HomeMy WebLinkAboutMINUTES - 10142003 - U1 TO: BOARD OF SUPERVISORS K. Contra
FROM: Mark DeSaulnier, Supervisor Costa
District IV f
DATE: October 14, 2003
County
SUBJECT: Services to be Provided by the Mental Health Division at the
Crestwood Behavioral Health, Inc.
SPECIFIC REQUEST(S)OR RECOMMENDATION(S)&BACKGROUND AND JUSTIFICATION
RECOMMENDATION: ACCEPT the report of the CAO and the County Department of Mental Health
as to the status of the placement of clients in the Crestwood facility and the status of its initial
operation.
DIRECT the County Administrator's Office to continue to work with all stakeholders to ensure the
responsible operation of the Crestwood facility under industry best practices and to review steps
being taken to guarantee the safety and security of neighbors and clients.
DIRECT the County Administrator and the Department of Mental Health to report back to the Board
of Supervisors no later than 90 days from this date and quarterly thereafter as to the management
and security of the facility.
FISCAL IMPACT: No financial impact.
BACKGROUND: Crestwood Behavioral Health, Inc. intends to provide Mental Health Rehabilitation
Center, Residential Treatment Facility and Adult Residential Facility services at their Crestwood
Healing Center located at 550 Patterson Boulevard in Pleasant Hill. The Health Services
Department, Mental Health Division (Mental Health)will provide intensive oversight of the treatment
of County consumers at this facility. Mental Health staff will be involved in all aspects of each
consumer's stay at the facility. The County's involvement in this facility exceeds their historical
involvement in similar facility. As the facility becomes occupied, on site psychiatric and mental
health staff, including utilization review nurses will provide services at the facility. The facility will
utilize industry"best practices" in providing services.
The high level of collaboration between Crestwood and the Mental Health Division at the Pleasant
Hill facility will be ongoing. With the full participation of all stakeholders we hope to provide
exceptional cae for our consumers in the program as they recover and re-enter their and
communities and integrate the facility into a safe and secure neighborhood.
CONTINUED ON ATTACHMENT: YES SIGNATURE:
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RECOMMENDATION OF COUNTY ADMINISTRATOR RECOMMENDATION OF BOARD COMMITTEE
APPROVE OTHER
SIGNATURE(S):
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ACTION OF BOARD ON October 14, 2043 APPROVE AS RECOMMENDED X OTHER
SEE A'1'LACHED LIST FOR SPEAKERS.
VOTE OF SUPERVISORS I HEREBY CERTIFY THAT THIS IS A TRUE
AND CORRECT COPY OF AN ACTION TAKEN
X UNANIMOUS(ABSENT None ) AND ENTERED ON THE MINUTES OF THE
BOARD OF SUPERVISORS ON THE DATE
AYES: NOES: SHOWN,
ABSENT: ABSTAIN:
ATTESTED October 14, 2443
CONTACT: Dorothy Sansoe 5-1009 JOHN SWEETEN,CLERK OF THE
BOARD OF SUPERVISORS AND
CC: CAO COUNTY ADMINISTRATOR
Health Services Department ,
Mental Health Division
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DEPUTY
SPEAKER LIST
Patricia Blum, Crestwood Behavioral Health, 550 Patterson
Blvd., Pleasant Hill;
Dia Pintarich, Residents for Safe Neighborhoods in
Pleasant Hill, 113 Hawthorne give, Pleasant Hill;
Lenore Krause, 115 Hubbard Avenue, Pleasant Hill;
Bin Paridis, Residents for Safe Neighborhoods, 510
Patterson Blvd, Pleasant Hill;
Leona. Toussaint, 209 Powell give, Pleasant Hill;
Jon Toussaint, Residents for Safe Neighborhoods, 209
Powell Avenue, Pleasant F111
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CRESTEOOD BEHAVIORAL
HEALTH, Ir
CRSS TWOOD HEALING CENTER
FACILITYI `t TION
Behavioral Health Center
Contra Costa
Program Development
This program is designed to be a transitional program for consumers from Contra
Costa County reintegrating into the community. The program will be operated by
Crestwood Behavioral Health, Inc. and is designed by Patricia Blum, Executive Director
of Community Programs for Crestwood. The program will be multifaceted with three
distinct programs to be phased in within a two-gear period of time. All of the programs
rely on clubhouse principals, which include membership, individual contribution,
belonging and personal productivity.
The Programs
Mental Health Rehabilitation Center (M HRC) --This program will be designed
for 40 consumers and will be licensed by the Department of Mental Health. This
program will provide 24-hour nursing and rehabilitation support with an intensive clinical
staffing and security system to provide support and security while consumers are
exercising their community life skills and learning to be independent. The program
elements will include life skills training courses, d ual recovery, spiritual support,
wellness recovery action plans, creative art them py and prevocational training. This
program will meet and exceed the Title 9 licensin g standards for the MHRC.
Consumers would expect to live in this program for approximately one year.
Adult Residential Facility (ARF) -- This p rogram will provide residential services
and support for 24 consumers to live in the community in an independent living setting.
The program will provide meals, laundry support, educational and community linkages,
family support, peer mentorship, spiritual support and daily leisure activities to assist the
consumer in their successful reintegration into the community. The consumers
participating in this program will have a daily routi ne including a rehabilitation day
program on site, Dreamcatcher Consumer Empowerment Vocational preparation and
vocational linkages on site, transportation support, and case management. This
program shall be licensed by the Department of Social Services, Community Care
Licensing and shall meet and exceed all of the relevant Title 22 licensing standards,
Consumers may live in this setting indefinitely, providing an open end to support.
Residential Treatment Facility (RTF) — This program shall provide clinical
support and recovery services to 16 consumers who require an extended level of care
in successfully re-entering the community, This program shall be licensed by the
Department of Social Services, Community Care Licensing and shall be certified by the
Department of Mental Health, The program staff shall include clinical support to
facilitate wellness recovery action plans and to provide consumer-run recovery and life
skills courses. The consumers participating in this program may also participate in the
Dreamcatcher Vocational Program (through the Department of Rehabilitation), adult
education, community college, and community based programs throughout Contra
Costa County. The staff will provide case management, transportation, community
linkage and individualized service plans to facilitate recovery. Consumers are expected
to live in this program for approximately six to twelve months.
Exhibit "A" highlights the portions of the building to be utilized for each program,
as well as administrative space planned..
Crestwood Behavioral Health Center
Contra Costa
Licensing information
Crestwood has excellent statistics complying with licensing regulations. The
corporation has exceeded statewide averages for licensing compliance for decades.
The MHRC's have all received full licenses and have passed their annual reviews with
an average of fewer than three deficiencies per year. In fact, virtually all of the MHRC's
have received at least one deficiency-free survey since their inception.
Many state agencies either license the various types of facilities that Crestwood
operates or they certify the various programs operated within the facilities. Below is
information to help understand which entity is responsible for the licensing and
certification requirements of our programs.
Department of Mental Health
Licenses: Mental Health Rehabilitation Centers
Certifies: Day Treatment Programs
Transitional Residential Treatment Programs
Department of Social Services
Community Care Licensing
Licenses: Adult Residential Facilities
Social Rehabilitation Facilities
Certifies: n/a
Dgpartment of Rehabilitation
Licenses: n/a
Certifies: Vocational Training Programs
Crestwood Behavioral Health Center
Contra Costa
Phase In Process
The three programs shad be phased-in in the following sequence, based on the
current conditions.
Anticipated phase In Schedule
September 2003 Crestwood Healing Center anticipates the licensing and opening of
the initial program, the 40-bed Mental Health rehabilitation Center.
There shall be 20 consumers admitted during the initial 3 months.
December 2003 There shall be 20 consumers admitted to the 40-bed Mental Health
Rehabilitation Center during the subsequent 3 months.
March 2004 Crestwood Healing Center plans to open the second program,
which includes the 24-bed Adult residential Facility, with an onsite
Rehabilitation nay Treatment Program, the Dreamcatchers
Empowerment and Vocational Services serving only the residents
of the Crestwood Healing Center. There shall be only 20
consumers admitted from March'l, 2004 until May31, 2004. The
remaining 4 consumers shall be admitted after Junel, 2004.
June 2004 Crestwood Healing Center plans to open a 16-bed residential
Treatment Facility (RTF). This will be the final residential program
to be located at this site. This program will use the support
services of the Dreamcatcher Empowerment and Vocational
Program, with the focus on the Department of Rehabilitation
certified vocational service.
Crestwood Behavioral Health Center
Contra Costa
Security and Safety
The following security measures have been established to provide a safe, secure
and therapeutic environment, as well as to maintain the Safety and security of the
community.
Alarmed Egress —The interior and exterior doors shall be alarmed for motion.
The alarms are set to alert staff if a door is lightly pushed or actually opened. The
alarms are monitored by staff 24 hours per clay, and are maintained on a weekly and
monthly basis.
Closed Circuit Camera System —The facility shall install a closed circuit
camera System to monitor all of the exits. The television monitor shall be permanently
positioned at the unit office in the MHRC and shall be monitored by facility staff 24
hours per day.
Headcount System --The facility has an established headcount system in which
the staff monitors the consumer's location and activity throughout the 24-hour day.
Headcounts are conducted every two hours from 7:00 a.m. to 7:00 p.m. and hourly from
7:00 p.m. to 7:00 a.m.
Pass Policy—The facility has an established pass policy in which consumers
must earn the privilege of leaving the facility. The treatment team reviews all requests
for passes each day. Consumers who are granted a pass must be actively participating
in the program and neatly groomed. Qualified consumers progress through the
graduated pass system according to the following schedule.
First two weeps after admission No passes issued.
After two weeks Eligible to leave on pass with staff
supervision
After four weeks Eligible to leave on pass,
accompanied by a peer, for up to
one hour/day.
After six weeks Eligible to leave on pass,
accompanied by a peer, for up to
two hours/day.
After eight weeks Eligible to leave alone for up to
one hour/day.
After ten weeks Eligible to leave along for up to two
hours/day.
Consumers are assessed daily for appropriateness to participate in the pass
program and must sign out with staff listing a destination. The pass privilege will be
suspended for two weeks for any infractions. The facility staff shall exercise reasonable
efforts to: 1) stagger issuance of walking passes throughout the day.
2) restrict the issuance of walking passes during the hours of 2:00pm and
4pm, when schools within the vicinity are in session.
No unsupervised, supervision in this case is understood as with staff or guest, walking
passes shall be issued after dusk, which is defined as one-half hour before sunset
Crestwood Behavioral Health Center
Contra Costa
Accountability and Quality Improvement
Crestwood Behaviorial Health, Inc. is prepared to provide stakeholders with the
following outcome data and evidence of compliance:
1. CQI+ Outcomes Measurement System, a behavioral health outcome
system, with quarterly and annual reports prepared by the most prominent
behavioral health outcomes corporation in the United States, Mental
Health Outcomes, Inc. These reports shall be provided to all
stakeholders, including the City of Pleasant Hill, who request this
information.
2. An analysis of the center's incident reports, prepared by a risk
management corporation. This information shall be provided to the City of
Pleasant Hill and to the county as requested.
3. A follow-up conducted by the City police department and Crestwood
Behaviorial Health, Inc. on the incidence of police intervention and
community disturbance, as directed by the City Planning Council.
4. Crestwood Behaviorial Health, Inc. has initiated the process for
accreditation by the Commission of Accreditation of Rehabilitation
Facilities. This accreditation is not required by any agency for residential
programs in California, and requires a higher standard of care than the
licensing standards in California. Crestwood has chosen to have this
program accredited to ensure a commitment to achieving and maintaining
the highest level of care and meeting the highest standards for a recovery
rehabilitation program.
5. Surveys of all licensed facilities are conducted by both department of
Mental Health and Department of Social Services on at least an annual
basis to ensure adherence to the standards of care set forth in either Title
9 or Title 22.
Crestwood Behavioral Health Center
Contra Costa County
Staffing Ratios for 40 bed MHRC
Position State Required Actual
Administrator 40 hAwk 40 hr\wk
Program Director 40 hr\wk 40 hr\wk
Director of Nursing 40 hr\wk 40 hr\wk
Recreation Director 40hr\wk 40 hr\wk
Licensed Staff 17 hr\day 24 hr\day
Case Manager 28 hr\day 32 hr\day
Mental Health Worker 32 hr\day
Consultant 8 hr\wk 8 hr\wk
Recreation Assistant 8 hr\day
Total Hours 213 Total Hours 264
Staffing Ratios for 24 bed ARF
Position State Required Actual
AM's
Administrator 8 8
Vocational Support Staff 24
Mental Heath Counselor 8 8
PM's
Mental Heath Counselor 16 16
Nights
Mental Heath Counselor 16 16
Total Hours 48 Total Hours 72
These are per day totals for staffing
Staffing Ratios for 16 bed RTF
Position State Required Actual
AM's
Administrator 8 8
Case Manager 8 16
PM's
Case Manager 8 8
Mental Heath Counselor 8
Nights
Mental Heath Counselor 8 16
Total Hours 32 Total Hours 36
These are per day totals for staffing
Crestwood Behavioral Health Center
Contra Costa
Corporate History
Crestwood Behaviorial Health, Inc. has successfully provided behavioral health
care to persons with a mental condition for over 30 years. The services have been
provided in a variety of setting, communities and facilities.
The Facilities
Facilities have included Skilled Nursing Facilities (SNF) with Special Treatment
Programs (STP), MHRCs, ARFs, RTFs, Day Treatment Programs, and Department of
Rehabilitation certified vocational service centers.
The Communities
Communities have included rural, urban and suburban communities. The most
rural community is set in the upper east hills of the Napa Valley, in a beautiful residential
community, Angwin, with homes currently ranging from $6100,000 to $4,200,000. The
most urban communities include the cities of Sacramento and San Jose. Both of these
facilities are located in commercial areas with adjacent residential communities. The
suburban communities include Stockton, Vallejo, Carmichael, Bakersfield, Fremont,
Eureka, Modesto, Napa and Redding. In Vallejo and Fremont, two of our centers, Our
House and Crestwood Manor-Fremont are located in purely residential neighborhoods,
while in the other communities the 14 additional facilities are located in mixed residential
and commercial properties, much like in Pleasant Hill.
The Settings
Crestwood Behaviorial Health, Inc. has sought to establish programs in settings
that are safe and provide a secure setting for the consumers, the employees, the
families and other stakeholders to travel to and to visit. Most of the centers are placed
in locations that have been previously been, or are currently, licensed as a SNF. This
setting is generally large enough to provide a residential program with room for support
groups, classrooms, activity space and is equipped with institutional or residential
kitchens, laundry and bathing facilities. The SNF setting is also consistent with the
recovery model, in allowing the consumer the needed support services while providing
private and semi-private residential space. The neighborhood communities which have
supported and nurtured the SNF, including the local volunteer groups, Boy Scouts, Girl
Scouts, senior centers and faith communities have also been the greatest supporters of
Crestwood Behavioral Health Centers.
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Introduction
Mission
The mission of CARF is to promote the quality, value, and optimal
outcomes of services through a consultative accreditation process
that centers on enhancing the,lives of the persons served.
Purposes 9
In support of our mission, vision, and values, CARF's purposes are:
To develop and maintain current,field-driven standards that
improve the value and responsiveness of the programs and n
services delivered to people in need of rehabilitation and other
life enhancement services.
To recognize organizations that achieve accreditation through
a consultative peer-review process and demonstrate their
commitment to the continuous improvement of their programs
and services with a focus on the needs and outcomes of the
persons served.
• To conduct accreditation research emphasizing outcomes
measurement and management, and to provide information
on common program strengths as well as areas needing
improvement.
To provide consultation,education, training, and publications
that support organizations in achieving and maintaining
accreditation of their programs and services.
• To provide information and education to consumers and other
stakeholders on the value of accreditation.
• To seek input and to be responsive to consumers and other
stakeholders.
Vision
Through responsiveness to a dynamic and diverse environment,
CARP serves as a catalyst for improving the quality of life of the
persons served by CART-accredited organizations and the programs
and services they provide.
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