Transcript Modoc County Health Services Organizational Chart

Modoc County Behavioral Health:
The context of a very small, frontier
county as an integrated system
provider
Karen Stockton, Ph.D., MSW, BSN
Director
• A general perspective on our journey to date
• We succeed or fail together
• Moving forward as a team
Modoc BH Context Summary
• Demographics
– 3rd smallest county with a population of about 9,100 it is
– located in the extreme northeastern corner of the state
with about 2.3 people per square mile.
– About 21 percent of the residents are below the poverty
level with an unemployment rate of 8.6%,
– Modoc County has the lowest median income of any
county in California.
– Spanish is the only threshold language in Modoc – about
11.5% of the population indicate they are Hispanic/Latino
with 8.8% report that Spanish their first language. About
4.5% of the population is Native American.
• There are 2 critical access hospitals – one in Alturas
and one in the Surprise Valley with attached Rural
Health Clinics. However, neither performs routine
surgery or is licensed to deliver babies. Patients must
go out of county to even get a mammogram.
• Including the 2 rural health clinics there are a total of 4
medical clinics in the county. Residents must go out of
county (on average 2-3 hours minimum), and often out
of state, for most specialty care or advanced medical
procedures.
• There are no mental health in-patient crisis
stabilization units, IMDs, or PHFs in Modoc County. All
clients needing these must be transported a minimum
of 3 hours (in good weather) to receive these services.
Client overview
– MH:
• Currently serving 220-250 MH unduplicated clients/month
• 396 unduplicated MH clients served in FY 14-15
– SUD
• Currently 33 open SUD client cases
• 90 unduplicated SUD clients FY 14-15
• Funding
– PEI is only 6% of the total MH program revenue
Client Demographics
• Mental Health - 396
– Ages:
• 0-18: 101
• 19-64: 278
• 65+: 21
– Gender:
• Female: 220
• Male: 176
– Ethnicity:
• Not Hispanic: 352
• Mexican/Mexican
American: 3
• Other Hispanic/Latino:8
• Unknown: 4
• Substance Use: 90
– Ages:
• 0-18: 3
• 19-64: 87
• 65+: 0
– Gender:>
• Female: 44
• Male: 46
– Ethnicity:
• Not Hispanic: 78
• Mexican/Mexican
American: 10
• Other Hispanic/Latino:2
• Other than the primary care clinics offering
telepsychiatry for mild to moderate MI
treatment needs, and one MSW contracting
with TEACH, Inc., the Community Corrections
Partnership & Partnership Health Plan for mild
to moderate MH benefits, there are no other
active BH providers in the County other than
those working for the school system.
• Modoc County Behavioral Health is virtually
the provider of BH services in the county.
Modoc County Health Services
Organizational Chart
c
Modoc County Board of Supervisors
•Medical Director for
•Health Services - Contractor
Contract
Telepsychiatry
Tara Shepherd, MA, CADC-CAS
Deputy Director, Behavioral Health
19.5 – 20.5 FTE
Karen Stockton, PhD
Director, Modoc County Health Services
Stacy Sphar, RN, PHN
Deputy Director, Public Health
Behavioral Health
Advisory Board
Warren Farnam, REHS
Deputy Director, Environmental Health
2 FTE
Sun Rays of Hope - a consumer owned and operated BH recovery and wellness center – contract. Our BH Peer Support
Specialist is liaison to this organization and is actively involved with and provides support for this organization.
Our working agency mission is to “promote whole person health and wellness through teamwork.” HS Staff are actively
involved collaborative teams: Prevention Collaborative, Drug, Family Wellness, Juvenile Dependency Court Treatment
Teams, and the Community Corrections Partnership, as well as others that are related to children and youth involved with
foster care and the school system, targeted health initiative, & disaster response teams,
Revised 2/10/2016
Modoc County Behavioral Health
Organizational Chart
Modoc County Board of Supervisors
Medical Director
for H.S. by Contract
Karen Stockton, PhD, MSW, BSN
Director, Modoc County Health Services
Contract
Telepsychiatry
Behavioral Health
Advisory Board
Stacy Sphar, RN, PHN
Deputy Director, Public Health
Also Supervising Nurse for BH
Psychiatric Nurse Practitioner Doctoral Student
Tara Shepherd, MA, CADC-CAS
Deputy Director, Behavioral Health
Michael Traverso, MFT
Clinician/Supervisor, Behavioral Health
Carol Hafen
Fiscal Officer
Tristin Teuscher, BA
Administrative Asst.
Juana Sherer
Administrative Assistant
Peggy Clevinger
Accounting Technician
Dori Budmark
Office Specialist II
(0.5 BH; 0.5 PH)
Jamie Brazil
Office Specialist II
Vacant
Office Specialist II
Revised 2/20/2016
Julie Williams, BSW
BH Specialist III
Registered SU
MSW Student
Lisa Reed, BS
BH Specialist III
Registered SUD
Paul Mueller, BA
BH Specialist III
MSW Student
G. “Billy” Diaz, MBA
BH Peer Specialist II
Spanish
Dolores Navarro Turner, MSW
BH Clinician I - Spanish
Alisha Romesha, MSW
BH Clinician I
Christopher Chinn, MSW
BH Clinician I
Camila Lopez Pasos, MSW
BH Specialist III - Spanish
Registered SUD
Devin Olio, MA
BH Clinician I
Registered SUD
Psy..D. Student
Vacant
SUD licensed, certified
or registered
12-13 FTE Direct Service Staff – 8 -9 Administrative & Support Staff
Green: MHSA WET Local Funding
Designated Peer – plus over 50% BH Staff are Consumers or Family Members
Rosemary Parks, RN
Program Manager
Peer Medical Case Management
& Older Adult Services
CeCe Toaetolu, LVN
BH Specialist III
Health & Medication Services
Lorie Petty, LVN
BH Specialist III
Health & Medication Services
Various P/T Extra Help transporters,
janitors, attendant care, clerical
help.
Elisa Robertson, LCSW
BH Clinician II - Spanish
(PT Extra Help) .2 FTE
Sondra Tate, CADC-CAS
(PT Extra Help )
• Direct Services Staff Responsibility
– 24/7 crisis response services including 5150,
hospitalization, and transport
– Placement out of county for PHP, Crisis
stabilization, IMD or SNF
– MI and SUD Outpatient services
– Drug, Family Dependency, & Juvenile Delinquency
Court Team participation
– Katie A Team
– Community Corrections Partnership participation
and SUD groups in jail
• Congregate Care Reform Bill responsibilities
for expanded MI treatment locally
• MHSA programs & FSP services
• Participation in program planning,
implementation, quality improvement, and
outcomes measurement
• Cultural competency training
• Community outreach and school services
including PEI programs & Innovation projects
• Oversight Entities & Reviews or Evaluations
– Tri-Annual MediCal Review – Mental Health
• Annual Cost Reports and Audits
• EQRO – Annual
– PIPs
– HEDIS measures, timeliness, access, re-hospitalization,
penetration, client satisfaction, quality improvement measures,
etc.
– Drug MediCal Review
– Drug & Alcohol Program Review
• Annual Cost Reports
– MHSA- Annual plans, cost reports & evaluation, audits
– PEI/Innovation – Plans, evaluation, audits
-Mental Health Council and other public information
demands.
Access & Linkage
• Referral Strategies
– Regulations based on false assumptions:
• Silos
• Multiple providers
• Multiple PEI programs
• Demographic data requirements for potential
responders – cultural sensitivity, ethical
considerations
Barriers to Measurement
• Already have multiple redundant tracking
systems for demographic reporting that do
not talk to each other:
– CSI, DCR, eBHS, CalOHMS & EHR: Anasazi
• Data elements are not consistent with CSI
• In very small counties, even with “personally
identifiable information” (PHI) removed there
is significant likelihood of a HIPPA breach.