COALITION ON MENTAL ILLNESS 3rd Wednesday monthly meeting

Meeting Notice:  All interested in mental health are welcome

Wednesday, April 21, 2010 — 8:00 a.m. to 9:30 a.m.
Mental Health Association of Greater Dallas
624 N. Good-Latimer, Suite 210, Dallas, Texas  75204
Nannie Hogan Boyd Conference Room

Speaker: Mike Griffiths, Dallas County Director of Juvenile Services on Juvenile Justice and Mental Health

Mike will be retiring soon from Dallas County.  This is your chance to hear his insights on mental health care for juveniles involved in the justice system, and his advice for system improvements.

Directions to MHA:  Mental Health America of Greater Dallas is located in the historic St. James AME Church building on Good-Latimer Expressway between Swiss Avenue and Live Oak Street.    It is a 3-story light brown brick building with white trim and white columns on the Good-Latimer side.   Directions are below.  Please call 214-871-2420 for directions if you get lost.

The North Texas Behavioral Health Authority (NTBHA) is holding a Public Open Meeting  to discuss and receive stakeholder input on the “transfer of authority”  from the Department of State Health Services (DSHS) in Austin to the NTBHA Board of Directors in Richardson.  The meeting will be held on May 12, 2010 from 10:00am-11:00am at NTBHA, 1201 Richardson Dr., Suite 210, Richardson, Texas 75080.  Thanks.

For more information contact:  Alice Watson, Executive Assistant, North Texas Behavioral Health Authority, 1201 Richardson Drive, Suite 270, Richardson, TX  75080.  214-366-9407 ext. 112.  214-366-9417 Fax.  awatson@ntbha.org

From NAMI Collin County:

There will be a Town Hall Meeting for the North Texas Behavioral Health Authority (NTBHA) to gather information and input on the Public Sector Behavioral Health program (NorthSTAR) on Tuesday, March 9, from 6 to 8 PM at Custer Road Methodist Church.  The church is located on the west side of Custer Road north of Spring Creek and south of Legacy. 

We hope to see you all there!

Sharon DeBlanc
President NAMI of Collin County

OPEN TO THE PUBLIC  –  Regarding the Public Mental Health System in Dallas County (NorthSTAR)

DALLAS COUNTY  Behavioral Health System Redesign Task Force

Thursday, March 25, 2010  9:30 a.m.

Dallas County Health & Human Services Building    Hickman Conference Room (Room 627)
2377 Stemmons Freeway   Dallas, Texas  75207

Commissioner John Wiley Price, Chair  and Commissioner Maurine Dickey, Vice-Chair

Call to Order – 9:30 a.m.
Reports
(9:35 a.m.) Update on Parkland Study – Josh Flores
(9:40 a.m.) Update on Collin County Study – Dr. des Anges Cruser
(9:45 a.m.) Update on Transfer of Authority to NTBHA – Alex Smith
(9:55 a.m.) Update on NorthStar Psychiatrists Survey  – Dr. Ed Nace
(10:00 a.m.) Update on Goals of Project Transform – Ryan Brown

Legislative Advocacy Plan
(10:05 a.m.) – Legislative Report – Craig Pardue
(10:15 a.m.) – Review Advocacy Template – Janie Metzinger
(10:20 a.m.) – Discuss CJAB Legislative Agenda Item – Ron Stretcher
(10:25 a.m.) – Review/Assign Legislative Visits – Shay Cathey

Next Meeting Date: April 22, 2010

Adjournment

President’s Column from the Winter 2010 NTSPP Newsletter*

            The city of Seattle saved $4 million in hospital, jail and other public services after 95 homeless people moved into one housing project. These 95 people’s visits to hospitals and jails before had cost tax-payers nearly $8.2 million. Other facts concerning the wisdom of providing permanent supportive housing for the chronically homeless can be found in Kim Horner’s Dallas Morning News article of Sunday December 13, 2009. This article focuses on Dallas’s empty Plaza Hotel which a developer has been attempting to make available for permanent supportive housing. The state rejected this developer’s application for tax credits in March 2009, most likely because of neighborhood opposition. As a result, the twelve-story Plaza building remains empty and thousands of people in Dallas remain on the streets or in jail or emergency rooms, incurring costs of tens of millions of dollars, not to mention the human misery.

            Politics and bureaucracy seem to overrule humanitarian and common sense solutions. The American Heritage Dictionary defines bureaucracy as “administration of the government chiefly through bureaus or department staff with unelected officials”; “management or administration marked by diffusion of authority among numerous offices and adherence to inflexible rules of operation”; “an administration in which the need or inclination to follow complex procedures impedes effective action”. The dynamics of a bureaucracy can promote self-protection and self-serving behaviors at the expense of the actual mission of the bureaucracy.

            Can we as individual citizens and physicians, or as a small organization such as NTSPP, have some influence? I think we can but it does require patience, time and study of the issues. Should we not as a medical organization speak more loudly in the interest for permanent supportive housing? I hope that we will and I would welcome your thoughts on what NTSPP could do.

              Along similar lines, the possibility of the transfer of authority for mental health services may arrive in north Texas under the aegis of the North Texas Behavioral Health Authority. It is premature to assume that this is a done deal as the authority for mental health services resides in Austin in the Department of State Health Services. Several of us think it is critical that the authority be local, i.e. with the seven north Texas counties served by the NorthStar system. Should this transfer take place, it will be critical that the North Texas Behavioral Health Authority (NTBHA) have sufficient funds and personnel to do the job. NTBHA has a very strong board under the leadership of Judge Michael Chitty and has recently hired and effective executive director, Mr. Alex Smith. In my opinion, an additional positive step would be the creation of a NTBHA medical director’s position. This has existed in the past but not in recent years. Again, the issue of bureaucracy is relevant as the needs of the chronically and persistently mentally ill and addicted in the north Texas area needs to be a focus of concern and not issues of bureaucratic infighting. The Department of State Health Services allocates 38% of its $2,942,000,000 budget to mental health and addiction services. Yet, the Department of State Health Services does not have a psychiatrist with line authority. There is a psychiatrist on board but the position is more that of a consultant than one with authority to design appropriate services. If a psychiatrist or, more appropriately, several psychiatrists were to be included in the Department of State Health Services organization with real authority; it would behoove our professional organizations to consult with such psychiatrists and help assure that bureaucratic procedures do not impede what needs to be done for the individuals for whom the bureaucracy actually has been created to serve. 

            I believe we, as citizens and physicians as well as a relatively small professional organization, can play a constructive role if we are willing to relate to these issues and interact with the entities which carry the responsibility. What is your point of view?

                                                                        Edgar P. Nace MD,  President NTSPP,   NTSPPpresident@gmail.com

*Note:  All psychiatrists and psychiatrists in training  in the Dallas Area for whom we have email addresses  receive the complete newsletter by e-mail.  Didn’t receive one?  Send your name with degree and email address to NTSPPchapter@gmail.com. 

URGENT NOTICE:  ON THE TABLE IN AUSTIN:  CUTTING 50 beds at Terrell State Hospital (and Rusk, Wichita Falls, San Antonio

REMEDY:   PLEASE e-mail hhs.communications@hhsc.state.tx.us by 5 pm today Friday February 12 with your OPPOSITION.

BACKGROUND  from reliable sources:

HHS held a meeting with little public notice yesterday in Austin to consider ways to meet Gov Perry’s 5% budget reduction including the strategy of cutting beds at Texas state mental hospitals!  TSH is at or above capacity most of the time!  Terrell State Hospital, Rusk, Wichita Falls and San Antonio would ALL lose 50 beds.  (TSH reportedly has always been at or above funded census while other facilities were often not). TSH would have to cut 110 staff or 2 treatment teams.  Consider the present back-up into jails, the Bridge, the streets, the ERs people already experience when TSH is on divert presently.  Now imagine these cuts in play.    PLEASE e-mail hhs.communications@hhsc.state.tx.us by 5 pm today!

___________________________________________________

BACKGROUND From Matt Roberts NAMI Dallas:

John Dornheim (NAMI Dallas member and NAMI Texas President) attended the meeting.  He spoke in opposition to the cuts. Joe Lovelace also spoke in opposition to the cuts (Joe is a former NAMI Dallas president, currently working for the sate MHMR association).  Others spoke against the cuts as well. Here are some disturbing stats regarding what these cuts could mean:

- The loss of 50 beds could force Terrell to house Male adolescents with Female adolescents or adolescents could be housed with children. (Bad,Bad,Bad)

- In 2009 Terrell was full (i.e. sending patients away) an astonishing 33% of the time.

-Take away 50 beds and the projection is that Terrell will be full (i.e. sending patients away) 80% of the time.  (That projection comes from the administrator of Terrell State Hospital)

___________________________________________________________

SAMPLE EMAIL LETTER:

Below is one e-letter from Consumer Family Advocate Mike Katz with further information on this catastrophic proposal.  E-MAIL TODAY by 5 PM to hhs.communications@hhsc.state.tx.us and encourage everyone you know to do so.

From: michael katz
Sent: Friday, February 12, 2010 8:57 AM
To: ‘hhs.communications@hhsc.state.tx.us‘
Subject: Fight cut backs in NorthSTAR Mental Health Services

Gentlemen,

Re: Budget reduction options

Please do not cut back Behavioral Health Care funding/services in NORTHSTAR.

NorthSTAR is an open door system without wait lists that is already providing 17% of the mental health services in TEXAS for just 7% of the Texas funding.

NorthSTAR has proven over and over again its efficiency in giving the best access and treatment for the public mental health dollar in the state.

NorthSTAR has already put in place measures that provide less community outpatient treatment due to the increased numbers of individuals seeking help, mostly due to the economic downturn and the efforts in NorthSTAR in outreach to homeless individuals with mental illnesses and so many caught up in the criminal justice system who need treatment and not incarceration.  The outcomes of these programs are excellent. The potential of budget cut backs will endanger public safety, overburden already over burdened community resources and continue the terrible lives that so many who live with these illnesses sadly endure.

The potential of losing 50 beds at Terrell State Hospital will be a disaster based on current statistics which show that Terrell State Hospital was on divert for 122 of 365 days in calendar year 2009, which is 33.4% of the time. It is projected that with the loss of 50 beds Terrell State Hospital would be on divert up to 80% or more.

If funding is cut it will just mean more expensive treatment costs just down the road for longer periods of time.

Thank You.

Michael Katz

A family member and advocate for persons that live with mental illnesses and their families.

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____________________________________________________________________________________________

From NTSPP:  PLEASE SEND YOUR EMAIL TODAY by 5 p to hhs.communications@hhsc.state.tx.us !!!!

For more information on the Austin considerations, write NTSPPchapter@gmail.com and we will send to you.  We respect your time and and mailbox capacity.

Open to the public:  become an NTSPP facebook fan to receive notification instantly of our posts.

If you are a psychiatrist and not already on our email list, please advise us at NTSPPchapter@gmail.com.

COMI Meeting ~ Wednesday, January 20, 2010 — 8:00 a.m. to 9:30 a.m.
Mental Health Association (MHA) of Greater Dallas, 624 N. Good-Latimer, Suite 210, Dallas, Texas  75204  Nannie Hogan Boyd Conference Room
Speaker: Josh Floren—Sr. Vice President, Medicine Services,Parkland Health and Hospital System
Topic:  Parkland Study of Community Mental Health Delivery System (Proposed Study Outline below)

Background:  Parkland Health and Hospital System has undertaken a study of the community mental health delivery system.  They hope to have a third party engaged to conduct the research by the end of this month, and the study completed by the end of March 2010.  This study will be critically important to the future of mental health and substance abuse treatment in our region, so it is equally important for the mental health and substance abuse treatment community to be informed and engaged.  Please study the following and formulate your questions for Mr. Floren.

Proposed Study Outline
Assessment of Community Mental Health Delivery System Status in Dallas County

The Parkland Health & Hospital System (Parkland) Board of Managers has directed its management staff to undertake a study of the county community mental health delivery system.  As a member of the recently established Behavioral Health System Re-design Task Force (Task Force), Parkland would like to offer to coordinate the conduct of this study based on the objectives established by this Task Force which are outlined below.  We believe that because the direction of Parkland’s Board is consistent with the objectives outlined by the Task Force one single study could provide an outstanding fact and analytic basis which could propel the Task Force’s work and provide the information sought by Parkland’s Board.

The contemplated outline of the study is presented below.  We would be happy to consider modifications that the Task Force might propose such that the findings could satisfy the lines of inquiry for both the Task Force and Parkland.

Parkland would like to engage a third party, selected through a competitive request for proposal process, to perform the study.  We would like to complete selection and engagement by the end of calendar 2009 with a target study completion by March 31, 2010.  Parkland feels that the Task Force would be an excellent steering committee to assist the study and oversee the subsequent action items coming from the study results.

* * * * *

Study Purpose:  To provide an organized and fact based assessment of the status of mental health in the Greater Dallas area that can be used to:

• Advance the community’s knowledge and awareness
• Establish a vision for an evidence based and community responsive mental health system
• Promote practical solutions to address immediate system gaps
• Establish an outline of long term infrastructural requirements to achieve the envisioned mental health system
• Promote policy development and advocacy

Study Approach:  To establish a strong collaborative of community mental health stakeholders to:

• Provide oversight for the design and execution of the study:

–         Shape the framework of the study,

–         Elaborate the study plan,

–         Engage expert resources to refine and execute the study work,

• Examine the study findings,
• Generate the vision, recommended solutions and action plan based upon the study’s findings,
• Establish the policy development and advocacy platforms to support the action plan.

Study Topics:  Encompass a broad spectrum of community mental health issues including, but not limited to, the following:

• Determine Study Scope

–          Mental health diseases, disorders, diagnoses  (include mental health and substance abuse)

–         Geographic area

–         Comparatives to be studied: peer communities, state, national, international

–         Best practices to be studied: peer communities, systems, interventions, policy and advocacy organizations and initiatives, other

• Population and Need Assessment

–         Population-based incidence analysis, examining historic data, trends and projections

–         Examination of special populations – e.g. perinatal, jail, children, homeless, elderly, victims of crime and domestic violence

–         Examination of demographic and socioeconomic disparities

• Examination of the Mental Health Care Delivery System

–         Hospitals – Inpatient, Emergency, Outpatient care: state, public, private

–         Provider supply / manpower – psychiatrists and psychologists

?   Private practice

?   Academic

?   Other institutional settings

–         Extended providers and systems: licensed professional counselors, licensed chemical dependency counselors, marriage and family therapists, psychiatric nurses and social workers

–         Residential treatment facilities

–         Support services

• Examination of Mental Health Services Utilization: Diagnoses, Use Rates, Dispositions

–         Inpatient services

–         Emergency services

–         Outpatient services

–         Justice system facilities

–         Residential treatment

–         Homeless

–         Community-based support

–         Issues of care coordination and chronic disease management

• Examination of Mental Health Services Funding

–         Employer based insurance coverage

–         Medicare and Medicaid funding, eligibility and coverage

–         Issues related to underinsured and uninsured populations

–         Issues related to scope and adequacy of coverage

• Examination of Best Practices in Mental Health Services

–         Identify and document best practices in mental health across all study topic areas – consider Texas and national models

–         Catalog the best practices for use in gap assessment and vision development

• Examination and Consideration of the Relative Strengths and Weaknesses of each of a Variety of Mental Health Care Delivery Models – examples may include:

–         Highly centralized, hospital-centric system

–         Community-based with structured linkage to hospital or health system

–         Highly integrated with primary care system

• Identify, Quantify and Describe Mental the Current Health System Gaps
• Develop Short Term and Long Term Strategies

Proposed Potential Stakeholders – representative(s) from:

• Dallas County Commissioners Court
• Parkland Health & Hospital System

–         Violence Intervention and Prevention Center

–         Homeless Outreach Medical Services (HOMES)

–         Dallas County Jail / Juvenile Detention

• Child and Family Guidance Center, Dallas
• Children’s Medical Center Dallas
• Community Experts
• Dallas Independent School District
• Dallas County Juvenile Department
• Dallas County Medical Society
• Green Oaks Hospital
• Homeward Bound
• LifeNet Community Behavioral Healthcare, Dallas
• Mental Health America of Greater Dallas
• MetroCare Services
• Metro Dallas Homeless Alliance
• Mosaic Family Services, Dallas
• National Alliance on Mental Illness
• NorthStar
• North Central Texas Council of Governments
• North Texas Behavioral Health Authority
• Phoenix House, Dallas
• The Bridge
• Timberlawn Hospital
• University of North Texas, School of Public Health
• UT Southwestern Medical School
• UT Arlington School of Social Work
• Value Options of Texas

Expert Resources –

• Texas Health Institute
• Texas Department of Aging and Disability Services

NAMI  (National Alliance for the Mentally Ill) Dallas provides an orientation class for family members of people experiencing a severe mental illness.  This class, called Family to Family focuses on the family member.  Participants gain the information, skills and emotional support they will need to care for their loved one over the life of the chronic illness.  Good candidates for this course are
-          Family members with a newly diagnosed loved one
-          Family members who have limited or no information about mental illness
-          Family members willing to accept that mental illnesses have a biological component
-          Family members who are not informed about the local mental health system

Family members who graduate from the class report it is “life changing”.  The 12-week course is structured to teach caregivers about brain biology, medications, communication, and self care.    The course is taught by trained family member volunteers who have a loved one struggling with a mental illness.

Classes begin in January and are now enrolling. To refer patients or families, simply have them call NAMI Dallas at 214-341-7133 or visit www.namidallas.org.  NAMI  staff and volunteers will connect the family member to the most appropriate class.

www.ntbha.org for details and directions

NTBHA is near the corner of Arapaho and Central Expressway in Richardson Texas

FREE Program with Psychiatrist Speakers and Panelists  for Mental Illness Awareness WeekHaving Opportunities for Positive Expansions Conference  (H.O.P.E.) 4  Dallas
Saturday—October 10^th  World Mental Health Day       10 am—1 pm
Fellowship Bible Church Dallas   9330 N. Central Expwy   Dallas TX 75231

Free & Open to the General Public ~ Please register ahead***

 10 am:       Support Groups: Who, What, When, Where, Why & How   Ricardo Aguilar
 11 am:        Ask a Psychiatrist Breakout Sessions:   Psychiatrists will present and answer your questions on these psychiatric disorders:
                             Schizophrenia  ~  Les Secrest MD
                             Bipolar and Mood Disorders ~ Madeline Harford MD
                             Child and Adolescent Psychiatry ~ Catherin Roberts MD
                             Addictions ~ Carlos Tirado MD MPH
                             Personality Disorders & Psychotherapy ~ Kathi Sommerfelt MD
 12 noon:   Panel Discussion—Open Forum with all Psychiatrists together
 1:00 pm:   Adjournment

***Costs: FREE !  Please REGISTER with Ricardo Aguilar, Mental Health America of Greater Dallas at 214-871-2420 ext. 118 or raguilar@mhadallas.org

Sponsored by:   The North Texas Society of Psychiatric Physicians, Mental Health America of Greater Dallas  www.mhadallas.org , AND Value Options  www.valueoptions.com.

MENTAL ILLNESS AWARENESS WEEK  is OCTOBER 4-10, 2009.  NTSPP is grateful to the Texas Foundation for Psychiatric Education and Research for its grant supporting MIAW events. 

NTSPP is the local chapter of the Texas Society of Psychiatric Physicians (www.txpsych.org) which is the district branch of the American Psychiatric Association (www.psych.org).