HomeMy WebLinkAboutMINUTES - 02281995 - FHS.2 To: BOARD OF SUPERVISORS F&HS-02 Contra
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FAMILY AND HUMAN SERVICES COMMITTEE Costa
FROM:
February 13, 1995 �;; _ ,..�T° County
DATE: I cuue+�
SUBJECT: STATUS REPORT ON SERVICE INTEGRATION, THE POLICY ACADEMY AND FAMILY
MAINTENANCE ORGANIZATION
SPECIFIC REOUEST(S)OR RECOMMENDATION(S)&BACKGROUND AND JUSTIFICATION
n
RECOMMENDATIONS :
1 . ACCEPT the attached- report dated February 9 , 1995 from the
County Administrator' s Office on the Policy Academy and the
attached report dated February 10, 1995 from Supervisor
DeSaulnier' s Office on the Policy Academy.
2 . APPROVE the expansion of the Policy Academy to include two ,
additional union representatives who represent County
employees in the Health Services, Social Services or Probation
Departments .
3 . REQUEST the Policy Academy to meet with the Family and Human
Services Committee on Monday, April 10, 1995 at 9 : 00 A.M. at
the Ambrose Park & Recreation District' s Community Center at
3105 Willow Pass Road, Bay Point, so that we can all tour the
facility and see the service integration program at work.
4 . REQUEST the Policy Academy to meet with our Committee more
frequently so that we can continue to provide oversight and
policy guidance to the work of the Policy Academy.
5 . ACCEPT the attached report dated February 9, 1995 from the
County Administrator' s office regarding the status of our
service integration efforts and REQUEST that the County
Administrator provide a further status report to our Committee
on April 10, 1995 when we meet with the Policy Academy in Bay
Point.
CONTINUED ON ATTACHMENT: YES SIGNATURE:
-RECOMMENDATION OF COUNTY ADMINISTRATOR RECOMMENDATION OF BOARD COM I E
APPROVE OTHER
SIGNATURE(S): MARK DeSAULNTER JF H
ACTION OF BOARD ON Fehr ua rye, 1999 A PROVED AS RECOMMENDED 7K— OTHER
VOTE OF SUPERVISORS
I HEREBY CERTIFY THAT THIS IS A TRUE
UNANIMOUS(ABSENT ) AND CORRECT COPY OF AN ACTION TAKEN
AYES: NOES: AND ENTERED ON THE MINUTES OF THE BOARD
ABSENT: ABSTAIN: OF SUPERVISORS ON THE DATE SHOWN.
ATTESTED FEB 2 8 1995
Contact: PHIL BATCHELOR.CLERK OF THE BOARD OF
cc: See Page 3 SUPERVISORS AND COUNTY ADMINISTRATOR
DEPUTY
F&HS-02
-2-
6 . ACCEPT the attached report dated February 8, 1995 from the
Director, Office for Service Integration, Health Services
Department, regarding the status of the Family Maintenance
Organization and REQUEST that the Health Services Director
provide a further status report to our Committee on April 10,
1995 when we meet with the Policy Academy in Bay Point.
7 . REQUEST the County Administrator, Acting Social Services
Director, Community Services Director, Health Services
Director and the members of the Policy Academy to determine
what the best way is to accomplish their respective objectives
regarding the Policy Academy, Services Integration and the
Family Maintenance Organization and what their staffing and
financial needs are to accomplish these objectives and report
those needs to our Committee on April 10, 1995 in Bay Point so
that our Committee is aware of and can begin to address their
needs in a constructive manner.
BACKGROUND:
On December 13, 1994, the Board of Supervisors referred continuing
oversight of these subjects to the 1995 Internal Operations
Committee. With the establishment of the 1995 Family and Human
Services Committee on December 20, 1994 , these subjects were
referred to the 1995 Family and Human Services Committee with a
request that the County Administrator' s Office report on these
subjects approximately every two months .
On February 13, 1995, our Committee met with Sara Hoffman, Senior
Deputy County Administrator and Mary. Foran, Director, Office for
Service Integration in the Health Services Department. We received
and reviewed the attached reports .
We continue to be impressed with the work which has been undertaken
by the Policy Academy. We would like to work closely with the
Policy Academy as it develops outcomes for the five key areas which
have been identified for its work over the next five years . At the
same time, we would like to view the Service Integration Programs
in actual operation. As a result, we are asking that our meeting
on April 10, 1995 be held at the site of the East County Service
Integration Program, the Ambrose Park and Recreation District 's
Community Center in Bay Point, and that the Policy Academy join us
for this meeting. We will tour the facility after hearing progress
reports on Service Integration and Family Maintenance Program and
after having discuss with the Policy Academy their work.
Supervisor Smith noted that an application has been made to Chevron
for funds to provide staffing for the Policy Academy and that
Chevron has committed to 10 hours a week in facilitation from a
member of their staff who is experienced in this area.
We are also pleased with the progress which is reflected in the
attached report on Service Integration. We understand that the
departments are looking at financing alternatives, including ways
to combine and realign funding streams .
Mary Foran reviewed with us the attached report on the Family
Maintenance Organization. Supervisor Smith noted the importance of
finding the money to do what needs to be done. This discussion led
to our direction to staff to identify the staffing and funding
needs to fully implement the recommendations being made by the
Policy Academy, Services Integration and the Family Maintenance
Organization in order to see what the total scope of need is with
which we are faced. Eventually, we will want to conduct a needs
assessment across a broad spectrum of health needs . This will,
however, require money.
r r '
F&HS-02
-3-
What we have asked the staff to provide to our Committee is an
assessment of what staff believes is the best way to accomplish the
goals of these programs and what the cost is to accomplish this .
This at least will provide us with a goal toward which we can
strive, even if we are never able to fully accomplish this goal .
cc : County Administrator
Acting Social Services Director
County Probation Officer
Health. Services Director
Community Services Director
Public Health Director, HSD
Mental Health Director, HSD
Substance Abuse Program Administrator, HSD
Mary Foran, Office for Service Integration, HSD
Sara Hoffman, Senior Deputy County Administrator
CONTRA COSTA COUNTY
OFFICE OF THE COUNTY ADMINISTRATOR
651 Pine Street, 10th Floor
Martinez, California 94553
Telephone: 646-1390
DATE: February 9, 1995
TO: Supervisor Mark DeSaulnier
Supervisor Jeff Smith
Family and Human Services Committee
FROM: Sats Hof rnan L)0
Senior Deputy Administrator
SUBJECT: Progress Report on the Policy Academy
As directed by the Internal Operations Committee, the Policy Academy has expanded its
membership to include community-based organizations and consumer and geographic
representations as well as an increased number of staff representatives. Two orientation
meetings have been held for the new members: one to overview each of the strategies
and the history and background of the Policy Academy and the other to outline the
organizational structure and procedures.
On February 1 - 3, Policy Academy members attended the Policy Academy III. The
meetings resulted in consensus on five key areas of work for the Policy Academy over
the next five years. These are:
1. Communication
2. Evaluation of the strategies
3. Training
4. Out-of-Home Placement
5. Staff support/resources.
The group then developed its draft outcomes for each of the key areas of work. These
will be discussed at the next Policy Academy meeting and finalized for further action.,
FE33 — 1.0 — '95 FR I 1 G = 39 ^S' k-4 F- cLu n er
2301 STANWELL DRIVEK, _ CONTRA CO3TA COUNTY
CONCORD,CALIFORNIA 94520.4008 BOARD OF SUPERVISORS
(510)640-5763
(514)046-5767(FAX)
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TO: Family & Human Services
Supervisors Mark DeSaulnier and Jeff Smith
FROM: Policy Academy
DATE: February 10, 1995
RE: Policy Academy Recommendation
At its meeting on Wednesday, February 8, 1995, the Policy Academy voted to
recommend to your committee that the Academy be expanded by two additional union
representatives. The Academy was requested to consider this because of the
different line staff involved in the three diffezvnt county departments (health,
probation and social services)involved with systems change who are represented by
three.different unions (AFSCME, Local 1 and SEIU).
As Ms. Hoffman's report to your committee had already been prepared when the
Academy approved this recommendation tQ Family and Human Services, this request
is forwarded to you as part of the Policy Academy report that you have already
received.
Thank you for your consideration of this request.
ksm
CONTRA COSTA COUNTY
OFFICE OF THE COUNTY ADMINISTRATOR
651 Pine Street, 10th Floor
Martinez, Califomia 94553
Telephone: 646-1390
DATE: February 9, 1995
TO: Supervisor Mark. DeSaulnier
Supervisor Jeff Smith
Family and Human Services Committee
FROM: Sara Hoffman 7�-
Senior Deputy Administrator
SUBJECT: Progress Report on Service Integration
Since the November 28, 1994 report, progress has been made in the following areas.-
Client
reas:Client Enrollment and Services
The Bay Point team is currently serving approximately 960 families: 800 income-eligible
families and 160 non-income eligible families. The North Richmond team is currently
serving 362 families: 262 eligibility families and 100 non-income eligible families.
A notable recent accomplishment was the 100% immunization rate achieved for all
children at Verde School in North Richmond. In addition, 35 client families have found
jobs through efforts of the GAIN workers (26 in North Richmond and 9 in Bay Point).
As part of the prevention/early intervention activities, the North Richmond team has begun
planning to provide a grandparent support group and an alcohol and drug prevention
group for latency age (7 - 11 years old) minors currently under probation supervision. In
addition, the Bay Point team has set up a substance abuse support group.
Both teams are now entering into the case conference stage where team members from
different disciplines sit down to discuss the family. The teams are learning the dynamips
of case conferencing and experiencing first hand the benefits of each discipline's
perspective. Over the next several months, these conferences will take place with the
families, with both staff and families discussing family goals and planning the needed
steps to accomplish those goals.
Common case management will be facilitated with the development of a management
information system. We are continuing to work with Data Processing through a
subcommittee which has developed a rough prototype. Further review will be necessary
prior to implementation. In addition, funding will need to be identified for the project.
Staffing Issues
Both teams have mental health components with a therapist scheduled to be at the site
four hours a week. We are currently looking at the possibility of increasing this time by
use of graduate students.
Steps are now being taking to convert the current temporary probation officer positions
to project positions. This will add stability to the probation officers presence. Other staff
changes are centered in North Richmond. The current team facilitator will be returning
to the district office by the end of February. Four staff have applied for the position;
interviews will take place near the end of the month. In addition, the child welfare
position has been vacant several months, when that worker accepted a new position in
another county. The Social Service Department is looking to backfill that position with
a child welfare worker capable of providing early intervention work. Also, efforts are
underway to correct the situation in North Richmond where staff presence has not been
reliable.
Under the service integration model, we are asking staff to redefine their relationships
with each other. The North Richmond team has been dealing with a number of difficult
team building issues. These were discussed at a day long retreat in January and the
facilitator was able to assist the team in focusing their energy on next steps in the team
development process. This experience is proving the critical nature of interpersonal
relationships in a multi-disciplinary approach.
Employee Organizations
A meeting with the employee organizations was scheduled in January; however, this was
rescheduled to early March. In original discussions, a number of issues with the unions
were held in abeyance pending resolution of the AB 1741 application. With the 1741
designation, there are a number of issues which will be discussed.
1741 Status
Eight state officials toured the two sites in January. Their response was very positive and
enthusiastic. Since then, we have met with the other four 1741 counties and the state
and set up working groups to address 1741 issues. In addition, we have drafted waiver
requests in the area of elimination of paperwork associated with CA-7s for AFDC, Medi-
Cal and food stamps; elimination of yearly redetermination of eligibility; development of
time study categories to allow claiming for intervention/early intervention work; redefinition
of the target population that can be served under GAIN; and allowances for
interdisciplinary claiming of activities. The waiver request should be sent into the state
this week.
Region IX is interested in meeting with the counties and we have been involved in a
planning to scheduled a forum for late March.
Other Issues
Service integration is receiving considerable attention. Staff presented the program at the
National Eligibility Workers' annual conference in San Francisco in January. The
presentation elicited considerable comment. In addition, tours of the facilities are planned
in February for both the Hewett Foundation and the Cowell Foundation.
Health Services Department
' • OFFICE OF THE DIRECTOR
•:' '� _ Office for Service Integration
- 597 Center Avenue, Suite 365
-F_ Martinez, CA 94553
(510) 313-6254
(510) 313-6708 - Fax
To: Supervisor Mark DeSaulnier
Supervisor Jeff Smith
Family and Human Services Committee
From: Mary Foran-
Director,
oranDirector, Office for Service Integration
Date: February 8, 1995
Subject:. PROGRESS REPORT ON PLANNING THE FAMILY
MAINTENANCE ORGANIZATION
In November we provided you with a brief report on the findings of the FMO parent Focus
Groups. Since that time, the. FMO planning staff has been engaged in the following
planning activities.
Researching Parent Support Program Modelg
Because the great majority of parents who participated in the focus groups spoke to the
need for parent education, information and referral, and support, FMO staff have been
evaluating support program models for possible inclusion in the FMO. These programs are
both internal to Health Services, such as Newborn Connections and CCHP Targeted Case
Management, and external, such as Kaiser Permanente's parent support programs and the
Family Mosaic Pro_ject's wrap around care program. These programs have been evaluated
for:
■ Cost effectiveness, including available funding
■ Availability of evaluation results
■ Training and resource requirements
■ Adaptability to HSD system
FMO staff will be recommending those programs believed to be most appropriate for the
FMO in upcoming program planning work sessions with staff and advisors.
A-306
Contra Costa County
Progress Report on Planning Page 2
the Family Maintenance Organization
February 8, 1995
Development of Outcomes, Indicators and Proposed Program Activities
The FMO is focused on defining how health care and health promotion efforts can be
organized both to prevent family health problems from developing, and to intervene, when
necessary, earlier rather than later when problems do occur. The following particular values
are guiding the FMO planning:
■ Identify and build on family strengths --e.g.,develop plans for action in partnership
with families which are based upon what is working well in their lives.
■ Create culturally competent programs and systems — e.g., increase bilingual,
bicultural staff.
■ Create family-focused programs and systems -- e.g.,include consideration of child
care and transportation needs when developing services.
■ Create programs which mesh with and complement other family support system
change efforts in the county -- e.g. the Service Integration Teams, the Family
Preservation/Family Support project.
Staff are defining a proposed set of outcomes, indicators and program activities. For the
FMO, the term Program Activities applies to the full range of possible actions which might
be taken to improve family health, from individual one-to-one services, to support groups,
to linkage with other resources, to community advocacy and organizing.
The proposed outcomes are divided into two broad categories: Family Health Outcomes
and System Outcomes. The Family Health Outcomes include attention to both prevention
and early intervention issues. The system outcomes are included. to highlight how system
change will support the achievement of the family health outcomes.
Prevention and Early Intervention
The purpose of the proposed prevention-oriented program activities is to prevent or reduce
the seriousness of common health problems from occurring in families. By preventing
health problems typically found in many families, we can reduce the number of families who .
become "at risk" or "in crisis" for more serious health and social problems. This approach
will lower the costs of providing health services to families because more costly problems
have been avoided.
Progress Report on Planning Page 3
the Family Maintenance Organization
February 8, 1995
The early intervention outcomes seek to address the inevitable challenges and difficulties
of family life. In theory, if families get the help they need when they need it, they can
reduce the likelihood of normal, short-term crises from becoming chronic family dysfunction
and/or long-term, resource-intensive health problems. Thus, the FMO,in addition to broad
family support activities, will include program activities to assist families experiencing life
change crises (such as job loss, divorce and family relationship difficulties) so that they can
receive timely, reliable help, and linkage to more interventive services, when necessary.
The proposed outcomes, indicators and proposed program activities have been organized
into the categories of Healthy Family Relationships, Healthy Infants, Healthy Children,
Healthy Adolescents and Healthy Adults in recognition that the familial relationship is a
dominant force contributing to the health status of both adults and children, and that
different outcomes are needed and appropriate for the different stages of development.
Next Steps
The next step in our planning process is to review rigorously the outcomes, agree on those
to be pursued and then debate the best possible activities to achieve the outcomes. Staff
as well as parent, program and policy advisors are being invited to participate in the
discussion and review of these options. The proposed family and system outcomes are
attached for your review and information.. For some of the outcomes we have included
sample proposed program activities to give you,a flavor of the document we are developing.
We hope you find this information helpful and welcome your feedback.
cc: Mark Finucane
js:FMOdisc2:fhscomm.rpt/February 8, 1995
Famil Maintenance Or arnization
Y g
Goals, Desired Outcomes and Possible Activities
Goals: To improve the overall health status of families, where health is
defined to mean optimum physical and mental well-being,
To create a health delivery system which focuses on prevention and
early intervention and is flexible enough to serve a variety of
families.
Desired Family Health Outcomes
(Family is defined as any relationship between adult and minor child where the adult
provides primary care and support.)
Healthy Family Relationships
Prevention-Oriented Outcomes:
1. The family has the resources to nurture and support all its members, to solve
problems which arise and to seek appropriate help when necessary.
2. The adult relationships in the family are positive and mutually supportive.
3. The adult•-child relationships in the family are loving and developmentally
appropriate.
Possible Activities to Achieve Family Outcomes 1-3
♦ Parent education classes on such topics as
■ early childhood development
■ communicating with your teen
■ adult relationships
■ when to bring your child to the doctor
♦ Support groups for single parents, adolescents, etc.
♦ Parent to Parent support and mentoring network
♦ Parent support "hot" line
4C�P
Early Intervention-Oriented Outcomes: ''q4P
4. When substance abuse is a problem in the family, the issue is identified and
recovery activities for all family members are pursued.
5. When persistent or transient mental health problems are present, they are
recognized and appropriate services to stabilize or ameliorate the problems are
pursued.
6. When domestic violence or child abuse or neglect are problems in the family, the
issues are recognized and appropriate services and supports to change the
behaviors are pursued.
7. When the challenges and changes offamily life occur(such as, divorce, death,job
loss, school failure, juvenile delinquency, etc.), the family uses informal and
formal, internal and external resources to "right" itself.
Healthy Infants
8. Babies are born healthy.
Healthy Children
9. Children are physically, emotionally and socially ready for school.
10. Children succeed in school.
Healthy Adolescents
11. Adolescents are prepared for responsible adulthood.
Healthy Adults
12. Families achieve and maintain optimal physical health and are free from
preventable chronic diseases.
Possible Activities to Achieve Family Outcome 12
♦ County-sponsored weight reduction programs, information classes
(cholesterol, diabetes, etc.), and exercise classes (aerobics, walking, dance,
etc.)
♦ Link with Cooperative Extension to provide parent nutrition education,
food budgeting, nutritious meal preparation classes
♦ Negotiate an FMO member discount for existing weight management and
fitness programs
♦ County-sponsored smoking cessation programs
Desired System Outcomes
1. Family health prevention programs are incorporated into the array of programs
offered by the health system.
2. Health staff work witb family members in a culturally competent manner to
become aware of and nurture family strengths and to address family health
concerns.
3. The special needs of parents accompanied by children while taking advantage
of desired programs are addressed. (This includes providing child-friendly
physical environments and supervision of children while parents are being
examined by providers, as well as assisting with transportation needs.)
4. When family health problems are identified, the system offers timely, culturally-
appropriate, problem-appropriate, and effective Unkage to formal and informal
early intervention and treatment services. (This includes helping families solve
problems with substance abuse, mental health, domestic violence, child abuse and
neglect, inadequate nutrition, unsafe housing, divorce, job loss, juvenile
delinquency, etc.)
5. The health system is structured to encourage and permit utilization at the
appropriate level.
Possible Activities to Achieve System Outcomes 1-5
♦ Develop and implement the Help Desk to provide staff with the information
and referral assistance they need to help families.
♦ Incorporate family strengths inventory and desired assistance assessment
process into regular medical visits and medical record.
♦ Continue cultural competence staff training activities.
♦ Offer family group appointments.
♦ Establish role of"Family Health Advocate" to provide personal assistance in
linking families to desired prevention activities and intervention services.
♦ Assess how to expand resources to assist families with persistent, serious
and complex problems. E.g. individual and family counseling resources.
Js:FMOdisc2:thscomaLrpVFebruary 8,1995