Loading...
Mental Health and Addiction Ad Hoc Agenda 04/02/2019Mental Health and Addiction Ad Hoc Committee Meeting April 2, 2019 – 8:30 am 5th Floor Training Room 3299 Tamiami Trail East, Bldg. F Naples, FL 34112 1. Call to Order 2. Pledge of Allegiance 3. Roll Call 4. Adoption of the Agenda 5. Public Comment 6. Adoption of Minutes from Previous Meeting 7. Staff Reports 8. New Business 8.1. Priority 2 – Permanent Supportive Housing (continued) 8.2. Review of Calgary Housing Solutions - Guest Speaker: Tim Hearn 8.3. Review of Committee Vacancies 8.4. Reconsideration of Previous Applications 8.5. Priority 3 – Data Collaborative 9. Old Business 9.1. Future Meeting Schedule 9.2. Discussion of Bed Supply per capita (continued from March 19) 9.3. Collier County Vital Signs Report (Christine Welton – any follow-up?) 9.4. Priority 1 – Central Receiving System 10. Announcements 11. Committee Member Discussion 12. Next Meeting Time, Date and Location 12.1. April 16, 2019 – 8:30 am – same location 13. Adjournment 30.B.2 Packet Pg. 924 Attachment: [Linked] Agenda and Back-up Document Packet - April 2, 2019 (8779 : Collier County Mental Health and Addiction Ad Hoc Mental Health and Addiction Ad Hoc Committee Meeting | Meeting Minutes Page 1 MINUTES OF THE REGULAR MEETING OF THE COLLIER COUNTY Mental Health and Addiction Ad Hoc Committee Meeting March 19, 2019 Naples, Florida LET IT BE REMEMBERED that the Collier County Mental Health and Addiction Ad Hoc Committee met on this date at 8:30 A.M. at 3299 Tamiami Trail East, Building F, 5th Floor Training Room, Naples, Florida with the following Members Present: Mental Health Committee Present: Dale Mullin Dr. Thomas Lansen Scott Burgess The Honorable Janeice Martin Janice Rosen Dr. Jerry Godshaw Dr. Paul Simeone The Honorable Michelle McLeod Dr. Pam Baker Reed Saunders Dr. Michael D’Amico Susan Kimper Not Present: Lt. Leslie Weidenhammer Russell Budd Dr. Emily Ptaszek Christine Welton Pat Barton Also Present: Sean Callahan – Executive Director, Corporate Business Ops Heather Cartwright-Yilmaz – Sr. Operations Analyst 30.B.2 Packet Pg. 925 Attachment: [Linked] Agenda and Back-up Document Packet - April 2, 2019 (8779 : Collier County Mental Health and Addiction Ad Hoc Mental Health and Addiction Ad Hoc Committee Meeting | Meeting Minutes Page 2 1. Call to Order & Pledge of Allegiance Chairman Scott Burgess called the meeting to order at 8:34 A.M. and led the Pledge of Allegiance. 3. Roll Call – Committee Members Twelve (12) members of the Mental Health and Addiction Ad Hoc Committee were present, representing a quorum. 4. Adoption of the Agenda A motion to approve the agenda was made and was unanimously adopted. Mr. Callahan clarified that the date of the next meeting was April 2, 2019, and that there was a typo on the agenda. 5. Public Comment There was no public comment. 6. Adoption of Minutes from Previous Meeting Following discussion with changes, a motion was made and Minutes from previous meeting were approved as amended. 7. Staff Reports 7.1. Bruce McAndrews Resignation: Mr. Callahan announced that Mr. McAndrews had resigned from the Committee, announced that the Committee now has two at-large vacancies. Mr. Callahan informed the Committee that they could reconsider applications that already came in or advertise the vacancies again. Additionally, Mr. Callahan mentioned that Ms. Barton has been experiencing health problems and will update next meeting. 8. New Business 8.1. Priority 2 – Permanent Supportive Housing The Committee moved to discussion of their second priority, permanent supportive housing. Discussion ensued around and the need for housing in the community. Without it, programs will not work long-term. 8.2. Collier County Vital Signs Report (Christine Welton) 30.B.2 Packet Pg. 926 Attachment: [Linked] Agenda and Back-up Document Packet - April 2, 2019 (8779 : Collier County Mental Health and Addiction Ad Hoc Mental Health and Addiction Ad Hoc Committee Meeting | Meeting Minutes Page 3 Due to Ms. Welton’s absence, Mr. Burgess lead the discussion on the Collier County Vital Signs report. Ms. McLeod went referenced statistics from the Collier County Vital Statistics Report on page 41 and 42 regarding homelessness. Committee members agreed that schools and HUD have different ways to gather information which reflected some of the discrepancies discussed in the numbers from different reports. Dr. Godshaw pointed out that the information was gathered in September 2017 following Hurricane Irma, so further discrepancies may be contained in the data. Mr. Burgess pointed out that Florida and Collier County had a significant number of uninsured people in a chart on pages 58-59. 25-34-year old males were particularly high in uninsured population; with 28% in Florida; 41% in Collier County; and 19% nationally. In addition to this data, Mr. Burgess commented that it is restrictive for Medicaid standards here compared with other states. Committee members discussed social coverage for the uninsured and how that in other states the level of services is better than private insurance. Judge Martin described a case regarding a young lady that had ran out of bed days for the rest of her life. The discussion then went into the services for Marchman and Baker Act clients and how the system treats these cases differently. Mr. Burgess discussed burning through lifetime days and added that programs should not be able to discriminate around organs. Medical conditions should be paid for all of organs even mental health coverage for the brain. 30.B.2 Packet Pg. 927 Attachment: [Linked] Agenda and Back-up Document Packet - April 2, 2019 (8779 : Collier County Mental Health and Addiction Ad Hoc Mental Health and Addiction Ad Hoc Committee Meeting | Meeting Minutes Page 4 Committee discussion ensued around the low number of primary care and healthcare providers in the community. They discussed the disparity for being cash only and the needs were increasing for other methods. Dr. Larsen advised that the number of PA’s and Nurse practitioners was growing, which was a positive thing for the community. Mr. Burgess reference a chart on page 56, and that the ratio of physician to individual is 1,410 to 1 in Collier County for Primary Care Physicians. Committee members discussed that Mental Health care providers had increased, however, there was still a significant rate of disparity. Having other physical issues like heart attack, cardiac as a recurring problem is also on the increase. Dr. Larsen discussed the causes for not seeing more Mental Health Care providers moving to the area. Discussion ensured around losing qualified people because they cannot afford to live here. Dr. D’Amico referenced the system of care in Sarasota, and the diversity in funding sources. Many unmet needs are filled with grant funding and other places. Dr. D’Amico pointed out that the culture seemed different in that area and that many causes were solved by grassroots approaches. Discussion ensued from Committee members on how to best get organizations together to open dialogue and come up with workflows that work across multi-agency footprint. Dr. D’Amico commented on funding needs, and while philanthropic models are a good way to get an idea started, they are not sustainable long-term. Dr. Baker suggested that having a panel of grant writers would benefit the community programs in place. Dr. Baker said some 30.B.2 Packet Pg. 928 Attachment: [Linked] Agenda and Back-up Document Packet - April 2, 2019 (8779 : Collier County Mental Health and Addiction Ad Hoc Mental Health and Addiction Ad Hoc Committee Meeting | Meeting Minutes Page 5 grant writing had been done, and that there are individuals that can do the grant writing for a fee with tax dollars to match. Mr. Burgess recommended starting with philanthropy and then pursuing grant dollars. Further discussion ensued around Medicaid being a problem, and if it only pays for half then the program will not sustainable. The Committee concluded that it takes a partnership of the County, the State and Federal level. 8.3. Review of Calgary Housing Solutions (Dale Mullin) Mr. Mullin reviewed the Calgary 10-year plan on eradicating homelessness and pointed out that we must engage whole community to be sustainable. If we do not engage the community then we are fighting upward battle. Dr. Lansen recommending casting out vision in strategic plan for the homeless and identifying the first group of individuals that are high need high users – the ones that are in jail or hospitals. By using people where the assistance needed is known, start to build a system of care. Mr. Burgess suggested that if the program can show that it is successful in numbers then more funding will be available. Dr. Baker discussed rental assistance, and the lack of landlords that are willing to rent to mental health patients or those with addiction. The payments are Fair Market; however, the landlords are not willing to rent. Committee members agreed that the community needs to be educated on the facts and that new initiatives need to be created to set aside 10% for those with extremely low income or mental illness in new communities in the local community. Mr. Callahan suggested that they could make a recommendation partition off a certain amount of affordable housing for residents with mental health issues, but that would be a policy decision by the Board of County Commissioners. Dr. Baker discussed Jerry’s House and that the home was purchased by the foundation. Jerry’s House rents back to client at their affordable prices and provides wrap around services. Dr. Baker commented that the Committee should look at models like this. Discussion then ensued around the ‘not in my backyard mentality’ in our community. Dr. Baker said the key to success is to treat it as a regular rental property. Mr. Mullin reviewed how he got involved with Mr. Hearn and the Calgary solution while seeking funding for housing at a veteran’s event. Mr. Mullin met with community leader from Canada who described how they came up with 10-year plan, key goals, and information. Calgary was first one in Canada to take on project like this. Committee members would like to invite Mr. Hearn to our next meeting and spend 20 minutes with presentation. 30.B.2 Packet Pg. 929 Attachment: [Linked] Agenda and Back-up Document Packet - April 2, 2019 (8779 : Collier County Mental Health and Addiction Ad Hoc Mental Health and Addiction Ad Hoc Committee Meeting | Meeting Minutes Page 6 Judge Martin discussed programs in other counties. Sarasota has programs that rolled out for the mental health system, but they were already focused on solutions for homelessness as a community, which made the programs much more successful. The same approach could be useful in Collier County. Dr. Baker says there are about 100 critically chronic homeless, but they are only counted if they are willing to come in. Committee discussion ensued around accurate data collection for the homeless that do not volunteer information. Judge Martin commented that the Sheriff’s Office has the manpower and resources to assist in collecting accurate data about the homeless. Mr. Mullin commented that there was no count for veterans in the data, but that only select locations at St. Matthews, Tree of Life and Immokalee were available for the data count. Mr. Mullin commented that Collier County does have a homeless problem for veterans, but the data collection is not accurate. 8.4. Veteran Data for Collier County (Dale Mullin) Mr. Mullin discussed the data results he was able to obtain from the VA and the different statistics it contained but reiterated the lack of data surrounding homelessness in the veteran’s community. Dr. Baker commented that every veteran in Charlotte County can get housing, so we should be able to do it in Collier County. Mr. Mullin commented that the Committee needed to get a real count of how many homeless veterans we have in Collier County. Dr. Baker suggested having a fair to provide services in one spot to get haircut, shave, healthcare and do a count at that time. Mr. Mullin advised that names and numbers were collected during a fair a few weeks ago. Mr. Mullin described the 3-day class they helped to develop with Homebase and the four universities that are leading edge for clinical and support for veterans. Dr. Larsen asked who the training was for, either peers or providers. Mr. Mullin said he will invite Homebase to a future meeting to spend 20 minutes to share what they are learning. Mr. Mullin will set up in the next month or so. 8.5. Committee Vacancies Mr. Burgess asked the Committee whether they would like to reconsider previous to the Committee to fill the two at-large vacancies or readvertise and consider new applicants. Discussion ensued, and the Committee decided to reconsider applicants that had previously applied at the next meeting. Mr. Burgess made a motion to review the original applicant pool at the next meeting to fill vacancies, which was approved unanimously. 9. Old Business – Continued to next meeting 30.B.2 Packet Pg. 930 Attachment: [Linked] Agenda and Back-up Document Packet - April 2, 2019 (8779 : Collier County Mental Health and Addiction Ad Hoc Mental Health and Addiction Ad Hoc Committee Meeting | Meeting Minutes Page 7 9.1. Future Meeting Schedule 9.2. Priority 1 – Centralized Receiving System (CRS) 9.3. Discussion of Bed Supply per capita 10. Future Meeting Schedule • April 2nd at 8:30 am • April 16th at 8:30 am • April 30th at 8:30 am • May 14th at 8:30 am • May 28th at 8:30 am 10. Announcements There were no announcements. 11. Committee Member Discussion Committee members discussed the short timeline in between now and the June workshop. 12. Next Meeting Time, Date and Location The next meeting is scheduled for April 2, 2019 at 8:30 A.M. in the Fifth Floor Training Room. 13. Adjournment The meeting was adjourned at 10:09 A.M. with nothing further to discuss. Collier County Mental Health and Addictions Ad Hoc Advisory Committee Scott Burgess – Chairman The foregoing Minutes were approved by Committee Chair on April 2, 2019, “as submitted” [ ] or “as amended” [ ] 30.B.2 Packet Pg. 931 Attachment: [Linked] Agenda and Back-up Document Packet - April 2, 2019 (8779 : Collier County Mental Health and Addiction Ad Hoc Mental Health and Addiction Ad Hoc Committee Meeting April 2, 2019 Item 8.2 – Review of Calgary Housing Solutions Provided by Dale Mullin Sean, See a copy of the following email and 3 attachments. A lot of material but very interesting material on homelessness in Calgary....a world class solution. Tim Hearn (Canadian) is the individual I spoke about. He is a part time resident of Collier County - Gray Oaks. ****************************************************************************** *********** Good morning, Tim Per your request, I am attaching some off the shelf material that we hope addresses what you are looking for. I’m sure that Diana will chime in if she has anything else to add. 1.) A Centralized Receiving System - Mental Health/Addiction Patients Attached is the Our Living Legacy report (you have this in hard copy, but now you can share it digitally). On pages 46- 48, you can find information on Coordinated Service Delivery, and more specifically on page 47, what we would call our centralized receiving system, Coordinated Access and Assessment (CAA). The goal is to serve the most vulnerable and acute first, which could certainly include those with mental health issues and addictions. You can find a helpful visual on how the process works on page 48. 2.) Permanent Supportive Housing (Scattered Sites & Supportive Services) Attached is the Together to Zero report (you also have this in hard copy). In the Strategic Directive 2 Section (Home for Everyone), there is a section on The Housing Continuum. In the visual, scattered site and place-based housing are a part of the Supportive Care Housing piece. This might be good context for the Ad Hoc group. The last attachment is an overview of Calgary’s Homeless Serving System of Care. Here you can find more details on CHF funded programs, both scattered site and placed based. 30.B.2 Packet Pg. 932 Attachment: [Linked] Agenda and Back-up Document Packet - April 2, 2019 (8779 : Collier County Mental Health and Addiction Ad Hoc Also, I know that you and Doug are well-versed in these areas, but Doug’s Ad Hoc Committee might benefit from an overview of the following terms and their specific definitions. You can find these definitions at the end of the attached Living Legacy Report. • PSH, Permanent supportive housing: Long term housing for people experiencing homelessness with deep disabilities (including cognitive disabilities) without a length of stay time limit. Support programs are made available, but the program does not require participation in these services to remain housed (Systems Planning Framework). • Supportive Housing: Supportive Housing provides case management and housing supports to individuals and families who are considered moderate to high acuity. In Supportive Housing programs, the goal for the client is that over time and with case management support, the client(s) will be able to achieve housing stability and independence. While there is no maximum length of stay in Supportive Housing programs, the housing and supports are intended to be non- permanent as the goal is for the client to obtain the skills to live independently, at which point the client will transition out of the program and into the community, where they may be linked with less intensive community-based services or other supports (Systems Planning Framework). • Place-based housing: Refers to physical housing with program supports for individuals typically with high acuity (Systems Planning Framework). • Scattered site housing: A housing model that utilizes individual rental units located throughout the community, typically owned by private market landlords. Rent supplements are typically applied. Again, we hope this is helpful to you, Tim. If you need anything else, please let me know. Best, Teresa Teresa Hiser Development Manager Calgary Homeless Foundation Main: 403.237.6456 teresah@calgaryhomeless.com www.calgaryhomeless.comesting reading. Galgary in know internationally for the work that have done in solving their homeless problems. 30.B.2 Packet Pg. 933 Attachment: [Linked] Agenda and Back-up Document Packet - April 2, 2019 (8779 : Collier County Mental Health and Addiction Ad Hoc Note: Permanent Supportive Housing-Housing Units contained in a central purpose built building from which people are not expected to graduate | Supportive Housing-Individual Housing units throughout the greater community with no time limit but from which people usually graduate Defined as: Prevention Services provide short term financial assistance and limited case management in order to prevent housing loss due to a housing crisis. Defined as: Outreach involves moving outside the walls of the agency to engage people experiencing homelessness who may be disconnected and alienated not only from mainstream services and supports, but from the services targeting homeless persons as well. Defined as: System-Level Priorities are unique and diverse programs which provide support to the greater Homeless Serving System of Care. Non-Market Housing Defined as: Non-market housing is typically described as subsidized, social or affordable housing units. Grad Rent Subsidy Defined as: GRS is a rent supplement program that provides financial assistance for clients to obtain and maintain affordable housing after completion of a support program. Defined as: Adaptive Case Management programs offer client directed, flexible supports and financial assistance to those experiencing homelessness, to secure and sustain housing. Defined as: Supportive Housing (SH) provides case management and housing supports to adults and families who are considered mid to high acuity. The goal is that over time and with case management support, the client(s) will be able to achieve housing stability and independence. Defined as: Permanent Supportive Housing (PSH) provides long term housing and support with no time limit for high acuity individuals experiencing major barriers and exhibiting complex needs, and who will require ongoing support to maintain their housing. Defined as: ACT is an integrated team-based approach designed to provide comprehensive community-based supports to help people remain stably housed. These teams may consist of physicians and other health care provides, social workers and peer support workers. Agency Program Aspen Family Home Stay Boys and Girls Club Unity Project Children’s Cottage Society HomeBridge Children’s Cottage Society Rapid Rehousing McMan Rapid Rehousing Agency Program Aboriginal Friendship Centre Outreach and Cultural Reconnection Alpha House DOAP Team Wood’s Homes Exit Reach Agency Program Distress Centre of Calgary CAA Team at SORCe Aboriginal Friendship Centre Indigenous Gathering Place Keys to Recovery Creation Lodge Keys to Recovery ASCHH Liaison Canadian Accreditation Council Accreditation Agency Program CUPS Community Development Agency Program CUPS Grad Rent Subsidy Program CUPS Graduated Housing Program Agency Program Children’s Cottage Fee for Service Closer to Home Fee for Service CUPS Fee for Service Discovery House Fee for Service Inn From The Cold Fee for Service **No target # of clients for Fee for Service programs Agency Program Alpha House Alpha Housing Accessible Housing Bridge to Home Aspen Family Sustainable Families Boys and Girls Club Aura Infinity Project Home Fire Children’s Cottage HomeLinks Calgary Dream Centre Living in Community Calgary John Howard Adult Housing Reintegration Roofs for Youth CUPS Key Case Management Discovery House Community Housing Inn from the Cold Housing with Intensive Supports McMan Hope Homes Hope Homes Aboriginal Aboriginal Friendship Centre Aboriginal Homeless Initiative The Alex HomeBase Keys To Recovery Keys To Recovery Inn From The Cold Journey House 1 Journey House 2 Metis Calgary Family Services Rainbow Lodge Wood’s New Horizon Alberta Health Services Bridgeland & Ophelia Supportive Housing Agency Program Alpha House Madison Francis Manor Sunalta Lodging House Aurora Women’s Housing Program The Alex Abbeydale Place Prelude Accessible Housing Newbridge CASS Stepping Stone Manor Langin Place YW of Calgary Providence Croydon Sharp Foundation Murrary’s House TBD The Maple * Opening 2018 Agency Program The Alex Pathways to Housing % of Funding: 3% % of Funding 3% % of Funding: 2% % of Funding: 9% % of Funding: 3% % of Funding: 46% % of Funding: 23% % of Funding: 11% Total $: 1,222,000 Total $: 1,595,000 Total $: 904,000 Total $: 4,169,000 Total $: 1,141,000 Total $: 21,072,000 Total $: 10,292,000 Total $: 5,187,000 # of Clients: N/A # of Clients: N/A # of Clients: N/A # of Clients: 476 # of Clients: 20** # of Clients: 1200 # of Clients: 310 # of Clients: 200 Cost/Client: N/A Cost/Client: N/A Cost/Client: N/A Cost/Client: $8759 Cost/Client: N/A Cost/Client: $17,560 Cost/Client: $33,200 Cost/Client: $25,935 30.B.2 Packet Pg. 934 Attachment: [Linked] Agenda and Back-up Document Packet - April 2, 2019 (8779 : Collier County Mental Health and Addiction Ad Hoc Updated: 31 August 2018 Prevention Services 3% Outreach 3% Non-Market Housing & GRS 9%System-Level Priorities 2% Adaptive Case Management 3% Supportive Housing 46% Permanent Supportive Housing 23% Assertive Community Treatment (ACT) 11% Supportive Housing $21,072,000 Permanent Supportive Housing $10,292,000 ACT $5,187,000 Non-Market Housing & GRS $4,169,000 Outreach $1,595,000 Prevention Services $1,222,000 Adaptive Case Management $1,141,000 System-Level Priorities $ 904,000 30.B.2 Packet Pg. 935 Attachment: [Linked] Agenda and Back-up Document Packet - April 2, 2019 (8779 : Collier County Mental Health and Addiction Ad Hoc Updated: 31 August 2018 Defined as: Prevention Services provide short term financial assistance and limited case management in order to prevent housing loss due to a housing crisis. Defined as: Outreach involves moving outside the walls of the agency to engage people experiencing homelessness who may be disconnected and alienated not only from mainstream services and supports, but from the services targeting homeless persons as well. Defined as: System-Level Priorities are unique and diverse programs which provide support to the greater Homeless Serving System of Care. Non-Market Housing Defined as: Non-market housing is typically described as subsidized, social or affordable housing units. Grad Rent Subsidy Defined as: GRS is a rent supplement program that provides financial assistance for clients to obtain and maintain affordable housing after completion of a support program. Defined as: Adaptive Case Management programs offer client directed, flexible supports and financial assistance to those experiencing homelessness, to secure and sustain housing. Defined as: Supportive Housing (SH) provides case management and housing supports to individuals and families who are considered mid to high acuity. In this program type, the goal for the client is that over time and with case management support, the client(s) will be able to achieve housing stability and independence. Defined as: Permanent Supportive Housing (PSH) provides long term housing and support with no time limit for high acuity individuals experiencing major barriers and exhibiting complex needs, and who will require ongoing support to maintain their housing. Defined as: ACT is an integrated team-based approach designed to provide comprehensive community-based supports to help people remain stably housed. These teams may consist of physicians and other health care provides, social workers and peer support workers. Agency Program Agency Program Alpha House DOAP Team Aboriginal Friendship Centre Outreach and Cultural Reconnection Agency Program Distress Centre of Calgary CAA Team at SORCe Aboriginal Friendship Centre Indigenous Gathering Place Keys to Recovery Creation Lodge Keys to Recovery ASCHH Liaison Canadian Accreditation Council Accreditation Agency Program CUPS Community Development Agency Program CUPS Grad Rent Subsidy Program CUPS Graduated Housing Program Agency Program Agency Program Alpha House Alpha Housing Accessible Housing Bridge to Home Calgary Dream Centre Living in Community Calgary John Howard Adult Housing Reintegration CUPS Key Case Management Aboriginal Friendship Centre Aboriginal Homeless Initiative The Alex HomeBase Keys To Recovery Keys To Recovery Alberta Health Services Bridgeland & Ophelia Supportive Housing Agency Program Alpha House Madison Francis Manor Sunalta Lodging House Aurora Women’s Housing Program The Alex Abbeydale Place Prelude Accessible Housing Newbridge CASS Stepping Stone Manor Langin Place YW of Calgary Providence Croydon Sharp Foundation Murrary’s House TBD The Maple * Opening 2018 Agency Program The Alex Pathways to Housing Total $: 0 Total $: 1,415,000 Total $: 904,000 Total $: 4,169,000 Total $: 0 Total $: 12,332,000 Total $: 10,292,000 Total $: 5,187,000 # of Clients: N/A # of Clients: N/A # of Clients: N/A # of Clients: 476 # of Clients: 0 # of Clients: 784 # of Clients: 310 # of Clients: 200 Cost/Client: N/A Cost/Client: N/A Cost/Client: N/A Cost/Client: $8,758 Cost/Client: N/A Cost/Client: $15,730 Cost/Client: $33,200 Cost/Client: $25,935 30.B.2 Packet Pg. 936 Attachment: [Linked] Agenda and Back-up Document Packet - April 2, 2019 (8779 : Collier County Mental Health and Addiction Ad Hoc Updated: 31 August 2018 Adults Sector 74% Youth Sector 10% Families Sector 14% System-Level Priorities 2% 30.B.2 Packet Pg. 937 Attachment: [Linked] Agenda and Back-up Document Packet - April 2, 2019 (8779 : Collier County Mental Health and Addiction Ad Hoc Updated: 31 August 2018 Defined as: Prevention Services provide short term financial assistance and limited case management in order to prevent housing loss due to a housing crisis. Defined as: Outreach involves moving outside the walls of the agency to engage people experiencing homelessness who may be disconnected and alienated not only from mainstream services and supports, but from the services targeting homeless persons as well. Defined as: System-Level Priorities are unique and diverse programs which provide support to the greater Homeless Serving System of Care. Non-Market Housing Defined as: Non-market housing is typically described as subsidized, social or affordable housing units. Grad Rent Subsidy Defined as: GRS is a rent supplement program that provides financial assistance for clients to obtain and maintain affordable housing after completion of a support program. Defined as: Adaptive Case Management programs offer client directed, flexible supports and financial assistance to those experiencing homelessness, to secure and sustain housing. Defined as: Supportive Housing (SH) provides case management and housing supports to individuals and families who are considered mid to high acuity. In this program type, the goal for the client is that over time and with case management support, the client(s) will be able to achieve housing stability and independence. Defined as: Permanent Supportive Housing (PSH) provides long term housing and support with no time limit for high acuity individuals experiencing major barriers and exhibiting complex needs, and who will require ongoing support to maintain their housing. Defined as: ACT is an integrated team-based approach designed to provide comprehensive community-based supports to help people remain stably housed. These teams may consist of physicians and other health care provides, social workers and peer support workers. Agency Program Agency Program Boys and Girls Club Unity Project McMan Rapid Rehousing Agency Program Wood’s Exit Reach Agency Program Distress Centre of Calgary CAA Team at SORCe Aboriginal Friendship Centre Indigenous Gathering Place Keys to Recovery Creation Lodge Keys to Recovery ASCHH Liaison Canadian Accreditation Council Accreditation Agency Program Agency Program Agency Program Boys and Girls Club Aura Infinity Project Home Fire Calgary John Howard Roofs for Youth McMan Hope Homes Hope Homes Aboriginal Woods New Horizon Agency Program Agency Program Total $: 171,000 Total $: 180,000 Total $: 904,000 Total $: 0 Total $: $0 Total $: 4,312,000 Total $: 0 Total $: 0 # of Clients: N/A # of Clients: N/A # of Clients: N/A # of Clients: N/A # of Clients: N/A # of Clients: 162 # of Clients: N/A # of Clients: N/A Cost/Client: N/A Cost/Client: N/A Cost/Client: N/A Cost/Client: N/A Cost/Client: N/A Cost/Client: $26,671 Cost/Client: N/A Cost/Client: N/A 30.B.2 Packet Pg. 938 Attachment: [Linked] Agenda and Back-up Document Packet - April 2, 2019 (8779 : Collier County Mental Health and Addiction Ad Hoc Updated: 31 August 2018 Defined as: Prevention Services provide short term financial assistance and limited case management in order to prevent housing loss due to a housing crisis. Defined as: Outreach involves moving outside the walls of the agency to engage people experiencing homelessness who may be disconnected and alienated not only from mainstream services and supports, but from the services targeting homeless persons as well. Defined as: System-Level Priorities are unique and diverse programs which provide support to the greater Homeless Serving System of Care. Non-Market Housing Defined as: Non-market housing is typically described as subsidized, social or affordable housing units. Grad Rent Subsidy Defined as: GRS is a rent supplement program that provides financial assistance for clients to obtain and maintain affordable housing after completion of a support program. Defined as: Adaptive Case Management programs offer client directed, flexible supports and financial assistance to those experiencing homelessness, to secure and sustain housing. Defined as: Supportive Housing (SH) provides case management and housing supports to individuals and families who are considered mid to high acuity. In this program type, the goal for the client is that over time and with case management support, the client(s) will be able to achieve housing stability and independence. Defined as: Permanent Supportive Housing (PSH) provides long term housing and support with no time limit for high acuity individuals experiencing major barriers and exhibiting complex needs, and who will require ongoing support to maintain their housing. Defined as: ACT is an integrated team-based approach designed to provide comprehensive community-based supports to help people remain stably housed. These teams may consist of physicians and other health care provides, social workers and peer support workers. Agency Program Aspen Family Home Stay Children’s Cottage Society HomeBridge Children’s Cottage Society Rapid Rehousing Agency Program Agency Program Distress Centre of Calgary CAA Team at SORCe Aboriginal Friendship Centre Indigenous Gathering Place Keys to Recovery Creation Lodge Keys to Recovery ASCHH Liaison Canadian Accreditation Council Accreditation Agency Program Agency Program Children’s Cottage Fee for Service Closer to Home Fee for Service CUPS Fee for Service Discovery House Fee for Service Inn From The Cold Fee for Service **No target # of clients for Fee for Service programs Agency Program Aspen Family Sustainable Families Children’s Cottage HomeLinks Discovery House Community Housing Inn from the Cold Housing with Intensive Supports Inn From The Cold Journey House 1 Journey House 2 Metis Calgary Family Services Rainbow Lodge Agency Program Agency Program Total $: 1,051,000 Total $: 0 Total $: 904,000 Total $: 0 Total $: 1,141,000 Total $: 4,428,000 Total $: 0 Total $: 0 # of Clients: N/A # of Clients: N/A # of Clients: N/A # of Clients: N/A # of Clients: 20** # of Clients: 254 # of Clients: N/A # of Clients: N/A Cost/Client: N/A Cost/Client: N/A Cost/Client: N/A Cost/Client: N/A Cost/Client: N/A Cost/Client: $17,433 Cost/Client: N/A Cost/Client: N/A 30.B.2 Packet Pg. 939 Attachment: [Linked] Agenda and Back-up Document Packet - April 2, 2019 (8779 : Collier County Mental Health and Addiction Ad Hoc TogetherToZero Charting Calgary’s Path To the End of HomelessnessDecember 2018 Absolute Functional 30.B.2 Packet Pg. 940 Attachment: [Linked] Agenda and Back-up Document Packet - April 2, 2019 (8779 : Collier County Mental Health and Addiction Ad Hoc The lead author of the Living Legacy Collective Impact Report & “Together to Zero” strategic directives was Alina Turner of Turner Strategies, in collaboration with I Heart Home, Calgary Homeless Foundation and the many agencies within Calgary’s Homeless-Serving System of Care AUTHORS: Dr. Alina Turner - Turner Strategies Victoria Ballance, Joel Sinclair - Calgary Homeless Foundation ENGAGEMENT TEAM: Nancy Loraas - Next Level Leadership Emily Bedford, Megan Donnelly - I Heart Home, Calgary Homeless Foundation INDIGENOUS ENGAGEMENT TEAM: Karen Pheasant-Neganigwane Ange Neil Katelyn Lucas - Aboriginal Standing Committee on Housing and Homelessness 30.B.2 Packet Pg. 941 Attachment: [Linked] Agenda and Back-up Document Packet - April 2, 2019 (8779 : Collier County Mental Health and Addiction Ad Hoc ”“Coming together is a beginning. Keeping together is a progress. Working together is success. - Henry Ford ”“Individual commitment to a group effort - that is what makes a team work, a company work, a society work, a civilization work. - Vince Lombardi 30.B.2 Packet Pg. 942 Attachment: [Linked] Agenda and Back-up Document Packet - April 2, 2019 (8779 : Collier County Mental Health and Addiction Ad Hoc Acknowledgements WE WOULD LIKE TO EXPRESS OUR DEEP APPRECIATION TO ALL THOSE WHO MADE THIS DOCUMENT A POSSIBILITY. FIRST AND FOREMOST, OUR SINCERE GRATITUDE GOES OUT TO EVERY FRONT LINE WORKER WHO ATTENDED OUR ENGAGEMENT SESSIONS AND OFFERED THEIR STORIES WITH RESPECT, TRUST, AND VULNERABILITY. THESE STRATEGIC DIRECTIVES WOULD NOT BE POSSIBLE WITHOUT THEIR WILLINGNESS TO BELIEVE IN A FUTURE WITHOUT HOMELESSNESS IN OUR CITY, AND THE COURAGE THEY HAVE TO DEDICATE THEIR LIVES TO MAKING IT A REALITY. IT WAS A GREAT PRIVILEGE FOR US TO CAPTURE THEIR STORIES, THOUGHTS AND IDEAS, WHICH ALLOWS US ALL TO ADVANCE UPON OUR PRACTICES TO CONTINUALLY IMPROVE OUR SERVICE TO THOSE WHO ARE EXPERIENCING HOMELESSNESS. We would also like to thank the Government of Canada, the Government of Alberta, and City of Calgary for their unprecedented support for our collective mission and their substantial contributions to capital projects and programs which have allowed us to demonstrate tremendous success and arrive at the place we are today. We also want to thank Indigenous Elders, Chiefs and Council, leaders and individuals who continually inform us to ensure we are culturally inclusive, and for always providing their truth and wisdom through honesty and vulnerability. We thank those with lived and living experience of homelessness who share their stories, opinions and thoughts, and consistently give of themselves to help us craft a system of care that is focused on people first and meeting the needs of those we serve. Many thanks to all Calgarians who volunteer, educate and participate in our collective vision of ending homelessness by gifting us with their time, talents and resources. A vision toend homelessness in Calgarycan only be achieved, together. 30.B.2 Packet Pg. 943 Attachment: [Linked] Agenda and Back-up Document Packet - April 2, 2019 (8779 : Collier County Mental Health and Addiction Ad Hoc Our Consultation Process TO MARK THE CONCLUSION OF CALGARY’S 10 YEAR PLAN TO END HOMELESSNESS, MEMBERS OF CALGARY’S HOMELESS-SERVING SYSTEM OF CARE (HSSC) AS WELL AS BROADER STAKEHOLDER GROUPS (PUBLIC, CORPORATE CALGARY, THOSE WITH LIVED EXPERIENCE OF HOMELESSNESS, INDIGENOUS ELDERS, YOUTH AND ADULTS) WERE INVITED TO GIVE REFLECTIONS ON THE PAST DECADE OF ENDING HOMELESSNESS IN OUR CITY IN ORDER TO INFORM HSSC DIRECTIVES MOVING FORWARD. Phase I of this engagement process involved 54 long-standing individuals within the HSSC who had extensive knowledge of Calgary’s 10 Year Plan to End Homelessness. The purpose of these sessions was to identify the key topics to bring to discussions with the broader community. These discussions focused on the following questions: z What’s working? z What’s not working? z What unique factors made this possible? z What’s most important? z Is there anything we’re missing or that we should be asking? Discussions within the first phase sessions identified eight key topic areas to explore in Phase II of the engagement process: 1. Caring for the Front Lines 2. Data and Reporting 3. Empowering Calgarians 4. Homeless-Serving System Planning 5. Housing 6. Poverty and Homelessness 7. Shelter Visioning 8. Empowering Calgarians: The Public Phase II called to all members of the HSSC, as well as broader stakeholder groups such as key members of the primary public systems, corporate Calgary, community volunteers, agency board members, agency executives, the public, and those with lived experience of homelessness to contribute their thoughts, stories, knowledge and opinions. Each session focused on one of the topics listed above, and Phase II saw 12 engagement sessions attended by over 200 participants for a total of 53 hours. In addition, 42 public online surveys were completed. All Phase I and II engagement sessions were facilitated by Nancy Loraas of Next Level Leadership. Remarks were collected in the form of minutes, written long-answer and short-answer forms, and online surveys. Separate and complementary sessions were completed with Indigenous Elders, leaders, youth, and adults many with current or past experience of homelessness. Elders were consulted first, and guided subsequent conversations as participants were invited to give their reflections on the unique perspective of Indigenous homelessness in Calgary. These sessions were led by Indigenous facilitators: Karen Pheasant-Neganigwane, Ange Neil and Katelyn Lucas. Honouring oral tradition, remarks from these sessions were collected through video and voice recording. The directives reflect feedback received throughout the consultation process and the quotes included in this report are a few of the remarks made by engagement session participants. 30.B.2 Packet Pg. 944 Attachment: [Linked] Agenda and Back-up Document Packet - April 2, 2019 (8779 : Collier County Mental Health and Addiction Ad Hoc Introduction:Together to Zero ON JANUARY 29, 2008, THE CITY OF CALGARY LAUNCHED A BOLD INITIATIVE TO END HOMELESSNESS IN OUR COMMUNITY. CALGARY’S 10 YEAR PLAN TO END HOMELESSNESS WAS FOUNDED ON THE ASPIRATIONAL GOAL OF ENDING HOMELESSNESS IN OUR CITY IN TEN YEARS. AS A FIRST OF ITS KIND IN CANADA, THE ORIGINAL VISION OF CALGARY’S 10 YEAR PLAN WAS THAT ALL PEOPLE FACING HOMELESSNESS IN CALGARY WILL HAVE ACCESS TO SAFE, DECENT AND AFFORDABLE HOUSING AS WELL AS THE RESOURCES AND SUPPORTS NECESSARY TO SUSTAIN THAT HOUSING BY THE YEAR 2018. While Calgary did not achieve its ambitious goal of ending homelessness, over the past decade our community has had many successes. We’ve housed almost 10,000 people, built almost 600 units of permanent housing with supports, and we’ve developed a well-coordinated homeless- serving system of care that the rest of the world consistently looks to emulate. Calgary is a leader in our country. Our city has consistently led the charge to end homelessness in Canada – and as we have collaborated and coordinated around Calgary’s 10 Year Plan, we have learned a lot. We have learned that Housing First does not equal housing only, and that many people may require wrap around supports to help them be successful. We have discovered that the true causes of homelessness come from external macro factors, and that prevention must predominantly occur in the primary public systems. We have created a Homeless Management Information System (HMIS) that allows us to better assess the state of homelessness in our city, and we have also learned that while the goal of a true Absolute Zero end to homelessness remains our collective aspirational goal we realize that this is not realistic in practice without significant changes within our primary systems. It makes more sense for us to focus on achieving what is now known as Functional Zero - whereby efforts are concentrated on reaching a point where there are enough services, housing and emergency shelter beds for everyone who needs them. This way, anyone who does experience homelessness does so only briefly, is rehoused quickly and successfully, and is unlikely to return to homelessness again. Functional Zero is a realistic and achievable goal in our city, if we all work together. This guiding document is a consolidation of a decade of knowledge combined with what we, as a community, envision as the primary strategic areas of focus crucial to achieving this collective goal. Through our Living Legacy engagement sessions participants clearly articulated what they felt are the most critical areas of focus for our city. Their collective knowledge directly informed the creation of the six core Strategic Directives within this guiding document that will take us Together to Zero. These six Strategic Directives provide an intentional framework by which public systems, homeless-serving agencies, the public, corporate Calgary, and partners, can best utilize the shared knowledge gained over the last ten years to adjust and align our individual agencies’ strategic and tactical plans, governance models, initiatives, and programs to function better within the Homeless-Serving System of Care (HSSC) in order to best meet the needs of vulnerable Calgarians who are at risk of or experiencing homelessness. While stopping homelessness before it ever begins will always be our shared goal, collectively aligning ourselves with the Strategic Directives outlined within this guiding document will help Calgary to achieve Functional Zero and empower our community to continue charting our path forward to the end of homelessness in Calgary. Absolute Functional 30.B.2 Packet Pg. 945 Attachment: [Linked] Agenda and Back-up Document Packet - April 2, 2019 (8779 : Collier County Mental Health and Addiction Ad Hoc CALGARY’S HOMELES S S ERVIN G S YSTEM OF CAREPrimary PublicSystems CHSSC - Default System Public systems: (Housing, Income Supports, Justice, Childrens’s Services, Health) The primary systems of care in our city. Though they are distinct, they integrate with each other in service to individuals. Calgary’s Homeless-Serving System of Care (CHSSC) is a default system. The not-for-profit agencies in the HSSC can, with appropriate and guaranteed resources, provide services (right connecting or direct) to clients who have fallen through fractures within primary public systems. Growing the HSSC will never solve the broader systemic issues that cause homelessness. Public systems invest in housing and supports and contribute resources to address the complex needs of clients experiencing homelessness. Intentional, systems-informed service oriented partnerships between primary public systems and not-for-profits (before homelessness occurs) optimizes ecosystem effectiveness. CHSSC focus is on achieving a point where there are enough services, housing and emergency shelter beds for everyone who needs them so that anyone who experiences homelessness does so only briefly, is rehoused quickly and successfully, and is unlikely to return to homelessness again. 1 2 4 3 Primary prevention occurs within the primary public systems. CHSSC Catches those who fall through fractures within the primary systems. If a client presents within the HSSC, primary prevention is no longer possible. CHSSC reconnects clients back to the primary systems whenever possible. 5 1 2 3 5 What isFunctional Zero? OVER THE PAST DECADE WE’VE LEARNED THAT WE REQUIRE A MORE AGILE SYSTEM, AND CONCURRENTLY, WE NEED A MORE AGILE VISION OF SUCCESS. THE MOVE AWAY FROM FIXED-POINT TARGETS TO INDICATORS OF PROGRESS ENABLED US TO THINK ABOUT SUCCESS IN A DIFFERENT WAY, AND WE NOW FRAME SUCCESS IN TERMS OF FUNCTIONAL ZERO. A Functional Zero end to homelessness means that public systems and the HSSC have a systematic response in place that ensures homelessness is prevented whenever possible or is otherwise a rare, brief, and non-recurring experience. Functional Zero for Calgary does not mean that no one will ever experience homelessness but, rather, as a system of care (public and HSSC) we will have the resources that allow us to measure the capacity, sustainability, and effectiveness of our system in real time. This, in turn, allows us to ensure that our focus is on reconnecting clients to the appropriate public systems and achieving a point where there are enough services, housing, and emergency shelter beds for everyone who needs them so that anyone who experiences homelessness does so only briefly, is rehoused quickly and successfully, and is unlikely to return to homelessness again. It also means that as a community, we have absolute zero tolerance for ignoring homelessness, normalizing it, doing nothing to prevent it, and doing nothing to stop it. Functional Zerofor Calgary: 30.B.2 Packet Pg. 946 Attachment: [Linked] Agenda and Back-up Document Packet - April 2, 2019 (8779 : Collier County Mental Health and Addiction Ad Hoc 1PEOPLE FIRST OF PRIMARY CONSIDERATION FOR ANY FUTURE EFFORTS, THE HSSC MUST REMAIN GROUNDED IN A PEOPLE-FIRST APPROACH. THIS MEANS THAT WE MUST CONTINUALLY REMIND OURSELVES THAT WHILE WE EXIST TO SERVE THOSE MOST VULNERABLE, WE MUST ALSO BE MINDFUL OF ALL WHO ARE INVOLVED IN OUR EFFORTS TO PREVENT AND END HOMELESSNESS IN OUR CITY.STRATEGIC DIRECTIVE30.B.2 Packet Pg. 947 Attachment: [Linked] Agenda and Back-up Document Packet - April 2, 2019 (8779 : Collier County Mental Health and Addiction Ad Hoc ”“ The Voice ofLiving and Lived Experience The Homeless Charter of Rights is empowering. It’s helping leaders understand what they need to support what people are going through, and it’s what will empower people experiencing homelessness when they are in public. It is clear that more can be done to diminish the gap between the recipients of our services and those who deliver and fund those services. We have long lamented the lack of service user input in program design – yet have only begun to implement measures that circumvent service-centric systems. Moving forward, we need to explore the potential of a culture of innovation with the voice of people with lived experience at its core. Embedding their input at key points in the program development-delivery continuum will enable and facilitate an iterative improvement process that allows the HSSC to better meet the needs of clients. IN 2015, CALGARY’S PLAN WAS UPDATED WITH A PEOPLE FIRST LENS, WHICH MEANS THAT WE MEET THOSE AT RISK OF, OR EXPERIENCING HOMELESSNESS WHERE THEY ARE, AND ALLOW THEM TO MAKE THEIR OWN CHOICES FOR SERVICES AND HOUSING. AT ITS CORE, WE MUST CONTINUE TO FOCUS OUR EFFORTS AROUND ALLOWING THE VOICE OF LIVED AND LIVING EXPERIENCE TO CONSTANTLY INFORM THE WORK THAT WE DO. WHAT THIS ULTIMATELY MEANS IS THAT WE MUST CONTINUALLY LISTEN AT THE SERVICE LEVEL WHILE CONSISTENTLY SEEKING INPUT AT THE PROGRAMMATIC LEVEL. 30.B.2 Packet Pg. 948 Attachment: [Linked] Agenda and Back-up Document Packet - April 2, 2019 (8779 : Collier County Mental Health and Addiction Ad Hoc “”Action on Truth & Reconciliation:The Effects of Colonization &Recognition of Cultural Differences I think right at this point, what it means to be Indigenous is that we’re all recovering. Maybe not necessarily from addiction but we are recovering from our own misery. And that has yet to be recognized as society, as a whole, or even acknowledged. ENDING HOMELESSNESS IN CALGARY MUST ADDRESS THE HISTORY AND IMPACT OF COLONIZATION THAT IS A PRIMARY DRIVER OF HOMELESSNESS FOR INDIGENOUS PEOPLE, AND EFFORTS WILL ONLY BE EFFECTIVE WITH THE LEADERSHIP OF, AND AUTHENTIC PARTNERSHIPS WITH, INDIGENOUS PEOPLES IN OUR COMMUNITY. THE TREMENDOUS OVERREPRESENTATION OF INDIGENOUS PEOPLE AMONGST MARGINALIZED GROUPS, INCLUDING THOSE EXPERIENCING HOMELESSNESS, CLEARLY INDICATES THE ONGOING EFFECTS OF COLONIALIZATION. THE IMPACTS OF RESIDENTIAL SCHOOLING, THE SIXTIES SCOOP, AND ONGOING RACISM CONTRIBUTE TO FURTHER INTERGENERATIONAL TRAUMA COMPOUNDING ITS EFFECTS ON INDIGENOUS PEOPLE’S HEALTH AND WELLBEING. Truth must inform reconciliation. This is not a check box exercise. A renewed focus on building partnerships and nurturing trust with First Nations is a crucial next step – as is building partnerships with Inuit and Métis communities. In support of this process, Indigenous Elders, youth and adults with lived experience provided specific feedback into the strategic directive development process to facilitate a better understanding of homelessness from an Indigenous perspective. Many Indigenous Elders attributed the core issues that contribute to homelessness in the Indigenous community to the intergenerational trauma caused by residential schools and colonization; a loss of connection to family, community and culture – including language, traditional values, spirituality and ceremony; as well as a lack of appropriate housing and government funding to create additional housing that is required on the reserves. Indigenous Elders also discussed the high occurrence of addiction to drugs and alcohol and prevalence of domestic violence. Many also highlighted that stereotypes still exist and that often this stems from a lack of understanding and knowledge of history and culture. The Elders shared their view that the younger generations have lost their parenting skills as many 30.B.2 Packet Pg. 949 Attachment: [Linked] Agenda and Back-up Document Packet - April 2, 2019 (8779 : Collier County Mental Health and Addiction Ad Hoc of them are repeating the parenting techniques learned within the residential school system. These parenting techniques are believed to be contributing to the continued cycle of abuse and trauma, and elder generations (typically grandparent figures) have had to step in to raise grandchildren in a healthy and traditional way to bridge the knowledge gap within the younger generations’ lack of parenting skills. Addiction for many is linked to a lack of connection and access to cultural engagement, specifically to history, language, land, traditions, ceremony and community. It was also noted that Indigenous peoples have an “identity problem.” This stems from being disconnected from their community and traditional culture, which contributes to a lack of acceptance of their heritage and a diminished feeling of pride and self-worth. Indigenous self-determination is core to truth and reconciliation and must underpin the development of homelessness programs and strategies. Further, the urban Indigenous community is non-homogenous and there is a diversity of Indigenous culture. This means rather than “Indigenizing” programs, we must participate in meaningful engagement and co-development processes with Indigenous partners in Calgary and Alberta. The HSSC must continue to explore, in partnership with Indigenous governments and partners, what role the HSSC should play in support of self-determination. Such reflection will need to be a key priority post-2018 as we work together to solve the homelessness crisis affecting Indigenous people. “” I’m intimidated going into a room full of white people even if it’s all about recovery. I understand that comfort level with our own people, and that we need to be around our own people to heal. 30.B.2 Packet Pg. 950 Attachment: [Linked] Agenda and Back-up Document Packet - April 2, 2019 (8779 : Collier County Mental Health and Addiction Ad Hoc The challenges of working with high-complexity individuals experiencing homelessness continues to negatively impact our front line workers. The psychological stressors, and/or vicarious trauma of working with clients who have or are experiencing trauma, addictions and mental illness combined with the physical and environmental challenges factor into everyday life for those working on the front lines. Our staff are the primary advocates for those they serve, however, the burden on staff working with complex populations continues to take its toll. In a CHF-commissioned study interviewing 245 staff in 13 agencies, Drs. Wagemakers Schiff and Lane (2016) assessed burnout and post-traumatic stress in Calgary’s homeless-serving sector. The study points out that a disproportionate number of front line workers have minimal education and training for dealing with the complexity of the clients they are serving. Many staff have no training in counselling or intervention skills (particularly in addictions) prior to being hired into these critical front line positions. According to the study, about 25% of workers in the homeless-serving sector in Calgary suffer from burnout and compassion fatigue that heavily impacts job performance and decreases their quality of life. Further, approximately 36% of those interviewed reported symptoms that would very likely result in a PTSD diagnosis. This vicarious traumatization is likely the result of a combination of prior traumatic experiences, traumatic work events, and being witness to client trauma. This sentiment was reflected in our engagement sessions with participants stating that their jobs are constantly crisis-driven, which is highly stressful, and HSSC front line staff suggested a number of possible ideas to better support them in their work. They did reflect that collaboration among agencies was beneficial for their work life and that the strong sense of community within and among agencies is beneficial for their mental health. Individuals in supervisory roles acknowledged that more leadership training would also be highly beneficial, but also strongly suggested safer and more effective channels for front line staff to express concerns and feedback to leadership and executive levels within their respective organizations. Front line workers also expressed that peer-to-peer support, mentorship and talking with others who have had similar experiences is much more effective than third party counselling, and while front line staff recognized that existing training (such as the vicarious trauma workshops) was beneficial to ongoing work, there was an overall acknowledgement that gaps still remained. Beyond 2018, leaders within the HSSC must review working conditions, professional capacity building, and training needs to meaningfully support those on the front line who are doing the extraordinarily difficult work. Caring for the Front Lines ONE OF THE MOST CONSISTENT THEMES THAT FLOWED THROUGH OUR ENGAGEMENT SESSIONS IS THAT OUR FRONT LINE WORKERS FEEL NEGLECTED AND WITHOUT SUPPORT. THROUGHOUT THE FEEDBACK PROCESS, IT CONSISTENTLY BECAME CLEAR WE NEED TO BEGIN TO GIVE THE SAME LEVEL OF ATTENTION AND CARE TO OUR OWN PEOPLE AS WE GIVE TO THOSE WE SERVE. ”“One of the challenges is often that we work in an environment that’s always crisis-driven and staff is under stress. The challenge is that we don’t turn around and acknowledge that and put resources in place that mitigate the crisis component. We don’t turn our mission for clients around on ourselves. 30.B.2 Packet Pg. 951 Attachment: [Linked] Agenda and Back-up Document Packet - April 2, 2019 (8779 : Collier County Mental Health and Addiction Ad Hoc Living and Lived Experience: z Enhance client-centered lens by integrating client feedback intentionally through program development, implementation, and evolution. z Continue to leverage the voice of lived experience by listening to people, committees and groups such as the Client Action Committee and Youth Advisory Table, and allow their input to consistently inform the work that we do. z Intentionally seek out those living in homelessness to be more responsive to real- time needs as their experiences are time, system, and landscape dependent. Caring for the front lines: z Review opportunities to enhance training and peer-to-peer supports to augment frontline staff capacity. z Examine and create more opportunities for front line worker concerns and feedback within homeless-serving organizations and throughout the greater system of care. z Continue collaborating and fostering a greater sense of community between and among agencies within the HSSC. Action on Truth and Reconciliation: z Stop “Indigenizing” programs and start right connecting to existing Indigenous communities and services to foster greater self-determination and participate in meaningful engagement and co-development processes with Indigenous partners within Calgary and Alberta. z Seek guidance from Indigenous Elders and partners to increase awareness of culture and intergenerational trauma and their impact on people, structures, and policies within HSSC agencies and organizations. z Respectfully incorporate Indigenous ways of knowing, oral tradition, ceremony, acknowledgement, and history into more culturally-appropriate service delivery. People First Priority Areas of Focus: 30.B.2 Packet Pg. 952 Attachment: [Linked] Agenda and Back-up Document Packet - April 2, 2019 (8779 : Collier County Mental Health and Addiction Ad Hoc 2 HOME FOR EVERYONE OVER THE PAST DECADE THE HSSC HAS BECOME MUCH MORE ADAPTABLE AS IT’S SHIFTED TO MEET CLIENTS’ NEEDS. HOWEVER, INCREASED FLEXIBILITY IS REQUIRED WHEN IT COMES TO THE HOUSING CONTINUUM IN ORDER TO MAINTAIN THIS CLIENT-CENTERED LENS. HOUSING FIRST IS NOT HOUSING ONLY, AND HOUSING CAPACITY AND DESIGN MUST BE IN ALIGNMENT WITH THE DIVERSE NEEDS OF THE INDIVIDUALS WE SERVE.STRATEGIC DIRECTIVE30.B.2 Packet Pg. 953 Attachment: [Linked] Agenda and Back-up Document Packet - April 2, 2019 (8779 : Collier County Mental Health and Addiction Ad Hoc HousingFirst Chronic health issues, (particularly mental illness, disabilities, and physical illness), increase risk for homelessness. Those experiencing housing instability often face a multitude of challenges – including mental health issues, addictions, domestic violence, limited education, barriers to employment, and involvement with multiple systems like Children’s Services and Justice. Housing First works for people, public systems, and communities by delivering access to housing with wrap around supports. However, Housing First is not housing only. It is a people-centric approach that recognizes the unique needs of individuals and families, as housing and programs need to be adaptable and reflective of the changing dynamics of individuals and families experiencing homelessness. Over the past decade the sector has primarily prioritized high-complexity clients, ensuring that limited resources were strategically utilized. We now recognize that housing and programming must be made available for mid-complexity clients as an intervention and prevention measure. The current housing continuum does not capture the differing needs within different program types and it has been expressed that a more comprehensive definition of “success” within a Housing First model is required as clients often found a space that they like and simply elected to stay there. We also need to examine opportunities to further incorporate an Indigenous lens into our housing strategies – such as providing multi-family dwellings with programming that promotes healing, community and culture. A key learning over the past decade revealed that, while there are pieces of the service network that the non-profit sector can deliver more effectively and cost- efficiently on behalf of mainstream systems, it can only do so with adequate resourcing and collaboration to achieve ongoing system coordination. The lack of capacity and access to public services such as counseling, mental health supports, and addictions services continue to be a key barrier for those experiencing homelessness. This is why we need other public systems to invest and operate in housing and supports as well – Health, Justice, Children’s Services, and others can contribute resources to address the complex needs of clients experiencing homelessness. For instance, the Collaborative for Health and Home (CHH) identified 900 complex, long-term homeless individuals who are in need of an integrated health and housing response as result of their complex mental health, addiction, and physical health challenges. The HSSC does not have the capacity, the expertise, nor the authority to build and operate such a facility; we need Alberta Health’s leadership to address this need. Similarly, correctional facilities require additional community-based housing units and supports appropriate to the levels of need of the person released. Provincial and federal corrections systems must contribute to the development of housing stock and supports specific to the needs of shared complex service participants with housing instability. Youth leaving provincial foster care also need transition supports, including rent subsidies and access to affordable housing. The HSSC can be a part of all of these solutions, however, it cannot be expected to take them on alone. CALGARY’S 10 YEAR PLAN WAS BUILT UPON THE PHILOSOPHY OF HOUSING FIRST. VERY EARLY ON, WE UNDERSTOOD THE NOTION OF HOUSING FIRST AS THE IDEA OF PROVIDING A PERSON EXPERIENCING HOMELESSNESS WITH HOUSING, WHILE SIMULTANEOUSLY OFFERING THEM SUPPORTS TO ADDRESS COEXISTING ISSUES THEY MAY BE FACING. “” Housing First wasn’t in our philosophy 10 years ago. The person-centered supports are amazing, but it was disruptive to the system. 30.B.2 Packet Pg. 954 Attachment: [Linked] Agenda and Back-up Document Packet - April 2, 2019 (8779 : Collier County Mental Health and Addiction Ad Hoc Intensity of Support Non-market housing Market housing Level of Subsidy Level of Income No Housing EmergencyTransitional Housing Supportive CareHousing Non-Market Housing(Rental and Ownership)Market Housing(Rental and Ownership) Calgary’s Housing Continuum Calgary’s Community Housing Affordability Collective (CHAC) represents an important first step for a sector that needs to advance its collaborative work towards an integrated and coordinated approach to better meet the community’s needs. Enhancing the coordination of the housing continuum with the homeless-serving system of care will further ensure a seamless integration of these resources for clients at risk of or experiencing homelessness. Moving forward, addressing the unique needs of diverse groups will continue to be a priority at the program and system levels. Adding much needed affordable housing stock will meet the needs of some individuals, however other individuals experiencing homelessness will require long-term housing with on- site intensive supports delivered through supportive housing models with integrated public health care. Accordingly, housing units and program design will need to be built across the housing spectrum in alignment with the diverse needs of the individuals we serve. Finally, all citizens of Calgary should have a safe, secure, affordable and well-maintained home from which to realize their full potential and be contributing members of our community. Marginalized persons, such as those exiting homelessness, have the right to be protected from discriminatory practices which limit their housing opportunities. This view aligns with the recently released National Housing Strategy which declared “housing rights are human rights.” Applying a human rights based framework that fosters participation, inclusion and non-discrimination must be prioritized by all orders of government, with municipal leadership being critical. The Housing Continuum A SHORTAGE OF AVAILABLE AFFORDABLE HOUSING UNITS CONTINUES TO CREATE BOTTLENECKS AT ALL POINTS ON THE HOUSING CONTINUUM AS CALGARIANS STRUGGLE TO MOVE FROM TRANSITIONAL TO PERMANENT HOUSING, FROM NON-MARKET TO MARKET RENTAL HOUSING, OR FROM RENTAL HOUSING TO HOME OWNERSHIP. THE PRIVATE SECTOR IS ALSO A KEY PARTNER IN THIS EFFORT, AND WE WILL CONTINUE TO NEED THEM TO DEVELOP AFFORDABLE HOUSING OPTIONS AND WORK WITH THE NON-MARKET HOUSING SECTOR TO ENHANCE ACCESS TO AVAILABLE STOCK. WE WILL ALSO NEED TO WORK IN PARTNERSHIP WITH OUR AFFORDABLE HOUSING PROVIDERS TO EXPLORE NEW DELIVERY MECHANISMS THAT ARE FLEXIBLE AND INNOVATIVE. City of Calgary Affordable Housing Strategy http://www.calgary.ca/CS/OLSH/Documents/Affordable-housing/Corporate-Affordable-Housing-Strategy.pdf 30.B.2 Packet Pg. 955 Attachment: [Linked] Agenda and Back-up Document Packet - April 2, 2019 (8779 : Collier County Mental Health and Addiction Ad Hoc Housing First: z Continue to focus on refining, perfecting, and adapting the Housing First model to maintain and improve our client-centric approach. z Examine opportunities to further incorporate an Indigenous lens into our Housing First strategies. z Increase housing sustainability by focusing our efforts on utilizing strengths-based approaches to fostering client resiliency and to empowering clients to optimize and/ or build natural supports, thus becoming less reliant on systems supports. The Housing Continuum: z Work with all orders of government leadership (Federal, Provincial, Municipal, Indigenous) to develop policies that increase affordable housing options and apply a human rights based framework that fosters participation, inclusion and non- discrimination. Considerable efforts have more recently emerged at all orders, which is encouraging. z Engage the private sector as a key partner in this effort. We will continue to need them to help develop affordable housing options and work with the non-market housing sector to enhance access to available stock. z Work with affordable housing partners to leverage common assets, becoming increasingly innovative in our collective work. Home For Everyone Priority Areas of Focus: 30.B.2 Packet Pg. 956 Attachment: [Linked] Agenda and Back-up Document Packet - April 2, 2019 (8779 : Collier County Mental Health and Addiction Ad Hoc 3 DATA AND KNOWLEDGE WE HAVE A CRITICAL BLIND SPOT IN OUR CAPACITY TO END HOMELESSNESS DUE TO THE LACK OF DATA INTEGRATION THROUGHOUT AND BETWEEN THE HSSC AND THE PRIMARY PUBLIC SYSTEMS OF CARE. IN THIS SENSE, WE DO NOT HAVE ENOUGH VISIBILITY IN THE FULL SCALE AND DYNAMICS OF THE ECOSYSTEM INVOLVED. MEASURING AND MONITORING SUCCESS REQUIRES A REAL TIME, SYSTEM-LEVEL LENS AND, DESPITE PROGRESS, A TRUE INFORMATION SYSTEM THAT TIES TOGETHER ALL SERVICES WITHIN THE ECOSYSTEM CURRENTLY DOES NOT EXIST IN CALGARY.STRATEGIC DIRECTIVE30.B.2 Packet Pg. 957 Attachment: [Linked] Agenda and Back-up Document Packet - April 2, 2019 (8779 : Collier County Mental Health and Addiction Ad Hoc Research & Real-TimeKnowledge Dissemination However, even though we recognize the importance of data in developing agile responses to social issues, we are still working on the creation of an integrated ecosystem that truly closes the gap between evidence and practice. We need to increase our capacity to respond to emerging and current requirements. Given that as many as 10,000 services exist in the Calgary ecosystem it is essential that we map this complexity and monitor its trends and outcomes. Access to real time data from a larger network of services can drive agile system planning and help link all agencies within the HSSC together through our shared mandate. We also know that sustaining an end to homelessness requires the coordination of the entire HSSC in partnership with the primary public systems, and advancing solutions in policy, interventions, and research will continue to be required to inform decision making. IN ORDER TO ACHIEVE FUNCTIONAL ZERO, IT IS IMPERATIVE THAT WE DEVELOP A SYSTEM THAT LEVERAGES REAL TIME DATA. USING DATA TO INFORM RESEARCH (WHICH IN TURN INFORMS PRACTICE) HAS ENABLED US TO BETTER TAILOR INTERVENTIONS THAT MEET THE NEEDS OF DIVERSE CLIENTS AND ASSESS THE EFFICACY AND EFFICIENCY OF SERVICES IN ORDER TO ENHANCE AND IMPROVE CLIENT OUTCOMES. DataSharing We also know that our capacity to end homelessness relies on greater data integration between the HSSC and primary public systems such as Children’s Services, Health, and Justice. This existing data disconnect results in having no way of knowing whether new service participants are coming into the system as a whole, or if they are cycling through various components. This hampers system planning and in turn, our capacity to respond appropriately and adjust in real time. In order to move system planning forward, efforts to enhance coordinated service delivery are critical, and this includes having better visibility into all components within the system. The ability of service providers, multi-disciplinary teams, police officers and health professionals to respond in the most appropriate and beneficial manner to individuals in need also requires appropriate information sharing, and we will need to resolve this lack of integration if we are to move forward and enhance coordinated service delivery across systems, rather than simply within our own. WE’VE MADE GREAT STRIDES OVER THE LAST DECADE IN TERMS OF DATA COLLECTION AND UTILIZATION, AND WHILE WE HAVE FOUND THAT THE INCREASE IN DATA SHARING THROUGHOUT THE HSSC IS HIGHLY BENEFICIAL, WE STILL NEED TO DEVELOP NEW TECHNOLOGICAL SOLUTIONS TO SUPPORT MORE SEAMLESS DATA INTEGRATION ACROSS THE HSSC AND PRIMARY PUBLIC SYSTEMS. 30.B.2 Packet Pg. 958 Attachment: [Linked] Agenda and Back-up Document Packet - April 2, 2019 (8779 : Collier County Mental Health and Addiction Ad Hoc Key Performance Metrics Current KPIs are limited to measuring program performance within the HSSC, and while this is crucial for monitoring the efficacy of Housing First programs themselves, they don’t capture the interaction between funded and non-funded agencies (shelters in particular). Our progress over the recent years has illustrated that system-level KPIs will need to be developed to measure alignment and coordination across the entire HSSC and into the public systems. While the HSSC has developed and continues to refine our KPIs at a program level, it is essential that our performance management approach becomes more agile and able to inform adjustments in real time as part of a comprehensive approach that tackles the structural, systemic, community, institutional, interpersonal, and individual causes of homelessness. Moving forward we need to identify and start measuring system-level indicators in order to be more nimble in our planning and become more proactive in our collective response. Measurement Tools As we work towards our goals, we require a way to measure our success. Historically, our HSSC has relied on tools such as our biennial Point in Time Counts (PiT) to measure the current state of progress. PiT counts are important for identifying trends but they only provide a snapshot of homelessness within a specific time period and are, therefore, of limited value as a lagging indicator. We need to develop more agile system planning mechanisms that effectively track inflow and outflow in real time, while providing an accurate picture of what is happening across services in terms of participant needs and outcomes. Future work in this area must focus on developing and implementing measurement tools, such as the Scope of Needs and Services List (Calgary’s version of a By Names List) that allows us to have a real-time and more holistic snapshot of people experiencing homelessness along with their needs and the services that they require. These types of real time data tools are better equipped to capture the flow of individuals entering and exiting the HSSC, and allow us to better serve them by right connecting them to public systems or services, thus ending their experience of homelessness as quickly as possible. Measurement UTILIZING EVIDENCE-BASED BEST PRACTICES, KEY PERFORMANCE INDICATORS (KPIS) ENABLE US TO BUILD A HIGH-PERFORMING SYSTEM OF CARE THAT STABLY HOUSES THOSE WHO ARE EXPERIENCING CHRONIC AND EPISODIC HOMELESSNESS, AND ALLOWS US TO BE MORE RESPONSIVE TO CALGARY’S UNIQUE NEEDS. ”“To measure impact, we have our agency impact, but as a system, what is the goal? Is it the systems impact or our program impact? The system impact needs to be something that agencies can actually measure within their programs. That’s not happening right now. ”“I like the data sharing idea – one system, or more than one, integrated and accessible by different programs. You automatically build tighter community. 30.B.2 Packet Pg. 959 Attachment: [Linked] Agenda and Back-up Document Packet - April 2, 2019 (8779 : Collier County Mental Health and Addiction Ad Hoc Data Sharing: z Maintain client autonomy and privacy while improving agency and program collaboration. Use client-centered language to educate clients on their right to privacy, and give them a comprehensive understanding of how data sharing meets their needs, why their data is being collected, who can see it, and how it is being used. z Increase data sharing commitments and agreements by all agencies within the HSSC and the primary public systems of care. z Investigate and examine technological solutions to support data integration within and between the HSSC and primary public systems of care. z Enhance system of care visibility. Ongoing efforts to enhance coordinated service delivery are critical; this includes having enhanced visibility of all components of the system. We need to develop workable and effective solutions in support of information sharing provisions and protocols. Measurement: z Develop and adhere to systems-level performance indicators to inform real time systemic adjustments as part of a comprehensive approach that incorporates the structural, systemic, community, institutional, interpersonal, and individual causes of homelessness. z Integrate a Scope of Needs and Services List that enables the HSSC to have a real time snapshot of the needs of, and services required by, the individuals we serve. Research & Real-Time Knowledge Dissemination: z Examine system mapping to enable real time, full visibility of all services and agencies to all organizations within the HSSC. z Provide access to real time, actionable data to drive agile system planning in order to link all agencies within the HSSC into a cohesive system of care through our common shared mandate. Data and Knowledge Priority Areas of Focus: 30.B.2 Packet Pg. 960 Attachment: [Linked] Agenda and Back-up Document Packet - April 2, 2019 (8779 : Collier County Mental Health and Addiction Ad Hoc 4 AGILE HSSCPLANNING STRATEGIC DIRECTIVEAGILE SYSTEM PLANNING IS ABOUT MORE THAN SETTING TARGETS AND MONITORING PERFORMANCE. AN AGILE SYSTEM WOULD BEGIN WITH PREVENTION WITH A FOCUS ON BEING RESPONSIVE, NOT REACTIVE. FASTER, AND MORE STRATEGIC CYCLES OF DEVELOPMENT ARE NEEDED THROUGHOUT THE HSSC, NOT ONLY IN THE PROGRAM IMPLEMENTATION, BUT ALSO IN WORKING ALONGSIDE PRIMARY PUBLIC SYSTEMS. 30.B.2 Packet Pg. 961 Attachment: [Linked] Agenda and Back-up Document Packet - April 2, 2019 (8779 : Collier County Mental Health and Addiction Ad Hoc AGILE HSSCPLANNING SystemCoordination At a programmatic level, and as the HSSC continues to advance (and the capacity of the system to deliver on client-centered outcomes related to housing referrals, housing placement and housing stability evolves) it is critical that we are measuring the right things and integrating what we learn into our agency-specific service delivery plans. As our community becomes increasingly data-driven, comparison and evaluation are major mechanisms for systems improvement, decision making and planning. Data, measurement and reporting doesn’t always effectively capture progress made with clients – or alternatively, areas of concern. For example, there needs to be a better understanding of rehoused placements and the instances of Housing First graduates coming back into the system. Moving forward, a review and refinement of the indicators used to assess program performance will be important. This will need to be an iterative process that ensures program KPIs align with on-the- ground experiences of the front line. Finally, we know that sustaining Functional Zero requires the coordination of the entire HSSC in partnership with primary public systems, and advancing solutions in policy, interventions, and research will continue to be needed. As shifts in our environment impact homelessness we need to course- correct in real time to ensure effectiveness, and as we relieve the current backlog in our system we can work with public systems to shift public system resources to enhance our focus on prevention, and move upstream to address the root causes of homelessness in a coordinated manner. Accordingly, the HSSC can play a critical role in creating service delivery models that right connect people to primary public systems and increase capacity and access to essential services for people at risk of or experiencing homelessness. A SYSTEM PLANNING APPROACH WITH A NEUTRAL BACKBONE SYSTEM PLANNER ORGANIZATION TO DRIVE COORDINATION, AND WHERE APPROPRIATE, INTEGRATION EFFORTS AMONG THE HSSC AND PUBLIC SYSTEM PARTNERS (SUCH AS HEALTH AND JUSTICE) WILL BE REQUIRED TO MAINTAIN FASTER, LEANER CYCLES OF DEVELOPMENT THROUGHOUT THE SYSTEM OF CARE. TO THAT END, AGILE HSSC PLANNING IS MORE THAN SETTING TARGETS AND MONITORING PERFORMANCE. IT REQUIRES A LEAD SYSTEM PLANNER ORGANIZATION TO DEVELOP A NIMBLE AND ITERATIVE APPROACH TO CONTINUAL IMPROVEMENT. ”“We do need more funding allocated to preventative work, but if we’re going to get into it, let’s think about accountability and not take on the work that other agencies and system can or are already doing better. 30.B.2 Packet Pg. 962 Attachment: [Linked] Agenda and Back-up Document Packet - April 2, 2019 (8779 : Collier County Mental Health and Addiction Ad Hoc ”“We need to tailor the scorecards and benchmarks according to programs. What if we looked at a positive change in client complexity rather than agency performance? It’d be a lot more client focused. 30.B.2 Packet Pg. 963 Attachment: [Linked] Agenda and Back-up Document Packet - April 2, 2019 (8779 : Collier County Mental Health and Addiction Ad Hoc System Coordination: z Enhance our understanding of Housing First program graduation rates. Utilize existing data to generate a better understanding of Housing First graduate rehousing to determine system capacity needs. z Explore primary public systems capacity and integration of Housing First program graduates to understand recidivism patterns back into homelessness. z Explore strategies to intentionally manage the inflow from mental health, addiction, health, and correctional facilities into homelessness and Housing First programs. z Explore opportunities to enhance and adjust current program KPIs to align with on-the-ground experiences at the front line level. These indicators, as well our interpretation and reporting of data, will need to follow an iterative process that adjusts as needed based on real time inputs from front line workers. Agile HSSC Planning Priority Areas of Focus: 30.B.2 Packet Pg. 964 Attachment: [Linked] Agenda and Back-up Document Packet - April 2, 2019 (8779 : Collier County Mental Health and Addiction Ad Hoc 5 ECOSYSTEM INTEGRATION ONE OF THE GREATEST CHALLENGES FACED IN OUR WORK ON HOMELESSNESS STEMS FROM THE FACT THAT HOMELESSNESS CANNOT BE SOLVED BY THE HOMELESS-SERVING SYSTEM OF CARE ALONE; IN FACT, THE HSSC ITSELF IS A SECONDARY, DEFAULT SYSTEM THAT EMERGED TO RESPOND TO THE GAPS AND FRACTURES THAT PEOPLE ARE FALLING THROUGH WITHIN THE PRIMARY PUBLIC SYSTEMS OF CARE.STRATEGIC DIRECTIVE30.B.2 Packet Pg. 965 Attachment: [Linked] Agenda and Back-up Document Packet - April 2, 2019 (8779 : Collier County Mental Health and Addiction Ad Hoc ECOSYSTEM INTEGRATION HomelessnessPrevention While we continue to focus on ending long-term homelessness amongst those experiencing chronic and episodic homelessness, we must also enhance the system of care to efficiently house those at imminent risk of or who experience short-term homelessness as well. To meet our goal of achieving Functional Zero in Calgary, we need to stop people from becoming homeless in the first place. As an example, the higher incidence of homelessness among those who exit Children’s Services provides impetus to examine how that system prepares and supports young people for transitions to adulthood. In the case of Income Supports, inadequate shelter allowance exacerbates homelessness risk for those receiving social benefits yet who are unable to pay rent. This would suggest that this system could shift policy and procedures in this area to reduce homelessness long-term. The higher incidence of people experiencing mental illness in shelters also suggests a gap in the Health system that enables this issue to emerge in the first place. Similarly, the higher incidence of homelessness for people involved with the Justice system points to the need to explore what might be done around Justice investment in appropriate housing as part of the release planning process. It is very difficult to bring these systems together at the local level and engage in cross-system planning and investment coordination. This is partially to do with the accountability of systems beyond Calgary itself to the province or nationally, as well as their understanding of where accountability for homelessness lies in relation to ministerial or departmental mandates. Health might argue that homelessness is not a health issue and thus outside their responsibility realms; same could be said by Justice or Children’s Services. However, all of these systems require significant policy shifts. While difficult, this work on cross-system leadership and ecosystem planning will continue to be a priority for Calgary to achieve its objectives on ending homelessness. This will require incremental changes to primary public systems as agile system planning requires new skills, will and knowledge. OVER THE PAST DECADE, OUR EMPHASIS ON REDUCING CHRONIC AND EPISODIC HOMELESSNESS HAS FOCUSED THE HSSC’S INTERVENTIONS ON TERTIARY AND SECONDARY PREVENTION. HOWEVER, WE ALSO RECOGNIZE THAT WITHOUT ALL TYPES OF PREVENTION, SUCCESS IS VERY LIMITED. IN FACT, PREVENTING HOMELESSNESS WILL REQUIRE AN INTENTIONAL PREVENTION EFFORT TO IDENTIFY THOSE AT THE GREATEST RISK AND BEST MATCH THEM WITH APPROPRIATE RESOURCES BEFORE HOMELESSNESS OCCURS. THIS HAS IMPLICATIONS FOR GOVERNMENT AND NON-PROFIT AGENCIES WHO ARE NOT WITHIN THE HSSC TO COLLECTIVELY RECOGNIZE THAT IN ORDER TO BE PART OF THE SOLUTION, THEY WILL HAVE TO RETHINK SIGNIFICANT ASPECTS OF THEIR APPROACH TO SERVICE DELIVERY, POLICY DEVELOPMENT, AND IMPLEMENTATION. ”“We’ve increased our level of collaboration; we share a lot of information and build a lot of trust. We can expand this to the administrative and public systems too. 30.B.2 Packet Pg. 966 Attachment: [Linked] Agenda and Back-up Document Packet - April 2, 2019 (8779 : Collier County Mental Health and Addiction Ad Hoc CALGARY’S HOMELES S S ERVIN G S YSTEM OF CAREYouth Families Singles Ethnicit y « L GBTQ2S+ « Human Rights « Domestic Violence « Gender Lens « Addiction « Poverty « Indigeneity « Mental Health « Aging « A c c e s s i b i l i t y « And More « HealthJusticeHousing Chi ld ren ’sServ icesIncomeSupports Calgary's Homeless- Serving System of Care is not a primary system. Public Systems The primary systems of care in our city. Though they are distinct, they integrate with each other in service to individuals. Populations The primary segmentation of individuals within the eco-system. Pressure points within the system These pressure points are common throughout the system and are not tied to primary systems. homeless-serving sector services those who fall through the primary systems. Calgary’sEcosystem: Much more needs to be done to develop effective strategies on the primary prevention side to stem the flow of new cases of homelessness before they occur. This includes the development of more affordable housing, and changing policies to ensure vulnerable groups – such as youth leaving care – are not discharged into homelessness. In addition, we need to find ways to increase incomes for vulnerable populations, including enhancing income supports, access to living wage employment, and other poverty reduction measures that are specifically aligned towards ending homelessness. However, it is important to remember that these issues and their solutions are not within the direct powers or accountability of the HSSC. In fact, growing the HSSC will never solve these systemic issues within the broader ecosystem and primary public systems. We need leadership within these systems to accept accountability and take action on addressing the gaps and drivers contributing to homelessness within their own ministries, programs and services. 30.B.2 Packet Pg. 967 Attachment: [Linked] Agenda and Back-up Document Packet - April 2, 2019 (8779 : Collier County Mental Health and Addiction Ad Hoc Homelessness Prevention: z Leverage Community Systems Integration (CSI) Table to drive coordination, and where appropriate, integration efforts across the HSSC with our public system partners such as Health, Children’s Services, and Justice to address the gaps and drivers within their own systems that are contributing to homelessness. z Leverage the Collaborative to Health and Home (CHH) to continue to advance access to intensive case management and health supports including mental health and addicitons services as homeless Calgarians transition into supportive housing. z Enhance the integration of the HSSC with poverty reduction and affordable housing efforts being led by Enough for All and CHAC in order to maintain momentum beyond 2018. Ecosystem Integration Priority Areas of Focus: 30.B.2 Packet Pg. 968 Attachment: [Linked] Agenda and Back-up Document Packet - April 2, 2019 (8779 : Collier County Mental Health and Addiction Ad Hoc 6 STRATEGIC INVESTMENT & EMPOWERING CALGARIANS WITHOUT THE SUPPORT OF ALL ORDERS OF GOVERNMENT, THE SUCCESSES WE HAVE ACHIEVED TO DATE WOULD NOT HAVE BEEN POSSIBLE, AND MOVING FORWARD, SUPPORT FROM ALL ORDERS OF GOVERNMENT WILL CONTINUE TO BE ESSENTIAL. CRITICAL MASS IS REQUIRED TO AFFECT SUSTAINABLE CHANGE, BUT CRITICAL MASS CAN ONLY BE ACHIEVED IF ALL CALGARIANS PARTICIPATE IN OUR COLLECTIVE EFFORTS TO END HOMELESSNESS IN OUR CITY, AND ACTIVELY ENGAGE IN THE BETTERMENT OF OUR COMMUNITY.STRATEGIC DIRECTIVE30.B.2 Packet Pg. 969 Attachment: [Linked] Agenda and Back-up Document Packet - April 2, 2019 (8779 : Collier County Mental Health and Addiction Ad Hoc FunderEngagement The Government of Alberta supported (rather than dictated) directions to Calgary, and this created space for the emergence of local capacity to develop systems planning approaches appropriate to solve local complex social issues. This enabling approach was reinforced at the federal level by the Homelessness Partnering Strategy (now called Reaching Home) and the National Housing Strategy – which put the onus of community planning at the local level, rather than in government (provincial or federal). Notwithstanding the above, the successes we have achieved to date would not have been possible without investment from all orders of government (Federal, Provincial, Municipal) and moving forward, support from all orders of government will continue to be essential. The Federal Government’s National Housing Strategy has marked a momentous shift in the affordable housing sector, though the details of the rollout are yet to be determined. The Government of Alberta’s Affordable Housing Strategy (2017), with a commitment of $1.2 billion over five years to improve the system’s 70,000 housing units and construct an additional 4,100 units by 2021 is a promising investment within the affordable housing sphere. We will also need The City of Calgary to continue to support policies that remove barriers and increase affordable housing options and provide assertive leadership with federal, provincial and industry partners on tackling the affordable housing gap. As noted, concerted coordination and integration efforts across the HSSC with our partners in Health, Justice, Income Supports, poverty reduction, mental health and addiciton, affordable housing, and others will be required to maintain momentum beyond 2018. The levels of resources needed will require constant monitoring and adjustment to respond to shifting drivers of demand. We will need to develop common ways of measuring leading and lagging indicators provincially and nationally to ensure a consistent approach emerges. Though parts of the HSSC have been aligned through joint provincial, federal, and philanthropic funding to a high degree, resource infrastructure can and should be strategically examined from an ecosystem perspective. Failure to do so will continue to hamper efforts as we have no way of knowing whether diverse funders (governments, foundations, charities, etc.) are working at cross-purposes, duplicating efforts, or even whether we are serving different groups and to what effect. Moving forward, we need to ensure diverse funders are aligned across the HSSC and that KPIs and outcomes are co-created and shared. GOVERNMENTS’ TRUST AND ENABLING APPROACH TO LOCAL LEADERSHIP THROUGH THE COMMUNITY BASED ORGANIZATION AND COMMUNITY ENTITY MODELS WAS A CRITICAL FACTOR IN CALGARY’S SUCCESS OVER THE PAST DECADE. THEIR SUPPORT FOR LOCAL AUTONOMY IN BACKBONE ENTITY-DRIVEN SYSTEM PLANNING ALONG WITH THE PROVISION OF RESOURCES AND ENABLING POLICY WERE CRITICAL. ”“What’s working is how well we work together collaboratively as agencies and as a sector; we have built off of that and started collaborating to determine how we can provide the best sector-wide support. 30.B.2 Packet Pg. 970 Attachment: [Linked] Agenda and Back-up Document Packet - April 2, 2019 (8779 : Collier County Mental Health and Addiction Ad Hoc HOME FOR EVERYONE However, there is still a considerable lack of public knowledge on homelessness as well as a great amount of shame and stigma associated with the people who experience it, and innovative approaches to connecting, informing, and engaging with the public need to be developed through a comprehensive and collective communication vehicle. Unified messaging through a single brand will contribute to a stronger HSSC voice and minimize the confusion that comes from trying to navigate multiple messages from multiple sources. Critical mass can only be achieved if all Calgarians participate in our collective efforts to achieve Functional Zero within our city, and actively engage in the betterment of our community. This requires that all Calgarians have a deeper understanding of homelessness and what causes it, and challenge the myths and stigma surrounding those experiencing it. ENDING HOMELESSNESS REQUIRES THE ENGAGEMENT OF ALL CALGARIANS, EACH CONTRIBUTING IN A MANNER THAT FITS THEIR CAPACITY. BY LENDING PUBLIC SUPPORT AND ENCOURAGING COMMUNITY ACTION ON HOMELESSNESS, MANY HAVE CONTRIBUTED TO THE SUCCESSES WE’VE HAD OVER THE PAST DECADE THROUGH EMBRACING PERMANENT HOUSING WITH SUPPORTS IN LOCAL NEIGHBOURHOODS; PROVIDING VOLUNTEER HOURS IN AFFORDABLE HOUSING BUILDINGS; AND BY FUNDRAISING TO PAY DOWN BUILDING MORTGAGES. ”“We almost have a unified voice – a better ability to advocate. Because of that, we can work really well together, streamline services, and address the problem more effectively in the future. 30.B.2 Packet Pg. 971 Attachment: [Linked] Agenda and Back-up Document Packet - April 2, 2019 (8779 : Collier County Mental Health and Addiction Ad Hoc Funder Engagement: z Identify opportunities for better integration of governance, funding, and policy across systems, services, and sectors to support more seamless access to, and transition among services. I Heart Home: z Develop a collective communications mechanism for the HSSC to work in concert with existing initiatives such as CHAC’s Common Voice for affordable housing. z Create more public awareness of the scope and causes of homelessness in Calgary, and the performance of programs that are delivering desired outcomes towards the collective goal. z Address the stigma and discrimination associated with homelessness in Calgary through collective HSSC communication. Strategic Investment & Empowering Calgarians Priority Areas of Focus: 30.B.2 Packet Pg. 972 Attachment: [Linked] Agenda and Back-up Document Packet - April 2, 2019 (8779 : Collier County Mental Health and Addiction Ad Hoc Conclusion: Together,We can get toZeroAbsolute Functional CALGARY’S HOMELESS-SERVING SYSTEM OF CARE IS COMPRISED OF A NETWORK OF AGENCIES AND PUBLIC SYSTEM PARTNERS WORKING TOGETHER TO ENSURE THAT THOSE AT IMMINENT RISK OF OR EXPERIENCING HOMELESSNESS HAVE TIMELY ACCESS TO THE RIGHT HOUSING WITH THE RIGHT SUPPORTS AT THE RIGHT TIME. THE STRATEGIC DIRECTIVES AND PRIORITY AREAS OUTLINED IN THIS GUIDING DOCUMENT ARE BASED ON THE LESSONS AND WISDOM GLEANED FROM OVER A DECADE OF COLLECTIVE IMPACT, COLLABORATION AND COORDINATION. Complex social issues like homelessness are cross-cutting, whether we consider them through the lens of a government jurisdiction, department, or service delivery approach. Across and within the ecosystem, (including the HSSC), system of care service providers and programs continue to mainly operate in a fragmented manner. The strategic directives and priority areas outlined in this guiding document provide a strategic framework to drive alignment across system of care participants and enable co-ordination at the strategic and service delivery levels to achieve Functional Zero within our city. As the system planner for Calgary’s HSSC, Calgary Homeless Foundation is honoured to continue to collaborate with the HSSC to deliver services, housing and programs, and coordinate resources in alignment with the strategic directives outlined in this document. No single agency, system or service can end homelessness alone. It’s no longer sustainable to care solely about one’s own organizational mandate and associated initiatives. To achieve transformational change we must drive for shared accountability and identify ways to co-ordinate at the ecosystem and strategic level as well as the service delivery level. 30.B.2 Packet Pg. 973 Attachment: [Linked] Agenda and Back-up Document Packet - April 2, 2019 (8779 : Collier County Mental Health and Addiction Ad Hoc ”“ z Each time a person or family at risk of or experiencing homelessnes is supported to access and maintain permanent housing z When there are fewer paths in and a timely path out, for everyone z When our system response is such that: when a person falls into homelessness, the system finds them, treats them with dignity and respect, gets them into permanent housing with supports if/as needed, and does so in days and weeks – not months and years - Diana Krecsy, CEO, CHF ”“Teamwork is the ability to work together toward a common vision. The ability to direct individual accomplishments toward organizational objectives. It is the fuel that allows common people to attain uncommon results. - Andrew Carnegie We Will Have Ended Homelessness When: 30.B.2 Packet Pg. 974 Attachment: [Linked] Agenda and Back-up Document Packet - April 2, 2019 (8779 : Collier County Mental Health and Addiction Ad Hoc HOME FOR EVERYONE WWW.IHEARTHOMEYYC.COM TogethertoZeroAbsolute Functional 30.B.2 Packet Pg. 975 Attachment: [Linked] Agenda and Back-up Document Packet - April 2, 2019 (8779 : Collier County Mental Health and Addiction Ad Hoc Mental Health and Addiction Ad Hoc Committee Meeting April 2, 2019 Item 8.3 – Review of Committee Vacancies Filled Positions Membership Credential Committee Member Organization 1 Veterans Service Organization Dale Mullin Wounded Warriors of Collier 2 Collier County Sheriff’s Office Lt. Leslie Weidenhammer CCSO 3 Licensed Psychiatrist/Psychologist Dr. Emily Ptaszek Healthcare Network of SWFL 4 Licensed Behavioral Health Prof. Susan Kimper NCH 5 Medical Health Professional Dr. Thomas Lansen 6 David Lawrence Center Scott Burgess DLC 7 NAMI Dr. Pam Baker NAMI 8 At-large Honorable Janeice Martin 20th Judicial Circuit 9 Collier County Grantor Agency Robert (Reed) Saunders 10 Homeless Advocacy Organization Christine Welton Hunger & Homeless Coalition 11 Peer Specialist CM Michelle McLeod City of Naples 12 Recovery Community Janice Rosen 13 At-large Dr. Michael D’Amico 14 At-large Russell Budd PBS Contractors 15 At-large Pat Barton 16 At-large Dr. Jerry Godshaw 17 At-large Dr. Paul Simeone Lee Health Vacant Positions Membership Credential Committee Member Organization At-large (2) Vacant 30.B.2 Packet Pg. 976 Attachment: [Linked] Agenda and Back-up Document Packet - April 2, 2019 (8779 : Collier County Mental Health and Addiction Ad Hoc 07/2014 ADVISORY COMMITTEE APPLICANT ROUTING MEMORANDUM FROM: Jessica Hayes, Office of the County Attorney DATE: January 7, 2019 APPLICANT: Diane Aronson 15867 Secoya Reserve Cir Naples, FL 34110 APPLYING FOR: Mental Health and Addiction Advisory Committee We currently have three seats expiring on March 31, 2019 on the above referenced advisory committee. The pending vacancies were advertised and persons interested in serving on this committee were asked to submit an application for consideration. TO ELECTIONS OFFICE: Attn: Shavontae Dominique Please confirm if the above applicant is a registered voter in Collier County, and in what commissioner district the applicant resides. Registered Voter: Yes Commission District: 2 TO STAFF LIAISON: Attn: Sean Callahan The application submitted by Ms. Aronson is attached for your review. Please let me know, in writing, the recommendation for appointment to the advisory committee. Your recommendation memo should include: _____ The names of all applicants considered for the vacancy or vacancies. _____ The committee’s recommendation for appointment or non-appointment. _____ The category or area of qualification the applicant is to be appointed in. _____ If the applicant is a reappointment, please include attendance records for the past two years. _________________________________________________________________________________ TO ADVISORY BOARD COORDINATOR: Attn: Wanda Rodriguez _____ This applicant is not recommended for appointment. –OR– _____ This applicant is recommended for appointment. A recommendation memo is attached, please prepare an agenda item for the next available BCC agenda. If you have any questions, please call me at 252-8123. Thank you for your attention to this matter. 30.B.2 Packet Pg. 977 Attachment: [Linked] Agenda and Back-up Document Packet - April 2, 2019 (8779 : Collier County Mental Health and Addiction Ad Hoc 07/2014 Advisory Board Application Form Collier County Government 3299 Tamiami Trail East, Suite 800 Naples, FL 34112 (239) 252-8400 Application was received on: 1/6/2019 10:00:52 PM. Name: Diane Aronson Home Phone: 239-631-1144 Home Address: 15867 Secoya Reserve Circle City: Naples Zip Code: 34110 Phone Numbers Business: 781-316-4162 E-Mail Address: aronsons@comcast.net Board or Committee: Collier County Mental Health and Addiction Ad Hoc Advisory Committee Category: Place of Employment: Food & Drug Administration - Special Gov. Employee How long have you lived in Collier County: 5-10 How many months out of the year do you reside in Collier County: I am a year-round resident Have you been convicted or found guilty of a criminal offense (any level felony or first degree misdemeanor only)? No Not Indicated Do you or your employer do business with the County? No Not Indicated NOTE: All advisory board members must update their profile and notify the Board of County Commissioners in the event that their relationship changes relating to memberships of organizations that may benefit them in the outcome of advisory board recommendations or they enter into contracts with the County. Would you and/or any organizations with which you are affiliated benefit from decisions or recommendations made by this advisory board? Yes I am a volunteer at Collier County NAMI. I do not know if or how NAMI may or may not directly 30.B.2 Packet Pg. 978 Attachment: [Linked] Agenda and Back-up Document Packet - April 2, 2019 (8779 : Collier County Mental Health and Addiction Ad Hoc [YY-1562/1106981/1] benefit from decisions or recommendations made by this committee, however, I do believe that the populations served by NAMI would benefit. Are you a registered voter in Collier County? Yes Do you currently hold an elected office? No Do you now serve, or have you ever served on a Collier County board or committee? No Not Indicated Please list your community activities and positions held: -Volunteer in the Art Room at Collier County NAMI - I have had a life-long interest/involvement with mental illness and drug addiction due to friends and relatives who have been impacted. My work for the last three years has been with the population served at the NAMI Sarah Ann Center who are interested in arts and crafts. -Past President of Secoya Reserve HOA Education: BS in Education Experience / Background I have served on many Advisory Board's, more than a dozen Board's of Directors, as CEO of nonprofits, worked with medical societies, consultant to FDA, CDC,HHS, NIH, author, spokesperson with media. Since 2006, I have been a part-time Consumer and Patient Representative at the FDA serving at countless Advisory Committee Meetings which have evaluated drugs or medical devices. I am happy to provide a full CV if required. 30.B.2 Packet Pg. 979 Attachment: [Linked] Agenda and Back-up Document Packet - April 2, 2019 (8779 : Collier County Mental Health and Addiction Ad Hoc 07/2014 ADVISORY COMMITTEE APPLICANT ROUTING MEMORANDUM FROM: Jessica Hayes, Office of the County Attorney DATE: January 7, 2019 APPLICANT: Carol Barkauskas 5961 Golden Oaks Lane Naples, FL 34119 APPLYING FOR: Mental Health and Addiction Advisory Committee We currently have three seats expiring on March 31, 2019 on the above referenced advisory committee. The pending vacancies were advertised and persons interested in serving on this committee were asked to submit an application for consideration. TO ELECTIONS OFFICE: Attn: Shavontae Dominique Please confirm if the above applicant is a registered voter in Collier County, and in what commissioner district the applicant resides. Registered Voter: yes Commission District: 3 TO STAFF LIAISON: Attn: Sean Callahan The application submitted by Mr. D’Amico is attached for your review. Please let me know, in writing, the recommendation for appointment to the advisory committee. Your recommendation memo should include: _____ The names of all applicants considered for the vacancy or vacancies. _____ The committee’s recommendation for appointment or non-appointment. _____ The category or area of qualification the applicant is to be appointed in. _____ If the applicant is a reappointment, please include attendance records for the past two years. _________________________________________________________________________________ TO ADVISORY BOARD COORDINATOR: Attn: Wanda Rodriguez _____ This applicant is not recommended for appointment. –OR– _____ This applicant is recommended for appointment. A recommendation memo is attached, please prepare an agenda item for the next available BCC agenda. If you have any questions, please call me at 252-8123. Thank you for your attention to this matter. 30.B.2 Packet Pg. 980 Attachment: [Linked] Agenda and Back-up Document Packet - April 2, 2019 (8779 : Collier County Mental Health and Addiction Ad Hoc 07/2014 Advisory Board Application Form Collier County Government 3299 Tamiami Trail East, Suite 800 Naples, FL 34112 (239) 252-8400 Application was received on: 1/10/2019 2:09:31 PM. Name: Carol Barkauskas Home Phone: 239-572-0187 Home Address: 5961 Golden Oaks Lane City: Naples Zip Code: 34119 Phone Numbers Business: E-Mail Address: naplescarol@yahoo.com Board or Committee: Collier County Mental Health and Addiction Ad Hoc Advisory Committee Category: Not indicated Place of Employment: Collier Schools How long have you lived in Collier County: more than 15 How many months out of the year do you reside in Collier County: I am a year-round resident Have you been convicted or found guilty of a criminal offense (any level felony or first degree misdemeanor only)? No Not Indicated Do you or your employer do business with the County? Yes School teacher NOTE: All advisory board members must update their profile and notify the Board of County Commissioners in the event that their relationship changes relating to memberships of organizations that may benefit them in the outcome of advisory board recommendations or they enter into contracts with the County. Would you and/or any organizations with which you are affiliated benefit from decisions or recommendations made by this advisory board? Yes Placement for mentally ill students 30.B.2 Packet Pg. 981 Attachment: [Linked] Agenda and Back-up Document Packet - April 2, 2019 (8779 : Collier County Mental Health and Addiction Ad Hoc [YY-1562/1106981/1] Are you a registered voter in Collier County? Yes Do you currently hold an elected office? No Do you now serve, or have you ever served on a Collier County board or committee? No Not Indicated Please list your community activities and positions held: Education: BA in Business Management, Masters in Social Work Experience / Background Mental Health/Addictions 30 years School system 13 years 30.B.2 Packet Pg. 982 Attachment: [Linked] Agenda and Back-up Document Packet - April 2, 2019 (8779 : Collier County Mental Health and Addiction Ad Hoc Advisory Board Application Form Collier County Government 3299 Tamiami Trail East, Suite 800 Naples, FL 34112 (239) 252-8400 Application was received on: 1/23/2019 7:59:12 AM. Name: Caroline Brennan Home Phone: 239-289-4929 Home Address: 25020 Divot Drive City: Bonita Springs Zip Code: 34135 Phone Numbers Business: 239-377-0531 E-Mail Address: brennaca@collierschools.com Board or Committee: Collier County Mental Health and Addiction Ad Hoc Advisory Committee Category: Not indicated Place of Employment: Collier County Public Schools How long have you lived in Collier County: How many months out of the year do you reside in Collier County: Have you been convicted or found guilty of a criminal offense (any level felony or first degree misdemeanor only)? No Not Indicated Do you or your employer do business with the County? No Not Indicated NOTE: All advisory board members must update their profile and notify the Board of County Commissioners in the event that their relationship changes relating to memberships of organizations that may benefit them in the outcome of advisory board recommendations or they enter into contracts with the County. Would you and/or any organizations with which you are affiliated benefit from decisions or recommendations made by this advisory board? No 30.B.2 Packet Pg. 983 Attachment: [Linked] Agenda and Back-up Document Packet - April 2, 2019 (8779 : Collier County Mental Health and Addiction Ad Hoc Not Indicated Are you a registered voter in Collier County? Do you currently hold an elected office? No Do you now serve, or have you ever served on a Collier County board or committee? No Not Indicated Please list your community activities and positions held: Previous Board Member, Collier County Hunger and Homeless Coalition Facilitate the Early Childhood Network Member Youth Resource Coalition Education: Bachelor of Science in Education from Northeastern University, Boston, MA Master's in Social Work from Hunter College Graduate School of Social Work, NY, NY Licensed Clinical Social Worker Experience / Background Currently serve as the Supervisor for Mental Health support and Social Emotional Learning for Collier County Public Schools. Previously served as the Mental Health Specialist for Head Start for 10 years and the Homeless and Foster Care Liaison for CCPS. Served as the Children's Program Supervisor for the shelter for Abused Women and Children for 10 years. 30.B.2 Packet Pg. 984 Attachment: [Linked] Agenda and Back-up Document Packet - April 2, 2019 (8779 : Collier County Mental Health and Addiction Ad Hoc 07/2014 ADVISORY COMMITTEE APPLICANT ROUTING MEMORANDUM FROM: Jessica Hayes, Office of the County Attorney DATE: January 9, 2019 APPLICANT: Doug Campbell 78 Seagate Drive Naples, FL 34103 APPLYING FOR: Mental Health and Addiction Advisory Committee We currently have three seats expiring on March 31, 2019 on the above referenced advisory committee. The pending vacancies were advertised and persons interested in serving on this committee were asked to submit an application for consideration. TO ELECTIONS OFFICE: Attn: Shavontae Dominique Please confirm if the above applicant is a registered voter in Collier County, and in what commissioner district the applicant resides. Registered Voter: yes Commission District: 4 TO STAFF LIAISON: Attn: Sean Callahan The application submitted by Mr. Campbell is attached for your review. Please let me know, in writing, the recommendation for appointment to the advisory committee. Your recommendation memo should include: _____ The names of all applicants considered for the vacancy or vacancies. _____ The committee’s recommendation for appointment or non-appointment. _____ The category or area of qualification the applicant is to be appointed in. _____ If the applicant is a reappointment, please include attendance records for the past two years. _________________________________________________________________________________ TO ADVISORY BOARD COORDINATOR: Attn: Wanda Rodriguez _____ This applicant is not recommended for appointment. –OR– _____ This applicant is recommended for appointment. A recommendation memo is attached, please prepare an agenda item for the next available BCC agenda. If you have any questions, please call me at 252-8123. Thank you for your attention to this matter. 30.B.2 Packet Pg. 985 Attachment: [Linked] Agenda and Back-up Document Packet - April 2, 2019 (8779 : Collier County Mental Health and Addiction Ad Hoc 07/2014 Advisory Board Application Form Collier County Government 3299 Tamiami Trail East, Suite 800 Naples, FL 34112 (239) 252-8400 Application was received on: 1/8/2019 4:14:56 PM. Name: Doug Campbell Home Phone: 2392698104 Home Address: PO BOX 413005 City: NAPLES Zip Code: 34101-3005 Phone Numbers Business: E-Mail Address: jdcampbell78@jdcjr.com Board or Committee: Collier County Mental Health and Addiction Ad Hoc Advisory Committee Category: Not indicated Place of Employment: Retired How long have you lived in Collier County: How many months out of the year do you reside in Collier County: I am a year-round resident Have you been convicted or found guilty of a criminal offense (any level felony or first degree misdemeanor only)? No Not Indicated Do you or your employer do business with the County? No Not Indicated NOTE: All advisory board members must update their profile and notify the Board of County Commissioners in the event that their relationship changes relating to memberships of organizations that may benefit them in the outcome of advisory board recommendations or they enter into contracts with the County. Would you and/or any organizations with which you are affiliated benefit from decisions or recommendations made by this advisory board? No Not Indicated 30.B.2 Packet Pg. 986 Attachment: [Linked] Agenda and Back-up Document Packet - April 2, 2019 (8779 : Collier County Mental Health and Addiction Ad Hoc [YY-1562/1106981/1] Are you a registered voter in Collier County? Yes Do you currently hold an elected office? No Do you now serve, or have you ever served on a Collier County board or committee? No Not Indicated Please list your community activities and positions held: Past member Substance Abuse and Mental Health Local Advocacy CommitteeChair, Friends of Foster Children Guardian ad Litem beginning 1999 President, Naples Auto Donation Center Director, Healthcare Network of SWFL Education: BS, Johns Hopkins Experience / Background I have been a volunteer child and mental health/substance abuse advocate in Collier County for 20 years. My career was in oil and chemical manufacrturing and management. 30.B.2 Packet Pg. 987 Attachment: [Linked] Agenda and Back-up Document Packet - April 2, 2019 (8779 : Collier County Mental Health and Addiction Ad Hoc 07/2014 ADVISORY COMMITTEE APPLICANT ROUTING MEMORANDUM FROM: Jessica Hayes, Office of the County Attorney DATE: January 17, 2019 APPLICANT: Slone DeLong 200 Vintage Cir, #403 Naples, FL 34119 APPLYING FOR: Mental Health and Addiction Advisory Committee We currently have vacancies on the above referenced advisory committee. The pending vacancies were advertised and persons interested in serving on this committee were asked to submit an application for consideration. TO ELECTIONS OFFICE: Attn: Shavontae Dominique Please confirm if the above applicant is a registered voter in Collier County, and in what commissioner district the applicant resides. Registered Voter: Commission District: TO STAFF LIAISON: Attn: Sean Callahan The application submitted by Ms. DeLong is attached for your review. Please let me know, in writing, the recommendation for appointment to the advisory committee. Your recommendation memo should include: _____ The names of all applicants considered for the vacancy or vacancies. _____ The committee’s recommendation for appointment or non-appointment. _____ The category or area of qualification the applicant is to be appointed in. _____ If the applicant is a reappointment, please include attendance records for the past two years. _________________________________________________________________________________ TO ADVISORY BOARD COORDINATOR: Attn: Wanda Rodriguez _____ This applicant is not recommended for appointment. –OR– _____ This applicant is recommended for appointment. A recommendation memo is attached, please prepare an agenda item for the next available BCC agenda. If you have any questions, please call me at 252-8123. Thank you for your attention to this matter. 30.B.2 Packet Pg. 988 Attachment: [Linked] Agenda and Back-up Document Packet - April 2, 2019 (8779 : Collier County Mental Health and Addiction Ad Hoc Board of County Commissioners 3299 East Tamiami Trail, Suite 800 Naples, FL 34112 (239) 252-8400 Application for Advisory Committees/Boards Name:__Slone DeLong_____________________________________ Home Phone: _417-224-4071_______ Home Address: __200 Vintage Circle #403____Zip Code:__34119____________ Business Phone:_2396242291_____________ E-mail address:_slone.delong@gmail.com____________ Board or Committee Applied for:____Mental Illness and Addiction Ad Hoc Committee_______________ Category (if applicable):_____________Member At-Large _______________________________ Example: Commission District, Developer, environmentalist, lay person, etc. How long have you lived in Collier County: _4___ How many months out of the year do you reside in Collier County: _Year round resident____ Have you ever been convicted or found guilty of a criminal offense (any level felony or first degree misdemeanor only)? Yes _____ No __X___ If yes, explain: ___________________________________________________________________________________________ Place of Employment: NCH Healthcare System Do you or your employer do business with the County? Yes _____ No __X__ If yes, explain:____________________________________________________________________________________ Would you and/or any organizations with which you are affiliated benefit from decisions or recommendations made by this advisory board? Yes____ No_X_ If yes, explain: ___________________________________________________________________________________ ________ NOTE: All advisory board members must update their profile and notify the Board of County Commissioners in the event that their relationship changes relating to memberships of organizations that may benefit them in the outcome of advisory board recommendations or they enter into contracts with the County. Are you a registered voter in Collier County: Yes _X__ No _____ Do you currently hold public office? Yes _____ No __X_ If so, what is that office? ___________________ _________________________________________________________________________________________ Do you now serve, or have you ever served, on a Collier County board or committee? Yes _____ No _X__ 30.B.2 Packet Pg. 989 Attachment: [Linked] Agenda and Back-up Document Packet - April 2, 2019 (8779 : Collier County Mental Health and Addiction Ad Hoc If yes, please list the committees/boards: ___________________________________________________________________________________________ Please list your community activities (civic clubs, neighborhood associations, etc. and positions held:  Leadership Collier Foundation – Greater Naples Chamber of Commerce  Growing Associates in Naples (GAIN) Class of 2018  Member January 2018 - present  Young Professionals Leading in Healthcare  NCH Healthcare System young professional organization  Founding Member, May 2016 – Present  Board of Directors, Event and Outreach Coordinator, May 2016 – Present  Young Professionals of Naples  Member, April 2015 – Present  Board of Directors, Public Relations Coordinator, August 2015 – August 2016  American College of Healthcare Executives  Member, October 2013 – Present  Western Florida Chapter Membership Committee  HIMSS – South Florida Chapter  Member, August 2017 – Present  Advocacy Committee  Southwest Florida Regional Technology Partnership  Member, October 2015 – Present  Big Brothers Big Sisters – Sun Coast  Mentor Volunteer November 2017 – Present Education:  Master of Healthcare Administration  Missouri State University, Springfield, Missouri, Class of 2014  Bachelor of Arts in Biology  Drury University, Springfield, Missouri, Class of 2012  Minors: Psychology, Chemistry, & Global Studies  Certificate: Leadership Experience: Over the past several years I have worked as a Population Health/Community Development Project Manager. I have worked closely with individuals who struggle getting access to healthcare they need for a variety of reasons - a big one was the lack of affordable mental healthcare options. I have listened to the people who are struggling and many times the reason they are experiencing adversity is because of poor policy and negative stigma. On a project I worked on in Missouri – we used community partnerships to build relationships with individuals then educate them on using the healthcare options in their area that best suited their needs all while “retraining” healthcare staff to see these individuals differently to reduce stigmas. Collier County is my home, I want to use the skill and experience I have to help my community. 30.B.2 Packet Pg. 990 Attachment: [Linked] Agenda and Back-up Document Packet - April 2, 2019 (8779 : Collier County Mental Health and Addiction Ad Hoc I have a strong passion for helping people as I have several relatives and friends who struggle with mental illness and addictions - some of which have lost their lives to their illness. Please attach any additional information you feel pertinent. This application should be forwarded to DL-AdvisoryBoardOn- LineApplications@colliercountyfl.gov, or by mail or in person to Wanda Rodriguez, County Attorney’s Office, 3299 East Tamiami Trail, Suite #800, Naples, FL 34112. Thank you for your interest in serving the citizens of Collier County. 30.B.2 Packet Pg. 991 Attachment: [Linked] Agenda and Back-up Document Packet - April 2, 2019 (8779 : Collier County Mental Health and Addiction Ad Hoc 07/2014 ADVISORY COMMITTEE APPLICANT ROUTING MEMORANDUM FROM: Jessica Hayes, Office of the County Attorney DATE: January 7, 2019 APPLICANT: Jill Rowe Dizio 178 Society Court Marco Island, FL 34145 APPLYING FOR: Mental Health and Addiction Advisory Committee We currently have three seats expiring on March 31, 2019 on the above referenced advisory committee. The pending vacancies were advertised and persons interested in serving on this committee were asked to submit an application for consideration. TO ELECTIONS OFFICE: Attn: Shavontae Dominique Please confirm if the above applicant is a registered voter in Collier County, and in what commissioner district the applicant resides. Registered Voter: yes Commission District: 1 TO STAFF LIAISON: Attn: Sean Callahan The application submitted by Ms. Meade is attached for your review. Please let me know, in writing, the recommendation for appointment to the advisory committee. Your recommendation memo should include: _____ The names of all applicants considered for the vacancy or vacancies. _____ The committee’s recommendation for appointment or non-appointment. _____ The category or area of qualification the applicant is to be appointed in. _____ If the applicant is a reappointment, please include attendance records for the past two years. _________________________________________________________________________________ TO ADVISORY BOARD COORDINATOR: Attn: Wanda Rodriguez _____ This applicant is not recommended for appointment. –OR– _____ This applicant is recommended for appointment. A recommendation memo is attached, please prepare an agenda item for the next available BCC agenda. If you have any questions, please call me at 252-8123. Thank you for your attention to this matter. 30.B.2 Packet Pg. 992 Attachment: [Linked] Agenda and Back-up Document Packet - April 2, 2019 (8779 : Collier County Mental Health and Addiction Ad Hoc Advisory Board Application Form Collier County Government 3299 Tamiami Trail East, Suite 800 Naples, FL 34112 (239) 252-8400 Application was received on: 1/6/2019 2:20:01 PM. Name: Jill Rowe DiZio Home Phone: 239-784-0838 Home Address: 178 Society Court City: Marco Island Zip Code: 34145 Phone Numbers Business: E-Mail Address: jdizioster@gmail.com Board or Committee: Collier County Mental Health and Addiction Ad Hoc Advisory Committee Category: Not indicated Place of Employment: Retired How long have you lived in Collier County: 10-15 How many months out of the year do you reside in Collier County: I am a year-round resident Have you been convicted or found guilty of a criminal offense (any level felony or first degree misdemeanor only)? No Not Indicated Do you or your employer do business with the County? No Not Indicated NOTE: All advisory board members must update their profile and notify the Board of County Commissioners in the event that their relationship changes relating to memberships of organizations that may benefit them in the outcome of advisory board recommendations or they enter into contracts with the County. Would you and/or any organizations with which you are affiliated benefit from decisions or recommendations made by this advisory board? No 30.B.2 Packet Pg. 993 Attachment: [Linked] Agenda and Back-up Document Packet - April 2, 2019 (8779 : Collier County Mental Health and Addiction Ad Hoc Not Indicated Are you a registered voter in Collier County? Yes Do you currently hold an elected office? No Do you now serve, or have you ever served on a Collier County board or committee? No Not Indicated Please list your community activities and positions held: Current Community Activities: Champions For Learning Mentor, Level 2 Volunteer at Tommie Barfield Elementary School, Development Committee member at Marco Island Academy, Active member of Marco Island Woman's Club, Sidewalker and Leader Volunteer at Naples Therapuetic Riding Center Education: Bachelor of Science in Early Childhood and Elementary Education from Nova Southeastern University, Master of Education in Moderate Special Needs, Special Education from Framingham College Experience / Background I have 38 years of experience in the field of education ranging from preschool teacher and elementary to middle school teacher in both regular and special education. I have worked with and seen first-hand the needs of children and their families with regard to mental illness and addiction and the resulting behavior and social consequences. Now that I am retired I would welcome the opportunity to join a committee to develop a strategic plan to address mental illness and substance abuse disorders. Representatives from the field of education should definitely be included on this committee. 30.B.2 Packet Pg. 994 Attachment: [Linked] Agenda and Back-up Document Packet - April 2, 2019 (8779 : Collier County Mental Health and Addiction Ad Hoc January 25, 2019 To Whom it May Concern, I’m honored to write to you on behalf of Jill Rowe Dizio who has expressed a very strong interest to me in serving on the Collier County Mental Health and Addiction Ad Hoc Advisory Committee. Where to begin! I interviewed and hired Ms. Dizio in 2005 for a teaching position at Tommie Barfield Elementary School and never regretted that decision. She is a top educator with 38 years of experience along with communication skills, compassion as well as the competence and desire to contribute to her community. She has volunteered actively at the following; Champions for Learning – Mentor Naples Therapeutic Riding Center – Leader and Walker Marco Island Academy Development Committee – Member Tommie Barfield Elementary – Level 2 Volunteer Ms. Dizio has a background in Special Needs/Special Education (Master’s Degree) and has experience and understanding of mental illness, addiction, and the related social consequences and behaviors after 38 years as an educator. Her sincere desire to help in the area of mental illness and substance abuse disorders in her community is paramount. As a result of her experience and commitment to students in pre-K through high school, she will be a valuable asset to the Mental Health and Addiction Advisory Committee. I recommend her without reservation. Sincerely, Jory Westberry, Ed.D. Collier County School Board Member  30.B.2 Packet Pg. 995 Attachment: [Linked] Agenda and Back-up Document Packet - April 2, 2019 (8779 : Collier County Mental Health and Addiction Ad Hoc 07/2014 ADVISORY COMMITTEE APPLICANT ROUTING MEMORANDUM FROM: Jessica Hayes, Office of the County Attorney DATE: January 11, 2019 APPLICANT: Kathleen W. Kenney 508 Bristle Cone Lane Naples, FL 34113 APPLYING FOR: Mental Health and Addiction Advisory Committee We currently vacancies on the above referenced advisory committee. The pending vacancies were advertised and persons interested in serving on this committee were asked to submit an application for consideration. TO ELECTIONS OFFICE: Attn: Shavontae Dominique Please confirm if the above applicant is a registered voter in Collier County, and in what commissioner district the applicant resides. Registered Voter: yes Commission District: 1 TO STAFF LIAISON: Attn: Sean Callahan The application submitted by Ms. Kenney is attached for your review. Please let me know, in writing, the recommendation for appointment to the advisory committee. Your recommendation memo should include: _____ The names of all applicants considered for the vacancy or vacancies. _____ The committee’s recommendation for appointment or non-appointment. _____ The category or area of qualification the applicant is to be appointed in. _____ If the applicant is a reappointment, please include attendance records for the past two years. _________________________________________________________________________________ TO ADVISORY BOARD COORDINATOR: Attn: Wanda Rodriguez _____ This applicant is not recommended for appointment. –OR– _____ This applicant is recommended for appointment. A recommendation memo is attached, please prepare an agenda item for the next available BCC agenda. If you have any questions, please call me at 252-8123. Thank you for your attention to this matter. 30.B.2 Packet Pg. 996 Attachment: [Linked] Agenda and Back-up Document Packet - April 2, 2019 (8779 : Collier County Mental Health and Addiction Ad Hoc 07/2014 Advisory Board Application Form Collier County Government 3299 Tamiami Trail East, Suite 800 Naples, FL 34112 (239) 252-8400 Application was received on: 1/11/2019 8:46:26 AM. Name: Kathleen W kenney Home Phone: 5082803009 Home Address: 508 bristle cone lane City: Naples Zip Code: 34113 Phone Numbers Business: E-Mail Address: Kathleen.kenney@comcast.net Board or Committee: Collier County Mental Health and Addiction Ad Hoc Advisory Committee Category: Citizen Place of Employment: Retired How long have you lived in Collier County: 5-10 How many months out of the year do you reside in Collier County: 6-9 Have you been convicted or found guilty of a criminal offense (any level felony or first degree misdemeanor only)? No Not Indicated Do you or your employer do business with the County? No Not Indicated NOTE: All advisory board members must update their profile and notify the Board of County Commissioners in the event that their relationship changes relating to memberships of organizations that may benefit them in the outcome of advisory board recommendations or they enter into contracts with the County. Would you and/or any organizations with which you are affiliated benefit from decisions or recommendations made by this advisory board? No Not Indicated 30.B.2 Packet Pg. 997 Attachment: [Linked] Agenda and Back-up Document Packet - April 2, 2019 (8779 : Collier County Mental Health and Addiction Ad Hoc [YY-1562/1106981/1] Are you a registered voter in Collier County? Yes Do you currently hold an elected office? No Do you now serve, or have you ever served on a Collier County board or committee? No Not Indicated Please list your community activities and positions held: I run a women's golf league at Hibiscus golf course and I also work there part time. I sometimes teach bridge Education: 2 years of college Miami university in Oxford, ohio Experience / Background I have dealt with addiction in myfamily for more than 20 years.I would love to be a part of a group that could make a difference in the treatment of mental health and ways to improve the important care they receive. 30.B.2 Packet Pg. 998 Attachment: [Linked] Agenda and Back-up Document Packet - April 2, 2019 (8779 : Collier County Mental Health and Addiction Ad Hoc 07/2014 ADVISORY COMMITTEE APPLICANT ROUTING MEMORANDUM FROM: Jessica Hayes, Office of the County Attorney DATE: January 29, 2019 APPLICANT: Sara K. Kuralt 1200 Goldfinch Way Naples, FL 34105 APPLYING FOR: Mental Health and Addiction Advisory Committee We currently have vacancies on the above referenced advisory committee. The pending vacancies were advertised and persons interested in serving on this committee were asked to submit an application for consideration. TO ELECTIONS OFFICE: Attn: Shavontae Dominique Please confirm if the above applicant is a registered voter in Collier County, and in what commissioner district the applicant resides. Registered Voter: yes Commission District: 4 TO STAFF LIAISON: Attn: Sean Callahan The application submitted by Ms. Kuralt is attached for your review. Please let me know, in writing, the recommendation for appointment to the advisory committee. Your recommendation memo should include: _____ The names of all applicants considered for the vacancy or vacancies. _____ The committee’s recommendation for appointment or non-appointment. _____ The category or area of qualification the applicant is to be appointed in. _____ If the applicant is a reappointment, please include attendance records for the past two years. _________________________________________________________________________________ TO ADVISORY BOARD COORDINATOR: Attn: Wanda Rodriguez _____ This applicant is not recommended for appointment. –OR– _____ This applicant is recommended for appointment. A recommendation memo is attached, please prepare an agenda item for the next available BCC agenda. If you have any questions, please call me at 252-8123. Thank you for your attention to this matter. 30.B.2 Packet Pg. 999 Attachment: [Linked] Agenda and Back-up Document Packet - April 2, 2019 (8779 : Collier County Mental Health and Addiction Ad Hoc 30.B.2 Packet Pg. 1000 Attachment: [Linked] Agenda and Back-up Document Packet - April 2, 2019 (8779 : Collier County Mental Health and Addiction Ad Hoc 30.B.2 Packet Pg. 1001 Attachment: [Linked] Agenda and Back-up Document Packet - April 2, 2019 (8779 : Collier County Mental Health and Addiction Ad Hoc 07/2014 ADVISORY COMMITTEE APPLICANT ROUTING MEMORANDUM FROM: Jessica Hayes, Office of the County Attorney DATE: January 2, 2019 APPLICANT: Judith F. Meade 3424 Donoso Ct. Naples, FL 34109 APPLYING FOR: Mental Health and Addiction Advisory Committee We currently have three seats expiring on March 31, 2019 on the above referenced advisory committee. The pending vacancies were advertised and persons interested in serving on this committee were asked to submit an application for consideration. TO ELECTIONS OFFICE: Attn: Shavontae Dominique Please confirm if the above applicant is a registered voter in Collier County, and in what commissioner district the applicant resides. Registered Voter: Yes Commission District: 2 TO STAFF LIAISON: Attn: Sean Callahan The application submitted by Ms. Meade is attached for your review. Please let me know, in writing, the recommendation for appointment to the advisory committee. Your recommendation memo should include: _____ The names of all applicants considered for the vacancy or vacancies. _____ The committee’s recommendation for appointment or non-appointment. _____ The category or area of qualification the applicant is to be appointed in. _____ If the applicant is a reappointment, please include attendance records for the past two years. _________________________________________________________________________________ TO ADVISORY BOARD COORDINATOR: Attn: Wanda Rodriguez _____ This applicant is not recommended for appointment. –OR– _____ This applicant is recommended for appointment. A recommendation memo is attached, please prepare an agenda item for the next available BCC agenda. If you have any questions, please call me at 252-8123. Thank you for your attention to this matter. 30.B.2 Packet Pg. 1002 Attachment: [Linked] Agenda and Back-up Document Packet - April 2, 2019 (8779 : Collier County Mental Health and Addiction Ad Hoc Advisory Board Application Please fill out the following form to apply for a Collier County Advisory Board / Committee. Once you have filled out all the necessary fields, click the button below. Name: Judith F Meade Please type your name as it appears on your voter registration Home Address: 3424 Donoso Ct City: Zip Code: Naples 34109 Home Phone: Business Phone: 239-316-4659 703-459-8185 Ex. 239-555-5555 Ex. 239-555-5555 Important: E-mail address is required to receive a copy of your application. Email Address: jfmeadecoaching@hotmail.com Board or Committee: Collier County Mental Health and Addiction Ad Hoc Advisory Committee Category (if Applicable) Not indicated i.e., Commission District, Developer Environmentalist, Citizen At-Large, etc. Place of Employment: How long have you lived in Collier County? 1-2 30.B.2 Packet Pg. 1003 Attachment: [Linked] Agenda and Back-up Document Packet - April 2, 2019 (8779 : Collier County Mental Health and Addiction Ad Hoc How many months out of the year do you reside in Collier County? I am a year-round resident Have you been convicted or found guilty of a criminal offense (any level felony or first-degree misdemeanor only)? No Do you or your employer do business with the County? No Would you and/or any organizations with which you are affiliated benefit from decisions or recommendations made by this advisory board? No NOTE: All advisory board members must update their profile and notify the Board of County Commissioners in the eve Judith F Meade nt that their relationship changes relating to memberships of organizations that may benefit them in the outcome of advisory board recommendations or they enter into contracts with the County. Are you a registered voter in Collier County? Yes Do you currently hold an elected office? No Do you now serve, or have you ever served on a Collier County board or committee? No Please list your community activities and positions held: Our church has many opportunities to volunteer within the church and within the Naples Community. I have volunteered with several different projects and work with a section of the Church Thrift Store. Example: Civic clubs, neighborhood associations, etc. 30.B.2 Packet Pg. 1004 Attachment: [Linked] Agenda and Back-up Document Packet - April 2, 2019 (8779 : Collier County Mental Health and Addiction Ad Hoc Education: East Tennessee State University, Johnson City, Tennessee, B.S. School of Social Work Memphis State University, Memphis, Tennessee, M.S. in Vocational Rehabilitation Counseling Virginia Polytechnic Institute Northern Virginia Graduate Center, Post Masters Certificate in Marriage and Family Therapy Virginia Polytechnic Institute Northern Virginia Graduate Center - Doctoral Program n Adult Education: Completed 12 hours Fast Track Coaching (Coaching Certificate) Experience / Background Military Family Life Consultant: Provided brief short-term solution-focused problem solving, coaching, support, non-medical counseling, and education to military members and their families at military installations in the U.S. and internationally. Provided psycho-education to assist military service members and their families in coping with the impact of deployments and reintegration on the family and the stressors unique to military life. Fifteen years in private practice as a Licensed Marriage and Family Therapist in the State of Virginia Consultant for (OASSIS) The Organization of Attempters and Suicide in Interfaith Services (Part time for one year) Served as an adviser to the Board of Directors, assessed the needs of the organization and made recommendations, initiated and facilitated interfaith communities in monthly awareness and presentation programs. Licensed Professional Counselor and Licensed Marriage and Family Therapist in the State of Virginia. My goal is to get licensed in Florida. Any information provided to the Board of County Commissioners Office in connection with the Collier County website shall become a public record and available to the public in accordance with Chapter 119, Florida Statutes. Collier County Board of County Commissioners 3299 Tamiami Trail East, Suite 800 Naples, FL 34112-5749 30.B.2 Packet Pg. 1005 Attachment: [Linked] Agenda and Back-up Document Packet - April 2, 2019 (8779 : Collier County Mental Health and Addiction Ad Hoc 07/2014 ADVISORY COMMITTEE APPLICANT ROUTING MEMORANDUM FROM: Jessica Hayes, Office of the County Attorney DATE: January 29, 2019 APPLICANT: Trista Meister 1355 Sandpiper Street Naples, FL 34102 APPLYING FOR: Mental Health and Addiction Advisory Committee We currently have vacancies on the above referenced advisory committee. The pending vacancies were advertised and persons interested in serving on this committee were asked to submit an application for consideration. TO ELECTIONS OFFICE: Attn: Shavontae Dominique Please confirm if the above applicant is a registered voter in Collier County, and in what commissioner district the applicant resides. Registered Voter: yes Commission District: 4 TO STAFF LIAISON: Attn: Sean Callahan The application submitted by Ms. Meister is attached for your review. Please let me know, in writing, the recommendation for appointment to the advisory committee. Your recommendation memo should include: _____ The names of all applicants considered for the vacancy or vacancies. _____ The committee’s recommendation for appointment or non-appointment. _____ The category or area of qualification the applicant is to be appointed in. _____ If the applicant is a reappointment, please include attendance records for the past two years. _________________________________________________________________________________ TO ADVISORY BOARD COORDINATOR: Attn: Wanda Rodriguez _____ This applicant is not recommended for appointment. –OR– _____ This applicant is recommended for appointment. A recommendation memo is attached, please prepare an agenda item for the next available BCC agenda. If you have any questions, please call me at 252-8123. Thank you for your attention to this matter. 30.B.2 Packet Pg. 1006 Attachment: [Linked] Agenda and Back-up Document Packet - April 2, 2019 (8779 : Collier County Mental Health and Addiction Ad Hoc 07/2014 Advisory Board Application Please fill out the following form to apply for a Collier County Advisory Board / Committee. Once you have filled out all the necessary fields, click the button below. Name: Trista Meister Please type your name as it appears on your voter registration Home Address: 1355 Sandpiper Street City: Naples Zip Code: 34102 Home Phone: 239-417-8661 Business Phone: 239-785-3362 Important: E-mail address is required to receive a copy of your application. Email Address: trista@mindfulmarketingfl.com Board or Committee: Collier County Mental Health and Addiction Ad Hoc Advisory Committee Place of Employment: Mindful Marketing Florida, LLC How long have you lived in Collier County? more than 15 How many months out of the year do you reside in Collier County? I am a year-round resident Have you been convicted or found guilty of a criminal offense (any level felony or first degree misdemeanor only)? No Do you or your employer do business with the County? No Would you and/or any organizations with which you are affiliated benefit from decisions or recommendations made by this advisory board? No NOTE: All advisory board members must update their profile and notify the Board of County Commissioners in the event that their relationship changes relating to memberships of organizations 30.B.2 Packet Pg. 1007 Attachment: [Linked] Agenda and Back-up Document Packet - April 2, 2019 (8779 : Collier County Mental Health and Addiction Ad Hoc [YY-1562/1106981/1] that may benefit them in the outcome of advisory board recommendations or they enter into contracts with the County. Are you a registered voter in Collier County? Yes Do you currently hold an elected office? No Do you now serve, or have you ever served on a Collier County board or committee? No Please list your community activities and positions held: Trista is a 2004 Leadership Collier graduate and currently serves on the Marketing Committee for the Alumni Association where she served as Chair for more than three years. She is also serving as the Vice Chair for the 2019 Class. Her previous community involvement includes serving as President, Board Member, and Publicity chair for the Public Relations, Marketing and Advertising Professionals of Collier County and as a volunteer committee member for a variety of fundraising events focused on education, healthcare and social services. Trista was also invited to serve on the Strategic Planning Communications Committee for Collier County Public Schools in 2014 and 2012. Education: Trista earned her Bachelor of Science degree in psychology from the University of Florida (UF) where she graduated with honors. She went on to pursue her Master of Business Administration from the University of South Florida (USF) where she also graduated with honors. While at USF, she earned certificates in advanced marketing strategies and management information systems. Experience / Background Trista Meister is an independent public relations and marketing consultant with Mindful Marketing Florida, LLC, a business she started in 2018 after serving more than 20 years as a communications expert in the non-profit and for-profit sectors in Southwest Florida. Prior to starting Mindful Marketing, Trista served as the Communications Director for David Lawrence Center (DLC), an award winning, not-for-profit mental health and addiction recovery treatment center, for more than 15 years. During her tenure with DLC, she managed all internal and external communications including the development of advertising, marketing collateral, websites and social media content as well as media and 30.B.2 Packet Pg. 1008 Attachment: [Linked] Agenda and Back-up Document Packet - April 2, 2019 (8779 : Collier County Mental Health and Addiction Ad Hoc [YY-1562/1106981/1] community relations. She is honored to continue to maintain a consulting relationship with the Center, whose mission she holds near and dear to her heart. Prior to joining DLC, she served as a Marketing Manager at Fifth Third Bank, Marketing Coordinator at Arvida Real Estate and Marketing Coordinator for Fischer International, a national software and technology firm. Throughout her career, Trista has received many accolades including: the 2015 Naples Chamber of Commerce Communications Volunteer of the Year award; 2012 Gulfshore Business Magazine Top 40 Under 40 Up-and-Coming Business Leader Award; 2004 David Lawrence Center Teamwork Award; and the 2000 Fifth Third Bank President’s Award for Teamwork. Any information provided to the Board of County Commissioners Office in connection with the Collier County website shall become a public record and available to the public in accordance with Chapter 119, Florida Statutes. Collier County Board of County Commissioners 3299 Tamiami Trail East, Suite 800 Naples, FL 34112-5749 Thanks. Trista Meister, President 239-785-3362 | Trista@MindfulMarketingFL.com 30.B.2 Packet Pg. 1009 Attachment: [Linked] Agenda and Back-up Document Packet - April 2, 2019 (8779 : Collier County Mental Health and Addiction Ad Hoc 07/2014 ADVISORY COMMITTEE APPLICANT ROUTING MEMORANDUM FROM: Jessica Hayes, Office of the County Attorney DATE: January 8, 2019 APPLICANT: Charlotte Nycklemoe 244 Melrose Place Naples, FL 34104 APPLYING FOR: Mental Health and Addiction Advisory Committee We currently have three seats expiring on March 31, 2019 on the above referenced advisory committee. The pending vacancies were advertised and persons interested in serving on this committee were asked to submit an application for consideration. TO ELECTIONS OFFICE: Attn: Shavontae Dominique Please confirm if the above applicant is a registered voter in Collier County, and in what commissioner district the applicant resides. Registered Voter: yes Commission District: 4 TO STAFF LIAISON: Attn: Sean Callahan The application submitted by Ms. Aronson is attached for your review. Please let me know, in writing, the recommendation for appointment to the advisory committee. Your recommendation memo should include: _____ The names of all applicants considered for the vacancy or vacancies. _____ The committee’s recommendation for appointment or non-appointment. _____ The category or area of qualification the applicant is to be appointed in. _____ If the applicant is a reappointment, please include attendance records for the past two years. _________________________________________________________________________________ TO ADVISORY BOARD COORDINATOR: Attn: Wanda Rodriguez _____ This applicant is not recommended for appointment. –OR– _____ This applicant is recommended for appointment. A recommendation memo is attached, please prepare an agenda item for the next available BCC agenda. If you have any questions, please call me at 252-8123. Thank you for your attention to this matter. 30.B.2 Packet Pg. 1010 Attachment: [Linked] Agenda and Back-up Document Packet - April 2, 2019 (8779 : Collier County Mental Health and Addiction Ad Hoc 07/2014 Advisory Board Application Form Collier County Government 3299 Tamiami Trail East, Suite 800 Naples, FL 34112 (239) 252-8400 Application was received on: 1/7/2019 5:02:19 PM. Name: Charlotte Nycklemoe Home Phone: 2394552261 Home Address: 244 Melrose Place City: Naples Zip Code: 34104 Phone Numbers Business: E-Mail Address: drchargar@gmail.com Board or Committee: Category: MI and Addiction Ad Hoc Cmtte Place of Employment: Retired How long have you lived in Collier County: 5-10 How many months out of the year do you reside in Collier County: I am a year-round resident Have you been convicted or found guilty of a criminal offense (any level felony or first degree misdemeanor only)? No Not Indicated Do you or your employer do business with the County? No Not Indicated NOTE: All advisory board members must update their profile and notify the Board of County Commissioners in the event that their relationship changes relating to memberships of organizations that may benefit them in the outcome of advisory board recommendations or they enter into contracts with the County. Would you and/or any organizations with which you are affiliated benefit from decisions or recommendations made by this advisory board? No Not Indicated 30.B.2 Packet Pg. 1011 Attachment: [Linked] Agenda and Back-up Document Packet - April 2, 2019 (8779 : Collier County Mental Health and Addiction Ad Hoc [YY-1562/1106981/1] Are you a registered voter in Collier County? Yes Do you currently hold an elected office? No Do you now serve, or have you ever served on a Collier County board or committee? No Not Indicated Please list your community activities and positions held: Past League of Women Voters Collier County President 2015 - 2017 League of Women Voters Florida Board of Director - present League of Women Voters Florida Juvenile Justice Committee Chair Education: University of Minnesota Experience / Background Served on state National Alliance for the Mentally Ill (NAMI) 3 yeaars - Minnesota NAMI Legislative Committee Chair - Minnesota Director of Legislative Affairs for National Association of Office Parks Assn - 30 yr. Career in Commercial Industrial Real Estate Mother of 3 children diagnosed with severe and persistant MI. Lots of experience as a parent and advocacy. 30.B.2 Packet Pg. 1012 Attachment: [Linked] Agenda and Back-up Document Packet - April 2, 2019 (8779 : Collier County Mental Health and Addiction Ad Hoc 30.B.2 Packet Pg. 1013 Attachment: [Linked] Agenda and Back-up Document Packet - April 2, 2019 (8779 : Collier County Mental Health and Addiction Ad Hoc 07/2014 ADVISORY COMMITTEE APPLICANT ROUTING MEMORANDUM FROM: Jessica Hayes, Office of the County Attorney DATE: January 2, 2019 APPLICANT: Rhona Saunders 6955 Carlisle Court, Unit 313 Naples, FL 34109 APPLYING FOR: Mental Health and Addiction Advisory Committee We currently have three seats expiring on March 31, 2019 on the above referenced advisory committee. The pending vacancies were advertised and persons interested in serving on this committee were asked to submit an application for consideration. TO ELECTIONS OFFICE: Attn: Shavontae Dominique Please confirm if the above applicant is a registered voter in Collier County, and in what commissioner district the applicant resides. Registered Voter: Yes Commission District: 2 TO STAFF LIAISON: Attn: Sean Callahan The application submitted by Ms. Saunders is attached for your review. Please let me know, in writing, the recommendation for appointment to the advisory committee. Your recommendation memo should include: _____ The names of all applicants considered for the vacancy or vacancies. _____ The committee’s recommendation for appointment or non-appointment. _____ The category or area of qualification the applicant is to be appointed in. _____ If the applicant is a reappointment, please include attendance records for the past two years. _________________________________________________________________________________ TO ADVISORY BOARD COORDINATOR: Attn: Wanda Rodriguez _____ This applicant is not recommended for appointment. –OR– _____ This applicant is recommended for appointment. A recommendation memo is attached, please prepare an agenda item for the next available BCC agenda. If you have any questions, please call me at 252-8123. Thank you for your attention to this matter. 30.B.2 Packet Pg. 1014 Attachment: [Linked] Agenda and Back-up Document Packet - April 2, 2019 (8779 : Collier County Mental Health and Addiction Ad Hoc Advisory Board Application Form Collier County Government 3299 Tamiami Trail East, Suite 800 Naples, FL 34112 (239) 252-8400 Application was received on: 1/2/2019 9:46:07 AM. Name: Rhona Saunders Home Phone: 2394501215 Home Address: 6955 Carlisle Court, Apt 313, UNIT 313 City: Naples Zip Code: 34109 Phone Numbers Business: E-Mail Address: rhonanaples@gmail.com Board or Committee: Category: Mental Illness and Addiction Ad Hoc Place of Employment: Retired How long have you lived in Collier County: more than 15 How many months out of the year do you reside in Collier County: I am a year-round resident Have you been convicted or found guilty of a criminal offense (any level felony or first degree misdemeanor only)? No Not Indicated Do you or your employer do business with the County? No Not Indicated NOTE: All advisory board members must update their profile and notify the Board of County Commissioners in the event that their relationship changes relating to memberships of organizations that may benefit them in the outcome of advisory board recommendations or they enter into contracts with the County. Would you and/or any organizations with which you are affiliated benefit from decisions or recommendations made by this advisory board? No 30.B.2 Packet Pg. 1015 Attachment: [Linked] Agenda and Back-up Document Packet - April 2, 2019 (8779 : Collier County Mental Health and Addiction Ad Hoc Not Indicated Are you a registered voter in Collier County? Yes Do you currently hold an elected office? No Do you now serve, or have you ever served on a Collier County board or committee? Yes Tourist Development Council Emergency Services Advisory Board Code Enforcement Board Please list your community activities and positions held: Founder, Naples Press Club Treasurer, Naples Better Gov't Committee Naples Players Council on World Affairs Founder, Mended Hearts and volunteer, NCH Volunteer, CCSO and Crisis Intervention Training volunteer Education: BS Journalism and Political Science, Ohio University Graduate Studies, American University Experience / Background Owner, CEO of marketing communications firm in D.C. Long time gov't and business mentor/advisor/strategic planner 30.B.2 Packet Pg. 1016 Attachment: [Linked] Agenda and Back-up Document Packet - April 2, 2019 (8779 : Collier County Mental Health and Addiction Ad Hoc 07/2014 ADVISORY COMMITTEE APPLICANT ROUTING MEMORANDUM FROM: Jessica Hayes, Office of the County Attorney DATE: January 28, 2019 APPLICANT: Charles Sellon 901 Egrets Run Apt. 102 Naples, FL 34108 APPLYING FOR: Mental Health and Addiction Advisory Committee We currently have vacancies on the above referenced advisory committee. The pending vacancies were advertised and persons interested in serving on this committee were asked to submit an application for consideration. TO ELECTIONS OFFICE: Attn: Shavontae Dominique Please confirm if the above applicant is a registered voter in Collier County, and in what commissioner district the applicant resides. Registered Voter: yes Commission District: 2 TO STAFF LIAISON: Attn: Sean Callahan The application submitted by Mr. Sellon is attached for your review. Please let me know, in writing, the recommendation for appointment to the advisory committee. Your recommendation memo should include: _____ The names of all applicants considered for the vacancy or vacancies. _____ The committee’s recommendation for appointment or non-appointment. _____ The category or area of qualification the applicant is to be appointed in. _____ If the applicant is a reappointment, please include attendance records for the past two years. _________________________________________________________________________________ TO ADVISORY BOARD COORDINATOR: Attn: Wanda Rodriguez _____ This applicant is not recommended for appointment. –OR– _____ This applicant is recommended for appointment. A recommendation memo is attached, please prepare an agenda item for the next available BCC agenda. If you have any questions, please call me at 252-8123. Thank you for your attention to this matter. 30.B.2 Packet Pg. 1017 Attachment: [Linked] Agenda and Back-up Document Packet - April 2, 2019 (8779 : Collier County Mental Health and Addiction Ad Hoc Advisory Board Application Form Collier County Government 3299 Tamiami Trail East, Suite 800 Naples, FL 34112 (239) 252-8400 Application was received on: 1/28/2019 4:12:11 PM. Name: Charles Houston Sellon Home Phone: 703-283-0105 Home Address: 901 Egrets Run Apt. 102 City: Naples Zip Code: 34108 Phone Numbers Business: E-Mail Address: charles.sellon@verizon.net Board or Committee: Collier County Mental Health and Addiction Ad Hoc Advisory Committee Category: At Large Place of Employment: Retired How long have you lived in Collier County: 4-5 How many months out of the year do you reside in Collier County: I am a year-round resident Have you been convicted or found guilty of a criminal offense (any level felony or first degree misdemeanor only)? No Not Indicated Do you or your employer do business with the County? No Not Indicated NOTE: All advisory board members must update their profile and notify the Board of County Commissioners in the event that their relationship changes relating to memberships of organizations that may benefit them in the outcome of advisory board recommendations or they enter into contracts with the County. Would you and/or any organizations with which you are affiliated benefit from decisions or recommendations made by this advisory board? No 30.B.2 Packet Pg. 1018 Attachment: [Linked] Agenda and Back-up Document Packet - April 2, 2019 (8779 : Collier County Mental Health and Addiction Ad Hoc Not Indicated Are you a registered voter in Collier County? Yes Do you currently hold an elected office? No Do you now serve, or have you ever served on a Collier County board or committee? No Not Indicated Please list your community activities and positions held: Member: Naples Men's Discussion Group Applicant: Greater Naples Leadership Masters Program Volunteer/Finance Committee for a major Florida political campaign in 2018 Education: BA in Government from Harvard University Experience / Background I have over 40 years experience in the financial services industry in the US and UK. I have held senior management positions;been responsible for developing strategies in a highly competitive market place;planned and executed budgets;and developed and delivered new products and business lines in major financial institutions. Thus I acquired a skill set which required me to write well; speak in front of groups; manage the development of policies and new lines of business; and coordinate the successful delivery of same. I believe that Collier County needs to develop a comprehensive plan to coordinate the delivery of mental health care to enhance that which is currently provided by the David Lawrence Center and the County jail.My skill set, developed in a business career, is a transferable asset of problem solving abilities which I would like to apply to the complex issues of delivering mental health care to a broad cross section of the 30.B.2 Packet Pg. 1019 Attachment: [Linked] Agenda and Back-up Document Packet - April 2, 2019 (8779 : Collier County Mental Health and Addiction Ad Hoc 07/2014 ADVISORY COMMITTEE APPLICANT ROUTING MEMORANDUM FROM: Jessica Hayes, Office of the County Attorney DATE: January 28, 2019 APPLICANT: Dennis L. Shaw 4418 Tamarind Way Naples, FL 34119 APPLYING FOR: Mental Health and Addiction Advisory Committee We currently have vacancies on the above referenced advisory committee. The pending vacancies were advertised and persons interested in serving on this committee were asked to submit an application for consideration. TO ELECTIONS OFFICE: Attn: Shavontae Dominique Please confirm if the above applicant is a registered voter in Collier County, and in what commissioner district the applicant resides. Registered Voter: yes Commission District: 3 TO STAFF LIAISON: Attn: Sean Callahan The application submitted by Mr. Shaw is attached for your review. Please let me know, in writing, the recommendation for appointment to the advisory committee. Your recommendation memo should include: _____ The names of all applicants considered for the vacancy or vacancies. _____ The committee’s recommendation for appointment or non-appointment. _____ The category or area of qualification the applicant is to be appointed in. _____ If the applicant is a reappointment, please include attendance records for the past two years. _________________________________________________________________________________ TO ADVISORY BOARD COORDINATOR: Attn: Wanda Rodriguez _____ This applicant is not recommended for appointment. –OR– _____ This applicant is recommended for appointment. A recommendation memo is attached, please prepare an agenda item for the next available BCC agenda. If you have any questions, please call me at 252-8123. Thank you for your attention to this matter. 30.B.2 Packet Pg. 1020 Attachment: [Linked] Agenda and Back-up Document Packet - April 2, 2019 (8779 : Collier County Mental Health and Addiction Ad Hoc Advisory Board Application Form Collier County Government 3299 Tamiami Trail East, Suite 800 Naples, FL 34112 (239) 252-8400 Application was received on: 1/27/2019 1:17:32 PM. Name: Dennis L. Shaw Home Phone: 239-776-6422 Home Address: 4418 Tamarind Way City: Naples Zip Code: 34119 Phone Numbers Business: E-Mail Address: dshaw.fc@gmail.com Board or Committee: Collier County Mental Health and Addiction Ad Hoc Advisory Committee Category: Not indicated Place of Employment: MVP Realty How long have you lived in Collier County: 3-4 How many months out of the year do you reside in Collier County: I am a year-round resident Have you been convicted or found guilty of a criminal offense (any level felony or first degree misdemeanor only)? No Not Indicated Do you or your employer do business with the County? No Not Indicated NOTE: All advisory board members must update their profile and notify the Board of County Commissioners in the event that their relationship changes relating to memberships of organizations that may benefit them in the outcome of advisory board recommendations or they enter into contracts with the County. Would you and/or any organizations with which you are affiliated benefit from decisions or recommendations made by this advisory board? No 30.B.2 Packet Pg. 1021 Attachment: [Linked] Agenda and Back-up Document Packet - April 2, 2019 (8779 : Collier County Mental Health and Addiction Ad Hoc Not Indicated Are you a registered voter in Collier County? Yes Do you currently hold an elected office? No Do you now serve, or have you ever served on a Collier County board or committee? No Not Indicated Please list your community activities and positions held: Education: Bachelor of Science-Business Administration Experience / Background Semi-retired realtor. Former general sales manager for Motorhome Manufacturer.Over 40 years experience in sales, marketing and customer service. Parent of two children that have both struggled with mental health/addiction issues. Over nine years of experience navigating the mental health resources in Iowa and SW Florida. Parent of child that died by suicide. 30.B.2 Packet Pg. 1022 Attachment: [Linked] Agenda and Back-up Document Packet - April 2, 2019 (8779 : Collier County Mental Health and Addiction Ad Hoc 07/2014 Advisory Board Application Form Collier County Government 3299 Tamiami Trail East, Suite 800 Naples, FL 34112 (239) 252-8400 Application was received on: 1/8/2019 12:21:52 PM. Name: Karen Stelmacki Home Phone: 239-839-7010 Home Address: 15241 Avalon Bay Blvd Unit 2801 City: Fort Myers Zip Code: 33919 Phone Numbers Business: 239-848-7546 E-Mail Address: Stelmaka@collierschools.com Board or Committee: Collier County Mental Health and Addiction Ad Hoc Advisory Committee Category: Not indicated Place of Employment: Collier County Public Schools How long have you lived in Collier County: How many months out of the year do you reside in Collier County: Have you been convicted or found guilty of a criminal offense (any level felony or first degree misdemeanor only)? No Not Indicated Do you or your employer do business with the County? No Not Indicated NOTE: All advisory board members must update their profile and notify the Board of County Commissioners in the event that their relationship changes relating to memberships of organizations that may benefit them in the outcome of advisory board recommendations or they enter into contracts with the County. Would you and/or any organizations with which you are affiliated benefit from decisions or recommendations made by this advisory board? No Not Indicated 30.B.2 Packet Pg. 1023 Attachment: [Linked] Agenda and Back-up Document Packet - April 2, 2019 (8779 : Collier County Mental Health and Addiction Ad Hoc [YY-1562/1106981/1] Are you a registered voter in Collier County? No Do you currently hold an elected office? No Do you now serve, or have you ever served on a Collier County board or committee? No Not Indicated Please list your community activities and positions held: Facilitator, Collier Schools Mental Health Workgroup (started in 2014 with 3 agencies and has since expanded in compliance with Florida Governor's Executive Order 3/2018) Co-chair, Collier Schools Sharing the Commitment Advisory (2003-2014) Secretary, Collier Early Childhood Coalition (1995-1997) no longer in existence Subcommittee member, Children's Museum Planning Education: Masters in Education - Advanced Graduate Study in Educational Leadership Masters in Communication Disorders Experience / Background 29 years with Collier County Public Schools (22 years as an administrator of special education and 5 years as a senior administrator - Executive Director of Exceptional Education and Student Support Services 30.B.2 Packet Pg. 1024 Attachment: [Linked] Agenda and Back-up Document Packet - April 2, 2019 (8779 : Collier County Mental Health and Addiction Ad Hoc Mental Health and Addiction Ad Hoc Committee Meeting April 2, 2019 – 8:30 am Item 9.2 Discussion of Bed Supply Per Capita THIS IS A ONE WAY COMMUNICATION. Good evening, Committee Members. Please find two items that Pam Baker wanted to share with the Committee attached to this email. The first is an article regarding psychiatric beds per capita. This article provides (particularly pages 3-4) some clarity to the question raised by Judge Martin at Friday’s meeting. Pam emphasized that the number includes state hospital beds. The second attachment shows the number of licensed psychiatric hospital beds in Collier County. Per Pam’s email: “Attached shows the number of licensed psychiatric hospital beds in Collier County. This does not include the DLC CSU which is not a ‘hospital’ by definition. With the Willough at 82 and NCH 23, we technically already have more than the recommended number. They just are not used for emergent / Baker Act capacity. Thank you for distributing to the Committee.” Have a good evening. Respectfully, Sean Callahan Exec. Director of Corporate Business Operations Office of the County Manager 3299 Tamiami Trail E, Building F, Suite 202, Naples Florida 34113 Phone: 239.252.8383 Cell: 239.272.6516 E-mail: Sean Callahan@colliercountyfl.gov “HOW ARE WE DOING?” Please CLICK HERE to fill out a CUSTOMER SURVEY. We appreciate your feedback! 30.B.2 Packet Pg. 1025 Attachment: [Linked] Agenda and Back-up Document Packet - April 2, 2019 (8779 : Collier County Mental Health and Addiction Ad Hoc 30.B.2 Packet Pg. 1026 Attachment: [Linked] Agenda and Back-up Document Packet - April 2, 2019 (8779 : Collier County Mental BACKGROUND PAPER September 2016 Psychiatric Bed Supply Need Per Capita SUMMARY The United States is in the midst of a psychiatric bed shortage that worsens every year. By early 2016, the practice of closing state mental hospitals, often called “deinstitutionalization,” had eliminated more than 96% of the last-resort beds that existed in the mid-1950s; after a brief period of expansion in the 1990s, private hospitals, too, are shrinking their psychiatric inpatient capacity. The consequences are many and far-ranging, yet most states continue to decrease the number of state hospital beds they supply per capita and, because of financial disincentives, private and other inpatient-service providers are not stepping in to replace those that are lost. Despite widespread consensus that “more beds are needed,” neither the United States nor its individual states have conducted research to establish evidence-based bed supply ranges. The Treatment Advocacy Center in 2008 published the most commonly cited bed target in the United States — 40 to 60 beds per 100,000 people — but no official effort has been made to validate or revise this number. New computer modeling holds promise for developing evidence-based targets in the future. ________________ BACKGROUND Although most people with a diagnosed mental illness never require hospitalization, and many with the most serious conditions can be successfully treated in the community, inpatient psychiatric treatment remains an essential component of a complete mental healthcare continuum. “While community and hospital-at-home teams can be effective for many (but not all) patients, inpatient care is essential when an acute episode is accompanied by potentially high risks of suicide or violence,” Stephen Allison and a team of international colleagues write in the September issue of Australian & New Zealand Journal of Psychiatry. Psychiatric units in general hospitals and private psychiatric hospitals occasionally admit individuals who are severely ill, but most do not have the resources to provide intensive psychiatric care. Additionally, because individuals with the most severe and chronic mental illnesses experience high rates of unemployment, poverty and homelessness, they often do not have personal resources or health insurance to pay for their hospitalization, which discourages hospitals from admitting them. In 2013, uninsured individuals with schizophrenia or bipolar disorder were less likely than any other psychiatric patient category to receive hospital care. As La and colleagues write in their 2015 report on psychiatric bed supply and demand in North Carolina, “state psychiatric hospitals are the ultimate safety net for people with mental illness.” Yet the number of available psychiatric beds grows smaller every year. In 1955, there were an estimated 559,000 state and county psychiatric beds, or nearly 340 beds per 100,000 people. By early 2016, the state hospital bed population had dropped more than 96%, to 37,679 beds, or 11.7 beds per 100,000 people. Of these, nearly half were occupied by criminal offenders with serious mental illness; barely six beds per 100,000 people remained for individuals with acute or chronic psychiatric disease who had not committed crimes. 30.B.2 Packet Pg. 1027 Attachment: [Linked] Agenda and Back-up Document Packet - April 2, 2019 (8779 : Collier County Mental Health and Addiction Ad Hoc 2|Page Treatment Advocacy Center • www.TreatmentAdvocacyCenter.org Psychiatric Bed Supply Need Per Capita Allison, S., Bastiampillai, T., Fuller, D. A., Gupta, A., and Sherry, K. W. Chan. (2016). The Royal Australian and New Zealand College of Psychiatrists guidelines: Acute inpatient care for schizophrenia. Australian & New Zealand Journal of Psychiatry. La, E. M., Lich, K. H., Wells, R., Ellis, A. R., Swartz, M. S., Zhu, R., & Morrissey, J. P. (2015). Increasing access to state psychiatric hospital beds: Exploring supply-side solutions. Psychiatric Services, 67, 523–528. Retrieved from http://ps.psychiatryonline.org/doi/abs/10.1176/appi.ps.201400570 . Parks, J., & Radke, A. (Eds.). (2014). The vital role of state psychiatric hospitals. Alexandria, VA: National Association of State Mental Health Program Directors. Retrieved from http://www.nasmhpd.org/sites/default/files/The%20Vital%20 Role%20of%20State%20Psychiatric%20HospitalsTechnical%20Report_July_2014.pdf Agency for Healthcare Research and Quality. National statistics on mental health hospitalizations. US Department of Health & Human Services. Fuller, D. A., Sinclair, E., Geller, J., Quanbeck, C., Snook, J. (2016). Going, going, gone: Trends and consequences of eliminating state psychiatric beds, 2016. Arlington, VA: Treatment Advocacy Center. CONSEQUENCES When the safety net shrinks, the consequences appear to be many and far-ranging: •Emergency rooms overwhelmed by people in psychiatric crisis, resulting in critically ill psychiatric patients waiting days and even weeks to be admitted to a hospital •Mentally ill inmates who cannot be tried because they are unstable but who cannot be treated because there is no bed available for them •Ultra-short hospital stays for patients who do get admitted in order to turn beds over •Acutely ill individuals left untreated to suffer consequences that are often dire and sometimes fatal to themselves or others. Despite the impact and cost of such consequences — and the growing outcry they have provoked from a variety of constituencies — evidence-based guidelines for policymakers and public health officials to use in establishing and maintaining a safe minimum number of psychiatric beds do not exist. Informal consensus estimates and localized anecdotes serve in their place. A team of researchers in North Carolina has developed a computer-based alternative that holds promise but has not been applied to practice. American College of Emergency Physicians. (n.d.). “Psychiatric Emergencies.” Retrieved from http://newsroom.acep.org/fact_sheets?item=30093. Fuller, D. A., Sinclair, E., Geller, J., Quanbeck, C., Snook, J. (2016). Going, going, gone: Trends and consequences of eliminating state psychiatric beds, 2016. Arlington, VA: Treatment Advocacy Center. Allison, S., Bastiampillai, T., Fuller, D. A., Gupta, A., and Sherry, K. W. Chan. (2016). The Royal Australian and New Zealand College of Psychiatrists guidelines: Acute inpatient care for schizophrenia. Australian & New Zealand Journal of Psychiatry. 30.B.2 Packet Pg. 1028 Attachment: [Linked] Agenda and Back-up Document Packet - April 2, 2019 (8779 : Collier County Mental Health and Addiction Ad Hoc 3|Page Treatment Advocacy Center • www.TreatmentAdvocacyCenter.org Psychiatric Bed Supply Need Per Capita CONSENSUS BED SUPPLY RANGE In 2008, the Treatment Advocacy Center published a study that included a safe minimum number of public beds for adequate psychiatric services per 100,000 populations. Estimates were solicited “from 15 experts on psychiatric care in the US, [including] individuals who have run private and state psychiatric hospitals, county mental health programs, and experts on serious psychiatric disorders.” Participating experts were asked to estimate beds for children and forensic (criminal justice-involved) patients, as well as civil, adult patients. An estimated range of 40-60 public psychiatric beds per 100,000 people emerged, with a consensus around 50 beds per 100,000 population. Across the 34-member Organization for Economic Cooperation and Development (OECD), to which the United States belongs, the median number of psychiatric beds per 100,000 people in 2014 was 68 beds. This suggests that international policy and practice are operating slightly above the upper end of the consensus range. Torrey, E. F., Entsminger, K., Geller, J., Stanley, J., Jaffe, D. J. (2008). The shortage of public hospital beds for mentally ill persons. Arlington, VA: Treatment Advocacy Center. Organization for Economic Cooperation and Development. (2013). Health at a glance 2013: Hospital beds by function of health care, 2011 (or nearest year). Paris: OECD Publishing. Retrieved from http://www.keepeek.com/Digital-AssetManagement/oecd/social-issues-migration-health/health-at-a-glance- 2013/hospital-beds-by-function-of-health-care- 2011-or-nearest-year_health_glance-2013-graph72-en#page2 EVIDENCE-BASED BED SUPPLY RANGES Of the many social and personal conditions reported to correlate with psychiatric bed shortages, emergency room “boarding” of psychiatric patients because no bed is available for them and jail/prison wait-listing of mentally ill inmates for the same reason serve as the most direct indicators of how well the current psychiatric bed population is meeting demand. In that context, the American College of Emergency Physicians reports that ER boarding of psychiatric patients is now virtually universal in the United States, with some patients waiting weeks for hospital admission. At the same time, a majority of the states report maintaining wait lists for forensic beds, with some inmates waiting weeks for admission to a bed. While factors such as the adequacy of community-based services that avert the arrival of mentally ill patients in the ER or inmates in the jail, bed shortages are clearly implicated. When a California county simultaneously halved the number of its psychiatric beds and closed its outpatient stabilization clinic, the number of visits to the local medical center for psychiatric consultation tripled, and ER boarding times skyrocketed. These reports provide evidence that the current mental health bed population is not sufficient but continue to leave unanswered the question of how many beds would be necessary to better align supply with demand. A team of researchers at the University of North Carolina (UNC) and Duke University in 2015 reported on a computer modeling-based approach to answering the question. La and colleagues analyzed emergency room waits and hospital admissions for a 25-county region of North Carolina that is home to a population of 3.4 million people. The region’s total psychiatric bed capacity consisted of 398 beds in a state hospital, 494 adult psychiatric beds in 14 general or private psychiatric hospitals, and 66 non-hospital crisis beds in five facilities. Combined, this totaled 958 psychiatric beds, or approximately 28 adult beds per 100,000 population. The 30.B.2 Packet Pg. 1029 Attachment: [Linked] Agenda and Back-up Document Packet - April 2, 2019 (8779 : Collier County Mental Health and Addiction Ad Hoc 4|Page Treatment Advocacy Center • www.TreatmentAdvocacyCenter.org Psychiatric Bed Supply Need Per Capita average wait time in an emergency room for one of these beds at the time of the study (2010 to 2012) was 3.3 days. The authors used a computer simulation program to model different scenarios to ascertain how many additional psychiatric beds would be needed to achieve an average preadmission wait time of less than one day. The answer was 356 additional beds (total bed capacity of 1,314 patients) or about 39 adult beds per 100,000 population — approximately the lower end of the consensus range. This calculation included only adult patients (ages 18 – 64) and assumed a median duration of stay in the state hospital of 20 days, which was typical in the hospital under study at that time. This calculation did not include psychiatric beds for children or for forensic patients, who usually stay for extended period. La and colleagues noted other measures can be taken to decrease the need for psychiatric beds but their impact was outside the scope of the study. Such measures include assertive community treatment and the use of assisted outpatient treatment (AOT) to ensure medication adherence. In the state of South Australia (SA), public officials have essentially created a real-time test of the computer modeling project, adding psychiatric inpatient beds with the express purpose of reducing emergency room wait times for psychiatric patients. In October 2014, 284 psychiatric patients in the state were reported held in SA emergency rooms for 24 hours or more before admission to a mental health bed. By December 2015, that number was reduced nearly 75%, to 76 patients, and the average wait time for psychiatric hospitalism was cut in half. To reach that level, the state added 30 new acute care beds (typically used for patients with psychotic symptoms) and six new forensic beds. An additional four forensic beds were scheduled to reduce the time mentally ill offenders waited behind bars for a bed. American College of Emergency Physicians. (n.d.). Psychiatric emergencies [Fact sheet]. Retrieved from http://newsroom.acep.org/fact_sheets?item=30093 American College of Emergency Physicians. (2014.) Care of the psychiatric patient in the emergency department. Nesper, A. C., Morris, B. A., Scher, L. M., & Holmes, J. F. (2015). Effect of decreasing county mental health services on the emergency department. Annals of Emergency Medicine. Torrey, E.F. (2008). The Insanity Offense. New York: W.W. Norton. Stettin, B. (2014). An advocate’s observations on research concerning assisted outpatient treatment. Current Psychiatry Reports. Health Management Associates. (2015). State and community considerations for demonstrating the cost effectiveness of AOT services. Retrieved from http://tacreports.org/storage/documents/aot-cost-study.pdf Siebert, B. (2016, February 12). Mental health emergency room waiting times halved. InDaily. Retrieved from http://indaily.com.au/news/2016/02/12/mental-health-emergency-room-waiting-times-halved/ 30.B.2 Packet Pg. 1030 Attachment: [Linked] Agenda and Back-up Document Packet - April 2, 2019 (8779 : Collier County Mental Health and Addiction Ad Hoc 5|Page Treatment Advocacy Center • www.TreatmentAdvocacyCenter.org Psychiatric Bed Supply Need Per Capita CONCLUSION Psychiatric hospitals represent only one point on a care continuum, but they are a critical one for individuals in psychiatric crisis or otherwise in need of intensive services. As the Treatment Advocacy Center reported in Going, Going, Gone, its 2016 state survey of trends in hospital bed population, “With lawsuits and court orders proliferating over illegal boarding of psychiatric patients in hospital ERs and bed waits in jails, there is little doubt the United States needs more psychiatric beds to meet inpatient demand.” The report’s recommendation remains relevant: “In recognition of the national scope and consequences of the bed shortage and the need for baseline data nationwide and tools for setting targets,” the federal government should assess hospital bed need by type, facility and location. . . .” Fuller, D. A., Sinclair, E., Geller, J., Quanbeck, C., Snook, J. (2016). Going, going, gone: Trends and consequences of eliminating state psychiatric beds, 2016. Arlington, VA: Treatment Advocacy Center. 30.B.2 Packet Pg. 1031 Attachment: [Linked] Agenda and Back-up Document Packet - April 2, 2019 (8779 : Collier County Mental Health and Addiction Ad Hoc