Grand Jury Report: Mental Health Support at Youth Ranches

Recommendations 4

• R1c

  Page 6
  Probation leadership at the Ranches should evaluate communication systems currently in use by providers at each of the facilities, and they should work to ensure that open communication Board of Supervisors: Mike Wasserman. George Shkakawa, Dave Cortese, Ken Yeager, Liz Kniss Response to Santa Clara County Civil Grand Jury Report — Mental Health Support at Youth Ranches Gary A. Graves, Chief Operating Officer July 20, 2011 and file sharing programs are put into place. In addition, the frequency of site-wide team meetings or other programs should be increased in order to ensure that various team members know one another and are familiar with the treatment programs for all minors under their care. Response: The recommendation is in the initial process of implementation. Probation, SCVHSS, CMH, DADS and CBOs have begun discussions around improved communication and sharing of information. All partners recognize the value of each others insight and observations in the treatment of our clients. Verbal exchanges are often shared and at times written documentation as well. Recently implemented has been a higher level quarterly meeting amongst all the stakeholders where policies and practices are discussed. A vision of regularly scheduled multi-disciplinary case conferences at the worker level appears to be a strategy welcomed by all. Discussions around the frequency and logistics are still being worked out. However, certain federal regulations (notably C.F.R. 42 part 2, which provides strong privacy protections for individuals in treatment for substance abuse disorders) around the sharing of some information supersede even the Standing Order referenced and signed by the presiding judge. Still, all agencies understand the spirit and intent of the recommendation and continue to contemplate and seek legal counsel on avenues for a shared file.
• R2
  Santa Clara Valley Health & Hospital System should institute one chart or one recordkeeping system, such as the UNICARE system already in place, and require its use by CMH, Custody Health, DADS, and the relevant CBOs. Response: The recommendation requires further analysis. SCVHHS is at the initial stages of discussion and design of an electronic database to maintain records which would be used to share information. This project is still in its embryonic stage and may not come to fruition for another couple of years. In the interim, the CBOs will provide copies of each minor's records to the Medical Department for placement Board of Supervisors: Mike Wasserman, George Shirakawa, Dave Cortese, Ken Yeager, Liz Kniss County Executive: Jeffrey V. Smith Response to Santa Clara County Civil Grand Jury Report — Mental Health Support at Youth Ranches Gary A. Graves, Chief Operating Officer July 20, 2011 in the minor's Medical Record. The CBOs documentation will be maintained in a separate section of the Medical Record but it will be accessible to all parties which have legal access to minor's health information. The documentation completed by the Psychiatrists of the Mental Health Department is currently maintained in Medical Records maintained by the Medical Department. DADS is seeking legal directive on its federal regulations around the sharing of information, while the CBOs are upbeat to this idea as they also review policies and practices. It is estimated that resolution to many of the obstacles will be forthcoming, which will enable us to implement some form of a shared information system within the next 90 days.
• R3a

  Page 8
  Probation and CMH should agree on benchmarks to identify which minors in custody should receive mental health or social services counseling. Response: The recommendation has not yet been implemented, but will be implemented in the near future. The Probation Department will be implementing the Juvenile Assessment and Intervention System tool late this fall. The JAIS is one of the best evidence-based, gender-specific assessment and supervision systems in corrections. It is a valid and reliable risk assessment tool with proven supervision strategies to guide case planning, treatment, and supervision. The JAIS complements the professional judgment of Probation Officers by providing insight into the reasons causing a youth to act out and identifies strategies that emphasize public safety, rehabilitation, and accountability while focusing on criminogenic needs. The JAIS has two components; a screening section as well as a more thorough assessment component to identify areas of concern around substance abuse, mental health and or trauma. The entrance multi-disciplinary team will share the results of the JAIS to inform the treatment plan. Within each treatment plan individual goals will be set for each youth and monitored to ascertain progress and/or the need for modification. Implementation is scheduled for late fall 2011. Response to Santa Clara County Civil Grand Jury Report - Mental Health Support at Youth Ranches Gary A. Graves, Chief Operating Officer July 20, 2011
• R3b

  Page 9
  Probation and CMH should agree on which metrics are necessary to plan staffing needs, and review those metrics at regular communication meetings. Response: The recommendation has not yet been implemented, but will be implemented in the future. The Probation Department and CMH are at the initial stages of discussion around the utilization of the JAIS. Training on the interpretation and results will take place in early fall. Once implemented, an assessment of workload and caseload will be required to determine staffing needs for the ranch populations. Data around number of contacts per youth, hours of service in therapy versus crisis intervention are already being collected and presented at the higher level quarterly meeting. More discussion needs to be had around the qualitative measures of progress and how this information can be quantified. The foregoing instrument is a correct copy of the original. ATTEST: Maria Marinos Clerk of the (cid:9)BBoard oard 13P Deputy Clerk Date: (cid:9) AUG 0 9 2011