Minutes for Mental Health Board Meeting May 21, 2019
- Call to Order
Meeting called to order at 5:00 PM by Chair, Mary Ann Swanson
- Roll Call
- Mary Ann Swanson, District 2
- Peter mcaweeney, District 4
- Kathy Smith, District 5
- Bob Cobb, District 4
- Dick Kirk, District 1
- Sherry Weyers, District 5
Robert Hales, District 5
- Diana Marie Nelson, District 2
- Fran Adams, District 2
- Shellie Hadley, District 3
- Patricia Gray, District 1
- Maria Arreguin (excused)
- Bill Carter (SCBH Director)
- Sid McColley (Section Manager of Acute and Forensic Services)
- Melissa Ladrech (MHSA and WET Coordinator).
- Erika Klohe (St. Joseph’s)
- Mary-Frances Walsh (NAMI)
- Kate Roberge (GIRE)
- Sean Kelson (GIRE)
- Sean Bolan (GIRE)
- Laurie Petta (GIRE)
- Susan Keller (Community Network)
- and over 40 other community members.
- Announcements / Public Introductions & Comments
- You may submit agenda items for consideration prior to the Executive Committee meeting, normally held on the first Wednesday of each month, 10:30 AM to Noon. Email or call MHB clerk Rhonda Darrow (707) 565-4850, Rhonda.Darrow@sonoma-county.org to verify the next meeting date.
- There are vacancies in Districts 1, 3 and 4. If you are interested in serving on the Board, please contact Rhonda Darrow (707) 565-4850, Rhonda.Darrow@sonoma-county.org).
- Please direct all your questions to the Chair.
- The present members approved the minutes from April 16, 2019 with 2 ayes from Peter McaWeeney and Robert Hales. The MHB retreat minutes and Bylaws from April 27, 2019 were approved with two abstentions from Robert Hales and Peter MacWeeney.
Mary Ann Swanson announced the nominations for the two MHB Executive Committee officers: Kathy Smith, Chair and Dick Kirk will remain as Vice Chair. Kathy and Dick both accepted their nominations. Voting will take place at the next MHB meeting.
Kate Roberge, Consumer Education Coordinator of the Consumer Relations Program of Goodwill Industries (firstname.lastname@example.org), and/or Guests.
Kate Roberge read the following: “The proposed 2019-2020 Sonoma County Behavioral Health budget includes the elimination of all MHSA-funded peer programs. This would mean the end of the Wellness and Advocacy Center, the Peer Education and Training Program, the Petaluma Peer Recovery Center and the Russian River Empowerment Center. Peer programs are not extraneous. They are a vital and essential element of the continuum of care in our county. There are no alternatives or substitutes for what these peer support programs provide. Peer support promotes wellness, alleviates crisis, and mitigates despair. People who are frightened by the mental health system feel safe to stop isolating and seek services from their peers. People literally ‘come in from the cold” to access peer support. Peer programs are a cost-effective way to take pressure off of the rest of the mental health delivery system. People whose case managers and other mental health service providers are stretched thin have a place to go to get support before their distress gets out of hand and they end up at the Crisis Stabilization Unit or are hospitalized, at a much higher cost to the county. It is not uncommon to hear center members say that they would be dead or in jail if not for the peer support they receive at the peer-run centers. One Wellness and Advocacy Center member recently told staff, “The Wellness Center helped me to get sober, move towards employment and a life I wanted. It helped me to survive.” This member further stated that he was close to ending his life when he came to Wellness. Peer support is highly cost-effective. In Alameda County a 2014 study showed that, in an 18 month pilot program that brought peer providers into the system of care, there was a 72% reduction in re-hospitalizations, with a savings of over a million dollars. (Peers Engaging and Empowering in Recovery Services and Alameda County Behavioral Health) Peer programs are places where those with mental health challenges go to be heard and supported. They are places where wellness is cultivated and crisis is averted. They decrease the isolation and hopelessness that can so often result in crisis. Peer support saves lives, and saves money in crisis care, psychiatric hospitalization, law enforcement and emergency room costs. Over the years the peer-run centers have served thousands, helping keep those with mental health challenges from falling through the cracks in the system. As those cracks become wider and more pervasive, peer services will be needed more than ever. Thanks for listening. I would like to close by respectfully requesting that the Mental Health Board make a formal recommendation to the Board of Supervisors to preserve the funding for peer programs in Sonoma County.”
Sean Bolan reported on the Wellness and Advocacy Center’s impact statement (please see attached Impact Statement). His highlights: “In April 2019, we averaged 72 people per day, had 42 new member sign ups, and served 406 unique individuals with peer support and other essential recovery services. We maintain a clothes closet, laundry services and showers for members. With 60% of new members reporting as homeless—these are critically needed services.”
Sean Kelson read the following: “Hi, I am Sean Kelson, Program Manager of Interlink Self-Help Center and supervisor of the Petaluma Peer Recovery Center or PPRC, the youngest Peer Recovery Center in Sonoma County, collocated with the Sonoma County Behavioral Health’s Community Mental Health Center in Petaluma where we are able to give and accept warm hand-offs and cross refer, supporting the creation of another hub-like complex. All staff at PPRC are graduates of the Peer Support Specialist Training provided by the Peer Education and Training program. Not only does PPRC and all of our centers keep people out of higher levels of services, we help participants stay out of emergency rooms, hospitals, and the criminal justice system. We help participants achieve goals, make it to appointments, take next steps, find and/or maintain housing and employment, go back to school, get into lower levels of care and at times off of services completely.
The proposed defunding of these programs is beyond concerning. We have created an admirable infrastructure in our County with Peer training, and peer services in our four Centers. The Peer Education and Training Program offers Peer Support Specialist Training and its success has really greased the wheels to go far beyond what we have already done. Kate, the program coordinator and I worked with Susan Keller for three years on developing the impressive advanced care planning tools presented to you, along with a training program for peer providers to support peers in filling them out. Most of the people I have shard these tools with throughout our community have expressed great relief with these them and commented on how respectful, inviting and user friendly they are and have said things like “I would actually fill one of these out”. These tools are some of the results of peer involvement, continuing to help save money, lives and dignity. I helped Susan showcase these tools at a recent palliative care conference in SF and they were a big hit with docs and other providers from CA and a number other states. We have discussed with DOR the potential of funding on the job training positions for trained graduates and received a favorable response. We have made inroads with some health care agencies and are positioned well to be getting peer providers into health care organizations .This is just a taste of the many things we have been able to do in our community, having this foundation of support and training, besides all of the meetings we attend and support we provide.
As I said, we have a great infrastructure here that has continued to grow, save lives, save money and defunding all of this is beyond concerning. These evidenced based, successful, peer services are in alignment with the intention of what MHSA funding is supposed to be all about. I encourage you to do what you can to save these services so we can maintain this crucial safety net, and continue to grow. The proposed cuts would not save money; they simply shift financial responsibility to emergency rooms, hospitals, law enforcement agencies, correctional facilities and homeless shelters.”
Speaker: Shared how she graduated from the Peer Support Courses at the Wellness and Advocacy Center and had fewer visits to emergency rooms and Crisis Stabilization Unit. The Wellness and Advocacy Center is part of her recovery plan. Her goal is to work at the Wellness and Advocacy Center.
Speaker: Shared how the Wellness and Advocacy Center changed their life. He was accepted in the Peer Support Program, got a job as a Peer Support Specialist at Creekside and now has a full-time job at Aurora Hospital. All of this support literally changed his life.
Speaker: Shared how the Peer Support Class “changed my whole life and gave back my life.” She no longer has panic attacks since learning so much about herself in these classes. She learned at the Wellness and Advocacy Center to “treat everyone with dignity and respect.”
Speaker: Asked to please find creative solutions for peer recovery in this difficult budget time. Peer recovery is the heart of the mental health system.
Speaker: Shared he attends the Depression Group at the Wellness and Advocacy Center. This group is keeping him alive and out of isolation. We should be pushing for expansion of the Wellness Center. He brought a sign, Peer Lives Matter!
Speaker: Each of the peer-run centers is different and unique. It is coming down to only having one center open. It cannot be one size fits all. This center may not work for as many people and is them putting them at risk.
Speaker: Shared she is a member of the Wellness Center and did a caricature of all of those at the Wellness Center since 2008. She shared how this place has reduced hospitalizations. It is a supportive place during the day.
Speaker: Shared that she has been a member of the Wellness Center since 1987. She has always counted on peer support. She shared that she wrote a letter to the Board of Supervisors.
Tom La Grave: Shared that he is interested in being on the Mental Health Board, District 1. He wants to bring his knowledge as a social worker to the Board.
Mary Ann Swanson: Shared that we should be looking at unlikely allies, i.e., hospitals’ emergency rooms, health centers and health districts, to put on their thinking caps on how to keep the peer-run centers open. She shared the importance of having the centers in the different locations in the County.
Speaker: Shared how she has concerns about proposed cuts to the Wellness Centers. She requested the Mental Health Board to go to the Board of Supervisors to report how these centers are improving the quality of life for community members. She said that budget reductions cause severe lack of County staff, but peers can help with peer support for better outcomes. She referenced the article in The Press Democrat on May 16, “Sonoma County Residents Criticize Proposed $1.3 Million in Mental Health Services Cuts.”
Speaker: “The Wellness Center needs to stay open.”
Speaker: Shared that she has had lots of trauma in her life. The peer centers “changed my life…I want to live now. I have never said this before. The peer centers have made me stronger and able to share. Keep these centers open.”
Sonoma County Behavioral Health Division Organization Structure, Funding Sources, Including Mental Health Services Act (MHSA) (Bill Carter)
Please see Power Point Presentations (PDF: 743 kB)
The first several power-point slides were not presented by Melissa Ladrech, MHSA Coordinator, as Bill Carter decided that the audience was asking for more information and questions specifically to the budget reductions.
The County of Sonoma has a $34 million shortfall and has $8 million to mitigate potential cuts at the Board of Supervisors’ discretion. SCBH has a budget of $85 million. The proposed reductions for SCBH is $8 million.
Department of Health Services Reduction Impacts – Behavioral Health Division
- Eliminate Board and Care supplemental payments ($3.8 million)
- Reduce Peer and Family contracts ($1.2 million)
- Reduce Crisis Stabilization Unit from 16 beds to 12 beds
- Reduction of Adult Services Team and Outpatient contracts ($1.3 million)
- Eliminate Crisis, Assessment, Education and Training services ($361,000)
- Reduce Workforce Education and Training Program ($139,415)
Speaker: Will the Board of Supervisors offer any funding?
Bill Carter’s Answer: It will be at the Board of Supervisors’ discretion to use the $8 million where they feel it is most needed.
Speaker: There is more to see for some creativity for this budget.
Speaker: Why not put money from crisis facility to board and care facilities? Answer: Bill shared that this is a terrible reduction. The Board of Supervisors has the discretion to add back their $8 million discretionary fund or they could move money from another County department.
Speakers: There needs to be more education in the paper and radio on how to create philanthropy to support peer recovery from other medical facilities, i.e., Kaiser, Sutter, St. Joseph’s, and an urgent call on what will happen in the new fiscal year. There has been discussion about putting a tax increase on the 2020 ballot to fund behavioral health services and housing.
Speaker: This is a nationwide crisis. Everyone is in discussion with the County about how to fund for behavioral health services and housing.
Erika Klohe of St. Joseph’s: She asked for the audience to share their creative ideas and data/impact statements with her so she can bring to her different community meetings she is attending.
Speaker: There was a meeting with Partnership health plan of California with the Board of Supervisors. Partnership has half a billion dollars in their reserves and twenty percent can be used in Sonoma County.
Speaker: How about diverting funding from the jail to housing?
Speaker: They have different funding sources.
Speaker: Why is the budget so out of balance if okay in just a year ago?
Bill Carter’s Answer: There was not enough money to build a balance.
Speaker: Why isn’t the money from Whole Person Care being used for the peer-run centers?
Bill Carter’s Answer: Whole Person Care’s monies is a five-year grant with specifics uses for those homeless community members with mental and medical health issues. Private non-profit agencies can do fund raising. SCBH would support any efforts.
Speaker: The speaker was involved in the beginning stages of Mental Health Services Act. It was designated to be used for particular services and could not be used to supplant existing programs.
Speaker: Why are so many peer services being reduced?
Speaker: It is all very devastating reductions. It is deciding between the basic SCBH services of medication support, youth services’ mandates and case management to the peer-run centers.
Behavioral Health Director’s Report/HBH Fiscal Update/Mental Health System
Bill Carter or Designer
Sonoma County’s Mental Health Services Act [MHSA] page is at sonomacounty.ca.gov/Health/Behavioral-Health/Mental-Health-Services-Act/
The State’s MHSA page is at https://www.dhcs.ca.gov/services/mh/Pages/MH_Prop63.aspx
Please see Special Presentation above.
PEERS (Peopel Empowering each other to realize success) Coalition Intern Report
SRJC’s webpage about current health events around the campus: https://events.santarosa.edu/calendar-events
No report was given as Maria was excused from this meeting.
Sherry Weyers and Others
This is the link to California Association of Local Behavioral Health Boards and Commissions website: http://www.calbhbc.org/
No other reports shared at this meeting.
– Mary Ann Swanson
This is Mary Ann Swanson’s last meeting as the MHB Executive Committee Chair.
Mary Ann thanked everyone for weighing in, thinking creatively and taking positive energy to make these ideas known.
Kathy Smith requested that those community members who are lived-experienced and/or family members to please consider filling the Mental Health Board vacancies of Districts 1, 3 and 4. The composition of the MHB membership should be 50 percent lived-experienced and family members.
Dick Kirk shared appreciation of everyone’s input at tonight’s meeting. He requested a vote to send a resolution from the Mental Health Board to the Board of Supervisors to request keeping peer services in place – seconds received from the rest of the members.
Rhonda Darrow, Mental Health Board Clerk