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THE BOARD OF SUPERVISORS OF
CONTRA COSTA COUNTY, CALIFORNIA
Adopted this Order on December 20, 1994 , by the following vote:
AYES: Supervisors Smith, Bishop, DeSaulnier, Torlakson and Powers
NOES: None
ABSENT: None
ABSTAIN: None
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SUBJECT: Report on General Assistance Policies relating to the Administration of the BSI
Mental Status Examination
The Board had before it a December 20, 1994 report from Robert Hofmann, Acting
Welfare Director, on General Assistance Policies relating to the administration of the Brief
Symptom Inventory (BSI) Mental Status Examination which was prepared in response to a
request of the Board.
IT IS BY THE BOARD ORDERED that the attached report from the Acting Welfare
Director is ACCEPTED.
I hereby certify that this Is a true and correctcopy of
an action takon and entered on the minutes of the
Board of Supervi fs on thejdate shown.
ATTESTED: /?1'� G�c/a a���
PHIL BATCHELOR,Clerk of the Board
of Supervisors and County Administrator
By— Deputy
cc: County Administrator
Health Services Director
SOCIAL SERVICE DEPARTMENT CONTRA COSTA COUNTY
DATE: December 20, 1994
TO: Board of Supervisors cc: Phil Batchelor
FROM: Robert Hofmann 46
Acting Welfare Director
RE: General Assistance Policies Relating to the Administration of
the Brief Symptom Inventory (BSI) Mental Status Examination
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This report is prepared in response to the request of the Board of
Supervisors.
Background
The Brief Symptom inventory test (BSI) is the first step of the evaluation
required by the Williams v Contra Costa County lawsuit to identify those
applicants who are mentally disabled to the extent that they are unable to
cooperate or comply with GA program requirements, in order to avoid
sanctions of persons who are incapable of conforming to those
requirements. The second step is a mental status examination by a mental
health professional. If the results of the mental disability evaluation indicate
that the person is unable to comply with program requirements as a result of
mental disability, the client file will be flagged.
The alternative to the electronically scored BSI is for Social Service staff to
identify those applicants who, by the client's declaration and the worker's
observation, appear to be mentally impaired. Social Service staff lacks the
expertise to do this, and intake staff does not have the personal knowledge
of the individual applicants for this to be effective.
The BSI and the mental status examination also are used in screening for
employability, and potential eligibility for SSI benefits. By getting
documentation of possible mental disability at the time of the GA
application, the Department is able to identify persons who are not required
December 20, 1994 BSI Page 1
Gen 9c (New 3/86)
to participate in work programs, and those whose disability is severe enough
to qualify them for SSI benefits. The Department provides an SSI advocacy
service, and it is beneficial to begin the process as soon as possible. When
SSI is granted, the County is reimbursed for GA paid to the individual.
The Social Service Department has administered the BSI and provided for
the mental status examinations since September, 1994. No applicant has
been denied aid, and no recipient has been discontinued or sanctioned, for
declining to take the BSI test or for failing or refusing to keep an
appointment for a mental status examination.
Applicants and recipients who are physically disabled to the extent that they
are unable to cooperate or comply with GA program requirements also will
have their case files flagged.
Policies Relating to the BSI
The BSI is administered to applicants as part of the General
Assistance intake process. An applicant identified by the BSI results
as possibly having a mental disability will be referred for a mental
disability evaluation.
An applicant may decline to take the Brief Symptom Inventory (BSI) if
the applicant executes a written refusal to be tested and waiver of his
or her right to claim to have a mental disability which interferes with
complying with General Assistance program requirements.
At a future time, if an individual who previously declined to take the
BSI, wishes to establish mental disability, the person may request the
opportunity to take the BSI. If the BSI results indicate possible mental
disability, the client will be referred for a mental disability evaluation.
If the results of the mental disability evaluation indicate that the
person is unable to comply with program requirements as a result of
mental disability, the client file will be flagged.
If the applicant fails or refuses to comply with the evaluation, there
will be no presumption of mental disability. The applicant shall be
subject to all General Assistance program requirements.
December 20, 1994 BSI Page 2