 30 125 75 55 145 Community wide conference to acknowledge, promote and identify positive Latino role models in our communities 10-26-11 Cesar Chavez Junior High School 38 35 3 15 10 20 5 20 15 3 35 Parent meeting presentation on the risk and realities of gangs in our schools, and communities. The loss of values and the need to reconnect to our cultural roots
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11-03-11 Bethany Bible College MFT graduate 15 5 10 5 10 10 5 15 students. Student presentation for graduate students to highlight a career in the MH field, the challenges of clinical practice in a multicultural environment, and the need to develop cultural competence 11-09-11 Mintie White School Parent Meeting. 33 30 3 20 25 5 23 10 3 30 Parent meeting presentation on the risk and realities of gangs in our schools, and communities. The loss of values and the need to reconnect to our cultural roots 11-16-11 Cabrillo College Students. 35 20 10 5 25 10 20 15 20 15 Student and staff presentation addressing the individual challenges and obstacles associated with substance abuse, incarceration and how some individuals are able to overcome such obstacles. 11-18-11 Health Clinic Fresalud 20 20 10 15 5 15 5 20 Workshop for migrant field workers to create awareness, education, and assist parents how to identify if a loved one is experiencing stress, depression, and/or AOD problems
11-19-11 Mintie White School Parent Meeting. 33 30 3 20 25 5 23 10 3 30 Parent presentation workshop to create awareness about the importance of understanding our children's physical, emotional, psychological development, and what we can expect and how we may support them. 12-14-11 UCSC Cafeteria Staff workshop. 130 90 25 15 25 95 10 80 50 50 80 Training presentation for Spanish Speaking cafeteria staff on the importance of physical and emotional health and how these may contribute to stress and/or depression
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1-20-12 Mintie White School Parent Meeting. 23 20 3 10 15 5 15 5 3 20 Parent workshop to address the importance of physical and emotional health, the human development process and how parents and caregivers may support their loved ones at home and school 1-31-12 Cabrillo College students. 35 25 8 2 30 5 20 15 15 20 Gang culture presentation to talk about how gangs affect our community, create fear, insecurity, trauma, violence, and affect student's emotional health. 2-21-12 Neighborhood Services City of Wats. 35 35 15 5 20 10 25 10 35 Presentation to cover an overview of the Culturally specific family-strengthening curriculum. 5-15-12 Pajaro Valley Prevention and Student 30 20 15 10 20 20 10 20 10 Assistance Program. Cultural Competence presentation for non profit agency staff who work with Latino youth and their families. Discussed effective and culturally appropriate practices and considerations in working with Latino families. 5-21-12 RISE Male Jail Program. 12 5 7 12 12 12 Presentation with male inmates to discuss substance abuse challenges and the recovery process, emotional health, and the importance of seeking help and supports. 6-6-12 Cara Y Corazon Curriculum Training. 40 30 10 40 25 15 25 15 Facilitator training on the implementation of the culturally specific curriculum at various schools and community sites in the county 9-11-12 Gault School Parent meeting. 23 20 3 10 18 5 18 5 3 20 Presentation to cover an overview of the Culturally specific family-strengthening curriculum
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9-13-12 Bethany Bible College MFT graduate 12 4 8 12 8 4 12 students. Student presentation for graduate students to highlight a career in the MH field, the challenges of clinical practice in a multicultural environment, and the need to develop cultural competence
9-14-12 RISE Male Jail Program. 12 5 7 12 12 8 4 Presentation with male inmates to discuss substance abuse challenges and the recovery process, emotional health, and the importance of seeking help and supports. 9-21-12 RISE Male Jail Program. 12 5 7 12 12 8 4 Presentation with male inmates to discuss substance abuse challenges and the recovery process, emotional health, and the importance of seeking help and supports. 10-9-12 Binational Health Week Event. 38 38 20 5 25 8 30 8 38 Parent workshop to address the importance of physical and emotional health, the human development process and how parents and caregivers may support their loved ones at home and school
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W.E.T. Training Academy Log 2011 – 2012
Training Event Description of How long Attendance by # of Date (s) of Name of presenter Training and often Function Attendees Training and Total Supervision/Consultation Topics include the following: Monthly. 2 hour 7/15/11 Total= 6 7/15/11 Jerry Solomon, PhD trainings 0 -Administration 8/19/11 3 -Direct Services 9/16/11 3 -Contracted Svcs. 10/14/11 0 -Support Staff 11/18/11 0 -Other 12/16/11
8/19/11 Total= 9 0 -Administration 6 -Direct Services 3 -Contracted Svcs. 0 -Support Staff 0 -Other
9/16/11 Total= 8 0 -Administration 5 -Direct Services 3 -Contracted Svcs. 0 -Support Staff 0 -Other
10/14/11 Total= 9 0 -Administration 6 -Direct Services 3 -Contracted Svcs. 0 -Support Staff 0 -Other
11/18/11 Total= 6 0 -Administration 4 -Direct Services 2 -Contracted Svcs. 0 -Support Staff 0 -Other
12/16/11 Total= 8
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0 -Administration 5 -Direct Services 3 -Contracted Svcs. 0 -Support Staff 0 -Other Group Supervision for Topics to include the following: Monthly. 2 hour 7/18/11 Total= 4 7/18/11 Jerry Solomon, PhD Group Facilitators trainings 0 -Administration 8/15/11 2 -Direct Services 9/19/11 1 -Contracted Svcs. 10/17/11 1 -Support Staff 11/21/11 0 -Other 12/19/11
8/15/11 Total= 6 0 -Administration 5 -Direct Services 1 -Contracted Svcs. 0 -Support Staff 0 -Other
9/19/11 Total= 6 0 -Administration 4 -Direct Services 2 -Contracted Svcs. 0 -Support Staff 0 -Other
10/17/11 Total= 6 0 -Administration 4 -Direct Services 2 -Contracted Svcs. 0 -Support Staff 0 -Other
11/21/11 Total= 5 0 -Administration 3 -Direct Services 2 -Contracted Svcs. 0 -Support Staff 0 -Other
12/19/11 Total= 7 0 -Administration 6 -Direct Services 1 -Contracted Svcs. 0 -Support Staff
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0 -Other
Xinachtli Presentation Topics include the following: Once. 2 hour 1 -Administration Total= 50 7/28/11 Jaime Molina, MSW, “Xinachtli” Germinating Seed training 23 -Direct Services Jeanette G. Cooper & Curriculum is a comprehensive 9 -Contracted Svcs. Joaquin Barreto bilingual/bicultural youth 12 -Support Staff development process designed 5 -Other to provide adolescent female youth the guidance for a healthy development into adulthood. The philosophy is based on indigenous Nahuatl traditional principles of the individual’s interconnectedness to the family, the community, and the nation. This curriculum provides a dialectic process of Reflección, Concientización, Creación, and Acción while supporting & building on the strengths of the individual. This presentation will provide: . Historical Overview . Purpose . Projected Outcomes . PEI Approach Peer Panel Presentation Topics include the following: Once. 1.5 hour 3 -Administration Total= 34 8/24/11 Adrian Bernard, Stephan A panel of peers has been training 14 -Direct Services DuBose, Sara Leonard & created to tell their life stories 4 -Contracted Svcs. Nina Stratton and speak to the benefits and 11 -Support Staff deficits in the current mental 2 -Other health system. Having challenges are not unique to anyone and we hope to express that people living with mental health challenges are not much different from anyone else, especially those who provide care. Having lived through upheavals of mind and walking, even thriving through them, we have a keen insight into ourselves and have a perspective, which can open
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new possibilities in health care as we understand it. Four peer speakers will tell our story. We will be ready for any questions after that. We hope to create awareness of our strengths and weaknesses, our compassion as well as our frustrations, and call out to health care providers to do the same for the peer community. A bridge between consumer and provider must be made if we are to progress and transform the current mental health system. Male Sexual Abuse: Topics include the following: Once. 6 hour 2 -Administration Total= 67 9/15/11 Stephen L. Braveman, Helping Clients Emerge This workshop proposes to training 20 -Direct Services LMFT, DST, Nickloas J. from Boyhood Shadows educate clinicians about 25 -Contracted Svcs. MacDaniel, MFTI, Anne incidence, co-morbidity & 1 -Support Staff Karcher, Ph.D., Jorge common clinical presentations 19 -Other Ramirez, Ph.D., Richard B. of men who have experienced Pecarovich & Gregory childhood sexual abuse. A strong Thomas emphasis is placed on treatment strategies that work with male survivors. The incidence & long-term affects of childhood sexual abuse will be contrasted with that of women, for whom clinicians may be more familiar. The main objectives of this workshop are to educate clinicians to more accurately identify and treat men who have been sexually abused as children through film, lecture style presentation & experiential exercises. Culturally Focused Topics include the following: Once. 6 hour 2 -Administration Total= 34 9/23/11 Isabel S. Perez-Yañez, Treatment: Serving Our Cultural traditions of Latinos, training 7 -Direct Services MPH, CHES, CATC Diverse Community Native American session, 14 -Contracted Svcs. Patrick Meyer, LCSW, GLBTQ 1 -Support Staff Cabrillo College Human 10 -Other Services Program The Changing Face of Topics include the following: Once. 2 hour 0 -Administration Total= 46 9/27/11 Elizabeth Gonzalez, Psy D Mexican Immigration: Experiences of Oaxaqueño youth training 21 -Direct Services Student at UCSC
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Experiences of living in California. Elizabeth 5 -Contracted Svcs. Psychology Department Indigenous Oaxaqueño Gonzalez, Ph.D. Student at 9 -Support Staff Youth UCSC’s Psychology Department, 11 -Other discuses findings from her research conducted in Santa Cruz and Watsonville in which Oaxaqueño/a immigrant adolescents and college students describe the discrimination they experience from their Mexican peers. Ms. Gonzalez also discussed how this form of discrimination could have an impact on student’s identity development and academic performance. Finally, she talked about the Guelaguetza in Santa Cruz as an example of ways that Indigenous Oaxaqueño Community has been able to resist this discrimination & foster pride in their indigenous heritage. How to Reduce Burnout Topics include the following: Once. 4 hour 0 -Administration Total= 19 10/04/11 Andrew Purchin, LCSW for Mental Health Andrew Purchin, LCSW, is training 8 -Direct Services Providers generously donating his time to 7 -Contracted Svcs. provide this workshop. 00 -Support Staff Participants will have the 4 -Other opportunity to explore counter transference and other work related issues through the making of art. Goals for this training are: to process challenging interactions – with clients & colleagues to clarify counter – transference issues, and to have fun expressing! Presence of Gangs in Topics include the following: Once. 2 hour 2 -Administration Total= 15 10/19/11 SGT. Roy Morales, & Our Community De- De-briefing & follow-up to training 11 -Direct Services Deputy Anthony Gonzalez Briefing 6/23/11 training that focused on 00 -Contracted Svcs. from the Santa Cruz next steps, strategies, and/or 2 -Support Staff County Sheriff’s Office what MH clinicians can do to 0 -Other address this reality.
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Effective Topics include the following: Once. 2 hour 0 -Administration Total= 48 10/25/11 Jaime Molina, MSW Communication from a The concept of communication, training 19 -Direct Services Cultural Perspective as it relates to ensuring a 17 -Contracted Svcs. cultural presence in how we 9 -Support Staff communicate & how the listener 3 -Other (s) may interpret our message (s). The following was also addressed: Congruency in communication Rules of Dignity in communication 100%/100% in mutual conversations Styles of communication Triangle Speakers Panel Topics include the following: Once. 2 hour 2 -Administration Total= 44 11/29/11 Triangle Speakers Panel Presentation Panel presentation to dispel training 19 -Direct Services Presentation myths & stereotypes of the 5 -Contracted Svcs. lesbian, gay, bisexual, 7 -Support Staff transgender, an queer 11 -Other community. Education through personal experience. Family Therapy Amidst Topics include the following: Twice. 4 hour 3 -Administration Total= 20 11/30/11 & Tony Hoffman, Ph.D. Difficulty: An Ecological 2-Part training seminar (4-hours training 17 -Direct Services 12/09/11 Perspective each session). 00 -Contracted Svcs. Attendees to learn: 00 -Support Staff The applicability of Family 0 -Other Therapy Review of family therapy tactic Focus on solutions & family problem-solving Seeking Safety Topics include the following: Once. 5.5 hour 0 -Administration Total= 32 12/02/11 Gabriella Grant, Director Training for professionals on training 4 -Direct Services of the California Center of Seeking Safety: A Treatment for 11 -Contracted Svcs. Excellence for Trauma PTSD/Substance Use Disorder. 00 -Support Staff Informed Care 17 -Other Transition Age Youth Topics include the following: Once. 2 hour 2 -Administration Total= 27 12/06/11 Transition Age Youth (TAY) Mental Health-sponsored training 11 -Direct Services (TAY) Panel Presentation Transition Age Youth (TAY) 10 -Contracted Svcs. panel will tell their stories. In 3 -Support Staff their stories, poetry, and rap 1 -Other songs, the youth emphasize the steps they have taken in their
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personal path of recovery from major mental illness. It is hoped that by articulating their stories, they will provide healing for themselves as well as a positive recovery model for their peers. Helping Young Children Topics include the following: Once. 6 hour 4 -Administration Total= 115 2/03/12 Barbara Kalmanson, Ph.D. Who Have Experienced training 33 -Direct Services Trauma Dr. Kalmanson will discuss the 30 -Contracted Svcs. effects of trauma and traumatic 00 -Support Staff stress on the brain in children 48 -Other
0-5. The conference will offer specific interventions to address those effects. Black Men Speak! Topics include the following: Once. 2 hour 3 -Administration Total= 49 2/27/12 Black Men Speak! Black Men Speak! Speaker’s training 19 -Direct Services bureau will inform and 10 -Contracted Svcs. enlighten the mental health 4 -Support Staff community about issues 13 -Other concerning African American males with mental health and substance abuse challenges. Family Therapy Amidst Topics include the following: Once. 2 hour 0 -Administration Total= 1 3/20/12 Tony Hoffman, Ph.D. Difficulty: An Ecological Boosters 2-hours each session training 1 -Direct Services Perspective Attendees to learn: 00 -Contracted Svcs. The applicability of Family 00 -Support Staff Therapy 0 -Other Review of family therapy tactic Focus on solutions & family problem-solving Women in Recovery Topics include the following: Once. 2 hour 3 -Administration Total= 42 3/22/12 Panel from Salvation Panel presentation from women training 12 -Direct Services Army “Corner House” in the Salvation Army “Corner 5 -Contracted Svcs. House” recovery program. A 15 -Support Staff program description & 7 -Other admission guidelines will be followed by participant testimony and personal journeys of recovery.
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NAMI Provider Topics include the following: Weekly. 3 hour 3/26/12 Total= 20 3/26/12 NAMI Panel Education Program The NAMI Provider Education training 0 -Administration 4/02/12 Program is a series of classes, 00 -Direct Services 4/09/12 taught by a Collaborative Team One 5-week 8 -Contracted Svcs. 4/16/12 Consisting of ~ Consumers, session of 3- 00 -Support Staff 4/23/12 Family Members, and Mental hour classes per 12 -Other Health Professionals. Classes session. meet 3 hours a week for 5 4/02/12 Total= 22 weeks. 0 -Administration Topics will include the 00 -Direct Services following: 8 -Contracted Svcs. • Bio-psycho-social model 00 -Support Staff of collaborative treatment 14 -Other • The lived experience of mental illness – 4/09/12 Total= 19 adjustments and coping 0 -Administration strategies 00 -Direct Services • The stages of adaptation to 7 -Contracted Svcs. psych meds and treatment 00 -Support Staff The positive outcomes of the 12 -Other team collaboration of consumers, family members and 4/16/12 Total= 20 a professional working together. 0 -Administration 00 -Direct Services 8 -Contracted Svcs. 00 -Support Staff 12 -Other
Total= 20 4/23/12 0 -Administration 00 -Direct Services 7 -Contracted Svcs. 00 -Support Staff 13 -Other Homeless Topics include the following: Once. 2 hour 4 -Administration Total= 72 4/05/12 Social Security Admin. w/Schizophrenia Social Security Administration training 14 -Direct Services Staff & Santa Cruz County Presumptive Disability (SSA) will establish a joint pilot 8 -Contracted Svcs. Staff (HSPD Pilot Program) that will allow for a 9 -Support Staff Presumptive Disability category 37 -Other for schizophrenia. The pilot between SSA and community partners in the San Francisco and Santa Cruz counties will permit all parties to assist this
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vulnerable population with the disability processing time from months to days for our homeless population who are suffering from schizophrenia or schizoaffective disorder.
Designing & Running Topics include the following: Once. 6 hour 2 -Administration Total= 24 4/13/12 Jerry Solomon, Ph.D. Therapeutic Groups: An An opportunity for clinicians to training 10 -Direct Services Introduction to Effective see their clients in a social 11 -Contracted Svcs. Approaches Working milieu & to encourage the 00 -Support Staff with the Mentally Ill development of their prosocial 1 -Other /relationship skills. Groups are often an ideal venue in which to disseminate information and to consolidate learning among adults and kids. Most clinicians enjoy facilitating groups once they become comfortable with the basic skills required to run an effective group.
Some common clinical challenges encountered while facilitating groups for the seriously mentally ill, their families and friends. Dynamics such as group formation, goal creation and attainment, maintaining the therapeutic frame & counter-transference issues will be explored. Special attention will be placed upon establishing & nourishing drop-in & psychoeducational/manualized groups. Methamphetamine: Topics include the following: Once. 3 hour 6 -Administration Total= 105 4/18/12 Jan Tice, Santa Cruz Understanding the Topics to be covered: training 32 -Direct Services County Sr. Departmental Addiction and Early Scope of the Problem in Santa 48 -Contracted Svcs. Admin. Analyst Recovery Process Cruz County Understanding 4 -Support Staff Meth Addiction as Brain 15 -Other Trauma Specifics about the effects
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of methamphetamine Methamphetamine induced brain trauma Treatment Considerations Program Structure Program Content – Evidence Based Practices & time for all of you questions El Andalon Film Topics include the following: Once. 2 hour 0 -Administration Total= 43 4/19/12 Film Panel Members Documentary follows Don training 17 -Direct Services Sergio Castro. For almost 50 5 -Contracted Svcs. years, he has worked the land 13 -Support Staff with the indigenous people of 8 -Other Chiapas, built schools & treated burn victims at no cost. Work, Works! Topics include the following: Once. 3 hour 1 -Administration Total= 22 4/24/12 Connie Tanner, M.S. Employment as a Best Practice & Innovative training 6 -Direct Services Powerful Tool for Employment Support The 11 -Contracted Svcs. Mental Health Recovery benefits of working, Pre- 00 -Support Staff Employment, Supported 4 -Other Employment, Competitive Employment, The Americans with Disabilities Act, Disclosure, Reasonable Accommodations, Maintaining Employment, Benefits 101, The role of providers, family members and peers, Santa Cruz County Resources, & more. Mindfulness Based Stress Topics include the following: Once. 2 hour 5/01/12 Total= 9 5/01/12 Richard Nanas, LCSW Reduction (MBSR) This 4-week training seminar 4-week session 2 -Administration 5/15/12 (2-hour session per week) will 7 -Direct Services 5/29/12 provide a variety of techniques 00 -Contracted Svcs. 6/05/12 to manage stress at work and in 00 -Support Staff everyday lives. Attendees will: 0 -Other • Learn how to utilize Total= 8 mindfulness as a 5/15/12 therapeutic tool and as an 1 -Administration effective approach to 7 -Direct Services everyday life issues. 00 -Contracted Svcs. • Learn how to use MBSR in 00 -Support Staff psychotherapy. 0 -Other Total= 6 • Utilize experiential
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exercises, group 5/29/12 discussions, and didactic 0 -Administration teaching. 6 -Direct Services 00 -Contracted Svcs. 00 -Support Staff 0 -Other Total= 8 6/05/12 1 -Administration 7 -Direct Services 00 -Contracted Svcs. 00 -Support Staff 0 -Other Differential Diagnosis of Topics include the following: Once. 2 hour 4 -Administration Total= 44 5/04/12 Jerry Solomon, Ph.D. Substance Abusing This workshop will explore training 27 -Direct Services Clients differential diagnostic 12 -Contracted Svcs. considerations when ruling out 00 -Support Staff substance abuse as a potential 1 -Other diagnosis. This workshop will be taught at the intermediate level. All participants are expected to have easy familiarity with the DSM IV and basic diagnostic principles. Law & Ethics Training Topics include the following: Once. 6 hour 0 -Administration Total= 00 5/17/12 Linda Garrett, JD This will be a six-hour training 00 -Direct Services presentation covering a broad 00 -Contracted Svcs. range of topics, with questions 00 -Support Staff and discussion during & 0 -Other following each topic. Topics to include new laws, treatment consents, confidentiality, access to records, mandated reporting, & ethical issues. Discuss issues regarding changes in the law or regulation that may impact the disclosure of confidential information, how HIPAA Privacy affects our ability to share information among health care providers & others, consents for treatment etc. Designing & Running Topics include the following: Twice. 1.5 hour 5/22/12 Total= 5 5/22/12 Jerry Solomon, Ph.D. Therapeutic Groups: An The group modality offers training 0 -Administration 6/12/12
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Introduction to Effective clinicians a unique opportunity 4 -Direct Services Approaches Working to see their clients in a social 1 -Contracted Svcs. with the Mentally Ill milieu and to encourage the 00 -Support Staff development of their prosocial 0 -Other /relationship skills. Groups are often an ideal venue in which to 6/12/12 Total= 9 disseminate information and to 2 -Administration consolidate learning among 3 -Direct Services adults and kids. Most clinicians 3 -Contracted Svcs. enjoy facilitating groups once 1 -Support Staff they become comfortable with 0 -Other the basic skills required to run an effective group. “Conocimiento” Topics include the following: Once. 2 hour 0 -Administration Total= 25 5/30/12 Jaime Molina, MSW (Knowing Ourselves) This workshop will focus en training 3 -Direct Services recognizing how some of us are 8 -Contracted Svcs. walking through everyday life 00 -Support Staff unaware, lacking positive 14 -Other meaning to our lives, or a clear sense of direction. It's essential to reflect, remember and reconnect with our true journey. By way of this interactive exercise (conocimiento), participants will have the opportunity to reconnect with themselves and re-discover their self-confidence to connect with others.
A Strategic Approach to Topics include the following: Once. 6 hour 0 -Administration Total= 00 6/21/12 Chad Morris, Ph.D. Tobacco Recovery in Identify and address the special training 5 -Direct Services Mental Health, Drug & tobacco cessation needs among 9 -Contracted Svcs. Elisa Laird-Metke, Alcohol Programs persons with mental illness 2 -Support Staff Technical Assistance Legal and/or substance abuse 38 -Other Center disorders. • Make system changes that Vanessa Marvin, The help address tobacco use Center for Policy and promote cessation Organizing within the mental health and substance abuse Kirsten Hansen, The treatment fields. Center for Tobacco • Advance policies within Cessation/California behavioral health facilities Smokers’ Helpline
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and programs to address tobacco use and create smoke-free environments. • Build successful working partnerships between local / state resources and behavioral health programs to achieve sustainable outcomes. Solution Focused Brief Topics include the following: Twice. 3 hour 6/21/12 Total= 00 6/21/12 Fran Wickner, Ph.D. Therapy (SFBT) training 2 -Administration 6/29/12 Workshop will consist of lecture, 18 -Direct Services presenter's case examples, role- 12 -Contracted Svcs. plays, and handouts. Participants 00 -Support Staff will be encouraged to bring their 8 -Other own cases to the training so the group can work out a SFBT 6/29/12 Total= 00 treatment plan. Questions on 2 -Administration specific cases will also be used as 15 -Direct Services examples of how to use SFBT 11 -Contracted Svcs. with clients. 00 -Support Staff 7 -Other
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W.E.T. Training Academy Log 2012 – 2013(to date)
Training Event Description of How long Attendance by # of Date (s) of Name of presenter Training and often Function Attendees Training and Total “Conocimiento” Topics include the following: Once. 2 hour 1 -Administration Total= 31 7/31/12 Jaime Molina, MSW (Knowing Ourselves) Recognizing how some of us training 11 -Direct Services are walking through everyday 8 -Contracted Svcs. life unaware, lacking positive 9 -Support Staff meaning to our lives, or a clear 2 -Other sense of direction. It's essential to reflect, remember and reconnect with our true journey. Through this interactive exercise (conocimiento), particpants will have the opportunity to reconnect witht themselves and re-discover their self- confidence to connect with others. Triangle Speakers Topics include the following: Once. 2 hour 4 -Administration Total= 41 8/30/12 Triangle Speakers Panel Our panel presentations dispel training 24 -Direct Services myths and stereotypes of the 4 -Contracted Svcs. lesbian, gay, bisexual, 8 -Support Staff transgender, a queer 1 -Other community. We educate through personal experience. Designing & Running Topics include the following: 4x. 2 hour 1 -Administration Total= 11 9/11/12 Jerry Solomon, Ph.D. Therapeutic Groups – Explores some of the common training 6 -Direct Services Boosters clinical challenges 3 -Contracted Svcs. encountered while facilitating 1 -Support Staff groups for the seriously 00 -Other mentally ill, their families and friends. Dynamics such as 0 -Administration Total= 8 11/06/12 group formation, goal creation 5 -Direct Services and attainment, maintaining 3 -Contracted Svcs. the therapeutic frame and 0 -Support Staff counter-transference issues 00 -Other will be explored. Special attention will be placed upon Total= 00 1/22/13 establishing and nourishing 0 -Administration 00 -Direct Services
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drop-in and psycho 00 -Contracted Svcs. educational/manualized 0 -Support Staff groups. 00 -Other
0 -Administration Total= 00 6/25/13 00 -Direct Services 00 -Contracted Svcs. 0 -Support Staff 00 -Other
Hearing Voices Topics include the following: Once. 2 hour 0 -Administration Total= 35 9/19/12 Connie Tanner, M.S. A unique training designed to training 13 -Direct Services help mental health 12 -Contracted Svcs. professionals better understand 3 -Support Staff their participants. Designed to 7 -Other educate and enlighten service providers about the complexities of following through with daily activities while hearing voices. Provides useful tools and resources for supporting individuals who experience these and other symptoms. Trauma Informed Care Topics include the following: Twice. 3 hour 0 -Administration Total= 32 9/21/12 Gabriella Grant, Director training 1 -Direct Services of the California Center of 1. To increase the general 9 -Contracted Svcs. Excellence for Trauma knowledge of trauma- 0 -Support Staff Informed Care informed concepts, research 22 -Other & resources. 2. To apply trauma- 0 -Administration Total= 29 9/28/12 informed approaches to 1 -Direct Services addressing challenging 10 -Contracted Svcs. student behavior: truancy, 0 -Support Staff substance abuse, gang- 18 -Other involvement, and self-harm. 3. To learn specific trauma- informed approaches when working w/students generally & in particular with unsafe coping strategies, such as substance abuse, dropping out, running away, fighting,
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or isolating. 4. To learn how to make school policies trauma- informed in order to reduce reliance on suspension & expulsion to address unsafe
behaviors. Updates to the Topics include the following: Once. 2 hour 0 -Administration Total= 21 9/24/12 Barbara Bentley, Ph.D. Diagnosis & Treatment Learn the updates to training 17 -Direct Services of ADHD the AAP guidance 2 -Contracted Svcs. on the diagnosis and 0 -Support Staff 2 -Other treatment of ADHD Review the diagnostic criterion and co-morbidities associated with ADHD Discuss risk factors and possible causes identified by neurological studies Review evidenced based treatments Address frequently asked questions Trauma Informed Care Topics include the following: Once. 4 hour 0 -Administration Total= 34 9/26/12 Gabriella Grant, Director 1. To increase the general training 7 -Direct Services of the California Center of knowledge of trauma- 20 -Contracted Svcs. Excellence for Trauma informed concepts, research 0 -Support Staff Informed Care & resources. 7 -Other 2. To apply trauma- informed approaches to addressing challenging student behavior: truancy, substance abuse, gang- involvement, and self-harm. 3. Specific trauma-informed approaches when working w/students generally & in particular with unsafe coping strategies, such as substance abuse, dropping
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out, running away, fighting, or isolating. 4. To learn how to make Seven Challenges trauma- informed & how to use safety as a key component in strengths-based counseling.
Adult CBT & Topics include the following: Once. 6 hour 0 -Administration Total= 27 10/03/12 Jerry Solomon, Ph.D. Depression This workshop will explore the training 7 -Direct Services use of cognitive behavioral 16 -Contracted Svcs. therapy (CBT) in the treatment 00 -Support Staff of adult depression. CBT is an 4 -Other empirically based approach that has documented success treating depression as well as other mental disorders. Specific strategies helpful in schema change will be discussed. Videos of skilled practitioners will illustrate these techniques. Attention will be paid to the structure & format of the sessions, managing client resistance and maintaining a collaborative frame.
Developing Positive Topics include the following: Once. 2 hour 0 -Administration Total= 14 10/12/12 Jaime Molina, MSW & Rights of Passage Traditional rites of passage training 12 -Direct Services Joaquin Barreto, MH have served as symbolic 00 -Contracted Svcs. Client Specialist transitions or events that honor 00 -Support Staff beginnings & endings, as well 2 -Other as maturity, & responsibilities. Today, rites of passage are being forgotten, or redefined in negative ways, such as celebrating the first time one drinks, gets drunk, or gets high; getting jumped into a gang; getting on probation;
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becoming sexually active at a young age (or getting pregnant). As adults who work with youth and families (either as parents, guardians, or in a professional capacity), it is our role to guide individuals in positive directions to become responsible adults. We need to reestablish and develop ways to honor and support positive rites of passage for their true and honorable meaning. Trauma Informed Topics include the following: Once. 6 hour 2 -Administration Total= 72 10/22/12 Beth Filson, CPS, MFA Care: Why Does 1. How Trauma- training 10 -Direct Services Trauma Matter? Informed Care shifts 43 -Contracted Svcs. the question from 00 -Support Staff “What’s wrong with 19 -Other you?” to “What happened to you? Implications for services & supports. The Adverse Childhood Experience Study? 2. It’s got to work for everybody! The impact of trauma and violence on staff & people receiving services. 3. The critical role of peers in the community - Distinct roles and relationships in peer support and clinical support. 4. Role of respite programs in breaking the cycle of crisis and stabilization. 5. Next steps in
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building healing partnership between peer support and clinical support: A dialogue for Action. Adult CBT & Topics include the following: Once. 2 hour 0 -Administration Total= 3 10/29/12 Jerry Solomon, Ph.D. Depression This workshop will explore the training 1 -Direct Services Booster #1 use of cognitive behavioral 2 -Contracted Svcs. (For October 3rd therapy (CBT) in the treatment 00 -Support Staff training) of adult depression. CBT is an 0 -Other empirically based approach that has documented success treating depression as well as other mental disorders. Specific strategies helpful in schema change will be discussed. Videos of skilled practitioners will illustrate these techniques. Attention will be paid to the structure & format of the sessions, managing client resistance and maintaining a collaborative frame. Fetal Alcohol Spectrum Topics include the following: Once. 2 hour 1 -Administration Total= 31 10/29/12 Barbara Bentley, Ph.D. Disorders: Evidenced Learning Objectives training 21 -Direct Services Based Diagnosis & Review the impact 6 -Contracted Svcs. Treatments of alcohol exposure 00 -Support Staff on the developing 3 -Other brain Learn the University of Washington Center of Excellence in FASD’s 4-Digit Diagnostic Code Discuss the range of needs of children exposed to alcohol & all systems of care impacted Review evidenced based interventions
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studies through the CDC funded treatment sites Address frequently asked questions Adult CBT & Topics include the following: Once. 6 hour 1 -Administration Total= 36 11/02/12 Jerry Solomon, Ph.D. Depression This workshop will explore the training 14 -Direct Services use of cognitive behavioral 11 -Contracted Svcs. therapy (CBT) in the treatment 0 -Support Staff of adult depression. CBT is an 10 -Other empirically based approach that has documented success treating depression as well as other mental disorders. Specific strategies helpful in schema change will be discussed. Videos of skilled practitioners will illustrate these techniques. Attention will be paid to the structure & format of the sessions, managing client resistance and maintaining a collaborative frame. Emotional CPR Topics include the following: Once. 2 hour 2 -Administration Total= 27 11/09/12 Daniel B. Fisher, MD, Goal: To introduce the training 4 -Direct Services Ph.D. community to a new approach 8 -Contracted Svcs. to teach the public to 2 -Support Staff communicate more effectively 11 -Other on an emotional level During crises and everyday life Learning Objectives: Audience will demonstrate that they understand: a. Origin and foundations of eCPR b. Each of components of eCPR, C,P,and R c. The importance of Self care, which is called iCPR d. The six principles of dialogue e. What & how the principles
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appear in the action of a role play Pervasive Development Topics include the following: Once. 2 hour 1 -Administration Total= 39 11/26/12 Barbara Bentley, Ph.D. Disorders: An Pervasive Developmental training 25 -Direct Services Overview of the Disorders: An overview of the 6 -Contracted Svcs. Diagnosis & diagnosis and treatment 00 -Support Staff Treatments Objectives: 7 -Other 1. Systematically review the 3 major domains of impairment required to meet criterion for a Pervasive Developmental Disorder 2. Discuss the “gold standard” process for diagnosis 3. Learn how to assess the behavioral symptoms of autism in the context of a child’s development 4. Review the systems of care and eligibility process for referrals to the regional center, school district, private therapy services 5. Review evidenced based treatment models including Applied Behavior Analysis and Pivotal Response Intervention 6. Learn specific strategies from the Floor time Model (Greenspan) and how to implement some of these techniques into treatment for children with and without a pervasive developmental disorder Intersections on Topics include the following: Once. 3 hour 4 -Administration Total= 45 11/27/12 Isabel Perez-Yañez, MPH, Alcoholism & Cultural This training will identify and training 17 -Direct Services CHES, CATC Competence explore ways providers can 11 -Contracted Svcs. become more culturally 9 -Support Staff responsive when working with 4 -Other Latinos and their families. Practical applications of best- practice approaches to service delivery will be emphasized.
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An overview of the multidimensional needs of Latinos seeking treatment, which may include topics related to: race, ethnicity, assimilation, acculturation, trauma – including experiences with oppression and racism, spirituality, immigration, sexual orientation, age, and linguistics. Broader environmental and societal factors that affect employment, migration, policies and laws will also be examined. Adult CBT & Topics include the following: Once. 2 hour 1 -Administration Total= 9 12/04/12 Jerry Solomon, Ph.D. Depression This workshop will explore the training 4 -Direct Services Booster #1 use of cognitive behavioral 3 -Contracted Svcs. (For November 2nd therapy (CBT) in the treatment 00 -Support Staff training) of adult depression. CBT is an 1 -Other empirically based approach that has documented success treating depression as well as other mental disorders. Specific strategies helpful in schema change will be discussed. Videos of skilled practitioners will illustrate these techniques. Attention will be paid to the structure & format of the sessions, managing client resistance and maintaining a collaborative frame.
The Challenge: Topics include the following: Once. 6 hour 3 -Administration Total= 31 12/03/12 Isabel Perez-Yañez, MPH, Incorporating · Gain a working definition of training 14 -Direct Services CHES, CATC Culturally & culture 9 -Contracted Svcs. & Tina Tong Yee, Ph.D. Linguistically · Assess cultural impacts in 2 -Support Staff Appropriate Services everyday interaction and in our 3 -Other work
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· Become familiar with the 14 CLAS standards & their function as an organizational framework for moving organizations towards becoming Culturally & linguistically competent. · Identify seven cultural competency indicators used in assessing our health and behavioral care delivery organization Seeking Safety Topics include the following: Once. 6 hour 0 -Administration Total= 24 12/18/12 Gabriella Grant, Director Plan how to effectively training 5 -Direct Services of the California Center of support people in various ways 14 -Contracted Svcs. Excellence for Trauma to heal from trauma. 00 -Support Staff Informed Care 5 -Other Adult CBT & Topics include the following: Once. 2 hour 0 -Administration Total= 1 1/08/13 Jerry Solomon, Ph.D. Depression This workshop will explore the training 0 -Direct Services Booster #2 use of cognitive behavioral 1 -Contracted Svcs. (For October 3rd therapy (CBT) in the treatment 00 -Support Staff training) of adult depression. CBT is an 0 -Other empirically based approach that has documented success treating depression as well as other mental disorders. Specific strategies helpful in schema change will be discussed. Videos of skilled practitioners will illustrate these techniques. Attention will be paid to the structure & format of the sessions, managing client resistance and maintaining a collaborative frame. The Treatment of Topics include the following: Once. 6 hour N/A Total= 120 1/12/13 Richard Schwartz, Ph.D. Trauma & the Internal Identify the basic theory & training Family Systems Model principles of Internal Family Systems therapy. Know how to access their clients’ Self – a core of Compassion & other
Names in stories have been changed to protect confidentiality. 129 Santa Cruz County Mental Health & Substance Abuse Services: MHSA Annual Update- Draft for Public Review
leadership qualities. Utilize the model in treating trauma. Clinical Supervision Topics include the following: Twice. 7.5 hour 0 -Administration Total= 13 1/15/13 Melanie Stern, LCSW Training This lively & interactive training 6 -Direct Services workshop on Clinical 4 -Contracted Svcs. Supervision meets the 00 -Support Staff BBS requirements for 3 -Other Clinical Supervision training for LMFT, LCSW and Psychologists. The training will provide participants with 0 -Administration Total= 21 1/29/13 techniques, ideas, and 9 -Direct Services opportunities to share 9 -Contracted Svcs. their knowledge, 00 -Support Staff challenges and rewards. 3 -Other Through the use of vignettes, problem solving, lecture and role- plays, participants will explore this very important relationship of supervisor and supervisee. Bring your wisdom and your humor.
Names in stories have been changed to protect confidentiality. 130