HEALTH & WELL-BEING WORKGROUP
Thursday, February 14, 2013
9:00 am – 11:30 am
Reentry Resource Center
151 W. Mission St., San Jose
Minutes
Objectives for Meeting #1:
1. Review minutes from January 25th
2. Review goal and objectives for Health & Well-Being Workgroup
3. Explore promising practices and models in the area of health, mental health, and substance abuse
4. Conduct assets/barriers/gap analysis for health, mental health, and substance abuse
Co-Chairs: Reymundo Espinoza & Aimee Reedy
Present: Aimee Reedy (Public Health), Amelia Vega (DOC), Cheryl Berman (DADS), Chris Ferry (Custody Health), Dr. Ari Kriegman (Health & Hospital), Dr. Sara Doorley (Health & Hospital), Gary Montrezza (Pathway Society), Jeremy Orcutt (Family Children Services), Lynn Morison (Bill Wilson Center), Reymundo Espinoza (Gardner Family Health Network), Todd Hansen (The Health Trust), Vanessa Fajardo (Probation), Lorena Madrid (Reentry Resource Center), and Javier Aguirre (County Executive’s Office)
I. Recap from January 25th Meeting
· Reymundo provided a recap of the Jan. 25th meeting including (1) the need to establish a framework for the integrated model of health, mental health, and substance abuse; (2) developing a mechanism for linking services in the community and sharing of client’s information; and (3) understanding the impacts of health care reform.
II. Responses to Information and Data Requests
· Buu responded to the requests for information and data from Jan. 25th.
o In-Custody Infrastructure and facility needs/structural needs: Need further discussion at the policy level
o CAIS Assessment Tool – Buu provided copies of the CAIS Assessment Tool for Men and Women
o What types of assessments are being done? Who is doing it, when and where they are done? – Custody Health conducts medical and mental health screening during the first 90 days when an individual comes into custody. Probation and Department of Correction conduct a CAIS assessment for AB 109 individuals at entry. The Multi-Agency Program (MAP) at the Reentry Resource Center is developing an integrated behavioral health assessment that will be administered to all individuals coming into the Reentry Resource Center.
o Criteria/Eligibility for accessing services for AB 109 and type of services – Individuals who are rated as moderate- and high-risk based on the CAIS assessment will have access to housing assistance/housing voucher, general assistance, mental health counseling, substance abuse treatment services, and supportive services (transportation, food assistance, clothing)
III. Promising Practices/Models for Health, Mental Health, and Substance Abuse
· Mental Health/Department of Alcohol and Drug Services (DADS) Merger – The two departments are tasked with combining departments within 18 months (2014). Current efforts are already in place to combine behavioral health with primary care in Ambulatory Care system.
· Reentry Resource Center: Multi-service team in place, including representation from Custody Health, DADS, Mental Health, peer mentors, housing liaison, and eligibility workers. The team is developing an integrated assessment tool.
· Adult Reentry Services Request for Proposals: An RFP will be released in March/April to fund community-based services to support the adult reentry population.
· Transitional Health Clinic (under development): The Transitional Health Clinic will be modeled after the medical home concept and located in the Reentry Resource Center. The Clinic will be staff with 1 physician, 1 Nurse, and part-time psychologist and health specialist. The Clinic will be opened in Summer/Fall timeframe.
· Reymundo expressed that any integrated model that the County will adopt must consider the following: (1) Pre-Release and probation entry; (2) Patient-centered health home; and (3) Community-based components.
· Buu also shared other promising model in other States:
o Summit County ADM Crisis Center (Ohio): Provides a cost-effective and humane point of entry to comprehensive alcohol and drug treatment services for chemically dependent residents of Summit County, Ohio.
o East St. Louis Spotlight Reentry Center (St. Louis): Day reporting center program designed for chronic offenders at risk for recidivism. These cognitive behavioral treatment programs operated under evidence-based principles. Programs include regular reporting to the center, cognitive behavioral treatment, life skills training, and on-going alcohol and drug testing. Staff uses an evidence-based assessment tool to determine risk and needs and objectively identify the appropriate level of supervision and treatment. In addition, the center offers access to valuable community resources that can help break down barriers to successful community reintegration. These community resources include food and housing, health services, education, employment, proper identification, legal support, family classes, wellness, substance abuse. After completing the program, offenders are required to periodically return for Aftercare.
o Comprehensive Healthcare Reentry Program (Colorado): Provide wrap around services for ex-offenders which includes chronic and acute medical care as well as mental health treatment, with a substance abuse treatment component. They also provide a mentoring program which utilizes a clearinghouse of reentry services available to ex-offenders in the community.
o The Empowerment Program (Colorado): Provides reentry services for women leaving prisons and jails. Employment, drug and mental health assessment and treatment, education and some housing resources are available. Services are trauma-informed and woman-centered. Empowerment is a licensed drug and specialty mental health agency. No fees charged.
IV. Conduct Assets/Barriers/Gap Analysis
A. Systems issues to address
· Define the decision making process for identification, triage, referrals
· Define the flow of the individuals through the system and address bottlenecks; what are the touch points and transition?
· Develop strategies for data and information sharing, including the exchange of health information and services availability, consider issues of confidentiality and ethics; comprehensive consent agreement
· Develop strategies for effective referral mechanisms and linkages with community based organization
· Develop strategies to address funding restrictions for populations and/or services
B. Service Gaps/Needs to address
· Case management
· Navigation services
· Peer Mentorship (UCSF model)
· Up-to-date referral information
· Building out the planned Transitional Medical Home
· Linking to the discharge clinic planned for in-custody
· Integrated data and information sharing
· Centralized assessment center/in-take system
C. Decisions the Workgroup needs to make or information we need to understand
· Who is the priority population for the reentry center and all of the associated services that will be part of the pilot? What are the eligibility and criteria?
· What outcomes are we trying to achieve?
· How do we reconcile the priority based on risk for recidivism and health risk?
· Who is currently being served by the Reentry Resource Center (RRC)? What is the RRC capacity?
V. Next Steps for Meeting #2
· Flow chart of individuals from entry to release
· Data needed on referral/reentry population and current capacity
· Prioritize needs based on needs/gaps analysis
VI. Tour of Main Jail & Custody Health Led by Chris Ferry
FUTURE MEETINGSThursday, February 28, 2013, 9-11:30am
Thursday, March 14, 2013, 9-11:30am
Thursday, March 28, 2013, 9-11:30am
Location: Reentry Resource Center, 151 W. Mission St., San Jose