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BCC Minutes 06/06/2017 W (Community Mental Health Services) June 6, 2017 1 MINUTES OF THE COLLIER COUNTY BOARD OF COUNTY COMMISSIONERS WORKSHOP MEETING Naples, Florida, June 6, 2017 LET IT BE REMEMBERED the Board of County Commissioners in and for the County of Collier, having conducted business herein, met on this date at 9:00 AM in a WORKSHOP SESSION in Building “F” of the Government Complex, Naples, Florida with the Following members present: Chairman: Penny Taylor Vice Chairman: Andy Solis Donna Fiala (Excused) Burt L. Saunders (Excused) William L. McDaniel, Jr. ALSO PRESENT: Leo Ochs, County Manager Jeff Klatzkow, County Attorney Nick Casalanguida, Deputy County Manager Tim Durham, Executive Manager, Corporate Business Operations Steve Carnell, Public Services Division Administrator Troy Miller, Television Operations Manager COLLIER COUNTY Board of County Commissioners 1 i r SUEZ* WORKSHOP AGENDA COMMUNITY MENTAL HEALTH SERVICES Board of County Commission Chambers Collier County Government Center 3299 Tamiami Trail East,3rd Floor Naples,FL 34112 June 06,2017 9:00 AM Commissioner Penny Taylor,District 4-BCC Chair Commissioner Andy Solis,District 2 -BCC Vice-Chair Commissioner Donna Fiala,District 1;CRAB Co-Chair Commissioner Burt Saunders,District 3 Commissioner William L.McDaniel,Jr.,District 5;CRAB Co-Chair Notice:All persons wishing to speak must turn in a speaker slip.Each speaker will receive no more than three(3)minutes. Collier County Ordinance No.2003-53 as amended by Ordinance 2004-05 and 2007-24,requires that all lobbyists shall, before engaging in any lobbying activities(including but not limited to,addressing the Board of County Commissioners), register with the Clerk to the Board at the Board Minutes and Records Department. 1. PLEDGE OF ALLEGIANCE 2. WORKSHOP TOPICS 2.A. Welcome-Commissioner Andy Solis 2.B. Overview of Current County Services-Steve Carnell,Public Services Department Head 2.C. State of Mental Health-US,State,Collier-Scott Burgess,CEO,David Lawrence Center 2.D. Impact on Systems-Sheriff Kevin Rambosk 2.E. Partnerships/Prevention/Diversion- Sgt.Leslie Weidenhammer&Manager Katina Bouza,Collier County Sheriffs Office;Judge Janeice Martin&Judge Christine Greider,Collier County Courts; Dr. Susan Kimper,Naples Community Hospital (NCH); Scott Burgess,CEO,David Lawrence Center; Pamela Baker, CEO, National Alliance on Mental Illness(NAMI); Dr.Kamela Patton,Superintendent, Collier County Public Schools 3. PUBLIC COMMENTS 4. ADJOURN Inquiries concerning changes to the Board's Agenda should be made to the County Manager's Office at 252-8383. June 6, 2017 2 Any persons in need of the verbatim record of the meeting may request a copy of the video recording from the Collier County Communications and Customer Relations Department or view online. 1. Call to Order Chairman Taylor called the meeting to order at 9:00 a.m. and the Pledge of Allegiance was recited. 2. Workshop Topics A. Welcome - Commissioner Andy Solis Commissioner Solis welcomed the attendees noting:  The purpose of the workshop is to review community aspects of mental health and addiction issues.  The goal is for the County to develop a long-range plan to address the needs of a segment of the community’s population.  The County will be looking at three main areas: the services of the David Lawrence Center and other health facilities, the court system and the jail. He introduced the PowerPoint “Workshop: Mental Health & Addiction” which will be presented throughout the meeting by the various professionals in attendance. B. Overview of Current County Services - Steve Carnell, Public Services Department Head Mr. Carnell noted:  Several organizations in the County deal with mental health issues including the court system, Sheriff’s Office, the Fire Districts, EMS and the school system.  Mental health related expenditures are funded through a CJMHSA grant and other partnerships.  The County monitors grantees and assists with any issues that arise. C. State of Mental Health - US, State, Collier - Scott Burgess, CEO, David Lawrence Center Mr. Burgess provided an overview of state of mental health issues noting 1 out of 4 persons (61.5M) in the US are affected by various conditions. Two suicide deaths occur for every homicide. The number continues to increase which places a stress on available resources such as overnight housing and related treatment facilities available for individuals. D. Impact on Systems - Sheriff Kevin Rambosk Sheriff Rambosk reported:  There are approximately 2M persons incarcerated who suffer from mental illness and the jail is not the appropriate locale to deal with these issues.  In Collier County 99% of those incarcerated return to society with approximately 25% in need of treatment.  The conditions not only pose a risk to the individual but to all those required to deal with them including the public, law enforcement officers, EMS providers, etc.  The County recognizes training is critical and has taken steps to institute “Crisis Intervention Training” (CIT).  One area of major concern is the rise of substance abuse cases with the State previously addressing the prescription medication crisis with those now turning to use of heroin. June 6, 2017 3 E. Partnerships/Prevention/Diversion - Sgt. Leslie Weidenhammer & Manager Katina Bouza, Collier County Sheriff's Office; Judge Janeice Martin & Judge Christine Greider, Collier County Courts; Dr. Susan Kimper, Naples Community Hospital NCH); Scott Burgess, CEO, David Lawrence Center; Pamela Baker, CEO, National Alliance on Mental Illness (NAMI); and Dr. Kamela Patton, Superintendent, Collier County Public Schools Katina Bouza, Reintegration Manager, Collier County Jail provided an overview of the Collier County jail services available for these individuals noting 25% of the population suffers from mental illness. There are 102 beds available with 182 of those in need. An inmate must volunteer to receive the services as mandatory requirements are not an option for jail administration. There is only one homeless shelter in Collier County and a major issue is where to place these individuals in housing upon release. Sgt. Leslie Weidenhammer, Collier County Sheriff’s Department noted the mental health system in the US is under-resourced with many of the individual ending up in the criminal justice system or dying from opiod overdoses. In Collier County, there is one call an hour requiring an officer to respond to a situation where a mental health issue is involved. Officials recognize these individuals do no improve with conventional incarceration and a substantial amount of new training is available for those required to deal with the issues. It was noted the County is creating a Mental Health Unit and Mobile Response Crisis Team which includes fire fighters and EMS professionals to aid in addressing the issues. Honorable Janeice Martin noted she presides over Mental Health Court which needs to be a core function within the system. The goal is to restore individuals to society as productive citizens through a variety of partnerships. One major concern is the amount of deaths occurring as a result of the additions or mental health issues. The County through its recognition of the problem now has a successful program in place. Honorable Christine Greider noted a segment of the population which are secondary victims are children of those affected noting they become neglected, abandoned, abused, etc. Not only does it become a lasting behavioral issue but may affect development of the child’s brain through poor parenting and nutrition. One measure undertaken by the County was placing a dedicated individual in the response team as opposed to those involved simply handing out a business card identifying someone to call if they so desire. It was noted Florida Statutes tend to play “catch up” on the issues and the County has not experienced any ill affects from the lack of response, in fact, Collier County is being used as a model to amend and develop statutory items. Break: 10:37 a.m. Reconvened: 10:50 a.m. Chief James Cunningham, North Collier Fire Control and Rescue District reported first responders provided 1,100 opioid treatments over a 12-month time frame in Collier County. There has been a ten-fold increase in medication provided in the field to address an event. An issue for the public is that these individuals are transported to a hospital before the David June 6, 2017 4 Lawrence Center (DLC) fills beds needed by other individuals. Another concern is the potential violent activities and property destruction (fire) associated with the calls. First responders respond to calls supplied with armored vests. Susan Kimper, MSN provided an overview of the services available at Naples Community Hospital who does collaborate with the County to address issues. Scott Burgess, David Lawrence Center (DLC) provided an overview of services available at the DLC, the only comprehensive mental health facility in Collier County. The services include a walk in clinic, substance abuse treatment, children’s community services, holistic and specialty treatment. Pamela Baker, National Alliance on Mental Illness noted the organization partners with the County and provides educational, support and other related services and one key to Collier County is all those involved have become major advocates for the system. Kamela Patton, Superintendent, Collier County School District reported the District partners with the Sheriff’s Office and other County agencies to improve services for children. One key to the success of the system is to identify those in need as early as possible. The District is training teachers, bus drivers, custodians, administrators, etc. to identify high-risk students. Statistics indicate 50 percent of those are affected by age 14, with 75 percent affected by age 24. The condition not only affects social issues but the person’s ability to learn. Suzanne Kaye, Mental Health Resource Center/FACT Team noted they work with clients to become more independent in the community through education in finances, medical issues, nutrition, housing assistance, etc. One issue for all involved is funding of resources as in their case, they are currently working with budgetary numbers developed for the year 1999. 3. Public Comment Speakers Carlos Ruiz, “Against All Odds” recipient and US military veteran commented on his prolonged battle with PTSD and how he has become a productive member of society through the support of the Mental Health/Veterans Court. Bower Thomas family, Mr. Thomas and his family addressed the attendees on the successful treatment through Mental Health Court and agreed with the collateral damage caused to his and other children noting the program saved his life. Repacz family reported on their child’s success through Mental Health Court. Bill O’ Neil, David Lawrence Center Committee noted developing a long-term plan for the community is the key to addressing the issues. Jerry Godshaw spoke on the enormous financial cost to the taxpayers for long-term incarceration versus treatment opportunities with statistics indicating $1 in treatment saves the taxpayers $8 in expenditures. He recommended the County dedicate resources necessary to help those in need. Lisa Gruenloh, Drug Free Collier noted a strong prevention component should be implemented into the programs. Dr. Emily Ptaszek, Health Care Network of SW Florida reported early treatment is essential and funding partnerships is a large factor in addressing the issues at hand. June 6, 2017 Doug Campbell noted there is a strong support system available in the area with a tremendous amount of volunteer resources available that could aid in addressing the issues. Araceli Gomez, Immokalee Interagency Council expressed concern on the potential for bias by those involved against ethnic groups affected by the conditions and recommended any forums, solutions, etc. that involve participation by minority representatives. Amira Fox, States Attorney's Office supports treatment courts, makes the community safer, and is a more effective use of taxpayer's funds. Kathy Smith, Public Defender noted proper allocation of resources is needed to ensure preventative programs and that other treatment avenues exist (as opposed to incarceration) to provide effective solutions for those involved. Beverly Bell, DLC provided an overview of treatment statistics at the Center, noting the programs are successful when utilized properly. Commissioner Solis noted the BCC will be reviewing the issues related to the topic in an effort to eliminate any "bottlenecks" in the process to help ensure the system is as effective as possible for residents of Collier County. There being no further business for the good of the County, the meeting was adjourned by order of the chair at 12:45 P.M. ***** COLL £ ' I UNTY BOARD OF COUNTY ATTEST: -- 4: DWIGHT E.BROCK,C,L0'.!K COM NERS 4 #111 Deputy Clorif Chairman, F: y Taylor • . Attest as to Chow: These minutes approved by the Board/Committee on 1 ii I 1 as presented or as amended. 5