Loading...
Agenda 11/12/2019 Item # 2C (Minutes 10/29/19 Mental Health Workshop)11/12/2019 COLLIER COUNTY Board of County Commissioners Item Number: 2.C Item Summary: October 29, 2019 BCC Mental Health and Addiction Ad Hoc Committee Workshop Meeting Minutes Meeting Date: 11/12/2019 Prepared by: Title: Executive Secretary to County Manager – County Manager's Office Name: MaryJo Brock 11/05/2019 7:23 AM Submitted by: Title: County Manager – County Manager's Office Name: Leo E. Ochs 11/05/2019 7:23 AM Approved By: Review: County Manager's Office MaryJo Brock County Manager Review Completed 11/05/2019 7:23 AM Board of County Commissioners MaryJo Brock Meeting Pending 11/12/2019 9:00 AM 2.C Packet Pg. 18 October 29, 2019 1 MINUTES OF THE COLLIER COUNTY BOARD OF COUNTY COMMISSIONERS WORKSHOP MEETING Naples, Florida, October 29, 2019 LET IT BE REMEMBERED, that the Board of County Commissioners in and for the County of Collier, having conducted business herein, met on this date at 9:00AM in a WORKSHOP SESSION in Building “F” of the Government Complex, Naples, Florida with the Following members present: Chairman: William L. McDaniel, Jr. Vice Chairman: Burt L. Saunders Donna Fiala Andy Solis Penny Taylor ALSO PRESENT: Leo Ochs, County Manager Jeff Klatzkow, County Attorney Nick Casalanguida, Deputy County Manager Sean Callahan, Executive Director, Corporate Business Operations October 29, 2019 2 Any persons in need of the verbatim record of the meeting may request a copy of the video recording from the Collier County Communications and Customer Relations Department or view online. I. Introduction of Timeline and Committee Members Chairman McDaniel called the meeting to order at 9:04 a.m. and the Pledge of Allegiance was recited. Commissioner Solis recognized the 19 Committee Members’ service and role in developing the “Mental Health and Addiction Services Five Year Strategic Plan 2020-2024.” II. Introduction of Consultant and Technical Review Process Mr. Callahan noted that the purpose of the workshop is to provide an overview of the strategic plan and obtain direction from the Board of County Commissioners prior to its consideration for adoption at a regularly scheduled November or December BCC Meeting. III. Plan Background Scott Burgess, David Lawrence Center, (DLC) provided an overview of the timeline for developing the plan with 2 BCC workshops and approximately 21 Committee meetings held over the past 2 – 3 years. Chet Bell, Management Consultant, SMA Behavioral Health Services, Inc., reported that he was engaged midway through the endeavor to assist in developing the plan. The plan contains priorities, goals, action steps and continued reporting to monitor its progress. He noted that he was the CEO of a Community Receiving Facility developed in the Daytona Beach area. Mark A. Engelhardt, USF Faculty Research Associate in the Department of Mental Health Law and Policy, also participated in the activity as a technical advisor and noted that the focus of the plan is recovery for individuals affected, and to reduce the prevalence of substance abuse and mental illness. Mr. Burgess noted that the Mission Statement is “The Committee will collaboratively plan for and support a coordinated effort for a full array of evidence informed services to improve the lives of adults with mental health and substance use disorders and overall quality of life in the Collier County community.” He noted:  That the Committee used the format employed by the Substance Abuse and Mental Health Services Administration (SAMHSA), to develop the plan with four major pillars that support a life in recovery: Health, Home, Purpose and Community.  Within the four pillars there are 10 guiding principles of recovery: 1. Recovery emerges from hope. 2. Recovery is person-driven. 3. Recovery occurs via many pathways. 4. Recovery is holistic. 5. Recovery is supported by peers and allies. 6. Recovery is supported through relationship and social networks. 7. Recovery is culturally-based and influenced. 8. Recovery is supported by addressing trauma. 9. Recovery involves individual, family and community strengths and responsibility. 10. Recovery is based on respect. IV. Covering the Six Priorities & Special Consideration October 29, 2019 3 1. Central Receiving Facility/System Build and Operate a Central Receiving Facility/System to Serve Persons Experiencing an Acute Mental Health or Substance Use Crisis for those requiring evaluation and stabilization under the Baker or Marchman Acts. Mr. Burgess reported that the statistics indicate a major increase over the past 10 years for those in the area requiring services. The DLC facility currently has 30 beds in service; with a population the size of Collier County, it would require over 100 beds. The facility would cost $25M to construct with annual operating costs estimated at $2 - $3M, and it would be open 24/7/365. Kevin Rambosk, Collier County Sheriff’s Office, spoke in support of the plan and the County is on the forefront of addressing these issues. The increased access to these facilities and programs are greatly needed in Collier County; as these individuals do not benefit from incarceration. 2. Supportive Housing Increase Housing and Supportive Services for Persons with Serious Mental Illness and/or Substance Use Disorders Pamela Baker, CEO, NAMI, reported that housing is a critical component of recovery and individuals cannot compete given the limited amount of income they have available and the cost of housing in the county. Another issue is the stigmas faced in society by those in need. Michael Overway, Interim Executive Director Hunger and Homeless Coalition of Collier County reported that to be successful, housing supports should follow evidence based and informed practices. Including the use of the SAMHSA (Substance Abuse and Mental Health Services Administration) Permanent Supportive Housing Tool Kit and the “Housing First” philosophy/model in which housing is a right, not a privilege. Recommendations include increasing the opportunity for rental assistance, improving sober housing facilities, establishing peer respite homes for brief periods of stay, and ensuring rapid re- housing for those experiencing temporary homelessness. 3. Data Collaborative Establish a Mental Health and Substance Use Disorder Data Collaborative for Data Sharing, Collection and Outcomes Reporting Mr. Callahan reported that the concept is to use data collaboratively to enhance the delivery of mental health programs to Collier County residents, by encouraging communication and participation among all interested parties (community providers, organizations, interested government agencies, and educational institutions). The priority could be implemented by staff, and a Steering Committee could be engaged to assist in the endeavor. Break: 10:24 a.m. Reconvened: 10:35 a.m. 4. Justice System Response Increase the Capacity and Effectiveness of Justice System Response for Persons Experiencing Serious Mental Illness and/or Substance Use Disorders Judge Janeice Martin reported that the County utilizes a Drug Court, Mental Health Court, and Veterans Court, for those identified in serious need of intervention. The program has been highly successful. Immediately following the June 2018 Board of County Commissioners’ Workshop on Mental Health and Addiction, a Rapid Response Team was formed in the 20th Judicial Circuit, to address October 29, 2019 4 profoundly mentally ill persons in jail facing misdemeanor charges. She cited examples of its successes with 14 participants, 3 of which are still in the program, 10 have completed it and 1 was terminated. Recommendations include expediting diversion for those with mental health or substance abuse issues prior to arrest, and expanding trauma-informed and trauma-responsive practices, to all divisions of the justice system. Incorporating the use of court-supervised clinical assessments and treatment plans as appropriate in each division. 5. Non-Emergency Baker and Marchman Act Transportation Revise and Implement Non-Emergency Baker Act and Marchman Act Transportation Plans Lt. Leslie Weidenhammer, Collier County Sheriff Office, spoke on the need to establish a non- emergency transportation plan for individuals receiving involuntary evaluation and/or treatment, under either Chapter 394 or 397 F.S. (Baker Act/Marchman Act) for those being transferred between local receiving facilities and local hospitals. 6. Community Prevention, Education, and Advocacy Improve Community Prevention, Advocacy, and Education Related to Mental Health and Substance Use Disorders Caroline Brennan, Coordinator of School Counseling, Collier County Schools, noted that it is important to provide evidence based education and training on mental health and substance use disorders to the community at large, and increase access to recovery. One avenue to aid the endeavor is to create an ongoing mental health and substance use disorder educational program for community businesses and organizations, to increase knowledge and public awareness. A major concern is children who are at an increasing risk. Special Consideration #1: Veterans Improve Services to Veterans Experiencing Mental Health and/or Substance Use Disorders Dale Mullin, Wounded Warriors of Collier County, reported that the goal is to make the public and the veteran community aware of the transitional, mental health, substance use, housing, and employment needs of post-combat Veterans, and mobilize resources to address these issues for those in need and their families. Recent veterans are more at risk, not only from their service but the “war at home” they experience. Goals include increasing awareness, mobilizing resources to address issues, and reducing the number of suicides, which is a major concern for veterans. V. Next Steps Mr. Callahan reported that the intent is for the Board of County Commissioners is to consider adoption of a plan at either the November or December meeting. VI. Questions & Discussion The following was noted during BCC discussions:  Mr. Bell noted that the facility in the Daytona area was funded via 2016 Legislative initiatives which are no longer available and it would be beneficial to contact local legislative representation on the feasibility of re-establishing funding.  Based on data, approximately 16,000 persons may need housing assistance in the County. A major issue is ensuring access to “wrap around” services needed by these individuals to maintain a stable environment and successful recovery. October 29, 2019 5  Eligibility for the “Housing First” program is not dependent on psychiatric treatment compliance and sobriety. Concern was expressed on potential issues such as the acceptance of the housing by others in the area or potential behavioral issues disrupting the neighborhood. Further discussion occurred with participants noting:  Linking sobriety to housing may be detrimental, as when you remove an individual from a stable housing environment upon relapse; as it may greatly compromise their ability to succeed.  Experience indicates these opportunities are much more successful in the community when they are professionally supervised and linked with services, as opposed to private entities simply providing housing in an “unsupervised” setting.  There may be upfront costs associated with many solutions, but there is substantial savings to the public when they are implemented (i.e. reducing the number of incarcerations which are a substantial cost to the taxpayer). The Board requested Staff to: 1. Provide data on the costs of construction and operation of other Community Receiving Facilities in the State and how both activities were/are funded. 2. Provide an analysis on the cost savings and avoidance benefits associated with undertaking the various measures. Chairman McDaniel recommended consideration be given to adding a priority to address the juvenile system, including any collaborations of parties available for improving the process (justice system, Department of Children and Family Services, etc.). Discussion occurred on the timeline for adopting the plan with some noting it may be advantageous to delay the item until the above items are available, while others noted those factors may be considered after the plan is adopted (during the implementation phase) which will be a long term endeavor. The Board directed Staff to schedule the item for consideration during a December BCC meeting. There being no further business for the good of the County, the meeting was adjourned by order of the chair at 12:10 P.M. COLLIER COUNTY BOARD OF COUNTY COMMISSIONERS _________________________________ Chairman, William L. McDaniel These minutes approved by the Board/Committee on ______________________________________, as presented ______________ or as amended _________________.