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BCC Minutes 06/05/2018 W (Mental Health) June 5, 2018 1 MINUTES OF THE COLLIER COUNTY BOARD OF COUNTY COMMISSIONERS WORKSHOP MEETING Naples, Florida, June 5, 2018 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 9:00AM in a WORKSHOP SESSION in Building “F” of the Government Complex, Naples, Florida with the Following members present: Chairman: Andy Solis Vice Chairman: William L. McDaniel, Jr. Donna Fiala Burt L. Saunders Penny Taylor ALSO PRESENT: Leo Ochs, County Manager Jeff Klatzkow, County Attorney Steve Carnell, Public Services Department Head Mike Sheffield, Director of Communications Geoff Willig, Operations Analyst COLLIER COUNTY Board of County Commissioners art l I, r MENTAL HEALTH WORKSHOP AGENDA Board of County Commission Chambers Collier County Government Center 3299 Tamiami Trail East,3rd Floor Naples,FL 34112 June 05,2018 9:00 AM Commissioner Andy Solis,District 2-BCC Chair Commissioner William L.McDaniel,Jr.,District 5-BCC Vice-Chair;CRAB Co-Chair Commissioner Donna Fiala,District 1; CRAB Co-Chair Commissioner Burt Saunders,District 3 Commissioner Penny Taylor,District 4 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. Agenda and Strategic Plan 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 5, 2018 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. Welcome and Pledge of Allegiance Chairman Andy Solis 9:05 a.m. How We Got Here and Why - Chairman Andy Solis Commissioner Solis noted the BCC met last year in a similar workshop and the purpose of today’s gathering is to provide updates on the past year’s activity and future goals of the County. 2. Brief Update and Review of the Last Year  Collier County Sheriff’s Office – Sgt. Leslie Weidenhammer & Chief Chris Roberts Sgt. Weidenhammer provided a PowerPoint “Brief Update and Review of Last Year” which outlined the Sheriff’s Office activities over the past year. She noted:  Capacity for the jail and other venues continues to be a major issues as well as the increase in injuries suffered by officers responding to mental health issue calls.  They have developed the Mental Health Unit, Crisis Intervention Team which assists in dealing with issues.  The team acts on referrals from various sources such as schools, police responses, etc.  They also link individuals with services, participates in wellness checks, addresses needs of Baker Acted individuals, monitor kids and adults, etc.  One goal is to enhance the treatment outside of incarceration (the traditional avenue), as studies indicate individuals with mental health issues do not recover in a jail setting.  It is also a cost factor, as those with issues remain in jail an average of 5 times longer than conventional inmates.  Mental Health Intervention Team; Katina Bouza Ms. Bouza provided an overview of the team’s services noting:  The focus is removing individuals from the jail setting and placing them into treatment.  It provides a network for employment, emergency housing and other resources for those individuals in need.  The Sheriff’s Office received 18,000 calls last year on the issue and the number of Baker Acts has increased significantly in Collier County.  David Lawrence Center – Scott Burgess, CEO Mr. Burgess outlined the advancements and enhancements over past year to address the needs of the community noting:  “Baker Acts” have tripled over the past 10 years to a total of 1,500 in 2017 and a major issue is the capacity of available beds and services.  The organization has expanded its service for those in need in areas such as inpatient for adults and children, outpatient services, assistance in the specialty courts, substance abuse treatment, care coordination services, etc.  In total there has been an 80 percent increase in service over the past 5 years.  National Association for the Mentally Ill – Pam Baker, CEO June 5, 2018 3 Ms. Baker reported:  The Sarah Ann Center logs 5,500 visits per year for adults seeking daily activities.  The site provides wellness services, socialization avenues, support groups, a hot lunch partnership with the St. Mathews House, etc.  The County provided support in 2017 which allowed an increase in drivers for the operation, additional staffing, etc. which is especially beneficial to the disabled persons with mental health issues.  There is no cost or intake process for the individual utilizing the services which provides easy access to daily activities.  Treatment Courts - Judge Janeice Martin Judge Martin provided an overview of the 3 treatment courts (Veterans, Drug and Mental Health) which seeks to provide an avenue to return an individual to a family, business, etc. as a productive member of society. The County funded 3 additional staff members in 2017 which was a tremendous help to the program and allowed the hiring of 3 additional staff members allowing the process to become more efficient and successful. Commissioner Solis noted:  The initiatives developed last year were a good starting point but the demand for services continues to outweigh the supply.  In July of 2017, stakeholders began to consider the development of a strategic plan to address the issue with meetings held in November of 2017 and April of 2018 to review the concept.  The endeavor resulted in a list of priorities identified under Item 3 and a recommendation of an ad hoc committee of the BCC be convened to develop the strategic plan. Kevin Rambosk, Collier County Sheriff spoke noting the concept of a strategic plan is favorable and the County is ahead of curve compared to other jurisdictions. The solution for those in need of treatment is not usually incarceration and the goal is to direct people to services where they may get the help they need to become productive members of the community. Break: 10:24 a.m. Reconvened: 10:35 a.m. 3. Criminal Justice, Mental Health & Substance Abuse Planning Council Strategic Planning Sessions – Review and Identified Priorities with their Champions  Centralized Receiving System / Addiction Receiving and Baker Act Receiving Facility – Scott Burgess, CEO David Lawrence Center; Allan Weiss, CEO Naples Community Hospital Mr. Burgess noted:  Florida is now 50th in per capita spending in the US on mental health issues.  The County has a growing population which is placing increasing demands for services.  The County currently has 30 Baker Act beds while industry standards recommend 100 for the population level of the County.  The concept to address the growing demand is to develop a central receiving facility to support a wide stream of needs including additional bed capacity, more treatment June 5, 2018 4 opportunities, increased education and assessment, etc. in an attempt to minimize an individuals issue(s) before they are more difficult to treat.  The 55,000 square foot facility envisioned is estimated to cost $26.5M Mr. Weiss noted one major key is monitoring and addressing issues in children, as studies indicate healthy kids lead more productive adult lives. Juvenile issues, if not identified, have a major impact on long term costs of treatment over their life span.  Permanent Supportive Housing (Scattered Sites & Supportive Services) – Pam Baker, CEO NAMI, and Beverly Belli, DLC Ms. Baker and Belli reported:  Shelter is a major issue for these individuals given the high cost of housing in the County and the limited income most of these individuals possess, many of whom are on fixed incomes such as SSI disability.  Those housed are easier to monitor and treat as opposed to a homeless person who is constantly on the move or seeks out a facility increasing the costs for their service.  There are programs which support 30 percent of housing costs with 18 beds at the David Lawrence Center, but the need far outweighs the demand.  Behavioral Health Data Collaborative – Chairman Andy Solis Commissioner Solis reported an initiative will be developed to promote data sharing between Stakeholders which will improve decision making capabilities. There are models for the program from Pinellas County and other organizations.  Increase Use of Evidence-based Practices – Nancy Dauphinais, COO David Lawrence Center Ms. Dauphinais provided on overview of the practices that demonstrate successful treatment which provides for consistent practices and the optimal use of funds. The avenues include a focus on early intervention, medication assisted treatment for opiods disorder, peer support services and trauma informed care.  Increase Effectiveness and Capacity of Treatment Courts – Judge Janeice Martin and Beverly Belli, DLC Judge Martin provided an overview on the effectiveness of the courts noting:  One new approach considering to be implemented is a weekly initial “orientation” process to inform those recently incarcerated on the aspects and goals of the program that is available to them.  The BCC did provide additional resources in 2017 which greatly assisted the program.  The goal should be to achieve the efficient outcomes with any funding, as an increase in funding does not always lead to a greater success for a program.  Baker Act/Marchman Act Transportation – Sgt. Leslie Weidenhammer, CCSO Sgt. Weidenhammer provided an update on the secondary transport services provided by the Sheriff’s Office (583 in 2017) which includes rides from facilities to a hospital, etc. through a Memorandum of Understanding. The Agency continues to review the program to determine what additional or different options are available for the community service. June 5, 2018 5  Build Sustainability for Criminal Justice, Mental Health & Substance Reinvestment Grant – CJMHSA Planning Council The County is in the 7th year of a $350K annual grant and a priority should be to ensure the funding remains in place, which requires optimal data collections to demonstrate the County’s needs. 4. Public Comment & Commissioner Discussion Speakers Dale Mullin, Wounded Warriors of Collier County noted the goal of the organization is to increase public awareness of Veterans issues. Most Veterans have completed multiple tours duty with many returning with PTSD, traumatic brain injures, etc. They also participate in addressing needs such as housing and other issues. Polly Kelly, David Lawrence Center the partnership between Collier County and DLC, provides life changing support for residents helping to promote a healthier community. Earle Borman, Friends of David Lawrence 1963 Community Mental Health Act transferred services from the Federal Government to State and Local however the funding was not redirected to localities. Historically, Collier County has moved forward in addressing issues and the practice should continue or increase in the future. Kathy Smith, Public Defender the funds provided by Collier County were utilized to employ a social worker who participates in jail visits, assists in developing treatment plans, and seeks early intervention which has help yield the 60 percent graduation rate in the specialty courts. Mathew McAleer drug court graduate 2014 - 15 reported that he has been “clean” for 5 years and now owns his own business with 10 employees. Nicole Steele drug court alumni reported the services through the s ystem were an immense help in changing her life and now she has full custody of her children and employed as a graphic designer. Amira Foy, State Attorney’s Office grateful to BCC for the extra resources made available which establishes an avenue for a more favorable outcome for individuals and improves the safety of the community. Armondo Hernandez, Home Base advised the organization assists Veterans and service members through clinical health and wellness opportunities, provides social base programs. He noted 9 percent of Collier County’s population is comprised of veterans. During comments by Commissioners the following was noted:  There should be a strong focus on addressing juvenile issues within the programs.  Opportunities for grant funding for construction of the central facility is under investigation, however the funds are made available for operations, not construction of facilities. 5. Next Steps Moving Forward – Chairman Andy Solis Commissioner Solis reported he will bring forth an item to the Board of County Commissioners for establishing an Ad Hoc Committee which will be responsible to develop a strategic plan to be brought to the BCC for approval. There being no further business for the good of the County, the meeting was adjourned by order of the chair at 12:18 P.M. • June 5, 2018 COLLIER ' I UNTY BOA' I OF COUNTY COMM :SIO. RS /Or • -••• airman,Andy Solis ATTEST: CRYSTAL K.KINZEL, INTERIM CLERK 4 ccj s!gnatur@:op „. • '4/04 1.1'0 (06/18 These minutes approved by the Board/Committee on as presented or as amended 6