Graphic Designer Paul Aleman, it Admin Mary Norris, it Asst Admin Cana Marks

Recommendations 9

• R1

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  The MCGJ recommends that the JDF continue to provide excellent services and programs. REQUIRED RESPONSES: Pursuant to Penal Code Section 933 and 933.05, the Madera County Grand Jury requests responses as follows: From the following elected officials : Board of Supervisors 200 West Fourth Street Madera, CA 93637 INVITED RESPONSES: Pursuant to Penal Code Section 933 and 933.05, the Madera County Grand Jury requests responses as follows: From the following governing body : Madera County Chief Probation Officer 300 South G Street Suite 100 Madera CA 93637 Board of State and Community Corrections (BSCC) 2590 Venture Oaks Way, Suite 200 Sacramento, CA. 95833 Madera County Juvenile Justice Commission 300 South G Street Suite 100 Madera CA 93637 169 170 This Page Intentionally Left Blank 171 Madera County’s Behavioral Health Services Madera County Grand Jury Final Report 2324-02 June 19, 2024 SUMMARY: Every generation has its challenges, and how individuals deal with those challenges varies from person to person. In the past, the topic of mental health was widely misunderstood and even considered taboo. In recent years, mental health is more openly talked about in schools, workplaces, social circles, and the media. This seems even more prevalent since the Covid-19 pandemic that the world endured. Many people are realizing that mental health struggles are common, and help is available. The 2023-2024 Madera County Grand Jury (MCGJ) investigated the Madera County Department of Behavioral Health Services (MBHS) to determine how MBHS is supporting the community in their mental health and well-being. The MCGJ found that MBHS has many beneficial programs to address mental health, substance use disorders, and crisis situations, as well as very dedicated staff that make a difference in the lives of many. The MCGJ also found that MBHS has long-term issues in both employee and client retention that has negatively impacted current and future services. While a variety of funding continues to come in for the expansion of services for the changing and growing needs of the community, without properly addressing the current issues, the success and support of MBHS clients is limited. BACKGROUND: Americans are seeing a decrease in the restrictions implemented due to the Covid-19 pandemic. However, the impact on mental health has remained. Youth and adults alike experienced sudden and extreme isolation, instability, and loss, and there has been a significant increase in depression, anxiety, suicide rates, and substance use. According to the National Alliance on Mental Illness (NAMI), one in five adults and one in six youth (ages 6-17) experience a mental health disorder each year. Now more than ever, services and support for mental health and substance abuse disorders are essential to the community. This led the Madera County Grand Jury (MCGJ) to investigate how the Madera County Department of Behavioral Health Services (MBHS) addresses these drastic needs. Behavioral Health is a relatively new term that is often used interchangeably with mental health; however, there are fundamental differences between the two that impact the diagnosis and treatment of the concerns. While mental health has to do with thoughts and feelings, behavioral health has more to do with a person's actions. Diagnoses such as depression, anxiety, bipolar, and schizophrenia all fall under the mental health umbrella, and substance abuse, gambling addictions, and eating disorders fall under the behavioral health definition. Many individuals struggle with both mental and behavioral health issues. According to reports published in the Journal of American Medical Association, roughly 50 percent of individuals with severe mental health disorders are also affected by substance abuse. These disorders, called co-occurring disorders, are treatable conditions best addressed simultaneously. The MBHS offers mental health and alcohol and drug services for all ages across Madera County, with offices in Madera, Chowchilla, and Oakhurst. Services are primarily for individuals with Medi-Cal, low-income, or the uninsured. Their mission statement is to promote the prevention of and recovery from mental illness and substance abuse for the individual, families, and communities we serve by providing accessible, caring, and culturally competent services. These services include assessments, counseling/therapy, psychiatric evaluation and treatment, case management, prevention and educational courses, and crisis services. In 2023, the MBHS had an operating budget of $41,223,600. These funds come from multiple sources, including health care programs, state funds, assembly bills, and various block grants.
• R2

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  The MCGJ recommends that MBHS update its Workforce Training Policy to expand the number of professional development training sessions and certifications available to employees, with costs incurred by MBHS of the MCGJ report posting.
• R3

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  The MCGJ recommends that MBHS add Spanish-language media outlets to their outreach efforts to the Hispanic/Latino community of the MCGJ report posting.
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  The MCGJ recommends that MBHS consult with a professional of the MCGJ report posting to improve the interior of the treatment areas and create a more therapeutic environment.
• R5

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  The MCGJ recommends that MBHS coordinate press releases, local news coverage, and social media campaigns to highlight the C.A.R.E.S. team and their services of the MCGJ report posting. 174
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  The MCGJ recommends that MBHS implement an internal program to support the well-being and mental health of its employees of the MCGJ report posting. REQUIRED RESPONSES: Pursuant to Penal Code sections 933 and 933.05, the MCGJ requests responses as follows; From the following elected county officials : Madera County Board of Supervisors 200 W. 4th St. #4 Madera, CA 93637 INVITED RESPONSES: Pursuant to Penal Code sections 933 and 933.05, the MCGJ requests responses as follows; From the following governing bodies : Director of Madera County Department of Behavioral Health 209 E. 7th St., Madera, CA 93638 175 176 177 178 179 180 181 182 183 184 185 186 187 188 189 190 191 192 193 194 This Page Intentionally left Blank 195 Madera County Animal Services: It’s A Dog’s Life Madera County Grand Jury Final Report 2324-03 June 19, 2024
• R7
  COVID temperature scanners and preventative materials such as masks, hand sanitizers continue to be readily available throughout our clinics, notification of infections are sent to all staff as applicable to safeguard the health and wellbeing of our clients and staff. A partnership with CredibleMind and the creation of the https://madera.crediblemind.com/ website a few years ago, provides our staff with resources for all around well-being through literature and podcasts on many topics as well as assessments to monitor one's own well-being and suggesting resources to provide relief. In addition, a WellScreen tool is being considered for implementation which promises to contribute to the County's expansion in access to local and self-help behavioral health resources, improved access for youth and acute mental health candidates and lower overall behavioral health service costs through improved triage efficiency." The response of the Director of Behavioral Health Services to the above Recommendation is considered appropriate and is submitted as the Board of Supervisors' response. The Board acknowledges the Grand Jury's review and time involved in this matter and appreciates 193 the opportunity to respond to the findings and recommendations. Sincerely, my K Robert PoythressChairman of the Board of Supervisors 8 10 194 This Page Intentionally left Blank 195 Madera County Animal Services: It's A Dog's Life Madera County Grand Jury Final Report 2324-03 June 19, 2024 Summary Madera County Animal Services (MCAS) has long been a cornerstone of community welfare, providing vital services ranging from animal adoption to public health protection. However, recent investigations by the Madera County Grand Jury (MCGJ) have shed light on the organization's persistent challenges, spanning over two decades. The findings of the 2023-2024 MCGJ report highlight three recurring themes: facility shortcomings, understaffing, and the absence of a comprehensive Policy and Procedure manual. Despite years of acknowledgment by the Madera County Board of Supervisors and MCAS directors, these issues still need to be solved, posing significant hurdles to effective operations and community service. Background Animal shelter services play an essential role in the community, by adopting out pets to loving homes and helping keep the streets clean and safe from animal-transmitted diseases. The Madera County website lists the following services provided by the Department of Madera County Animal Services (MCAS):
• R8
  The Central Regional Partnership through the Mental Health Services Act Workforce Education and Training (WET) program has developed a Retention Program (RP) opportunity. Madera County, in collaboration with other counties in the region, has partnered with the California Mental Health Services Authority (CalMHSA) to make this funding available to the county Public Mental Health System workforce. It will award up to $2,265 to qualified workers within the Region's Behavioral Health care that commit to a 12-month service obligation in a recognized hard-to-fill or hard-to-retain position. Through this program, the Regional Partnership seeks to support its qualified providers that service the most underserved populations within the county and work in the most hard- to-retain positions.
• R9
  During the review process of MCBHS by the Madera County Grand Jury, Madera County labor unions and human resources department were in the process of negotiations as a result of the new classification and compensation study. Since then, staff have been provided with salary 187