dallas county behavioral health leadership team thursday ... · * indicates items requiring...

* Indicates items requiring approval from Dallas County Behavioral Health Leadership Team

Dallas County Behavioral Health Leadership Team

Thursday, January 8, 2015

Henry Wade Juvenile Justice Center

2600 Lone Star Drive, Dallas, TX

Room 203-A at 9:30 -11:30 a.m.

I. Welcome and Call to Order

II. Review/ Approval of Minutes from last meeting*

III. Sunset Commission

IV. BHLT Activity Tracking

Legal Research

V. Dallas County Behavioral Health Housing Workgroup

VI. Reports from and Charges to BHLT Committees

CSP Governance Committee

Clinical Operations Team

FACT

BHSC

Legislative Committee

VII. NorthSTAR Update

NTBHA Update

ValueOptions NorthSTAR Update

State Advisory Committees

VIII. The Cottages at Hickory Crossing Update

IX. Funding Opportunities

In-Jail Competency Update

X. Upcoming Events and Notifications

XI. Public Comments

XII. Adjournment

Behavioral Health Leadership Team Minutes from December 11, 2014

Page 1 of 4

Dallas County Behavioral Health Leadership Team

Meeting Notes

Thursday, December 11, 2014

Welcome and Call to Order

The meeting was called to order by Commissioner John Wiley Price at 9:35 AM.

Review/Approval of Minutes

The minutes from the BHLT meeting held on October 9, 2014 were included in the packet.

BHLT committee members voted to approve the minutes as printed.

Introductions and Absent BHLT Members:

Nakish Greer was introduced as the new Dallas County Criminal Justice Administrative

Assistant.

Sunset Commission:

Commissioner John Wiley Price and Commissioner Dr. Theresa Daniel opened the meeting for

discussions on the Sunset Commission report and how BHLT should proceed on this issue.

Commissioners Price and Daniel acknowledged the recommendations from the Sunset Advisory

Committee; however, encouraged BHLT to submit a collective NorthSTAR position. Alex

Smith reminded BHLT that all responses to the Sunset Commission recommendations are due by

March 2015. Mr. Smith, Sharon Phillips, and Janie Metzinger encouraged the committee to

prepare an alternative plan for addressing indigent care and Medicaid patients. Tom Collins

suggested that the committee should decide if it wants to fight Sunset Committee

recommendations or if it wants to offer an alternative plan.

According to Ron Stretcher, Tom Luce, member of the Sunset Commission expressed to state

officials that the NorthSTAR community has many concerns about the state being unwilling to

negotiate in good faith. Therefore, Mr. Luce suggested that the state appoint high-level state

officials to work directly with NorthSTAR leaders. Mr. Stretcher suggested that our next steps

include: determine the state’s “bottom-line” on requirements for a NorthSTAR’s alternative plan,

begin discussion on Medicaid vs. indigent, identify the state’s lead contact person for

negotiation.

Commissioner Price stated that the BHLT committee needed to identify a group of individuals,

and a lead negotiator, to represent itself in this matter. The committee voted to limit the

representative group to 5 members. Commissioner Price, Commissioner Daniel and Ron

Stretcher stressed that the selected representative group would bring all of their

recommendations for action to BHLT for consideration.


Page 2 of 4

The following persons were nominated to represent BHLT in NorthSTAR negotiations: Kris

Gaw, Matt Roberts, Dr. John Burress, Sandy Potter, Ron Stretcher, Alex Smith, Carol Luckey,

Tom Collins, Sherry Cusumano, Doug Denton, Janie Metzinger (Ms. Metzinger declined the

nomination), Dr. Adam Brenner (Dr. Brenner declined the nomination), Judge Kristen Wade

(Judge Wade declined the nomination).

Official BHLT members (or their approved designee) voted by ballot and selected the following

individuals:

Ron Stretcher, Dallas County Director of Criminal Justice (voted lead negotiator)

Alex Smith, NTBHA CEO (representative for all NorthSTAR counties)

Sandy Potter, ValueOptions CEO

Carol Lucky, Child and Family Guidance Center CEO

Matt Roberts, Mental Health Association CEO

Commissioners Price and Daniel directed the committee’s attention to BHLT resolution 12-2014,

which designates the selected individuals to negotiate on its behalf with the Health and Human

Services Commission and related entities in modifying the NorthSTAR delivery system. The

BHLT voted to approve this resolution.

Presentations:

Yes Waiver: Sandy Potter, ValueOption CEO, provided an overview of the Youth

Empowerment Services (YES) Waiver. In situations where families are not able to cover costs

of their child’s mental health treatment, the YES Waiver provides those youth with home and

community-based services. The cost for the program must be Medicaid neutral and allows

youth, who are not otherwise Medicaid eligible, to received YES services. The goals of the

program included: provide flexible community-based service to children with SED and their

families, develop individualized plans of care through a family-centered process, reduce out-of-

home placements, improve clinical and functional outcomes of children. Ms. Potter reported that

DSHS will contract directly with YES Waiver providers and that those agencies must provide the

entire array of services (directly of subcontract). In order to participate, children must be 3-18

years of age, reside in the NorthSTAR region, and be eligible for Medicaid (parent income is not

a factor). ValueOptions will register each child on the inquiry list phone line, as well as screen

and refer individuals to assessment sites.

RAISE: Dr. John Burress, CEO, Metrocare Services and Elisa Rees, Director, Altshuler Center

for Education & Research, provided an overview of the Recovery After Initial Schizophrenic

Episode (RAISE) program. Dr. Burress stated that Metrocare Services continues to negotiate

with the state on this program and services are expected to begin January 1, 2015. This program

aims to serve persons with newly onset psychosis to improve patient outcomes. Dr. Burress

stated that Metrocare Services is conducting a research study on this program using control and

experimental groups. This program targets persons between the ages of 15- 30 years old who

have had symptoms of psychosis for less than a year. Ms. Rees stated that potential clients need

to have an IQ over 85 and be indigent. Ms. Rees also reviewed the RAISE eligibility checklist

and provided advertisement flyers.

Crisis Services Project Update: Charlene Randolph, Policy Analyst, Dallas County Criminal

Justice Department, presented an update on the 1115 Wavier- Crisis Services Project (CSP).

Mrs. Randolph provided an overview of CSP program goals, identified populations served,


Page 3 of 4

lessons learned, and future initiatives. In addition, Mrs. Randolph provided an overview on

project achievements reported in the End of Demonstration Year (DY) 3 report. Mrs. Randolph

reported that CSP achieved all of its Category 1 Process Metrics and provided required baseline

data for Category 3 Outcomes. Mrs. Randolph provided a recap of CSP revenues and

expenditures during DY3. Mrs. Randolph also highlighted examples of how CSP has helped

transform care in the RHP 9.

BHLT Activity Tracking: Ron Stretcher stated that Cloutman & Cloutman legal firm continues

to conduct research on legal remedies to address the inequity of NorthSTAR funding. Mr.

Stretcher directed the committee’s attention to BHLT resolution 13-2014, which allows CSP to

fund transitional housing at Salvation Army. The BHLT committee voted to adopt the resolution.

Commissioners Price and Daniel directed the committee’s attention to BHLT resolution 11-2014,

which allows a cost increase for the CSP Value Options Care Manager. The BHLT committee

voted to adopt the resolution. Sandy Potter abstained from this vote.

Behavioral Health Housing Work Group (BHHWG) Update: Commissioner Daniel reported

that the BHHWG continues to identify housing inventory.

Reports from and Charges to BHLT Committees

Crisis Services Project (CSP) Governance Committee: Charlene Randolph provided this

update during the presentation.

Clinical Operations Team (ACOT): Sherry Cusumano reported that ACOT members are

working to develop an algorithm and training for boarding homes that have the most frequent

APOWWS to higher-levels of care. ACOT is also exploring other initiatives to reduce

recidivism.

FACT: Dr. Jane LeVieux reported that FACT continues to explore gaps in care and the

committee is focused on children with autism. Dr. LeVieux reported that FACT has invited

community providers to speak on this issue.

BHSC: Judge Kristen Wade reported that the committee has been focused on the budgeting of

530 funds and is exploring ways to pay for additional transitional housing.

Legislative Advisory Committee: The committee continues to be focused on the Sunset

Advisory Committee’s report on the Health and Human Services Commission (HHSC).

NTBHA Update: Alex Smith stated the NTBHA board has not met this month.

State Advisory Committees: Commissioner Dr. Daniel reported the Advisory Committee is

surveying all Texas counties to establish baseline data on statewide mental health services.

The Cottages at Hickory Crossing Update: Ron Stretcher reported that construction on the

Cottages continues and we should start seeing building structures in the near future.

In-Jail Competency Update: Ron Stretcher stated that the contractor continues to work with the

state on understanding Jail Commission standards.


Page 4 of 4

Upcoming Events and Notifications: Sherry Cusumano reported that Commissioner Daniel and

Assistant Fire Chief Norman Seals recently received awards from NAMI Dallas. Sr. Corporal

Herb Cotner announced an upcoming training on Post-Traumatic Stress Disorder for law

enforcement and military personnel. Registration information on this event can be found on the

NAMI Dallas website. Dr. Rick Davis announced that MHA is having a reception to honor

licensed boarding homes on December 17th

.

Adjournment: A motion was made, seconded, and approved to adjourn the meeting at 11:35

AM.

BHLT Workgroup Recommendations for Action

1

Current BHLT Action Items

Suggestions, Recommendations & Motions

Person Initiating

Workgroup/ Person Tasked

Plan for Accomplishment

Current Status Follow-Up Date Completed

9/11/2014 Tom Collins expressed

concern with having to

visit non-medical

facilities (such as

boarding homes) before

referring Green Oaks

clients. Mr. Collins

proposed having a

dedicated entity

responsible for this task.

Tom Collins Behavioral

Health Housing

Work Group

(BHHWG)

The BHHWG will

facilitate a

community

discussion on how

to address this

issue.

This is being

addressed by

BHHWG.

10/9/2014 BHLT members asked for

a description of boarding

home standards.

Tom Collins Janie Metzinger Janie Metzinger

will provide BHLT

with a document

that overviews

boarding home

standards.

In progress This is being

addressed by

BHHWG.


2

Current Completed BHLT Action Items Date Suggestions,

Recommendations & Motions

Person Initiating

Workgroup/ Person Tasked

Plan for Accomplishment

Current Status Follow-Up Date Completed

12/11/2014 BHLT will designate a

team to negotiate with

HHSC to modify

NORTHSTAR

Ron Stretcher BHLT

committee

BHLT members

will vote by

ballot to select

the negotiating

team.

BHLT voted to

designate the

following

committee

members to

negotiate on its

behalf: Ron

Stretcher (Lead),

Alex Smith,

Carol Luckey,

Matt Roberts,

Sandy Potter

12/11/2014


3

History of BHLT Action-Items and Accomplishments

On-Going & Accomplished Action Items Date Completed Current Status

Coordinate efforts of BHLT sub-committees, community agencies, and DSRIP projects to ensure collaboration and education

On-going Charlene Randolph continues to monitor these efforts

Discuss crisis services, stabilizations, alternatives to care, and dynamics that lead to better outcomes in BHLT sub-committees

On-Going ACOT routinely discusses this issue at monthly meetings

Educate DSRIP projects regarding their impact on ValueOptions NorthSTAR On-Going CSP discusses at RHP 9 Learning Collaborative events

Monitor DSRIP projects operations, focus, outcomes to help identify areas that need additional supports and shifting

On-Going CSP receives information at RHP 9 Learning Collaborative events

Discuss Dallas PD concerns regarding clients being released from the hospital without a discharge plan

On-Going ACOT routinely discusses this issue at monthly meetings

Receive information on the Regional Legislative Team Committee’s identified priority issues

On-Going Legislative Committee will routinely provide this information

Facilitate collaboration between NAMI and Dallas County Juvenile Department to implement stigma training (Ending the Silence) into The Academy of Academic Excellence and schools

On-Going FACT routinely discusses and is helping to coordinate this activity.

Explore the availability of funding for supported services (i.e. case management) persons receiving DHA housing vouchers.

On-Going BHHWG routinely discusses this issue.

Explore sustainability of 1115 Waiver Projects On-Going CSP and BHLT will continue to explore this issue

Invited Mr. Thompson join Councilwoman Davis’ Workgroup Complete Jay Dunn addressed this issue

Wrote a response to House Bill (HB) 3793. HB 3793 (83rd Legislative session) that directs a plan for appropriate and timely mental health services and resources for forensic and civil/voluntary populations

12/12/13

Documented who's responsible for each CSP milestone 1/17/14

Shared creative options for utilizing DSHS housing funds to ValueOptions NorthSTAR Complete VO published guidelines based on suggestions

Established Behavioral Health Housing Workgroup 2/7/14 The workgroup continues to meet monthly.

Approved funding Care Coordinator position at ValueOptions to assist the CSP 2/24/14

Applied for the SAMHSA Sequential Intercept Mapping workshop 2/13/14 BHLT was not a chosen participant

Provided BHLT will more information regarding Foster Care Redesign 3/25/2014


4

On-Going & Accomplished Action Items Date Completed Current Status

Provided description for Specialty Court Case Coordinator Position 4/1/2014

Provided BHLT members with information on the Qualifications of Homelessness and accessing ValueOptions Housing funds

5/8/2014

Addressed patient complaints on Parkland police 5/16/2014

Received update on Children’s and Parkland’s 1115 Waiver projects 6/12/2014

Followed-up on DSHS Housing for HCBS-AMH 7/10/2014 Dallas County suspended its request

Distributed MHA Flyer on Teen MH Conversation 7/10/2014

Received update on Green Oaks’ and Baylor’s1115 Waiver behavioral health projects 8/14/2014

Received requested information on Dallas Marketing Group 7/18/2014

Reviewed Janie Metzinger’s response letter to Sunset Commission’s review on the counting of mentally ill individuals in Texas

8/11/2014

Distributed program overview and access information for Baylor’s 1115 Waiver program to BHLT members

8/25/2014

Adopted resolutions supporting Abilene Christian University research proposal and UTSW Homeless Services Project

9/11/2014

Received update on Timberlawn’s 1115 Waiver behavioral health projects 9/11/2014

Approved legal research on Texas mental health funding laws 10/9/2014

Received literature on nine models for integrating behavioral health and primary health care

10/10/2014

Supported response letter to the Sunset Advisory report and voted to approve resolution declaring its support of NorthSTAR

10/15/2014

Dallas County Behavioral Health Housing Work Group

Dallas County Administration, 411 Elm Street, 1st Floor, Dallas Texas 75202

December 8, 2014 Minutes

Mission Statement: The Dallas County BH Housing Work Group, with diverse representation, will formulate

recommendations on the creation of housing and housing related support services designed to safely divert members of

special populations in crisis away from frequent utilization of expensive and sometimes unnecessary inpatient stays,

emergency department visits and incarceration.

Success will be measured in placement of consumers in housing and the decreased utilization of higher levels of care

(hospitals and emergency care visits) and reduced incarceration in the Dallas County Jail. The Dallas County BH Work

Group is committed to a data driven decision-making process with a focus on data supported outcomes.

ATTENDEES: Theresa Daniel, Commissioner; Blake Fetterman, Salvation Army; Ian Mattingly, LumaCorp; Thomas Lewis, DCHHS; Sandy Potter, Value Options; Dr. Paul Scott, Bridge; Zachary Thompson, DCHHS; Cindy Patrick, Meadows; Teresa Scherrer, NTBHA; Sandy Rollins, TX Tenants; Lori Davidson, City of Dallas; Kevin Franklin, MDHA; Eryca Peters, MDHA; Charlene Randolph, Dallas County; Christina Gonzales, Dallas County; Claudia Vargas, Dallas County; Germaine White, Dallas County. CALL TO ORDER: Commissioner Daniel opened the meeting with introductions and a review of the November 10, 2014 minutes. The minutes were approved with no changes. PROJECT DEVELOPMENT REPORT: Brooke Etie, Chair The subgroup continues to evaluate the feasibility of the Northwood property as a potential housing project. The Dallas County Tax office has offered to provide additional information on the property. A tour of the property is planned for January 2015. COORDINATED ACCESS DIRECTORY REPORT: Liam Mulvaney, Chair A directory of housing resources is located on the MHDA website, per Kevin Franklin. Zachary Thompson confirmed the MDHA link has been placed on the DCHHS website to assist consumers searching for housing.

MDHA will pilot the coordinated assessment tool in mid-January, 2015. The new tool will pull in the VI SPDAT (Vulnerability Index and the Service Prioritization Decision Assistance Tool) used by the VA system. Additional information about the coordinated access system pilot is attached. Comments and suggestions were made regarding the scoring of clients, monitoring agencies’ adherence to protocols, and expanding to non-clinical care providers. Kevin Franklin will provide a demonstration of the new tool at the next BH/HWG meeting in January.

RESOURCES REPORT: Janie Metzinger & Jay Dunn, Co-Chairs The subgroup continues to work towards a resource template that can be used for planning purposes. Charles Gulley is analyzing the Housing Information Count tool to potentially serve as a baseline template for this project. BEST PRACTICES REPORT: Commissioner Theresa Daniel, Chair Boarding Homes – Commissioner Daniel met with the group that addresses disabilities issues statewide to discuss the issue of handicap accessibility at boarding homes. Currently, the organization is focused on the abuse of handicap parking and is not open to expanding their focus at this time

Legislative Discussion – Ian Mattingly, LumaCorp, attended the meeting as a guest to share information regarding a bill for which he is seeking co-sponsors. The bill would ease someone’s prior criminal history as a risk for rental housing. The goal is to provide options for landlords who are interested in helping this population but are concerned with potential litigation if an incident was to occur at their property. In addition, the hope is to reduce the fear and risk to liability insurers who rate properties based on the crime rate of an area. If the area is deemed ‘high crime’, the rates are increased impacting the finances of the landlords. Mr. Mattingly also commented that his firm, LumaCorp, is one that offers a limited number of vouchers. Landlords are concerned with having a large portion of their revenues from one source of funding. Working with the Dallas Housing Authority or on any third party contract increases business expenses; there are delays in getting vouchers for people on the waiting list. Additional comments regarding options and challenges for landlords were discussed, such as the use of a master lease as a way to provide protection to landlords. FUNDING SOURCES AD HOC REPORT – Liam Mulvaney, Ron Stretcher, Co-Chairs Charlene Randolph announced that the Cooperation for Supportive Housing (CSH) is having a webinar on Wednesday, December 10, 2014 to announce the availability of grants for supportive housing. The grants are available to governments and non-profits with a government partner requiring technical assistance and/or a feasibility study for supportive housing initiatives. Germaine White will forward the details of the webinar to the BH/HWG members. INDUSTRY UPDATES:

Homeless Information – Days in Jail Report – Christina Gonzales provided an overview of the most recent homeless information report for November. The latest report shows the number of prisoners that are homeless is lower, while the number of offenses and severity of the offenses is higher. Several comments were made in terms of possible reasons for this change and whether it is a trend. The information will be further analyzed to determine the reason. A copy of the report is attached.

The Salvation Army Tour – Blake Fetterman hosted the Best Practices Subgroup meeting and provided a tour of their programs, including the Health Care for Homeless Veterans program. Salvation Army is renovating their men’s unit to create a more open and welcoming environment for clients versus the current jail-like atmosphere. The renovated men’s unit is schedule to open in January 2015.

NorthSTAR SPN Case Rate Report – Sandy Potter provided an update on the latest report capturing data through August 2014. A copy of the report is attached.

NorthSTAR Monthly Housing Outcomes Data – Sandy Potter shared the initial report created to measure the outcomes of the housing assistance dollars administered by Value Options. According to Ms. Potter, the initial results are encouraging, indicating that the average monthly costs per member decreased along with other key indicators. A copy of the report is attached.

Commissioner Daniel adjourned the meeting with an open invitation for members to join one of the four subgroups. If there are people who should be invited to these meetings because of their experience and expertise, please notify Commissioner Daniel or Liam Mulvaney.

Next Meeting: Thursday, January 22, 2015 at 10:00 am

Dallas County Administration Building, 411 Elm Street, 1st Floor, Allen Clemson Courtroom If you need parking, please contact Germaine White

Behavioral Health Housing Work Group Best Practices Sub-Group

FINAL - Minutes – November 17, 2014

Attendees: Theresa Daniel (Dallas County), Daniel Byrd (Value Options), Cindy Patrick (Meadows), Dr.

Paul Scott (The Bridge), Blake Fetterman (Salvation Army), and Germaine White (Dallas County).

Commissioner Daniel opened the meeting with comments on the subgroups’ effort to determine the ideal housing model(s) for those individuals with behavioral health issues that are high utilizers of the jails and the emergency rooms. Housing Exemplars Update: Cindy Patrick, Blake Fetterman and Liam Mulvaney contacted the San Francisco Direct Access to Housing program as identified by the Meadows Mental Health Policy Institute. The program is facilitated by the San Francisco health department for housing services. It is part of their mission; their guiding principal is: “Homelessness is a Health Issue.”

$162 million spent on homelessness.

Clients have to obtain benefits to keep housing.

Created stabilization units as a stop gap between homelessness and housing

Single room occupancy (SRO)

Started with 20 beds, now have 300 located at different SRO hotels

Case management is provided, but services are not as intensive

Caseload ratio is 1:20 clients

No clinical staff. They want to work on improving this capability

Up to six (6) months stay; it takes up to six months to get connected to other services, obtain proper IDs and benefits

Permanent Supportive Housing with master level staff consisting of nurses, case managers and in-home support & care. They are able to bill Medicaid and Medicare for services. Results are incredible. They hold on to your unit for 90 days – if jailed, in hospital, etc.

1700 units, 50% are true chronically homeless

164 exits - less than 10% leave / more than 90% stay.

Of the 9.6% that leave: o 1.3% were evicted o 1% moved to different housing o 32% passed away

Master Lease Units - A local operating subsidy in San Francisco that uses general funds that pays for services. The Agency holds the risk but the developers are willing to participate. San Francisco also requires that any developer having subsidized homes, 20% must be set aside for the homeless.

The eligibility criteria is different from HUD; they no longer use the once in for 30 days definition.

Ms. Fetterman commented on the challenges staff and clients can face when trying to get documented proof of a person’s chronic homeless status. Without that documentation, the door closes on many housing opportunities.

Additional Topics The Bridge: Dr. Paul Scott shared that The Bridge has a pilot model of up to 60 units of scattered site. The ratio is 1 to 20 and can support people in 2015 with the new Healthy Collaborative Initiative. The Texas Vets Initiative: Cindy Patrick shared that the State is releasing a RFP, The Texas Vets Initiative. The REP deadline to respond is January 15, 2015. The total available amount is $1 million, to be matched with private funds. Money Follow the Person: Germaine White had a brief conversation with Laura Gold, Project Director at DADS and Penny Larkin, Senior Policy Analyst & Director, Money Follow the Person at DADS. The Money Follow the Person program was identified by Marjorie Petty, HHS, as a model to study for the population we have targeted. The Dallas Housing Authority is a local participant. Ms. Larkin would like to invite her partners (TDHCA and DSHS) to participate in the next conference call. In addition, the Best Practices committee suggested that Brooke Etie and Ann Lott join as additional participants. Ms. White will schedule the conference call in December. Boarding Homes: Commissioner Daniel received a referral to an individual who is involved in an organization focused on people with disabilities and the Americans with Disabilities Act (ADA). This organization may be able to assist with the ADA compliance concerns at boarding homes. The current criteria for a licensed boarding home do not require compliance with ADA. Daniel Byrd shared that the MHA Oversight Committee may be able to amend the type of information collected to include ADA accessibility. Mr. Byrd will be attending the next MHA Oversight Committee meeting and will inquire about including this information. Mr. Byrd also commented on the financial viability of a boarding home to serve the population we have targeted. Value Options does not have contracts with boarding homes. Tour of the Salvation Army’s Health Care for Homeless Veterans: Blake Fetterman provided an impressive tour of the facility for the various homeless and shelter programs operated by the Salvation Army. Many THANK YOUs to Blake, her staff and the residents.

DALLAS COUNTY BEHAVIORAL HEALTH HOUSING WORK GROUP Coordinated Access Directory Committee

Minutes – November 6, 2014

ATTENDEES: Liam Mulvaney, LifeNet; Mamie Lewis, City of Dallas; Teresa Scherrer, NTBHA; Kevin Franklin, MDHA, Eryca Peters, MDHA; Zachary Thompson, DCHHS; Thomas Lewis, DCHHS; and Germaine White, Comm. District 1 The meeting was called to order at 10:07am by Liam Mulvaney. Liam Mulvaney informed the group that Commissioner Theresa Daniel had generously offered the Dallas County website as a host for a Directory of Resources for the homeless. In response to this offer, a meeting took place on August 11, 2014 between representatives of the Dallas County IT Department, Mr. Mulvaney, Kevin Franklin, and Mike Faenza. After the last BH/HWG meeting, it was determined that the MDHA Directory site will be the place to which visitors to the County’s website are directed. Dallas County will place a ‘pointer’ on the Health & Human Services website. Germaine White will follow-up with the Dallas County IT department to determine when and where the pointer will be placed and to ensure that Zachary Thompson is involved in that decision. The committee discussed the pros and cons of placing additional directories on MDHA’s website. Germaine White will share the additional directories collected by the committee with Kevin Franklin to determine the best way to increase the comprehensiveness of information located on the MDHA website. Coordinated Access Directory – HUD requires the local Continuum of Care (MDHA) to move towards a coordinated access system that has a comprehensive collection of available resources and is able to assess the needs of those needing housing. The committee’s function is to support MDHA’s efforts in the creation of a Coordinated Access System. Kevin Franklin shared information regarding MDHA’s progress towards the creation of the system. They are in the pilot stage of introducing the assessment tool with key stakeholders. MDHA is available to provide a demonstration on how the product will work upon request. The early demonstrations have been positive. Initially, the coordinated access system will be used by the Continuum of Care members. Beginning in January, all new contracts with HUD must confirm they are using coordinated access. The committee briefly discussed the Parkland’s PCCI project and the feasibility of aligning their efforts to develop a coordinated access system. Liam Mulvaney, Kevin Franklin and others will pursue conversations with Parkland. In addition, the committee briefly discussed the Network of Cares program utilized by Tarrant Care and potential next steps. The meeting was adjourned at 2:55p.m.

Project Development Committee Meeting Minutes

Thursday, October, 10, 2014 – 10:00 A.M.

Overview:

The Project Development Committee (PDC) meeting took place on Thursday, October, 10, 2014,

at 10:00 am, at the Dallas Housing Authority building. The members present were Brooke Etie,

Ron Stretcher, Liam Mulvaney, Jim Mattingly, and J C Thomas, Jr.

Discussion was had on the direction of the group, in the past, with the conclusion reached that

going forward the focus of the PDC will be on the creation of Housing.

Next Steps:

1. Visit the Northwood Property for our next meeting. (Brooke)

2. Follow up with the County Tax Office for 4-5 Bedrooms on Foreclosure list for possible

use for Boarding Homes. (Ron)

3. Go to Dallas Housing Authority (DHA) website to request the list of Project-Based RFPs

that were submitted to DHA. (J C)

4. Get Private Developers on board – Ron to ask Larry James, Germaine has a referral.

5. Ask Commissioner Daniel to invite Corporation for Supported Housing (CSH) back to

the table.

DALLAS COUNTY CRISIS SERVICES PROJECTS

BHLT GOVERNANCE COMMITTEE MEETING

DECEMBER 2, 2014

ATTENDEES: Ron Stretcher, Charlene Randolph, Angie Byrd, Ashley Ray, Jessica Martinez, Dave Hogan,

Janice Jefferies, Mani Alvai, Scott Black, Alyssa Aldrich, Kay McKennery, Ken Medlock, Preston Looper,

Stephanie Urban

The meeting was called to order by Charlene Randolph, Dallas County Criminal Justice Policy Analyst, at 3:30 PM.

COMMITTEE MEMBERSHIP AND CHARTER:

The CSP Governance Committee members made introductions. CSP committee members reviewed the minutes

and voted to approve them without modifications.

1115 WAIVER AND CRISIS SERVICES PROJECT UPDATE

Charlene Randolph provided a status update on CSP activities over the last month. Mrs. Randolph stated CSP

continues to provide crisis stabilization services and connect forensic clients committed to a prescriber within 7-

or 30- days after hospital discharge. Mrs. Randolph reported that CSP continues to monitor Forensic Diversion

Unit (FDU) services provided by Metrocare Services, collaborate with Dallas County Public Defender’s Office

on the transportation pilot project, and partner with Timberlawn on assessments and discharge planning. Mrs.

Randolph also stated that CSP has continued conversations with ValueOptions regarding after-care engagement

packages and Salvation Army regarding transitional housing needs.

Mrs. Randolph provided an update on milestone achievements and Demonstration Year (DY) 3 reporting. Mrs.

Randolph stated that CSP was able to submit the DY3 report by its deadline. Mrs. Randolph reported that

HHSC will provide feedback on the DY3 report by December 8, 2014, and matched funds of approximately

$4.6 million are expected January 30, 2015. Mrs. Randolph stated that CSP will continue discussions with

HHSC regarding calculating recidivism and reporting outcome achievement in DY4 and DY5. Ron Stretcher

reviewed a handout that provided an overview of DY3 milestone goals, reported achievements, IGT needed,

and expected matched funds. Charlene Randolph also reviewed a handout that detailed CSP revenue and

expenses. Mrs. Randolph stated that the CSP service goal increased in DY4 and that, during this time period,

CSP is obligated to serve 350 unique clients monthly. Mrs. Randolph reported that the CSP outcome goals in

DY4 are to reduce jail readmissions by 5%, and connect at least 32% of forensic clients to a prescriber within 7-

days.

Angie Byrd, Transicare Clinical Director, presented information on a current CSP client.

- 45-year-old Caucasian male referred by Dallas County MHPD

- Client was charged with assault with bodily injury to child, elderly, and/ or disabled person and was

found competent to stand trial

- Client has a diagnosis of Huntington’s disease; however, he was reluctant to accept his diagnosis

- Client did not meet NorthSTAR criteria

- Client was able to establish a positive relationship with his caseworker and began to acknowledge his

diagnosis

- Transicare secured an appointment for neurological testing

- Although nursing home placement is likely, the client is now able to live independently in a boarding

home

- Transicare staff assisted the client with completing Medicaid paperwork

- Client works to maintain his independence and takes every opportunity to engage in physical activities

- Transicare staff is actively looking for a grief group and a psychiatrist to treat his depression over family

estrangement and deterioration of his disease

- The client’s criminal charges were dropped

Scott Black reviewed the Transicare service report. During October 2014, Transicare received 18 referrals,

served 58 unduplicated clients, and ended the month with 34 active clients. Mr. Black reported that

Transicare’s DY4 monthly goal is to provide wrap-around services to 60 unduplicated clients. After data

analysis, Mr. Black noted that approximately 34% of Transicare clients are successful in services; however,

28% rapidly disengage. Transicare will continue to explore this issue and identify methods for improving client

engagement. Initially, Transicare reported that three clients connected to a prescriber within 7 days of hospital

discharge from Terrell; however, they later discovered that one of those clients was only seen by clinic staff

instead of the prescribing doctor. Therefore, only two of the forensic clients connected to a prescriber within 7

days after hospital discharge and two connected to a prescriber within 30 days. CSP is currently working with

Value Options to create an after-care engagement package to specifically address this issue.

Preston Looper provided an overview of clients served by Adapt. Mr. Looper reported that Adapt provided

services to 748 unique clients during the month of October, of which 687 clients were served at Dallas County

jail and 61 were served at Timberlawn. Mr. Looper discussed plans to analyze NorthSTAR utilization for CSP

clients from jail and Timberlawn. Mr. Looper reported that Adapt continues to work on increasing CSP face-

to-face assessments and improving collaboration with Parkland Jail Health.

RHP9 LEARNING COLLABORATIVE

Charlene Randolph reported that RHP 9 will hold the Behavioral Health Cohort meeting on December 11, 2014

and the Shared Learning Event on January 25, 2015.

VALUEOPTIONS NORTHSTAR CASE COORDINATOR

In order to learn more about the CSP project, Janice Jefferies stated that over the last month she has met with

Dallas County and CSP program staff. Ms. Jefferies reported that she has also attended Transicare case

staffings and has plans to meet more often with Adapt over the next month. Ms. Jefferies stated that she will

work on developing a monthly status report that will highlight her activities.

TRANSPORTATION PILOT

During October, Mr. Black reported that Transicare served 7 clients in the transportation pilot program. Mr.

Black stated that 80% of clients are now successfully connecting to their clinic and court appointment, which is

up from the previous connection rate of 60%.

METROCARE (FDU/LIAISONS)

Jessica Martinez announced that she will be leaving FDU. Stephanie Urban was introduced as the interim FDU

manager and Kay McKennery was introduced as the Director supervising this program. During the month of

October, Jessica Martinez reported that FDU began the month with 40 clients and ended the month with 39

clients. Ms. Martinez stated that the FDU team is clinically reviewing clients who have been in the program for

a long time, and educating partners on the FDU program redesign and ACT requirements. The FDU team is

also working to develop a monthly status report.

HOUSING

Ron Stretcher reported that CSP is currently working with Salvation Army to supplement funding for

transitional housing for persons on probation and expand transitional housing services to CSP clients.

ACCESS TO SPNS

CSP staff met with ValueOptions to discuss findings from SPN clinic visits and plans to establish an after-care

engagement package. Ron Stretcher reported that ValueOptions seemed very open to our ideas and CSP will

work to finalize the plan to improve client engagement at clinics.

SIP

Dave Hogan stated that he has not heard anything from the City of Dallas attorneys on hiring the SIP

caseworkers. Ron Stretcher reported that CSP was ready to move on this initiative and Mr. Hogan agreed to

provide a status update at the next meeting.

TRAUMA-INFORMED CARE

Charlene Randolph was contacted by SAMSHA regarding BHLT’s application and she will work with the

contractor to schedule a phone conference. Mrs. Randolph will provide a status update at the next CSP

Governance meeting.

COTTAGES UPDATE

Mr. Stretcher stated construction is underway and he continues to be satisfied with the progress being made on

the Cottages.

NEXT STEPS/ACTION ITEMS:

Next Meeting: January 6, 2015

MEETING ADJOURNED AT 5:00 PM

Crisis Services Project

Status Report and Next Steps

January 6, 2015

Implementation Activities

Transicare - Transportation pilot project with Public Defenders Office - Forensic Competency at Terrell State Hospital

Adapt

- Timberlawn

Forensic Diversion Unit

Value Options NorthSTAR Care Coordination

After-care engagement

Transitional housing

IGT Status

DY3: o DY3 Report submitted- reported all milestones and baseline complete o HHSC Approval/ Feedback: December 8, 2014 o Submitted IGT January 2, 2015- $1,916,577 o Match funds expected January 30, 2015- approximately $4,639,494

Metrics and Milestones

Tracking Milestone achievement in Performance Logic

Four Category 1 Milestones Provisionally approved- final decision Feb/ March

Presented CSP Summary Report at BHLT

Category 3: Submitting CJ Readmission Baseline figures (new: 31% over 12 months)

DY4: o Began October 1, 2014 o Monthly Service Goal: 350 o CJ Readmissions: Reduce by 5% o 7-day Follow-up: 32%; 30-day Follow-up: 57%

Status Update

Harris Logic (JIMI/ Stella)

Central Dallas Community Development Corporation (Cottages at Hickory Crossing)

CDC Case workers (SIP)

Anchor Information

Thursday, January 29, 2015: RHP 9 Shared Experience and Learning Event # 3

ACS 1115 CSP Monthly Production ReportPast Year Average

Oct-14 Nov-14 AVERAGE TOTAL

Total Service Episodes: 449 750 479 102 1,229

Total Unique Consumers: 328 748 444 99 1,192

Percentage Change to DY3 227.93% 135.30%

Oct-14 Nov-14 AVERAGE TOTALService Episodes: 689 435 94 1,124

Unique Consumers:By N* ID 650 376 513 1,026

By Client ID 37 24 31 61

TOTAL Unique Consumers: 687 400 91 1,087TOTAL Unique Consumers as %: 99.71% 91.95%

Unique F2F: By N* ID 78 64 71 142


TOTAL Unique F2F: 100 81 15 181TOTAL Unique F2F as a %: 93% 76%

F2F Percentage: 15.67% 24.60% 19.13% 19.13%

Encounters by Type: Triage 689 435 562 1,124

Care Coordination 1060 1029 1045 2,089

F2F Encounter 108 107 108 215

TOTAL Encounters: 1857 1571 286 3,428

Female: Black 131 87 109 218

White 58 36 47 94

Hispanic 33 9 21 42

Other 2 2 2

Unknown 3

TOTAL Female: 224 135 30 356

Male: Black 301 214 258 515

White 95 54 75 149

Hispanic 63 24 44 87

Other 6 7 7 13

Unknown 1

TOTAL Male: 465 300 64 764

Frank Crowley Specific Report

Oct-14 Nov-14 AVERAGE TOTALService Episodes: 61 44 9 105

Unique Consumers:By N* ID 50 37 44 87


TOTAL Unique Consumers: 61 44 9 105TOTAL Unique Consumers as %: 100% 100% 17% 100%

Unique F2F: By N* ID 41 33 37 74


TOTAL Unique F2F: 48 38 7 86TOTAL Unique F2F as a %: 98% 100% 16% 99%

F2F Percentage: 80.33% 86.36% 82.86% 82.86%

Encounters by Type: Triage 61 44 53 105

Care Coordination 360 268 314 628

F2F Encounter 49 38 44 87

TOTAL Encounters: 470 350 410 820

Female: Black 14 6 10 20

White 3 7 5 10

Hispanic 8 7 8 15

Other 4 4 4

Unknown 2

TOTAL Female: 29 22 4 49

Male: Black 17 14 16 31

White 8 3 6 11

Hispanic 6 5 6 11

Other 1 1 1

Unknown

TOTAL Male: 32 22 5 54

Age of Triage Encounters: Adult 38 30 34 68

Minor 21 11 16 32

Uncollected 2 3 3 5

TOTAL Age of Triage Encounters: 61 44 9 105

Age of F2F Encounters: Adult 32 30 31 62

Minor 17 8 13 25

Uncollected 0 0 0 0

TOTAL Age of F2F Encounters: 49 38 7 87

F2F Outcomes: Crisis Residential 2 2 2

Inpatient 8 3 6 11

Inpatient- Civil 2 2 2

Intensive Outpatient 4 3 4 7

Legal Referral 1 1 1

Medical Referral 3 1 2 4

Other Higher Level of Care 1 1 1

Partial Hospitalization Program 1 1 1 2

Residential-CD 2 2 2 4

Residential-SUD/ COPSD 1 1 1

Routine Outpatient 25 20 23 45

Southern Area Behavioral Health UCC 5 2 4 7

TOTAL Outcomes 49 38 7 87

Diversion Rate 83.67% 92.11% 87.36%

Timberlawn Specific Report

Sep-13 Oct-13 Nov-13 Dec-13 Jan-14 Feb-14 Mar-14 Apr-14 May-14 Jun-14 Jul-14 Aug-14 Sep-14 Oct-14 Nov-141 Beginning Census 0 13 20 22 24 24 25 34 30 33 41 37 33 36 34

2

3 Admissions4 Referred 29 15 11 12 23 15 38 28 31 31 24 23 20 18 27

5

6 Admitted 16 5 5 7 9 6 15 6 8 12 3 1 6 4 8

7 Not Admitted Unable To Assess 2 2 1 1 4 3 7 2 2 3 3 4 1 2 6

8 Not Admitted Post Assess on Criteria 2 4 4 3 6 4 7 9 14 14 15 8 5 6 7

9 Pre-Admit In Process 9 4 1 1 4 2 9 11 7 2 3 10 8 6 6

10

11 Admitted (prior mo) 0 3 2 0 0 0 1 2 4 2 0 0 3 0 2

12 Not Admitted Unable To Assess (prior mo) 0 5 0 0 0 4 0 4 3 0 0 2 2 0 1

13 Not Admitted Post Assess on Criteria (prior mo) 0 1 2 1 1 0 1 2 3 5 0 1 3 3 2

14 Unresolved Pre-Admit Lag 1 1 2 2 3 1

15

16 > 1 Month Lag Admits 1 1 1 1 0 3

17

18 Total Admissions 16 8 7 7 9 6 16 8 13 14 4 2 10 4 13

19

20 Discharged21 Successfully Transferred 0 0 2 3 3 2 3 7 2 0 2 2 2 1 3

22 Discharge Rapid Disengagement 3 1 0 2 2 1 3 3 1 0 3 0 2 3 1

23 Discharge Midterm Disengagement 0 0 2 0 0 0 0 1 0 0 2 3 2 1 0

24 Discharge Intervening Factor 0 0 1 0 4 2 1 1 7 6 1 1 1 1 1

25

26 > 1 Month Lag Discharges

27

28 Total Discharged 3 1 5 5 9 5 7 12 10 6 8 6 7 6 5

29

30 Active End Of Month 13 20 22 24 24 25 34 30 33 41 37 33 36 34 42

31

32 Monthly Unduplicated 22 27 31 28 37 34 55 63 65 66 60 60 52 58 54

33 DSRIP YTD Unduplicated Served 22 27 40 52 69 82 116 144 177 209 228 253 274 58 75

34

35 Encounters: 36 F2F Encounter 94 177 169 142 208 197 253 331 293 397 362 340 264 300 226

37 Care Coord 103 225 202 165 181 141 114 172 155 125 100 161 177 127 90

38 Total 197 402 371 307 389 338 367 503 448 522 462 501 441 427 316

Transicare Reporting

Crisis Services Project

dallas county behavioral health leadership team thursday ... · * indicates items requiring...

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