Contra Costa County Grand Jury • 2020-2021

Contra Costa Grand Jury Report Tele-Mental Health: Expansion of Remote Access to Care To: Contra Costa County

12 pages
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Findings and Recommendations 17 findings

F1
Prior to the Covid-19 pandemic, tele-mental health and audio-only services available through BHS were a small portion of the outpatient services provided (7% in 2018; 8% in 2019).
No recommendations for this finding
F2
During the Covid-19 pandemic, BHS did not offer training to prepare clinicians or clients for effective and confidential use of tele-mental health services.
Related Recommendations (2)
R3
Develop a training program for BHS clinicians, network providers, and support staff to facilitate the use of tele-mental health.
R4
Develop a training program for clients to facilitate and provide support for the use of tele-mental health.
F3
During the Covid-19 pandemic, BHS tele-mental health services continue to be underutilized. While audio-only increased to 52% of all outpatient services, tele-mental health was 18% of outpatient services delivered. Consolidated Appropriations Act (2021): 1775-1776. CCBHS Remote Work Survey (September 2, 2020). CCBHS Contract Providers Remote Work Survey (September 10, 2020).
No recommendations for this finding
F4
At the outset of the Covid-19 pandemic, tele-mental health and audio-only services decreased the number of missed appointments.
No recommendations for this finding
F5
Tele-mental health services are appropriate for clients who are more stable, verbal and insightful.
No recommendations for this finding
F6
Tele-mental health services are appropriate to use with clients displaying symptoms of anxiety and depression.
No recommendations for this finding
F7
The greater use of audio-only services has the limitation of not offering visual cues, which provide clinicians with important clinical information.
No recommendations for this finding
F8
Tele-mental health services are not appropriate for a. Homeless populations b. Patients presenting with chronic schizophrenia with a limited capacity to manage the tasks of daily life c. Patients prescribed controlled substances or injectable medication.
No recommendations for this finding
F9
BHS has not incorporated tele-mental health into a comprehensive service delivery model to offer a broad range of opportunities for underserved populations to receive outpatient mental health services.
Related Recommendations (2)
R1
Develop a hybrid plan to integrate tele-mental health services with in-person services in their clinics.
R2
Coordinate with network provider groups to integrate tele-mental health services with in-person services.
F10
Access to outpatient mental health services in Contra Costa County suffers from difficulties with transportation to clinics, long wait times for appointments, and insufficient availability of after-hours appointments.
No recommendations for this finding
F11
BHS has a limited number of clinicians who can provide culturally and linguistically sensitive services to diverse minority groups.
No recommendations for this finding
F12
Increasing access to mental health services is a priority for Contra Costa County BHS.
No recommendations for this finding
F13
The FCC reported 99.2% of Contra Costa County residents have access to internet broadband for greater use of tele-mental health services.
No recommendations for this finding
F14
BHS has not followed the directives of the California Telehealth Advancement Act of 2011 to develop telehealth services to better meet the needs of underserved populations in the community.
No recommendations for this finding
F15
The Congressional Consolidated Appropriations Act of 2021 expands Medicare services to allow tele-mental health services to be integrated with in-person sessions, and to be received by beneficiaries in their home without geographic limitations.
No recommendations for this finding
F16
BHS lacks an adequate electronic data system to evaluate the efficacy of outpatient mental health services provided.
Related Recommendations (7)
R5
Collect outcome data from BHS providers and programs to provide feedback to improve mental health services delivered to the community.
R6
Collect outcome data from network providers to provide feedback to improve mental health services delivered to the community.
R7
Increase the use of the MyChart health care information system to make clinical information accessible to clients and providers.
R8
Modernize the electronic data collection capabilities of the quality management program to provide meaningful information about mental health services.
R9
Develop appropriate clinical metrics to evaluate outcomes that improve the effectiveness of mental health services provided.
R10
Seek grants and MHSA funding to upgrade the technological resources of the quality management program. By June 30, 2022, it is recommended that Contra Costa Board of Supervisors:
R11
Allocate funds for BHS to upgrade its quality management program.
F17
BHS does not collect clinical data from network providers, which limits accountability for the outpatient mental health services provided to county residents.
Related Recommendations (7)
R5
Collect outcome data from BHS providers and programs to provide feedback to improve mental health services delivered to the community.
R6
Collect outcome data from network providers to provide feedback to improve mental health services delivered to the community.
R7
Increase the use of the MyChart health care information system to make clinical information accessible to clients and providers.
R8
Modernize the electronic data collection capabilities of the quality management program to provide meaningful information about mental health services.
R9
Develop appropriate clinical metrics to evaluate outcomes that improve the effectiveness of mental health services provided.
R10
Seek grants and MHSA funding to upgrade the technological resources of the quality management program. By June 30, 2022, it is recommended that Contra Costa Board of Supervisors:
R11
Allocate funds for BHS to upgrade its quality management program.

No Responses Found 1

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Contra Costa County Board of Supervisors Elected County Office